bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preexisting chronic pain is not associated with moderate-to-severe acute pain after laparoscopic cholecystectomy: a prospective cohort study
Authors: Nepali Bishal , Subedi Asish , Pokharel Krishna , Ghimire Ashish , Prasad Jagat Narayan 
Published: November 2024

Abstract

Introduction:
We aimed to evaluate the relationship between preexisting chronic pain and acute postoperative pain after laparoscopic cholecystectomy (LC) and to identify predictors of acute postsurgery pain.

Methods:
In this prospective cohort study, patients undergoing LC with general anesthesia were enrolled. The primary outcome was the incidence of moderate-to-severe pain during movement in the first 24 hours after surgery. Logistic regression analysed the association of perioperative risk factors with acute postoperative pain. Model performance was assessed using receiver operating characteristic curves (ROC), calibration belt plots, and 10-fold cross-validation.

Results:
Of the 193 patients analysed, 49.74% experienced moderate–severe acute pain. Univariable analysis indicated that preoperative chronic pain increased the likelihood of acute postoperative pain (odds ratio [OR], 2.53; 95% confidence interval [CI], 1.40–4.55). Risk factors identified in the multivariable analysis were higher preoperative pain intensity (OR, 1.28; 95% CI, 1–1.65), sleep disturbances (OR, 1.42; 95% CI, 1.24–1.61), intraoperative fentanyl supplementation (OR, 3.68; 95% CI, 1.48–9.12), incision extension for gallbladder retrieval (OR, 7.27; 95% CI, 1.58–33.39), and abdominal drain placement (OR, 6.09; 95% CI, 1.08–34.34). Dexamethasone use was associated with reduced pain (OR, 0.05; 95% CI, 0.004–0.74). The model demonstrated strong discrimination (ROC = 0.909) and good calibration (test statistic = 0.02; P = 0.89). Cross-validation showed slightly lower accuracy (ROC = 0.896).

Conclusions:
Preexisting chronic pain was not associated with acute postoperative pain following laparoscopic cholecystectomy. Significant predictors for acute pain included higher preoperative pain intensity, sleep disturbances, intraoperative fentanyl, incision extension, and abdominal drain placement, while dexamethasone use was associated with reduced pain.
Long-Term Surgical Outcomes of Intermediate Cleft Rhinoplasty
Authors: Ng Jinggang J , Cheung Liana , Massenburg Benjamin B , Cho Daniel Y , Wu Meagan , Romeo Dominic J , Swanson Jordan W , Jackson Oksana A , Low David W , Taylor Jesse A 
Published: November 2024

Background:
The risk/benefit ratio of operating on the cleft nasal deformity in the period of mixed dentition remains debated. This study characterizes our 18-year experience with intermediate cleft rhinoplasties to add data and nuance to the discussion.

Methods:
We performed a retrospective cohort study of patients who underwent intermediate cleft rhinoplasty from 2006 to 2023. Demographic information and operative details were collected. Primary outcomes were operative complications and need for subsequent rhinoplasty.

Results:
Three-hundred and forty-two patients undergoing 372 intermediate rhinoplasties were included: 150 (40.3%) with no graft/implant, 165 (44.4%) with iliac crest cartilage graft, 36 (9.7%) with ear cartilage, 19 (5.1%) with a resorbable plate, and 3 (0.8%) with nasal cartilage. Use of iliac crest graft predicted fewer subsequent rhinoplasties independent of age at surgery, age at most recent follow-up, sex, race, syndromic status, cleft severity, intranasal stenting duration, and surgeon (β=-0.234, p=0.012). Employment of a V-Y chondromucosal flap in the unilateral cleft lip group (β=-0.401, p=0.002) and placement of a columellar strut graft in the bilateral cleft lip group (β=-0.450, p=0.028) predicted fewer subsequent rhinoplasties. The proportion of rhinoplasties utilizing iliac crest grafts increased over time (r(372)=0.806, p<0.001). Most (55.0%) patients with follow-up beyond age 18 (n=60) did not require subsequent rhinoplasty.

Conclusions:
Iliac crest cartilage grafting as a columellar strut in bilateral clefts and a chondromucosal V-Y advancement in unilateral clefts were associated with a decreased need for future rhinoplasty. Further work is needed to understand the risk/benefit ratio, surgical burden, and patient-reported outcomes of intermediate rhinoplasty.
Predictors of Facial Synkinesis Severity
Authors: Rail Benjamin , Gault Natalie A. , Dragun Anthony J. , Bhatia Sahejbir S. , Geltser Chaia S. , Lee MinJae , Rozen Shai M. 
Published: November 2024

BACKGROUND:
There is a lack of studies exploring factors influencing synkinesis severity. This study aims to identify factors that may contribute to variations in severity of facial synkinesis.

METHODS:
Patients with a diagnosis of facial synkinesis presenting between 2009 and 2024 were reviewed. The synkinesis score of the eFACE Facial Nerve Clinician-Graded Scale was analyzed for associations with patient characteristics and facial palsy history using univariable and multivariable analysis.

RESULTS:
Two-hundred-forty-nine synkinesis patients were included in the study. The etiology of facial palsy was infectious or idiopathic in 185 patients (74%), tumor resection in 40 patients (16%), trauma in 17 patients (7%), and compression of the facial nerve by a benign tumor in seven patients (3%). Factors independently associated with more severe synkinesis scores included age of facial palsy onset over 50 years (-7.4, 95% CI, [-10.9, -3.9]; p < 0.001), diabetes (-8.6, 95% CI, [-14.9, -2.3]; p = 0.007), smoking (-4.9; 95% CI, [-8.0, -1.8]; p = 0.003), and intratemporal facial nerve injury (-19.4; 95% CI, [-27.8, -10.8]; p < 0.001). Other variables including sex, race, hypertension, and etiology were not found to be independently associated with synkinesis severity.

CONCLUSIONS:
Older age at facial palsy onset, diabetes, smoking, and intratemporal facial nerve injury were found to be independently associated with more severe synkinesis. These findings are novel and may aid in prognostication and treatment selection.
Thromboembolism prophylaxis timing is associated with center mortality in traumatic brain injury: A Trauma Quality Improvement Program retrospective analysis
Authors: Coaston Troy N. , Vadlakonda Amulya , Shen Aricia , Balian Jeffrey , Cho Nam Yong , Benharash Peyman , Barmparas Galinos ,   on behalf of the Academic Trauma Research Consortium (ATRIUM)
Published: November 2024

BACKGROUND
Timing of venous thromboembolism chemoprophylaxis (VTEPPx) in traumatic brain injury (TBI) is complex given concerns for potential worsening of hemorrhage. While timing of VTEPPx for TBI patients is known to vary at the patient level, to our knowledge, variation at the hospital level and correlation with quality metrics have not been quantified in a cohort of nonneurosurgical patients.

METHODS
This was a retrospective cohort study of the Trauma Quality Improvement database from 2018 to 2021. The primary outcome was variation in VTEPPx timing. This was ascertained by empirical Bayesian methodology using multilevel mixed-effects logistic regression. Secondary outcomes included the association of risk-adjusted VTEPPx timing and hospital characteristics such as volume and risk-adjusted mortality, which was assessed through Pearson's correlation coefficient (r). Risk-adjusted mortality was similarly calculated using multilevel mixed-effects modeling.

RESULTS
Of 132,028 patients included in the current study, 38.7% received care at centers in the earliest quartile of VTEPPx timing, classified as Early (others labeled Delayed). Patients receiving care at Early centers presented with severe TBI at a similar rate to Delayed (17.4% vs. 19.0%; absolute standardized mean difference, 0.04). Early center patients more commonly received unfractionated heparin as opposed to low-molecular-weight heparin compared with Delayed (40.5% vs. 27.6%; absolute standardized mean difference, 0.28). At the center level, 12% of observed variation in VTEPPx was attributable to differential hospital practices. Overall trauma volume (r = −0.22, p < 0.001) and TBI volume (r = −0.19, p < 0.001) were inversely associated with risk-adjusted VTEPPx timing. In addition, centers initiating VTEPPx earlier had lower overall (r = 0.17, p < 0.001) and TBI-related mortality (r = 0.17, p < 0.001).

CONCLUSION
There is significant center-level variation in timing of VTEPPx among TBI patients. Earlier VTEPPx was associated with improved center outcomes overall and among TBI patients, supporting usage of VTEPPx timing as a holistic measure of quality.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
Does time to operating room affect outcomes after pediatric blunt hollow viscus injury? A Trauma Quality Improvement Program analysis
Authors: Johnston William R. , Croughan Allison L. Mak , Hwang Rosa , Allukian Myron , Nance Michael L. , Nace Gary 
Published: November 2024

BACKGROUND
Blunt hollow viscus injuries (HVIs) are relatively rare and difficult to diagnose. Whether a delay in operative intervention impacts outcomes for pediatric patients with blunt HVI has not been investigated via analysis of multicenter databases.

METHODS
We queried the Trauma Quality Improvement Program database from 2016 to 2020 for patients younger than 18 years who underwent an operation of the stomach, small intestine, large intestine, or rectum within 72 hours of emergency department arrival after blunt injury. We excluded patients with solid organ injury and additional extra-intestinal abdominal or thoracic operations. Patients were categorized by the time from emergency department presentation to operating room arrival: 1 to 5, 5 to 12, 12 to 24, and 24 to 72 hours. We analyzed baseline characteristics and outcomes between groups.

RESULTS
We identified 1,700 patients, including 147 (9%) who were operated on >24 hours after arrival. Patients with delayed operations demonstrated higher Injury Severity Scores and higher Abbreviated Injury Scale scores for the head, face, and upper extremities and were more likely to require an orthopedic operation. Patients who received a delayed operation were less likely to have full-thickness injury noted in the operating room and demonstrated longer hospital and intensive care unit stays. However, there was no difference in superficial surgical site infection (SSI), deep SSI, organ space SSI, severe sepsis, or mortality between groups.

CONCLUSION
Diagnosis and operative intervention for blunt HVI may be delayed in the presence of distracting injuries and in the absence of full-thickness perforation. While these patients typically have a more severe injury profile and require longer hospital stays, they do not appear to have increased rates of SSI, sepsis, or mortality.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level IV.
Long-term accuracy of the National Emergency Laparotomy Audit risk score: Analysis of the impact of comorbidities on mortality 5 years after emergency laparotomy
Authors: Barazanchi Ahmed W.H. , Bhat Sameer , Park Brittany , Zeng Irene , MacFater Wiremu , Xia Weisi , MacCormick Andrew D. , Taneja Ashish , Hill Andrew G. 
Published: November 2024

BACKGROUND
The National Emergency Laparotomy Audit (NELA) risk prediction tool has demonstrated superiority in predicting 30-day mortality after emergency laparotomy (EL). The aim of our study was to evaluate the accuracy of NELA in calculating long-term (5 year) mortality and determine factors predicting long-term risk of death after EL.

METHODS
This retrospective cohort study included consecutive patients who underwent EL for any indication other than trauma between May 2012 and June 2017 at a large tertiary and academic teaching center. The primary outcome was all-cause postoperative mortality at 1 and 5 years. The c statistic (<1.0, excellent; <0.90, good; 0.80, fair; 0.70, poor) was used to assess accuracy of the NELA. Multivariable regression was used to identify independent risk factors for 5-year mortality after EL.

RESULTS
From a total of 758 patients, observed mortality continued to increase from 15.4% at 1 year up to 31.4% at 5 years. The NELA risk score accurately classified deceased patients at both 1 year (c = 0.82; 95% confidence interval [CI], 0.78–0.85) and 5 years (c = 0.82, 0.79–0.85) after EL. History of ascites (adjusted odds ratio [aOR], 3.3; 1.0–11.3; p = 0.048), chronic obstructive pulmonary disease (aOR, 1.9; 1.1–3.4; p = 0.030), congestive heart failure (aOR, 3.6; 1.2–11.5; p = 0.025), myocardial infarction (aOR, 2.6; 1.5–4.6; p = 0.001), and a new cancer diagnosis (aOR, 2.8; 1.7–4.8; p < 0.0001) were independent prognostic factors for death 5 years after EL.

CONCLUSION
Long-term prognosis after EL remains poor for at least 5 years postoperatively. The NELA score is accurately able to predict risk of death up to 5 years after EL. History of ascites, chronic obstructive pulmonary disease, congestive heart failure, myocardial infarction, and a new diagnosis of cancer were independent prognostic factors for long-term mortality after EL.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level IV.
Meioc-Piwil1 complexes regulate rRNA transcription for differentiation of spermatogonial stem cells
Authors: Kawasaki Toshihiro , Nishimura Toshiya , Tani Naoki , Ramos Carina , Karaulanov Emil , Shinya Minori , Saito Kenji , Taylor Emily , Ketting Rene F. , Ishiguro Kei-ichiro , Tanaka Minoru , Siegfried Kellee R. , Sakai Noriyoshi 
Published: November 2024

AbstractRibosome biogenesis is vital for sustaining stem cell properties, yet its regulatory mechanisms are obscure. Herein, we show unique properties of zebrafishmeiocmutants in which spermatogonial stem cells (SSCs) do not differentiate or upregulate rRNAs. Meioc colocalized with Piwil1 in perinuclear germ granules, but Meioc depletion resulted in Piwil1 accumulation in nucleoli. Nucleolar Piwil1 interacted with 45S pre-rRNA.piwil1+/-spermatogonia with reduced Piwil1 upregulated rRNAs, andpiwil1+/-;meioc-/-spermatogonia recovered differentiation later than those inmeioc-/-. Further, Piwil1 interacted with Setdb1 and HP1α, andmeioc-/-spermatogonia exhibited high levels of H3K9me3 and methylated CpG in the 45S-rDNA region. These results indicate that zebrafish SSCs maintain low levels of rRNA transcription with repressive marks similar toDrosophilapiRNA targets of RNA polymerase II, and that Meioc has a unique function on preventing localization of Piwil1 in nucleoli to upregulate rRNA transcripts and to promote SSC differentiation.
COFFEE CONSUMPTION AND PREVALENCE OF INSOMNIA DISORDER IN MEDICAL INTERNS AT THE AUTONOMOUS UNIVERSITY OF SANTO DOMINGO, DOMINICAN REPUBLIC, SEPTEMBER 2022-MARCH 2023
Authors: Ogando Montero Andy Bienvenido , Nuñez Figuereo Inomar 
Published: November 2024

AbstractThis study aims to investigate the relationship between insomnia and coffee consumption among medical interns at the Autonomous University of Santo Domingo, Dominican Republic. The research stems from the observation of high coffee consumption among healthcare personnel, particularly those exposed to night shifts and conditions that impact sleep quality. A cross-sectional, descriptive, and quantitative study was conducted with a sample of 299 interns, divided into groups based on the presence or absence of insomnia symptoms according to DSM-V criteria. The results indicate a significant relationship between coffee consumption and the prevalence of insomnia, with higher incidence among interns who consume coffee daily. This study provides evidence on how coffee consumption, within the Dominican cultural context and the demands of the medical environment, can affect sleep quality among medical interns. These findings highlight the need to consider caffeine consumption as a potential factor in the assessment and management of sleep disorders within this group of healthcare professionals.
Leveraging hierarchical structures for genetic block interaction studies using the hierarchical transformer
Authors: Li Shiying , Arora Shivam , Attaoua Redha , Hamet Pavel , Tremblay Johanne , Bihlo Alexander , Liu Bang , Rutter Guy 
Published: November 2024

AbstractInitially introduced in 1909 by William Bateson, classic epistasis (genetic variant interaction) refers to the phenomenon that one variant prevents another variant from a different locus from manifesting its effects. The potential effects of genetic variant interactions on complex diseases have been recognized for the past decades. Moreover, It has been studied and demonstrated that leveraging the combined SNP effects within the genetic block can significantly increase calculation power, reducing background noise, ultimately leading to novel epistasis discovery that the single SNP statistical epistasis study might overlook. However, it is still an open question how we can best combine gene structure representation modelling and interaction learning into an end-to-end model for gene interaction searching. Here, in the current study, we developed a neural genetic block interaction searching model that can effectively process large SNP chip inputs and output the potential genetic block interaction heatmap. Our model augments a previously published hierarchical transformer architecture (Liu and Lapata, 2019) with the ability to model genetic blocks. The cross-block relationship mapping was achieved via a hierarchical attention mechanism which allows the sharing of information regarding specific phenotypes, as opposed to simple unsupervised dimensionality reduction methods e.g. PCA. Results on both simulation and UK Biobank studies show our model brings substantial improvements compared to traditional exhaustive searching and neural network methods.
Immunosenescence profile is associated with increased susceptibility to severe COVID-19
Authors: Ventura Lucas Haniel A. , Torres Lícia , Camatta Giovanna Caliman , Zamame Jofer , Coelho Monique Macedo , Ramalho-Pinto Cecília Horta , Gervazio João , Caixeta Felipe , Nascimento Leandro , Oliveira Mariana Almeida , Martins Vinícius Dantas , Oliveira Marcos Felipe , da Costa Murilo Soares , Sato Hugo Itaru , Guimarães Henrique Cerqueira , Barbuto Rafael Calvão , Veiga Ana Paula Rocha , Ataíde Najara , Caetano Gabriela Prandi , Rangon Sarah , Júnior Mauro Lúcio O. , Fortes Fernanda Calvo , Zuccherato Luciana , Speziali Elaine , Martins-Filho Olindo Assis , Coelho Verônica , Avritchir Roberto , Souza Rafael , Ayupe Marina , Loureiro Caio , Passos Maria Eduarda , Neves Ana Clara Mota , Leite Pauline , Teixeira Santuza Maria Ribeiro , Tupinambas Unaí , Felicori Liza Figueiredo , Silveira-Nunes Gabriela , Maioli Tatiani Uceli , Fonseca Denise Morais , Teixeira-Carvalho Andrea , Faria Ana Maria Caetano 
Published: November 2024

AbstractIn this study we tested the hypothesis that the immunosenescence profile could account for the disproportional susceptibility of the elderly to severe forms of COVID-19. The immunological profiles of volunteers residing in endemic and non-endemic areas for chronic infectious diseases were analyzed at early stage of SARS-CoV-2 infection. A unique signature of inflammatory plasma mediators was identified in COVID-19 volunteers when compared to individuals with other flu-like syndromes. COVID-19 severity correlated with high levels of inflammatory mediators; among them, CXCL9, a serum marker of aging. Patients who progressed to hospitalization displayed high frequencies of CD8+and CD4+T cells expressing exhaustion and senescence markers and showed reduced and more mature B cell repertoires, which are typical of senescence. They also had an acceleration of epigenetic age measured by DNA methylation. Therefore, severe COVID-19 correlated with phenotypic, functional, and epigenetic features of accelerated immunosenescence at onset of infection.
Evaluation of near-infrared light therapy for the treatment of neurodegenerative diseases: Limited penetration depth into the brain likely hinders efficacy
Authors: Tittelmeier Jessica , Kaub Leon , Milz Stefan , Kugelmann Daniela , Hof Patrick R. , Schmitz Christoph , Nussbaum-Krammer Carmen 
Published: November 2024

ABSTRACTBackgroundNear-infrared (NIR) light therapy is used to treat various musculoskeletal disorders. It has been proposed that transcranial NIR light treatment may also be beneficial for Alzheimer’s disease (AD). However, the ability of NIR light to penetrate the scalp and skull efficiently and induce cytoprotective responses in the brain parenchyma has not been sufficiently examined so far. This study aimed to evaluate whether the amount of NIR light that can penetrate through the human skull can cause a biological effect.MethodsThree commercially available devices (a medical laser emitting light at a wavelength of 905 nm and two LED helmets operating at wavelengths of 810 nm and 1070 nm, respectively) were used to measure the NIR light transmittance through human post-mortem skulls with a thermal power sensor. Furthermore, the biological effects of the fraction of light power that passed through the skull were investigated in a human neuronal cell line and inC. elegans.ResultsThe 905 nm laser achieved transmittances of up to 0.31% (173 µW/cm2) of its input power, and the LED helmets 0.71% (41 µW/cm2; 810 nm) and 0.45% (19 µW/cm2; 1070 nm) of their respective input powers. NIR light exposure at a power density of 134 mW/cm2was sufficient to activate mitochondrial metabolism in cultured human neurons andC. elegans, as demonstrated by increased cytochrome c oxidase activity and induction of mitochondrial chaperones. However, this stimulatory effect was no longer observed when the applied power density was reduced to 2.5 mW/cm2.ConclusionsMore than 99% of the NIR light emitted by the investigated devices was either absorbed or scattered by the human skull. The residual NIR light that would reach underlying brain structures was too weak to elicit biological effects. In conclusion, NIR light treatment is unlikely to be effective to treat brain diseases such as AD due to the low penetrability of the skull.
Hypometabolism in Autism Spectrum Disorder: Insights from Brain and Blood Transcriptomics
Authors: Balasubramanian Rami , Saha Debayan , Arun Ananya , Vinod PK 
Published: November 2024

AbstractAutism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by challenges in social communication, repetitive behaviors, and restricted interests. Recent research has emphasized the importance of metabolic dysfunctions in the pathophysiology of ASD. This study investigates metabolic alterations associated with ASD by analyzing transcriptomic data obtained from the prefrontal cortex (bulk tissue and single-nucleus) and data from peripheral blood mononuclear cells (PBMC). We assessed the metabolic activity of each patient based on gene expression profiles, revealing significant downregulation of vital metabolic pathways, including glycolysis, the tricarboxylic acid (TCA) cycle, and oxidative phosphorylation, indicative of hypometabolism. Our analysis also highlighted dysregulation in lipid, vitamin, amino acid, and heme metabolism, which may contribute to the neurodevelopmental delays associated with ASD. Cell-specific metabolic activities in the ASD brain showed altered pathways in astrocytes, oligodendrocytes, excitatory neurons, and interneurons. Furthermore, we identified critical metabolic pathways and genes from PBMC gene expression data that distinguish ASD patients from typically developing individuals. Our findings demonstrate a consistent pattern of metabolic dysfunction across brain and blood samples. This research provides a comprehensive understanding of metabolic alterations in ASD, paving the way for exploring potential therapeutic strategies targeting metabolic dysregulation.