bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal Validation of Right Ventricular Pressure Monitoring for the Assessment of Right Ventricular Systolic Dysfunction in a Large Animal Ischemic Model
Authors: Couture Etienne J. , Moses Kevin , Monge García Manuel Ignacio , Potes Cristhian , Haddad Francois , Grønlykke Lars , Garcia Fernando , Paster Eden , Pibarot Philippe , Denault André Y. 
Published: January 2023

CONTEXT:
Right ventricular (RV) dysfunction is a major cause of morbidity and mortality in intensive care and cardiac surgery. Early detection of RV dysfunction may be facilitated by continuous monitoring of RV waveform obtained from a pulmonary artery catheter. The objective is to evaluate the extent to which RV pressure monitoring can detect changes in RV systolic performance assess by RV end-systolic elastance (Ees) following the development of an acute RV ischemic in a porcine model.

HYPOTHESIS:
RV pressure monitoring can detect changes in RV systolic performance assess by RV Ees following the development of an acute RV ischemic model.

METHODS AND MODELS:
Acute ischemic RV dysfunction was induced by progressive embolization of microsphere in the right coronary artery to mimic RV dysfunction clinically experienced during cardiopulmonary bypass separation caused by air microemboli. RV hemodynamic performance was assessed using RV pressure waveform-derived parameters and RV Ees obtained using a conductance catheter during inferior vena cava occlusions.

RESULTS:
Acute ischemia resulted in a significant reduction in RV Ees from 0.26 mm Hg/mL (interquartile range, 0.16–0.32 mm Hg/mL) to 0.14 mm Hg/mL (0.11–0.19 mm Hg/mL; p < 0.010), cardiac output from 6.3 L/min (5.7–7 L/min) to 4.5 (3.9–5.2 L/min; p = 0.007), mean systemic arterial pressure from 72 mm Hg (66–74 mm Hg) to 51 mm Hg (46–56 mm Hg; p < 0.001), and mixed venous oxygen saturation from 65% (57–72%) to 41% (35–45%; p < 0.001). Linear mixed-effect model analysis was used to assess the relationship between Ees and RV pressure-derived parameters. The reduction in RV Ees best correlated with a reduction in RV maximum first derivative of pressure during isovolumetric contraction (dP/dtmax) and single-beat RV Ees. Adjusting RV dP/dtmax for heart rate resulted in an improved surrogate of RV Ees.

INTERPRETATION AND CONCLUSIONS:
Stepwise decreases in RV Ees during acute ischemic RV dysfunction were accurately tracked by RV dP/dtmax derived from the RV pressure waveform.
Prevalence of Obstructive Sleep Apnea With Floppy Eyelid Syndrome: A Systematic Review and Meta-analysis
Authors: Bulloch Gabriella , Seth Ishith , Alphonse Stephen , Sathe Aditya , Jennings Matthew , Sultan Dana , Rahmeh Rami , McNab Alan A. 
Published: January 2023

Purpose:
This study investigated the prevalence of obstructive sleep apnea (OSA) in floppy eyelid syndrome (FES) patients and evaluated the severity of OSA with FES prevalence.

Methods:
Cochrane CENTRAL, Medline, Science Direct, Google Scholar, and PubMed databases were searched for studies on FES patients and its association with OSA syndrome, of any design, published from January 1, 1997, to January 1, 2022. A random-effects model that weighted the studies was used when there was heterogeneity between studies (p < 0.10) and if I2 values were more than 50%. All p values were 2-tailed and considered statistically significant if <0.05.

Results:
A total of 12 studies comprising 511 patients were included in this meta-analysis. Of these, 368 were male (77.6%) and the average age was 55.10 years. The overall prevalence of OSA in FES patients was 57.1% (95% CI: 46.5–74.8%), M:F ratio was 48:1 (98% male), and 69.1% of patients received their OSA diagnosis at the time of the study. Of those with FES, tear film abnormalities were the most common ocular comorbidity (78.9%) followed by keratoconus (20.6%), glaucoma (9.8%), and lower eyelid ectropion (4.6%). Obesity was the most common systemic morbidity (43.7%) followed by hypertension (34.0%) and diabetes mellitus (17.9%).

Conclusion:
This meta-analysis demonstrates OSA is a common comorbidity in the FES population. Ophthalmologists are often the first to evaluate patients with FES, and considering this coincidence, routine screens for sleep apnea symptoms in at-risk FES patients should be undertaken. Large case-control studies are required to better elucidate the exact prevalence of OSA and other morbidities in patients with FES, and to better understand the etiology of FES.
Mirogabalin improves cancer-associated pain but increases the risk of malignancy in mice with pancreatic cancer
Authors: Itaya Tomoaki , Sano Makoto , Kajiwara Ichie , Oshima Yukino , Kuramochi Tomoya , Kim Jinsuk , Ichimaru Yoshimi , Kitajima Osamu , Masamune Atsushi , Ijichi Hideaki , Ishii Yukimoto , Suzuki Takahiro 
Published: January 2023

Abstract
Mirogabalin, a selective voltage-gated calcium channel α2δ ligand, improves peripheral neuropathic pain; however, its effects on patients with cancers including pancreatic ductal adenocarcinoma (PDAC) remain unknown. We analyzed the effects of mirogabalin on a KPPC (LSL-Kras

G12D/+

; Trp53

flox/flox

; Pdx-1

cre/+
) mouse model of PDAC. Six-week-old KPPC mice received oral mirogabalin (10 mg/kg/day) (n = 10) or vehicle water (n = 14) until the humane end point. Cancer-associated pain was evaluated using the scores of hunching and mouse grimace scale (MGS). Tumor status and plasma cytokine levels were determined using histopathological analysis and cytokine array, respectively. The effects of mirogabalin on the proliferative ability of PDAC cell lines were determined. The scores of the hunching and MGS improved after mirogabalin administration with a decrease in the plasma levels of inflammatory cytokines, such as tumor necrosis factor-α, interleukin-6, and interferon-γ. Although no significant difference in the survival rate was observed, mirogabalin significantly increased pancreatic tumor size and proliferative index of Ki-67 and cyclins. Local arginase-1+ M2-like tumor-associated macrophages and CD31+ tumor blood vessels increased after mirogabalin administration. By contrast, the number of α-smooth muscle actin+ cancer-associated fibroblasts, desmoplastic stroma, and CD8+ T cells decreased. Local myeloperoxidase+ tumor-associated neutrophils and CD45R+ B cells were unaltered. Mirogabalin enhanced the proliferative ability of PDAC cell lines with the upregulation of cyclins and cyclin-dependent kinases; however, it inhibited the potential of pancreatic stellate cells in vitro. Therefore, our results suggest that mirogabalin improves cancer-associated pain but enhances the proliferative potential of PDAC in vitro and in vivo.
ST elevation myocardial infarction – national trend analysis with mortality differences in outcomes based on day of hospitalization
Authors: Jha Anil , Ojha Chandra P. , Bhattad Pradnya Brijmohan , Sharma Ashish , Thota Ajit , Mishra Ajay Kumar , Krishnan Anand M. , Roumia Mazen 
Published: January 2023

Background
Patientswho present with acute ST elevation myocardial infarction (STEMI) need emergent revascularization. Our study aims to investigate the outcomes in patients with STEMI admitted during weekends versus weekdays.

Methods
We conducted a retrospective analysis of the nationwide inpatient sample database. Patients with an admitting diagnosis of STEMI identified by the International Classification of Disease code for the year 2016 were analyzed. A weighted descriptive analysis was performed to generate national estimates. Patients admitted over the weekend were compared to those admitted over the weekday. Patients were stratified by demographic and clinical factors including the Elixhauser comorbidity index. The primary outcome was in-hospital mortality and secondary outcomes were percutaneous coronary intervention (PCI) utilization rate, rate of transfer-out, length of stay (LOS), and total hospital charges. Statistical analysis including linear and logistic regression was performed using STATA.

Results
A total of 163 715 adult patients were admitted with STEMI, of which 27.9% (45 635) were admitted over the weekend. There were 76.2% Caucasians, 9.3% African Americans, and 8.0% Hispanics. Mean age of the patients was 63.2 years (95% CI, 62.9–63.5) for the weekend group and 63.7 years (95% CI, 63.5–63.9) for weekday admissions. The majority of the patients in both groups had Medicare (43.7% and 45.8% on weekends and weekdays, respectively; P = 0.0047). After adjusting for age, sex, race, income, Elixhauser comorbidity index, PCI use, hospital location, teaching status, and bed size, mortality was not significantly different in weekend versus weekday admissions (odds ratios 1.04; P = 0.498; 95% CI, 0.93–1.16). There was no significant difference in mean total charge per admission during the weekend versus weekday admissions ($107 093 versus $106 869; P = 0.99.) Mean LOS was 4.1 days for both groups (P = 0.81).

Conclusions
There were no significant differences in mortality, LOS, or total hospital charge in STEMI patients being admitted during the weekend versus weekdays.
Clinical implication of totally occluded infarct-related coronary artery in non-ST-segment elevation myocardial infarction: the TOTAL-NSTEMI study
Authors: Güner Ahmet , Çörekçioğlu Büşra , Uzun Fatih , Kalçik Macit , Ulutaş Ahmet Emir , Akman Cemalettin , Can Cemil , Keten Mustafa Ferhat , Küp Ayhan , Gürsoy Mustafa Ozan , Kalkan Semih , Çizgici Ahmet Yaşar , Kahraman Serkan , Güner Ezgi Gültekin , Külahçioğlu Şeyhmus , Yalçin Ahmet Arif , Ertürk Mehmet 
Published: January 2023

Background
A subset ofpatients found to have total occlusion of the culprit artery (TOCA), present with non-ST-segment elevation myocardial infarction (NSTEMI) and elevated biomarkers. The aim of this study is to assess the effect of the TOCA in patients presenting with NSTEMI.

Methods
This multicenter observational study was retrospectively conducted between 2015 and 2019. Thrombolysis in myocardial infarction (TIMI) flow grades 0–1 was defined as the TOCA. The primary end point included a combination of all-cause death, myocardial infarction, target vessel revascularization, stent thrombosis, and stroke.

Results
Of 3272 patients, TIMI 0–1 flow in the culprit artery was present in 488 (14.9%) patients. TOCA was more likely to be of thrombotic origin (54.1% vs. 10.3%; P < 0.001) and visible collaterals (22.5% vs. 4.4%; P < 0.001). The rates of 30-day (14.3% vs. 7.2%; P < 0.001) and 2-year (25% vs. 19.1%; P = 0.003) primary end points were significantly higher in TOCA patients. Fatal arrhythmias were remarkably higher at 30-day (8.6% vs. 4%; P < 0.001) and 2-year (9% vs. 5.2%; P = 0.001) follow-ups. Mechanical complications were also higher in patients with TOCA at 30 days (0.8% vs. 0.2%; P = 0.013). Moreover, TOCA (OR, 1.379; P = 0.001) was one of the independent predictors of MACCE in NSTEMI patients.

Conclusion
The current data suggest that patients with TOCA in the context of NSTEMI are at higher risk of MACCE, fatal arrhythmias, and mechanical complications.
A challenging case of lumbar vertebral burst fracture with alcohol withdrawal delirium: A case report
Authors: Koizumi Keisuke , Uehara Masashi , Oba Hiroki , Ikegami Shota , Kamanaka Takayuki , Hatakenaka Terue , Miyaoka Yoshinari , Fukuzawa Takuma , Hayashi Koji , Takahashi Jun 
Published: January 2023

Background:
Delirium tremens is a symptom of alcohol withdrawal syndrome that occurs 48 to 96 hours after the last drink in 5% of withdrawing patients.

Methods:
This report describes the clinical progression of a case of lumbar vertebral burst fracture with alcohol withdrawal delirium that was difficult to manage.

Results:
A 47-year-old man was rushed to our hospital complaining of lumbar back pain and numbness in both lower extremities resulting from a 6-m fall during civil engineering work. Computed tomography (CT) revealed a L1 burst fracture with a highly protruding bone fragment in the spinal canal. Magnetic resonance imaging disclosed significant compression of the conus and intramedullary signal changes. We immediately performed posterior spinal fusion and vertebroplasty using instrumentation. On the 4th postoperative day, he became severely agitated, as diagnosed as having delirium tremens related to alcohol withdrawal syndrome, and soon began appropriate medication with diazepam. Although his symptoms persisted until 6 days postoperatively, follow-up CT detected no evidence of screw loosening or breakage.

Conclusion:
We encountered a patient with severe delirium tremens developing several days after thoraco-lumbar fusion surgery. Prompt internal fixation successfully treated the spinal injury and prevented neurological damage. It may also be necessary to consider treatment strategies for patients with a background of heavy alcohol consumption in consideration of delirium tremens and other symptoms of alcohol withdrawal.
Past, present and future of genomics for kidney stone disease
Authors: Jahrreiss Victoria , Özsoy Mehmet , Seitz Christian , Somani Bhaskar 
Published: January 2023

Purpose of review
To summarize the latest findings and developments in genomics for kidney stone disease (KSD) that help to understand hereditary pathomechanisms, identify high risk stone formers, provide early treatment and prevent recurrent kidney stone formation.

Recent findings
Several gene loci associated to KSD have presently been discovered in large Genome-wide association studies. Monogenic causes are rare, but are thought to have higher penetrance, while polygenic causes are more frequent with less penetrance. Although there is a great effort identifying genetic causes of KSD, targeted therapies are scarce.

Summary
There have been great advancements in genetic research in identifying genetic variants associated with KSD. Identifying these variants and understanding the underlying pathophysiology will not only provide individual risk assessment but open the way for new treatment targets and preventive care strategies.
Robotic radical cystectomy – more precision needed?
Authors: Walz Simon , Aslani Valese , Sawodny Oliver , Stenzl Arnulf 
Published: January 2023

Purpose of review
Recently, several trials as well as registry-data analyses investigating the role of robot-assisted radical cystectomy with extra or intracorporal urinary diversion were completed and follow up matured. This review aims to comment on the current evidence-based findings and interpret the future role of the robotic approach as a part of the treatment of bladder cancer.

Recent findings
Numerous trials and registry-data analyses revealed no significant differences in progression-free and overall survival after open radical cystectomy or robot-assisted radical cystectomy irrespective of urinary diversion. Perioperative parameters, especially intraoperative blood loss, transfusions, thromboembolic events, wound infections and hospitalization were significantly increased in open radical cystectomy. Patients’ convalescence, and especially early postsurgical quality of life, was improved by the robotic approach. The highly demanding surgery itself displayed by a flat learning curve required more than 130 surgeries per institution to reach a stable plateau of complications. The performance of high-quality radical cystectomy irrespective of the approach was significantly increased in high-volume centres. Local recurrence occurs in 11% after radical cystectomy. Current research focuses on intraoperatively usable detection methods and instruments to minimize the risk of residual tumour cells.

Summary
Taken together, the total intracorporal approach in radical cystectomy holds the potential to improve perioperative parameters and reduces hospitalization without impairing oncological performance of the procedure. To provide best results for the patient radical cystectomy and especially the technically challenging total intracorporal procedure will gain importance in bladder cancer treatment but should be limited to high-volume centres.
Stroke in Pediatric Cancer Patients: A Systematic Review
Authors: Catueno Samanta , Ali Sara , Barrientos Ricardo , Valdez Marcos , Mba Nkechi , Sherani Farha , Bhalala Utpal 
Published: January 2023

Objective:
Pediatric cancer patients have an increased risk of stroke. However, there is a knowledge gap regarding stroke in early stages of pediatric cancer. The objective of this project is to describe the current knowledge on stroke in pediatric cancer patients.

Design:
Systematic review.

Materials and Methods:
After Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, literature search was conducted in PubMed, Cochrane, and Google Scholar from January 1, 1995, up to February 1, 2022.

Results:
A total of 3499 studies were identified, of which 8 met inclusion criteria. The incidence of stroke in pediatric cancer patients varied between 0.47% and 2.9%, and prevalence between 1% and 3%. The risk factors identified were leukemia diagnosis, cranial radiation, thrombocytopenia, coagulopathy, and infection. There was a higher rate of diagnosis with magnetic resonance imaging than with computed tomography scan. Treatment was inconsistent, and patients with cancer were less likely to receive antithrombotic treatment when compared with patients without cancer. The highest mortality was among hemorrhagic stroke. Recurrence rate was 5% to 19%.

Conclusions:
The risk for stroke is increased in the pediatric cancer population and can lead to devastating results. The available reports include few patients, with heterogeneous cancer diagnoses and outcomes. Large-scale multicenter studies are needed, focusing on early diagnosis, risk factors, and management strategies of stroke in children with underlying cancer.
Do Children With an Allergic Transfusion Reaction Require Premedication For All Blood Products?
Authors: Bahabri Aban , Barty Rebecca , Li Na , Liu Yang , Kovalova Tanya , Chan Anthony K.C. 
Published: January 2023

Background:
Children with a history of allergic transfusion reactions (ATRs) receive antihistamine premedication with or without hydrocortisone to prevent subsequent reactions. We aim to examine the frequency of developing ATRs to subsequent different blood product type transfusions.

Methods:
A retrospective chart review of children who received blood product transfusions (packed red blood cells, platelets, frozen plasma, intravenous immunoglobin, albumin, and cryoprecipitate) and developed ATRs. Cases were identified through Transfusion Transmitted Injuries Surveillance System- Ontario database with a complementary chart review. Demographics and subsequent transfusions records were described.

Results:
During this period, 35,925 blood products were transfused to 4153 patients. Thirty-eight ATRs were reported in 30 patients. All ATRs were minor except 1 anaphylaxis to albumin transfusion. Seven patients (23%) developed multiple ATRs, and all of them were of the same blood product type. A total of 60 subsequent different blood product types were transfused to the 7 patients who had multiple ATRs; none of those transfusions caused ATR.

Conclusion:
In children with a history of ATR, developing a reaction to a different blood product type is rare. Hence, premedicating those transfusions is not warranted.
Ontological Adaptation in Transition to Adulthood
Authors: Chiappelli Joshua , Beason Tiffany 
Published: January 2023

Abstract
In this theoretical review, the neurodevelopmental model of psychotic disorders is considered within the framework of ontological development, referring to the individual-level construction of a sense of reality regarding identity and worldview. Following Erikson's theory of development, the challenge of forging a personal and social identity is a developmental process typical of late adolescence and early adulthood. Accompanying this process is a developmentally normal increase in exploratory and risk-taking behavior, which sometimes includes challenging and defying cultural norms. Although many aspects of ontological adaptation are developmentally appropriate, we argue that psychopathology such as psychosis can be rooted in an abnormal deviation of this process, in which aberrant salience accelerates the typical drive to develop a meaningful sense of identity, leading to delusion formation. By placing psychosis onset within a broader context of normal development, this model offers a humanistic approach for understanding experiences of new onset of psychotic disorders.
Case Report: Recurrent Acute Macular Neuroretinopathy—Monitoring Recovery with Multimodal Imaging
Authors: Oliver Joshua C. , DePoe Scott A. 
Published: January 2023

ABSTRACT

Significance
Acute macular neuroretinopathy (AMN) is a rare, non-progressive condition affecting the outer retina that can be diagnosed clinically utilizing widely available multimodal imaging techniques. This case report presents an exceedingly rare same eye recurrence of AMN and describes the characteristic imaging findings of this unique, not fully understood clinical entity.

Purpose
The following report provides a detailed account of recurrent AMN from four hours of symptom onset through four months with repeat multimodal imaging captured at different visits. This report also devotes some discussion to the current understanding of its pathophysiology, associations, management, and imaging characteristics.

Case Report
A 32-year-old female with unilateral recurrent AMN was monitored frequently with various multimodal imaging from four hours after onset of new scotoma through four months. The primary finding in the acute stage was a hyperreflective lesion of the outer nuclear (ONL) and outer plexiform layers followed by disruption of underlying external limiting membrane, ellipsoid zone, and photoreceptors. This resolved into stable ONL thinning and subtle disruption of the deeper layers after one week. Fundus photography revealed a red-brown petaloid lesion adjacent to the fovea, and optical coherence tomography angiography revealed subtle decreased perfusion of the choriocapillaris layer throughout follow up.

Conclusions
AMN is a rare non-progressive condition of the outer retina most often affecting otherwise healthy young females and is most associated with recent flu-like illness and oral contraceptives. The underlying mechanism of AMN remains unknown, but modern imaging techniques have elucidated the disease locus to be choroidal and/or deep capillary plexus. It is important for eye care providers to recognize AMN as a clinical entity distinct from other retinal conditions that require different management.
The Impact of Donor Preparation for Tissue Procurement on Postmortem Vitreous Isopropanol Concentration
Authors: Avedschmidt Sarah E. , Melton Annamaria , Turner Katherine A. , Sommer Stephanie , Olden Nick K. , Cohle Stephen 
Published: January 2023

Abstract
Volatile chemicals can be relevant in the determination of the cause and manner of death by forensic pathologists. Isopropanol is a secondary alcohol that is occasionally seen on postmortem toxicology testing. A series of 11 forensic autopsy cases was previously reported in which the presence of isopropanol in the vitreous humor was suspected to be due to postmortem contamination from the body preparation process for tissue procurement.
In collaboration with a tissue procurement agency, donor vitreous humor was collected from one eye before body preparation for procurement and from the other eye postpreparation. The specimens underwent testing for volatile substances by headspace gas chromatography.
Of the 50 cases, 8 (16%) showed statistically significant changes in the prepreparation and postpreparation isopropanol concentrations. Postpreparation isopropanol concentrations ranged from 5 to 104 mg/dL (median, 18 mg/dL). Seven of the 8 cases had undetectable prepreparation isopropanol, whereas the remaining case had a detectable prepreparation isopropanol.
In conclusion, surface contamination of the decedent's body with chemicals used in body preparation can lead to the passive absorption into the body, resulting in the presence of isopropanol in postmortem toxicology samples. Forensic pathologists need to be aware of this when interpreting postmortem samples after tissue procurement.