bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of rehabilitation initiated in the early phase after simultaneous deceased donor liver and kidney transplantation: A case report
Authors: Tanaka Shinya , Mizuno Yota , Nojiri Shusuke , Futamura Daiki , Nagaya Motoki , Nishida Yoshihiro , Sano Yuta , Ishida Shohei , Kato Masashi , Kurata Nobuhiko , Jobara Kanta , Fujimoto Yasuhiro , Ogura Yasuhiro 
Published: September 2023

Rationale:
The purpose of this case report is to describe a case of successful early rehabilitation intervention for simultaneous liver and kidney transplantation (SLKT).

Patient concerns:
A 51-year-old Japanese man was diagnosed with Caroli disease 27 years ago. Hemodialysis was introduced due to end-stage renal disease 17 years ago.

Diagnoses:
After successful SLKT, the patient was extubated on postoperative day (POD) 1, liberated from dialysis on POD 4, and discharged from the intensive care unit on POD 9.

Interventions:
Supervised rehabilitation was started on POD 2, and the patient was able to walk 100 m on POD 9. Electrical muscle stimulation therapy was started to improve muscle weakness in both legs on POD 16, and aerobic exercise using a cycle-ergometer was started on POD 24.

Outcomes:
The 6-minute walking distance improved from 324 m on POD 14 to 501 m on POD 28. The patient could walk 4000 to 5000 steps per day at hospital discharge, and was discharged home on POD 32. There were no adverse events, including worsening hepatic or renal function, during the rehabilitation period. One month after discharge, the patient was able to perform 30 to 40 minutes of aerobic exercise every day, and returned to work 5 months after discharge.

Lessons:
This case shows that early rehabilitation intervention immediately after SLKT safely and rapidly improved physical performance without adverse events. The results in the present case suggest that regular physical assessment and appropriate interventions with a variety of exercise modalities can contribute to improved physical performance in SLKT patients.
Diagnostic challenges in tuberculous meningitis: a case report with negative genexpert result
Authors: Ghimire Bardan , Thapaliya Ishwor , Yadav Jeshika , Bhandari Sujata , Paudyal Man B. , Mehta Neha , Bhandari Sagar , Adhikari Yagya R. , Sapkota Sanjaya , Bhattarai Madhur 
Published: September 2023

Introduction:Tuberculous meningitis (TBM) is a severe form of tuberculosis affecting the meninges, primarily caused byMycobacterium tuberculosis. Diagnosis of TBM poses numerous challenges due to its nonspecific clinical presentation and the limitations of diagnostic tests like GeneXpert.Case presentation:The authors report a case of a 22-year-old female from Eastern Nepal presenting with acute-onset fever, headache, vomiting, and neck pain. Cerebrospinal fluid (CSF) analysis showed lymphocytic pleocytosis, elevated protein, low glucose levels, and cobweb coagulum indicative of TBM. However, the GeneXpert test revealed negative results.Discussion:In resource-limited settings like Nepal, where access to GeneXpert MTB/Rif is limited, CSF analysis and clinical algorithms play a crucial role in diagnosing TBM. Relying solely on GeneXpert results may lead to false negatives, so a high level of suspicion based on patient risk factors is essential. Prompt initiation of empirical antitubercular therapy is vital for a favorable outcome in TBM cases.Conclusion:Negative MTB PCR results from CSF can be misleading in diagnosis of tubercular meningitis. Therefore, comprehensive evaluations, including detailed patient history, physical examination, and CSF fluid analysis, are crucial in high tuberculous prevalence countries to ensure accurate and timely diagnosis.
Risk Factors for Primary Angle-closure Glaucoma: A Systematic Review and Meta-analysis of 45 Studies
Authors: Wang Ying , Dong Xing-Xuan , Hou Xiao-Wen , Pan Chen-Wei 
Published: September 2023

ABSTRACT

SIGNIFICANCE
This study summarized primary angle-closure glaucoma (PACG)–related factors across different dimensions.

OBJECTIVES
This review aimed at systematically summarizing the associated factors of PACG in published literatures.

METHODS
A systematic review and meta-analysis were conducted by searching the electronic databases including PubMed, EMBASE, and Web of Science from their inception to November 2021. The pooled risk estimates of continuous and categorical variables were calculated using weighted mean difference (WMD) and odds ratio (OR; 95% confidence intervals [CIs]), respectively.

RESULTS
We included 45 studies in this review. In the meta-analysis, intraocular pressure (WMD, 3.13; 95% CI, 2.37 to 3.89), anterior chamber depth (WMD, −0.52; 95% CI, −0.70 to −0.34), axial length (WMD, −0.77; 95% CI, −1.26 to −0.28), retinal nerve fiber layer (WMD, −21.23; 95% CI, −30.21 to −12.25), and spherical equivalent (WMD, 1.02; 95% CI, 0.66 to 1.38) were the most common ophthalmic anatomic factors, and lower body weight (WMD, −3.65; 95% CI, −6.48 to −0.82) was the most significant general morphological indicators. The presence of cataract (OR, 3.77; 95% CI, 3.46 to 4.11) and hyperlipidemia (OR, 1.10; 95% CI, 1.02 to 1.20) were significantly associated with PACG. Increased level of triglyceride (WMD, 0.17; 95% CI, 0.06 to 0.27) was associated with PACG. In addition, an association between short-term antidepressant exposure (OR, 1.36; 95% CI, 1.08 to 1.70) and acute angle-closure glaucoma was observed.

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS
This review identified a few consistent factors related to PACG, providing important information for primary care physicians, general ophthalmologists, and public health professionals to counsel their patients on PACG risks.
Financial Inequities in Optometric Education in Canada: A Comparison of Two Optometry Programs
Authors: Bitton Etty , Jones Deborah , Wittich Walter 
Published: September 2023

ABSTRACT

SIGNIFICANCE
The advancing age of the population will require increased access to eye care services to manage eye diseases and vision correction. Optometric education requires a sound financial plan to manage student debt. This study evaluates the financial inequalities of optometric programs in Canada and how this may impact the provision of eye care professionals.

PURPOSE
The objective of this study was to compare the financial inequities in optometric education in Canada from the 2020 graduating class.

METHODS
A cross-sectional study assessed monetary variables related to the study of optometry in Canada, including academic and personal expenses, and overall debt and expenses related to the COVID-19 lockdown for the 2020 graduating class.

RESULTS
A total of 108 optometry students from the 2020 graduating classes of the University of Montreal and the University of Waterloo responded, with 68 (female/male respondents, 53:15; mean [standard deviation] age, 25.66 [2.01] years) completing the study. Waterloo students spent more years in university (P < .001), had higher academic fees (P < .001), spent more on traveling to their family residence (P = .007), and received more provincial (P = .002) and federal (P < .001) loans than Montreal students. Overall debt before optometry was similar among students but differed (P < .001) at the end of their program, with Waterloo students having a higher debt burden.

CONCLUSIONS
There is a financial inequity in optometric education in Canada depending on the chosen program. Cumulative optometry student debt for the 2020 graduating class in Canada ranges from Can $0 to $189,000 with an average of Can $65,800 and a median of Can $50,000. The results of this study can assist financial and government agencies, and future optometry students to better understand the financial burdens and establish a financial plan to study optometry in Canada, to respond to the growing eye care needs of the public.
The Effect of Varied Microperimetric Biofeedback Training in Central Vision Loss: A Randomized Trial
Authors: Silvestri Valeria , De Rossi Francesca , Piscopo Paola , Perna Fabiana , Mastropasqua Leonardo , Turco Simona , Rizzo Stanislao , Mariotti Silvio Paolo , Amore Filippo 
Published: September 2023

ABSTRACT

Significance
This investigation reports for the first time the effects of different microperimetric biofeedback strategies in visually impaired subjects with central field loss.

Purpose
To evaluate the effects of two MP-3 micro-perimeter biofeedback strategies on the visual performance of subjects with central vision loss. Moreover, changes between the groups were compared to provide indications of practice with biofeedback stimulation in subjects with central vision loss.

Methods
Using simple randomization, 19 participants were trained according to two different biofeedback stimulation approaches using the MP-3 microperimeter. Patients were assigned to two different groups: subjects trained for 2 days a week (Group A) and 3 days a week (Group B). The patients in each group were randomized to perform a total of 10 or 15 sessions.

Results
Fixation stability increased from 4.5°2 (± 2.8) to 2.3°2 (± 2.2) and from 8.2°2 (± 6.9) to 1.4°2 (± 1) after 2 and 3 weekly biofeedback training sessions, respectively (P < .05). Biofeedback training induced a significant improvement of 40.7% and 29.4% in reading speed for groups A and B, respectively (P < .05). A comparison of two weekly biofeedback training sessions with three weekly biofeedback sessions demonstrated greater fixation stability in Group B (P < .05).

Conclusions
This study conclude that a biofeedback intervention is effective in enhancing oculomotor control in patients with central vision loss. In our study, a more intensive biofeedback strategy seemed to produce significantly better results in terms of functional vision parameters.
Nonresuscitation Fluid Accumulation and Outcomes After Pediatric Cardiac Surgery: Single-Center Retrospective Cohort Study
Authors: Hudkins Matthew R. , Miller-Smith Laura , Evers Patrick D. , Muralidaran Ashok , Orwoll Benjamin E. 
Published: September 2023

OBJECTIVES:
Postoperative patients after congenital cardiac surgery are at high risk of fluid overload (FO), which is known to be associated with poor outcomes. “Fluid creep,” or nonresuscitation IV fluid in excess of maintenance requirement, is recognized as a modifiable factor associated with FO in the general PICU population, but has not been studied in congenital cardiac surgery patients. Our objective was to characterize fluid administration after congenital cardiac surgery, quantify fluid creep, and the association between fluid creep, FO, and outcome.

DESIGN:
Retrospective, observational cohort study.

SETTING:
Single-center urban mixed-medical and cardiac PICU.

PATIENTS:
Patients admitted to the PICU after cardiac surgery between January 2010 and December 2020.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
There were 1,459 postoperative encounters with 1,224 unique patients. Total fluid intake was greater than maintenance requirements on 3,103 of 4,661 patient days (67%), with fluid creep present on 2,624 patient days (56%). Total nonresuscitation intake was higher in patients with FO (defined as cumulative fluid balance 10% above body weight) versus those without. Fluid creep was higher among patients with FO than those without for each of the first 5 days postoperatively. Each 10 mL/kg of fluid creep in the first 24 hours postoperatively was associated with 26% greater odds of developing FO (odds ratio [OR] 1.26; 95% CI, 1.17–1.35) and 17% greater odds of mortality (OR 1.17; 95% CI, 1.05–1.30) after adjusting for risk of mortality based on surgical procedure, age, and day 1 resuscitation volume. Increasing fluid creep in the first 24 hours postoperatively was associated with increased postoperative duration of mechanical ventilation and PICU length of stay.

CONCLUSIONS:
Fluid creep is present on most postoperative days for pediatric congenital cardiac surgery patients, and fluid creep is associated with higher-risk procedures. Fluid creep early in the postoperative PICU stay is associated with greater odds of FO, mortality, length of mechanical ventilation, and PICU length of stay. Fluid creep may be under-recognized in this population and thus present a modifiable target for intervention.
Anatomy of the Facial Glideplanes, Deep Plane Spaces, and Ligaments: Implications for Surgical and Nonsurgical Lifting Procedures
Authors: Minelli Lennert , Brown Cameron P. , van der Lei Berend , Mendelson Bryan 
Published: September 2023

Background:
The soft-tissue glideplanes of the face are functionally important and have a role in facial rejuvenation surgery. The aim of this study was to improve understanding of soft-tissue mobility of the face and its effect on the redraping of tissues involved in face lifting. The consequences of no-release and extensive-release lifting were analyzed to explain the difference in efficacy and potential longevity between these 2 contrasting philosophies.

Methods:
Preliminary dissections and macrosectioning were followed by a definitive series of standardized layered dissections on 50 cadaver heads, along with histologic analysis, sheet plastination, and mechanical testing.

Results:
The previously described spaces are potential surgical dissection planes deep to the superficial fascia layer. The classically described retaining ligaments are local reinforcements of a system of small retaining fibers (retinacula cutis and deep retinacula fibers) that provide support to the soft tissues of the face and neck against gravitational sagging while allowing certain mobility. This mobility is used when mobile tissues are lifted without surgical release. However, the process of dragging up these fibers results in a loss of their previous antigravitational, supportive orientation.

Conclusions:
No-release lifting techniques, such as thread lifts and minimal-invasive face lifts, tighten tissue laxity with a change of the gravity-opposing tissue architecture, placing the weight of the flap solely on the fixation, which limits longevity of the lift. The alternative—full release with redraping—enables reattachment of the flap to a higher position, with preservation of the original deep fascial architecture with its antigravity orientation and natural mobility, conceivably improving the longevity of the lift.
Elemental Bioimaging of Sheep Bone and Articular Cartilage After Single Application of Gadolinium-Based Contrast Agents
Authors: Richter Henning , Verlemann Christine , Jeibmann Astrid , Martin Louise F. , Luebke Andreas M. , Karol Agnieszka , Sperling Michael , Radbruch Alexander , Karst Uwe 
Published: September 2023

Background
Gadolinium-based contrast agents (GBCAs) are applied to enhance magnetic resonance imaging. Gadolinium (Gd), a rare earth metal, is used in a chelated form when administered as GBCA to patients. There is an ongoing scientific debate about the clinical significance of Gd retention in tissues after administration of GBCAs. It is known that bone serves as Gd reservoir, but only sparse information on localization of Gd in bone is available.

Purpose
The aim of this study was to compare Gd tissue concentration and spatial distribution in femoral epiphysis and diaphysis 10 weeks after single-dose injection of linear and macrocyclic GBCAs in a large animal model.

Materials and Methods
In this prospective animal study, Swiss-Alpine sheep (n = 36; age range, 4–10 years) received a single injection (0.1 mmol/kg) of macrocyclic (gadobutrol, gadoteridol, and gadoterate meglumine), linear (gadodiamide and gadobenate dimeglumine) GBCAs, or saline. Ten weeks after injection, sheep were killed, and femur heads and shafts were harvested. Gadolinium spatial distribution was determined in 1 sample of each treatment group by laser ablation–inductively coupled plasma–mass spectrometry. All bone specimens were analyzed histopathologically.

Results
Injection of GBCAs in female Swiss-Alpine sheep (n = 36) resulted in Gd localization at the endosteal and periosteal surface and in a subset of GBCAs additionally at the cement lines and the bone cartilage junction. No histopathological alterations were observed in the investigated tissue specimens.

Conclusions
Ten weeks after single injection of a clinically relevant dose in adult sheep, both linear species of GBCA resulted in considerably higher accumulation than macrocyclic GBCAs. Gadolinium deposits were restricted to distinct bone and cartilage compartments, such as in bone linings, cement lines, and bone cartilage junctions. Tissue histology remained unaffected.
Artificial Intelligence and the Simulationists
Authors: Rodgers David L. , Needler Mathew , Robinson Alexander , Barnes Roxie , Brosche Theresa , Hernandez Jessica , Poore Julie , VandeKoppel Paul , Ahmed Rami 
Published: September 2023

Summary Statement
The recent introduction of ChatGPT, an advanced, easy-to-use, and freely available artificial intelligence (AI) program, created new possibilities across many industries and professions including healthcare simulation. ChatGPT has the potential to streamline healthcare simulation-based education while also providing insights for the scenario development process that conventional case development may miss. However, there are issues related to accuracy, relevance, and structure of the products produced by the ChatGPT AI program. This article examines 2 AI-generated simulation case examples highlighting strengths and weaknesses while providing guidance on the use of ChatGPT as a simulation resource.
Effectiveness of Sinopharm’s BBIBP-CorV Booster Vaccination Against COVID-19-Related Severe and Critical Cases and death in Morocco During the Omicron Wave
Authors: Belayachi Jihane , Mhayi Abdelkader , Majidi Hind , Fahime ElMostapha El , Abouqal Redouane 
Published: September 2023

ObjectiveThis study investigates the effectiveness of booster doses on the Omicron wave in Morocco against COVID-19 severe and critical hospitalizations and deaths;Participants/methodsThis study uses nationally representative data on COVID-19 from 15 December 2021 to 31 January 2022. To investigate the effectiveness of the inactivated COVID-19 vaccine BBIBP-CorV (Vero Cells) Sinopharm booster doses on the Omicron wave in morocco by using real-world data established from nationally representative statistics on COVID-19 cases, deaths and vaccinations.Statistical AnalysesThe screening method was used to estimate vaccine effectiveness against COVID-19 severe or critical hospitalization and COVID-19-related deaths. The data were grouped by, age subgroup, sex, week, and geographical area and were analyzed by using binary logistic regression with an offset for vaccine coverage.ResultsThe overall sinopharm VE estimate is 89% (95% CI 85 to 92) effective in curbing COVID-19 death, and 81% (95% CI 78 to 84 in curbing COVID-19 severe critical hospitalization. Death-related VE estimate was 86% (95% CI 81 to 90) for patients aged 1Z65 years, 96% (95% CI 90 to 98) for those aged < 65 years, 95% (95% CI 88 to 98) in no risk factor patient was, 91% (95% CI 85 to 94) with 1 risk factor; 90% (95% CI 83 to 95) with 2 risk factors; 72% (95% CI 52 to 84) in patient with 3 risk factors and more. Severe critical hospitalization VE, estimate was 78% (95% CI 74 to 82) for patients aged 1Z65 years, 87% (95% CI 82 to 90) for those aged < 65 years, 86% (95% CI 80 to 90) in no risk factor patient was, 80% (95% CI 73 to 84) with 1 risk factor; 80% (95% CI 70 to 85) with 2 risk factors; 80% (95% CI 68 to 86) in patient with 3 risk factors and more.ConclusionsSinopharm Boosters are effective in increasing protection against Omicron variant-related COVID-19 death and severe critical hospitalization. The protection is reduced with older age and higher risk factors. These findings emphasize the importance of targeted vaccination strategies for different demographic groups and underscore the protective benefits of the third booster Sinopharm vaccine.
Early initiation of polymyxin B hemoperfusion therapy for cancer patients with refractory septic shock
Authors: Lee Jae Hoon , Han Won Ho 
Published: September 2023

AbstractPurposeIn this study, we analyzed correlations between 28-day mortality and hemodynamic changes, measured using polymyxin B-immobilized fiber column direct hemoperfusion initiation time, in patients with cancer with refractory septic shock.Materials and methodsWe retrospectively analyzed 45 patients with cancer who received polymyxin B-immobilized fiber column direct hemoperfusion due to refractory septic shock. Patients were categorized into early (<12 h between refractory septic shock and initiation of polymyxin B-immobilized fiber column direct hemoperfusion) and late (>12 h) initiation groups. Changes in vasoactive inotrope scores, sequential organ failure assessment scores, and PaO2/FiO2ratios before and 24 h after polymyxin B-immobilized fiber column direct hemoperfusion, were compared.ResultsUnivariable analysis showed that 28-day mortality risk was associated with diabetes mellitus (odds ratio=3.081; 95% confidence interval =1.290–7.360;p=0.011), lactic acid (odds ratio=1.010; 95% confidence interval =1.005– 1.014;p<0.0001), and sequential organ failure assessment score (odds ratio=1.190; 95% confidence interval =1.044–1.357;p=0.009). Multivariable analysis showed that 28-day mortality risk was associated with diabetes mellitus (odds ratio=2.718; 95% confidence interval =1.013–7.291;p=0.047), early initiation (odds ratio=0.268; 95% confidence interval =0.094–0.765;p=0.014), and lactic acid (odds ratio=1.009; 95% confidence interval =1.004– 1.014;p<0.0001). Overall survival was slightly higher in the early than in the late initiation group (p=0.0515). Comparisons of variables before and 24 h after polymyxin B-immobilized fiber column direct hemoperfusion revealed that vasoactive inotrope scores decreased in both the early and late groups (Δ318vs.Δ114;p=0.001 andp=0.005, respectively), whereas the PaO2/FiO2ratio slightly increased (Δ127.5vs.Δ95.6;p=0.350 andp=0.390, respectively) over time.ConclusionsIn patients with cancer with refractory septic shock, early initiation of polymyxin B-immobilized fiber column direct hemoperfusion reduced inotrope-vasopressor requirement and 28-day mortality.
Fish oil supplementation modifies the genetic potential for blood lipids
Authors: Sun Yitang , McDonald Tryggvi , Baur Abigail , Xu Huifang , Bateman Naveen Brahman , Shen Ye , Li Changwei , Ye Kaixiong 
Published: September 2023

AbstractBackgroundDyslipidemia is a well-known risk factor for cardiovascular disease, which has been the leading cause of mortality worldwide. Although habitual intake of fish oil has been implicated in offering cardioprotective effects through triglyceride reduction, the interactions of fish oil with the genetic predisposition to dysregulated lipids remain elusive.ObjectivesWe examined whether fish oil supplementation can modify the genetic potential for the circulating levels of four lipids, including total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides.MethodsA total of 441,985 participants with complete genetic and phenotypic data from the UK Biobank were included in our study. Polygenic scores (PGS) were calculated in participants of diverse ancestries. Multivariable linear regression models were used to assess associations with adjustment for relevant risk factors.ResultsFish oil supplementation mitigated genetic susceptibility to elevated levels of total cholesterol, LDL-C, and triglycerides, while amplifying genetic potential for increased HDL-C among 424,090 participants of European ancestry (Pinteraction< 0.05). Consistent significant findings were obtained using PGS calculated based on multiple genome-wide association studies or alternative PGS methods. We also showed that fish oil significantly attenuated genetic predisposition to high triglycerides in African-ancestry participants.ConclusionsFish oil supplementation attenuated the genetic susceptibility to elevated blood levels of total cholesterol, LDL-C, and triglycerides, while accentuating genetic potential for higher HDL-C. These results suggest that fish oil may have a beneficial impact on modifying genome-wide genetic effects on elevated lipid levels in the general population.