bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Distal Fascicle of the Anterior Inferior Tibiofibular Ligament: A Potential Landmark for Lateral Ankle Ligament Reconstruction
Authors: Wang Anhong , Zhao Feng , Shi Weili , Lian Chenyu , Xie Xing , Jing Lizhong , Liu Ziming , Zhang Keying , Jiang Dong , Guo Qinwei 
Published: October 2023

Background: A reliable landmark and precise distances from the ligament attachments are needed for lateral ankle stabilization surgery. The distal fascicle of the anterior inferior tibiofibular ligament (AITFL) has been used to locate the anterior talofibular ligament (ATFL) or calcaneofibular ligament (CFL) centers on the fibula. However, there is no anatomic study to validate the distal fascicle of the AITFL as a landmark of lateral ankle ligament stabilization, and more importantly, the exact distances from the ATFL or CFL attachments to the distal fascicle of the AITFL are unknown. Methods: Sixteen frozen cadaveric specimens (8 paired specimens) with no previous history of ankle injury were used in this study. Whether the distal fascicle of AITFL was present in each specimen was confirmed. Then, the distances from the most distal insertion of the AITFL’s distal fascicle to the footprint centers of the ATFL and CFL on the fibula were measured. All measurements were performed by 2 observers, and the intraobserver and interobserver reliabilities were analyzed by intraclass correlation coefficients (ICCs). Results: The distal fascicle of the AITFL was found in all specimens (100%). The mean distance from the most distal insertion of the AITFL’s distal fascicle to the footprint centers of the ATFL, CFL, and the intersection center of the 2 ligaments on the fibula was 6.0 to 7.1 mm, 11.5 to 13.2 mm, and 9.0 to 10.0 mm, respectively. Excellent interobserver and intraobserver agreement (all ICCs > 0.9, P < .01) was shown in the anatomic measurements of these distances. Conclusion: In this cadaveric study, we found that the distal fascicle was a constant structure of the AITFL in the lateral ankle. The distances from the most distal insertion of the AITFL’s distal fascicle to the ligamentous footprint centers were reliable and may be used to identify the origins of the ATFL and CFL for lateral ankle ligament reconstruction. Clinical Relevance: This anatomic study validates the AITFL’s distal fascicle as a potential landmark and, more importantly, determines the range of distances from AITFL’s distal fascicle to the attachment centers of lateral ankle ligaments by anatomic measurements. The data may be used to identify the ATFL and CFL for lateral ankle stabilization surgery and become particularly valuable for endoscopic or arthroscopic techniques.
Nicotine Dependence and Rates of Postoperative Complications in Achilles Tendon Repair
Authors: DeShazo Sterling , Pescatore Sabrina M. , Panchbhavi Vinod K. 
Published: October 2023

Background: Nicotine is a modifiable risk factor that is well demonstrated to cause deleterious effects on tendon healing and overall health. Individuals that have a dependence on nicotine may be at an elevated risk for numerous postoperative complications when compared to nondependent patients. The purpose of this study is to evaluate the complications postoperatively between nicotine- and non–nicotine-dependent Achilles tendon repairs. Methods: The global health network database, TriNetX, was used to access and analyze deidentified patient information. Two cohorts were identified for the purposes of this study. Cohort A was defined as patients who had an Achilles tendon repair ( Current Procedural Terminology [ CPT]: 27650 or CPT: 27654) and had a dependence to nicotine ( International Classification of Diseases, Tenth Revision, code: F17). Cohort B was defined as patients who had an Achilles tendon repair but did not have a dependence to nicotine. Data were gathered from health care organizations from August 21, 2000, to August 21, 2023. All postoperative complications were analyzed between 1 and 90 days after the Achilles tendon repair. Results: A total of 2117 nicotine-dependent patients were matched with 18 102 non–nicotine-dependent patients. After propensity matching for age at event, ethnicity, race, sex, and type 2 diabetes mellitus, nicotine-dependent patients who underwent Achilles tendon repair experienced higher associated risk for numerous postoperative complications. When compared to nondependent patients, nicotine-dependent patients had increased risk for wound disruption (risk ratio [RR] 1.55, 95% CI 1.11-2.16) and infection following a procedure (RR 1.64, 95% CI 1.09-2.47) within 90 days post Achilles tendon repair. Conclusion: In this database study using propensity matching, nicotine-dependent patients who underwent Achilles tendon repair were correlated with an increased associated risk for wound disruption and infection after a procedure than their non–nicotine-dependent counterpart. Level of Evidence: Level III, retrospective cohort study.
Outcomes After Proximal Medial Gastrocnemius Recession and Stretching vs Stretching as Treatment of Chronic Plantar Fasciitis at 6-Year Follow-up
Authors: Riiser Martin Okelsrud , Husebye Elisabeth Ellingsen , Hellesnes Jan , Molund Marius 
Published: October 2023

Background: Evidence from prospective short-term studies suggest that proximal medial gastrocnemius recession is a safe and efficient procedure to treat chronic plantar fasciitis resistant to nonoperative treatment. The aim of this study was to evaluate the long-term clinical outcomes of proximal medial gastrocnemius recession and stretching compared to a stretching exercise protocol for patients with chronic plantar fasciitis and an isolated gastrocnemius contracture (IGC). Methods: Forty patients with plantar fasciitis lasting more than 1 year were prospectively randomized to a home stretching exercise program only, or to proximal medial gastrocnemius recession in addition to the stretching program. Clinical and functional data in this study were obtained at baseline and 6-year follow-up. The main outcome was the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score. Secondary outcomes were the visual analog scale (VAS) for pain, the Manchester Oxford Foot Questionnaire (MOxFQ), ankle dorsiflexion, and Achilles complex performance. Results: Thirty-three of 40 patients completed the 6-year follow-up. Seven patients had crossed over from nonoperative treatment to operative treatment. At 6 years, the operative group demonstrated significantly better outcomes with AOFAS (88.9 vs 78.6, P = .012), for pain measured by VAS (2.5 vs 5.5, P < .001) and with the MOxFQ total score (24.4 vs 45.9, P = .05) (per protocol analysis excluding crossovers). No between-group differences were observed for ankle dorsiflexion or Achilles complex performance at 6 years. Conclusion: This study demonstrates that the improved function and reduced level of pain by proximal medial gastrocnemius recession and stretching is better compared to stretching alone after 6 years of follow-up for patients with chronic plantar fasciitis and a concomitant isolated gastrocnemius contracture. Level of Evidence: Level I, randomized controlled trial.
Immediate effect of anti-VEGF injections on optic nerve head: Correlation between intraocular pressure and anatomical peripapillary changes
Authors: Viggiano Pasquale , Buonamassa Rosa , Grassi Maria Oliva , Boscia Giacomo , Borrelli Enrico , Landini Luca , Evangelista Federica , Malerba Maria Giovanna , Alessio Giovanni , Boscia Francesco 
Published: October 2023

Purpose This study was designed to investigate retinal nerve fiber layer (RNFL) and radial peripapillary capillaries (RPC) changes on optical coherence tomography (OCT) angiography and OCT thickness alterations associated with acutely increased intraocular pressure after intravitreal injections. Methods This observational clinical study was conducted on 35 eyes (35 patients) with treatment-naïve age-related macular degeneration (AMD) and type 1 or type 2 MNV were enrolled. All patients underwent anti-vascular endothelial grow factor (VEGF) intravitreal injections with 0.05-mL aflibercept (2 mg) between January 2022 and October 2022. Peripapillary OCT angiography perfusion density, retinal nerve fiber layer thickness, and intraocular pressure (IOP) were measured before and immediately after intravitreal injections. In particular, the analysis was performed at the following visits: (T0) 5 to 15 min before the injection of aflibercept; (T1) 2 to 5 min after the injection of aflibercept. Paired t-test was used to compare pre-injection and post-injection values. Results The mean baseline IOP (T0) value was 17.26 ± 2.4 mmHg and the immediate post-injection IOP (T1) mean value was 34.7 ± 11.50 mmHg (P < 0.01). The mean global RNFL thickness before and immediately after the injection was 100.9 ± 18.8 m and 98.6 ± 17.4 m (P = 0.001). Furthermore, the topographical RNFL analysis showed significant thickness reduction of the nasal and inferior sectors after the procedure when compared to T0 (P = 0.046 and P = 0.001). On the contrary, the mean RCP density changes at T1 did not reach statistically significant (P = 0.636). Furthermore, we found a significant negative correlation between the retinal nerve fiber layer global thickness and the IOP changes (Pearson's correlation = −0.126; P = 0.031). In particular, the nasal RNFL region showed a significant negative correlations with IOP values (Pearson's correlation = −0.198, P = 0,046). Conclusions We reported acute IOP changes that are associated with reduced RNFL thickness in a group of patients undergoing intravitreal injections of anti-VEGF drugs for neovascular age-related macular degeneration. Moreover, topographical sub-analysis revealed that the nasal RNFL region is most prone to IOP fluctuations. This finding may explain the sudden visual acuity change in patients immediately after injection and may sustain injuries to optic nerve head structures producing glaucomatous damage.
Assessment and safety of the new esthesiometer BRILL: Comparison with the Cochet-Bonnet Esthesiometer
Authors: Merayo-Lloves Jesús , Gómez Martín Carmen , Lozano-Sanroma Javier , Renedo Laguna Concepción 
Published: October 2023

Background Corneal sensitivity can decrease by several ocular conditions, such as dry eye or refractive surgery, which favor ocular epithelial lesions and is measured using an esthesiometer. The study's primary objective was to demonstrate the efficacy and safety of the non-contact esthesiometer BRILL, which delivers air pulses to the corneal surface to assess corneal sensitivity. Methods A single-center, prospective, controlled pilot study was carried out in adult patients with healthy eyes and or with pathology. Corneal sensitivity measurements were made in triplicate for both eyes at three consecutive visits. The esthesiometer BRILL was used in all visits, and on the last visit, the contact esthesiometer Cochet-Bonnet was also used. The results of both devices were compared by transforming them into force values. Results 54 subjects with a mean age of 50.43 (SD 16.55, interval 18–87), 77.78% women, were included. Comparing the forces applied by both esthesiometers in the healthy eyes, in the eyes with pathology in all the groups, and in the dry eyes showed significant differences, p = 0.03603, p = 0.00614, and p = 0.0001, respectively. Conclusion The BRILL esthesiometer proved to be an effective and safe tool for non-contact assessment of corneal sensitivity with operator-independent repeatability. The measurements had a good agreement and comparable range with the Cochet-Bonet aesthesiometer measurements in healthy and dry eyes but with no interchangeable values. This portable device can help ophthalmologists and optometrists to diagnose eye pathologies that cause decreased corneal sensitivity and to assess the efficacy of therapy and disease progression.
Transfemoral Access to Implant Iliac Branch Devices After Previous Aortic Grafts
Authors: Torrealba Jose , Grandi Alessandro , Nana Petroula , Panuccio Giuseppe , Rohlffs Fiona , Kölbel Tilo 
Published: October 2023

Objective: To report on the outcomes of patients undergoing an iliac branch device implantation after previous open or endovascular aorto-biliac repair, using exclusively femoral access for catheterization and delivery of the covering stent to the hypogastric artery. Methods: Single-center retrospective study in which all patients in whom an iliac branch device was implanted after previous open or endovascular aorto-biliac repair were identified. Patients in whom the hypogastric artery catheterization and delivery of the bridging cover stent were achieved via exclusive femoral access were included. Different techniques were used based on surgeon preference. Technical success and access-related complications, as well as iliac branch device endoleak or occlusions during follow-up, were evaluated. Results: From 2015 to 2021, 28 patients with a prior open or endovascular aorto-biliac repair underwent 34 iliac branch device implantations. Most (71%) had juxtarenal or thoracoabdominal aortic aneurysms, 82% had common iliac artery aneurysms, and 25% had hypogastric artery aneurysms. Bilateral iliac branch device implantations were performed in 21% of the patients, and in 26% of cases, landing in the superior gluteal artery was obtained. An “up-and-over” technique from the contralateral groin was used in 65% of the cases, and a steerable sheath in 35%. Technical success was 94%, with no complications related to access or technique to catheterize and deliver the stents in the hypogastric artery. The cohort had 20% of major complications, with 3 perioperative deaths. Kaplan–Meier estimated an iliac branch device freedom from occlusion and endoleak was 92% and 83% at 2 years. Conclusions: The implantation of an iliac branch device over previous aortic or open endografts involving the aortic bifurcation is feasible and safe. We suggest using a femoral approach as the primary access of choice. Clinical Impact In this study we present 28 patients with previous aortoiliac grafts in which iliac branch devices were performed as a subsequent step.We demonstrated the feasibility of the technique despite the difficulty of crossing a neobifurcation, with a steep angle, without complications associated with the technique. Based on our experience, we recommend transfemoral access as the first option for bypassing the hypogastric artery stent, preserving upper extremity access and its possible complications.
Corneal immune cells as a biomarker of inflammation in multiple sclerosis: a longitudinal study
Authors: Petropoulos Ioannis N. , John Karen , Al-Shibani Fatima , Ponirakis Georgios , Khan Adnan , Gad Hoda , Mahfoud Ziyad R. , Altarawneh Heba , Rehman Muhammad Hassan , Al-Merekhi Dhabia , George Pooja , Ibrahim Faiza , Francis Reny , Canibano Beatriz , Deleu Dirk , El-Sotouhy Ahmed , Vattoth Surjith , Stettner Mark , Own Ahmed , Shuaib Ashfaq , Akhtar Naveed , Kamran Saadat , Malik Rayaz A. 
Published: October 2023

Background: Corneal immune cells (ICs) are antigen-presenting cells that are known to increase ocular and systemic inflammatory conditions. Objective: We aimed to assess longitudinal changes in corneal IC in patients with multiple sclerosis (MS) and relation to disability and ongoing treatment. Design: Prospective observational study conducted between September 2016 and February 2020. Methods: Patients with relapsing-remitting MS (RRMS) ( n = 45) or secondary progressive MS (SPMS) ( n = 15) underwent corneal confocal microscopy (CCM) at baseline and 2-year follow-up for estimation of corneal IC density [dendritic cells with (DCF) (cells/mm2) or without nerve fiber contact (DCP); and non-dendritic cells with (NCF) or without nerve fiber contact (NCP)]. Optical coherence tomography, neuroimaging, and disability assessments were additionally performed. Healthy controls ( n = 20) were assessed at baseline. Results: In both RRMS and SPMS compared to controls, DCP ( p < 0.001 and p < 0.001, respectively) and DCF ( p < 0.001 and p = 0.005) were higher and NCF ( p = 0.007 and p = 0.02) was lower at baseline. DCP showed excellent performance in identifying patients with MS (sensitivity/specificity = 0.88/0.90) followed by DCF (0.80/0.75) and NCF (0.80/0.85). At follow-up compared to baseline, DCP ( p = 0.01) was significantly reduced, and NCP ( p = 0.004) and NCF ( p = 0.04) were increased. Subgroup analysis showed that baseline NCP and NCF were significantly higher ( p = 0.04–0.05) in patients who switched disease-modifying treatment, and baseline NCP ( p = 0.05) was higher in patients on interferon. Conclusion: Baseline and change in corneal IC were related to axonal degeneration and treatment status. Evaluation of corneal IC using CCM may allow an assessment of ongoing inflammation, disease progression, and the effect of treatment in MS.
Efficacy of intraoperative subanesthetic dose of ketamine/esketamine in preventing postoperative cognitive dysfunction: a systematic review and meta-analysis
Authors: Zhou Na , Chen Chengchuan , Liu Yubei , Yu Zhaolan , Chen Yanhua 
Published: October 2023

Background: Postoperative cognitive dysfunction (POCD) is a common complication after anesthesia surgery, especially in older people, that can persist weeks or months after surgery as a short-term impairment of cognitive abilities, or even for a prolonged duration over years, potentially progressing into permanent cognitive dysfunction. However, the pathogenesis of POCD is not fully understood, and therefore an optimal solution for preventing POCD has yet to be established. Some studies have shown that intraoperative ketamine/esketamine reduces the incidence of POCD, but this remains controversial. Objectives: We evaluated the effect of intraoperative subanesthetic doses of ketamine/esketamine versus no intervention in adults undergoing general anesthesia surgery on the incidence of POCD. Data Sources: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and searched the PubMed, Embase, Ovid, Cochrane, Scopus, and Web of Science databases for the MeSH terms ‘ketamine’, ‘esketamine’, and ‘Postoperative Cognitive Complications’ from database inception to 25 June 2023. Results: We found no statistically significant difference in the incidence of POCD within 7 days for intraoperative subanesthetic dose of ketamine/esketamine compared with the control group [relative risk (RR) = 0.57, 95% confidence interval (CI): 0.32, 1.01], and the results from the subgroup analysis based on age (>60 years) also revealed that the difference was not statistically significant (RR = 0.49, 95% CI: 0.23, 1.04). Conclusion: Compared with controls, intraoperative subanesthetic dose of ketamine/esketamine has no advantage in preventing POCD in patients, or in elderly patients. This study provides reference data for POCD research and clinical drug intervention strategies. Registration: Prospective Register of Systematic Reviews (PROSPERO; registration number CRD42023401159).
Recent and past toxoplasmosis infections, associated factors, and awareness among pregnant women in Nigeria
Authors: Onyinye Nnemelu Perpetua , Ikechukwu Mbachu , Chinedu Ndukwe , Chukwuanugo N Ogbuagu , Nnamdi C Onyenyili Ikemefuna , Nne Akujobi Comfort 
Published: October 2023

Objectives: The study determined the rate of recent and past Toxoplasma gondii infections, associated factors, and awareness among expectant mothers assessing antenatal care in a tertiary hospital in Nigeria. Methods: This prospective cohort study was conducted among pregnant women. A questionnaire was used to gather information on socio-demographics, infection risk factors, and awareness of the infection. Using an ELISA kit, the IgG and IgM antibodies against Toxoplasma gondii were assessed in blood samples from these women. For samples that tested positive for IgM, a real-time polymerase chain reaction was used to amplify the DNA. SPSS version 23 was used for data entry and analysis. The p-value < 0.05 was adjudged to be significant. Results: A total of 250 pregnant women participated in the study. The rate of recent infection (IgM antibody positivity) was 3.6% (9/250), while past infection (IgG antibody positivity) was 68.4% (171/250). Polymerase chain reaction confirmed 5/9 recent infections as positive. Factors significantly associated with toxoplasmosis were gardening ( p = 0.037) and undercooked meat ( p = 0.023). Only 27 out of 250 pregnant women in this research had heard of toxoplasmosis, which translates to a low awareness rate of 10.8%. Conclusions: The recent infection among pregnant women in this study indicates the possibility of mother-to-child transmission with attendant sequelae. There was a significant association between past Toxoplasmosis gondii infections and stillbirth. Routine screening for toxoplasmosis should be incorporated into the antenatal program since none of the symptoms could significantly predict illness. In addition, regular antennal care instruction should cover toxoplasmosis education.
Ifood: Development and usability study of a social media-based applet for dietary monitoring
Authors: Lan Yushan , Xu Xiaowei , Guo Zhen , Sun Lianglong , Lai Jianqiang , Li Jiao 
Published: October 2023

Background Dietary monitoring is critical to maintaining human health. Social media platforms are widely used for daily recording and communication for individuals’ diets and activities. The textual content shared on social media offers valuable resources for dietary monitoring. Objective This study aims to describe the development of iFood, an applet providing personal dietary monitoring based on social media content, and validate its usability, which will enable efficient personal dietary monitoring. Methods The process of the development and validation of iFood is divided into four steps: Diet datasets construction, diet record and analysis, diet monitoring applet design, and diet monitoring applet usability assessment. The diet datasets were constructed with the data collected from Weibo, Meishijie, and diet guidelines, which will be used as the basic knowledge for further model training in the phase of diet record and analysis. Then, the friendly user interface was designed to link users with backend functions. Finally, the applet was deployed as a WeChat applet and 10 users from the Beijing Union Medical College have been recruited to validate the usability of iFood. Results Three dietary datasets, including User Visual-Textual Dataset, Dietary Information Expansion Dataset, and Diet Recipe Dataset have been constructed. The performance of 4 models for recognizing diet and fusing unimodality data was 40.43%(dictionary-based model), 18.45%(rule-based model), 59.95%(Inception-ResNet-v2), and 51.38% (K-nearest neighbor), respectively. Furthermore, we have designed a user-friendly interface for the iFood applet and conducted a usability assessment, which resulted in an above-average usability score. Conclusions iFood is effective for managing individual dietary behaviors through its seamless integration with social media data. This study suggests that future products could utilize social media data to promote healthy lifestyles.