bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ovarian cancer
Authors: Thull Tessa , Kempton Danielle 
Published: June 2024

Abstract
Ovarian cancer is the second most common gynecologic cancer in the United States and the deadliest gynecologic cancer worldwide, with a 5-year survival rate of less than 50%. Because of its vague symptoms, more than half of patients present with advanced disease and metastasis. This article reviews the epidemiology, pathogenesis, risk factors, screening, presentation, and diagnosis of ovarian cancer, in addition to providing an overview of the standard approach to treatment and novel targeted biologic therapies.
Comparing Relative Value Units for Intramedullary Limb Lengthening Procedures to Common Pediatric Orthopaedic Surgeries to Determine Adequate Compensation
Authors: Flanagan Jill C. , Gilani Sonia , Bafor Anirejuoritse , Iobst Christopher A. 
Published: June 2024

Objective:
Reimbursement for surgical procedures is determined by a computation of the relative value unit (RVU) associated with CPT codes. It is based on the amount of work required to provide a service, resources available, and level of expertise involved. Given the evolution of changes in the limb lengthening field, we wanted to evaluate whether the RVU values were comparable across different orthopaedic subspecialties. Consequently, this study compares the work relative value unit (wRVU) totals of 3 common pediatric orthopaedic surgeries—arthroscopic ACL reconstruction, spinal fusion for adolescent idiopathic scoliosis, and antegrade femoral intramedullary limb lengthening.

Methods:
This was an IRB-approved, multicenter, retrospective chart review. Charts of subjects who had ACL reconstructions, including meniscal repairs; spinal fusion surgeries for adolescent idiopathic scoliosis (7 to 12 levels), including Ponte osteotomies, and femoral antegrade internal limb lengthening procedures, each completed by fellowship-trained orthopaedic surgeons were reviewed. Comparisons were carried out between several parameters, including mean duration per procedure, number of CPT codes billed per procedure, number of postoperative visits in the 90-day global period, and the wRVU for each procedure.

Results:
Fifty charts (25 per center) per procedure were reviewed. The wRVU per hour was lowest in the antegrade femur lengthening group (P < 0.0001). The number of postoperative visits in the 90-day global postsurgery period was significantly higher in the antegrade femur lengthening group (P < 0.0001). Intramedullary limb lengthening also had the least number of CPT codes billed.

Conclusions:
RVUs per time are statistically lowest in the limb lengthening group and highest in the scoliosis group. The limb lengthening patient also requires significantly more visits and time in the postoperative period compared with the other groups. These extra visits during the global period do not add any RVU value to the lengthening surgeon and occupy clinic spots that could be filled with new patients. Based on these data, a review of the RVU values assigned to the limb lengthening codes may be necessary.

Level of Evidence:
Level III—retrospective comparison study.
Quantitative Comparison of Ventilation Parameters of Different Approaches to Ventilator Splitting and Multiplexing
Authors: Kim Doowon , Roy Steven , McBeth Paul , Lee Jihyun 
Published: June 2024

CONTEXT:
Amid the COVID-19 pandemic, this study delves into ventilator shortages, exploring simple split ventilation (SSV), simple differential ventilation (SDV), and differential multiventilation (DMV). The knowledge gap centers on understanding their performance and safety implications.

HYPOTHESIS:
Our hypothesis posits that SSV, SDV, and DMV offer solutions to the ventilator crisis. Rigorous testing was anticipated to unveil advantages and limitations, aiding the development of effective ventilation approaches.

METHODS AND MODELS:
Using a specialized test bed, SSV, SDV, and DMV were compared. Simulated lungs in a controlled setting facilitated measurements with sensors. Statistical analysis honed in on parameters like peak inspiratory pressure (PIP) and positive end-expiratory pressure.

RESULTS:
Setting target PIP at 15 cm H2O for lung 1 and 12.5 cm H2O for lung 2, SSV revealed a PIP of 15.67 ± 0.2 cm H2O for both lungs, with tidal volume (Vt) at 152.9 ± 9 mL. In SDV, lung 1 had a PIP of 25.69 ± 0.2 cm H2O, lung 2 at 24.73 ± 0.2 cm H2O, and Vts of 464.3 ± 0.9 mL and 453.1 ± 10 mL, respectively. DMV trials showed lung 1’s PIP at 13.97 ± 0.06 cm H2O, lung 2 at 12.30 ± 0.04 cm H2O, with Vts of 125.8 ± 0.004 mL and 104.4 ± 0.003 mL, respectively.

INTERPRETATION AND CONCLUSIONS:
This study enriches understanding of ventilator sharing strategy, emphasizing the need for careful selection. DMV, offering individualization while maintaining circuit continuity, stands out. Findings lay the foundation for robust multiplexing strategies, enhancing ventilator management in crises.
Deep Learning Versus Corneal Tomography Features to Detect Subclinical Corneal Edema in Fuchs Endothelial Corneal Dystrophy
Authors: Fitoussi Léa , Zéboulon Pierre , Rizk Maria , Ghazal Wassim , Rouger Hélène , Saad Alain , Elahi Sina , Gatinel Damien 
Published: June 2024

Purpose:
To compare a deep learning model with corneal tomography features for detecting subclinical corneal edema in patients with Fuchs endothelial corneal dystrophy (FECD).

Methods:
We trained a deep learning model to detect corneal edema on 379 optical coherence tomography B-scans of normal and edematous corneas. 51 eyes of 32 patients with FECD were analyzed and compared with 100 eyes of 50 normal patients. For each eye, the cornea was scanned on the same day using 2 modalities of the same swept-source optical coherence tomography device (Anterion): corneal tomography maps and 6 high-resolution radial B-scans. The 6 radial B-scans were analyzed using our model from which an en face map of edema was reconstructed. The location exhibiting the highest probability of edema was derived from that map. Two corneal surgeons assessed the tomography maps and labeled the location of the supposed highest edema. This location was compared with our model's en face map.

Results:
According to tomography features, 64.7% of eyes presented subclinical edema. Our model and tomography features agreed in 80% of cases for the presence or absence of subclinical edema. The average distance between the location of maximal edema determined by human experts on tomography maps and that derived from our model's en face map was 1.91 ± 1.15 mm. Our model detected superior peripheral edema in a majority of eyes.

Conclusions:
Despite being based on different approaches, both methods agreed in the detection of subclinical edema in most cases. The location of detected edema was very similar in both methods. In cases where both methods disagree, our approach provides new objective results that might help the surgeon in making a decision in difficult cases.
Multiple Follicular Hybrid Tumors Presenting in Association With Myotonic Dystrophy Type 1
Authors: Wang Robin H. , Krouse Adam , Eilers David B. , Dahiya Madhu 
Published: June 2024

Abstract:
Follicular hybrid cysts are uncommon entities derived from 2 or more components of the folliculo–sebaceous–apocrine unit. The pathogenesis of follicular hybrid cysts is uncertain; however, they are proposed to derive from the multipotent nature of follicular stem cells. Myotonic dystrophy type 1 is an inherited muscular dystrophy caused by an unstable trinucleotide repeat expansion in the myotonic dystrophy protein kinase gene, notably associated with multiple pilomatricomas. We report a novel case of multiple follicular hybrid tumors presenting in association with myotonic dystrophy type 1. We suspect that multipotent follicular stem cells, under the influence of the hypermutability phenotype present in myotonic dystrophy type 1, contributed to the pathogenesis of multiple follicular hybrid tumors in our patient.
Successful Treatment of Disseminated Fusariosis in a 15-Month-old Boy With Refractory Acute Lymphoblastic Leukemia Using High-dose Voriconazole
Authors: Petrikkos Loizos , Kourti Maria , Stathi Angeliki , Antoniadi Kondilia , Ampatzidou Mirella , Stefanaki Kalliopi , Zachariadou Levantia , Iosifidis Elias , Roilides Emmanuel , Polychronopoulou Sophia 
Published: June 2024

Background:
Infections due to rare molds, such as Fusarium spp., cause severe and difficult-to-control diseases with increasing frequency. Data on fusariosis in children and on the use of voriconazole (VCZ), considered a drug of choice, are scarce in infants and children <2 years of age.

Case Presentation:
We present the first, to our knowledge, pediatric case of disseminated mycosis due to Fusarium musae in a 15-month-old boy with relapsed/refractory acute lymphoblastic leukemia, diagnostics and outcome. Herein, at this severely immunocompromised patient, after prompt diagnosis, disseminated fusariosis was successfully treated with high-dose VCZ at a final dose of 15 mg/kg of body weight twice a day. This occurred by achieving adequate drug exposures as determined by drug susceptibility testing and followed by therapeutic drug monitoring without observed toxicity.

Conclusions:
Appropriate diagnostic approach and timely administration of optimal antifungal therapy with VCZ were important for the successful treatment of disseminated fusariosis. Therapeutic drug monitoring, especially in <2-year-old children, is necessary to achieve sufficient drug exposure for optimal therapeutic response without toxicity.
Reusing surgical materials for cataract surgery: an assessment of potential contamination
Authors: Shukla Aakriti Garg , Chang David F. , Dhanaseelan Thamizhselvi , Vivekanandan Vellam Ramakrishnan , Gubert Joseph , Robin Alan L. , Venkatesh Rengaraj 
Published: June 2024

Purpose:
To evaluate microbiological cultures of cataract surgical devices and products that were reused for multiple cases.

Setting:
Aravind Eye Hospital, Pondicherry, Tamil Nadu, India.

Design:
Prospective cohort study.

Methods:
Samples from multiple surgical instruments and products that were reused for consecutive cataract surgeries underwent bacterial and fungal cultures and were monitored alongside positive controls for 7 days. This included instruments that were processed using immediate use steam sterilization (IUSS) between cases (eg, surgical cannulas, syringes, phacoemulsification and coaxial/bimanual irrigation/aspiration [I/A] tips, phacoemulsification and I/A sleeves) (Group 1), instruments that were used without sterilization between cases (eg, phacoemulsification tubing/handpieces, coaxial I/A handpieces) (Group 2), and the residual (unused) fluid from balanced salt solution bags after being used for multiple patients (Group 3).

Results:
3333 discrete samples were collected from all 3 product groups that were reused across multiple patients. In all collected samples, no bacterial or fungal growth was observed. Of the 3241 cataract surgeries that used reused and IUSS-sterilized instruments alongside instrument sets cultured on the same day and balanced salt solution bags shared across multiple patients, no eyes developed endophthalmitis over a 6-week follow-up period.

Conclusions:
Bacterial or fungal growth was not found in extensive microbiological cultures of IUSS-sterilized ophthalmic surgical instruments and cataract surgical products that were reused in multiple patients. This microbiological data complements clinical endophthalmitis data from 2 million consecutive cases at the Aravind Eye Hospital, suggesting that their instrument and surgical supply processing practices may allow for safe and sustainable ophthalmic care.
Consistency of Physical Therapist Discharge Recommendations in Acute Care
Authors: Widenhoefer Tricia , Dickman Kendall , Meara Grace , Liter Donovan , Schoonveld Sarah , Almonroeder Sarah , Almonroeder Thomas Gus 
Published: June 2024

Introduction:
Physical therapists assist with discharge planning for hospitalized patients by making recommendations regarding a patient’s optimal discharge location and ongoing rehabilitation needs. The purpose of this study was to examine the consistency of discharge recommendations made by physical therapists with experience working in an acute care setting, when provided with a set of clinical vignettes describing hospitalized patients.

Review of Literature:
Considering the complex/multifactorial nature of making discharge recommendations, one would expect there to be inconsistencies among physical therapists. However, we are not aware of a previous study examining the level of consistency for discharge recommendations made by physical therapists, when reviewing a set of clinical vignettes.

Subjects:
Nineteen physical therapists working in an acute care setting.

Methods:
The physical therapists were provided with 10 clinical vignettes describing hospitalized patients via an electronic survey distributed across three rehabilitation departments. Each vignette described the patient’s medical condition, past medical history, prior level of function, living situation, key examination findings, and other general characteristics. After independently reviewing each case, the physical therapists selected a discharge recommendation from a list of standard options. Fleiss’ kappa was examined to assess the level of agreement among the physical therapists.

Results:
Overall, Fleiss’ kappa was 0.28, which reflects fair agreement among the physical therapists.

Discussion and Conclusion:
The 19 physical therapists who participated in this study only exhibited fair agreement with respect to their discharge recommendations. This relatively low level of agreement suggests that efforts to improve the consistency of discharge recommendations should be explored.
Development and validation of a nomogram for nonalcoholic fatty liver disease in Western Xinjiang, China
Authors: Zheng Shuaiyin , Li Di , Shi Zhuoyue , Yang Ying , Li Lidan , Chen Peidi , A bulimiti Xieerwaniguli , Li Fuye 
Published: June 2024

Objective
The aim of this study was to establish a simple, nonalcoholic fatty liver disease (NAFLD) screening model using readily available variables to identify high-risk individuals in Western Xinjiang, China.

Methods
A total of 40 033 patients from the National Health Examination were divided into a training group (70%) and a validation group (30%). Univariate regression and least absolute shrinkage and selection operator models optimized feature selection, while a multivariate logistic regression analysis constructed the prediction model. The model’s performance was evaluated using the area under the receiver operating characteristic curve, and its clinical utility was assessed through decision curve analysis.

Results
The nomogram assessed NAFLD risk based on factors such as sex, age, diastolic blood pressure, waist circumference, BMI, fasting plasma glucose, alanine aminotransferase, platelet count, total cholesterol, triglycerides, low-density lipoprotein–cholesterol, and high-density lipoprotein–cholesterol. The area under the receiver operating characteristic curves were 0.829 for men and 0.859 for women in the development group, and 0.817 for men and 0.865 for women in the validation group. The decision curve analysis confirmed the nomogram’s clinical usefulness, with consistent findings in the validation set.

Conclusion
A user-friendly nomogram prediction model for NAFLD risk was successfully developed and validated for Western Xinjiang, China.
Evolution of Pediatric Critical Care Medicine Physicians Clinical and Academic Profile by Gender*
Authors: Wai Kitman , Pollack Murray M. , Basu Sonali 
Published: June 2024

OBJECTIVES:
To examine career trajectory and academic profile of Pediatric Critical Care Medicine (PCCM) physicians, with special focus on gender differences.

DESIGN:
Observational cross-sectional study of PCCM fellowship graduates using publicly available data.

SETTING:
Publicly available databases including National Provider Identifier registry, American Board of Pediatrics, Doximity, official hospital websites, and Scopus.

SUBJECTS:
Two thousand one hundred twenty-nine PCCM fellowship graduates employed in clinical positions in U.S. practice locations.

INTERVENTION:
None.

MEASUREMENTS AND MAIN RESULTS:
Physician demographic characteristics included gender and time since fellowship completion. Current career and academic characteristics included employment data, publication productivity (h-index), and academic rank. Data from 2129 career PCCM physicians was included, with recent graduates showing a notable increase in female representation. Workplace characteristics revealed that most PCCM physicians worked in university-affiliated hospitals, with higher percentages of female physicians working in university-affiliated hospitals compared with male physicians. The study also highlighted significant gender disparities in academic metrics, with male physicians having higher h-indices (3 vs. 2; p < 0.001) and more publications (6 vs. 4; p < 0.001) than their female counterparts across various career phases. Additionally, the analysis showed gender differences in academic rank, with a higher proportion of female faculty holding assistant and associate professor ranks (58.2% vs. 47.5%; p < 0.001), while a greater percentage of male faculty held the rank of professor (20.2% vs. 11.1%; p < 0.001). Multiple variable regression analysis identified both male gender and time since fellowship graduation as independently associated with a physician’s h-index, while only time since fellowship graduation was linked to current academic rank.

CONCLUSIONS:
This is the first analysis of career and academic characteristics of practicing PCCM physicians, additionally studying the association of gender and career trajectory. Gender discrepancy was seen in employment hospital characteristics, h-indices, and academic rank. Additional studies are required to further explore the impact of gender on career trajectory.
Knee Contact Forces of Individuals With Osteoarthritis and Those With Lower Limb Amputation
Authors: Andrag Lizanne , Kunorozva Lovemore , Derman Wayne , Runciman Phoebe 
Published: June 2024

Objective
Osteoarthritis is a major cause of impairment. Research has shown that individuals with unilateral lower limb amputation are 17 times more likely to develop osteoarthritis on their sound side limb. Therefore, this review aimed to describe similarities and differences in the biomechanical loading variables of individuals with osteoarthritis and those with unilateral lower limb amputation.

Design
Researchers systematically searched PubMed-Medline, EBSCOhost, and Web of Science for articles published between January 1990 and February 2022. Included studies investigated the biomechanical profiles (peak external knee adduction moment; peak external knee flexion moment; ground reaction force; external knee adduction moment loading rate; external knee adduction moment impulse) of both population groups.

Results
A total of 31 articles were included in this review. Only knee adduction moment and knee flexion moment presented similar profiles in both groups, while all other variables were dissimilar. The use of advanced prostheses reduced the loading on the sound side of individuals with unilateral lower limb amputation.

Conclusions
As both knee adduction moment and knee flexion moment are surrogate measures for knee contact forces, interventions need to target these variables to help manage and prevent the development of osteoarthritis. Interventions, particularly for addressing these variables in individuals with unilateral lower limb amputation, should be further investigated in future research.
STHD: probabilistic cell typing of single Spots in whole Transcriptome spatial data with High Definition
Authors: Sun Chuhanwen , Zhang Yi 
Published: June 2024

AbstractRecent spatial transcriptomics (ST) technologies have enabled single- and sub-cellular resolution profiling of gene expression across the whole transcriptome. However, the transition to high-definition ST significantly increased data sparsity and dimensionality, posing computational challenges in identifying cell types, deciphering neighborhood structure, and detecting differential expression - all are crucial steps to study normal and disease ST samples. Here we present STHD, a novel machine learning method for probabilistic cell typing of single spots in whole-transcriptome, high-resolution ST data. Unlike the current binning-aggregation-deconvolution strategy, STHD directly models gene expression at single-spot level to infer cell type identities without cell segmentation or spot aggregation. STHD addresses sparsity by modeling count statistics, incorporating neighbor similarities, and leveraging reference single-cell RNA-seq data. We show in VisiumHD data that STHD accurately predicts cell type identities at single-spot level, which achieves precise segmentation of both global tissue architecture and local multicellular neighborhoods. The high-resolution labels facilitate various downstream analyses, including cell type-stratified bin aggregation, spatial compositional comparisons, and cell type-specific differential expression analyses. Moreover, STHD labels further reveal frontlines of inter-cell type interactions at immune hubs in cancer samples. STHD is scalable and generalizable across diverse samples, tissues, and diseases, facilitating genome-wide analyses in various spatial organization contexts. Overall, computational modeling of individual spots with STHD facilitates discoveries in cellular interactions and molecular mechanisms in whole-genome spatial technologies with high resolution. STHD is available athttps://github.com/yi-zhang/STHD.
Predicting biological activity from biosynthetic gene clusters using neural networks
Authors: Goyat Hemant , Singh Dalwinder , Paliyal Sunaina , Mantri Shrikant 
Published: June 2024

AbstractMicroorganisms like bacteria and fungi have been used for natural products that translate to drugs. However, assessing the bioactivity of extract from culture to identify novel natural molecules remains a strenuous process due to the cumbersome order of production, purification, and assaying. Thus, extensive genome mining of microbiomes is underway to identify biosynthetic gene clusters or BGCs that can be profiled as particular natural products, and computational methods have been developed to address this problem using machine learning. However, existing tools are ineffective due to a small training dataset, dependence on old genome mining tools, lack of relevant genomic descriptors, and prevalent class imbalance. This work presents a new tool, NPBdetect, that can detect multiple bioactivities and has been designed through rigorous experiments. Firstly, we composed a larger training set using MIBiG database and a test set through literature mining to build and assess the model respectively. Secondly, the latest antiSMASH genome mining tool was used to obtain BGC and introduced new sequence-based descriptors. Thirdly, neural networks are used to build the model by dealing with class imbalance issues through the class weighting technique. Finally, we compared the NPBdetect tool with an existing tool to show its efficacy and real-world utility in detecting several bioactivities with high confidence.