bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term arteriovenous fistula prognosis for maintenance hemodialysis patients who accepted PIRRT by using arteriovenous fistula
Authors: Wei Suijiao , Jiao Jing , Yu Yan , Tian Xiujuan , Yang Xiaoxia , Feng Shidong , Li Yajuan , Zhang Peng , Bai Ming 
Published: March 2023

Background: Maintenance hemodialysis (MHD) patients are often admitted to the hospital for severe morbidities. Prolonged intermittent renal replacement therapy (PIRRT) is required during the hospital staying. There are controversial opinions on the use of arteriovenous fistula (AVF) as vascular access for PIRRT in MHD patients. Methods: Patients with AVF who accepted PIRRT in our center between January 2014 and June 2021 were retrospectively screened. AVF dysfunction and patient mortality were assessed as endpoints. Univariate and multivariate regression models were employed to identify the risk factors of AVF dysfunction. Results: About 162 patients were included in our present study. Twenty-six experienced AVF dysfunction, of whom 53.8%, 19.2%, and 27.0% had percutaneous transluminal balloon angioplasty, surgical revision, and AVF reconstruction, respectively. The accumulated AVF dysfunction rates were 11.8%, 16.2%, and 21.0% in 1, 2, and 3 years, respectively. Multivariate analysis revealed that smoking (HR 2.750, 95% CI 1.181–6.402, p = 0.019), higher platelet (PLT, HR 1.009, 95% CI 1.000–1.017, p = 0.047), higher prothrombin activity (PTA, HR 1.039, 95% CI 1.012–1.066, p = 0.004), and lower diastolic blood pressure (DBP, HR 0.963, 95% CI 0.932–0.996, p = 0.026) were independent risk factors for AVF dysfunction. During the follow-up period, 37 patients died. Conclusions: Overall, the use of AVF for PIRRT might not dramatically increase the incidence of AVF dysfunction. And, Smoking, lower DBP, higher PLT, and higher PTA were associated with increased AVF dysfunction.
Single Room Maternity Care Versus Traditional Maternity Care: A Cross-Sectional Study Examining Differences in Mothers’ Perceptions of Readiness for Discharge and Satisfaction and Health Outcomes
Authors: Hall Marc , Afzal Arfan , White Deborah E. 
Published: March 2023

Background Single room maternity care (SRMC) includes all aspects of the birth process (labour, delivery, postpartum) in a single room with a consistent team of healthcare providers. Traditional maternity care (TMC) involves having mothers labouring and delivering their baby in one room and then transferring to a room on another unit, which also means a transition in providers. Although many hospitals have transitioned to SRMC, there has been limited evidence to support their development. Methods This study was conducted in two large hospitals (one offering SRMC, the other TMC) in Western Canada. A cross-sectional between-subjects design was used to compare differences between SRMC and TMC. New mothers were asked to complete validated questionnaires. Health information was collected from administrative and health databases. The main outcomes included readiness for hospital discharge, mothers’ satisfaction, newborn length of stay, and mother length of stay. Several covariates were examined. Results In total, 506 (292 SRMC; 214 TMC) mothers participated. Readiness for discharge and maternal satisfaction were significantly higher in SRMC. Although newborn and mother length of stay were significantly reduced in SRMC compared to TMC for univariate tests, mother length of stay was not significantly different when adjusting for other variables. Conclusions There are positive health and psychosocial outcomes for mothers and newborns in the SRMC model of care compared to TMC. Since readiness for discharge and satisfaction are associated with positive maternal-infant interactions and transitions to community, SRMC could be the better approach. Further research should examine healthcare provider outcomes and implementation costs.
Influence of Defatting and Pasteurization on Nutrients and Oxidative Stress Markers in Human Milk
Authors: D’Alessandro Annamaria , Pastore Anna , Amadio Patrizia , D’Agostini Matteo , Terreri Sara , Carsetti Rita , Argentieri Marta , Bernaschi Paola , Onetti Muda Andrea , Porzio Ottavia , Dotta Andrea , Salvatori Guglielmo 
Published: March 2023

Background: It is well known that the best nutritional option for infants is human milk, and that when breastfeeding is not possible, human milk banks are a possible alternative. However, in the case of infants with fat transport disorder like chylothorax, defatting of human milk is mandatory. Research Aim: The aim of the study was to reduce milk fat content without reducing other nutrients, increasing oxidative stress, or introducing harmful microorganisms. Methods: In this prospective, cross-sectional, observational study, we examined the influence of defatting and pasteurization of 50 donor samples on fat, macro- and micronutrients, as well as on oxidative stress markers. Results: Low-temperature centrifugation proved to be very efficient in defatting, reducing the concentration of triglycerides by 85% and cholesterol by 50%. The macronutrients (proteins, albumin, and Immunoglobulin A) did not undergo significant changes due to defatting and pasteurization procedures, while iron decreased by 36%. However, as the majority of iron is retained, this result does not remarkably change the milk composition. Furthermore, oxidative stress markers and antioxidant levels were unchanged, and the milk result was microbiologically safe. Conclusions: Cold milk centrifugation proved to be an effective technique that allows the reduction of human milk lipids. The determination of triglycerides and cholesterol can be used as an indicator of skimming. This procedure is not accompanied by substantial modifications of other components present in the milk.
Tethered Oral Tissue Release Among Breastfed Infants: Maternal Sources of Information and Treatment
Authors: Winkel Taylor , Wilson Jennifer , Spence Marsha , Colby Sarah , Springer Cary , Hedrick Mark , Kavanagh Katherine 
Published: March 2023

Background: Despite limited clinical consensus regarding surgery for tethered oral tissues (“tongue-tie”) for resolving breastfeeding-related issues, the procedure has been increasing in the United States. Greater understanding of maternal experiences with obtaining surgical release may help to improve breastfeeding outcomes. Research Aim: To explore experiences of breastfeeding mothers with infants having undergone “tongue-tie” surgery. Method: This online, cross-sectional, observational survey occurred between August and September 2020. Eligibility included being ≥ 18 years of age and previously or currently breastfeeding an infant with ≥ 1 tissue surgically released. Of 463 screens, 318 mothers were eligible and 115 consented. The final sample was 90. Results: The sample was predominantly white ( n = 86; 95%), non-Hispanic ( n = 84; 93%), married/cohabitating ( n = 85; 94%), and currently providing their own milk ( n = 81; 89%). Difficult latch was the primary reason for seeking help. Participants reported lingual ( n = 84; 93%), labial ( n = 79; 88%), and buccal ( n = 16; 17%) tissue-release, with 80% ( n = 73) reporting > 1 released. For each tissue released, > 80% ( n = 72) of participants felt “very confident” in their ability to correctly identify it and 97% ( n = 87) felt “very involved” and “strongly agreed” with surgical release. International Board Certified Lactation Consultants® were the most frequently identified source of information ( n = 45; 50%) and referrals ( n = 38; 42%), while pediatric dentists most frequently performed interventions ( n = 60; 67%). Conclusions: Participants reported being confident, involved, and in agreement with surgical release and lactation support professionals were frequent information and referral sources.
Mid-term follow-up results of gradual capitate lengthening for the treatment of stage IIIA Kienbock’s disease
Authors: Kariksiz Mesut , Karakoyun Ozgur 
Published: March 2023

Purpose This study aimed to evaluate the mid–term radiological and clinical results of gradual lengthening of capitate for the treatment of stage IIIA Kienbock’s disease. Methods We retrospectively reviewed nine patients (five females, four males) with Lichtman stage IIIA Kienbock’s disease who underwent gradual capitate lengthening at our hospital. Their clinical (range of motion (ROM), grip strength, visual analogue scale (VAS) value for pain, and Mayo wrist score (MWS)) and radiological outcomes (in terms of progression of arthritis and carpal height ratio) at the last follow-up were compared to the preoperative values. Results The mean age of the nine patients was 30 years (range: 20–38 years). The mean follow-up period was 73.8 (60–83) months. The average grip strength increased from 14.3 kg preoperatively to 22.3 kg at the last follow-up. The mean MWS increased from 58.8 preoperatively to 79.4 postoperatively. The mean VAS values decreased from the preoperative values: from 1.9 to 0.36 at rest, from 3.75 to 1.6 during mild effort, and from 5.35 to 3 during severe effort. The average carpal height ratio changed from 0.38 preoperatively to 0.53 postoperatively. None of the patients had any arthritic changes in their wrists. Conclusion Gradual lengthening of capitate offers satisfactory mid-term results for treating stage IIIA Kienbock’s disease.
Risks Associated With Posterior Ankle Hindfoot Arthroscopy Complications
Authors: Chinnakkannu Karthikeyan , Barbachan Mansur Nacime Salomao , Glass Natalie , Phisitkul Phinit , Amendola Annunziato , Femino John E. 
Published: March 2023

Background: The use of posterior ankle and hindfoot arthroscopy (PAHA) has been expanding over time. Many new indications have been reported in the literature. The primary objective of this study was to report the rate of PAHA complication in a large cohort of patients and describe their potential associations with demographical and surgical variables. Methods: In this IRB-approved retrospective comparative study, patients who underwent posterior ankle and/or hindfoot arthroscopy in a single institution from December 2009 to July 2016 were studied. Three fellowship-trained orthopaedic foot and ankle surgeon performed all surgeries. Demographic data, diagnosis, tourniquet use, associated procedures, and complications were recorded. To investigate a priori factors predictive of neurologic complication after PAHA, univariate and multivariable logistic regression was utilized. Where appropriate, sparse events sensitivity analysis was tested by fitting models with Firth log-likelihood approach. Results: A total of 232 subjects with 251 surgeries were selected. Indications were posterior ankle impingement (37%), flexor hallux longus disorders (14%), subtalar arthritis (8%), and osteochondral lesions (6%). Complications were observed in 6.8% (17/251) of procedures. Neural sensory lesions were noted in 10 patients (3.98%), and wound complications in 4 ankles (1.59%). Seven neurologic lesions resolved spontaneously and 3 required further intervention. In a multivariable regression model controlled for confounders, the use of accessory posterolateral portal was the significant driver for neurologic complications (odds ratio [OR] 32.19, 95% CI 3.53-293.50). Conclusion: The complication rate in this cohort that was treated with posterior ankle and/or hindfoot arthroscopy was 6.8%. Most complications were due to neural sensorial injuries (sural 5, medial plantar nerve 4, medial calcaneal nerve 1 ) and 3 required additional operative treatment. The use of an accessory posterolateral portal was significantly associated with neurologic complications. The provided information may assist surgeons in establishing diagnoses, making therapeutic decisions, and instituting surgical strategies for patients that might benefit from a posterior arthroscopic approach. Level of Evidence: Level III, retrospective comparative study.
Post-Pulmonary Embolism Impairment Six Months after Acute Pulmonary Embolism: A Prospective Registry
Authors: Alizadehasl Azin , Farrashi Melody , Naghsbandi Mona , Khansari Nakisa , Moosavi Jamal , Shafe Omid , Mohebbi Bahram , Bakhshandeh Hooman , Pouraliakbar Hamid Reza , Rezaei-Kalantari Kiara , Naghavi Batoul , Talakoob Hamed , Mohseni Salehi Maryam , Kaviani Raheleh , Amin Ahmad , Barco Stefano , Sadeghipour Parham 
Published: March 2023

Background Little evidence is available on post-pulmonary embolism impairment (PPEI), a recently defined complication of pulmonary embolism (PE) encompassing dysfunctional clinical and imaging parameters. In the present study, we sought to evaluate its frequency with a focus on the main components. Methods In this prospective registry, we included patients with a confirmed diagnosis of acute PE and focused on those with initial right ventricular (RV) dysfunction. Their baseline, pre-discharge, and 6 month follow-up clinical and imaging characteristics were recorded. The main study outcomes were incomplete RV functional recovery, exercise capacity limitations (based on the 6 minute walk test), and their combination, which defines PPEI, within six months of acute PE. Results Of 170 consecutive patients with a confirmed diagnosis of acute PE, 123 accepted to participate in the follow-up study, of whom 87 had initial RV dysfunction. The 6 month rates of incomplete RV functional recovery, signs of an intermediate-to-high echocardiographic probability of PH, and exercise limitations were observed in 58.6, 32.1, and 45.9%, respectively. A total of 22 (25.2%; 95% CI 15.5-34.4%) patients had PPEI. The RV/LV ratio and the fractional area change on discharge after acute PE were more often impaired among patients with incomplete RV recovery, exercise limitations, and a high probability of PH at 6 months. In contrast, an initial impaired RV diastolic function indices appeared to characterize patients with a limited exercise capacity at 6 months. Discussion PPEI affects one fourth of patients surviving acute PE with half of them presenting with RV dysfunction or exercise limitations.
Superficial Femoral Artery in-Stent Restenosis Treated with Paclitaxel-Coated Balloon Angioplasty – Results of Three-Year Follow-Up
Authors: Peclat de Oliveira Julio Cesar , Alvim Fiorelli Rossano Kepler , Rolim Maia Peclat Ana Paula , Peclat de Oliveira Lucas Maia , Oliveira Rafael , Belczac Sergio Quilici , Almeida Renato Santos , Dalio Marcelo Bellini , Joviliano Edwaldo Edner , Gutfilen Bianca 
Published: March 2023

Background In-stent restenosis remains a common and important complication after endovascular treatment of superficial femoral artery peripheral artery disease. It occurs in 14 to 35% of cases in 1 year and there is still no efficient treatment for this condition. Paclitaxel-coated balloons have shown promising results. Objective Investigate the 3 year results of superficial femoral artery in-stent restenosis treated with paclitaxel-coated balloon angioplasty, using the Lutonix™ 035 device. Methods We conducted a retrospective observational study with patients with symptomatic (Rutherford 2 to 5) superficial femoral artery in-stent restenosis, that were treated with paclitaxel-coated balloon angioplasty using the Lutonix™ 035 device, in a single center from January 2016 to December 2020. Duplex scan was used to follow the patients. Primary patency was obtained through Kaplan-Meier analysis. Mortality, and amputation rates were also evaluated. Results 105 patients were included. Two patients had technical failure and required an additional stent, and were thus excluded. 103 patients were analyzed. Primary patency was 91.26, 80.47, and 67.71%, respectively, in the first, second, and third year after the procedure. There were no deaths 30 days after the procedure. There were no major amputations during the 3 year follow-up. Conclusion Paclitaxel-coated balloon angioplasty with the Lutonix™ 035 device was a safe and effective treatment to superficial femoral artery in-stent restenoses. The results were maintained along the 3 year follow-up.
Incidence of spontaneous intracranial hypotension in Olmsted County, Minnesota: 2019–2021
Authors: Pradeep Aishwarya , Madhavan Ajay A , Brinjikji Waleed , Cutsforth-Gregory Jeremy K 
Published: March 2023

Background As the myriad clinical and radiographic presentations of spontaneous intracranial hypotension are increasingly recognized, disease prevalence appears to rise. True incidence data remain insufficient. We sought to calculate the incidence of spontaneous intracranial hypotension among the residents of Olmsted County, Minnesota. Methods Our institution is a quaternary care center for spontaneous intracranial hypotension evaluation and provides primary neurologic care for local residents. All patients who were evaluated at our institution from 2019 to 2021 for spontaneous intracranial hypotension were reviewed, and cases of spontaneous intracranial hypotension with advanced imaging work-up using digital subtraction myelography or dynamic computed tomography myelography were identified. Patients who were residents of Olmsted County were identified. Results Fourteen patients with spontaneous intracranial hypotension were identified in Olmsted County during the study period, all of whom were adults and underwent our institution's standard spontaneous intracranial hypotension work-up. In Olmsted County, the incidence of spontaneous intracranial hypotension was 3.8 per 100,000 adult population, including 3.2 per 100,000 adult females and 2.5 per 100,000 adult males. Seven of 14 patients (50%) had a cerebrospinal fluid-venous fistula. Conclusion This study uniquely presents the incidence rate of spontaneous intracranial hypotension in the general population of Olmsted County, Minnesota. Spontaneous intracranial hypotension is more common in women than men and has an overall incidence roughly equivalent to that of aneurysmal subarachnoid hemorrhage in Olmsted County, a widely known neurologic condition. Approximately half the cases of spontaneous intracranial hypotension are due to cerebrospinal fluid-venous fistulas, which generally require specialty expertise for diagnosis and treatment.
Heterogeneity of surrogate outcome measures used in critical care studies: A systematic review
Authors: Verghis Rejina , Blackwood Bronagh , McDowell Cliona , Toner Philip , Hadfield Daniel , Gordon Anthony C , Clarke Mike , McAuley Daniel 
Published: March 2023

Background: The choice of outcome measure is a critical decision in the design of any clinical trial, but many Phase III clinical trials in critical care fail to detect a difference between the interventions being compared. This may be because the surrogate outcomes used to show beneficial effects in early phase trials (which informed the design of the subsequent Phase III trials) are not valid guides to the differences between the interventions for the main outcomes of the Phase III trials. We undertook a systematic review (1) to generate a list of outcome measures used in critical care trials, (2) to determine the variability in the outcome reporting in the respiratory subgroup and (3) to create a smaller list of potential early phase endpoints in the respiratory subgroup. Methods: Data related to outcomes were extracted from studies published in the six top-ranked critical care journals between 2010 and 2020. Outcomes were classified into subcategories and categories. A subset of early phase endpoints relevant to the respiratory subgroup was selected for further investigation. The variability of the outcomes and the variability in reporting was investigated. Results: A total of 6905 references were retrieved and a total of 294 separate outcomes were identified from 58 studies. The outcomes were then classified into 11 categories and 66 subcategories. A subset of 22 outcomes relevant for the respiratory group were identified as potential early phase outcomes. The summary statistics, time points and definitions show the outcomes are analysed and reported in different ways. Conclusion: The outcome measures were defined, analysed and reported in a variety of ways. This creates difficulties for synthesising data in systematic reviews and planning definitive trials. This review once again highlights an urgent need for standardisation and validation of surrogate outcomes reported in critical care trials. Future work should aim to validate and develop a core outcome set for surrogate outcomes in critical care trials.
Variation in hepatic segmental portal venous pulsed wave Doppler flow distribution in patients with NAFLD: A pilot study
Authors: Verma Ashish , Kumar Ishan , Indal Manish , Shukla Sunit , Singh Pramod Kumar , Shukla Ram Chandra 
Published: March 2023

Purpose: To evaluate the segmental variations in portal venous pulsed wave colour Doppler flow velocity in patients with moderate to severe non-alcoholic fatty liver disease in comparison with healthy controls Materials and Methods: In this prospective, observational, case–control study, the maximum velocity of all the segmental branches of portal vein were evaluated on colour Doppler in patients with moderate to severe non-alcoholic fatty liver disease, and the values were compared between three groups (1) Healthy controls ( n = 30), (2) non-alcoholic fatty liver disease group, that is moderate to severe fatty liver without features of portal hypertension ( n = 32) and (3) non-alcoholic steatohepatitis-portal hypertension group, that is those non-alcoholic fatty liver disease patients with features of portal hypertension ( n = 13). Results: Compared to controls, non-alcoholic fatty liver disease group showed a lower velocity in all the eight segments of liver. The ratio of segment 2 to segment 7 peak portal vein maximum velocity was significantly higher in non-alcoholic fatty liver disease (1.03 ± 0.21) compared to controls (0.90 ± 0.17) and even higher in non-alcoholic steatohepatitis-Portal hypertension group (1.83 ± 0.40) with p value of 0.003. Conclusion: Our study demonstrates the occurrence of flow redistribution occurring in cases of non-alcoholic fatty liver disease patients with the left lobe receiving higher portal venous flow. This flow redistribution was even more pronounced in a subset of non-alcoholic fatty liver disease patients who developed features of portal hypertension.