bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of Trachomatous Trichiasis Case-identification Approaches in Ethiopia
Authors: Diallo Alpha Oumar , Bayissasse Belay , Sisay Alemayehu , Seyum Dawit , Weaver Jerusha , Munoz Beatriz , Merbs Shannath L. , Gower Emily W. 
Published: September 2023

Background:
Trachoma control programs use multiple approaches to identify individuals with trachomatous trichiasis (TT). Evidence is limited regarding which approaches are most effective and cost-efficient.

Methods:
We evaluated the effectiveness of two TT case-identification approaches in Ethiopia: community mobilization to encourage self-referral for centralized screening and house-to-house screenings conducted by case finders. We compared the number of true cases found per 1000 population and costs associated with case identification under each approach, stratified by villages that received one or multiple screening visits.

Results:
We conducted screenings in 396 villages. In villages receiving one house-to-house visit, case finders identified 14,229 suspected cases, of whom 10,513 (73.9%) presented for TT confirmation. A median of 17.2% (interquartile range [IQR]: 9.1%–27.8%) of those presenting truly had TT (positive predictive value). In single-visit villages, the community mobilization approach yielded higher rates of confirmed cases than the house-to-house approach (1.5 [IQR: 1.1, 2.6] vs. 1.1 [IQR: 0.5, 1.9] cases per 1000 population), and the median cost of identifying a TT case was less ($5.59 vs. $31.18) using community mobilization than house-to-house. In multiple-visit villages, additional screening visits increased the median rate of confirmed cases to 2.5 per 1000 population in community mobilization villages, but the rate remained unchanged in house-to-house villages.

Conclusions:
Community mobilization-based TT case finding had a higher yield than house-to-house, at a substantially lower cost. Future research should examine whether additional tools to aid case finders in their diagnosis increases case-finding efficiency and accuracy and whether TT prevalence and surgical program duration impact case-finding success.
High Summer Temperatures and Heat Stroke Mortality in Spain
Authors: Tobías Aurelio , Madaniyazi Lina , Gasparrini Antonio , Armstrong Ben 
Published: September 2023

Background:
Heat stroke is a significant cause of mortality in response to high summer temperatures. There is limited evidence on the pattern and magnitude of the association between temperature and heat stroke mortality. We examined this association in Spain, using data from a 27-year follow-up period.

Methods:
We used a space-time-stratified case–crossover design. We analyzed data using conditional quasi-Poisson regression with distributed lag nonlinear models.

Results:
Spain recorded a total of 285 heat stroke deaths between 1990 and 2016. Heat stroke deaths occurred in 6% of the days in the summer months. The mean temperature was, on average, 5 °C higher on days when a heat stroke was recorded than on days without heat stroke deaths. The overall relative risk was 1.74 (95% confidence interval = 1.54, 1.96) for a 1 °C rise in mean temperature above the threshold of 16 °C, at which a heat stroke death was first recorded. We observed lagged effects as long as 10 days.

Conclusions:
Although heat stroke represents a small fraction of total heat-attributable mortality during the summer, it is strongly associated with high temperatures, providing an immediately visible warning of heat-related risk.
Nonselective beta-blockers may lead to stage 2 acute kidney injury and waitlist mortality in child class C cirrhosis
Authors: Lai Mason , Fenton Cynthia , Ge Jin , Rubin Jessica , Lai Jennifer C. , Cullaro Giuseppe 
Published: September 2023

Background and Aims:
Nonselective beta-blockers (NSBB) protect patients with compensated cirrhosis; however, it is unclear if NSBB is associated with acute kidney injury (AKI) in patients with decompensated cirrhosis. We aimed to determine if the use of NSBB was associated with an increased risk of stage II AKI or greater and waitlist mortality (WLM) among patients with decompensated cirrhosis awaiting liver transplant stratified by cirrhosis severity.

Methods:
Included were 1816 outpatients listed for liver transplantation at UCSF from June 2012 to April 2022. Our primary outcome was stage 2 AKI (>200% increase in serum creatinine). Our secondary outcome was WLM (all-cause mortality). Our primary exposure was the use of any NSBB derived using natural language processing of clinical notes. Multivariable Cox proportional hazards models with time-dependent variables were used to determine the HR of NSBB use on stage 2 AKI and WLM, stratified by Child-Pugh Score.

Results:
The average age of the cohort was 58 years old, with 35% identifying as female. In multivariable time-dependent models, NSBB use was associated with 1.53 × (95 CI 1.19–1.97) the hazard of stage 2 AKI in the cohort overall and 1.80 × (95 CI 1.26–2.57) among those with Child C cirrhosis, respectively. Similarly, NSBB use was associated with 1.30 × (95 CI 1.07–1.59) and 1.45 × (95 CI 1.03–2.03) the hazard of WLM, overall and in Child C, respectively. NSBB use was not significantly associated with AKI nor WLM among those with Child A.

Conclusion:
NSBB use is associated with Stage 2 AKI and WLM in patients awaiting liver transplantation and Child C cirrhosis. These data suggest cautious use of NSBBs in patients in this population.
Time trends in mortality and life expectancy in 22,658 patients hospitalized with alcohol-associated cirrhosis: A nationwide cohort study
Authors: Wester Axel , Shang Ying , Stål Per , Hagström Hannes 
Published: September 2023

Background:
The management of alcohol-associated cirrhosis has improved in the last decades, but whether the prognosis has changed over time is uncertain. We aimed to assess time trends in mortality and life expectancy in patients hospitalized with alcohol-associated cirrhosis.

Methods:
In this population-based cohort study, we used the Swedish national population and health registers to identify all patients with a first episode of in-hospital alcohol-associated cirrhosis from 1969 to 2019 (n = 22,658). Time trends in 1-year mortality were assessed with multivariable Cox regression. A flexible parametric model was fitted to evaluate loss in life expectancy.

Results:
Crude mortality was similar in the 2010s and 1980s (unadjusted HR = 1.00, 95% CI = 0.93–1.08, ptrend = 0.767). However, when adjusting for baseline characteristics, mortality was lower in the 2010s than in the 1980s (adjusted HR = 0.74, 95% CI = 0.68–0.80), including both liver- and nonliver-related mortalities. These results were consistent in men but not in women, where only nonliver mortality had decreased. The average loss in life expectancy for patients with alcohol-associated cirrhosis compared with the general population was similar throughout the study period (in the 2010s: 14.3 y shorter (95% CI = 13.7–14.9) in men and 15.8 years shorter (95% CI = 14.9–16.7) in women).

Conclusion:
Mortality in patients hospitalized with alcohol-associated cirrhosis has improved somewhat when accounting for baseline characteristics, but the loss in life expectancy remains substantial. This underscores the need for new therapeutic options and health policy interventions to further improve the dismal prognosis and life expectancy of patients with alcohol-associated cirrhosis.
Characterization of Rheum palmatum mitochondrial genome and comparative analysis among Caryophyllales species
Authors: Gao Longlong , Hao Lijun , Xu Wenjie , Xin Tianyi , Song Chi , Lin Yulin , Zhu Lingping , Song Jingyuan 
Published: September 2023

Objective:
This work aimed to report the first complete mitochondrial genome (mitogenome) of Rheum palmatum, summarize the features of Caryophyllales mitogenomes, and to reveal the potential of utilizing the mitogenomes of R. palmatum and other Caryophyllales species for inferring phylogenetic relationships and species identification.

Methods:
Both Illumina short reads and PacBio HiFi reads were utilized to obtain a complete mitogenome of R. palmatum. A variety of bioinformatics tools were employed to characterize the R. palmatum mitogenome, compare the reported mitogenomes in Caryophyllales and conduct phylogenetic analysis.

Results:
The mitogenome of R. palmatum was assembled into a single master circle of 302,993 bp, encoding 35 known protein-coding genes, 18 transfer RNA genes, and three ribosome RNA genes. A total of 249 long repeats and 49 simple sequence repeats were identified in this mitogenome. The sizes of mitogenomes in Caryophyllales varied from 253 kb to 11.3 Mb. Among them, 23 mitogenomes were circular molecules, one was linear, and one consisted of relaxed circles, linear molecules, and supercoiled DNA. Out of the total mitogenomes, 11 were single-chromosome structure, whereas the remaining 14 were multi-chromosomal organizations. The phylogenetic analysis is consistent with both the Engler system (1964) and the Angiosperm Phylogeny Group III system.

Conclusions:
We obtained the first mitogenome of R. palmatum, which consists of a master circle. Mitogenomes in Caryophyllales have variable genome sizes and structures even within the same species. Circular molecules are still the dominant pattern in Caryophyllales. Single-chromosome mitogenomes account for nearly a half of all the mitogenomes in Caryophyllales, in contrast to previous studies. It is feasible to utilize mitochondrial genomes for inferring phylogenetic relationships and conducting species identification.
From drusen to type 3 macular neovascularization
Authors: Bousquet Elodie , Santina Ahmad , Corradetti Giulia , Sacconi Riccardo , Ramtohul Prithvi , Bijon Jacques , Somisetty Swathi , Voichanski Shilo , Querques Giuseppe , Sadda SriniVas , Freund K. Bailey , Sarraf David 
Published: September 2023

Abstract

Purpose:
To investigate the imaging features preceding the occurrence of type 3 (T3) macular neovascularization (MNV) using tracked spectral-domain optical coherence tomography (SD-OCT).

Method:
From a cohort of eyes with T3 MNV and ≥ 12 months of prior tracked SD-OCT, T3 lesions that developed above soft drusen were selected for OCT analysis. Retinal imaging findings at the location where type T3 MNV occurred were analyzed at each follow-up until the onset of T3 MNV. The following OCT parameters were assessed: drusen size (height and width), outer nuclear layer (ONL)/ Henle fiber layer (HFL) thickness at the drusen apex, and the presence of intraretinal hyperreflective foci (HRF), retinal pigment epithelium (RPE) disruption, incomplete RPE and outer retina atrophy (iRORA), and complete RORA (cRORA).

Results:
From a cohort of 31 eyes with T3 MNV, T3 lesions developed above soft drusen in 20 eyes (64.5%). Drusen showed progressive growth (p<0.001) associated with ONL/HFL (p<0.001) thinning prior to T3 MNV. The following OCT features were identified preceding the occurrence of T3 MNV, typically at the apex of the drusenoid lesion: disruption of the external limiting membrane (ELM)/ellipsoid zone (EZ) and/or the RPE, HRF, and iRORA/cRORA.

Conclusion:
Our results demonstrate specific anatomic alterations preceding the occurrence of T3 MNV that most commonly originates above soft drusen. Drusen growth, reduced ONL/HFL thickness, and RPE atrophy at the drusen apex precede the development of T3 MNV. Identifying these OCT features should warrant close monitoring for identification of T3 MNV which can benefit from prompt intravitreal anti-VEGF therapy.
A CASE OF ELSCHNIG SPOTS OBSERVED USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AFTER STENTING FOR INTERNAL CAROTID ARTERY DISSECTION
Authors: Saito Kazuma , Uchida Yuto , Tokui Shunsuke , Akiyama Hideo 
Published: September 2023

Purpose:
We report the case of a 28-year-old man who developed Elschnig spots after stenting for an internal carotid artery dissection using optical coherence tomography angiography.

Methods:
This was a case report.

Results:
The patient developed a visual field defect in the left eye immediately after endovascular stenting for left internal carotid artery dissection. Fundus examination revealed white lesions and numerous mottled orange–red lesions in the posterior pole and midperiphery of the left eye. Indocyanine green angiography revealed mottled hypofluorescein areas in the early and late stages, coinciding with the orange–red lesions. Optical coherence tomography angiography showed flow void areas in the choriocapillaris layer, consistent with the orange–red lesions, which were diagnosed as Elschnig spots associated with choroidal circulatory failure. The spots disappeared approximately 2 months after surgery, and the flow void on optical coherence tomography angiography also disappeared.

Conclusion:
We report a case of Elschnig spots associated with transient choroidal circulatory failure after stenting for internal carotid artery dissection. Optical coherence tomography angiography detected improved circulation at the level of the choriocapillaris with the disappearance of Elschnig spots.
PROGRESSION OF CHOROIDAL THICKNESS ON ENHANCED DEPTH IMAGING-OPTICAL COHERENCE TOMOGRAPHY AS THE FIRST SIGN OF ORBITAL LYMPHOMA
Authors: Vela José Ignacio , Giró-Rosa Marta , García-Vilaró Marta , Loscos-Giménez Irene , Rego-Lorca Daniela , Schwember Philipp 
Published: September 2023

Purpose:
To present an orbital extranodal marginal zone B-cell lymphoma (mucosa-associated lymphoid tissue lymphoma) with increased choroidal thickness as the first diagnostic sign.

Methods:
A patient presented with mild blurred vision in the left eye. Progressively increased choroidal thickness was demonstrated by enhanced depth imaging–optical coherence tomography and ocular ultrasound-confirmed diffuse choroidal effusion. Orbital MRI revealed a well-circumscribed intraconal orbital mass surrounding the optic nerve and molding around the globe. An orbital biopsy of the lesion with subsequent histologic and immunohistochemical analyses demonstrated mucosa-associated lymphoid tissue lymphoma.

Results:
After initial treatment with rituximab without improvement, the patient received orbital radiotherapy (36 Gy in 20 sessions). A reduction in choroidal thickness was observed during follow-up visits. Congestion of the choroidal vasculature and choroidal infiltration by the lymphoma are discussed as possible causative mechanisms.

Conclusion:
Enhanced depth imaging–optical coherence tomography can be a helpful tool to detect the presence of orbital lymphoid tumors in contact with the globe and to monitor response to therapy.
Occupational Pregnancy Discrimination Is Associated With Negative Health Impacts for Pregnant Persons and Their Children
Authors: Borrowman Jaclyn Dziewior , Krumboltz Raegan , Jones Melissa , Whitaker Kara M. 
Published: September 2023

Objective
The aim of the study is to examine associations between occupational pregnancy discrimination, maternal, and child health.

Methods
A nationwide sample of individuals currently in their third trimester of pregnancy who worked full-time (>35 hr/wk) were recruited. Surveys were completed during the third trimester and 6 weeks postpartum.

Results
Respondents (N = 183) were mostly White (57.9%), had at least a bachelor’s degree (60.8%), and worked 40.3 hr/wk. Occupational pregnancy discrimination increased the odds of clinically significant depressive/anxiety symptoms by 8% and 17%, respectively (odds ratio = 1.1, 95% confidence interval: 1.0–1.1; odds ratio = 1.2, 95% confidence interval: 1.1–1.2). Discrimination was also associated with postpartum depression occurrence (P = 0.02). Social support level mitigated the association between pregnancy discrimination, depressive symptoms (β = 2.1, P < 0.01), and anxiety symptoms (β = 7.25, P < 0.01).

Conclusions
Poorer mental health during and after pregnancy was associated with occupational pregnancy discrimination but effects were mitigated by social support.
Neurosurgical application of pineal region tumor resection with 3D 4K exoscopy via infratentorial approach: a retrospective cohort study
Authors: Hua Wei , Zhang Xin , Wang Qijun , Qiu Tianming , Yang Zixiao , Wang Xiaowen , Xu Hao , Zhang Jinsen , Yu Guo , Fu Minjie , Chen Liang , Zhu Wei , Mao Ying 
Published: September 2023

Background:
The pineal region tumors are challenging for neurosurgeons and can lead to secondary hydrocephalus. The advent of the exoscope has provided clinical interventions with high image quality and an ergonomic system for pineal region tumor operations. In this study, we describe the exoscopic approach used to facilitate the surgical resection of pineal region tumors and relieve hydrocephalus.

Materials and Methods:
In this retrospective cohort study, we consecutively reviewed clinical and radiological data of 25 patients with pineal region lesions who underwent three-dimensional exoscopic tumor resection at a single center.

Results:
The patient cohort consisted of 16 males and 9 females, with an average age of 34.6 years (range, 6-62 years; 8 cases aged ≤18). Pathological examination confirmed eight pineal gland tumors, four gliomas, nine germ cell neoplasms, two ependymomas, and two metastatic tumors. Preoperative hydrocephalus was present in 23 patients. Prior to tumor resection, external ventricular drainage (EVD) with Ommaya reservoir implantation was performed in 17 patients. Two patients received preoperative endoscopic third ventriculostomy (ETV), and five patients received a ventriculoperitoneal (VP) shunt, including one who received both procedures. Gross total resection was achieved in 19 patients (76%) in the “head-up” park bench position using the exoscope. Eight patients (31.6%) with third ventricle invasion received subtotal resection, mainly in glioma cases, which was higher than those without invasion (0%), but not statistically significant (P=0.278, Fisher’s exact test). No new neurological dysfunction was observed after surgery. Two patients (8%) developed intracranial and pulmonary infections, and two patients (8%) suffered from pneumothorax. Hydrocephalus was significantly relieved in all patients postoperatively, and four patients with relapse hydrocephalus were cured during the long-term follow-up. Postoperative adjuvant management was recommended for indicated patients, and a mean follow-up of 24.8±14.3 months showed a satisfied outcome.

Conclusion:
The exoscope is a useful tool for pineal region tumor resection and hydrocephalus relief, particularly with posterior third ventricle invasion, as total resection could be achieved without obvious complication. The special superiority of exoscope for indicated pineal region tumors should be highlighted.
Venous thromboembolism prophylaxis practices for patients with sickle cell disease prior to and during the COVID-19 pandemic
Authors: Davila Jennifer , Mitchell William B. , Morrone Kerry , Silver Ellen J. , Minniti Caterina P. , Billett Henny H. , Desai Payal C. , O’Brien Sarah H. , Manwani Deepa 
Published: September 2023

Patients with sickle cell disease (SCD) are predisposed to a hypercoagulable state due to alterations in the coagulation system. Despite concern for the development of venous thromboembolism (VTE) in this population, there are no standardized guidelines for routine thromboprophylaxis.
The objective of this study was to assess thromboprophylaxis practices of adult and pediatric treaters of SCD before and during the coronavirus disease of 2019 (COVID-19) pandemic.
A cross-sectional electronic survey was distributed to pediatric and adult hematology oncology practitioners through seven SCD-specific interest groups between May 29, 2020, and July 13, 2020.
Of 93 total responses, 14% (N = 13) reported they only treat patients more than 21 years old; 38.7% (N = 36) only treat patients 0–21 years old and 47.3% (N = 44) reported they treat both. Our study showed that before the COVID-19 pandemic, 96% of adult practitioners would recommend pharmacologic thromboprophylaxis, mechanical thromboprophylaxis or both for hospitalized adults with thromboprophylaxis, but only 76% of pediatric treaters would recommend any thromboprophylaxis in hospitalized children (P < 0.0001), with 24% of pediatric treaters choosing no thromboprophylaxis at all.
During the COVID-19 pandemic, pharmacologic thromboprophylaxis specifically was recommended for adults by 94% of treaters and for pediatric patients by 76% of treaters. These findings suggest that despite the lack of evidence-based thromboprophylaxis guidelines in adults and children with thromboprophylaxis, subspecialty treaters routinely provide pharmacologic thromboprophylaxis in their adult patients and will modify their practice in pediatric patients who are considered at a high risk for VTE.
The clinical implications of choroidal thickness combined with tear VEGFA in coronary artery disease
Authors: Zhou Tingquan , Wan Ting , Jin Xian , Chen Yu , Shen Chengxing 
Published: September 2023

Objective
The purpose of this study was to evaluate the effect of choroidal thickness and tear vascular endothelial growth factor A (VEGFA) as biomarkers of coronary artery disease (CAD).

Methods
This study was a retrospective observational case–control trial. A total of 637 patients who underwent coronary angiography to assess their coronary artery status were included. The patients were divided into two groups: 200 people in the No CAD group and 437 people in the CAD group. We evaluated the choroidal thickness of the right foveal membrane in all patients through optical coherence tomography angiography examination. We also collected tear samples from patients to measure VEGFA. The ROC curve and its area under the curve (AUC) were used for analysis.

Results
The central foveal choroid in the No CAD group was significantly thicker than that in the CAD group (289.09 μm ± 38.41; 229.03 μm ± 33.44, P < 0.01). The tear VEGFA in the CAD group was higher than that in the No CAD group (706.15 ng/mL ± 147.42; 419.66 ng/mL ± 105.85, P < 0.01). Spearman analysis showed that the correlation between choroidal thickness and Gensini score was –0.7387 (P < 0.01). The correlation between tear VEGFA level and Gensini score was 0.8636 (P < 0.01). Taking choroidal thickness and tear VEGFA as independent variables, we obtained AUC = 0.9647 (95% CI 0.9506–0.9789, P < 0.01) through binary logic regression and ROC curve analysis.

Conclusion
The combination of choroidal thickness and tear VEGFA in patients can serve as a clinical marker of CAD and its severity.
Immediate versus MOdified DElayed coloanal anastomosis after total mesorectal excision: A protocol for a randomized controlled trial
Authors: Bendib Hani , Anou Abdelkrim , Djelali Nabil , Oukrine Hind , Alikhodja Hassan , Azzouz Abdelghani , Djennaoui Azeddine , Chekman Chemseddine 
Published: September 2023

Background:
Immediate coloanal anastomosis (ICA) remains the standard technique for restoring the digestive tract after proctectomy for low rectal cancer. Often, it requires a temporary diversion stoma, thus increasing the risk of complications. Recent data have shown a great potential of the delayed coloanal anastomosis both in decreasing anastomosis morbidity and in avoiding ileostomy to the patients. More recently, a modified delayed coloanal anastomosis (mDCA) has been described and seems to have promising results. This study aims to determine whether mDCA is non-inferior to ICA.

Methods:
The IMODE trial is a randomized, controlled, non-inferiority trial designed to enroll 70 adults with mid or low rectal cancer. Participants are randomized to ICA or mDCA. The primary endpoint is the anastomotic fistulas rate at 6 months.

Conclusions:
The mDCA can constitute an interesting modality to restore the digestive tract following proctectomy for mid and low rectal cancer; this by decreasing the morbidity of the coloanal anastomosis on the one hand and by avoiding ileostomy on the other hand.