bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ten-year Review of Acute Pediatric Hematogenous Osteomyelitis at a New Zealand Tertiary Referral Center
Authors: Hunter Sarah , Crawford Haemish , Baker Joseph F. 
Published: March 2023

Background:
Acute hematogenous osteomyelitis (AHO) remains a cause of severe illness among children with the possibility of long-term consequences for growth and development. Recent research has highlighted an unusually high burden of disease in the New Zealand population compared with other Western regions. We have sought to identify trends in presentation, diagnosis, and management of AHO, with added focus on ethnicity and access to health care.

Methods:
A 10-year retrospective review of all patients <16 years with presumed AHO presenting to a tertiary referral center between 2008 and 2018 was performed.

Results:
One hundred fifty-one cases met inclusion criteria. The median age was 8 years with a male predominance (69.5%). Staphylococcus aureus was the most common pathogen using traditional laboratory culture method (84%). The number of cases per year decreased from 2008 to 2018. Assessment using New Zealand deprivation scores showed Māori children were most likely to experience socioeconomic hardship (P≤0.01). Median distance traveled by families to first hospital consult was 26 km (range 1 to 178 km). Delayed presentation was associated with need for prolonged antibiotic therapy. Incidence of disease varied by ethnicity with 1:9000 cases per year for New Zealand European, 1:6500 for Pacific, and 1:4000 for Māori. Overall recurrence rate was 11%.

Conclusions:
The incidence of AHO in New Zealand is concerningly high within Māori and Pacific populations. Future health interventions should consider environmental, socioeconomic, and microbiological trends in the burden of disease.

Level of Evidence:
Retrospective study, Level III.
Txnip Gene Knockout Ameliorated High-Fat Diet–Induced Cardiomyopathy Via Regulating Mitochondria Dynamics and Fatty Acid Oxidation
Authors: Li Aiyun , Zhang Yichao , Wang Jin , Zhang Yan , Su Wanzhen , Gao Feng , Jiao Xiangying 
Published: March 2023

Abstract:
Epidemic of obesity accelerates the increase in the number of patients with obesity cardiomyopathy. Thioredoxin interacting protein (TXNIP) has been implicated in the pathogenesis of multiple cardiovascular diseases. However, its specific role in obesity cardiomyopathy is still not well understood. Here, we evaluated the role of TXNIP in obesity-induced cardiomyopathy by feeding wild-type and txnip gene knockout mice with either normal diet or high-fat diet (HFD) for 24 weeks. Our results suggested that TXNIP deficiency improved mitochondrial dysfunction via reversing the shift from mitochondrial fusion to fission in the context of chronic HFD feeding, thus promoting cardiac fatty acid oxidation to alleviate chronic HFD-induced lipid accumulation in the heart, and thereby ameliorating the cardiac function in obese mice. Our work provides a theoretical basis for TXNIP exerting as a potential therapeutic target for the interventions of obesity cardiomyopathy.
Bulging after DIEP Breast Reconstruction: New Insights Concerning Rectus Diastasis and Medial Perforator Harvest
Authors: Nelissen Sophie H. , Krijnen Nienke A. , Tsehaie Jonathan , Schellekens Pascal P.A. , Paes Emma C. , Simmermacher Rogier K.J. , Maarse Wiesje 
Published: March 2023

Background:
The aim of this study was to evaluate the association between flap harvest technique and occurrence of abdominal bulging.

Methods:
A retrospective analysis of 159 patients undergoing DIEP flap breast reconstruction between 2014 and 2021 in the University Medical Center Utrecht was conducted. Outcomes measured were preoperative rectus diastasis, flap weight, laterality of flap harvest (unilateral or bilateral), timing of the harvest (immediate or delayed), number of perforators harvested (single or multiple), and location of the harvested perforator (medial, lateral, or both).

Results:
In 159 patients, 244 DIEP flaps were performed, 16 of these donor-sites (6.6%) developed a clinically evident abdominal bulge. When preoperative rectus abdominis diastasis was found (n = 97), postoperative bulging occurred significantly more often (P < 0.01). Patients in whom the medial perforator artery was harvested for reconstruction (n = 114) showed less abdominal bulging than patients in whom the lateral (n = 92) was harvested (P = 0.02). Using single versus multiple perforators for the DIEP flap, bilateral versus unilateral reconstruction or timing of the operation showed no significant difference in outcome of bulging (P = 1.00, P = 0.78, P = 0.59, respectively).

Conclusions:
The incidence of bulging in our study cohort is comparable to the literature. Harvesting the medial perforator artery for the DIEP flap showed less abdominal bulging than using the lateral perforator artery in a DIEP flap breast reconstruction. Also, preoperative rectus diastasis was found to be an important risk factor for the occurrence of bulging.
A Rare Case of Microblading Complicated by Orbital Exenteration and Frontal Defect Reconstructed Using Crane Principle
Authors: Soltany Amjad , Alajieh MHD Essam , Al Aissami Maen 
Published: March 2023

Summary:
This is a case of a rare complication of microblading in a middle-aged woman in a developing country, resulting in a right orbital exenteration and a forehead defect associated with bone exposure reconstructed using the crane principle. To the best of our knowledge, this case is the first one to report such an entity. We are aiming to highlight the importance of proper hygiene in such cosmetic procedures and to shed light on the crane principle as a suitable reconstructive choice, especially in circumstances where other reconstructive options are not available, or in specific situations like mass causalities when shorter operation time is required.
Seasonal variation in blood pressure control across US health systems
Authors: Nilles Ester Kim , Champon XiaoXia , Mulder Hillary , Shaw Kathryn M. , Smith Myra , Lampron Zachary M. , Wozniak Gregory , Chamberlain Alanna M. , Carton Thomas , Viera Anthony J. , Ahmad Faraz S. , Steinberg Benjamin A. , Chuang Cynthia H. , Mctigue Kathleen M. , McClay James C. , Polonsky Tamar S. , Maeztu Carlos , Sanders Margaret , Warren Nate , Singh Rajbir , Liu Mei , VanWormer Jeffrey J. , Park Soo , Modrow Madelaine Faulkner , Rakotz Michael , Cooper-Dehoff Rhonda M. , Pletcher Mark J. , O’Brien Emily C. 
Published: March 2023

Objective:
We aimed to characterize seasonal variation in US population-based blood pressure (BP) control and BP-related metrics and evaluate the association between outdoor temperature and BP control variation.

Methods:
We queried electronic health records (EHRs) from 26 health systems, representing 21 states, to summarize BP metrics by quarters of 12-month periods from January 2017 to March 2020. Patients with at least one ambulatory visit during the measurement period and a hypertension diagnosis during the first 6 months or prior to the measurement period were included. Changes in BP control, BP improvement, medication intensification, average SBP reduction after medication intensification across quarters and association with outdoor temperature were analyzed using weighted generalized linear models with repeated measures.

Results:
Among 1 818 041 people with hypertension, the majority were more than 65 years of age (52.2%), female (52.1%), white non-Hispanic (69.8%) and had stage 1/2 hypertension (64.8%). Overall, BP control and process metrics were highest in quarters 2 and 3, and lowest in quarters 1 and 4. Quarter 2 had the highest percentage of improved BP (31.95 ± 0.90%) and average SBP reduction after medication intensification (16 ± 0.23 mmHg). Quarter 3 had the highest percentage of BP controlled (62.25 ± 2.55%) and lowest with medication intensification (9.73 ± 0.60%). Results were largely consistent in adjusted models. Average temperature was associated with BP control metrics in unadjusted models, but associations were attenuated following adjustment.

Conclusion:
In this large, national, EHR-based study, BP control and BP-related process metrics improved during spring/summer months, but outdoor temperature was not associated with performance following adjustment for potential confounders.
Prevalence of masked hypertension and its association with left ventricular hypertrophy in children and young adults with chronic kidney disease: a systematic review and meta-analysis
Authors: Goulas Ioannis , Evripidou Kleo , Doundoulakis Ioannis , Kollios Konstantinos , Nika Thomai , Chainoglou Athanasia , Kotsis Vasilios , Stabouli Stella 
Published: March 2023

Objectives:
There are limited studies using ambulatory blood pressure monitoring (ABPM) to assess blood pressure (BP) status in young patients with chronic kidney disease (CKD) on dialysis or after kidney transplantation. The aim of this meta-analysis is to estimate the prevalence of both white-coat hypertension (WCH) and masked hypertension, along with the prevalence of left ventricular hypertrophy (LVH), in children and young adults with CKD on dialysis or after kidney transplantation.

Methods:
We performed a systematic review and meta-analysis of observational studies assessing the prevalence of BP phenotypes using ABPM, in children and young adults with CKD stages 2–5d. Records were identified by search in databases (Medline, Web of Science, CENTRAL) and sources of grey literature, until 31 December 2021. A random-effects meta-analysis of proportions (double arcsine transformation) was conducted.

Results:
Ten studies were included in the systematic review, reporting data from 1140 individuals (children and young adults with CKD with a mean age of 13.79 ± 4.35 years). Masked hypertension and WCH were diagnosed in 301 and 76 patients, respectively. It was estimated an overall pooled masked hypertension prevalence of 27% [95% confidence interval (95% CI) 18–36, I
2 = 87%] and an overall pooled WCH prevalence of 6% (95% CI 3–9, I
2 = 78%). Among kidney transplant recipients, masked hypertension had a prevalence of 29% (95% CI 14–47, I
2 = 86%). The prevalence of LVH was found 28% (95% CI 0.19–0.39) in a total of 238 CKD patients with ambulatory hypertension. In 172 CKD patients with masked hypertension, LVH was present in 49, with the estimated prevalence being 23% (95% CI 0.15–0.32).

Conclusion:
Masked hypertension has a significant prevalence in children and young adults with CKD. Masked hypertension carries an adverse prognosis, with an increased risk of LVH, warranting clinical attention when assessing cardiovascular risk in this population. Therefore, ABPM and echocardiography is of high importance when assessing BP status in children with CKD.

Protocol registration number (DOI):
10.17605/OSF.IO/UKXAF
Retinal vessel caliber and tortuosity and prediction of 5-year incidence of hypertension
Authors: Xue Can C. , Li Cai , Hu Jing F. , Wei Chuan C. , Wang Hua , Ahemaitijiang Kailimujiang , Zhang Qi , Chen Dong N. , Zhang Chun , Li Fan , Zhang Jicong , Jonas Jost B. , Wang Ya X. 
Published: March 2023

Purpose:
With arterial hypertension as a global risk factor for cerebrovascular and cardiovascular diseases, we examined whether retinal blood vessel caliber and tortuosity assessed by a vessel-constraint network model can predict the incidence of hypertension.

Methods:
The community-based prospective study included 9230 individuals who were followed for 5 years. Ocular fundus photographs taken at baseline were analyzed by a vessel-constraint network model.

Results:
Within the 5-year follow-up, 1279 (18.8%) and 474 (7.0%) participants out of 6813 individuals free of hypertension at baseline developed hypertension and severe hypertension, respectively. In multivariable analysis, a higher incidence of hypertension was related to a narrower retinal arteriolar diameter (P < 0.001), wider venular diameter (P = 0.005), and a smaller arteriole-to-venule diameter ratio (P < 0.001) at baseline. Individuals with the 5% narrowest arteriole or the 5% widest venule diameter had a 17.1-fold [95% confidence interval (CI):7.9, 37.2] or 2.3-fold (95% CI: 1.4, 3.7) increased risk for developing hypertension, as compared with those with the 5% widest arteriole or the 5% narrowest venule. The area under the receiver operator characteristic curve for predicting the 5-year incidence of hypertension and severe hypertension was 0.791 (95% CI: 0.778, 0.804) and 0.839 (95% CI: 0.821, 0.856), respectively. Although the venular tortuosity was positively associated with the presence of hypertension at baseline (P = 0.01), neither arteriolar tortuosity nor venular tortuosity was associated with incident hypertension (both P ≥ 0.10).

Conclusion and relevance:
Narrower retinal arterioles and wider venules indicate an increased risk for incident hypertension within 5 years, while tortuous retinal venules are associated with the presence rather than the incidence of hypertension. The automatic assessment of retinal vessel features performed well in identifying individuals at risk of developing hypertension.
Evidence-Based Mind-Body Interventions for Children and Adolescents with Functional Neurological Disorder
Authors: Kozlowska Kasia , Chudleigh Catherine , Savage Blanche , Hawkes Clare , Scher Stephen , Nunn Kenneth P. 
Published: March 2023

Learning objectives• Develop and implement treatment plans for children and adolescents with functional neurological disorder (FND)• Outline a plan to increase awareness and standardize the care for patients with FND using evidence-based interventionsAbstractFunctional neurological disorder (FND) in children and adolescents involves the biological embedding of lived experience in the body and brain. This embedding culminates in stress-system activation or dysregulation and in aberrant changes in neural network function. In pediatric neurology clinics, FND represents up to one-fifth of patients. Current research shows good outcomes with prompt diagnosis and treatment using a biopsychosocial, stepped-care approach. At present, however—and worldwide—FND services are scarce, the result of long-standing stigma and ingrained belief that patients with FND do not suffer from a real (“organic”) disorder and that they therefore do not require, or even deserve, treatment. Since 1994, the Mind-Body Program for children and adolescents with FND at The Children’s Hospital at Westmead in Sydney, Australia—run by a consultation-liaison team—has deliveredinpatientcare to hundreds of patients with FND andoutpatientcare to hundreds of others. For less-disabled patients, the program enables community-based clinicians to implement biopsychosocial interventions locally by providing a positive diagnosis (by a neurologist or pediatrician), a biopsychosocial assessment and formulation (by clinicians from the consultation-liaison team), a physical therapy assessment, and clinical support (from the consultation-liaison team and the physiotherapist). In this Perspective we describe the elements of a biopsychosocial mind-body program intervention capable of providing, as needed, effective treatment to children and adolescents with FND. Our aim is to communicate to clinicians and institutions around the world what is needed to establish effective community treatment programs, as well as hospital inpatient and outpatient interventions, in their own health care settings.
Group Differences in Postconcussion Cognitive, Physical, Sleep-Arousal, and Affective Symptom Subscales in High School and Collegiate Athletes by Race, Gender, and Competitive Level
Authors: Wallace Jessica , Karr Justin E. , Yengo-Kahn Aaron , Loftin Megan , Anand Malini , Hibbler Tamaria , Brewer Claire , Covassin Tracey 
Published: March 2023

Objective:
Prior psychometric research has identified symptom subscales for the Post-Concussion Symptom Scale (PCSS) based on confirmatory factor analysis (CFA), including cognitive, physical, sleep-arousal, and affective symptom factors. Study objectives included: (1) replicate the 4-factor PCSS model in a diverse sample of athletes with concussion, (2) test the model for invariance across race, gender, and competitive level, and (3) compare symptom subscale and total symptom scores across concussed groups with established invariance.

Setting:
Three regional concussion care centers.

Participants:
A total of 400 athletes who completed the PCSS within 21 days of concussion (64% boys/men, 35% Black, and 69.5% collegiate athletes).

Design:
Cross-sectional.

Main Measures:
A CFA tested the 4-factor model and measurement invariance testing was performed across racial, competitive level, and gender groups. Symptom subscales and total symptom severity scores were compared based on demographic groupings with established invariance.

Results:
The 4-factor model fit well and strong invariance was established across all demographic categories, indicating symptom subscales could be meaningfully compared across groups. Black and White athletes differed on total symptoms (U = 15 714.5, P = .021, r = 0.12), sleep-arousal symptoms (U = 15 953.5, P = .026, r = 0.11), and physical symptoms (U = 16 140, P = .051, r = 0.10), with Black athletes reporting slightly more symptoms. Collegiate athletes reported greater total symptom severity (U = 10 748.5, P < .001, r = 0.30), with greater symptom reporting on the cognitive (U = 12 985, P < .001, r = 0.21), sleep-arousal (U = 12 594, P < .001, r = 0.22), physical (U = 10 959, P < .001, r = 0.29), and emotional (U = 14 727.5, P = .005, r = 0.14) symptom subscales. There were no significant differences by gender in the total symptom score or subscale scores. After controlling for time since injury, no racial differences persisted, but a significant difference by competitive level in physical symptom reporting (F = 7.39, P = .00, η2 = 0.02) and total symptom reporting (F = 9.16, P = .003, η2 = 0.02) remained.

Conclusion:
These results provide external validation for the PCSS 4-factor model and demonstrate that symptom subscale measurements are comparable across race, genders, and competitive levels. These findings support the continued use of the PCSS and 4-factor model for assessing a diverse population of concussed athletes.
OCT to identify macular changes not clinically detectable in elderly patients with cataract
Authors: dos Santos Bruno Boalento , Ribeiro Junior Maurélio de Lima Batista , Garcia Nathalia Perussi , Colombo Barboza Guilherme Novoa , Colombo Barboza Marcello Novoa 
Published: March 2023

Purpose:
To demonstrate the importance of optical coherence tomography (OCT) in identifying macular changes not detected at clinical examination preceding cataract surgery in patients older than 60 years.

Setting:
Hospital Oftalmológico Visão Laser, Santos, São Paulo, Brazil.

Desing:
Prospective case series.

Methods:
Patients older than 60 years were selected for this cross-sectional prospective study conducted during preoperative examination for cataract surgery. Eyes with a previous diagnosis or clinical evidence of macular disease or with media opacity preventing OCT from being performed were excluded from the study. All the study participants underwent OCT and were then divided into 2 groups: patients with macular changes and patients without macular changes found on OCT.

Results:
Of 364 eyes screened (212 patients), 300 eyes (180 patients) were included in the study. OCT identified macular changes in 40 eyes (13.3%), with age-related macular degeneration being found in 13 eyes (4.3%), epiretinal membrane in 12 eyes (4%), intraretinal fluid in 12 eyes (4%), and macular hole in 3 eyes (1%). In the group with macular changes, the mean age was 74.4 ± 6.3 years compared with 70.4 ± 6.7 years for those without changes (P < .001).

Conclusions:
OCT proved an effective method for identifying macular diseases not detected at clinical evaluation before cataract surgery. Therefore, the relevance of performing OCT in these cases was confirmed and should be taken into consideration, particularly when evaluating patients older than 60 years.
Two independent variants causing neurofibromatosis type 1 in one Chinese family
Authors: Wang Yu-Meng , Cao Qiao-Yu , Zhang Jia , Pan Chao-Lan , Wang Xiao-Xiao , Li Ming 
Published: March 2023

Objective:
Neurofibromatosis type 1, resulting from NF1 mutation, is estimated to affect one in 3000 people worldwide. NF1 is a pathogenic gene with one of the highest mutation rates in humans. This study was aimed to report a case in which members of a Chinese family had two distinct NF1 variants.

Methods:
DNA was isolated from the peripheral blood of the proband and his wife and affected son. Whole-exome sequencing was performed on the proband, while next-generation sequencing was used to detect NF1 and other related genes in his wife and son. Sanger sequencing was conducted to confirm the variants.

Results:
An unreported variant c.6143T>G and a recurrent variant c.1063-2A>G of NF1 were identified in the proband and his affected son, respectively. The latter variant was not found in the peripheral blood lymphocytes of the proband and his wife. Paternity testing confirmed their parent-child relationship. We summarized the findings of similar reported cases.

Conclusion:
Our study described a rare phenomenon in which one Chinese family had independent NF1 variants. The findings indicate that clinicians need to sequence the whole NF1 gene of all family members rather than merely verifying the suspect variant detected in the proband.
Efficacy of microneedling with injectable platelet-rich fibrin (i-PRF) for facial skin rejuvenation
Authors: Vesala Anna-Maria , Nacopoulos Cleopatra , Karypidis Dimitrios , Ruga Emanuele 
Published: March 2023

Objective:
Autologous blood concentrates have been used in the field of aesthetics for more than two decades. Injectable platelet-rich fibrin (i-PRF) remains more advantageous than other concentrates because it can both initiate fibrin clotting and preserve the secretion of growth factors to promote tissue repair. This study was performed to assess the effectiveness of microneedling therapy with i-PRF for facial skin revitalization using validated patient-reported outcome measures.

Methods:
Twelve patients with facial wrinkles were enrolled in the study. Their ages ranged from 26 to 71 years. Three i-PRF therapy sessions were offered at 4-week intervals. The patients’ photographs were taken at all sessions without exception and throughout the treatment course. The results were clinically evaluated after the final stage of therapy. All 12 patients’ data were statistically analyzed.

Results:
Three i-PRF sessions resulted in moderate improvement in the patients’ skin texture, color, and elasticity as well as filling of soft wrinkles. Statistically significant improvement was found in both skin elasticity (P = 0.02) and filling of soft wrinkles (P = 0.001). No complications occurred in any of the three treatment sessions, and the treatments were well tolerated by all patients.

Conclusions:
The literature indicates that i-PRF has been a favorable substitute for platelet-rich plasma in all settings in which it has been used. Nevertheless, further trials involving large numbers of patients are required to verify the promising results of i-PRF in the field of dermatology.