bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Cervical Level Fused on Subsidence of Cage and Allograft in Anterior Cervical Discectomy and Fusion
Authors: Milestone Zachary P. , Duey Akiro H. , Ahmed Wasil , Gonzalez Christopher , Park Jiwoo , Liou Lathan , Ferriter Pierce , Markowitz Jonathan , Kim Jun S. , Cho Samuel K. 
Published: October 2024

Study Design:
Retrospective cohort.

Objective:
This study aims to evaluate the relationship between the cervical levels fused and the degree of subsidence following anterior cervical discectomy and fusion (ACDF) procedures.

Background:
Subsidence following ACDF may worsen clinical outcomes. Previous studies have linked lower cervical levels with higher rates of subsidence, but none have quantified the relative degree of subsidence between levels.

Materials and Methods:
Patients who underwent ACDF from 2016 to 2021 at a tertiary medical center were included in this study. Lateral cervical radiographs from the immediate postoperative period and the final follow-ups were used to calculate subsidence. Analysis of variance was used to examine the association between cervical levels fused and subsidence. Multivariable linear regression analysis controlled for age, sex, smoking status, osteopenia/osteoporosis, number of fused levels, cage-to-body ratio, and cage type while examining the relationship between the cervical level fused and subsidence.

Results:
This study includes 122 patients who underwent 227 levels fused. There were 16 (7.0%) C3–C4 fusions, 55 (24.2%) C4–C5 fusions, 97 (42.7%) C5–C6 fusions, and 59 (26.0%) C6–C7 fusions. There was a significant difference in the degree of anterior subsidence between cervical levels fused (P = 0.013) with a mean subsidence of 1.0 mm (SD: 1.6) for C3–C4, 1.1 mm (SD: 1.4) for C4–C5, 1.8 mm (SD: 1.5) for C5-C6, and 1.8 mm (SD: 1.6) for C6–C7 fusions. Relative to C6–C7 fusions, C4–C5 (P = 0.016), and C3–C4 (P = 0.014) fusions were associated with decreased anterior subsidence, whereas C5–C6 (P = 0.756) fusions were found to have similar degrees of anterior subsidence in the multivariable analysis.

Conclusion:
We found upper cervical levels experienced a smaller degree of anterior subsidence than lower levels, after controlling for demographic and implant characteristics. Surgeons can consider using larger cages at lower cervical levels to minimize these risks.
MACULAR CHANGES IN ADULTS WITH HISTORY OF PREMATURE BIRTH
Authors: Cox Jacob T. , Knapp Austen N. , Chen Cindy , Baynes Kimberly , Burton Danielle , Kaiser Peter K. , Srivastava Sunil K. , Rachitskaya Aleksandra V. 
Published: October 2024

Purpose:
To characterize changes in the macular structure and vascularity seen in premature-birth adults.

Methods:
Retrospective review of adult patients seen in the clinic from July 2018 to November 2020 with history of premature birth not requiring treatment for retinopathy of prematurity, as well as healthy controls. Swept-source ocular coherence tomography-angiography scans were analyzed for various parameters related to the macular structure and vascularity. Statistical analysis was performed using univariate linear regression.

Results:
Thirty-four eyes were included (17 eyes from 10 premature-birth adults, 17 eyes from 11 control patients). Prematurity was associated with vascular changes on ocular coherence tomography-angiography: decreased foveal avascular zone area (P = 0.001), decreased foveal avascular zone circularity index (P < 0.001), decreased superficial capillary plexus vessel density (P = 0.02), and decreased deep capillary plexus vessel density (P < 0.001). Prematurity was also associated with structural changes: shallower foveal pit depth (P < 0.001), decreased cube average thickness (P = 0.005), and increased central subfield thickness-to-cube average thickness ratio (P = 0.002).

Conclusion:
This is the largest published series of ocular coherence tomography-angiography data for premature-birth adults. Even without a history of retinopathy of prematurity treatment, premature birth is associated with multiple changes to the macular structure and vascularity that persist into adulthood. These include a smaller, more irregularly shaped foveal avascular zone, decreased juxtafoveal vascular density, and a shallower foveal pit.
Activation of TGR5 in the injured nerve site according to a prevention protocol mitigates partial sciatic nerve ligation–induced neuropathic pain by alleviating neuroinflammation
Authors: Shi Wen-ge , Yao Yao , Liang Ya-jing , Lei Jie , Feng Shi-yang , Zhang Zi-xian , Tian Yue , Cai Jie , Xing Guo-gang , Fu Kai-yuan 
Published: October 2024

Abstract
Neuropathic pain is a pervasive medical challenge currently lacking effective treatment options. Molecular changes at the site of peripheral nerve injury contribute to both peripheral and central sensitization, critical components of neuropathic pain. This study explores the role of the G-protein-coupled bile acid receptor (GPBAR1 or TGR5) in the peripheral mechanisms underlying neuropathic pain induced by partial sciatic nerve ligation in male mice. TGR5 was upregulated in the injured nerve site and predominantly colocalized with macrophages. Perisciatic nerve administration of the TGR5 agonist, INT-777 according to a prevention protocol (50 μg/μL daily from postoperative day [POD] 0 to POD6) provided sustained relief from mechanical allodynia and spontaneous pain, whereas the TGR5 antagonist, SBI-115 worsened neuropathic pain. Transcriptome sequencing linked the pain relief induced by TGR5 activation to reduced neuroinflammation, which was further evidenced by a decrease in myeloid cells and pro-inflammatory mediators (eg, CCL3, CXCL9, interleukin [IL]-6, and tumor necrosis factor [TNF] α) and an increase in CD86-CD206+ anti-inflammatory macrophages at POD7. Besides, myeloid-cell-specific TGR5 knockdown in the injured nerve site exacerbated both neuropathic pain and neuroinflammation, which was substantiated by bulk RNA-sequencing and upregulated expression levels of inflammatory mediators (including CCL3, CCL2, IL-6, TNF α, and IL-1β) and the increased number of monocytes/macrophages at POD7. Furthermore, the activation of microglia in the spinal cord on POD7 and POD14 was altered when TGR5 in the sciatic nerve was manipulated. Collectively, TGR5 activation in the injured nerve site mitigates neuropathic pain by reducing neuroinflammation, while TGR5 knockdown in myeloid cells worsens pain by enhancing neuroinflammation.
Examining Long-Term Influences of Frailty on Outcomes for Adults Undergoing Left Ventricular Assist Device Therapy
Authors: Schroeder Sarah E. , Pozehl Bunny , Struwe Leeza , Fisher Alfred , Alonso Windy 
Published: October 2024

Background
Frailty is common in adults with end-stage heart failure receiving a left ventricular assist device (LVAD). Short-term studies show frailty reversal post-LVAD. Little is known about long-term frailty and how frailty relates to key LVAD outcomes, including depression, quality of life (QoL), and cognition beyond 6 months.

Objective
The purpose of this study was to examine physical frailty, depression, QoL, and cognition from pre-LVAD implantation to 3, 6, and 12 months post-LVAD implantation.

Methods
Clinical data and measures of physical frailty, depression, QoL, and cognition pre- and post-LVAD were extracted from an existing institutional database. Descriptive statistics and tests for statistical significance were used to describe and compare changes over time. Frailty trajectories were identified to describe physical frailty from pre-LVAD to 12 months post-LVAD.

Results
The sample (n = 46) was predominantly male (76%), with a mean age of 64.7 ± 11 years, and over half (n = 25) were physically frail. Physical frailty was reduced by nearly half at 12 months. Frailty, depression, and QoL significantly improved at all time points (P < .001). Improvements in cognition did not reach statistical significance. Recipients of LVAD without improvement in frailty exhibited worse depression, QoL, and cognition scores at 12 months compared with those not frail pre-LVAD or no longer frail post-LVAD implantation.

Conclusion
Some recipients of LVADs experienced physical frailty reversal with benefits sustained long-term. Those without improvement recorded worse long-term patient-reported outcomes. Identifying factors that predict physical frailty response to LVAD implantation is a key area of future research.
Bolus exposure as a novel predictor of postoperative symptom resolution after laparoscopic Nissen fundoplication: a two-institutional retrospective cohort study
Authors: Jung Suh Woo , Lee Inhyeok , Lee InYeong , Kim Jeong Woo , Alromi Ahmad , Seo Won Jun , Park Shin-Hoo , Kwon Yeongkeun , Jang You Jin , Lee Chang Min , Kim Jong-Han , Park Joong-Min , Park Sungsoo 
Published: October 2024

Background:
Even in the absence of definite evidence of pathological acid reflux, antireflux surgery (ARS) can still effectively improve gastroesophageal reflux symptoms. Nonetheless, predicting postoperative reflux symptom improvement has been primarily dependent on acid-based parameters. No objective index reflecting both acid and nonacid reflux was identified to select ARS candidates.

Materials and methods:
Prospectively collected data of 121 patients with gastroesophageal reflux disease (GERD), who underwent laparoscopic Nissen fundoplication from two institutions, were retrospectively reviewed. The patients reported preoperative and postoperative GERD symptoms using the Korean version of the GERD questionnaire, along with the gastroesophageal reflux disease-health-related quality of life (GERD-HRQL). The patients were assessed for reflux symptoms using bolus exposure, acid exposure time (AET), and DeMeester score (DMS) as measurements were selected. For each reflux parameter, its association, correlation, and predictive capacity of the degree of postoperative symptom resolution were analyzed using χ
2 tests, point-biserial correlations, logistic regression analyses, and receiver operating characteristic curve analyses.

Results:
Seventy-two patients were eligible for this study. Bolus exposure was superior to the other parameters in terms of the degree of association and correlation with a resolution of typical symptoms. Bolus exposure also showed a higher diagnostic accuracy in predicting the resolution of epigastric pain (area under the curve [AUC]=0.723, P=0.013) and regurgitation (AUC=0.981, P<0.001). Secondary analyses were performed in patients without pathological reflux, defined as the DMS-negative (DMS <14.7) or AET-negative (AET <6%) groups. In the secondary analyses, bolus exposure showed considerable diagnostic accuracy with statistical significance for all typical symptoms in both the DMS-negative (heartburn: AUC=0.717, P=0.025; epigastric pain: AUC=0.717, P=0.025; regurgitation: AUC=0.975, P<0.001) and AET-negative (heartburn: AUC=0.681, P=0.045; epigastric pain: AUC=0.749, P=0.009; regurgitation: AUC=0.975, P<0.001) groups.

Conclusion:
Bolus exposure, a parameter of total reflux, was superior to AET or DMS in defining candidates for ARS. Further studies investigating the surgical indications for ARS in patients with nonacid reflux using bolus exposure are required.
Sexual Distress and Quality of Life in Women With Genital Erosive Lichen Planus—A Cross-sectional Study
Authors: Skullerud Kristin Helene , Gjersvik Petter , Eberhard-Gran Malin , Pripp Are Hugo , Qvigstad Erik , Vangen Siri , Helgesen Anne Lise Ording 
Published: October 2024

Objective
The study aimed to assess sexual distress and quality of life in women with moderate-to-severe genital erosive lichen planus (GELP).

Materials and Methods
Thirty-six women with GELP were recruited at the Oslo University Hospital in Norway. The diagnosis was confirmed by a dermatologist with experience in vulvovaginal disease and based on characteristic clinical changes in the vulva and/or vagina, and biopsy results if available. Clinical severity was measured using the GELP score with a score ≥5 required for inclusion. Sexual distress was measured using the revised Female Sexual Distress Scale (FSDS-R), and quality of life was measured using the Dermatology Life Quality Index (DLQI). Topical steroid treatment was allowed.

Results
The mean FSDS-R score was 22.7 (range 0–45) with 27 women reporting high scores for sexual distress (FSDS-R score >15). The mean DLQI score was 8.8 (range 1–19) with 15 women reporting a moderate impact (DLQI score 6–10), and 12 women reporting a very large impact (DLQI score 11–20) of GELP on their quality of life. No clear correlations were found between disease severity assessed by GELP scores and FSDS-R or DLQI scores. Age was not correlated with FSDS-R or DLQI scores.

Conclusions
These results demonstrate that a substantial number of women with GELP experience sexual distress and a reduced quality of life.
Long-term (15 y) complications and outcomes after liver transplantation for primary sclerosing cholangitis: Impact of donor and recipient factors
Authors: Mouchli Mohamad A. , Osman Mohamed K. , Busebee Bradley , Taner Timucin , Heimbach Julie K. , Eaton John , Mousa Omar , Cole Kristin , Watt Kymberly D. 
Published: October 2024

With longer survival of patients with primary sclerosing cholangitis (PSC) undergoing liver transplantation (LT), the frequency and risk factors associated with vascular and biliary complications in the allograft and the impact on long-term outcomes are poorly understood. To assess frequency and risk factors for long-term outcomes in patients after LT for PSC. All recipients of LT for advanced stage PSC for a non-cholangiocarcinoma indication from 1984 to 2012, with follow-up through March 2022 (>10+ y follow-up), were identified. One-, 5-, and 10-year cumulative risks of complications were estimated using the Aalen-Johansen method, where death was considered a competing risk. Two hundred ninety-three patients (mean age, 47.3 ± 12 y) formed our study cohort. One hundred and thirty-four patients received LT before 1995, and 159 were transplanted after 1995. Over a median (IQR) follow-up of 15.0 (10.3–22.1) years, LT was complicated by hepatic artery thrombosis (N = 30), portal vein stenosis/thrombosis (N = 48), biliary leak (N = 47), biliary strictures (N = 87), recurrent PSC (N=107), and graft failure (N=70). The 1-, 5-, 10-, and 15-year cumulative incidence of recurrent PSC was 1.0%, 8.0%, 23.5%, and 34.3%, respectively. The type of donor and older donor age were associated with an increased risk of biliary strictures. Donor age >60 years was associated with an increased risk of recurrent PSC. Long-term patient and graft survival have not changed significantly for patients transplanted for PSC. Controlling transplant-related factors, such as donor age, prompt identification of vascular and biliary complications early, and long-term rigorous follow-up, is recommended to continue to improve on these outcomes.
Effectiveness of Early Thiopurine Use in Korean Patients With Moderate-to-Severe Ulcerative Colitis
Authors: Hyun Hye Kyung , Kim Ji Won , Lee Jun , Jeen Yoon Tae , Kim Tae-Oh , Kim Joo Sung , Park Jae Jun , Hong SungNoh , Park Dong Il , Kim Hyun-Soo , Lee YooJin , Jung Eun Suk , Kim Youngdoe , Jung Su Young , Cheon Jae Hee 
Published: October 2024

Background:
Thiopurines play an important role in the management of steroid-refractory and steroid-dependent ulcerative colitis. However, the effectiveness of the early use of thiopurines in ulcerative colitis remains controversial.

Materials and Methods:
In this multicenter prospective cohort (MOSAIK) study, we divided patients with ulcerative colitis into those who underwent early (within 6 mo of diagnosis) and late (6 mo after diagnosis) thiopurine therapy to determine the effectiveness of early thiopurine treatment. The primary outcome was the cumulative rate of clinical relapse (Mayo score >2 points). Multivariate Cox proportional hazards regression was used to identify independent clinical factors associated with the outcomes.

Results:
Overall, 333 patients with moderate-to-severe ulcerative colitis were included. Of the 118 patients treated with thiopurines, 65 (55.1%) and 53 (44.9%) received thiopurine therapy within and after 6 months of diagnosis. The cumulative use rate of thiopurines was 38.9% at 3 years after diagnosis. The median initial dose of thiopurines was 0.7 mg/kg (0.3 to 2.0); the median maintenance dose was 1.1 mg/kg (0.3 to 2.4). The cumulative rate of clinical relapse was not significantly different between patients who started thiopurine therapy within 6 months of diagnosis and those who started therapy 6 months after diagnosis (P=0.712). The presence of extraintestinal manifestations (hazard ratio: 4.674, 95% CI: 1.210–18.061, P=0.025) independently predicted an increased risk of clinical relapse.

Conclusions:
Patients with ulcerative colitis who received early thiopurine therapy did not differ significantly in terms of clinical relapse compared with those who received late therapy.
USE OF MUSCULAR ULTRASOUND TO DETECT INTENSIVE CARE UNIT-ACQUIRED WEAKNESS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Gu Bin , Zhou Yu , Shi Rui , Miao Shumin , Pei Fei , Yuan Hao , Wang Luhao , Teboul Jean-Louis , Si Xiang , Guan Xiangdong , Wu Jianfeng 
Published: October 2024

ABSTRACT

Background: This systematic review and meta-analysis aims to detecting performance of muscular ultrasound for intensive care unit (ICU)-acquired weakness (ICUAW). Methods: We searched PubMed, Web of Science, Embase, Cochrane library, CNKI, VIP, and Wanfang databases for articles published before July 2024. A random-effects model was utilized to derive the summary estimates of sensitivity, specificity, and diagnostic odds ratio (DOR) with 95% confidence interval (CI). Additionally, the sources of heterogeneity were explored by subgroup analysis and meta-regression. Results: This meta-analysis comprised 10 prospective studies involving 561 participants, of whom 241 (42.96%) were diagnosed as ICUAW. Overall, muscular ultrasound exhibited good performance for detecting ICUAW, with the area of summary receiver operating characteristic (SROC) curve of 0.85 (95%CI 0.82–0.88), sensitivity of 0.76 (95%CI 0.70–0.81), specificity of 0.80 (95%CI 0.74–0.84), and DOR of 12.43 (95%CI 7.98–19.38). Upon predefined subgroup analysis, the rectus femoris exhibited significantly superior discriminatory ability in identifying ICUAW than the non-rectus femoris, with higher SROC (0.88 [95%CI 0.85–0.91] vs. 0.76 [95%CI 0.72–0.79], P < 0.01). Moreover, cross-sectional area was more effective than thickness, with higher specificity (0.86 [95%CI 0.80–0.91] vs. 0.74 [95%CI 0.68–0.79], P = 0.02) and SROC (0.89 [95%CI 0.86–0.92] vs. 0.76 [95%CI 0.72–0.80], P < 0.01). Furthermore, integrated analysis of these two indicators revealed that the cross-sectional area of rectus femoris was statistically superior to the thickness of rectus femoris, with higher sensitivity (0.82 [95%CI 0.74–0.87] vs. 0.75 [95%CI 0.65–0.83], P < 0.05) and AUC (0.91 [95%CI 0.88–0.93] vs. 0.80 [95%CI 0.76–0.83], P < 0.01). Conclusions: Muscular ultrasound could be a reliable tool for ICUAW detection. Compared with alternative indices, the cross-sectional area of the rectus femoris exhibits superior detection efficacy and may be considered as a valuable parameter for clinical application.
Genetic Insights into Sepsis: Mendelian Randomization Analysis of Cerebrospinal Fluid Metabolites
Authors: Xuan Xin , Huang Zhihao , Kong Zhiqian , Li Ruoyu , Li Jianfeng , Huang Haiyan 
Published: October 2024

Abstract

Background
Sepsis, a life-threatening response to infection leading to systemic inflammation and organ dysfunction, has been hypothesized to be influenced by metabolic alterations in cerebrospinal fluid (CSF). Despite extensive research, the specific metabolic pathways contributing to sepsis remain unclear. This study aims to elucidate the causal relationships between CSF metabolites and sepsis risk using Mendelian Randomization (MR), offering insights that could lead to novel therapeutic strategies.

Methods
We conducted a two-sample MR analysis using genetic variants as instrumental variables (IVs) to investigate 338 CSF metabolites identified through a genome-wide association study. Data on sepsis-related outcomes were extracted from the genome-wide association study (GWAS) catalog encompassing 486,484 individuals of European descent. IVs were rigorously selected based on stringent genetic association and linkage disequilibrium criteria. Statistical analyses, including inverse variance weighting (IVW) and weighted median methods, were performed using the 'TwoSampleMR' package in R software, supplemented by comprehensive sensitivity analyses to ensure the robustness of our findings.

Results
Our analysis identified 19 CSF metabolites causally associated with sepsis risk. Notably, metabolites such as 1-palmitoyl-2-stearoyl-gpc (16:0/18:0) and 2-hydroxyglutarate showed significant negative correlations with sepsis risk. The reverse MR analysis further revealed that sepsis could negatively impact certain CSF metabolite levels, particularly Ribonate, suggesting a bidirectional relationship. These relationships were substantiated by rigorous statistical testing and sensitivity analyses confirming the absence of horizontal pleiotropy and the stability of our results across various MR methods.

Conclusions
This study demonstrates significant causal associations between specific CSF metabolites and the risk of developing sepsis, highlighting the potential for these metabolites to serve as biomarkers or therapeutic targets. The bidirectional nature of these findings also suggests that sepsis itself may alter metabolic profiles, offering further avenues for intervention.
Activation of Wnt/β-catenin signalling by mutually exclusiveFBXW11andCTNNB1hotspot mutations drives salivary gland basal cell adenoma
Authors: Wong Kim , Bishop Justin A. , Weinreb Ilan , Motta Marialetizia , Del Castillo Velasco-Herrera Martin , Bellacchio Emanuele , Ferreira Ingrid , van der Weyden Louise , Boccacino Jacqueline M. , Rotundo Giovannina , Ciolfi Andrea , Cheema Saamin , Olvera-León Rebeca , Offord Victoria , Droop Alastair , Vermes Ian , Allgaeuer Michael , Hyrcza Martin , Anderson Elizabeth , Smith Katie , de Saint Aubain Nicolas , Mogler Carolin , Stenzinger Albrecht , Arends Mark J. , Brenn Thomas , Tartaglia Marco , Adams David J. 
Published: October 2024

AbstractWnt signalling must be ‘just right’ to promote tumour growth. Basal cell adenoma (BCA) and basal cell adenocarcinoma (BCAC) of the salivary gland are rare tumours that can be difficult to distinguish from each other and other salivary gland tumour subtypes. Due to their rarity, the genetic profiles of BCA and BCAC have not been extensively explored. Using whole-exome and transcriptome sequencing of BCA and BCAC cohorts, we identify a novel recurrentFBXW11missense mutation (p.F517S) in BCA, that was mutually exclusive with the previously reportedCTNNB1p.I35T gain-of-function (GoF) mutation. These driver events collectively accounted for 94% of BCAs.In vitro, mutant FBXW11 had a dominant negative affect, characterised by defective binding to β-catenin and the accumulation of β-catenin in cells. This was consistent with the nuclear expression of β-catenin observed in BCA cases harbouring theFBXW11p.F517S mutation and activation of the Wnt/β-catenin pathway. The genomic profiles of BCAC were distinct from BCA, with hotspotDICER1andHRASmutations and putative driver mutations affecting PI3K/AKT and NF-κB signalling pathway genes. A single BCAC, which may represent a malignant transformation of BCA, harboured the recurrentFBXW11mutation. These findings have important implications for the diagnosis and treatment of BCA and BCAC, which, despite histopathologic overlap, may be unrelated entities.