bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing Traditional and Newer Glaucoma Procedures by Physician Experience and Practice Location in the United States
Authors: Xiao Grace , Boland Michael V. 
Published: October 2024

Précis:
Analysis of Centers for Medicare and Medicaid Services (CMS) Physician Payment data found that physician certification year, degree of urbanization, and estimated income by zip code were significant in predicting the proportion of traditional glaucoma procedures performed by each provider in the United States.

Objective:
The prevalence of microinvasive glaucoma surgery (MIGS) compared with traditional procedures has been increasing in glaucoma management. It is important to understand whether the uptake of new glaucoma procedures is associated with aspects of the physician practice.

Methods:
In this cross-sectional study, data on glaucoma procedure distribution, degree of urbanization, and physician certification in the United States were extracted from the 2019 CMS Physician Payment and American Board of Ophthalmology databases. The distribution of traditional and MIGS procedure numbers for metropolitan versus non-metropolitan providers was visualized with boxplots and statistically compared using Mann-Whitney U tests. We used two-dimensional histograms and regression analyses to assess the relationship between certification year and volume of traditional versus MIGS procedures. A multivariable linear regression model was created using certification year, rural-urban commuting area code, and estimated income by practice zip code to predict the number and proportion of each type of glaucoma procedure.

Results:
This study included 2625 providers from the CMS physician payment data who performed only traditional procedures (n = 370), MIGS procedures (n = 1727), or both procedure types (n = 528) in 2019. The median number of MIGS procedures performed by each provider was greater in non-metropolitan areas (31 vs 29, P = 0.015), whereas the proportion of traditional procedures performed by each provider was greater in metropolitan areas (0.24 vs 0.08, P < 0.001). Regression analysis showed a positive relationship between the certification year and the proportion of traditional procedures performed by each provider (P < 0.001). Multivariable regression models found that certification year, rural-urban commuting area code, and estimated income of practice location were all significant predictors (P < 0.02) of the proportion of traditional procedures performed by each provider.

Conclusion:
In the United States, physicians in metropolitan areas and more recent certification years are more likely to perform a larger proportion of traditional procedures. This finding suggests that the distribution of glaucoma procedure types is related to physician factors such as degree of urbanization and duration of practice. More research is needed to better understand how such differences affect patient access and outcomes.
Classic yet challenging case of stump appendicitis: a case report
Authors: Bastakoti Aashish , Khatiwada Abhikanta , Luitel Prajjwol , Panthi Bishal , KC Soniya , KC Sharada 
Published: October 2024

Introduction:
Stump appendicitis is a rare complication of appendectomy in which residual appendiceal tissue becomes inflamed, mimicking acute appendicitis. This case report highlights the classic clinical presentation, diagnosis, and management of stump appendicitis.

Case presentation:
A 61-year-old male presented with abdominal pain and a past history of open appendectomy performed 4 years prior. Clinical examination, laboratory, and radiological findings were highly suggestive of stump appendicitis. Surgical exploration confirmed an inflamed appendiceal stump, which was resected, and the patient had an uneventful recovery postoperatively.

Discussion:
Stump appendicitis is a rare but important differential diagnosis in patients with a history of appendectomy who present with acute abdominal pain. Delayed diagnosis can result in complications such as perforation and peritonitis. Imaging plays a crucial role in diagnosis, and surgical resection, typically performed through open-completion appendectomy, remains the treatment of choice.

Conclusion:
Although stump appendicitis is rare, it should always be considered in patients with a prior appendectomy who present with acute abdomen. Early recognition and prompt surgical intervention are essential to prevent morbidity and mortality.
Predictive Model Based on Texture Analysis of Noncontrast Cardiac Magnetic Resonance Images for the Prognostic Evaluation of Cardiac Amyloidosis
Authors: She Jiaqi , Guo Jiajun , Sun Yi , Chen Yinyin , Zeng Mengsu , Ge Meiying , Jin Hang 
Published: October 2024

Objectives
We aimed to develop a predictive model based on textural features of noncontrast cardiac magnetic resonance (CMR) imaging for risk stratification toward adverse events in patients with cardiac amyloidosis (CA).

Methods
A cohort of 78 patients with CA was grouped into training (n = 54) and validation (n = 24) sets at a ratio of 7:3. A total of 275 textural features were extracted from the CMR images. MaZda and a support vector machine (SVM) were used for feature selection and model construction. An SVM model incorporating radiological and textural features was built to predict endpoint events by evaluating the area under the curve.

Results
In the entire cohort, 52 patients experienced major adverse cardiovascular events and 26 patients did not. By combining 2 radiological features and 8 texture features, extracted from cine and T2-weighted imaging images, the SVM model achieved area under the curves of the receiver operating characteristic and precision-recall curves of 0.930 and 0.962 in the training cohort and that of 0.867 and 0.941 in the validated cohort, respectively. The Kaplan-Meier curve of this SVM model criterion significantly stratified the CA outcomes (log-rank test, P < 0.0001).

Conclusions
The SVM model based on radiological and textural features derived from noncontrast CMR images can be a reliable biomarker for adverse events prognostication in patients with CA.
Node Reporting and Data System Combined With Computed Tomography Radiomics Can Improve the Prediction of Nonenlarged Lymph Node Metastasis in Gastric Cancer
Authors: Jiang Changqin , Fang Wei , Wei Na , Ma Wenwen , Dai Cong , Liu Ruixue , Cai Anzhen , Feng Qiang 
Published: October 2024

Objectives
To investigate the diagnostic performance of Node Reporting and Data System (Node-RADS) combined with computed tomography (CT) radiomics for assessing nonenlargement regional lymph nodes in gastric cancer (GC).

Methods
Preoperative CT images were retrospectively collected from 376 pathologically confirmed of gastric adenocarcinoma from January 2019 to December 2023, with 605 lymph nodes included for analysis. They were divided into training (n = 362) and validation (n = 243) sets. Radiomics features were extracted from venous-phase, and the radiomics score was obtained. Clinical information, CT parameters, and Node-RADS classification were collected. A combined model was built using machine-learning approach and tested in validation set using receiver operating characteristic curve analysis. Further validation was conducted in different subgroups of lymph node short-axis diameter (SD) range.

Results
Node-RADS score, SD, maximum diameter of thickness of tumor, and radiomics were identified as the most predictive factors. The results demonstrated that the integrated model combining SD, maximum diameter of thickness of tumor, Node-RADS, and radiomics outperformed the model excluding radiomics, yielding an area under the receiver operating characteristic curve of 0.82 compared with 0.79, with a statistically significant difference (P < 0.001). Subgroup analysis based on different SDs of lymph nodes also revealed enhanced diagnostic accuracy when incorporating the radiomics score for the 4- to 7.9-mm subgroups, all P < 0.05. However, for the 8- to 9.9-mm subgroup, the combination of the radiomics did not significantly improve the prediction, with an area under the receiver operating characteristic curve of 0.85 versus 0.85, P = 0.877.

Conclusion
The integration of radiomics scores with Node-RADS assessments significantly enhances the accuracy of lymph node metastasis evaluation for GC. This combined model is particularly effective for lymph nodes with smaller standard deviations, yielding a marked improvement in diagnostic precision.

Clinical Relevance Statement
The findings of this study indicate that a composite model, which incorporates Node-RADS, radiomics features, and conventional parameters, may serve as an effective method for the assessment of nonenlarged lymph nodes in GC.
Comparing Provider and ChatGPT Responses to Breast Reconstruction Patient Questions in the Electronic Health Record
Authors: Soroudi Daniel , Gozali Aileen , Knox Jacquelyn A. , Parmeshwar Nisha , Sadjadi Ryan , Wilson Jasmin C. , Lee Seung Ah , Piper Merisa L. 
Published: October 2024

Background
Patient-directed Electronic Health Record (EHR) messaging is used as an adjunct to enhance patient-physician interactions but further burdens the physician. There is a need for clear electronic patient communication in all aspects of medicine, including plastic surgery. We can potentially utilize innovative communication tools like ChatGPT. This study assesses ChatGPT's effectiveness in answering breast reconstruction queries, comparing its accuracy, empathy, and readability with healthcare providers' responses.

Methods
Ten deidentified questions regarding breast reconstruction were extracted from electronic messages. They were presented to ChatGPT3, ChatGPT4, plastic surgeons, and advanced practice providers for response. ChatGPT3 and ChatGPT4 were also prompted to give brief responses. Using 1–5 Likert scoring, accuracy and empathy were graded by 2 plastic surgeons and medical students, respectively. Readability was measured using Flesch Reading Ease. Grades were compared using 2-tailed t tests.

Results
Combined provider responses had better Flesch Reading Ease scores compared to all combined chatbot responses (53.3 ± 13.3 vs 36.0 ± 11.6, P < 0.001) and combined brief chatbot responses (53.3 ± 13.3 vs 34.7 ± 12.8, P < 0.001). Empathy scores were higher in all combined chatbot than in those from combined providers (2.9 ± 0.8 vs 2.0 ± 0.9, P < 0.001). There were no statistically significant differences in accuracy between combined providers and all combined chatbot responses (4.3 ± 0.9 vs 4.5 ± 0.6, P = 0.170) or combined brief chatbot responses (4.3 ± 0.9 vs 4.6 ± 0.6, P = 0.128).

Conclusions
Amid the time constraints and complexities of plastic surgery decision making, our study underscores ChatGPT's potential to enhance patient communication. ChatGPT excels in empathy and accuracy, yet its readability presents limitations that should be addressed.
Resection Weight Formulas for Reduction Mammoplasty
Authors: Gupta Nisha , Lava Christian X. , Ferdousian Sami , Li Karen R. , Bekeny Jenna C. , Fan Kenneth L. 
Published: October 2024

Purpose
Estimating resection weight for patients undergoing reduction mammoplasty (RM) informs surgical planning and outcomes. Existing formulas have limitations that make insurance coverage and accurate surgical planning challenging. We identified the most commonly used scales to evaluate their accuracy in estimating resection weight by applying them to a database of patients to compare calculated and actual resection weights.

Methods
A database search was conducted using combinations of relevant terms. A regression analysis was conducted using formulas with strong R
2 values (0.72–0.93) on a cohort of 1128 RM patients at a single institution.

Results
A total of 570 articles were identified. Fourteen manuscripts (n = 2232 patients [3320 breasts]) were ultimately included for review. Data on incisional patterns, pedicle supply, and breast measurements, such as sternal notch to nipple distance (n = 8 [57.1%]) or nipple to inframammary fold distance (n = 5 [35.7%]), were recorded. R
2 values in our cohort (>500 g, n = 891; <500 g, n = 237) were calculated via regression analyses with five formulas: Appel (0.391 vs 0.146), Boukovalas (0.3552 vs 0.043), Descamps (0.391 vs 0.238), Eder (0.328 vs 0.114), and Kocak (0.3283 vs R
2 indeterminate).

Conclusions
Our analysis suggests that formulas reporting strong R
2 values may have resulted from tailoring to surgeons' technique. Variation between cohorts is inevitable; however, we expect reliable results given our large sample. It is reasonable to conclude that existing formulas are not accurate representations of resection weights and thus are unreliable for surgical planning.
Concordance of ChatGPT With American Burn Association Guidelines on Acute Burns
Authors: Pandya Sumaarg , Alessandri Bonetti Mario , Liu Hilary Y , Jeong Tiffany , Ziembicki Jenny A. , Egro Francesco M. 
Published: October 2024

Abstract
Burn injuries often require immediate assistance and specialized care for optimal management and outcomes. The emergence of accessible artificial intelligence technology has just recently started being applied to healthcare decision making and patient education. However, its role in clinical recommendations is still under scrutiny. This study aims to evaluate ChatGPT's outputs and the appropriateness of its responses to commonly asked questions regarding acute burn care when compared to the American Burn Association Guidelines. Twelve commonly asked questions were formulated by a fellowship-trained burn surgeon to address the American Burn Association's recommendations on burn injuries, management, and patient referral. These questions were prompted into ChatGPT, and each response was compared with the aforementioned guidelines, the gold standard for accurate and evidence-based burn care recommendations. Three burn surgeons independently evaluated the appropriateness and comprehensiveness of each ChatGPT response based on the guidelines according to the modified Global Quality Score scale. The average score for ChatGPT-generated responses was 4.56 ± 0.65, indicating the responses were exceptional quality with the most important topics covered and in high concordance with the guidelines. This initial comparison of ChatGPT-generated responses and the American Burn Association guidelines demonstrates that ChatGPT can accurately and comprehensibly describe appropriate treatment and management plans for acute burn injuries. We foresee that ChatGPT may play a role as a complementary tool in medical decision making and patient education, having a profound impact on clinical practice, research, and education.
Evolution and Adaptations of Robotic DIEP Flap Surgery: A Systematic Review
Authors: Morkuzu Suat , Bayezid K Can , Ozmen Berk B , Eren Seyma Fatima , Farhat Souha , McLennan Alexandra L , James Andrew J , Nikkhah Dariush , Azoury Saïd C , Djohan Risal S , Bishop Sarah N. , Schwarz Graham S 
Published: October 2024

Background:
The integration of robotic technology into surgical procedures has gained considerable attention for its promise to enhance a variety of clinical outcomes. Robotic deep inferior epigastric perforator (DIEP) flap harvest has emerged as a novel approach for autologous breast reconstruction. This systematic review aims to provide a comprehensive overview of the current techniques, outcomes, and complications of robotic DIEP flap surgery.

Methods:
A systematic literature search was conducted after PRISMA 2020 guidelines across databases including PubMed, Embase, Google Scholar, and Web of Science from 2000 to 2023. Articles exploring robotic DIEP flap harvest for breast reconstruction were assessed to compare operative techniques, clinical outcomes, and complications. The risk of bias was evaluated using ROBINS-I and the Newcastle-Ottawa scale.

Results:
Fourteen studies involving 108 patients were included. Three studies used a totally extraperitoneal (TEP) technique, whereas 11 studies used a transabdominal preperitoneal (TAPP) approach. Preoperative planning utilized computed tomography angiography and magnetic resonance angiography imaging. The mean robotic operative time was 64 minutes, with total operative times averaging 574 minutes for TAPP and 497 minutes for TEP. The mean length of stay was 5 days, and the mean fascial incision length was 3 cm. Overall complication rate was 14.9%, with no significant difference compared with conventional DIEP flap procedures.

Conclusion:
Robotic DIEP flap harvest is a promising technique that may reduce postoperative pain and limiting abdominal donor site morbidity. Potential limitations include longer operative times, variable hospital stays, and increased costs.
Propensity Score–matched Donor and Recipient Outcomes: Robotic Versus Laparoscopic Donor Right Hepatectomy
Authors: Kim Na Reum , Han Dai Hoon , Joo Dong Jin , Lee Jae Geun , Kim Deok-Gie , Kim Myoung Soo , Choi Jin Sub , Choi Gi Hong 
Published: October 2024

Background.
Few studies have examined the long-term outcomes of recipients in minimally invasive donor hepatectomies, particularly comparing robotic and laparoscopic donor procedures. Understanding these outcomes is crucial for optimizing surgical approaches and improving the overall success of living donor liver transplantation. This study aimed to compare the feasibility and safety of robotic donor right hepatectomy (RDRH) and laparoscopic donor right hepatectomy (LDRH) by evaluating total follow-up patient outcomes.

Methods.
This retrospective, single-center study included 117 and 118 donors who underwent RDRH and LDRH between March 2016 and June 2023, respectively. After performing 1:1 propensity score matching, 71 donor–recipient pairs were included in each group. Donor and recipient complications were divided into early (within 90 d) and late (after 90 d) biliary and vascular complications.

Results.
In the matched cohort, major complication rates of donors were similar in both groups. Bile duct (BD) variation was not significantly different; however, the rates of multiple BD openings (26.8% versus 54.9%; P = 0.001) and major biliary complications in recipients were higher in the LDRH group (22.5% versus 42.3%; P = 0.012). The cumulative biliary complication rate was significantly higher in the LDRH group. Early biliary complications were not significantly different; however, the rate of late biliary complications was higher in the LDRH group (11.3% versus 23.9%; P = 0.047).

Conclusions.
RDRH demonstrated comparable postoperative complications to LDRH in donors but showed fewer recipient biliary complications. This could be attributed to the precision of robotic dissection and BD division, resulting in fewer multiple BD openings.
Bcl11b orchestrates subcerebral projection neuron axon development via cell-autonomous, non-cell-autonomous, and subcellular mechanisms
Authors: Itoh Yasuhiro , Woodworth Mollie B. , Greig Luciano C. , Engmann Anne K. , Tillman Dustin E. , Hatch John J. , Macklis Jeffrey D. 
Published: October 2024

SUMMARYBoth cell-intrinsic competency and extracellular cues regulate axon projection, but mechanisms that coordinate these elements remain poorly understood. Subcerebral projection neurons (SCPN) extend their primary axons from cortex through subcortical structures, including the striatum, targeting the brainstem and spinal cord. We identify that the transcription factor Bcl11b/Ctip2 functions in multiple independent neuron populations to control SCPN axon development.Bcl11bexpressed by SCPN is required cell-autonomously for axonal outgrowth and efficient entry into the internal capsule within the striatum, whileBcl11bexpressed by medium spiny neurons (MSN) non-cell-autonomously regulates SCPN axon fasciculation within the internal capsule and subsequent pathfinding. Further, integrated investigation ofBcl11b-null SCPN with transcriptomic, immunocytochemical, andin vivogrowth cone purification approaches identifies that Cdh13 is localized along axons and on growth cone surfaces of SCPNin vivo, and mediates Bcl11b regulation of SCPN axonal outgrowth. Together, these results demonstrate that Bcl11b controls multiple aspects of SCPN axon development by coordinating intrinsic SCPN cell autonomous subcellular mechanisms and extrinsic MSN non-cell-autonomous mechanisms.
Revealing Acute Consequences of Rapid Protein Elimination at Individual Synapses using Auxin-Inducible Degron 2 Technology
Authors: Elbaum Lilach , Yuan Weixiang , Seiler Johannes P.-H. , Blom Nadia , Chan Ya-Chien , Baig Ali Hyder , Brose Nils , Rumpel Simon , Ziv Noam E. 
Published: October 2024

AbstractA powerful approach to assess a protein of interest (POI) function is its specific elimination. Common knock-out and knock-down strategies, however, are protracted and often irreversible, challenging the assessment of acute or temporary consequences in the same cells and tissues. Here we describe the use of Auxin-Inducible Degron 2 (AID2) technology to study the real-time consequences of acute POI elimination in nerve cell synapses. We demonstrate its capacity in cultured neurons andin vivoto rapidly eliminate postsynaptic scaffold proteins fused at N-terminal, C-terminal, or nested sites to GFP derivatives or HaloTag. We show that acute PSD-95 or gephyrin elimination leads to the concomitant loss of AMPA or GABAAreceptors at the same synapses, and that, surprisingly, acute GKAP, but not PSD-95 elimination reduces postsynaptic scaffold size. Our findings highlight the utility of AID2 technology for rapidly eliminating synaptic POIs and studying real-time consequences in the same neurons and synapses.