bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcarotid artery revascularization (TCAR) stenting or angioplasty for intracranial carotid artery stenosis: Case series and novel application
Authors: Piper Keaton , Farooq Jeffrey , Yeung Elton , Flores-Milan Gabriel , Van Loveren Harry , Lau Tsz 
Published: March 2022

Background Carotid artery stenting is associated with a higher rate of stroke compared to carotid endarterectomy (CEA). This is likely due to procedural emboli resulting from plaque disruption. The transcarotid artery revascularization (TCAR) method aims to reduce the stroke rate by flow-reversal. TCAR, which has yet to be utilized for intracranial atherosclerotic disease (ICAD), may be particularly valuable given the lack of surgical treatment options for intracranial arterial stenosis. Objective Presented here are five cases of angioplasty or stenting that demonstrate the feasibility of TCAR for intracranial Internal Carotid Artery (ICA) stenosis treatment. Methods Five cases were reviewed retrospectively and summarized using PROCESS and CARE guidelines. Results All patients who underwent intervention between the petrous and ophthalmic segment of the ICA had no new neurologic deficit nor detected embolic stroke. One patient experienced an asymptomatic 5 mm hemorrhage on postoperative routine Computed Tomography (CT) head imaging. Conclusions This highlights a new method for treating intracranial ICA stenosis with a potentially reduced stroke risk. Given the historically higher stroke rates for cervical ICA stenting compared to carotid artery endarterectomy, this method may improve the previously higher stroke rates in endovascular carotid artery treatment, compared to CEA. Although this series is small, it illustrates a novel use for a rising technique that should be further evaluated in a larger study to validate its efficacy as a new treatment modality for surgically inaccessible intracranial disease.
Extent of mural thrombus is not associated with increased 5-year mortality following elective AAA repair
Authors: Siddiq Bilal , Dejong Matthew , Decicco Emily , Zielke Tara , D’Andrea Melissa , Aulivola Bernadette , Blecha Matthew 
Published: March 2022

Background Mural thrombus in abdominal aortic aneurysm (AAA) has been associated with increased rates of aneurysm growth as well as adverse cardiovascular events. The extent of mural thrombus in thoracoabdominal aortic aneurysms has recently been linked to 1-year mortality following endovascular repair and has been hypothesized as a marker for reduced cardiac reserve. This study investigates whether the extent of mural thrombus in infra-renal AAA is associated with 5-year mortality following elective repair. Methods Retrospective review of all patients undergoing elective infra-renal AAA repair at a single academic medical center between 2007 and 2016 was performed. The following variables at the time of surgery were investigated for association with 5-year mortality: age, sex, ethnicity, insurance status and co-morbidities, repair type, renal insufficiency, end-stage renal disease on dialysis, history of smoking, coronary artery disease, congestive heart failure, diabetes mellitus, hypertension, stroke, chronic obstructive pulmonary disease, body mass index category, AAA diameter, and ratio of aortic thrombus to total aneurysm diameter. Results Amongst 427 patients undergoing infra-renal AAA repair during the study period, 232 met extensive inclusion criteria. Univariate analysis found mean age (76 vs 72, p < 0.01), age cohort over 72 years (OR = 1.9, p = 0.04), renal insufficiency (OR = 3.1, p < 0.01), ESRD (OR = 6.5, p < 0.01), AAA diameter 6 cm or greater (OR = 2.3, p < 0.01), and mean AAA diameter (61.36 vs 56.99 mm, p < 0.01) all predictive of 5-year mortality. Multivariate analysis revealed renal insufficiency ( p < 0.01) and AAA diameter 6 cm or greater ( p = 0.03) to be significantly associated with 5-year mortality. The extent of mural thrombus was identical between 5-year survivors and non-survivors. The mean inner to outer AAA diameter was 0.65 in the survivor cohort and 0.64 in the mortality cohort. Inner to outer ratio of < 0.5 was identified in 23% of 5-year survivors and 27% of the mortality group. Conclusions In our experience, the extent of mural thrombus in AAA does not influence long-term survival after elective repair. AAA repair may provide protection against circulating components of mural thrombus which have the potential to promote atherosclerotic-related adverse events. Patients with renal insufficiency and larger AAA have increased risk of mortality 5 years after elective repair.
Vascular surgical management of profunda femoris artery aneurysms: A single center experience
Authors: Elzawy George , Eisenberg Naomi , Jaberi Arash , Roche-Nagle Graham 
Published: March 2022

Objective Profunda femoris artery aneurysms (PFAAs), which comprise true profunda femoris artery aneurysms (TPFAAs) and profunda femoris artery pseudoaneuryms (PFA PSAs), are rare but clinically significant diseases of the peripheral arterial vasculature. Our aim is to describe our institution’s 15-year experience with PFAAs (TPFAAs and PFA PSAs) to provide insight into patient characteristics, diagnostic imaging modalities, and surgical interventions that contribute to clinically important outcomes in patients with PFAAs. Methods We conducted a retrospective study at our institution using our radiology database. Results We identified six patients with PFA PSAs and four patients with TPFAAs. The clinical presentation of PFA PSAs included a triad of thigh pain, bleeding, and unexplained anemia. There was variety in the aetiologies of PFA PSAs, arising from catheterizations, upper thigh fractures, anastomotic complications, or unknown causes. Most patients with PFA PSAs had hypertension and coronary artery disease, and half of our cohort had peripheral vascular disease. All patients were imaged with duplex ultrasonography (DUS) or computed tomography (CT), the latter being more accurate. All patients with PFA PSAs underwent endovascular treatment, including glue, thrombin, or coil embolization as well as stent-graft insertions. All TPFAAs presented to our center were small and incidentally discovered, explaining the conservative management of our TPFAAs. Two of the four TPFAAs were idiopathic in nature, while one was attributed to post-stenotic dilatation, and another was found in a patient with Ehlers Danlos Syndrome. There was an association between TPFAAs and multiple synchronous or asynchronous aneurysms. Conclusion Pseudoaneurysms of the PFA are mostly iatrogenic in nature and can present with the triad of thigh swelling, bleeding, and unexplained anemia. If the clinical picture is suggestive of a PFA PSA but DUS does not detect a pseudoaneurysm, CT may be added as a more accurate imaging modality. Endovascular embolization is used in smaller pseudoaneurysms and in poor surgical candidates. Multiple glue, coil, or thrombin injections may be required to fully thrombose the pseudoaneurysm sac. True aneurysms of the PFA are associated with synchronous/asynchronous aneurysms and small TPFAAs should be carefully monitored, as there is a risk of enlargement and rupture.
The effects of gender and country of origin on acculturation, psychological factors, lifestyle factors, and diabetes-related physiological outcomes among Mexican Americans: The Starr County diabetes prevention initiative
Authors: Brown Sharon A , Becker Heather A , García Alexandra A , Velasquez Mary M , Tanaka Hirofumi , Winter Mary A , Perkison William B , Brown Eric L , Aguilar David , Hanis Craig L 
Published: March 2022

Objectives Examine acculturation and psychological, lifestyle, and physiological factors based on gender and country of origin (U.S. vs. Mexico). Methods Baseline data from the Starr County diabetes prevention study ( N = 300) were analyzed – acculturation ( language), psychological factors ( depression), lifestyle factors ( sedentary behaviors), and diabetes-related physiological outcomes ( insulin resistance). MANOVA and linear regression were used to examine variable relationships based on gender and country of origin and identify predictors of depression and insulin resistance. Results Participants were: predominantly female (73%); 51 years of age, on average; born in Mexico (71%); and Spanish-speaking. Individuals spent 11 of their waking hours (range = 0–18 h) in sedentary activities. Compared to females, more males spoke English and reported fewer hours in sedentary activities. Compared to participants born in Mexico, those born in the U.S. were more likely to: speak English; report depressive symptoms; and exhibit elevated BMI and insulin resistance rates. Two distinct models significantly predicted depression (R2 = 14.5%) and insulin resistance (R2 = 26.8%), with acculturation-language entering into both models. Discussion Significant gender and country-of-origin differences were found. Future research on diabetes prevention should examine other Hispanic subgroups and strategies for addressing individual differences, while employing cost-effective group interventions that incorporate these differences and reach more at-risk individuals.
The role of routine radial styloidectomy in proximal row carpectomy: a retrospective review of 120 patients
Authors: van Rijt Willem G. , Delnoy Robin E. , Bonhof-Jansen Elske E. D. J. , de Jong Tjeerd R. 
Published: March 2022

Impingement between the radial styloid and the trapezium can occur after a proximal row carpectomy (PRC). We hypothesized that a PRC with primary radial styloidectomy reduces the risk of radial impingement, without affecting clinical or functional outcomes. In this retrospective cohort study, 120 patients were divided into two groups: PRC with or without primary radial styloidectomy. Patient-related outcome, strength and range of motion after proximal row carpectomy were measured in a subgroup. The occurrence of radial impingement was significantly lower in the group with primary radial styloidectomy versus those without ( p = 0.002). Five patients in the latter group were subsequently treated by a secondary radial styloidectomy, as compared with one patient who underwent primary radial styloidectomy ( p = 0.034). There were no significant differences in range of motion or patient-related outcome observed between the two groups. From our study, a radial styloidectomy is recommended as a routine part of the PRC procedure to prevent radial impingement without negatively impacting on function. Level of evidence: IV
Teledentistry awareness, its usefulness, and challenges among dental professionals in Pakistan and Saudi Arabia
Authors: Chaudhary Farooq Ahmad , Ahmad Basaruddin , Javed Muhammad Qasim , Mustafa Saeed , Fazal Ayesha , Javaid Muhammad Mohsin , Siddiqui Ammar Ahmed , Alam Mohammad Khursheed , Ud Din Shahab 
Published: March 2022

Objectives This study aims to describe the perception of dental professionals in Pakistan and Saudi Arabia (SA) towards the practice of teledentistry, its usefulness and challenges. Methods A cross-sectional study was carried out among 190 dentists from January 2021 to April 2021. The participants were included in the study using snowball sampling method. A 26-item adopted questionnaire was distributed using different social media channels. Chi-square test was used for analysis. Results Out of 190 participants, 46.3% were from Pakistan and 53.7% were from SA. The majority of participants in both countries agreed that teledentistry would enhance guidelines and advice (74.2%), improve peer-to-peer interaction (79.5%) and make patient's referrals more efficient (75.8%). For the usefulness, most participants agree that it is economical for the patients (61.1%), improves communication (74.7%), helps in educating the patients (86.3%), avoid unnecessary travel (76.8%), helps monitoring (71.6%), and benefits patients in remote areas (74.7%); however, more Pakistani participants perceived that time spent with the patient would increase compared to SA participants ( p < 0.001) and a higher proportion of SA participants believe that it helps in communication and monitoring of patients ( p < 0.001) than Pakistani participants. Regarding the challenges in the use of teledentistry, few participants think that it violates the patient's privacy (22.6%) or is difficult to use (14.7%) or have distrust towards the teledentistry equipment (24.2%). Conclusion The results indicated a high awareness and a positive attitude towards teledentistry, and its adaptation in their dental practice in both countries. However, limited infrastructure, set-up cost, and information technology (IT) literacy are the main challenges in integrating teledentistry which can be overcome by strategic government initiatives, policies, and programs.
Pollen Allergy Screening with Allergen-Specific and Total Immunoglobulin E Titers
Authors: Yokoi Hidenori , Matsumoto Yuma , Kawada Michitsugu , Sakurai Hiroyuki , Saito Koichiro 
Published: March 2022

Background Allergic rhinitis is a typical type I hypersensitivity reaction, commonly caused by inhalant allergens. Accurate identification of the causative antigen is important for rapid diagnosis and treatment initiation. Objective This study examined the efficiency of serum-based allergen-specific immunoglobulin E and total immunoglobulin E antibody titers in screening for pollen allergy. We also examined the effect of cross-reactive carbohydrate determinants on specific immunoglobulin E titers in screening for pollen allergy, one of the causes of false positivity in specific immunoglobulin E measurements. Methods A questionnaire was used to evaluate the symptoms of pollinosis among participants who underwent a medical examination. One hundred and thirty-two participants reported pollen allergy symptoms and 127 reported an absence of symptoms. Specific immunoglobulin E levels were measured using the AlaSTAT 3g Allergy method. Seventeen components, including four types of cross-reactive carbohydrate determinant-specific immunoglobulin E antibodies, were measured and evaluated comparatively. Results The sensitivity and specificity of the tests in predicting the presence or absence of pollen allergy were analyzed. The values of the areas under the curves for immunoglobulin E antibody levels against cedar, cypress, orchard grass, and ragweed pollen were 0.87, 0.82, 0.63, and 0.56, respectively. A cross-reactive carbohydrate determinant-related false-positive effect on the pollen specific immunoglobulin E titer was noted in pollen screening. Conclusion Cedar pollen-specific immunoglobulin E titers showed sufficient accuracy for use in pollen allergy screening. The study of cross-reactive carbohydrate determinants suggested that subjects who tested positive for pollen often had false-positive results due to the impact of cross-reactive carbohydrate determinants.
Product Innovation and National Image of Chinese Products in the Eyes of Thai People
Authors: Luo Qiuxue , Suacamram Mayuree 
Published: March 2022

This paper developed products from Guangxi, China, for customers in Bangkok, Thailand, and investigates the influence of country image and product innovation on purchasing eight products: a tea shop, flower tea, traditional Chinese dress, Chinese language lessons, an instant hotpot, Chinese noodles, jujube, and Chinese jewelry. The study followed four steps: (1) researching the demand of product development from documents and interviews with Chinese entrepreneurs; (2) developing a product concept and presenting it to two business experts; (3) selecting five products with the highest expert ratings and conducting a survey to collect data about the products from Thai customers; and (4) analyzing the level of buying decisions and influence of product country image and product innovation on each of the five products. Content analysis, path analysis, and multigroup techniques were used for data analysis. Results revealed that products with a high level of product innovation and buying decisions that introduced technology provided better value and that product innovation influenced buying decisions in all product categories. Product country image, however, only influenced buying decisions for Chinese jewelry and Chinese language lessons. JEL Classification: M01, M03
Adverse Neonatal Outcomes and Associated Risk Factors: A Case-Control Study
Authors: Workineh Yeneneh Ayalew , Workie Hailemariam Mekonnen 
Published: March 2022

Background Adverse neonatal outcomes have a significant effect on perinatal and neonatal survival and the risk of developmental disabilities and illnesses throughout future lives. Hence, the objective of this study was to identify adverse neonatal outcomes and associated risk factors. Method Institutional based unmatched case-control study was conducted among 206 neonates. Neonates who had adverse outcomes were cases with their index mothers and those neonates who hadn’t had adverse outcomes were controls with their index mothers. Sociodemographic, potential neonatal risk factors, and clinical data were taken from the mothers and medical records. Data were entered into Epi Info v7 and analyzed using SPSS v23. Bivariate and multivariable logistic regression analyses were used to adjust for confounding factors of adverse neonatal outcomes. Frequencies, means, standard deviations, percentages, and cross-tabulations were used to summarize the descriptive statistics of the data. Results In this study, low birth weight (61.5%), preterm birth (57.7%), and low Apgar score at fifth minutes (53.9%) were the major identified adverse neonatal outcomes. Based on the multivariable logistic regression analysis, rural place of residence (AOR = 5.992 to 95% CI [1.011-35.809]), low monthly income (AOR = 4.364), middle monthly income (AOR = 4.364), and emergency cesarean section (AOR = 9.969) were the potential risk factors for adverse neonatal outcomes. Conclusions The adverse neonatal outcomes & the risk factors identified in this research have the potential to harm the health of the neonates. Thus, it needs emphasis to tackle the problems and save the life of the newborn through better and strengthened ANC follow-up, accesses to health care.
The absence of the autoimmune regulator gene (AIRE) impairs the three-dimensional structure of medullary thymic epithelial cell spheroids
Authors: Monteleone-Cassiano Ana Carolina , Dernowsek Janaina A. , Mascarenhas Romario S. , Assis Amanda Freire , Pitol Dimitrius , Santos Moreira Natalia Chermont , Sakamoto-Hojo Elza Tiemi , Issa João Paulo Mardegan , Donadi Eduardo A. , Passos Geraldo Aleixo 
Published: March 2022

Abstract
Background
Besides controlling the expression of peripheral tissue antigens, the autoimmune regulator (AIRE) gene also regulates the expression of adhesion genes in medullary thymic epithelial cells (mTECs), an essential process for mTEC-thymocyte interaction for triggering the negative selection in the thymus. For these processes to occur, it is necessary that the medulla compartment forms an adequate three-dimensional (3D) architecture, preserving the thymic medulla. Previous studies have shown that AIRE knockout (KO) mice have a small and disorganized thymic medulla; however, whether AIRE influences the mTEC-mTEC interaction in the maintenance of the 3D structure has been little explored. Considering that AIRE controls cell adhesion genes, we hypothesized that this gene affects 3D mTEC-mTEC interaction. To test this, we constructed an in vitro model system for mTEC spheroid formation, in which cells adhere to each other, establishing a 3D structure.

Results
The comparisons between AIRE wild type (AIREWT) and AIRE KO (AIRE−/−) 3D mTEC spheroid formation showed that the absence of AIRE: i) disorganizes the 3D structure of mTEC spheroids, ii) increases the proportion of cells at the G0/G1 phase of the cell cycle, iii) increases the rate of mTEC apoptosis, iv) decreases the strength of mTEC-mTEC adhesion, v) promotes a differential regulation of mTEC classical surface markers, and vi) modulates genes encoding adhesion and other molecules.

Conclusions
Overall, the results show that AIRE influences the 3D structuring of mTECs when these cells begin the spheroid formation through controlling cell adhesion genes.
Increased normalized lactate load is associated with higher mortality in both sepsis and non-sepsis patients: an analysis of the MIMIC-IV database
Authors: Chen Han , Gong Shu-Rong , Yu Rong-Guo 
Published: March 2022

Abstract
Background
The present study aimed to evaluate the association between normalized lactate load, an index that incorporates the magnitude of change and the time interval of such evolution of lactate, and 28-day mortality in sepsis and non-sepsis patients. We also compared the accuracy of normalized lactate load in predicting mortality between these two populations.

Methods
Data were extracted from the Medical Information Mart for Intensive Care (MIMIC)-IV database. We defined lactate load as the sum of the area under the lactate concentration curve; we also defined normalized lactate load as the lactate load divided by time. The performance of maximum lactate, mean lactate and normalized lactate load in predicting 28-day mortality in sepsis and non-sepsis patients were compared by receiver-operating characteristic curves analysis.

Results
A total of 21,333 patients were included (4219 sepsis and 17,114 non-sepsis patients). Non-survivors had significantly higher normalized lactate load than survivors in sepsis and non-sepsis patients. The maximum lactate, mean lactate, and normalized lactate load AUCs were significantly greater in sepsis patients than in non-sepsis patients. Normalized lactate load had the greatest AUCs in predicting 28-day mortality in both sepsis and non-sepsis patients. Sensitivity analysis showed that the AUC of normalized lactate load increased in non-sepsis patients when more lactate measurement was obtained, but it was not improved in sepsis patients.

Conclusions
Normalized lactate load has the strongest predictive power compared with maximum or mean lactate in both sepsis and non-sepsis patients. The accuracy of normalized lactate load in predicting mortality is better in sepsis patients than in non-sepsis patients.