bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Subcapsular Liver Hematoma With Preeclampsia, Eclampsia, or Hemolysis, Elevated Liver Enzymes, and Low Platelet Count Syndrome
Authors: Chahine Khalil M. , Shepherd Megan C. , Sibai Baha M. 
Published: January 2025

OBJECTIVE:
To describe the presentation, outcomes, and management strategies for cases of subcapsular liver hematoma associated with preeclampsia, eclampsia, or HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome.

METHODS:
This was a case series of individuals with subcapsular liver hematoma managed at a single level IV center over a 10-year period, from 2013 to 2024. Presenting signs and symptoms, laboratory findings, time of onset, management strategies, acute perinatal and maternal outcomes, and long-term outcomes such as subsequent pregnancies were reviewed in the medical record and recorded. Data were summarized using descriptive statistics, with results reported as means, standard deviations, and ranges. Categorical variables were summarized as counts and percentages.

RESULTS:
There were 13 cases of subcapsular liver hematoma associated with preeclampsia, eclampsia, and HELLP syndrome between 2013 and 2024. In 10 of the 13 pregnancies (76.9%), delivery was preterm. The most common presenting symptoms were epigastric or right upper quadrant pain (53.8%), followed by abdominal distention (38.5%). Diagnosis of subcapsular liver hematoma was made in the antepartum period for six patients and was made in the postpartum for seven patients. The diagnosis was confirmed in all cases by computed tomography. Conservative management with close hemodynamic monitoring and transfusion of blood and blood products was sufficient in 11 (84.6%) patients; two patients underwent surgical exploration. The mean duration of hospital stay was 10 days (range 2–21 days). Maternal complications included pleural effusions, acute kidney injury, and pulmonary edema. There were no maternal deaths. There were four stillbirths and no neonatal deaths. Four people had five subsequent pregnancies; delivery was preterm in all five pregnancies, two pregnancies were complicated by subsequent HELLP syndrome, and one patient developed recurrent subcapsular liver hematoma.

CONCLUSION:
Subcapsular liver hematoma is a rare complication of preeclampsia, eclampsia, and HELLP syndrome that is associated with substantial maternal and perinatal morbidities. Conservative management with hemodynamic monitoring and transfusion of blood and blood products was sufficient for management in the majority of cases. All subsequent pregnancies resulted in preterm births.
Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) from contaminated water and risk of childhood cancer in California, 2000–2015
Authors: Binczewski Natalie R. , Morimoto Libby M. , Wiemels Joseph L. , Ma Xiaomei , Metayer Catherine , Vieira Verónica M. 
Published: January 2025

Background:
Few studies have investigated associations between per- and polyfluoroalkyl substances (PFAS) and childhood cancers. Detectable levels of PFAS in California water districts were reported in the Third Unregulated Contaminant Monitoring Rule for 2013–2015.

Methods:
Geocoded residences at birth were linked to corresponding water district boundaries for 10,220 California-born children (aged 0–15 years) diagnosed with cancers (2000–2015) and 29,974 healthy controls. A pharmacokinetic model was used to predict average steady-state maternal serum concentrations of perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) from contaminated drinking water. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) per doubling of background exposure were calculated for cancers with at least 90 cases.

Results:
Predicted PFOS and PFOA maternal serum concentrations ranged from background (5 ng/ml PFOS and 2 ng/ml PFOA) to 22.89 ng/ml and 6.66 ng/ml, respectively. There were suggestive associations between PFOS and nonastrocytoma gliomas (n = 268; AOR = 1.26; 95% CI: 0.99, 1.60), acute myeloid leukemia (n = 500; AOR = 1.14; 95% CI: 0.94, 1.39), Wilms tumors (n = 556, AOR = 1.15; 95% CI: 0.96, 1.38), and noncentral system embryonal tumors (n = 2,880; AOR = 1.07; 95% CI: 0.98, 1.17), and between PFOA and non-Hodgkin lymphoma (n = 384; AOR = 1.19; 95% CI: 0.95, 1.49). Among children of Mexico-born mothers, there was increased risk of Wilms tumor (n = 101; AORPFOS = 1.52; 95% CI: 1.06, 2.18; AORPFOA = 1.59, 95% CI: 1.12, 2.24) and noncentral system embryonal tumors (n = 557; AORPFOS = 1.24, 95% CI: 1.03, 1.50; AORPFOA = 1.19, 95% CI: 0.98, 1.45).

Conclusion:
Results suggest associations between predicted prenatal maternal PFAS serum concentrations and some childhood cancers. Future analyses are warranted.
Robotic mitral valve surgery: evolving history, techniques, and training paths
Authors: Hasan Irsa , Amabile Andrea , Tam Derrick Y. 
Published: January 2025

Purpose of review
Over the past 25 years, robotic-assisted mitral valve surgery has gained significant recognition because of its potential to minimize patient trauma and improve clinical outcomes. This field has evolved from early efforts in minimally invasive mitral procedures to more refined and technically sophisticated approaches, driven by the need for smaller incisions and reduced recovery times.

Recent findings
This review will delve into the historical evolution of robotic-assisted mitral valve surgery, detailing the technical advancements that have shaped current practices and outlining the essential training pathways for a career as robotic mitral valve surgeon.

Summary
The development of robotic systems has marked a turning point, offering surgeons greater precision and dexterity, crucial adjuncts in complex mitral valve repairs.
Investigation of the Ocular Response and Corneal Damage Threshold of Exposure to 28 GHz Quasi-millimeter Wave Exposure
Authors: Kojima Masami , Tasaki Takafumi , Kamijo Toshio , Hada Aki , Suzuki Yukihisa , Kik Alfred , Ikehata Masateru , Sasaki Hiroshi 
Published: January 2025

Abstract
Electromagnetic radiation energy at millimeter wave frequencies, typically 30 GHz to 300 GHz, is ubiquitously used in society in devices for telecommunications; radar and imaging systems for vehicle collision avoidance, security screening, and medical equipment; scientific research tools for spectroscopy; industrial applications for non-destructive testing and precise measurement; and military and defense applications. Understanding the biological effects of this technology is essential. We have been investigating ocular responses and damage thresholds comparing various frequencies using rabbit eyes and dedicated experimental apparatus. In this study we investigated the 28 GHz quasi-millimeter wave band (wavelength: 10.7 mm), a candidate for 5G communication. Similar to millimeter wave frequencies, ocular damage from exposure to 28 GHz for 6 min (400 mW cm−2) included corneal epithelial damage, corneal edema, and opacity. The incident power density threshold, indicating a 50% probability of ocular damage from exposure for 6 min, was found to be 359 mW cm−2 for 28 GHz. Comparing the ocular exposure area for various millimeter wave frequencies (40, 75, 95 GHz) and 28 GHz quasi-millimeter waves using a thermosensitive liquid crystal capsule, we found that for millimeter waves, even at identical incident power densities, the ocular exposure area decreases as the frequency increases (lens effect). However, this lens effect was not observed at 28 GHz, where the entire anterior segment area was exposed to radio waves.
HIV Vulnerability Typologies Among Adolescent Girls and Young Women in Lesotho: A Population-Based, Cross-Sectional, Latent Class Analysis
Authors: Shrader Cho-Hee , Jovanovski Straso , Saito Suzue , Reed Domonique , Ndagije Felix , Greenleaf Abigail 
Published: January 2025

Abstract
Adolescent girls and young women ages 15–29 years (AGYW) living in Lesotho experience a disproportionate HIV burden. Using a household-based national survey in Lesotho, we conducted a three-step latent class analysis to identify typologies of AGYW most vulnerable to HIV infection. We first classified AGYW into HIV vulnerability groups based on self-reported sexual behaviors, then identified associations between typology and HIV diagnosis. HIV vulnerability behaviors included early sexual debut, condomless sex, multiple sexual partners in the past year, sex with partners they do not know the status of or are living with HIV, age disparate sex, use of contraceptives, and having children. Across all age groups, we found that HIV vulnerability typologies could be described as low vulnerability, high vulnerability, and parous. As AGYW age, they engage in more types of higher vulnerability sexual behaviors; interventions to reduce this risk should start at a younger age. Our findings emphasize the importance of implementing and scaling up biomedical strategies such as pre-exposure prophylaxis.
Current approach to diagnosis and management of low-phospholipid associated cholelithiasis syndrome
Authors: Soret Pierre-Antoine , Chazouillères Olivier , Corpechot Christophe 
Published: January 2025

Purpose of review
Low phospholipid-associated cholelithiasis (LPAC) syndrome is a rare genetic form of intrahepatic cholesterol lithiasis, affecting mainly young adults. This review describes the recent advances in genetic and clinical characterization, diagnosis and management of LPAC syndrome.

Recent findings
Recent publications report data from several retrospective cohorts. These cohorts describe the main clinical features, the most frequent radiological lesions, complications, the results of biliary endoscopic procedures and the prognosis associated with LPAC syndrome.

Summary
LPAC syndrome has been linked to a partial defect in the ATP binding cassette subfamily B member 4 (ABCB4) gene encoding the canalicular phospholipid transporter multidrug resistance protein 3, but this mechanism would explain only half the cases, or even fewer. This syndrome is characterized by the appearance of cholelithiasis at an abnormally early age (before 40) and by the persistence of biliary symptoms after cholecystectomy. The diagnosis is usually confirmed by an ultrasound scan of the liver, which reveals the presence of intrahepatic microlithiasis, as evidenced by comet-tail images or microspots along the intrahepatic bile ducts. Ursodeoxycholic acid, at a daily dose of 5–15 mg/kg, is the reference treatment. If not performed prior to diagnosis, cholecystectomy should be avoided wherever possible. In complicated or refractory forms, endoscopic biliary intervention may be necessary.
Ipsilateral Breast Carcinoma Recurrence
Authors: Fernández-Abad María , Caniego-Casas Tamara , Carretero-Barrio Irene , Calderay-Domínguez Milagros , Saavedra Cristina , Hardisson David , Palacios José , Pérez-Mies Belén 
Published: January 2025

Determining whether an ipsilateral breast carcinoma recurrence is a true recurrence or a new primary remains challenging based solely on clinicopathologic features. Algorithms based on these features have estimated that up to 68% of recurrences might be new primaries. However, few studies have analyzed the clonal relationship between primary and secondary carcinomas to establish the true nature of recurrences. This study analyzed 70 breast carcinomas from 33 patients using immunohistochemistry, FISH, and massive parallel sequencing. We compared 35 primary carcinomas with the associated recurrences, identifying 24 (68.6%) as true recurrences, 7 (20%) as new primaries, and 4 (11%) as undetermined. Twenty-eight primary carcinomas were invasive carcinomas (22 of no special type, 5 invasive lobular, and 1 invasive micropapillary carcinoma), and 7 were in situ (6 ductal and 1 lobular). Time to recurrence was longer for new primaries (median 12.8 y) than for true recurrences (median 6.8 y). Among the new primary cases, 6 of 7 (85%) patients had undergone mastectomy as their initial treatment. Clinicopathologic classifications of invasive carcinomas overestimated the number of new primaries (41.6% to 68.6%), partially due to phenotype conversion in 14% of true recurrences. Although 41.7% of recurrences showed private mutations or amplifications relevant to tumor progression, such as PIK3CA, PIK3R1, MAP3K1, AKT1, GATA3, CCND1, MDM4, or T P 5 3; a common mutational progression pattern was not identified. Further studies, including larger series, are necessary to evaluate the prognostic significance of the molecular classification of recurrences.
A Qualitative Assessment of Barriers, Facilitators, and Outcomes in a Simulation-Based Collaborative Quality Improvement Program
Authors: Alletag Michelle J. , Kant Shruti , Van Ittersum Wendy L. , Walls Theresa A. , Montgomery Erin E. , Anderson Hannah L , Mannenbach Mark S. , Auerbach Marc A. 
Published: January 2025

Objectives
ImPACTS (Improving Acute Care Through Simulation) is a collaborative simulation-based program partnering pediatric specialty centers (“hubs”) with general emergency departments (GEDs) to improve pediatric acute care. Objective measurements of ImPACTS, such as evaluating Pediatric Readiness Score (PRS) and simulation-based outcome improvements, have been reported previously. Barriers to and facilitators of program involvement and the downstream effects of the program have not been previously described. This study explores these aspects and key drivers for successful collaboration.

Methods
The authors performed open coding of semistructured interviews of hub team members and pediatric emergency care coordinators (PECCs) from community GED “spokes.” We then identified and explored themes within the categories of barriers to, facilitators of, and barrier mitigation strategies for successful partnerships from the perspectives of both groups.

Results
Analysis generated 4 dominant themes: buy-in, communication, personnel, and logistics. Engagement, institutional support, and buy-in of site leaders and individual participants were crucial to successful implementation, without which the programs were not completed or never started. Hubs benefited from project involvement via increased local engagement in pediatric readiness, organizational support, and further buy-in from institutional leadership, allowing for the future continuation of ImPACTS and similar programs. Benefits experienced by GEDs impacted education, pediatric readiness, and clinical and financial partnerships across institutions. Additionally, spoke interviewees cited downstream effects of participation, including increased collaboration and improved relationships with hub sites as being the most impactful.

Conclusion
Understanding the key drivers of all collaborators is instrumental in successfully implementing large-scale educational and quality initiatives like the ImPACTS program.
A National Survey of Caregiver Needs and Experiences When Attending the Emergency Department
Authors: Ali Samina , Rahimi Asa , Rajagopal Manasi , Ma Keon , Yaskina Maryna , Clerc Paul , Stang Antonia , Beer Darcy , Poonai Naveen , Kam April , Principi Tania , Gardner Katie , Wright Bruce , Plint Amy , Gouin Serge , Schreiner Kurt , Scott Shannon D. ,   on behalf of the Pediatric Emergency Research Canada Family Needs study team
Published: January 2025

Objectives
Despite being a frequent entry point of care, it remains unknown if families' needs are being met across pediatric emergency departments (PEDs). Study objectives were to describe caregivers' perceived overall PED experience and needs and to what extent these needs were met.

Methods
This descriptive, cross-sectional survey with medical record review was conducted in 10 Canadian PEDs. Caregivers completed electronic surveys in the PED and within 7 days postvisit. The primary outcome was the degree to which caregivers' overall needs were met in the PED.

Results
A total of 2005 caregivers participated; mean age was 37.8 (standard deviation 7.7) years and 74.3% (1462/1969) were mothers. Mean child age was 5.9 (standard deviation 5.1) years; 51.9% (1040/2003) were male. The median [interquartile range (IQR)] length of stay was 3.9 (2.6–6.1) hours. A total of 22.1% (322/1454) of caregivers reported that their overall needs were not adequately met (Likert scale 1–3/5). The top unmet needs during a PED visit were prompt medical care [20.3% (194/955)], access to practical items [16.8% (160/955)], and effective communication surrounding care [8.7% (83/955)]. Caregiver needs being met were associated with their child's needs being met [odds ratio (OR) 21.2 (13.1–34.2)], child's pain being well managed [OR 3.7 (2.4–5.6)], and satisfaction with overall length of stay [OR 2.6 (1.8–3.8)].

Conclusions
Almost one fourth of caregivers report their overall needs were not fully met. Improving the quality of PED experience through better communication (ie, wait time delays, medical updates) and earlier pain care initiation may improve family experiences while policymakers work nationally to address lengthy wait times.
Appropriate surgical management in skin and soft tissue infections
Authors: Frieders-Justin Viktor , Eckmann Christian , Glaser Benjamin 
Published: January 2025

Purpose of review
To present standards and recent technical innovations in the surgical management of skin and soft tissue infections (SSTI).

Recent findings
SSTI are a frequent cause of presentation in the acute care setting. They can range from simple and uncomplicated to severe and necrotizing infections. Surgical management plays an important role in the treatment of uncomplicated SSTI. Recent evidence indicates that a subgroup of patients (e.g. immunocompromised patients) profits from a postoperative course of antibiotic treatment of 5–7 days. In diabetic foot infections (DFI), repeated debridement to remove necrotic tissue and control infection can prevent minor and major amputation. In necrotizing soft tissue infections (NSTI), early and aggressive surgical debridement is paramount. Recent advancements have explored skin-sparing techniques in selective cases.

Summary
The management of SSTIs requires a combination of surgical and antimicrobial strategies tailored to the type and severity of the infection. Further clinical research is necessary in order to define more accurately those collectives in severe SSTI who profit from a less aggressive surgical approach.
Omadacycline for the treatment of skin and soft tissue infections
Authors: Vena Antonio , Castaldo Nadia , Giacobbe Daniele Roberto , Fantin Alberto , Bassetti Matteo 
Published: January 2025

Purpose of review
To evaluate the current evidence on the use of omadacycline for the treatment of skin and soft tissue infections (SSTIs).

Recent findings
This narrative review examines the available data on the pharmacology, clinical efficacy, safety profile, and comparative effectiveness of omadacycline in treating SSTIs, with a focus on its potential role in everyday clinical practice.

Summary
Omadacycline is a viable option for outpatient therapy and early discharge in patients with SSTIs, particularly in frail populations and those undergoing chronic polypharmacotherapy. Emerging real-world evidence highlights its potential utility beyond approved indications, particularly for infections caused by multidrug-resistant microorganisms where treatment options are limited. However, further studies are needed to confirm its role in contexts beyond its current approvals.
Intranodular Thyroid Metastasis of a Large Cell Neuroendocrine Carcinoma of the Endometrium
Authors: Richard Capucine , Al Ghuzlan Abir , Huchet Virginie , Cockenpot Vincent , Hescot Ségolène 
Published: January 2025

Abstract
A 64-year-old woman underwent initial 18F-FDG PET/CT staging for a suspicious endometrial mass, which showed high uptake in the endometrial mass and a focal uptake in a known left thyroid nodule. Histology revealed a high-grade large cell neuroendocrine carcinoma of the endometrium with FIGO (International Federation of Gynecology and Obstetrics) stage Ib. Further explorations revealed a synchronous thyroid metastasis. Patient then received adjuvant immunochemotherapy. This case showed a potential pitfall in the initial assessment of this rare and aggressive malignancy on which the therapeutic approach greatly depends.
Proactive Surgical Management and Outcomes of Unilateral Zygomaticomaxillary Complex Fractures in Major Trauma Patients: A National Level I Center Experience
Authors: Kim Min Ji , Lee Jun Suk , Lim Hyoseob 
Published: January 2025

Objective:
Managing facial trauma in patients with severe polytrauma presents significant challenges due to competing priorities, poor systemic conditions, and delayed surgical timing. At a national level I trauma center, the authors evaluated the feasibility and outcomes of proactive surgical intervention for unilateral zygomaticomaxillary complex (ZMC) fractures in severe trauma patients.

Methods:
This retrospective study included 81 patients with unilateral ZMC fractures treated at a regional level I trauma center between October 2019 and August 2021. Patients were categorized into high and low trauma severity groups based on the injury severity score (ISS). Three-dimensional (3D) computed tomography analyses were performed to evaluate surgical outcomes, including dimensional distances (Dx, Dy, and Dz) and the Asymmetry Index.

Results:
Of the 81 patients, 52 underwent surgical intervention. No significant differences were observed in 3D distances (Dx, Dy, and Dz) between the high and low ISS groups, both preoperatively and postoperatively. However, postoperative symmetry was superior in the high ISS group (P < 0.010). The average delay from injury to surgery was slightly longer in the high ISS group (8.69 versus 7.35 d, P = 0.248). Complications such as diplopia and paresthesia were more common in the high ISS group, but no significant differences in overall complication rates were observed between the groups.

Conclusion:
Proactive surgical management of unilateral ZMC fractures in major trauma patients is effective. Despite the systemic challenges in this population, timely intervention resulted in superior postoperative symmetry in the high ISS group and comparable 3D outcomes across trauma severities.