bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of peripheral corneal relaxing incisions for residual astigmatism in patients after cataract surgery
Authors: Wang Li , Koch Douglas D. 
Published: April 2023

Purpose:
To evaluate the outcomes of peripheral corneal relaxing incisions (PCRIs) for correcting residual astigmatism in eyes after cataract surgery.

Setting:
Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.

Design:
Retrospective case series.

Methods:
Retrospectively, we reviewed all consecutive cases that had previous cataract surgery and subsequent PCRIs by 1 surgeon. The PCRI length was determined according to a nomogram based on age and manifest refractive astigmatism. Visual acuity and manifest refractive astigmatism before and after the PCRIs were compared. Vector analysis was performed, and net refractive changes along the incision meridian were calculated.

Results:
Criteria were met by 111 eyes. After the PCRIs, mean uncorrected visual acuity was significantly improved, and the percentage of eyes with uncorrected distance visual acuity of ≥20/20 increased significantly by 36%; the mean refractive astigmatism magnitude decreased significantly, and the percentages of eyes with refractive cylinder of ≤0.25 diopters (D) and ≤0.50 D increased significantly by 63% and 75%, respectively (all P < .05). The vector magnitude difference between pre- and post-operative refractive astigmatism was 0.88 ± 0.38 D. The postoperative refractive astigmatism had significantly smaller centroid and variance values than the preoperative refractive astigmatism (P < .05).

Conclusions:
PCRIs are an effective approach for correcting low amounts of residual astigmatism in patients after cataract surgery.
Age-Adjusted All-Cause Mortality in Counties Served by PHAB-Accredited Local Health Departments Compared With Counties Served by Nonaccredited Local Health Departments: 1999 to 2020
Authors: Kovach Kevin A. 
Published: April 2023

Objectives:
To analyze trends in the age-adjusted all-cause mortality rate (AAMR) from 1999 to 2020 between counties served by a Public Health Accreditation Board (PHAB)-accredited local health department and a nonaccredited local health department to determine whether accreditation impacted the AAMR and whether there were differences in the AAMR preceding the first health departments being accredited in 2013.

Design:
Descriptive time trends and difference-in-differences analysis was used to explore differences in the AAMR between accredited counties and nonaccredited counties. Propensity score matching was used to develop a control group matched on county characteristics to address confounding.

Setting:
A national observational study using data obtained from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research, the American Community Survey, and a PHAB data set on accreditation status.

Participants:
All US counties with data on the AAMR and county characteristics.

Intervention:
Accreditation by the PHAB.

Main Outcome Measure:
The AAMR.

Results:
Difference-in-differences in the AAMR between accredited and nonaccredited counties were stable following the launch of the accreditation program in 2013, except for an improvement in 2020 in the total sample (32.2 deaths per 100 000 people, 95% confidence interval: 3.8-60.6, P = .03). Age-adjusted all-cause mortality rates were lower in accredited counties across the 22-year period. This was statistically significant every year in the total sample but only statistically significant in 2020 in the matched sample (P < .05). Prior to accreditation, the AAMR improved by 24.7 deaths per 100 000 people (P = .05) and 18.0 deaths per 100 000 people (P = .24) more among accredited counties between 1999 and 2008, among the total and matched samples, respectively.

Conclusion:
Currently, PHAB accreditation has not had a substantial impact on the AAMR, and the AAMR was higher among nonaccredited counties preceding the first health departments being accredited in 2013.
The Barriers to Bowel Cancer Screening Scale: Examining Structural Validity, Measurement Invariance, and Criterion Validity
Authors: Myers Larry , Goodwin Belinda , Viljoen Bianca , Roe Corina Galicher , Ireland Michael J. 
Published: April 2023

Objective:
The success of national cancer screening programs, such as the National Bowel Cancer Screening Program (NBCSP) in Australia, depends on public participation, which is currently an alarming 43.5% for the NBCSP. Understanding the barriers that impede screening participation requires valid measurement instruments. This study aims to cross-validate such an instrument with a new, large, and varied sample, as well as assess measurement invariance across subsamples at a greatest risk of nonparticipation (ie, testing whether the scale functions in similar ways across groups).

Design, Setting, and Participants:
A cross-sectional sample of 1158 participants from the target screening population (50-74 years) provided demographic information, responses to the Barriers to Home Bowel Screening (BB-CanS) scale, and information on their previous screening participation.

Results:
Both the full and the brief versions of the BB-CanS scale showed good model fit for the full sample and for gender and age subsamples. Despite the inter-factor correlations being high, the unidimensional and bi-factor models exhibited poorer fit. Improvement in fit was observed with scale refinement involving the removal of 7 items. All versions of the BB-CanS scale were invariant across gender and age subsamples. Age and gender differences emerged across several barriers and variance in all 4 barriers significantly predicted prior screening participation.

Conclusion:
The BB-CanS scale is a valid measure of 4 highly correlated barriers to home bowel cancer screening: disgust relating to screening, avoidance of test outcomes, practical difficulty (or challenges), and the need for a sense of greater autonomy. All versions of the instrument measure the equivalent construct across age and gender groups. Observed differences in barriers across at-risk groups provide targets for future intervention.
Total Surface Area of a Through-and-Through Oromandibular Defect Is Associated With Thromboembolic Events for Reconstruction With a Single Fibula Free Flap
Authors: Chen Ching-En , Ma Chun-Yu , Wang Tien-Hsiang , Lin Chih-Hsun , Wu Szu-Hsien , Perng Cherng-Kang , Ma Hsu , Shih Yu-Chung 
Published: April 2023

Background
Reconstruction of through-and-through composite oromandibular defects (COMDs) has been a challenge to plastic surgeons for decades. When using a free osteoseptocutaneous fibular flap, the skin paddle is restricted by the orientation of the peroneal vessels and the inset of bone segment(s). Although the combination of double flaps for extensive COMDs is viable and reliable, the decision of single- or double-flap reconstruction is still debated, and the risk factors leading to complications and flap failure of single-flap reconstruction are less discussed.

Aim and Objectives
The aim of this study was to determine objectively predictive factors for postoperative vascular complications in through-and-through COMDs reconstructed with a single fibula flap.

Methods
This was a retrospective cohort study in patients who underwent single free fibular flap reconstruction for through-and-through COMDs in a tertiary medical center from 2011 to 2020. The enrolled patients' characteristics, surgical methods, thromboembolic event, flap outcomes, intensive care unit care, and total hospital length of stay were analyzed.

Results
A total of 43 consecutive patients were included in this study. Patients were categorized into a group without thromboembolic events (n = 35) and a group with thromboembolic events (n = 8). The 8 subjects with thromboembolic events were failed to be salvaged. There was no significant difference in age, body mass index, smoking, hypertension, diabetes mellitus, and history of radiotherapy. The length of bony defect (6.70 ± 1.95 vs 9.04 ± 2.96, P = 0.004) and the total surface area (105.99 ± 60.33 vs 169.38 ± 41.21, P = 0.004) were the 2 factors that showed a significant difference between the groups. Total surface area was the only significant factor in univariate logistic regression for thromboembolic event (P = 0.020; odds ratio, 1.02; 95% confidence interval [CI], 1.003–1.033) and also in multivariate logistic regression analysis after adjusting confounding factors (P = 0.033; odds ratio, 1.026; 95% CI, 1.002–1.051).
The cutoff level of total surface area in determining thromboembolic event development was 159 cm2 (P = 0.005; sensitivity of 75% and specificity of 82.9%; 95% CI, 0.684–0.952).

Conclusions
Free fibula flap has its advantages and drawbacks on mandible restoration. Because there is a lack of indicators before, a large total surface area may be an objective reference for single-flap reconstruction of through-and-through COMDs due to an elevated risk of thromboembolic event.
Management of an Unusual Avulsion Trauma of Total Esophagus During Upper Gastrointestinal Endoscopy
Authors: Lin Ying-Sheng , Chang Chang-Cheng , Chen Hung-Chi 
Published: April 2023

Background
An esophageal defect usually resulted from surgical ablation of tumors or corrosive injury. Staged reconstructions are required usually in extensive defects.

Aim and Objectives
This study aimed to present a rare iatrogenic complication of total esophageal avulsion injury during upper gastrointestinal endoscopic treatment and to perform staged reconstructions to create a neoesophagus.

Materials and Methods
In the presented case, staged reconstructions with a tubed deltopectoral flap and a supercharged colon interposition flap were performed to reconstruct the hypopharynx and esophagus. However, recurrent choking occurred because of the extent of injury involving the epiglottis. A tubed free radial forearm flap connected to the lower buccogingival sulcus was used to create a new route for food passage.

Results
The patient resumed oral intake after rehabilitation.

Conclusions
The avulsion injury of the total esophagus is rare and devastating. Staged reconstructions with a tubed deltopectoral flap, a supercharged colon interposition flap, and a tubed free radial forearm flap would be a safe and reliable method.
Risk Factors for Treatment Failure in Skin and Soft Tissue Infections Caused by Nontuberculous Mycobacteria
Authors: Huang Chi-Han , Hsiao Fu-Yin , Wang Tien-Hsiang 
Published: April 2023

Background
This study investigated the characteristics of patients with skin and soft tissue infections (SSTIs) caused by nontuberculous mycobacteria (NTM) and identified the risk factors for treatment failure in these patients.

Material and Methods
Data of patients with NTM SSTIs who received treatment between January 2014 and December 2019 at Taipei Veterans General Hospital were collected retrospectively. Possible risk factors were determined using univariate and multivariate analysis with logistic regression models.

Results
A total of 47 patients (24 male, 23 female; age, 57.1 ± 15.2 years) were enrolled. Type 2 diabetes mellitus was the most common comorbidity. The most common mycobacterial species was the Mycobacterium abscessus complex, and the most commonly affected site was the axial trunk. Treatment was successful in 38 patients (81%). Six patients had recurrent infections (13%) after the treatment course was completed, and 3 patients (6.4%) died of NTM-related infection. Delayed treatment for more than 2 months and antibiotic-alone treatment were 2 independent risk factors for treatment failure of NTM SSTIs.

Conclusions
Delayed treatment for more than 2 months and antibiotic-alone treatment were associated with a higher failure rate in patients with NTM SSTIs. Therefore, the differential diagnosis of NTM infection should always be considered when the treatment course is prolonged but not effective. Early identification of causative NTM species and appropriate antibiotic treatment may lower the risk of treatment failure. Prompt surgical treatment is suggested if available.
Expression profiles of circRNAs and identification of hsa_circ_0007608 and hsa_circ_0064656 as potential biomarkers for COPD-PH patients
Authors: Yu Jinyan , Huang Shulun , Shen Weiyu , Zhang Zheming , Ye Shugao , Chen Yuan , Yang Yue , Bian Tao , Wu Yan 
Published: April 2023

AbstractThe authors have withdrawn their manuscript owing to their willingness to further analysis of the original data. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.
Functional annotation of the human PTSD methylome identifies tissue-specific epigenetic variation across subcortical brain regions
Authors: Li Hongyu , Wang Jiawei , Cruz Dianne A. , Modliszewski Jennifer L. , Corcoran David L. , Martínez-Magaña José Jaime , Montalvo-Ortiz Janitza L. , Roache John D. , Averill Lynnette A. , Young-McCaughan Stacey , Shiroma Paulo R. ,   Traumatic Stress Brain Research Group, Lewis David A. , Glausier Jill , Holtzheimer Paul , Friedman Matthew J. , Zhang Jing , Peterson Alan L. , Abdallah Chadi G. , Zhang Xinyu , Xu Ke , Krystal John H. , Duman Ronald S. , Zhao Hongyu , Williamson Douglas E. , Girgenti Matthew J. 
Published: April 2023

ABSTRACTPost-traumatic stress disorder is a mental disorder that may occur in the aftermath of severe psychological trauma. We examined 1,065,750 DNA methylation (DNAm) sites from 171 donors including neurotypicals, PTSD, and major depressive disorder cases across six areas implicated in the fear circuitry of the brain. We found significant differential methylation for PTSD near 195 genes and utilizing cross-region modeling, identified 6,641 candidate genes. Approximately 26% of differentially methylated CpGs were present near risk loci for PTSD. To identify potential therapeutic intersections for PTSD, we found significant methylation changes in theMAD1L1, ELFN1, andWNT5Agenes in ketamine responders. Finally, to better understand the unique biology of PTSD, we analyzed matching methylation data for a cohort of MDD donors with no known history of trauma or PTSD. Our results implicate DNAm as an epigenetic mechanism underlying the molecular changes associated with the subcortical fear circuitry of the PTSD brain.
Reference values for cut-point-free and traditional accelerometer metrics and associations with cardiorespiratory fitness: a cross-sectional study of healthy adults aged 20 to 89 years
Authors: Schwendinger F. , Wagner J. , Knaier R. , Infanger D. , Rowlands A.V. , Hinrichs T. , Schmidt-Trucksäss A. 
Published: April 2023

AbstractObjectivesTo compare the association between cardiorespiratory fitness (CRF) and cut-point-free accelerometer metrics (intensity gradient [IG] and average acceleration [AvAcc]) to that with traditional metrics in healthy adults aged 20 to 89 years and patients with heart failure, and 2) provide age-, sex-, and CRF-related reference values for healthy adults.MethodsIn the COmPLETE study, 463 healthy adults and 67 patients with heart failure wore GENEActiv accelerometers on their non-dominant wrist and underwent cardiopulmonary exercise testing. Cut-point-free (IG: distribution of intensity of activity across the day; AvAcc: proxy of volume of activity) and traditional (moderate-to-vigorous and vigorous activity) metrics were generated. The ‘rawacceleration’ application was developed to translate findings into clinical practice.ResultsIG and AvAcc yield complementary information on PA with both IG (p=0.009) and AvAcc (p<0.001) independently associated with CRF in healthy individuals. Only IG was independently associated with CRF in patients with heart failure (p=0.043). The best cut-point-free and cut-point-based model had similar predictive value for CRF in both cohorts. However, unlike traditional metrics, IG and AvAcc are comparable across populations and the most commonly used accelerometers. We produced age- and sex-specific reference values and percentile curves for IG, AvAcc, moderate-to-vigorous, and vigorous activity for healthy adults.ConclusionsIG and AvAcc are strongly associated with CRF and, thus, indirectly with the risk of non-communicable diseases and mortality in healthy adults and patients with heart failure. Our reference values enhance the utility of cut-point-free metrics and facilitate their interpretation.Trial registrationThis study was registered onclinicaltrials.gov(NCT03986892).What is already known on this topic –Cut-point free accelerometer metrics are valuable to assess physical activity because of their comparability across populations and association with various health parameters (e.g. body fat content or physical functioning). Yet, their interpretation is not straightforward.What this study adds –This study found a strong and independent association of cut-point-free metrics with cardiorespiratory fitness, a vital sign, in healthy individuals aged between 20 to 89 years and patients with heart failure. We produced the first reference values based on healthy individuals across the age span.How this study might affect research, practice or policy –Our reference values together with the new open-source application may simplify the interpretation of cut-point-free accelerometer metrics and their use in clinical practice and research.
Deep Learning for Perfusion Cerebral Blood Flow (CBF) and Volume (CBV) Predictions and Diagnostics
Authors: Talebi Salmonn , Gai Siyu , Sossin Aaron , Zhu Vivian , Tong Elizabeth , Mofrad Mohammad R. K. 
Published: April 2023

AbstractDynamic susceptibility contrast magnetic resonance perfusion (DSC-MRP) is a non-invasive imaging technique for hemodynamic measurements. Various perfusion parameters, such as cerebral blood volume (CBV) and cerebral blood flow (CBF), can be derived from DSC-MRP, hence this non-invasive imaging protocol is widely used clinically for the diagnosis and assessment of intracranial pathologies, including tumor classification, stroke assessment, seizure detection, etc. Currently, most institutions use commercially available software to compute the perfusion parametric maps. Conventionally, the parametric maps are derived by mathematical equations which require the selection of vascular input waveforms. However, these conventional methods often have limitations, such as being time-consuming and sensitive to user input, which can lead to inconsistent results; this highlights the need for a more robust and efficient approach like deep learning. Using relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) perfusion maps generated by an FDA-approved commercial software, we trained a multi-step deep learning (DL) model. The model used each 4D MRP dataset as input, and combined the temporal features extracted from each voxel with spatial information of the brain to predict voxel-wise perfusion parameters. DL-generated rCBV and rCBF maps were evaluated qualitatively and quantitatively. An auxiliary (control) model, with similar architecture, but trained with truncated datasets that had fewer time points, was designed to explore the contribution of temporal features. Our model is based on a multistage encoder-decoder architecture that leverages a 1D convolutional neural network (CNN) as the first encoder to capture temporal information, followed by a 2D U-Net encoder-decoder network to process spatial features. This combination of encoders allows our model to effectively integrate time-varying and spatial data, generating accurate and comprehensive CBV/CBF predictions for the entire brain volume. Our model demonstrates comparable results to that of FDA-approved commercial software.
Quantitative liver health imaging impacts surgical decision making and improves clinical outcomes in colorectal liver metastasis surgery
Authors: Welsh Fenella , Sethi Pulkit , Sundaravadnan Senthil , Cresswell Ben , Connell John , Knapp Sina , Brady J Michael , Banerjee Rajarshi , Rees Myrddin 
Published: April 2023

AbstractIntroductionPost-hepatectomy liver failure (PHLF), driven by insufficient volume and quality of the remnant liver following an operation, is a significant clinical problem that is currently underserved by pre-operative assessment methods. Clinical management and a patient’s recovery from post-operative liver related complications results in a protracted stay in hospital.Methods91 patients with colorectal liver metastasis being considered for liver resection were recruited onto the Precision1 trial. The imaging report from an additional non-quantitative multiparametric MRI (mpMRI) scan was examined and used to alter surgical decision making. Patient outcomes were monitored and evaluated against a standard of care comparator dataset blinded to mpMRI scan results.ResultsPreviously undiagnosed liver disease activity or elevated liver fat was detected using mpMRI in 23% of patients, whereas the liver health was unexpectedly good in 7% of patients; this resulted in a change to surgical plan in 29% of cases. The incidence of protracted (over 14 days) length of stay was reduced from 5% to 1% following the introduction of mpMRI reports into surgical decision-making process.ConclusionmpMRI is a safe method to evaluate liver health in patients being considered for liver resection. Surgical decision making can be altered to achieve a safer treatment strategy resulting in shorter hospital stays for patients.
Traditional Ecological Knowledge and non-food uses of stingless bee honey in Kenya’s last pocket of tropical rainforest
Authors: Héger Madeleine , Noiset Pierre , Nkoba Kiatoko , Vereecken Nicolas J. 
Published: April 2023

AbstractEthnopharmacological relevanceStingless bee honey is a natural remedy and therapeutic agent traditionally used by indigenous communities across the (sub-)Tropics. Despite the potential of forest honey, a prime non-timber forest product (NTFP), to revitalize indigenous foodways and to generate income in rural areas, reports on Traditional Ecological Knowledge involving stingless bees and their honey are lacking in Sub-Saharan Africa.Aim of the study:Our aim was to explore, understand and document the non-food uses of stingless bee honey and associated empirical knowledge in Kenya’s only tropical rainforest at Kakamega.Materials and MethodsWe used ethnographic techniques and methods, including semi-structured questionnaires and recording devices.ResultsPeople in Kakamega were able to discriminate between six different stingless bee species and provided an account on species-specific uses of honeys. Collectively, we identified 26 different uses.ConclusionStingless bee honey is essential in traditional (folk) medicine, but also in the cultural and spiritual life of indigenous communities in Kakamega.