bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chloramphenicol versus ceftriaxone for the treatment of pneumonia and sepsis in elderly patients with advanced dementia and functional disability. A propensity-weighted retrospective cohort study
Authors: Eynath Y , McNeil R , Buchrits S , Guz D , Fredman D , Gafter-Gvili A , Avni T 
Published: September 2024

Abstract

Background
Sepsis and pneumonia in the elderly comprise a significant portion of medical admissions. Chloramphenicol has been used in Israel for treatment of bacterial infections, without evidence regarding its efficacy and safety.

Objectives
We aimed to examine whether chloramphenicol was associated with similar outcomes to ceftriaxone, for treatment of sepsis and pneumonia in the elderly with dementia and functional disability.

Methods
Patients over 75, with dementia and functional disability, admitted to the internal medicine ward at Beilinson Hospital between 2011 and 2021, with community-acquired aspiration pneumonia or sepsis of undetermined source were included. Patients with mild dementia and independent in their activities of daily living were excluded. Primary outcome was 30- and 90-day all-cause mortality. A propensity-weighted multivariable model was constructed using inverse probability of treatment weighting. Results were expressed as OR with 95% CI.

Results
In total, 1558 patients were included: 512 treated with chloramphenicol and 1046 with ceftriaxone. The cohort consisted of elderly patients (mean age 87 ± 6.2 years) with comorbidities; 30- and 90-day all-cause mortality were similar [222/512 (43.3%) versus 439/1046 (41.9%) P = 0.602, and 261/512 (50.9%) versus 556/1046 (53.1%) P = 0.419, respectively]. Propensity-weighted, logistic multivariable analysis for 30- and 90-day all-cause mortality revealed similar mortality rates for chloramphenicol and ceftriaxone (OR 1.049 95% CI 0.217–1.158, OR 0.923 95% CI 0.734–1.112, respectively).

Conclusion
In this retrospective cohort of elderly debilitated patients hospitalized with pneumonia and sepsis, we found no difference in 30- and 90-day mortality between those treated with chloramphenicol or ceftriaxone. Further studies should determine the efficacy and safety of chloramphenicol in this population.
Using the electronic health record to provide audit and feedback in medical student clerkships
Authors: Xu Jacqueline , Silver Matthew A , Kim Jung , Mazotti Lindsay 
Published: September 2024

Abstract

Objectives
This article focuses on the role of the electronic health record (EHR) to generate meaningful formative feedback for medical students in the clinical setting. Despite the scores of clinical data housed within the EHR, medical educators have only just begun to tap into this data to enhance student learning. Literature to-date has focused almost exclusively on resident education.

Materials and Methods
Development of EHR auto-logging and triggered notifications are discussed as specific use cases in providing enhanced feedback for medical students.

Results
By incorporating predictive and prescriptive analytics into the EHR, there is an opportunity to create powerful educational tools which may also support general clinical activity.

Discussion
This article explores the possibilities of EHR as an educational resource. This serves as a call to action for educators and technology developers to work together on creating health record user-centric tools, acknowledging the ongoing work done to improve student-level attribution to patients.

Conclusion
EHR analytics and tools present a novel approach to enhancing clinical clerkship education for medical students.
Wnt7b overexpression in osteoblasts stimulates bone formation and reduces obesity in mice on a high-fat diet
Authors: Song Fangfang , Marmo Tyler , Song Chao , Liao Xueyang , Long Fanxin 
Published: September 2024

Abstract
Previous studies have shown that Wnt7b potently stimulates bone formation by promoting osteoblast differentiation and activity. As high-fat feeding leads to obesity and systemic metabolic dysregulation, here we investigate the potential benefit of Wnt7b overexpression in osteoblasts on both bone and whole-body metabolism in mice fed with a high-fat diet (HFD). Wnt7b overexpression elicited massive overgrowth of trabecular and cortical bone but seemed to ameliorate body fat accumulation in mice with prolonged HFD feeding. In addition, Wnt7b overexpression modestly improved glucose tolerance in male mice on HFD. Collectively, the results indicate that targeted overexpression of Wnt7b in osteoblasts not only stimulates bone formation but also improves certain aspects of global metabolism in overnourished mice.
Surgical explantation of the WATCHMAN device and right atrial thrombus: a case report
Authors: Mukasa Kotaro , Nishiori Hironobu , Ikeuchi Hiroki , Inui Tomohiko , Matsumiya Goro 
Published: September 2024

Abstract
A 74-year-old male with a history of cardioembolic stroke, chronic atrial fibrillation, and cerebral hemorrhage, who had undergone left atrial appendage closure using the WATCHMAN device 1 year prior, was diagnosed with a 25-mm intra-cardiac mass in the right atrium. The patient underwent the surgical removal of the right atrial mass and the explantation of the WATCHMAN device. The WATCHMAN device was explanted with an external incision at the base of the left atrial appendage, facilitating the removal of the device and the closure of the appendage through direct suturing. The pathological examination confirmed the right atrial mass to be a thrombus. The patient was discharged on postoperative Day 13. From the perspectives of simplicity and radicality, the external approach could be a good option.
Laparoscopic excision of an incidental vascular tumor
Authors: Boligo Sofia , Santos Cláudia , Branco Cláudia , Contente Helena 
Published: September 2024

Abstract
Anastomosing hemangioma (AH) is an exceedingly rare benign vascular tumor, often mistaken for malignant neoplasms due to its histological features. First described in 2009, AH has been documented in various sites, including the kidney, liver, and adrenal gland. This report presents a 64-year-old man who, following a bicycle accident, underwent imaging that revealed a nodule suspicious for a paraganglioma in the right para-caval region. Despite the high radiotracer uptake on 68Ga-DOTANOC PET scan, which suggested paraganglioma, the patient remained asymptomatic and laboratory tests ruled out excessive catecholamine secretion. Surgical excision led to a diagnosis of AH, distinguished by its unique anastomosing vascular pattern and histological similarity to angiosarcoma. This case underlines the diagnostic challenges and potential for overtreatment of AH, highlighting the need for heightened awareness and careful histopathological and imaging evaluation to avoid misdiagnosis and ensure appropriate management.
Sperm-carried IGF2: towards the discovery of a spark contributing to embryo growth and development
Authors: Cannarella Rossella , Rando Oliver J , Condorelli Rosita A , Chamayou Sandrine , Romano Simona , Guglielmino Antonino , Yin Qiangzong , Hans Tobias Gustafsson , Mancuso Francesca , Arato Iva , Bellucci Catia , Luca Giovanni , Lundy Scott D , La Vignera Sandro , Calogero Aldo E 
Published: September 2024

Abstract
Spermatozoa have been shown to carry key RNAs which, according to animal evidence, seem to play a role in early embryo development. In this context, a potential key growth regulator is insulin-like growth factor 2 (IGF2), a highly conserved paternally expressed imprinted gene involved in cell growth and proliferation which, recent observations indicate, is expressed in human spermatozoa. We herein hypothesized that sperm IGF2 gene expression and transmission at fertilization is required to support early embryo development. To test this hypothesis, we analyzed sperm IGF2 mRNA levels in the same semen aliquot used for homologous assisted reproductive technique (ART) in infertile couples and correlated these levels with embryo morphokinetics. To find a mechanistic explanation for the observed results, the transcriptomes of blastocysts obtained after injection of Igf2 mRNA in mouse parthenotes were analyzed. Sperm IGF2 mRNA negatively correlated with time of 2-cell stage (t2), t3, t4, t5, and time of expanded blastocyst (tEB), independently of maternal age, body mass index, anti-Müllerian hormone levels, and oocyte quality. An IGF2 mRNA index &gt;4.9 predicted the ability of the embryos to reach the blastocyst stage on Day 5, with a sensitivity of 100% and a specificity of 71.6% (AUC 0.845; P &lt; 0.001). In the animal study, transcriptome analysis demonstrated that 65 and 36 genes were, respectively, up- and down-regulated in the experimental group compared to the control group. These genes belong to pathways that regulate early embryo development, thus supporting the findings found in humans. This study has the potential to challenge the longstanding tenet that spermatozoa are simply vehicles carrying paternal DNA. Instead, it suggests that IGF2 mRNA in healthy spermatozoa provides critical support for early embryo development. Pre-ART sperm-carried IGF2 mRNA levels may be used as a marker to predict the chances of obtaining blastocysts to be transferred for infertile couples undergoing ART.
Estimating the Effect of Coronavirus Disease 2019 (COVID-19) Vaccination and Infection Variant on Post-COVID-19 Venous Thrombosis or Embolism Risk
Authors: O’Carroll Andrew , Richard Stephanie A , Byrne Celia , Rusiecki Jennifer , Wier Ben , Berjohn Catherine M , Fries Anthony C , Lalani Tahaniyat , Smith Alfred G , Mody Rupal M , Ganesan Anuradha , Huprikar Nikhil , Colombo Rhonda E , Schofield Christina , Lindholm David A , Mende Katrin , Jones Milissa U , Flanagan Ryan , Larson Derek T , Ewers Evan C , Saunders David , Maves Ryan C , Maldonado Carlos J , Sanchez Edwards Margaret , O’Connell Robert J , Simons Mark P , Tribble David R , Agan Brian K , Burgess Timothy H , Pollett Simon D 
Published: September 2024

Abstract

Background
Previous research has shown that vaccination reduces risk of post–coronavirus disease 2019 (COVID-19) venous thrombosis or embolism (VTE), but the effect of vaccine boosting on post-COVID-19 VTE risk reduction is unclear. We sought to estimate the effect of COVID-19 vaccination on the risk of post-COVID-19 VTE and to examine if the magnitude of this association differed among variant eras.

Methods
We performed a case-control study of Military Health System (MHS) beneficiaries who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2020–2022. Cases were defined as those with medically attended VTE within 90 days after their first positive SARS-CoV-2 test; controls were defined as SARS-CoV-2 infections without incident VTE by 90 days. Multivariate logistic regression estimated the odds of post-SARS-CoV-2 VTE based on pre-COVID-19 vaccine status, adjusting for other VTE risk factors.

Results
A total of 4646 MHS beneficiaries were included in this analysis; 1370 received a primary vaccine series and a further 790 received at least 1 booster at time of infection; 71 had VTE within 90 days of SARS-CoV-2 infection. Those who were vaccinated had lower odds of VTE (adjusted odds ratio [95% confidence interval]) compared to the unvaccinated following infection (primary series: 0.28 [.13–.62]; booster dose: 0.06 [.01–.46]). Post-COVID-19 VTE risk was lowest during the Omicron era, but VTEs were too rare to examine for an interaction of variant era and vaccine effect.

Conclusions
Among MHS beneficiaries, COVID-19 vaccination was associated with a reduced risk of post-COVID-19 VTE diagnosis; estimated risk reduction was larger among those who received a booster.
Nature as infrastructure to improve health: drawing on gardening and Indigenous health and connection to land research
Authors: Kingsley Jonathan 
Published: September 2024

Abstract
The world is currently grappling with several public health issues (like the increase in urbanization, chronic diseases and social isolation). Increased connection with nature has been identified as a possible solution to many of these concerns. This perspective paper draws on recent empirical evidence around the health and wellbeing benefits of nature. To highlight these benefits I will draw on insights from my own research focused on Indigenous people’s connection to land (known as Country in Australia) and gardening as a mechanism for engaging people in nature. This will be applied to support the notion that nature is critical infrastructure that has significant potential to improve public health outcomes. In doing this it must be acknowledged that these are only a few aspects of the relationship between nature and health based on my own expertise and paradigms developed from my research. I will conclude this perspective essay by providing five overarching recommendations to mainstream the evidence substantiating the health and wellbeing benefits of nature into policy and practice.
Structural neuroanatomy of human facial behaviors
Authors: Noohi Fate , Kosik Eena L , Veziris Christina , Perry David C , Rosen Howard J , Kramer Joel H , Miller Bruce L , Holley Sarah R , Seeley William W , Sturm Virginia E 
Published: September 2024

Abstract
The human face plays a central role in emotions and social communication. The emotional and somatic motor networks generate facial behaviors, but whether facial behaviors have representations in the structural anatomy of the human brain is unknown. We coded 16 facial behaviors in 55 healthy older adults who viewed five videos that elicited emotions and examined whether individual differences in facial behavior were related to regional variation in gray matter volume. Voxel-based morphometry analyses revealed that greater emotional facial behavior during the disgust trial (i.e. greater brow furrowing and eye tightening as well as nose wrinkling and upper lip raising) and the amusement trial (i.e. greater smiling and eye tightening) was associated with larger gray matter volume in midcingulate cortex, supplementary motor area, and precentral gyrus, areas spanning both the emotional and somatic motor networks. When measured across trials, however, these facial behaviors (and others) only related to gray matter volume in the precentral gyrus, a somatic motor network hub. These findings suggest that the emotional and somatic motor networks store structural representations of facial behavior and that the midcingulate cortex is critical for generating the predictable movements in the face that arise during emotions.
Relationships Between Hearing Status, Cognitive Abilities, and Reliance on Visual and Contextual Cues
Authors: Micula Andreea , Holmer Emil , Ning Ruijing , Danielsson Henrik 
Published: September 2024

Objectives:
Visual and contextual cues facilitate speech recognition in suboptimal listening conditions (e.g., background noise, hearing loss, hearing aid signal processing). Moreover, successful speech recognition in challenging listening conditions is linked to cognitive abilities such as working memory and fluid intelligence. However, it is unclear which cognitive abilities facilitate the use of visual and contextual cues in individuals with normal hearing and hearing aid users. The first aim was to investigate whether individuals with hearing aid users rely on visual and contextual cues to a higher degree than individuals with normal hearing in a speech-in-noise recognition task. The second aim was to investigate whether working memory and fluid intelligence are associated with the use of visual and contextual cues in these groups.

Design:
Groups of participants with normal hearing and hearing aid users with bilateral, symmetrical mild to severe sensorineural hearing loss were included (n = 169 per group). The Samuelsson and Rönnberg task was administered to measure speech recognition in speech-shaped noise. The task consists of an equal number of sentences administered in the auditory and audiovisual modalities, as well as without and with contextual cues (visually presented word preceding the sentence, e.g.,: “Restaurant”). The signal to noise ratio was individually set to 1 dB below the level obtained for 50% correct speech recognition in the hearing-in-noise test administered in the auditory modality. The Reading Span test was used to measure working memory capacity and the Raven test was used to measure fluid intelligence. The data were analyzed using linear mixed-effects modeling.

Results:
Both groups exhibited significantly higher speech recognition performance when visual and contextual cues were available. Although the hearing aid users performed significantly worse compared to those with normal hearing in the auditory modality, both groups reached similar performance levels in the audiovisual modality. In addition, a significant positive relationship was found between the Raven test score and speech recognition performance only for the hearing aid users in the audiovisual modality. There was no significant relationship between Reading Span test score and performance.

Conclusions:
Both participants with normal hearing and hearing aid users benefitted from contextual cues, regardless of cognitive abilities. The hearing aid users relied on visual cues to compensate for the perceptual difficulties, reaching a similar performance level as the participants with normal hearing when visual cues were available, despite worse performance in the auditory modality. It is important to note that the hearing aid users who had higher fluid intelligence were able to capitalize on visual cues more successfully than those with poorer fluid intelligence, resulting in better speech-in-noise recognition performance.
Online Utilization of the Nominal Group Technique to Gather Consensus Opinion Across Geographically Disparate Locations
Authors: Fallon Anthony Bruce , O'Connell Christine 
Published: September 2024

Introduction:
The nominal group technique (NGT) is a structured focus group that gathers opinion and generates consensus from groups on topics of interest. Previous studies using online NGTs (ONGTs) in health have been conducted in regions of high population density and internet connectivity. This activity aimed to determine the feasibility and utility of ONGTs in gathering opinion and reaching consensus on curriculum topics for a continuing research education program for health professionals dispersed across various locations in Southern Queensland.

Methods:
Fifteen clinical education academics from a range of health professions participated in 1-hour ONGT sessions from 2 University Department of Rural Health sites or their home offices. The traditional NGT was adapted for online use, using two free online platforms (Zoom for videoconferencing and Wooclap for voting and response collation).

Results:
The chosen platforms were effective in presenting ONGTs, allowing active and effective contributions to research topic ideas from all participants, including those with low internet connectivity. Silent generation enabled sharing, open discussion, and clarification of generated ideas. Wooclap was effective in reviewing and voting on generated responses and providing real-time feedback on voting outcomes. Outcomes were consistent with group consensus and useful in prioritizing research training topics.

Discussion:
The modified ONGT is effective in gathering opinion and gaining consensus from a geographically dispersed health workforce with varied levels of internet connectivity and experience with online platforms. It represents a cost-effective and time-effective alternative to face-to-face NGTs that is less likely to be affected by workforce disruptions.
Porto-sinusoidal vascular disorder in surgical candidates for liver metastases: Prevalence, noninvasive diagnosis, and burden on surgical outcomes
Authors: Dajti Elton , Serenari Matteo , Malvi Deborah , Dajti Gerti , Ravaioli Federico , Colecchia Luigi , Marasco Giovanni , Caputo Francesca , Renzulli Matteo , Vasuri Francesco , Vestito Amanda , Azzaroli Francesco , Barbara Giovanni , Ravaioli Matteo , Festi Davide , D’Errico Antonietta , Cescon Matteo , Colecchia Antonio 
Published: September 2024

Chemotherapy can cause vascular and metabolic liver injury in patients with liver metastases, but scarce data are available. We aimed to (i) describe the prevalence of porto-sinusoidal vascular disorder (PSVD) among patients undergoing resection for liver metastases; and (ii) assess whether liver (LSM) and spleen stiffness measurements could diagnose PSVD and predict postoperative complications. This is a prospective single-center study enrolling consecutive patients undergoing hepatic resection for metastases at a tertiary center. For each patient, we evaluated previous exposure to chemotherapy, comorbidities, elastography, type of surgery, histological features at the resection specimen, morbidity (post-hepatectomy liver failure and major complications according to Clavien-Dindo), and 90-day survival. Sixty-eight patients were included, of whom 60 (88%) had received chemotherapy. Twenty-nine (44%) patients had PSVD. Spleen stiffness measurements <21 kPa (negative predictive value 87%) and >40 kPa (positive predictive value 100%) could accurately diagnose PSVD. PSVD significantly increased the risk of post-hepatectomy liver failure (22% vs. 45%) and major complications (11% vs. 31%). Preoperative LSM was associated with postoperative morbidity. The cutoff LSMs <4.5 and >8 kPa predicted the risk of clinically significant post-hepatectomy liver failure (0%, 11%, and 33% in LSM <4.5, 4.5–8, and >8 kPa, respectively) and major complications (0%, 25%, 44% in LSM <4.5, 4.5–8, and >8 kPa, respectively). PSVD is very common among patients undergoing liver surgery for metastases, and it is associated with increased morbidity. LSM and spleen stiffness measurements can correctly identify patients with PSVD and those at risk of clinically relevant postoperative complications.