bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differentiating Branch Retinal Artery Occlusion From Normal Tension Glaucoma With Optical Coherence Tomography Angiography
Authors: Ferreira Nathalie Sena , Oltramari Laura , Sousa Natanael de Abreu , Makarczyk Luciana de Sá Quirino , Abe Ricardo Yuji 
Published: July 2022

Background:
To describe a patient with branch retinal artery occlusion that was misdiagnosed as normal tension glaucoma (NTG)

Case Presentation:
A female 76-year-old patient presenting inferior nasal visual field scotoma, neuroretinal thinning in the optic disk of the right eye with corresponding atrophy of superior retinal nerve fiber layer in optical coherence tomography (OCT). She was treated with latanoprost eye drops for NTG. However macular OCT angiography showed a localized thinning of the inner retina following the superior temporal branch retinal artery path, along with a superficial and medium capillary plexus reduction and superior macular ganglion cell layer atrophy. Further investigation with carotid arteries angio-tomography revealed an atheromatous lesion in the right and left carotid bulb with stenosis of 50–60%, in addition to aneurysms of the cavernous, pituitary and communicating segments of the left and right internal carotid artery, reinforcing the diagnosis of superior temporal branch retinal artery ischemic.

Conclusion:
This case highlights the importance of establishing differential diagnosis in cases of presumed NTG and reinforces the use of the OCT angiography in clinical practice.
Predicting Visual Field Progression by Optical Coherence Tomography Angiography and Pattern Electroretinography in Glaucoma
Authors: Lee Mee Yon , Park Hae-Young Lopilly , Kim Seong Ah , Jung Younhea , Park Chan Kee 
Published: July 2022

Précis:
Reduced P50-N95 amplitude on pattern electroretinography (PERG) and the presence of microvasculature dropout (MvD) on optical coherence tomography angiography (OCT-A) at baseline were significant factors associated with visual field (VF) progression in predominantly normal tension glaucoma (NTG) patients.

Objective:
We investigated the baseline demographics and ocular characteristics that predict future progression in glaucoma patients, including PERG and OCT-A parameters.

Methods:
One Hundred forty eyes with open angle glaucoma that were prospectively enrolled and followed up for at least 3 years, and underwent at least 5 serial VF tests were included. Baseline PERG was performed, and N35, P50, and N95 latencies and amplitudes were obtained. Superficial vessel density at the macula and complete loss of microvasculature within the deep retinal layer of the parapapillary region (MvD) were evaluated from baseline OCT-A images. Eyes with a glaucomatous VF defect in either both hemifields within 24 points of a central 10 degrees of fixation, and with no VF abnormality in the nasal periphery outside 10 degrees of fixation, were considered to have isolated central scotoma. During follow-up, detected disc hemorrhage (DH) was recorded. Parameters associated with VF progression were determined using linear regression analysis of the mean deviation (MD) values, in combination with an event-based analysis using the Glaucoma Progression Analysis (GPA) software from the Humphrey Field Analyzer. “Likely progression” using GPA was considered to have glaucoma progression.

Results:
Of the 140 eyes, 107 (76.4%) were NTG and 57 (40.7%) exhibited glaucoma progression as defined by Humphrey VF GPA. The MD slopes were −0.43±1.11 dB/y in the progressors and 0.59±1.27 dB/y in the nonprogressors (P<0.001). Glaucoma patients with progression showed frequent MvD on OCT-A, isolated central scotoma, frequent DH, and reduced baseline P50-N95 amplitude compared with patients without progression. Age at diagnosis (P=0.038) and baseline P50-N95 amplitude (P=0.019) showed significant associations with the MD slope. The presence of MvD on OCT-A (P<0.001) and baseline P50-N95 amplitude (P=0.037) were significantly associated with VF progression on GPA.

Conclusions:
The presence of MvD and retinal ganglion cell dysfunction by PERG at baseline, DH or central scotoma were significant factors associated with VF progression in predominantly NTG patients. These patients should be monitored more closely.
Evaluating the Effect of Policy Prohibiting Body Checking on Physical Contacts in U15 and U18 Youth Ice Hockey Leagues
Authors: Kolstad Ash T. , Chin Mathieu , Martinez German , Janzen Leticia , Krolikowski Maciej , Goulet Claude , Nadeau Luc , Hagel Brent E. , Emery Carolyn A. 
Published: July 2022

Objective:
To compare physical contacts (PCs) and head contacts (HCs) in nonelite U15 (ages 13-14) and U18 (ages 15-17) ice hockey players in body checking (BC) and non-BC leagues.

Design:
Cohort video analysis study.

Setting:
Ice hockey arenas in Calgary, Canada.

Participants:
Players from 13 BC and 13 non-BC games at the nonelite U15 and U18 levels (n = 52 total games).

Assessment of Risk Factors:
Games were videotaped and analyzed to compare PC variables between leagues allowing and prohibiting BC.

Main Outcome Measures:
Validated methodology for PC type (trunk PC and other types of PC with limb/stick/head), intensity (low and high intensity), and HC. Incidence rate ratios (IRRs) were estimated using Poisson regression (controlling for cluster by team game and offset by player minutes) to compare the incidence of PCs in BC and non-BC games.

Results:
The rate of trunk PCs was lower in the non-BC leagues for both U15 (IRR = 0.50, 99% confidence interval [CI]: 0.43-0.58) and U18 (IRR = 0.56, 99% CI: 0.46-0.67) players. This was most significant for BC contacts (U15: IRR = 0.18, 99% CI: 0.11-0.29; U18: IRR = 0.16, 99% CI: 0.08-0.34), although also significant for body contacts (U15: IRR = 0.54, 99% CI: 0.46-0.64; U18: IRR = 0.58, 99% CI: 0.48-0.70), other PCs, (U15: IRR = 0.60, 99% CI: 0.45-0.78; U18: IRR = 0.71, 99% CI: 0.58-0.88), and HCs (U15: IRR = 0.40, 99% CI: 0.22-0.71; U18: IRR = 0.37, 99% CI: 0.25-0.57).

Conclusions:
The incidence of BC was 82% lower in the U15 and 84% lower in U18 levels not allowing BC, with lower HC and other PC rates also in non-BC leagues. These findings demonstrate high adherence with BC policy change in youth ice hockey.
The Economic Burden of Disease in France From the National Health Insurance Perspective
Authors: Rachas Antoine , Gastaldi-Ménager Christelle , Denis Pierre , Barthélémy Pauline , Constantinou Panayotis , Drouin Jérôme , Lastier Dimitri , Lesuffleur Thomas , Mette Corinne , Nicolas Muriel , Pestel Laurence , Rivière Sébastien , Tajahmady Ayden , Gissot Claude , Fagot-Campagna Anne 
Published: July 2022

Background:
Identifying the most frequently treated and the costliest health conditions is essential for prioritizing actions to improve the resilience of health systems.

Objectives:
Healthcare Expenditures and Conditions Mapping describes the annual economic burden of 58 health conditions to prepare the French Social Security Funding Act and the Public Health Act.

Design:
Annual cross-sectional study (2015–2019) based on the French national health database.

Subjects:
National health insurance beneficiaries (97% of the French residents).

Measures:
All individual health care expenditures reimbursed by the national health insurance were attributed to 58 health conditions (treated diseases, chronic treatments, and episodes of care) identified by using algorithms based on available medical information (diagnosis coded during hospital stays, long-term diseases, and specific drugs).

Results:
In 2019, €167.0 billion were reimbursed to 66.3 million people (52% women, median age: 42 y). The most prevalent treated diseases were diabetes (6.0%), chronic respiratory diseases (5.5%), and coronary diseases (3.2%). Coronary diseases accounted for 4.6% of expenditures, neurotic and mood disorders 3.7%, psychotic disorders 2.8%, and breast cancer 2.1%. Between 2015 and 2019, the expenditures increased primarily for diabetes (+€906 million) and neurotic and mood disorders (+€861 million) due to the growing number of patients. “Active lung cancer” (+€797 million) represented the highest relative increase (+54%) due to expenditures for the expensive drugs and medical devices delivered at hospital.

Conclusions:
These results have provided policy-makers, evaluators, and public health specialists with key insights into identifying health priorities and a better understanding of trends in health care expenditures in France.
Patient Sense of Belonging in the Veterans Health Administration
Authors: Lafferty Megan , Strange Wynn , Kaboli Peter , Tuepker Anaïs , Teo Alan R. 
Published: July 2022

Background:
Health care systems have increasingly focused on patient engagement in efforts to improve patient-centered care. Appointment attendance is an integral component of patient engagement, and missed appointments are an ongoing problem for health care systems. Virtually no studies have examined how the sense of belonging is related to patient engagement within a health care system.

Objective:
To examine patient experiences in the Veterans Health Administration (VA) with outpatient appointment attendance to identify factors that affect sense of belonging and patient engagement.

Research Design and Participants:
This study draws from qualitative data collected as part of a study to reduce missed appointments through use of enhanced appointment reminder letters. We conducted semistructured interviews with 27 VA patients with primary care or mental health clinic visits, using deductive and inductive analysis to develop themes. More than half of the participants were Vietnam veterans, 24 were over 40 years old, 21 were White, and 18 were men.

Results:
We identified 3 factors that influence sense of belonging within the VA: (1) feelings of camaraderie and commitment toward other veterans were relevant to patient experience in the VA; (2) interactions with all staff influenced the engagement a patient felt with a particular clinic, care team, and the VA; (3) personalized communication and messaging could humanize the VA and demonstrate its interest in engaging with veterans. Lastly, we found (4) sense of belonging appeared to promote appointment attendance and patient engagement.

Conclusions:
There are multiple opportunities to strengthen patients’ sense of belonging within the health care system that serves them. For veterans, strategies that build their sense of belonging may be a novel approach to increase appointment attendance and patient engagement in their health care.
Current endoscopic approaches to biliary strictures
Authors: Sato Tatsuya , Nakai Yousuke , Fujishiro Mitsuhiro 
Published: July 2022

Purpose of review
To summarize the current status and future perspectives of the endoscopic management of biliary strictures.

Recent findings
In addition to conventional diagnostic modalities, such as cross-sectional imaging and endoscopic ultrasonography (EUS), per-oral cholangioscopy is helpful for indeterminate biliary strictures. It allows direct visualization of the biliary tract and targeted biopsy. For distal malignant biliary obstruction (MBO), a self-expandable metal stent (SEMS) via endoscopic retrograde cholangiopancreatography (ERCP) is a standard of care. EUS-guided biliary drainage (EUS-BD) is an emerging alternative to percutaneous transhepatic biliary drainage in cases with failed ERCP. EUS-BD is also an effective salvage option for perihilar MBO, which can not be managed via ERCP or percutaneous transhepatic biliary drainage. Preoperative drainage is necessary for most jaundiced patients as neoadjuvant chemotherapy is widely administered for resectable and borderline resectable pancreatic cancer, and a SEMS is preferred in this setting, too. For benign biliary strictures, a covered SEMS can improve stricture resolution and reduce the number of endoscopic sessions as compared to plastic stents.

Summary
ERCP and EUS play a central role in the diagnosis and drainage for both malignant and benign biliary strictures.
Safe, efficient, and effective screening colonoscopy
Authors: Dornblaser David W. , Gross Seth A. 
Published: July 2022

Purpose of review
Colorectal cancer continues to be one of the most common causes of cancer-related death. Widespread dissemination of screening colonoscopy in the United States has led to a significant reduction in the incidence and mortality. Here we review current literature with an aim to highlight recent improvements in the safety, efficiency, and effectiveness of screening colonoscopy.

Recent findings
Colon capsule endoscopy is an emerging noninvasive method to capture images of colonic mucosa for select patients with appreciable sensitivity for polyp detection. Recent literature supports the use of the novel oral anticoagulant apixaban over other anticoagulants to reduce the risk of gastrointestinal bleeding related to colonoscopy. Cold snare polypectomy for smaller lesions and prophylactic clipping following resection of large polyps in the proximal colon may reduce the rate of delayed bleeding. Novel methods and devices for improving bowel preparation continue to emerge. Mechanical attachment devices and artificial intelligence represent recent innovations to improve polyp detection.

Summary
Clinicians should be aware of relevant data and literature that continue to improve the quality and safety of screening colonoscopy and incorporate these findings into their clinical practice.
Medical malpractice and gastrointestinal endoscopy
Authors: Kantrowitz Michael G. 
Published: July 2022

Purpose of review
Medical liability is a perennial issue that most physicians will face at some point in their careers. Gastroenterologists routinely perform endoscopic procedures to aid in the diagnosis and treatment of their patients. Advances in endoscopic techniques and technology have accelerated movement of the field into a more surgical realm. These developments warrant consideration of pitfalls that may expose gastroenterologists to liability. This review will explore trends in malpractice facing gastroenterologists and offer strategies to deliver high quality and safe patient care.

Recent findings
Despite being a procedure-oriented subspeciality, only a minority of malpractice claims against gastroenterologists are related to procedures. Diagnostic error is among the most prevalent reason for lawsuits. The consequences of malpractice are costly due litigation and indemnity as well as the increase in defensive medical practice. Improving diagnostic quality, optimizing informed consent, and enhancing patient–physician communication are important elements of risk mitigation.

Summary
Understanding the important role that diagnosis plays in medical liability allows physicians to better evaluate risk and apply deliberate decision-making in order to practice confidently.
Role of endoscopy on enteral feeding
Authors: Michael Florian A. , Friedrich-Rust Mireen , Blumenstein Irina 
Published: July 2022

Purpose of review
The present review states current findings on the topic of enteral feeding and endoscopy. It is divided into two parts. First, important parts of the European Society of Gastrointestinal Endoscopy and European Society for Clinical Nutrition and Metabolism guidelines will be summarized and discussed. Second, important publications in the field of enteral nutrition published in the year 2021 will be discussed.

Recent findings

Summary
Currently published European guidelines on enteral nutrition provide well-structured guidance on preprocedural, periprocedural and postprocedural management. Relevant findings on endoscopy in enteral nutrition were currently rare. However, there were interesting meta-analysis and randomized controlled trials published on the topic of enteral feeding in surgery and intensive care medicine.
Neoadjuvant therapy in pancreatic cancer: a review and update on recent trials
Authors: Lo Winifred , Zureikat Amer 
Published: July 2022

Purpose of review
Neoadjuvant therapy (NAT) has been enthusiastically embraced for patients with operable pancreatic cancer (PDAC) in hopes of improving survival. However, the rapid integration of clinical trial data has made it difficult to discern optimal treatment strategies. The goal of this review is to summarize notable recent trials and their contributions to the field.

Recent findings
The results of ESPAC-5F, NEOLAP-AIO-PAK-0113, SWOG1505, PREOPANC, HyperAcutePancreas, and ALLIANCE A021501 are reviewed in detail. These studies sequentially evaluate the different neoadjuvant treatment strategies, use of neoadjuvant chemoradiation, and immunotherapy in resectable, borderline-resectable, and locally advanced PDAC. Resection rate ranged from 24.4 to 95.7% (median 64.9%). These trials demonstrate median survival ranging from 14.9 to 41.0 months with progression-free survival ranging from 7.7 to 24.2 months. Survival results may be confounded by ability to reach resection, use of modern chemotherapy vs. gemcitabine monotherapy, and inclusion of locally advanced PDAC. Several upcoming trials will directly examine efficacy of NAT vs. adjuvant therapy, chemoradiation in the NAT setting, and molecular testing-driven chemotherapy selection.

Summary
NAT is associated with improved survival for patients with borderline resectable PDAC but broader efficacy for resectable PDAC and optimal treatment strategy have yet to be defined.
DSA in solid organ transplantation: is it a matter of specificity, amount, or functional characteristics?
Authors: Louis Kevin , Lefaucheur Carmen 
Published: July 2022

Purpose of review
The present review describes the clinical relevance of human leukocyte antigen (HLA) donor-specific antibodies (HLA-DSAs) as biomarkers of alloimmunity and summarizes recent improvements in their characterization that provide insights into immune risk assessment, precision diagnosis, and prognostication in transplantation.

Recent findings
Recent studies have addressed the clinical utility of HLA-DSAs as biomarkers for immune risk assessment in pretransplant and peritransplant, diagnosis and treatment evaluation of antibody-mediated rejection, immune monitoring posttransplant, and risk stratification.

Summary
HLA-DSAs have proved to be the most advanced immune biomarkers in solid organ transplantation in terms of analytical validity, clinical validity and clinical utility. Recent studies are integrating multiple HLA-DSA characteristics including antibody specificity, HLA class, quantity, immunoglobulin G subclass, and complement-binding capacity to improve risk assessment peritransplant, diagnosis and treatment evaluation of antibody-mediated rejection, immune monitoring posttransplant, and transplant prognosis evaluation. In addition, integration of HLA-DSAs to clinical, functional and histological transplant parameters has further consolidated the utility of HLA-DSAs as robust biomarkers and allows to build new tools for monitoring, precision diagnosis, and risk stratification for individual patients. However, prospective and randomized-controlled studies addressing the clinical benefit and cost-effectiveness of HLA-DSA-based monitoring and patient management strategies are required to demonstrate that the use of HLA-DSAs as biomarkers can improve current clinical practice and transplant outcomes.
Sodium Bicarbonate Use During Pediatric Cardiopulmonary Resuscitation: A Secondary Analysis of the ICU-RESUScitation Project Trial*
Authors: Cashen Katherine , Reeder Ron W. , Ahmed Tageldin , Bell Michael J. , Berg Robert A. , Burns Candice , Carcillo Joseph A. , Carpenter Todd C. , Dean J. Michael , Diddle J. Wesley , Federman Myke , Fink Ericka L. , Frazier Aisha H. , Friess Stuart H. , Graham Kathryn , Hall Mark , Hehir David A. , Horvat Christopher M. , Huard Leanna L. , Maa Tensing , Manga Arushi , McQuillen Patrick S. , Morgan Ryan W. , Mourani Peter M. , Nadkarni Vinay M. , Naim Maryam Y. , Notterman Daniel , Palmer Chella A. , Pollack Murray M. , Schneiter Carleen , Sharron Matthew P. , Srivastava Neeraj , Wessel David , Wolfe Heather A. , Yates Andrew R. , Zuppa Athena F. , Sutton Robert M. , Meert Kathleen L. ,   for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) and National Heart Lung and Blood Institute ICU-RESUScitation Project Investigators
Published: July 2022

Objectives:
To evaluate associations between sodium bicarbonate use and outcomes during pediatric in-hospital cardiac arrest (p-IHCA).

Design:
Prespecified secondary analysis of a prospective, multicenter cluster randomized interventional trial.

Setting:
Eighteen participating ICUs of the ICU-RESUScitation Project (NCT02837497).

Patients:
Children less than or equal to 18 years old and greater than or equal to 37 weeks post conceptual age who received chest compressions of any duration from October 2016 to March 2021.

Interventions:
None.

Measurements and Main Results:
Child and event characteristics, prearrest laboratory values (2–6 hr prior to p-IHCA), pre- and intraarrest hemodynamics, and outcomes were collected. In a propensity score weighted cohort, the relationships between sodium bicarbonate use and outcomes were assessed. The primary outcome was survival to hospital discharge. Secondary outcomes included return of spontaneous circulation (ROSC) and survival to hospital discharge with favorable neurologic outcome. Of 1,100 index cardiopulmonary resuscitation events, median age was 0.63 years (interquartile range, 0.19–3.81 yr); 528 (48.0%) received sodium bicarbonate; 773 (70.3%) achieved ROSC; 642 (58.4%) survived to hospital discharge; and 596 (54.2%) survived to hospital discharge with favorable neurologic outcome. Among the weighted cohort, sodium bicarbonate use was associated with lower survival to hospital discharge rate (adjusted odds ratio [aOR], 0.7; 95% CI, 0.54–0.92; p = 0.01) and lower survival to hospital discharge with favorable neurologic outcome rate (aOR, 0.69; 95% CI, 0.53–0.91; p = 0.007). Sodium bicarbonate use was not associated with ROSC (aOR, 0.91; 95% CI, 0.62–1.34; p = 0.621).

Conclusions:
In this propensity weighted multicenter cohort study of p-IHCA, sodium bicarbonate use was common and associated with lower rates of survival to hospital discharge.
Clinical Application of Digital Joint Guide in the Fracture of the Condyle Neck
Authors: Gao Tingyi , Wang Dong , Han Rui , Du Yue , Luo Bing , Zhang Kai 
Published: July 2022

Purpose:
The purpose of this study is to use a digital guide plate for joint positioning to assist the reduction of condylar neck fractures and evaluate the accuracy of the reduction after surgery.

Materials and Methods:
In this study, 20 patients were selected from January 2016 to October 2020, and the reduction of the mandibular condyle neck fracture was designed virtual and digital based on the computed tomography data of the patients, based on the position of the condyle in the articular socket, the height of the ascending mandibular ramus, and the joints. The average value of the anterior space and the posterior space of the joint is these indicators, the position of the condyle is reconstructed, and the fracture reduction finger guide plate is designed. During the operation, the digital guide plate is used to assist the reduction of the condyle neck fracture. The postoperative follow-up was 4 to 12 months to check the accuracy of the reduction.

Results:
A total of 20 patients, all fractures achieved complete bone healing, the patients’ mouth opening was normal, no obvious complications were found, and none of the patients had facial paralysis. In the postoperative evaluation and preoperative virtual design plan, the chromatographic error was within 2 mm, and the magnetic resonance of the temporomandibular joint showed no displacement of the articular disc.

Conclusion:
The digital joint guide can reduce the fracture of the condyle neck while ensuring the position of the condyle in the joint socket, which is beneficial to reduce the occurrence of subsequent temporomandibular joint complications.