bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic Laser Retinopexy and Scleral Buckle Placement for Retinal Detachment Prevention in Pierson Syndrome: A Retrospective, Case Series Study
Authors: Sather Richard N. , Jiao George , Moon Jade Y. , Quiram Polly 
Published: February 2025

Purpose:
To report the impact of prophylactic 360° laser retinopexy and scleral buckle placement for retinal detachment (RD) prophylaxis in patients affected by Pierson syndrome (PS).

Method:
This retrospective case series included 11 PS patients (2015–2024), analyzing demographic data, ophthalmological exams, and genetic testing. Prophylactic interventions were compared with post-RD surgical interventions based on RD occurrence and timing. A one-sample proportion test evaluated outcome differences.

Results:
This study of 11 PS patients evaluated the effectiveness of prophylactic 360° laser retinopexy and scleral buckle (SB) placement. Ten patients carried the LAMB2 c.440A>G mutation and had associated findings of thyroid and renal disease. All retinal detachments (RDs) were combined tractional retinal detachment (TRD) and rhegmatogenous retinal detachment (RRD) due to posterior tears. Eight eyes with TRD-RRD were actively treated with laser retinopexy and SB; six (75%) experienced re-detachments. In contrast, seven eyes with TRD-RRD were treated prophylactically, with 86.6% of eyes treated with laser retinopexy and 100% of those receiving additional SB placement maintaining retinal integrity over an average follow-up of 3.4 years. Prophylactically treated eyes had significantly fewer RD recurrences compared to those treated surgically after RD onset (p < 0.01), highlighting the benefits of early combined intervention in PS.

Conclusion:
This study's results suggest a potential role for prophylactic laser retinopexy and subsequent scleral buckle placement to prevent RD among patients with a confirmed diagnosis of Pierson syndrome.
Persistent macular hole and cystoid macular edema treated with pars plana vitrectomy after failure with topical therapy
Authors: Rohowetz Landon J. , Flynn Harry W. 
Published: February 2025

Purpose:
To report a patient with a persistent macular hole and cystoid macular edema (CME) successfully treated with pars plana vitrectomy and internal limiting membrane peeling after failed topical therapy.

Methods:
Case report

Results:
A 70-year-old male presented with a history of decreased vision in the right eye for 3-4 months. Best-corrected visual acuity at the initial examination was 20/80 in the right eye and 20/30 in the left. Optical coherence tomography demonstrated vitreomacular traction with a full-thickness macular hole and prominent CME in the right eye. He was started on topical prednisolone acetate and ketorolac. The width of the hole initially decreased but eventually returned to baseline size despite continued topical therapy. Conservative management with topical therapy was continued in accordance with the patient’s preferences. He later underwent phacoemulsification 20 months after presentation without significant improvement in visual acuity. Pars plana vitrectomy with internal limiting membrane peeling and C3F8 tamponade was ultimately performed 2 years after initial presentation. Postoperatively, the macular hole was closed and visual acuity improved to 20/40 at 3 months.

Conclusion:
Macular holes with significant CME may close with topical therapy alone. In persistent or recalcitrant cases, delayed surgical intervention to close the macular hole can be successful even at 2 years.
Warfarin Versus Non–Vitamin K Inhibitor Medications and Cognitive Disease Progression in Atrial Fibrillation
Authors: Wood Kathryn A. , Ko Yi-An , Han Feier , Thunell Johanna , Zissimopoulos Julie , Wharton Whitney 
Published: February 2025

Background
Atrial fibrillation (AF) is associated with cognitive decline. Use of oral anticoagulant (OAC) medications offers a lower risk of dementia, but it is unclear whether differences exist between types of OAC agents.

Objective
This was a secondary analysis to explore whether the progression from normal cognition to mild cognitive impairment to dementia differs between adults with AF on warfarin versus non–vitamin K inhibitor medications (NOACs) using data extracted from the National Alzheimer's Coordinating Center clinical case series.

Methods
Subjects with AF on OACs, having normal cognition and no stroke at baseline, and at least 1 follow-up visit were included. OAC usage was calculated based on follow-up time and reported previous OAC use. Continuation ratio models (with subject-specific random intercepts) were used to examine the association between OAC type and cognitive diagnosis controlling for cognitive diagnosis from previous visit.

Results
Among 1475 eligible participants, 478 reported taking warfarin (n = 396) or NOACs (n = 82) at baseline (mean age of 79 years, 51% females, 84% non-Hispanic White). The median follow-up time was 4 years (interquartile range, 2–7). About 63% continued using either warfarin or NOACs, 44% switched from warfarin to NOACs, and 2% switched from NOACs to warfarin. After adjusting for age, sex, education, race, and cardiovascular clinical comorbidities, no significant association was found between OAC type and cognitive decline (P = .14).

Conclusions
We found similar risks of cognitive decline between those on NOACs or warfarin. Future studies should consider effects of age, length of time from AF diagnosis, and OAC adherence on this risk.
AI-driven evidence synthesis: data extraction of randomized controlled trials with large language models
Authors: Liu Jiayi , Lai Honghao , Zhao Weilong , Huang Jiajie , Xia Danni , Liu Hui , Luo Xufei , Wang Bingyi , Pan Bei , Hou Liangying , Chen Yaolong , Ge Long 
Published: February 2025

The advancement of large language models (LLMs) presents promising opportunities to enhance evidence synthesis efficiency, particularly in data extraction processes, yet existing prompts for data extraction remain limited, focusing primarily on commonly used items without accommodating diverse extraction needs. This research letter developed structured prompts for LLMs and evaluated their feasibility in extracting data from randomized controlled trials (RCTs). Using Claude (Claude-2) as the platform, we designed comprehensive structured prompts comprising 58 items across six Cochrane Handbook domains and tested them on 10 randomly selected RCTs from published Cochrane reviews. The results demonstrated high accuracy with an overall correct rate of 94.77% (95% CI: 93.66% to 95.73%), with domain-specific performance ranging from 77.97% to 100%. The extraction process proved efficient, requiring only 88 seconds per RCT. These findings substantiate the feasibility and potential value of LLMs in evidence synthesis when guided by structured prompts, marking a significant advancement in systematic review methodology.
Exercise-based cardiac rehabilitation for patients with coronary artery operation: a systematic review and meta-analysis based on current randomized controlled trials
Authors: Shi Yan , Xu Huiqing , Dong Jige 
Published: February 2025

Background:
Currently, exercise-based cardiac rehabilitation (CR) has been given increasing interest for its potentially beneficial effects on the health related quality of life (HRQoL) and outcomes of patients with coronary heart disease (CHD). The aim of this study was to evaluate the effect of exercise-based CR on patients after coronary artery bypass graſt (CABG) and percutaneous coronary interventions (PCI).

Methods:
We searched PubMed, Embase, Cochrane Library and Web of Science from inception to 1 December 2023 for relevant studies that evaluated the effect of exercise-based CR on patients after CABG and PCI. Our primary outcomes included the mortality, complications, hospital admissions and HRQoL between patients receiving exercise-based CR and usual care. All statistical analyses were performed using the standard statistical procedures provided in Review Manager 5.2 and Stata 12.0.

Results:
We finally indicated and included 25 randomized controlled trials (RCTs) with 4106 participants for the present analysis. Our pooled results indicated that, compared to usual care, exercise-based CR did not increasing the all-cause (RR 0.84; 95% CI 0.54 ‒ 1.31) and cardiovascular (RR 0.98; 95% CI 0.38 ‒ 2.54) mortality for patients after coronary artery operation. Similarly, exercise-based CR had equal effect on coronary artery complications for patients after coronary artery surgery, including CABG (RR 0.60; 95% CI 0.32 ‒ 1.15) and PCI (RR 0.92; 95% CI 0.55 ‒ 1.54). It was indicated that exercise-based CR significantly reduced the incidence of myocardial infarction (MI) by half with a RR of 0.50 (95% CI 0.28 ‒ 0.90). In addition, exercise-based CR also significantly reduced all-cause hospital admissions with a RR of 0.74 (95% CI 0.62 ‒ 0.88). Compared with usual care, exercise-based CR obviously improved HRQoL of patients after coronary artery operation evaluated with SF-36 summary scores (SMD 0.24; 95% CI 0.11 ‒ 0.38) and SF-36 8 domains (SMD 0.35; 95% CI 0.24 ‒ 0.46) respectively.

Conclusions:
Our analysis indicated that exercise-based CR had significant effect on the improvement of HRQoL of patients after coronary artery operation without increasing the mortality or incidence of re-intervention with operation.
Comparison of Outcomes for Emergency Medical Services–Transported Infants With Suspected Brief Resolved Unexplained Events Before and After the Coronavirus Disease 2019 Pandemic
Authors: Toy Jake , Bhargava Rishi , Lowe Calvin G. , Pham Phung K. , Shepard Nishelle , Aboudiab Myrna , Saidinejad Mohsen , Chow Jessica , Chang Todd P. , Altergott Caroline , Rai Ekra , Claudius Ilene , Moriel Gabriela , Conser Ellie , Gausche-Hill Marianne 
Published: February 2025

Objectives:
This study compares care-seeking behavior, care delivery, and outcomes for infants with suspected brief resolved unexplained events (BRUEs) who were treated by emergency medical services (EMS) and emergency department clinicians before and after the onset of the coronavirus disease 2019 (COVID-19) pandemic and stay-at-home mandates.

Methods:
This multicenter, retrospective observational study uses prehospital and hospital data on EMS-treated infants (age ≤12 months) with a primary paramedic impression of BRUE. We evaluated interventions, management, and outcomes, including transports and admissions, before (April 2019 to February 2020) and after (April 2020 to February 2021) the start of the pandemic and stay-at-home mandates in March 2020. We also characterized longitudinal trends in transports and hospital admissions for BRUE infants between July 2017 and February 2021. Data were analyzed using descriptive statistics and interrupted time series modeling.

Results:
There were no significant differences in demographic characteristics or infant presentations before and after the beginning of the pandemic and stay-at-home mandates. We noted an increase in transports during the before period, but transports plateaued in the after period. There was no significant difference in admissions between the before and after periods.

Conclusions:
For EMS-treated infants with paramedic-suspected BRUE, presentations and hospital admissions were similar before and after the beginning of the COVID-19 pandemic and stay-at-home mandates. There was a longitudinal increase in EMS transports for infants with suspected BRUE before the COVID-19 pandemic and stay-at-home mandates, which then leveled off in the after period.
Buccinator myomucosal neurovascular Island flap: anatomic cadaveric study and clinical experience.
Authors: Bassiri Gharb Bahar , DeLeonibus Anthony , Kotha Vikas S. , Figueroa Brian A. , Rezaei Majid , Maasarani Samantha , Sinclair Nicholas , Rampazzo Antonio 
Published: February 2025

BACKGROUND:
Utilization of peninsular buccal flaps for primary cleft palate repair is well-documented in the literature. However, there is no report on the application of an island flap for primary cleft palate repair. This study aims to reveal the clinical application of an axial neurovascular propeller buccinator myomucosal flap.

METHODS:
An anatomical study was performed by injection into the buccal pedicle of twenty-two fresh hemifacial cadavers. Additionally, we analyzed palatal healing and flap outcomes in twenty-five primary cleft palate reconstructions utilizing thirty-six pedicled propeller flaps.

RESULTS:
Cadaver study: the mean buccal artery diameter was 1±0.3 mm, the neurovascular pedicle entered the flap 11.4±2.9 mm anterior to the pterygomandibular raphe (1/6 th the length of the flap), and the buccal artery advanced inside the flap as much as 66.8%±6.0% of the total flap length. Clinical experience: all reconstructions were performed using a modified Furlow palatoplasty. Mean age of patients was 15.3 months and mean maximum cleft width was 11.7 mm. Eleven cases utilized bilateral flaps. The flap always reached the contralateral pillar, and the buccal nerve was always preserved. 11.11% flaps (4/36) underwent scar revision, and 5.56% flaps (2/36) were lost. Follow-up period was 11.3 months.

CONCLUSION:
This study suggests the utilization of axial neurovascular pedicled propeller buccinator myomucosal flaps is a safe and reliable option in primary cleft palate reconstruction. Our anatomical dissections and clinical outcomes reveal the consistent and robust nature of buccal neurovascular pedicle, and our modified surgical technique allows for preservation of the buccal nerve.
The Modified Frailty Index Predicts Outcomes in Immediate Implant-Based Breast Reconstruction
Authors: Danko Dora , Ash Makenna E. , Losken Albert , Thompson Peter W. 
Published: February 2025

Background
Risk stratification is a crucial tool to help in surgical planning and counseling. Historically, this has been measured by age, BMI, smoking status, or medical comorbidities. Frailty, the combined burden of the patient's comorbidities and risk factors, has gained traction as a method of combining disparate risk factors into one number. The modified 5-factor frailty index (mFI-5) is simple to calculate and takes only moments to assign a risk level to a patient.

Objectives
This study aimed to study the application and efficacy of the mFI-5 as a measurement of operative risk in immediate breast reconstruction.

Methods
A total of 650 patients undergoing breast reconstruction at our institution were identified. Patients were divided into 5 mFI-5 groups based on their associated comorbidities. Surgical outcomes were compared using the χ2 or Fisher exact tests for categorical variables and t tests for continuous variables.

Results
There were 452 patients stratified into the mFI-5 0 group, 155 patients into the mFI-5 1 group, 40 patients into the mFI-5 2 group, and 3 patients into the mFI-5 3 group. There were no patients in our cohort in either the mFI-5 4 or 5 groups. In comparison of the mFI-5 0 group to 1 group, there was a significant difference in postoperative day of infection (32.06 vs. 21.5 days. respectively; P = 0.049). When comparing to the mFI-5 2 group, there was a significant difference in overall complications on univariate analysis (P = 0.012), minor infections on univariate and multivariate analysis (P = 0.050 and P < 0.001), seroma formation on univariate analysis (P = 0.017), hematoma formation (P < 0.001), return to OR (P < 0.001), and replaced implant (P < 0.001) on multivariate analysis. When comparing the mFI-5 1 group to the mFI-5 2 group, there was a significant difference between overall complications on both univariate and multivariate analyses (P = 0.012 and P = 0.041) and minor infections on univariate analysis (P = 0.032).

Conclusions
The modified 5-factor frailty index is effective in predicting increased complication risks seen after IBR and may be helpful for surgeons when counseling patients and assessing overall operative risk.
Urogynecology Research Is Underrepresented in Top Obstetrics and Gynecology Journals
Authors: Saleeb Monica , Muluk Sruthi , Wood Nicole , Sappenfield Elisabeth , Tunitsky-Bitton Elena 
Published: February 2025

Importance
Patients with urogynecologic conditions commonly present to general gynecology practices. Consequently, it is imperative that journals for obstetrics and gynecology (OBGYN) represent topics pertinent to comprehensive women’s health, including urogynecology topics.

Objective
The aim of the study was to analyze the prevalence of urogynecology research compared to other topics in top OBGYN journals.

Study Design
This was a retrospective review of all papers published in top OBGYN-focused journals from 2000 to 2023. The publicly available PubMed package in R was used to extract papers. Stata, a statistical software package, was used to develop an algorithm searching for key words concerning urogynecology, obstetrics, benign gynecology, gynecologic oncology, and reproductive endocrinology and infertility. The algorithm was tested and cross-validated via manual review of papers published in 1999 to determine whether identified key words were accurate in determining paper content. The algorithm was modified with additional key words and revalidated based on this initial analysis.

Results
Validation of the algorithm using all 1999 publications from several top OBGYN journals found a 93.48% accuracy for correct identification and classification of papers. Analysis was performed for 81,174 articles between 2000 and 2023. An average of 6.64% of publications focused on urogynecology topics. In contrast, 41.42% of publications concerned obstetrics, 33.9% on other benign gynecology, 41.9% on gynecologic oncology, and 24.7% on reproductive endocrinology and infertility.

Conclusions
This study reveals consistent underrepresentation of urogynecology topics in leading OBGYN journals. Given that generalist gynecologists may not subscribe to subspecialty journals, this study underscores the need for the inclusion of urogynecologic research in OBGYN journals.
Accelerated Metabolomic Aging and Its Association with Social Determinants of Health in Multiple Sclerosis
Authors: Siavoshi Fatemeh , Noroozi Rezvan , Chang Gina , Schoeps Vinicius A. , Smith Matthew D. , Briggs Farren B.S. , Graves Jennifer S. , Waubant Emmanuelle , Mowry Ellen M. , Calabresi Peter A. , Bhargava Pavan , Fitzgerald Kathryn C 
Published: February 2025

AbstractBiological age (BA), shaped by genetics, lifestyle, and environmental exposures, reflects physiological changes and mediates the effects of social determinants of health (SDoH) in diseases other than multiple sclerosis (MS). We investigated BA acceleration through metabolic profiling in people with MS (PwMS) and its association with SDoH, measured by the area deprivation index. Accelerated BA was observed in PwMS compared to healthy controls in independent adult and pediatric-onset MS cohorts. Greater social deprivation correlated with greater BA acceleration in PwMS. These findings highlight BA as a potential mediator linking SDoH to MS outcomes and a target to reduce health disparities.
Acute exercise rewires the proteomic landscape of human immune cells
Authors: Walzik David , Joisten Niklas , Metcalfe Alan J , Proschinger Sebastian , Schenk Alexander , Wenzel Charlotte , Henneberg Alessa L. , Schneider Martin , Calderazzo Silvia , Groll Andreas , Watzl Carsten , Opitz Christiane A. , Helm Dominic , Zimmer Philipp 
Published: February 2025

SUMMARYExercise-driven alterations of the immune system are a key mechanism in the prevention and treatment of various diseases. Here, we performed mass spectrometry-based proteomics analysis on peripheral blood mononuclear cells (PBMCs) at a depth of >6000 proteins. Comparing time– and workload-matched high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) we discover versatile changes in the proteomic makeup of PBMCs and reveal profound alterations related to effector function and immune cell activation pathways within one hour after exercise. These changes were more pronounced after HIIE compared to MICE and occurred despite identical immune cell mobilization patterns between the two exercise conditions. We further identify an immunoproteomic signature that effectively predicts cardiorespiratory fitness. This study provides a reliable data resource that expands our knowledge on how exercise modulates the immune system, and delivers biological evidence supporting the WHO 2020 guidelines, which highlight exercise intensity as a relevant factor to maintain health.
Culture method surveillance ofVibrio choleraein a non-sewered sanitation refugee camp setting: Dzaleka Camp, Malawi
Authors: Shackelford Brandie Banner , Chigwechokha Petros , Ziba Lucious , Misomali Christopher , Kanjiru Mphatso , Buleya Patrick , Nyirenda Ruth Lusungu , Wolfe Marlene K. , Holm Rochelle H. 
Published: February 2025

AbstractRefugees living in camps are particularly vulnerable to infectious disease outbreaks because of overcrowding, inadequate preventative health care, and limited water, sanitation, and hygiene services. As a result of the high disease prevalence, surveillance of cholera in Malawi provides a strong rationale for site and pathogen selection for refugee camp wastewater and environmental surveillance feasibility studies. We conducted a study in Dzaleka camp, Malawi, during a nationwide cholera outbreak. Incentivized refugee volunteers took samples for 19 weeks from seven high-use public pit latrines and a vacuum pump truck used for desludging fecal sludge. The National Microbiological Reference Laboratory of the Public Health Institute of Malawi used culture methods with confirmation via VITEK®MS or Analytical Profile Index to detectVibrio cholerae. Academic partners provided technical input, training, and quality assurance through the study. The results were reviewed weekly at partner-coordination meetings. NoV. choleraewas detected in samples, but one quality assurance sample tested positive during the study period. Here, we discuss the unique challenges of conducting wastewater and environmental surveillance in refugee camp settings, including our operational framework. This study provides a framework for up-scaling wastewater and environmental surveillance efforts in other humanitarian contexts through robust partnerships, processes and in-country tools.Graphical AbstractHighlightsA refugee camp in Malawi was investigated during a nationwide cholera outbreakSamples were collected for 19 weeks from seven pit latrines and a pump truckVibrio choleraewas largely absent using culture methodsSurveillance of non-sewered sanitation in a camp setting is achievable through partnerships