bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Results of Combined Trabeculotomy Trabeculectomy in Primary Congenital Glaucoma
Authors: Malek Ines , Sayadi Jihene , Choura Racem , Mekni Manel , Rayhane Haythem , Khairallah Moncef , Nacef Leila 
Published: April 2023

Précis:
Primary congenital glaucoma (PCG) in Tunisian children seems to be characterized by a high prevalence of inherited and advanced forms of the disease. Primary combined trabeculotomy trabeculectomy (CTT) allowed satisfactory long-term intraocular pressure (IOP) control and reasonable visual outcome.

Purpose:
To report the long-term outcome of CTT as the initial glaucoma surgery in children with PCG.

Methods:
Retrospective analysis of children who underwent primary CTT for PCG between January 2010 and December 2019. The main outcome measures were IOP reduction, corneal clarity, complications, refractive errors, and visual acuity (VA). Success was defined as IOP <16 mm Hg without (complete) or with (qualified) antiglaucoma medication. The WHO criteria of vision loss were used to categorize visual impairment (VI).

Results:
Of 62 patients, 98 eyes were enrolled. At the last follow-up, the mean IOP was reduced from 22.7 ± 4.0 mm Hg to 9.7 ± 3.9 mm Hg (P < 0.0001). The complete success rate was 91.6%, 88.4%, 84.7%, 71.6%, 59.7%, and 54.3%, at the first, second, fourth, sixth, eighth, and tenth year, respectively. Follow-up averaged 42.1 ± 28.4 months. Preoperatively, 72 eyes (73.5%) had significant corneal edema versus 11 eyes (11.2%) at the end of the follow-up (P < 0.0001). Endophthalmitis was encountered in one eye. Myopia was the most common refractive error (80.6%). Data on Snellen VA were available for 53.2% of the patients; 33.3% achieved a VA ≥6/12, 21.2% had mild VI, 9.1% had moderate VI, 21.2% had severe VI, and 15.2% were blind. The failure rate was statistically correlated to the early disease onset (<3 mo) and to preoperative corneal edema (P = 0.022 and P = 0.037, respectively).

Conclusion:
Primary CTT seems to be a good procedure in a population with advanced PCG at presentation, problematic follow-up visits, and limited resources.
Haemodynamic monitoring in the perioperative setting
Authors: Quintão Vinícius Caldeira , Jreige Júnior Armindo , Rizk Stephanie Itala , Hajjar Ludhmila Abrahão 
Published: April 2023

Purpose of review
The aim of this study was to review the role of haemodynamic monitoring in the perioperative setting, highlighting who are the patients who most benefit, to describe the type of devices, to analyse the scientific evidence and to suggest algorithms of haemodynamic care in high-risk surgical patients.

Recent findings
In the last 50 years, many advances have contributed to better understand cardiovascular physiology at bedside, and haemodynamic monitoring has moved from invasive methods to minimally invasive and noninvasive devices. Randomized clinical trials have shown benefits of perioperative haemodynamic therapy to improve outcomes in high-risk surgical patients. A multimodal approach is purposed in the perioperative setting to optimize haemodynamic parameters, involving clinical analysis at bedside, the use of dynamic tests for fluid responsiveness and integration of variables, including cardiac output, systolic volume, tissue oxygen markers and echocardiographic measures.

Summary
In this review, we summarize the benefits of haemodynamic monitoring, the type of devices with advantages and disadvantages, the scientific evidence supporting perioperative haemodynamic therapy, and we suggest a multimodal approach to improve patients’ care.
Traumatic cardiac arrest
Authors: Lewis Jack , Perkins Gavin D. 
Published: April 2023

Purpose of review
This review considers the latest evidence relating to the epidemiology and outcomes, treatment guidelines, diagnostic and therapeutic interventions in traumatic cardiac arrest.

Recent findings
There is variation in the incidence and outcomes of traumatic cardiac arrest which is influenced in part by case definitions. Irrespective of case definitions outcomes from traumatic cardiac arrest are typically worse than those seen from cardiac arrest due to medical causes but not so poor as to consider that treatment is futile. Clinical guidelines focus on the prompt treatment of reversible causes, although evidence that this improves outcomes is limited. Point of care ultrasound to assist with the identification of reversible causes should be limited to experienced operators where there is thought to be a high likelihood of a reversible cause being present. Care should be taken to minimize interruptions in chest compressions during scanning. There is little recent evidence to support specific therapeutic interventions. The role of Resuscitative Endovascular Balloon Occlusion of the Aorta during traumatic cardiac arrest remains to be determined in on-going research.

Conclusion
Trauma related cardiac arrest differs from cardiac arrest due to medical causes. Whilst the core principles of treatment are similar, a higher priority is placed on identifying and treating reversible causes.
Advantages and limitations of noninvasive devices for cardiac output monitoring: a literature review
Authors: Ruste Martin , Jacquet-Lagrèze Matthias , Fellahi Jean-Luc 
Published: April 2023

Purpose of review
Individualized hemodynamic optimization often requires cardiac output monitoring, mostly for goal-directed therapy in the operating room and fluid responsiveness assessment in the intensive care unit. Different technologies for noninvasive cardiac output determination have become available over the recent years. It is therefore crucial for care providers to be made aware of the advantages and limitations of those different devices for an appropriate use at the bedside.

Recent findings
Nowadays, different noninvasive technologies exist, each with their advantages and limitations, but none are considered interchangeable with bolus thermodilution. Different clinical studies however, emphasize that the trending ability of such devices allows to guide decisions from care providers, and that their use may be associated with improved prognosis, especially in the operating room. Recent studies have also reported their potential use for hemodynamic optimization in specific populations.

Summary
Noninvasive cardiac output monitoring may have a clinical impact on patient outcomes. Further studies are required to evaluate their clinical relevance, notably in the intensive care unit. Noninvasive monitoring opens up the possibility for hemodynamic optimization in specific or low-risk populations, the benefit of which remains to be assessed.
Technique for removing a “cold-welded” interlocking screw from an intramedullary nail in the femur: A case report
Authors: Jian Wang , Jiangwei Fan , Jian Ran 
Published: April 2023

Rationale:
Removing a bent or broken intramedullary (IM) nail can be challenging even if the nail is intact. Several methods have been described for removing bent or broken nails. However, few studies have reported the removal of an IM nail when a proximal interlocking screw is cold-welded. We hope to share our successful treatment strategy for future use.

Patient concerns:
A 33-year-old male was admitted to our clinic for IM nail removal. The patient complained of discomfort in his right thigh when the weather changed. He had fallen down the stairs 3 years prior, causing a closed fracture of the right femur, and was treated with an IM nail.

Diagnoses:
Radiography showed an IM nail in the right femur.

Interventions:
Initially, the distal interlocking screw was easily removed using a screwdriver. Attempts to remove the proximal interlocking screw using various methods were futile. Finally, a high-speed cutting burr was used to cut the proximal interlocking screw.

Outcomes:
The IM nail was successfully removed.

Lessons:
A cold-welded proximal interlocking screw was encountered during IM nail removal. The applied technique is an effective alternative when a screw is difficult to remove using conventional tools.
Evaluating the Clinical Characteristics and Outcomes of Idiopathic Acute Pancreatitis
Authors: Anderson Kelsey L. , Shah Ishani , Tintara Supisara , Ahmed Awais , Freedman Steven D. , Kothari Darshan J. , Sheth Sunil G. 
Published: April 2023

Objective
Up to 30% of acute pancreatitis (AP) cases do not have an established etiology (idiopathic AP [IAP]). We evaluated the characteristics and outcomes of hospitalized IAP patients compared with those with established AP cause (non-IAP).

Methods
A retrospective study of AP patients admitted to a single center from 2008 to 2018 was performed. Patients were divided into IAP and non-IAP groups. Outcomes included mortality, 30-day and 1-year readmission, length of stay (LOS), intensive care unit admissions, and complications.

Results
Of 878 AP patients, 338 had IAP and 540 non-IAP (234 gallstone, 178 alcohol). Groups had similar demographics, Charlson Comorbidity Index, and pancreatitis severity. The IAP patients had more 1-year readmissions (0.64 vs 0.55, P = 0.006) but similar 30-day readmissions and mortality. Patients with IAP had shorter LOS (4.98 vs 5.99 days, P = 0.01), and fewer intensive care unit admissions (3.25% vs 6.85%, P = 0.03) and extrapancreatic complications (15.4% vs 25.2%, P = 0.001). There was no difference in pain level between groups.

Conclusions
The IAP patients tend to have more readmissions in 1 year, but less severe presentations, shorter LOS, and fewer complications. Readmission rates may be related to lack of defined etiology and treatment to prevent recurrence.
Cytokine-Induced Killer Cell Immunotherapy Combined With Gemcitabine Reduces Systemic Metastasis in Pancreatic Cancer
Authors: Choi Jin Ho , Nam Gun He , Hong Jun-man , Cho In Rae , Paik Woo Hyun , Ryu Ji Kon , Kim Yong-Tae , Lee Sang Hyub 
Published: April 2023

Objectives
To evaluate the efficacy and safety of cytokine-induced killer (CIK) cell therapy in pancreatic cancer.

Methods
An orthotopic murine model of pancreatic cancer and adjuvant therapy-mimicking xenograft murine model that underwent splenectomy was created. Eighty mice were randomized into four groups: the control, gemcitabine alone, CIK alone, and CIK with gemcitabine groups. The tumor growth was monitored using bioluminescence imaging once weekly.

Results
In the orthotopic murine model, the treatment groups showed a significantly longer survival than the control group (median: not reached vs 125.0 days; 95% confidence interval, 119.87–130.13; P = 0.04); however, the overall survival did not differ significantly among the treatment groups (P = 0.779). The metastatic recurrence rate and overall survival were also not significantly different among the groups in the adjuvant therapy-mimicking xenograft murine model (P = 0.497). However, the CIK and gemcitabine combination suppressed the metastatic recurrence effectively, with recurrence-free survival being significantly longer in the CIK with gemcitabine group than in the control group (median, 54 days; 95% confidence interval, 25.00–102.00; P = 0.013).

Conclusions
The combination of CIK and gemcitabine suppressed systemic metastatic recurrence, with promising efficacy and good tolerability in an adjuvant setting of pancreatic cancer.
Genetic Analysis of the ATG16L1 c.898A>G (p.T300A) Variant in Acute and Chronic Pancreatitis
Authors: Neubauer Claudia , Ewers Maren , Schulz Hans-Ulrich , Weiß Frank Ulrich , Lämmerhirt Felix , Lerch Markus M. , Bugert Peter , Landt Olfert , Algül Hana , Rosendahl Jonas , Witt Heiko 
Published: April 2023

Objectives
Human and animal studies suggest an important role of autophagy in the pathogenesis of pancreatitis. ATG16L1 (autophagy-related 16 like 1) is part of a protein complex that is involved in the formation of autophagosomes. The c.898A > G (p.T300A) variant of ATG16L1 is associated with Crohn disease. In this study, we analyzed ATG16L1 c.898A > G (p.T300A) for an association with pancreatitis.

Methods
We genotyped 777 patients and 551 control subjects of German origin by melting curve analysis using fluorescence resonance energy transfer probes. The patient group included 429 patients with nonalcoholic chronic pancreatitis (CP), 141 patients with alcoholic CP, and 207 patients with acute pancreatitis (AP). We classified AP by severity according to the Atlanta symposium 1992.

Results
Allele and genotype frequencies of ATG16L1 c.898A > G (p.T300A) did not differ significantly between patients and controls (G allele frequencies: nonalcoholic CP, 49.9%; alcoholic CP, 48.2%; AP, 49.5%; controls, 52.7%). We found no significant association with the severity of AP either.

Conclusions
Our data do not support a role of ATG16L1 c.898A > G (p.T300A) in the pathogenesis of AP or CP or an influence on the severity of AP.
The Association Between COVID-19 and Febrile Seizure
Authors: Hanlon Sean M. , Sim Don , Schneider Jack G. , Yang Ziyi , Thompson Sean M. 
Published: April 2023

Background/Objective
Throughout the pandemic, febrile seizures have resulted from infection secondary to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The objective of this study is to determine if there is an increased association between COVID-19 and febrile seizures as compared with other causes of febrile seizures.

Methods
This was a retrospective case control study. Data were collected from the National Institute of Health (NIH) supported National COVID Cohort Collaborative (N3C). Patients from 6 to 60 months who were tested for COVID-19 were included; cases were defined as COVID-19–positive patients whereas controls were defined as COVID-19–negative patients. Febrile seizures diagnosed within 48 hours of the COVID-19 test were considered to be associated with the test result. Patients were subjected to a stratified gender and date matching design followed by a logistic regression controlling for age and race.

Results
During the study period, 27,692 patients were included. Of those, 6923 patients were COVID-19–positive, among which 189 had febrile seizures (2.7%). After logistic regression, the likelihood of having febrile seizures concurrently with COVID-19 as compared with other causes was 0.96 (P = 0.949; confidence interval, 0.81, 1.14).

Conclusions
There were 2.7% of the patients with COVID-19 that were diagnosed with a febrile seizure. However, when subjected to a matched case control design with logistic regression controlling for confounding variables, there does not appear to be an increased risk of febrile seizures secondary to COVID-19 as compared with other causes.
Self-Efficacy in the Cannulation Technique for Intraosseous Access in Pediatric Cardiac Arrest
Authors: Márquez-Hernández Verónica V. , Gutiérrez-Puertas Lorena , García-Viola Alba , Garrido-Molina José Miguel , Gutiérrez-Puertas Vanesa , Aguilera-Manrique Gabriel , Rodríguez-García Ma. Carmen 
Published: April 2023

Objectives
The use of intraosseous (IO) access is recommended in cardiac arrest when peripheral venous access is not accessible. Various methodologies exist that are used for teaching and learning about cannulation of the IO route both in education and in research. The purpose of the present study was to compare self-efficacy in the cannulation technique for IO access through different techniques.

Methods
A randomized comparative study was conducted. A total of 118 nursing students participated. The participants were randomly distributed into 2 intervention groups: chicken bone and egg. A checklist was used for data collection to evaluate the IO cannulation technique in nursing students and another to analyze self-efficacy.

Results
The average total score of self-efficacy for all participants was 8.84 (standard deviation (SD) = 0.98). No statistically significant differences were found when comparing the total self-efficacy score and the intervention group (U = 1604.500; z = −0.733; P = 0.463). No statistically significant differences were found between both groups for the average total score of the procedure (U = 6916.500; z = −0.939; P = 0.348). The egg group carried out the IO cannulation procedure in a significantly less amount of time (M = 126.88, SD = 82.18) than the chicken bone group (M = 183.77, SD = 108.28), finding statistically significant differences (U = 4983.500; z = −5.326; P < 0.001).

Conclusions
Using an egg to teach and learn about IO access could be considered a methodology that is equally effective as using a chicken bone, with the advantage of achieving IO access in a lesser amount of time.
Diagnostic Yield of Abdominal Radiographs in the Pediatric Emergency Department
Authors: Kubiszewski Kacper , Patterson Suzannah , Chalise Sweta , Rivera-Sepulveda Andrea 
Published: April 2023

Background and objectivesAbdominal radiographs (ARs) are commonly used in the pediatric emergency department (PED). Their low diagnostic accuracy leads to overuse, excess radiation exposure, and increased resource usage. This study aims to assess the diagnostic yield of ARs in the evaluation of intraabdominal pathology in the PED.MethodsRetrospective, cross-sectional study of patients aged 0 to 18 years with an AR who visited the PED between 2017 and 2019. Diagnostic yield was analyzed with sensitivity, specificity, positive predictive value, negative predictive value (NPV), and likelihood ratio.ResultsA total of 4288 ARs were identified, with a rate of 6%. The overall abnormal AR rate was 31%. The incidences of an abnormal AR in abdominal pain, vomiting, and constipation were 26%, 37%, and 50%, respectively. There was a 13% rate of clinically significant diagnoses. The AR diagnostic yield showed 44% sensitivity, 70% specificity, 17% positive predictive value, and 90% NPV (P< 0.05). Unadjusted odds ratio analysis of positive AR and abdominal pain, vomiting, and constipation revealed an odds ratio of 0.68 (95% confidence interval [CI], 0.63–0.75), 1.22 (95% CI, 1.06–1.39), and 1.72 (95% CI, 1.54–1.91), respectively.ConclusionsThere is a low rate of intraabdominal pathologic processes that an AR can identify. A normal AR does not change patient management, nor does it reduce the need for further radiologic imaging. Despite a good NPV, the AR is not a useful diagnostic tool in the PED because of its limited ability to rule in or rule out clinically significant diagnoses.
Occupational Characteristics Associated With Professional Fulfillment and Burnout Among US Physiatrists
Authors: Makowski Maryam S. , Trockel Mickey , Paganoni Sabrina , Weinstein Stuart , Verduzco-Gutierrez Monica , Kinney Carolyn , Kennedy David J. , Sliwa James , Wang Hanhan , Knowlton Tiffany , Stautzenbach Tom , Shanafelt Tait D. 
Published: April 2023

Introduction
Multiple national studies suggest that among physicians, physiatrists are at increased risk for occupational burnout.

Objective
The aim of the study is to identify characteristics of the work environment associated with professional fulfillment and burnout among US physiatrists.

Design
Between May and December 2021, a mixed qualitative and quantitative approach was used to identify factors contributing to professional fulfillment and burnout in physiatrists.

Setting
Online interviews, focus groups, and survey were conducted.

Participants
The participants are physiatrists in the American Academy of Physical Medicine and Rehabilitation Membership Masterfile.

Main Outcome Measures
Burnout and professional fulfillment were assessed using the Stanford Professional Fulfillment Index.

Results
Individual interviews with 21 physiatrists were conducted to identify domains that contributed to professional fulfillment followed by focus groups for further definition. Based on themes identified, scales were identified or developed to evaluate: control over schedule (6 items, Cronbach α = 0.86); integration of physiatry into patient care (3 items, Cronbach α = 0.71); personal-organizational values alignment (3 items, Cronbach α = 0.90); meaningfulness of physiatrist clinical work (6 items, Cronbach α = 0.90); teamwork and collaboration (3 items, Cronbach α = 0.89). Of 5760 physiatrists contacted in the subsequent national survey, 882 (15.4%) returned surveys (median age, 52 yrs; 46.1% women). Overall, 42.6% (336 of 788) experienced burnout and 30.6% (244 of 798) had high levels of professional fulfillment. In multivariable analysis, each one-point improvement in control over schedule (odds ratio = 1.96; 95% confidence interval = 1.45–2.69), integration of physiatry into patient care (odds ratio = 1.77; 95% confidence interval = 1.32–2.38), personal-organizational values alignment (odds ratio = 1.92; 95% confidence interval = 1.48–2.52), meaningfulness of physiatrist clinical work (odds ratio = 2.79; 95% confidence interval = 1.71–4.71), and teamwork and collaboration score (odds ratio = 2.11; 95% confidence interval = 1.48–3.03) was independently associated with higher likelihood of professional fulfillment.

Conclusions
Control over schedule, optimal integration of physiatry into clinical care, personal-organizational values alignment, teamwork, and meaningfulness of physiatrist clinical work are strong and independent drivers of occupational well-being in US physiatrists. Variation in these domains by practice setting and subspecialty suggests that tailored approaches are needed to promote professional fulfillment and reduce burnout among US physiatrists.
PROTECTIVE EFFECTS OF HUMANIN-G IN HEMORRHAGIC SHOCK IN FEMALE MICE VIA AMPKα1-INDEPENDENT MECHANISMS
Authors: Wagner Monica L. , Ammann Allison , Piraino Giovanna , Wolfe Vivian , O'Connor Michael , Lahni Patrick , Ziady Assem , Zingarelli Basilia 
Published: April 2023

ABSTRACT

Introduction: Despite therapeutic advances in hemorrhagic shock, mortality from multiple organ failure remains high. We previously showed that the α1 subunit of AMP-activated protein kinase (AMPK), a crucial regulator of mitochondrial function, exerts a protective role in hemorrhagic shock. Humanin is a mitochondrial peptide with cytoprotective properties against cellular stress. Here, we investigated whether AMPKα1 influences systemic levels of endogenous humanin in hemorrhagic shock and whether treatment with the synthetic analog humanin-G affords beneficial effects. Methods: AMPKα1 wild-type (WT) and knockout (KO) female mice were subjected to hemorrhagic shock followed by resuscitation with blood and lactated Ringer's solution. In short-term studies, mice were treated with humanin-G or vehicle and sacrificed at 3 h after resuscitation; in survival studies, mice were treated with PEGylated humanin-G and monitored for 7 days. Results: Compared with the vehicle WT group, KO mice exhibited severe hypotension, cardiac mitochondrial damage, and higher plasma levels of Th17 cytokines but had similar lung injury and similar plasma elevation of endogenous humanin. Treatment with humanin-G improved lung injury, mean arterial blood pressure, and survival in both WT and KO mice, without affecting systemic cytokine or humanin levels. Humanin-G also ameliorated cardiac mitochondrial damage and increased adenosine triphosphate levels in KO mice. Beneficial effects of humanin-G were associated with lung cytoplasmic and nuclear activation of the signal transducer and activator of transcription-3 (STAT3) in AMPKα1-independent manner with marginal or no effects on mitochondrial STAT3 and complex I subunit GRIM-19. Conclusions: Our data indicate that circulating levels of humanin increase during hemorrhagic shock in AMPKα1-independent fashion as a defense mechanism to counteract metabolic derangement and that administration of humanin-G affords beneficial effects through STAT3 activation even in the absence of a functional AMPKα1.