bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of corneal biomechanical properties on intraocular pressure measurement in different types of Graves’ orbitopathy
Authors: Pérez-López Marta , Ting Darren S. J. , Lanzagorta-Aresti Aitor , Montolio-Marzo Santiago , Davó-Cabrera Juan , Cid-García Isabel 
Published: September 2022

Background/aims To compare the ocular biomechanical properties of inactive Grave’s orbitopathy (GO) patients and healthy subjects and to evaluate the influence of severity and phenotype of GO on these parameters. Methods This was a cross-sectional study. All included inactive GO patients and healthy controls underwent complete ocular examination, including Goldman applanation tonometry (GAT), corneal biomechanical analysis using Ocular Response Analyser (ORA), and corneal epithelial thickness analysis using Optovue. Patients with inactive GO were classified based on the severity and orbital phenotype (predominantly myogenic or lipogenic). Comparison among groups was performed. Results 60 eyes from 30 inactive GO patients and 30 healthy eyes were examined. Corneal hysteresis (CH) was significantly lower in inactive GO patients (9.6 [p25 8.1; p75 11.2]) compared to controls (10.4 [9.8; 11.5]) ( p = 0.012). In GO patients, cornea compensated intraocular pressure (IOPcc) was significantly higher than Goldman applanation tonometry IOP (IOP-GAT) ( p = 0.001). A total of 13.3% GO patients were initially classified as having ocular hypertension (OHT; defined as IOP > 21 mmHg with no signs of glaucomatous optic neuropathy) based on IOP-GAT measurement. According to IOPcc, 27.8% of GO patients were classified as OHT. In GO patients, no differences were found in corneal bimechanical properties according to the disease severity or orbital phenotype. Conclusions CH is significantly lower in inactive GO patients compared to healthy subjects. ORA corrected IOP was significantly higher in GO patients compared to IOP-GAT. No differences in corneal biomechanical properties between mild and moderate-to-severe GO disease and between myogenic and lipogenic orbitopathy were found.
The effect of treatment timing on clinical and psychological outcomes with Twin Block therapy: A multicentre two-arm parallel randomised controlled trial
Authors: Mandall Nicky , Littlewood Simon , Shah Jinesh , Watkinson Simon , Glossop Sarah , Dugdale Charlotte , Curran Edith , Walsh Tanya 
Published: September 2022

Objective: To evaluate whether delaying treatment with a twin block appliance affects treatment outcomes, in terms of skeletal and dental change and psychological disadvantage. Design: Multicentre, two-arm parallel randomised controlled trial. Setting: Three UK hospital orthodontic units. Methods: A total of 75 participants were randomly allocated into an Immediate Treatment Group (ITG) (n= 41) and an 18-month delayed Later Treatment Group (LTG) (n=34). Outcomes: Dentofacial changes were recorded from lateral cephalograms and study models, psychological impact was measured using a child perception questionnaire (CPQ11–14) and an Oral Aesthetic Subjective Impact Score (OASIS) at registration (DC1), 18 months (DC2) and 3 years (DC3). Results: The ITG initial effect was a mean ANB reduction was 1.6° ( P<0.001) (95% confidence interval [CI] = 0.89–2.29), and an overjet reduction of 5.06 mm ( P<0.001) (95% CI = 3.96–6.16) (boys: aged 12 years 8 months; girls: aged 11 years 8 months). There were no statistically significant differences between the ITG and LTG for twin block treatment outcomes, but the ITG active treatment time was longer ( P=0.004) (ITG: 13.1 months; LTG: 9.8 months). There was insufficient evidence to state that patients were psychologically disadvantaged by waiting 18 months for active twin block treatment ( P>0.05). Conclusion: Participants achieved similar clinical and psychological outcomes irrespective of whether they started their twin block at the age of referral (ITG) or 18 months later (LTG). This suggests that boys aged 12 years 8 months and girls aged 11 years 8 months, on average, are not disadvantaged by waiting 18 months for active twin block treatment.
Complex Endovascular Repair of Paravisceral Infective Native Aortic Aneurysms
Authors: Juszczak Maciej , Mann Harvinder , Riste Michael , Woodhouse Andrew , Sörelius Karl , Claridge Martin , Adam Donald J. 
Published: September 2022

Objective: To report the early and mid-term outcome of complex endovascular repair (EVAR) for paravisceral infective native aortic aneurysms (INAA). Methods: Interrogation of a prospectively maintained database identified consecutive patients who underwent non-elective complex EVAR for paravisceral INAAs in a single institution between December 2013 and June 2020. All patients were considered to have definite INAAs based on diagnostic criteria. Patients who had prior aortic repair were excluded. Results: A total of 26 patients (19 men; mean age 67 years [SD = 11.4]; median diameter 60 mm [IQR: 55–73]) with acute symptomatic (n = 24) or contained ruptured (n = 2) aneurysms underwent surgeon-modified fenestrated EVAR (SM-FEVAR; n = 24) or chimney-periscope EVAR (CHIMPS; n = 2). Median observed follow-up was 36.2 months (18.3–53.5). Nine patients had positive venous blood cultures and a further seven had recent or concomitant infection. All patients received pre- and post-operative antibiotic therapy and rifampicin-soaked endografts. A total of 95 vessels were targeted for preservation and 86 were stent-grafted. One vessel occluded intra-operatively and a further 3 occluded within 30 days. The 30-day/in-hospital mortality was 11.5% (n = 3), and the estimated 1- and 3-year survival (±SD) was 85% ± 7%. Infection-related complications (IRCs) occurred in two patients: both developed new INAA within 30 days of index repair and were treated by EVAR with no mortality. Estimated 3-year freedom from late re-intervention was 100%. One patient required infrarenal EVAR for a non-infective aneurysm at 43 months. Conclusion: Complex EVAR for paravisceral INAAs is associated with acceptable early and mid-term outcomes and is an acceptable alternative to open surgery. We propose that these patients are managed with long-term antimicrobials, impregnation of graft material with rifampicin, and rigorous post-operative surveillance. Clinical Impact A multi-disciplinary approach is required to deliver the best possible outcome for patients with this challenging aortic pathology.
Perceived Stress, Grit, and Self-Care Behaviors in First-Year Medical Students
Authors: Boyd Alan , Mealand Kyle , Briggs Early Kathaleen , Oestreich Emily 
Published: September 2022

Medical students experience more stress than the general population, which over time can cause mental and physical disease, including burnout. Identifying factors impacting stress during early medical training could inform strategies to minimize its impacts throughout training and in clinical practice. This study surveyed 238 first-year osteopathic medical students to assess stress (Perceived Stress Scale; PSS), grit, sleep quality (Pittsburgh Sleep Quality Index; PSQI), physical activity (Godin-Shephard Leisure-Time Physical Activity Score; LTPA), and nutrition habits (Rapid Eating Assessment for Participants; REAP) within the first 2 weeks of starting medical school and again 10 weeks later. Incomplete responses were removed, leaving 204 study participants. We observed statistically significant decreases in grittiness (∆grit = −2.230%, P = .002) and physical activity (∆LTPA = −22.147%, P < .0001), while perceived stress (∆PSS = 34.548%, P < .0001) and poor sleep quality (∆PSQI% = 19.853, P < .0001) increased. Correlation analyses identified the strongest relationships were between ∆PSS vs ∆PSQI ( r = .47, P < .0001) and ∆PSS vs ∆LTPA ( r = −.20, P < .01). Multivariable linear regression analysis isolated ∆PSQI ( P < .0001) and ∆LTPA ( P = .012) as statistically significant predictors of ∆PSS. These results suggest early, repeated curricular interventions focused on physical activity and sleep hygiene may help students better manage stress during medical education.
Targeted muscle reinnervation: A narrative review of a novel tool for the management of neuropathic pathology in major lower extremity amputations
Authors: Phair John , Choinski Krystina , Inglesby Dani C , Diamond Shawn , Sultan Steven M 
Published: September 2022

Objective The purpose of this narrative review is to provide the vascular surgery community with updated recommendations and information regarding the use of Targeted Muscle Reinnervation (TMR) for both the prevention and treatment of chronic pain and phantom limb pain occurring in patients after undergoing lower extremity amputation for peripheral artery disease. Methods Current available literature discussing TMR is reviewed and included in the article in order to provide a succinct overview on the indications, clinical applications, and surgical technique for TMR. Additionally, early studies showing favorable long-term results after TMR are discussed. Patient consent for publication was obtained for this investigation. Results TMR has been demonstrated to be an effective means of both treating and preventing neuroma-related symptoms including chronic pain and phantom limb pain. It has been proven to be technically feasible, and can help patients to have improved utilization of prostheses for ambulation, which can conceivably lead to a reduction in mortality. Conclusions TMR is an important tool to consider for any patient undergoing lower extremity amputation for a vascular-related indication. A vascular-plastic surgeon dual team approach is an effective means to prevent and reduce neuromas and associated chronic pain in this patient population.
Multi-institutional outcomes after femoropopliteal bypass in octogenarians
Authors: Kim Young , Cho Bennet S , DeCarlo Charles S , Latz Christopher A , Majumdar Monica , Zacharias Nikolaos , Mohapatra Abhisekh , Dua Anahita 
Published: September 2022

Objectives Open lower extremity revascularization is controversial among octogenarians; however, the indications for surgical bypass are higher in the elderly population. The aim of the study was to compare postoperative outcomes between octogenarians and non-octogenarians following femoropopliteal bypass surgery. Methods Our regional, multi-institutional database was queried for femoropopliteal bypass procedures performed between 1995 and 2020. Electronic medical records were individually reviewed for operative and postoperative data. Univariable and multivariable logistic regression were utilized to determine predictors of postoperative outcomes. Results Among 1315 patients who underwent femoropopliteal bypass, 234 (17.8%) were octogenarians. Octogenarians more frequently underwent bypass for lower extremity tissue loss (48.7% vs 30.2%), whereas claudication was more common among non-octogenarians (24.0% vs 9.8%) ( p < .001). Below-knee bypass target (72.2% vs 59.3%) and prosthetic conduit utilization (58.5% vs 43.7%) were more frequent in octogenarians ( p < .001 each). Overall hospital length of stay was longer among patients > 80 years (median 6 days [interquartile range [IQR] 4–9] vs 5 days [IQR 4–8], p = .017). The overall 30-day (5.6% vs 1.5%) and one-year mortality rates (25.6% vs 7.9%) were higher among octogenarians ( p < .001 each). On multivariable analysis, age greater than 80 years was found to be an independent risk factor for postoperative mortality (OR 3.79 [1.75–8.20], p = .0007) Conclusions Octogenarians undergoing bypass femoropopliteal bypass surgery have considerably worse postoperative outcomes, compared with non-octogenarians. These data may help inform elderly patients prior to undergoing open lower extremity revascularization.
Negotiating treatment and managing expectations in chronic kidney disease: A qualitative study in Argentina
Authors: Roberti Javier E , Alonso Juan P , May Carl R 
Published: September 2022

Objectives To describe how patients with CKD negotiated assigned responsibilities in the management of their disease, resulting in potential relational nonadherence. Methods Qualitative study performed in two healthcare facilities in Buenos Aires, Argentina, including 50 patients and 14 healthcare providers. We conducted semistructured interviews which were analysed using a frame of reference with concepts of Burden of Treatment and Cognitive Authority theories. Findings Adherence to treatment defined “good patients”. Patients needed to negotiate starting treatment, its modality and dialysis schedule, although most patients felt they did not participate in the decision process and that providers did not acknowledge implications of these decisions on their routine. Some patients skipped dialysis if concerns were not attended. Regularly, patients negotiated frequency of visits, doses, dietary restrictions and redefined relationships with their support networks, sometimes with devasting effects. As a result of overwhelming uncertainty some patients refused enrolling into a transplant program. When the frequency of complications increased, patients considered abandoning dialysis. Conclusion When patients perceived demands were excessive or conflicting, they entered into negotiations. Relationally induced nonadherence may arise when professionals do not or cannot enter into negotiations over patients’ beliefs or knowledge about what is possible for them to do.
Time interval from last visit to imaging diagnosis influences outcome in pancreatic adenocarcinoma: A regional population-based study on linked medico-administrative and clinical data
Authors: Balzano Vittoria , Laurent Emeline , Florence Aline-Marie , Lecuyer Anne-Isabelle , Lefebvre Carole , Heitzmann Patrick , Hammel Pascal , Lecomte Thierry , Grammatico-Guillon Leslie 
Published: September 2022

Background: Excessive waiting time intervals for the diagnosis and treatment of patients with pancreatic cancer can influence their prognosis but they remain unclear. The objective was to describe time intervals from the medical visit to diagnostic imaging and to treatment and their prognostic impact in pancreatic cancer in one French region. Methods: This retrospective observational multicentre study included all patients with pancreatic cancer seen for the first time in 2017 in multidisciplinary team meetings (MTMs), where clinical data were collected. A probabilistic matching with the medico-administrative data from the French national healthcare database ( Système National des Données de Santé) was performed to define the care pathway from clinical presentation to the beginning of treatment. Median key time intervals were estimated for both resected and unresected tumours. Factors associated with 1-year survival were studied using Cox model. Results: A total of 324 patients (88% of total patients with MTM presentation) were matched and included: male 54%, mean age 72 years ±9.2, Eastern Cooperative Oncology Group (ECOG) PS > 1 19.5%, metastatic disease at diagnosis 47.4%, tumour resection 16%. At 1 year, 57% had died (65% in the unresected group and 17% in the resected group). The median time interval from the medical visit to diagnostic imaging was 15 days [Q1–Q3: 8–44]. After imaging, median time intervals to definite diagnosis and to first treatment were 11 and 20 days, respectively. Significant prognostic factors associated with the risk of death at 1 year were ECOG PS > 1 (hazard ratio (HR) 2.1 [1.4–3.0]), metastasis (HR 2.7 [1.9–3.9]), no tumour resection (HR 2.7 [1.3–5.6]) and time interval between the medical visit and diagnostic imaging ⩾25 days (HR 1.7 [1.2–2.3]). Conclusion: Delay in access to diagnostic imaging impacted survival in patients with pancreatic cancer, regardless of whether tumour resection had been performed.
Comparative study of different SES neighborhood clinics for health literacy and internet access
Authors: Livingood William C , Bautista Maria A B , Smotherman Carmen , Azueta Daidre , Coleman Jeremy , Grewal Reetu , Stewart Eric , Orlando Lori A. , Scuderi Christopher 
Published: September 2022

Background As healthcare services are increasingly dependent on patient utilization of technology to effectively deliver services, the digital divide has the potential to exacerbate health disparities if health literacy and internet access present formidable barriers to patient use of technology. Methods We examined the differences in health literacy and internet access between lower and upper SES neighborhood primary-care clinics in Northeast Florida. The REALM-SF for health literacy was used to assess health literacy and census survey questions were used to assess internet and technology access, during the Fall, 2020. The clinics were affiliated with a safety-net hospital in a major city in Southeastern U.S. Results Analysis of key demographic data confirmed that the responding patients from economically disadvantaged neighborhood clinics resided in economically disadvantaged zip codes (307 responding patients lived in lower SES neighborhoods) and did have lower education levels (3% of the patients from Upper SES clinics had 11 grade or lower education, compared to 21%–29% of patients from Lower SES clinics). Patient health literacy significantly differed between clinics located in economically disadvantaged neighborhoods and clinics located in more affluent neighborhoods, with Upper SES clinics being 2.4 times more likely to have 9th grade or higher reading level. Access to internet technology was also higher in the Upper SES clinics, with 59% of respondents from Upper SES clinics versus 32%–40% from Lower SES clinics owning a computer or an IPAD. Conclusion Results of this study have important implications for patient-engaged use of digital technology for health. Healthcare and public health clinics should be aware of the difference in health literacy and internet access when implementing technology-based services, so that advances in medicine, including precision medicine and telehealth, can be disseminated and implemented with broad populations, including disadvantaged groups.
Relationship between multimorbidity and composite lifestyle status in Shenzhen, China
Authors: Yang Hua-Lu , Mo Bei-Rong , Molassiotis Alex , Wang Mian , He Gui-Lan , Xie Yao Jie 
Published: September 2022

Objective The study aimed to understand multimorbidity among adults in a high-tech city in southern coastal China that has undergone rapid economic development and to investigate its relationship with lifestyle status. Methods A population-based survey was conducted among 24 community centers in the Nanshan District of Shenzhen from February to December of 2018. Participants were recruited using a stratified random sampling approach. A self-administered questionnaire on typical chronic diseases, lifestyle factors, body composition, and social demographics was used to collect data. Multimorbidity was defined as two or more chronic diseases coexisting in a single person. An algorithm on body mass index, physical activity, drinking, smoking, and sleep quality was used to calculate lifestyle scores (0–9), with higher scores predicting a healthier lifestyle. Results A total of 2,905 participants were included in the analysis, with men accounting for 52.4%, and single for 25%. The prevalence of multimorbidity was 4.8%, and the mean lifestyle score was 4.79 ± 1.55. People who were old, retired, married, and had less education were more likely to have multimorbidity (all P < .05). A higher prevalence of multimorbidity was found among those who were obese, less engaged in physical activity, consumed more alcohol, and had poorer sleep quality (all p < .05). After adjusting for age, employment, education, and marital status, one unit increase in lifestyle score was associated with 0.74 times lower to have multimorbidity (OR: 0.74; 95% CI: 0.63–0.87, p < .05). Conclusion The prevalence of multimorbidity was relatively low in economically developed Shenzhen. Keeping a healthy lifestyle was related to the lower possibility of suffering from multiple chronic diseases.
Synthesis of Porous Hollow Spheres Co@TiO2−x-Carbon Composites for Highly Efficient Lithium-Ion Batteries
Authors: Liang Chunyong , Huang Zhongliang , Wang Hongshui , Yang Tai , Liu Ning , Liao Tingdi , Wang Feng , Wang Xi 
Published: September 2022

AbstractThe hollow TiO2 anode material has received great attention for next-generation LIBs because of its excellent stability, environmental friendly, and low volume change during lithiation/delithiation. However, there are some problems associated with the current anatase TiO2 anode materials in practical application owing to low lithium-ion diffusivity and poor reversible theoretical capacities. The introduction of defects has been turned out to be a significant and effective method to improve electronic conductivity, especially oxygen vacancies. In this paper, a facile hydrothermal reaction and subsequent chemical vapor deposition method were successfully used to fabricate Co@TiO2−x-carbon hollow nanospheres. These results suggest that the synthesized product exhibits good rate performance and superior cycling stability.
SUBATOMIC: a SUbgraph BAsed mulTi-OMIcs clustering framework to analyze integrated multi-edge networks
Authors: Loers Jens Uwe , Vermeirssen Vanessa 
Published: September 2022

AbstractBackgroundRepresenting the complex interplay between different types of biomolecules across different omics layers in multi-omics networks bears great potential to gain a deep mechanistic understanding of gene regulation and disease. However, multi-omics networks easily grow into giant hairball structures that hamper biological interpretation. Module detection methods can decompose these networks into smaller interpretable modules. However, these methods are not adapted to deal with multi-omics data nor consider topological features. When deriving very large modules or ignoring the broader network context, interpretability remains limited. To address these issues, we developed a SUbgraph BAsed mulTi-OMIcs Clustering framework (SUBATOMIC), which infers small and interpretable modules with a specific topology while keeping track of connections to other modules and regulators.ResultsSUBATOMIC groups specific molecular interactions in composite network subgraphs of two and three nodes and clusters them into topological modules. These are functionally annotated, visualized and overlaid with expression profiles to go from static to dynamic modules. To preserve the larger network context, SUBATOMIC investigates statistically the connections in between modules as well as between modules and regulators such as miRNAs and transcription factors. We applied SUBATOMIC to analyze a compositeHomo sapiensnetwork containing transcription factor-target gene, miRNA-target gene, protein–protein, homologous and co-functional interactions from different databases. We derived and annotated 5586 modules with diverse topological, functional and regulatory properties. We created novel functional hypotheses for unannotated genes. Furthermore, we integrated modules with condition specific expression data to study the influence of hypoxia in three cancer cell lines. We developed two prioritization strategies to identify the most relevant modules in specific biological contexts: one considering GO term enrichments and one calculating an activity score reflecting the degree of differential expression. Both strategies yielded modules specifically reacting to low oxygen levels.ConclusionsWe developed the SUBATOMIC framework that generates interpretable modules from integrated multi-omics networks and applied it to hypoxia in cancer. SUBATOMIC can infer and contextualize modules, explore condition or disease specific modules, identify regulators and functionally related modules, and derive novel gene functions for uncharacterized genes. The software is available athttps://github.com/CBIGR/SUBATOMIC.