bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Outcomes of Pediatric Keratoplasty at a Tertiary Care Center
Authors: Majmudar Shivani P. , Chhadva Priyanka , Tu Elmer Y. , Djalilian Ali R. , de la Cruz Jose , Cortina Maria Soledad 
Published: January 2025

Purpose:
To report the indications, postoperative visual outcomes, and long-term graft survival of primary pediatric keratoplasties performed at a single tertiary care center.

Methods:
We conducted a retrospective review of pediatric patients (16 years and younger) who underwent surgical intervention for corneal opacity at a tertiary care center to evaluate long-term graft survival and visual rehabilitation.

Results:
Seventy-three eyes of 46 patients met inclusion criteria. The mean patient age at the time of transplantation was 7.44 years (range, 5 months–15.72 years), and the average follow-up time was 5.82 years. Forty eyes (56%) had graft failure occurring at a mean time of 16.33 months (range, 27 days–12.58 years), of which 25 eyes (62.5%) underwent repeat keratoplasty. Cumulative graft survival probabilities at 1, 3, 5, and 7 years after keratoplasty were 60%, 55%, 44%, and 44%, respectively. Cox proportional hazards regression analysis showed Black ethnicity [hazard ratio (HR) = 4.72; confidence interval (CI), 1.16–19.23], mixed/other ethnicity (HR = 6.67, CI, 1.58–28.16), and keratoplasty in combination with another procedure (HR = 2.88; CI, 1.35–6.15) as significant risk factors of graft failure. 47 eyes (64%) achieved ambulatory vision (20/800 or better) at the last follow-up. Age younger than 5 years at time of keratoplasty was associated with better visual outcomes in patients with congenital disease (P = 0.0017).

Conclusions:
Pediatric keratoplasty has a high rate of graft failure but can achieve ambulatory vision in >60% of patients. Keratoplasty outcomes are improved in non-Hispanic, White patients and when the intervention is performed alone. Younger age at time of keratoplasty for congenital conditions improves the likelihood of overall visual rehabilitation.
Visual outcomes, contrast sensitivity and defocus profile with an aspheric monofocal intraocular lens utilizing positive spherical aberration
Authors: Law Elizabeth M. , Aggarwal Rajesh K. , Buckhurst Phillip J. 
Published: January 2025

Purpose:
To evaluate visual outcomes following bilateral implantation of the RayOne EMV intraocular lens with targeted micro-monovision.

Setting:
Southend Private Hospital, UK

Design:
Retrospective cohort

Methods:
50 subjects (100 eyes) assessed at 12 to 18 months post-operatively. Emmetropia was targeted in the dominant eye and myopia of -0.50 to -1.00D in the non-dominant eye. Uncorrected and distance corrected visual acuity was assessed monocularly and binocularly at distance (6m), intermediate (70cm) and near (40cm). Defocus was assessed from +1.50D to -4.00D monocularly and binocularly. Contrast sensitivity was assessed using a computerised Pelli-Robson chart.

Results:
Mean Spherical Equivalent (MSE) was -0.05±0.34D and -0.91±0.60D in the dominant and non-dominant eyes respectively. Uncorrected distance visual acuity (UDVA) was significantly different in the dominant (0.08±0.10LogMAR) and non-dominant eye (0.29±0.17LogMAR). (p<0.01). Corrected distance visual acuity (CDVA), distance corrected intermediate visual acuity (DCIVA) and distance corrected near visual acuity (DCNVA) were similar between eyes. However, significant differences were found between binocular uncorrected intermediate visual acuity (UIVA) (0.16±0.11LogMAR) and DCIVA (0.31±0.11LogMAR) (p <0.01) also, binocular uncorrected near visual acuity (UNVA)(0.30±0.17LogMAR) and DCNVA (0.50±0.19 LogMAR) (p<0.01). The non-dominant eye shows superior acuity eye in both UIVA (p<0.01) and UNVA(p<0.01). Contrast sensitivity showed no significant difference between eyes (p = 0.06). Significant improvement binocularly compared to monocularly was seen through imposed defocus -0.50 to -2.50D.

Conclusion:
The RayOne EMV with micro-monovision is a reliable method for improving intermediate and near visual acuity, by increasing the range of focus without compromise of distance acuity or contrast sensitivity.
Comparison of ticagrelor and clopidogrel in primary percutaneous coronary intervention patients: a single-center retrospective study
Authors: Yan Yufeng , Xu Haimei , Zhao Yingying , Lin Song , Zheng Yaguo 
Published: January 2025

Background
It is uncertain whether ticagrelor is more effective and safer than clopidogrel in ST-segment elevation myocardial infarction (STEMI) patients in the East Asian population in the real world. This study compared the clinical outcomes of ticagrelor and clopidogrel in STEMI patients undergoing primary percutaneous coronary intervention (PCI).

Methods
We retrospectively enrolled 1124 patients diagnosed with STEMI in Nanjing First Hospital from July 2011 to April 2019. Propensity score matching was used to balance baseline covariates between the ticagrelor and clopidogrel groups. The primary efficacy endpoint was all-cause death, and the primary safety endpoint was major bleeding, defined as Bleeding Academic Research Consortium type 3–5 bleeding.

Results
We enrolled 1124 STEMI patients in the analysis. After propensity score matching, 420 patients were included in each group. There was a lower incidence of all-cause death in the ticagrelor group when compared with the clopidogrel group during the follow-up (8.3 vs. 17.1%; hazard ratio: 0.481; P < 0.001). Ticagrelor was also associated with reduced myocardial infarction, cardiovascular death, and stent thrombosis. However, no difference was detected in major bleeding. Multivariate Cox regression analysis showed that age, Killip classification, creatinine, low-density lipoprotein, left ventricular ejection fraction, single vessel disease, inhospital intra-aortic balloon pump implantation, β-blockers, and ticagrelor were independent predictive parameters of all-cause death.

Conclusion
Compared with clopidogrel, ticagrelor reduced all-cause death but did not increase the incidence of major bleeding in primary PCI patients. Therefore, ticagrelor may be considered a viable substitute for clopidogrel.
Effect of selenium on the dysfunction of rat salivary glands induced by 131 I and expression of insulin-like growth factors and aquaporins
Authors: Fang Ju , Huang Nan , Li Xiaoqian , Yue Rongli , Qin Zhuoqi , Cheng Qiyao , Wang Yunzhi , Li Huiling , Hao Xinzhong , Cheng Yan 
Published: January 2025

Objectives
To investigate the effects of selenium on functional and histopathological changes and mRNA expression levels of insulin-like growth factors 1 and 2 (IGF-1 and -2) and aquaporins 4 and 5 (AQP-4 and -5) in 131I-induced damaged rat parotid glands.

Methods
Rats were divided into three groups: iodotherapy-with-selenium, iodotherapy-only, and control. Rats in the iodotherapy-with-selenium group were intragastrically administered 131I on the first day and selenomethionine through drinking water. Rats in the iodotherapy-only group were only administered 131I. Changes in parotid gland function were evaluated using the functional parameters of salivary gland dynamics imaging pre-experiment and on days 7, 30, and 90 post-treatment. Immunofluorescence and quantitative real-time PCR analyses detected IGF-1, IGF-2, AQP-4, and AQP-5 expression levels in tissues.

Results
The gland-to background ratio at a maximum count (G/BGmax), Tmax/Tmin, and Smax values were significantly impacted over time in the iodotherapy-with-selenium group; on day 30, the G/BGmax value was significantly higher than that in the iodotherapy-only group. Histopathological analysis revealed that on days 30 and 90, the iodotherapy-with-selenium group displayed greater parotid gland repair than the iodotherapy-only group. In the iodotherapy-with-selenium group, fluorescence intensity and mRNA levels of AQP-5 increased with the selenium supplementation period, reaching significantly higher levels on days 30 and 90 than in the iodotherapy-only group. Whereas the fluorescence intensity and mRNA levels of IGF-1 in the iodotherapy-with-selenium group were significantly higher on day 7 than on day 30 in the iodotherapy-only group.

Conclusion
Selenium may repair 131I-induced tissue and functional damage in rat salivary glands by upregulating AQP-5 and IGF-1 expression.
Young Adult Community Health Advisor–Led Intervention to Promote Colorectal Cancer Screening Uptake Among South Asians in Hong Kong
Authors: Rana Tika , Chan Dorothy N. S. , Choi Kai Chow , So Winnie K. W. 
Published: January 2025

Background
Colorectal cancer is the most common cancer globally, and its prevalence is high in minority populations.

Objectives
To investigate the effectiveness of a young adult community health advisor (YACHA)–led intervention in enhancing the colorectal cancer (CRC) screening uptake rate among asymptomatic South Asians aged 50 to 75 years residing in Hong Kong and to investigate the acceptability of this intervention.

Methods
A randomized controlled trial design was adopted. Eighty asymptomatic South Asian participants aged 50 to 75 years were recruited from the community in Hong Kong and then randomly allocated either to a YACHA-led intervention group or a control group. The intervention group received YACHA-led intervention, whereas the control group would receive the intervention after all follow-up assessments. The outcome measure was the uptake of CRC screening test. The acceptability of the intervention was explored through semistructured interviews.

Results
The findings showed that the CRC screening uptake rate of the intervention group was significantly higher than that of the control group (85.0% vs 2.5%, P < .001). All the interviewees were satisfied with the intervention.

Conclusion
The YACHA-led intervention improves the uptake of CRC screening among asymptomatic South Asians.

Implications for Practice
It is suggested that more resources should be allocated to empower young members of minority groups to reduce the health disparity.
Perceptions From Non-Magnet® Organizations
Authors: Rollins Scott M. 
Published: January 2025

OBJECTIVE
The aim of this study was to investigate the correlation between nurse leaders' transformational leadership and clinical nurses' structural empowerment in non-Magnet® hospitals, and the differences in this correlation by Magnet status.

BACKGROUND
Nurse leaders' transformational leadership has been positively correlated to increased structural empowerment in clinical nurses, primarily in Magnet-designated hospitals and those pursuing Magnet designation.

METHODS
A descriptive correlational study design was used to investigate the study aim. Clinical nurses from 1 hospital system in the northeast were offered the opportunity to participate.

RESULTS
In non-Magnet hospitals, nurse leaders' transformational leadership behaviors were strongly correlated to clinical nurses' structural empowerment (r = 0.831, P < .001). No statistically significant differences were found in this correlation by Magnet status.

CONCLUSIONS
Regardless of Magnet status, nurses experienced higher levels of structural empowerment when they perceived their nurse leaders' leadership behaviors as transformational in nature.
A Single-Site Approach
Authors: Smith-Miller Cheryl A. , Cline Michaela 
Published: January 2025

OBJECTIVE
This study serves as a replicable model for other healthcare institutions to gather information directly from nurses about their interactions within the work environment and the factors affecting their decision to stay.

BACKGROUND
Persistently high turnover rates reflect nurses' discontent. Although personal reasons, career advancement, and relocation are cited as the top reasons for departures, macro-level data overlook the organizational and unit-level factors that erode nurses' desire to stay.

METHODS
Survey methods were used for data collection. The analysis included statistical and qualitative methods.

RESULTS
Salary, benefits, and work schedules were important in influencing nurses' decisions to stay, but their importance varied by career stage. Ergonomic aspects of nurses' daily work were key themes.

CONCLUSIONS
Organizational and unit elements play enduring roles in job satisfaction. Critically examining nurses' work environment from meso- and micro-level ergonomic perspectives can enhance understanding of nurse retention and provide evidence to fine-tune retention strategies.
PICC Lines in Pregnancy and Other Peripartum Vascular Access Considerations
Authors: Sarosi Ellery , Gatta Luke A. , Berman Deborah R. , Bauer Melissa , Kuller Jeffrey A. 
Published: January 2025

ABSTRACT

Importance
To decrease associated infectious and thrombotic morbidity, it is important to understand the indications and risks of peripherally inserted central catheters (PICCs) and other vascular access means in pregnancy.

Objective
The objectives are 3-fold: (1) discuss indications and contraindications, approach to placement, and associated complications for PICC lines, arterial catheters, centrally inserted central catheters, and peripheral intravenous catheters; (2) review available data regarding complications associated with these catheters in pregnancy; and (3) propose an evidence-based approach to clinical decision making regarding vascular access in 2 clinical scenarios among pregnant patients.

Evidence Acquisition
A literature review identified relevant research, review articles, textbook chapters, databases, and societal guidelines, with a focus on obstetrical anesthesia and obstetric literature.

Results
Data on vascular access complications in pregnancy are limited; therefore, rates of complications are extrapolated from studies including nonpregnant subjects. Catheter choice is dependent on resuscitation requirements, monitoring indications, parenteral therapeutic needs, need for inpatient versus outpatient care, and anticipated duration of use.

Conclusions and Relevance
All pregnant patients require vascular access. A subset requires more invasive catheters for management of specific conditions such as trauma in pregnancy, postpartum hemorrhage, and puerperal sepsis. In addition, vascular access plays an important role in operative planning for patients with placenta accreta spectrum disorder and fetal disorders requiring intrauterine surgery. Gaining an understanding of the types of catheters and their associated complications will allow obstetricians, family medicine physicians, midwives, nurses, intensivists, and anesthesiologists to make informed decisions regarding catheter selection and management.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner will be better able to discuss indications and contraindications, approach to placement, and associated complications for PICC lines, arterial catheters, centrally inserted central catheters, and peripheral intravenous catheters; describe available data regarding complications associated with these catheters in pregnancy; and propose an evidence-based approach to clinical decision making regarding vascular access in 2 clinical scenarios among pregnant patients.
Children Born After Assisted Reproduction More Commonly Carry a Mitochondrial Genotype Associating With Low Birthweight
Authors: Mertens Joke , Belva Florence , van Montfoort Aafke P.A. , Regin Marius , Zambelli Filippo , Seneca Sara , de Deckersberg Edouard Couvreu , Bonduelle Maryse , Tournaye Herman , Stouffs Katrien , Barbé Kurt , Smeets Hubert J.M. , Van de Velde Hilde , Sermon Karen , Blockeel Christophe , Spits Claudia 
Published: January 2025

(Abstracted from Nat Commun 2024;15:1232
Assisted reproductive technology (ART) has enabled many couples before considered untreatably infertile to have children, though there have been concerns that children born using these technologies are at risk for adverse outcomes. These adverse outcomes vary, and many of them stem from unknown causes.
Future Directions in the Treatment of Low-Grade Gliomas
Authors: Kinslow Connor J. , Mehta Minesh P. 
Published: January 2025

Abstract
There is major interest in deintensifying therapy for isocitrate dehydrogenase–mutant low-grade gliomas, including with single-agent cytostatic isocitrate dehydrogenase inhibitors. These efforts need head-to-head comparisons with proven modalities, such as chemoradiotherapy. Ongoing clinical trials now group tumors by intrinsic molecular subtype, rather than classic clinical risk factors. Advances in imaging, surgery, and radiotherapy have improved outcomes in low-grade gliomas. Emerging biomarkers, targeted therapies, immunotherapy, radionuclides, and novel medical devices are a promising frontier for future treatment. Diverse representation in glioma research and clinical trials will help to ensure that advancements in care are realized by all groups.
Effect of age, harvest site and body mass index on the cell composition of the stromal vascular fraction
Authors: Yang Zi-Han , Zhang Tian-Yu , Chen Fang-Zhou , Xie Yun , Tan Poh-Ching , Li Qing-Feng , Zhou Shuang-Bai 
Published: January 2025

Background:
The stromal vascular fraction (SVF) of adipose tissue has now been widely used in plastic surgeries, clinical trials and therapies. However, the cell composition of SVF undergoes dynamic changes during aging and obesity, which may influence the efficacy of the SVF. This study analyzed the effects of age, harvest site and body mass index on the cell composition of the SVF.

Methods:
A study was performed on 162 patients. The age ranged from 13 to 88 years old, with body mass index (BMI) <25kg/m2 or ≥ 25kg/m2. Fat tissue was harvested from the abdominal region, hips, thighs or arms, and the SVF was isolated for flow cytometry.

Results:
Our results demonstrated that the declines of adipose derived stem cells (ADSCs) and endothelial cells (ECs) first occurred in donors aged 40-49 years old. Subsequently, the percentages of endothelial progenitor cells (EPCs), preadipocytes, and M2 macrophages started to decrease in donors aged 50-69 years old. Lower percentages of ECs and M2 macrophages were found in donors with higher BMI.

Conclusions:
This study demonstrated that the percentages of ADSCs and ECs of SVF, decreased significantly starting from donors over age 40, followed by changes in other cell subpopulations. Furthermore, donors with BMI ≥ 25kg/m2 had lower percentages of ECs and M2 macrophages.
Benefits and durability of an affordable prosthetic silicone cushion liner locally manufactured in a resource-limited environment: Enabling adoption of total surface bearing sockets and silicone cushion liners
Authors: Ghidini Claudia , Sharma Shova Kanta , Shrestha Saloman , Prasad Dhan , Favier Clément D. , Erenstone Jeffrey , Bull Anthony M. J. , Maharjan Suraj 
Published: January 2025

Introduction:
Prosthetic silicone liners improve comfort and skin protection and allow the use of total surface bearing (TSB) sockets, which provide enhanced proprioception and comfort. Unfortunately, silicone liners are cost-prohibitive in resource-limited environments (RLEs) where patellar tendon bearing (PTB) sockets with PE-lite liners remain standard, leading to patient discomfort and skin issues.

Objective:
This study evaluates the benefits and durability of an affordable silicone liner locally manufactured in an RLE to promote TSB socket adoption, aiming to enhance prosthetic care and patient outcomes.

Methods:
Ethical approval was granted by the Nepal Health Research Council. Twelve people with a unilateral transtibial amputation who were using a PTB socket with PE-lite participated in the study and received a new prosthesis (TSB socket with an affordable silicone liner). Participants performed mobility tests (2-Minute Walking Test, Timed Up and Go Test) and completed self-reported questionnaires for both prostheses. Liner durability was assessed.

Results:
Participant mobility improved while wearing the TSB socket and silicone liner. The new prosthesis was found to be comfortable, and there were no major problems identified although excessive sweating, typical with silicone liners, was reported. Liners were replaced after 6.1 (±3.1) months.

Conclusion:
A locally manufactured liner provided increased mobility and high levels of satisfaction. This affordable liner may be suitable for use in RLEs, enabling adoption of TSB sockets and improving rehabilitation outcomes of people with a transtibial amputation. However, durability concerns and excessive sweating would suggest that improvements can still be made.
Interprogram Differences in Core General, Core Plastic, and Plastic Surgery-Adjacent Training
Authors: Akhavan Arya A. , Atayeva Rena , Tiongco Rafael F. P. , Puthumana Joseph S. , Redett Richard J. , Lifchez Scott D. , Cooney Damon S. , Cooney Carisa M. 
Published: January 2025

Background
Plastic surgery training continues to evolve with integrated residents spending more time in plastic versus general surgery. Herein, we provide an updated description of interprogram differences in core general, core plastic, and plastic surgery-adjacent training curricula.

Methods
We obtained rotation schedules from US plastic surgery residency websites or program coordinators for AY2021–2022. Rotation months were recorded and categorized into Core General Surgery, Core Plastic Surgery, and Plastic Surgery-Adjacent. Rotations were compared to American Board of Plastic Surgery (ABPS) and Accreditation Council for Graduate Medical Education (ACGME) standards. Data were analyzed using descriptive statistics (SPSS, IBM Corp., v27.0, Armonk, NY).

Results
Of 84 programs, we obtained schedules for 63 (75%). Most offered 2 years of Core General Surgery followed by 4 years of Core Plastic Surgery training (n = 32, 50.8%). From postgraduate years 1–6, programs offered median 52 months [interquartile range (IQR): 47.5, 55] of Core Plastic Surgery, 12 months (IQR: 9, 14) of Core General Surgery, and 8 months (IQR: 6, 10) of Plastic Surgery-Adjacent rotations. Six (9.5%) programs' schedules included rotations specifically addressing all ABPS competency requirements; 1 (1.6%) included rotations addressing all ACGME Core General Surgery competency requirements. Departmental status was not associated with differences in training time.

Conclusions
Our results demonstrate that in AY2021–2022, integrated plastic surgery training programs offered 6 months less Core General Surgery, 3 months less Plastic Surgery-Adjacent, and 9 months more Core Plastic Surgery Rotations than in 2012. Very few program schedules include named rotations that specifically addressed all ABPS or ACGME competency requirements.