bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ambulatory Long Block: A Model of Precision Education and Assessment for Internal Medicine Residents
Authors: Warm Eric J. , Kinnear Benjamin , Knopp Michelle I. , Powers-Fletcher Margaret , Segev Mati , Willauer Alexandra , Schauer Daniel 
Published: December 2024

Abstract
High-quality precision education (PE) aims to enhance outcomes for learners and society by incorporating longitudinal data and analytics to shape personalized learning strategies. However, existing educational data collection methods often suffer from fragmentation, leading to gaps in understanding learner and program performance. In this article, the authors present a novel approach to PE at the University of Cincinnati, focusing on the Ambulatory Long Block, a year-long continuous ambulatory group-practice experience. Over the last 17 years, the Ambulatory Long Block has evolved into a sophisticated data collection and analysis system that integrates feedback from various stakeholders, as well as learner self-assessment, electronic health record utilization information, and clinical throughput metrics. The authors detail their approach to data prioritization, collection, analysis, visualization, and feedback, providing a practical example of PE in action. This model has been associated with improvements in both learner performance and patient care outcomes. The authors also highlight the potential for real-time data review through automation and emphasize the importance of collaboration in advancing PE. Generalizable principles include designing learning environments with continuity as a central feature, gathering both quantitative and qualitative performance data from interprofessional assessors, using this information to supplement traditional workplace-based assessments, and pairing it with self-assessments. The authors advocate for criterion referencing over normative comparisons, using user-friendly data visualizations, and employing tailored coaching strategies for individual learners. The Ambulatory Long Block model underscores the potential of PE to drive improvements in medical education and health care outcomes.
Mechanical Power Is Associated With Mortality in Pressure-Controlled Ventilated Patients: A Dutch, Single-Center Cohort Study
Authors: Goedegebuur Jamilla , Smits Floor E. , Snoep Jacob W. M. , Rietveld Petra J. , van der Velde Franciska , de Jonge Evert , Schoe Abraham 
Published: December 2024

IMPORTANCE:
Mechanical power (MP) could serve as a valuable parameter in clinical practice to estimate the likelihood of adverse outcomes. However, the safety thresholds for MP in mechanical ventilation remain underexplored and contentious.

OBJECTIVES:
This study aims to investigate the association between MP and hospital mortality across varying degrees of lung disease severity, classified by Pao
2/Fio
2 ratios.

DESIGN, SETTING, AND PARTICIPANTS:
This is a retrospective cohort study using automatically extracted data. Patients admitted to the ICU of a tertiary referral hospital in The Netherlands between 2018 and 2024 and ventilated in pressure-controlled mode were included.

MAIN OUTCOMES AND MEASURES:
Logistic regression, adjusted for age, sex, Acute Physiology and Chronic Health Evaluation-IV score, and Pao
2/Fio
2 ratio, was used to calculate the odds ratio (OR) for all-cause in-hospital mortality.

RESULTS:
A total of 2184 patients were analyzed, with a mean age of 62.5 ± 13.8 years, of whom 1508 (70.2%) were male. The mean MP was highest in patients with the lowest Pao
2/Fio
2 ratios (21.5 ± 6.5 J/min) compared with those with the highest ratios (12.0 ± 3.8 J/min; p < 0.001). Adjusted analyses revealed that increased MP was associated with higher mortality (OR, 1.06; 95% CI, 1.03–1.09 per J/min increase). Similarly, MP normalized for body weight showed a stronger association with mortality (OR, 1.004; 95% CI, 1.002–1.006 per J/min/kg increase). An increase in mortality was seen when MP exceeded 16–18 J/min.

CONCLUSIONS AND RELEVANCE:
Our findings demonstrate a significant association between MP and hospital mortality, even after adjusting for key confounders. Mortality increases notably when MP exceeds 16–18 J/min. Normalized MP presents an even stronger association with mortality. These results underscore the need for further research into ventilation strategies that consider MP adjustments.
Prenatal Spina Bifida Repair: A Survey of Current Practice in the United States
Authors: Garg Stuti P. , Shah Krish V. , Lentskevich Marina , Yau Alice , Gosain Arun K. 
Published: December 2024

Background:
Prenatal myelomeningocele (MMC) repair offers significant benefits over traditional postnatal repair, as demonstrated by the Management of Myelomeningocele Study trial. We characterize the current specialist involvement in prenatal and postnatal MMC repair.

Methods:
The top 50 US News Children’s Hospitals for Neonatology and Neurology/Neurosurgery were queried, resulting in 67 unique hospitals. Specialties involved in MMC repair were extracted via hospital websites and surveys.

Results:
Among the 58 hospitals included, only 18 (31%) offered both prenatal and postnatal MMC repair, and the remaining 40 (69%) offered postnatal repair only. Of the 40 hospitals offering postnatal repair only, neurosurgeons (n = 38), orthopedic surgeons (n = 34), and urologists (n = 33) were most often included. Of the 18 hospitals with prenatal repair, neurosurgeons (n = 18) and maternal–fetal medicine specialists (n = 14) were most commonly involved. Prenatal teams had pediatric and fetal surgeons involved more often than postnatal teams (P = 0.011 and P = 0.035, respectively). Only 7 prenatal teams included fellowship-trained fetal surgeons. Teams led by fetal surgeons always included neurosurgeons (n = 7) and maternal–fetal medicine specialists (n = 7) and were least likely to include plastic surgeons (n = 1).

Conclusions:
These data emphasize both the delayed adaptation of fetal repair of MMC by major children’s hospitals and lack of fellowship-trained specialists involved; only 31% of the major children’s hospitals offer prenatal repair of MMC, with only 39% of those hospitals being led by a fellowship-trained fetal surgeon. These data highlight the need for additional teams trained in prenatal MMC repair as well as the standardization of fetal surgery fellowships to allow for the development of prenatal repair teams.
Module Creation Within the TOPS Registry: An Opportunity for Longitudinal Collection of Procedure-specific Clinical Outcomes
Authors: Hallman Taylor G. , Qureshi Umer , Reisner Kathryn , Figueroa Ariel E. , Gosain Arun K. 
Published: December 2024

Summary:
The Tracking Operations and Outcomes for Plastic Surgeons (TOPS) data registry, first launched in 2002 by the American Society of Plastic Surgeons (ASPS) in collaboration with the Plastic Surgery Foundation (PSF), was designed to avoid the perceived shortcomings of other national data registries as they pertain to interests of the plastic surgery community. Given the diversity of plastic surgery practice, the ASPS and PSF sought to ensure that the TOPS registry platform would support detailed collection of data useful to plastic surgeons practicing in all subspecialties. Therefore, a key design element of the TOPS registry is its ability to incorporate custom-made modules that allow for focused collection of topic/procedure-specific information. Although the TOPS database has collected information on more than 1.6 million plastic surgery procedures and outcomes since its inception more than 20 years ago, only a handful of custom modules have been created. This article outlines the senior author’s experience collaborating with the ASPS and PSF to successfully develop and implement a custom module within the TOPS registry. This information serves to promote further awareness, usage, and creation of TOPS modules, as these modules enable assessment of complex clinical conditions by leveraging data collection efforts through the single largest national plastic surgery organization.
Does Seven Days of Postoperative Enoxaparin Increase Bleeding Risk in Abdominal Contouring Surgery? A Single-center Experience
Authors: Abushehab Abdallah , Tunaboylu Mehmet Furkan , Kuruoglu Doga , Meira Pazelli Alexandre , Hussein Sara M. , Sharaf Basel A. 
Published: December 2024

Background:
Venous thromboembolism (VTE) poses a major risk after abdominal contouring surgery, impacting morbidity and mortality. Despite various preventative strategies, surgeons are cautious about using enoxaparin for extended postoperative periods. This study aims to determine if a 7-day postoperative course of enoxaparin increases bleeding risks compared with a single dose of intraoperative unfractionated heparin in patients undergoing abdominal contouring surgery.

Methods:
A retrospective cohort analysis was performed on patients who underwent abdominoplasty or panniculectomy from August 2017 to October 2023. Patients were split into 2 groups: Group 1 received 5000 units of intraoperative unfractionated heparin in addition to 7 days of postoperative enoxaparin (40 mg daily); group 2 received only the intraoperative heparin dose. Primary outcomes included bleeding events and VTE incidence. Secondary outcomes were seroma, infection, surgical site dehiscence, necrosis, drain duration, and reoperation rates.

Results:
The study included 121 patients (111 women, 10 men), with 61 patients in group 1 and 60 in group 2. The average age was 49 ± 12 years, and the average body mass index was 29.8 ± 5 kg/m². No cases of VTE were reported. Postoperative bleeding occurred in 3 patients (4.9%) in group I and 2 patients (3.3%) in group 2, showing no statistically significant difference (P = 0.66). Secondary outcomes also showed no significant differences between the groups.

Conclusions:
Our study of 121 patients undergoing either abdominoplasty or panniculectomy demonstrated that administering enoxaparin for 7 days postoperatively is safe and does not increase the risk of bleeding.
Observations on the Etiology of Involutional Entropion
Authors: Custer Philip L. 
Published: December 2024

Purpose:
To review evidence supporting proposed anatomic etiologies of involutional entropion and propose additional potential contributing factors.

Methods:
A literature review was performed to identify publications describing possible etiologies of involutional entropion. The author’s clinical observations and information supporting new proposed causes are presented.

Results:
The frequency of perceived anatomic causes of entropion listed in modern publications include retractor dehiscence (97%), horizontal eyelid laxity (89%), orbicularis override (89%), enophthalmos (33%), tarsal atrophy (16%), and fat prolapse (10%). Evidence suggests attenuation of the retractors is a predominant factor in most patients. Tarsal atrophy, enophthalmos, and fat prolapse likely play a role in some individuals. The eyelid distraction test often shows horizontal margin laxity, although the eyelids typically are not elongated. Poor deep fixation and increased inferior mobility of the lateral canthus may contribute to marginal laxity and predispose patients to entropion. Lateral rectus capsulopalpebral fascia attenuation could lead to this canthal instability and reduced horizontal stability of the tarsal base.

Conclusions:
Various age-related anatomic changes predispose patients to involutional entropion. Findings may vary among individuals. Tarsal atrophy and relative enophthalmos reduce appositional tension between the eyelid and globe. Lower eyelid retractor dehiscence causes poor anterior lamellar fixation and rotary instability of the tarsal base. Orbital fat prolapse may displace the tarsal base and alter orbicularis mechanics. Dysfunction of the lateral rectus capsulopalpebral fascia may contribute to both canthal instability and reduced horizontal tension near the tarsal base. Each patient’s findings should be considered when individualizing surgical repair.
Food as medicine through the lenses of Food Access, Justice, and Sovereignty
Authors: Gonzalez Norma , Samad Ismail , Thomas Olivia , Rice Jenna , Valdez Rebecca , Burt Katherine 
Published: December 2024

Purpose of review
Food as Medicine (FAM) and supplemental nutrition programs like supplemental nutrition assistance program (SNAP), women, infants, and children (WIC), and school meals aim to combat rising diet-related chronic diseases and healthcare costs by addressing poor diet and food insecurity. However, their effectiveness is limited by a lack of community integration in planning, implementation, and evaluation. We introduce the Food Access, Justice, and Sovereignty (FAJS) framework, which expands FAM efforts to address acute food disparity through community-based strategies grounded in justice and sovereignty.

Recent findings
FAM interventions on adult populations have demonstrated a positive impact on food insecurity and its related chronic illness and shows promise for pediatric populations. However, community-driven solutions are essential for shifting power toward greater integration of the lived experiences of community, which can enhance positive behavioral changes needed for greater prevention and management of chronic illness.

Summary
Using community driven approaches through the lens of access, justice, and sovereignty address the effects of food insecurity and diet-related chronic diseases for adults and pediatric populations. Through the FAJS Framework, interventionalists can develop sustainable nutrition programs that engender community health, control, and lasting impact.
The combination effect of treadmill exercise and valerian hydroalcoholic extract on the heart of type 2 diabetic rats
Authors: Mirzaei Alireza , Zynivand Mahtab , Karimi Rouzbahani Arian , Moghimian Maryam , Yarimir Samira , Sedighi Mehrnoosh , Ghorbanzadeh Vajihe , Nazari Afshin 
Published: December 2024

Objectives:
Diabetes mellitus is a metabolic disorder recognized for inducing endothelial dysfunction in coronary arteries. This study aimed to investigate the synergistic effects of valerian hydroalcoholic extract and exercise in diabetic rats.

Methods:
Thirty-five Wistar rats were randomly divided into five groups: control, diabetes, diabetic rats undergoing treadmill exercise, diabetic rats administered valerian extract (200 mg/kg, oral), and diabetic rats receiving a combination of valerian extract and treadmill exercise for 8 weeks. Antioxidants and lipoproteins were assessed via blood sampling at the study’s conclusion. Hemodynamic parameters and the response of the coronary artery bed to constrictors and dilators were evaluated by connecting the heart to a Langendorff device.

Results:
Diabetes was associated with a diminished vascular vasodilator response, which was enhanced by the combined treatment of valerian extract and 8 weeks of exercise. Moreover, elevated levels of glutathione peroxidase (GPx) and superoxide dismutase (SOD) were observed in groups receiving both valerian extract and exercise.

Conclusions:
The findings suggest that the combination of treadmill exercise and hydroalcoholic extract may hold promise in managing cardiovascular complications in diabetic patients by leveraging their antioxidant properties.
Supraglottic mucous membrane plasmacytosis: a case report and literature review
Authors: Gillanders Sarah L. , Crotty Thomas J. , O’Neill James P. 
Published: December 2024

Introduction:
Mucous membrane plasmacytosis is a rare, inflammatory disorder characterized by polyclonal plasma cells infiltrating the mucosal tissue of the oral cavity, oropharynx, laryngopharynx, or genitalia.

Case presentation:
We present a case of supraglottic plasmacytosis which presented a management challenge due to a complicated past medical history preventing oral steroid administration.

Discussion:
A literature review is conducted to determine alternate treatment options in for this challenging case and others. A discussion of diagnosis, treatment and aftercare follows the case report and literature review.

Conclusion:
This case report illustrates the rare condition of laryngeal mucous membrane plasmacytosis. Application of steroids to the specific site of pathology appears to be a promising management course.
Airway management and ventilation strategy among obese adult patients: a comprehensive review and analysis
Authors: Ayenew Alaye Debas , Melkie Tadese Belayneh , Arefayne Nurhusen Riskey , Degu Zewditu Abdissa , Admassie Belete Muluadam 
Published: December 2024

Background:
Difficulties with mask ventilation and intubation are more prevalent in obese patients. Hence, health care practitioners engaged in airway management of obese individuals must exercise particular vigilance and care. Ventilation strategies can potentially have a detrimental impact on postoperative pulmonary function, prolong hospital stays, and increase costs. As a result, the aim of this review was to investigate airway management technique and ventilation strategies in obese adult patients.

Methods:
The PubMed, HINARI, Google Scholar, and Cochrane Review databases were searched using appropriate keywords and search engines for adequate evidence from studies meeting the inclusion criteria to reveal the endpoint, which was ventilation strategy and airway management in adult obese patients. Duplicate entries were eliminated through EndNote software. Screening of literature was conducted with proper appraisal checklist. This review was reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses 2020 statement.

Results:
The included literature covers a wide range of topics, including preoxygenation, making the patient in a 25° head-up position, use of 10–12cmH2O of positive end-expiratory pressure (PEEP) and continuous positive airway pressure (CPAP) during induction, placing the patient in a ramping posture during intubation, high-flow oxygenation (15 L/min) through the nasopharyngeal airway or nasal cannula during laryngoscopy, using low tidal volume during surgery, a 1:1/1.5:1 I:E ratio, PEEP of 10–20 cmH2O, Fio2 reduced to make SpO2 > 90, pressure-controlled (PC)/volume-controlled (VC) ventilation mode, and recruitment maneuver (RM). Following surgery, it was essential to provide oxygen therapy to maintain preoperative levels, provide CPAP/non-invasive positive pressure ventilation, place patients in semi-sitting positions, and provide thorough postanesthesia care unit monitoring in order to enhance patient outcomes with regard to morbidity and mortality among obese patients. To safely manage and overcome airway challenges in severely obese patients with a suspected difficult airway, awake fiberoptic intubation is recommended.

Conclusions:
Positioning the patient in a head-up position (semi-sitting), utilizing CPAP during preoxygenation, and administering oxygen via nasal cannula during intubation to prolong apnoea time and awake fibrotic for suspected difficult airway. Additionally, selecting appropriate ventilation modes (PC/VC), PEEP + RM, and positions during the intraoperative phase is crucial to improving outcomes in obese surgical patients.
Unmasking pseudopelade of Brocq in male adult: a rare case report
Authors: Usama Bin Shabbir Muhammad , Afridi Faryal , Waheed Aiman , Alvi Rafia , Hamza Gul Muhammad , Wardak Abdul Baseer 
Published: December 2024

Introduction and importance:
Pseudopelade of Brocq originally describes asymptomatic, irregularly shaped patches of atrophic hair loss. It designates a rare, idiopathic, slow progressive cicatricial alopecia without evident signs of folliculitis or inflammatory changes. This dermatological disorder still needs further research into its pathogenesis and treatment. We hope this case report provides valuable insight and a significant addition to the research gap as it is common in females but rare in male patients, and serves as a starting point for additional inquiry regarding causal link and epidemiology of disease.

Case presentation:
The authors present a rare case of Pseudopelade of Brocq in a male adult patient. The patient initially presented with progressive hair loss, but later examination revealed multiple atrophic patches of hair loss in the vertex area without any signs of inflammation. Subsequently, the patient was treated with corticosteroids and showed improvement in disease progression.

Discussion:
The pathogenesis of the Pseudopelade of Brocq is not well defined. Diagnosing this clinical entity is challenging due to delayed presentation which leads to increased patient suffering, preventable complications like baldness, and economic burdens.

Conclusion:
Pseudopelade of Brocq is a rare dermatologic manifestation. It is crucial to raise awareness among healthcare professionals regarding its delayed presentation to prevent its long-term complications.
Worldwide research tendency and collaborations on models of necrotizing enterocolitis: bibliometric exploration over the past three decades
Authors: Shu Boshen , Zhang Shufeng , Gao Jian , Wang Lin , Wang Xiaohui 
Published: December 2024

Background:
Necrotizing enterocolitis (NEC) is a devastating disease affecting the gastrointestinal tract in premature infants with high mortality and morbidity. We aimed to analyze the research tendency and collaborations on models of NEC over the past three decades.

Methods:
Bibliometric variables of included articles were retrieved from the Web of Science Core Collection from 1994 to 2023. Visualized studies were performed via VOSviewer software. Statistical analysis was applied by using GraphPad Prism and Microsoft Excel.

Result:
A total of 255 original articles from 17 countries were included in this study. The number of articles increased significantly from 22 (the year 1994-2003) to 161 (the year 2014-2023) (P < 0.0001). Collaborations in regions and countries have increased significantly over time (P < 0.0001). Developed regions contributed most of the research. While rat (56.08%) held the leading position in all types of models, followed by mouse (30.20%), notably, the proportion of mouse model has increased significantly from 4.55% to 41.36%.

Conclusion:
This study might provide valuable insights into the model research of NEC. Research tendency has evolved to be collaborative and inclusive with more collaborations, broad model types, and studies from developing regions. However, the lack of an evident and robust pathophysiology mechanism will continue to make NEC a quite challenging case to decode, and research with strong evidence level and high quality is still required.