bluuebunny/crossref_metadata_2025_split huggingface dataset:
Jowl Improvement With Injectable Fillers: Jawline Injections Alone Versus Jawline and Cheek Injections
Authors: Taub Amy Forman , Callender Valerie Dawn 
Published: July 2024

BACKGROUND
Jowling is a common aesthetic complaint in aging individuals.

OBJECTIVE
Injectable filler placed at the lateral jawline will improve the appearance of jowls, as defined by the Merz Aesthetic Jawline Grading Scale (MAJGS). This improvement will be independent of concomitant injection of filler into the lateral cheek.

METHODS
Fifteen female subjects with grade 2 to 3 jowls on a scale of 0 to 4 were enrolled to receive either VYC-20L in the mandibular angle/ramus (Group 1) or the mandibular angle/ramus and lateral cheek (Group 2). The subjects were evaluated by a blinded cosmetic dermatologist and themselves at 4 weeks after the last injection.

RESULTS
A statistically significant improvement was noted in Group 1 by all blinded reviewers and subjects. Group 2 did not reach statistical significance as evaluated by the blinded dermatologist although did by the subject’s rating. The average amount of filler injected per subject was 3.36 mL for group 1 and 8.38 mL for group 2. A novel adverse event was tenderness when chewing lasting for 2 to 3 days.

CONCLUSION
Injection of VYC-20L showed statistical improvement in a validated jowl scale when injected at the angle of the mandible and the mandibular ramus, independent of concomitant lateral cheek injections.
Facial Masculinization Surgery Using Polyetheretherketone Alloplasty: Statistical Shape Modeling–based Implant Designs
Authors: van der Wel Hylke , Merema Bram J. , Kraeima Joep , Schepers Rutger H. , Jansma Johan 
Published: July 2024

Summary:
The face is the initial feature used to judge gender in public spaces; it is also a source of significant gender dysphoria. Surgical techniques are available for non-cisgender male patients who desire a more masculine face by augmenting certain features to change the bony framework of the skull. Augmentation using virtually designed patient-specific polyetheretherketone implants has now become a more widely applied method in maxillofacial surgery. When designing implants for augmentation, a three-dimensional (3D) reference or template is very useful. Hence, a 3D statistical shape model was developed of a male skull shape from information from a population of 40 male patients containing the mean shape and principal components of shape variation. By overlaying the template and the patient’s 3D skull model, this method identified the regions of gender dimorphism in this case to be the orbital ridge, zygomatic regions, and frontal bossing area. Based on the 3D template overlay, polyetheretherketone augmentation implants were virtually designed in close consultation with a patient to augment the aforementioned regions. The virtual statistical shape modeling template offered an objective reference, and the possibility to fully involve the patient in the treatment planning.
Treatment of Patients With Electrical Injury by Using Modified Forearm Venous Flap
Authors: Yang Chenglan , Wang Qi , Zeng Xueqin , Zhou Jian , Jiang Lingli , Hu Peng , Wei Zairong 
Published: July 2024

Objective
Severe hand electrical injuries often occur in functional areas such as joints; the repair requires attention to both appearance and function due to the visibility of the hand. This study aimed to present the clinical experience of successfully repairing hand electrical injuries using improved forearm venous flaps.

Methods
From 2020 to 2022, 15 cases of severe hand electrical injuries were diagnosed, including 10 males and 5 females. Among them, 6 cases were repaired in the first web space, 4 in the thumb, 3 in the index finger, 2 in the middle finger, 2 in the ring finger, and 2 in the little finger. The size of venous flaps ranged from 2.0 cm × 1.8 cm to 12 cm × 4.0 cm. All patients underwent repair using improved forearm venous flaps. The follow-up period ranged from 5 to 8 months.

Results
All flaps survived without serious complications. All patients were satisfied with the postoperative aesthetics and function of their hands.

Conclusion
The improved forearm venous flap is a simple and reliable method for repairing hand electrical injuries.
Development and validation of early prediction models for new-onset functional impairment of patients with trauma at hospital discharge
Authors: Ohbe Hiroyuki , Yokokawa Yuta , Sato Tetsuya , Kudo Daisuke , Kushimoto Shigeki 
Published: July 2024

BACKGROUND
Early identification of individuals at risk of functional impairment after trauma is crucial for the timely clinical decision-making and intervention to improve reintegration into the society. This study aimed to develop and validate models for predicting new-onset functional impairment after trauma using predictors that are routinely collected within 2 days of hospital admission.

METHODS
In this multicenter retrospective cohort study of acute care hospitals in Japan, we identified adult patients with trauma with independence in carrying out activities of daily living before hospitalization, treated in the intensive or high-dependency care unit, and survived for at least 2 days between April 2008 and September 2023. The primary outcome was functional impairment defined as Barthel Index ≤60 at hospital discharge. In the internal validation data set (between April 2008 and August 2022), using the routinely collected 129 candidate predictors within 2 days of admission, we trained and tuned the four conventional and machine learning models with repeated random subsampling cross-validation. We measured the performance of these models in the temporal validation data set (between September 2022 and September 2023). We also computed the importance of each predictor variable in our model.

RESULTS
We identified 8,529 eligible patients. Functional impairment at discharge was observed in 41% of the patients (n = 3,506/8,529). In the temporal validation data set, all four models showed moderate discrimination ability, with areas under the curve above 0.79, and extreme gradient boosting showing the best performance (0.83). In the variable importance analyses, age was the most important predictor, followed by consciousness, severity score, cervical spinal cord injury, mild dementia, and serum albumin level at admission.

CONCLUSION
We successfully developed early prediction models for patients with trauma with new-onset functional impairment at discharge that achieved high predictive performance using routinely collected data within 2 days of hospital admission.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III
Factors Predicting Overnight Admission after Same-Day Mastectomy Protocol and Associated Financial Implications
Authors: Caminiti Nicholas , Maung Aye Aye , Gaskins Jeremy , Jacobs Emma , Spry Catherine , Nath Suhail , Scoggins Charles R , Wilhelmi Bradon J , McMasters Kelly M , Ajkay Nicolas 
Published: July 2024

BACKGROUND:
Same-day mastectomy (SDM) protocols have been shown to be safe, and their use increased up to 4-fold compared with prepandemic rates. We sought to identify factors that predict overnight patient admission and evaluate the associated cost of care.

STUDY DESIGN:
Patients undergoing mastectomy from March 2020 to April 2022 were analyzed. Patient demographics, tumor characteristics, operative details, perioperative factors, 30-day complication, fixed and variable cost, and contribution margin were compared between those who underwent SDM vs those who required overnight admission after mastectomy (OAM).

RESULTS:
Of a total of 183 patients with planned SDM, 104 (57%) had SDM and 79 (43%) had OAM. Both groups had similar demographic, tumor, and operative characteristics. Patients who required OAM were more likely to be preoperative opioid users (p = 0.002), have higher American Society of Anesthesiology class (p = 0.028), and more likely to have procedure start time (PST) after 12:00 pm (49% vs 33%, p = 0.033). The rates of 30-day unplanned postoperative events were similar between SDM and OAM. Preoperative opioid user (odds ratio [OR] 3.62, 95% CI 1.56 to 8.40), postanesthesia care unit length of stay greater than 1 hour (OR 1.17, 95% CI 1.01 to 1.37), and PST after 12:00 pm (OR 2.56, 95% CI 1.19 to 5.51) were independent predictors of OAM on multivariate analysis. Both fixed ($5,545 vs $4,909, p = 0.03) and variable costs ($6,426 vs $4,909, p = 0.03) were higher for OAM compared with SDM. Contribution margin was not significantly different between the 2 groups (−$431 SDM vs −$734 OAM, p = 0.46).

CONCLUSIONS:
Preoperative opioid use, American Society of Anesthesiology class, longer postanesthesia care unit length of stay, and PST after noon predict a higher likelihood of admission after planned SDM. OAM translated to higher cost but not to decreased profit for the hospital.
Large Language Models for Individualized Psychoeducational Tools for Psychosis: A cross-sectional study
Authors: Yilanli Musa , McKay Ian , Jackson Daniel I. , Sezgin Emre 
Published: July 2024

AbstractImportanceIn mental healthcare, the potential of Large Language Models (LLMs) to enhance psychoeducation is a burgeoning field. This study explored the potential of ChatGPT as an individualized psychoeducational support tool specifically for psychosis education.ObjectiveThe study aims to evaluate psychosis-related questions to provide accurate, clear, and clinically relevant individualized information for patients and caregivers.DesignThis cross-sectional study uses a qualitative analysis design. The researchers specifically employed a question-answering system (GPT-4 via ChatGPT) to generate responses to common questions about psychosis. Experts in the field then evaluated these responses to assess their quality for use in a clinical setting.Primary OutcomeResearchers presented ChatGPT with 20 common questions frequently asked by patients’ caregivers and relatives. Two experts in psychosis then assessed the quality of the responses using six criteria: accuracy (1-3), clarity (1-3), inclusivity (1-3), completeness (0-1), clinical utility (1-5) and an overall score (1-4).ResultsThe evaluation yielded positive results overall. Responses were rated as accurate (M±SD= 2.89±0.22) and clear (mean score of 2.93±0.18). There was potential for improvement in terms of inclusivity (mean score of 2.30±0.41), suggesting a need to incorporate more diverse perspectives. Completeness received high ratings (mean score of 0.93±0.18), indicating responses addressed all aspects of the questions. Most importantly, the responses were deemed clinically useful (mean score of 4.35±0.52).ConclusionsIn summary, this study underscores the significant promise of ChatGPT as a psychoeducational tool for patients with psychosis, their relatives, and their caregivers. The experts’ findings affirm that the information delivered by ChatGPT is not only accurate and clinically relevant but also conveyed conversationally, enhancing its accessibility and usability. The initial performance of ChatGPT as a psychoeducational tool in the context of psychosis education is undeniably positive.
Using Healthcare Claims Data to Identify Health Disparities for Individuals with Diagnosed and Undiagnosed Familial Hypercholesterolemia
Authors: McGowan Mary P. , Xing Chao , Khera Amit , Huang Chun-Yuan , Shao Yanqiu , Xing Michelle , Brandt Eric J. , MacDougall Diane E. , Ahmed Catherine D. , Wilemon Katherine A. , Ahmad Zahid 
Published: July 2024

AbstractBackgroundIndividuals with familial hypercholesterolemia (FH) require intensive lipid-lowering therapy, starting with high-intensity statins and adding ezetimibe and PCSK9 inhibitors (PCSK9i) as needed to reach target LDL-C levels. There are limited data on disparities in the use of these therapies among individuals with FH in the US.MethodsWe queried a large US healthcare claims repository consisting of 324 million individuals, focusing on prescriptions for high-intensity statins, ezetimibe, and PCSK9i in two patient groups: those diagnosed with FH (ICD-10 E.78.01) and those not diagnosed with FH but identified as having probable FH (PFH) via the FIND-FH® machine learning algorithm. We used multivariable regression models to examine correlations with demographic/socioeconomic variables.ResultsIn the FH cohort (n = 85,457), 45.9% were female, 79.4% identified as White, 12.2% Black, and 8.4% as Hispanic. In the PFH cohort (n = 287,580), 42.2% were female, 78.2% White, 13.7% as Black, and 8.1% as Hispanic. Males were more likely to be prescribed high-intensity statins than females: odds ratio (OR) [95% confidence interval (CI)] = 2.05 [1.97, 2.13] and 1.60 [1.56,1.63] in the FH and the PFH cohorts, respectively. In both cohorts, White individuals were more likely to get ezetimibe, PCSK9i, or combination therapy compared to Black individuals (ORs: 1.12-1.40). Higher income was associated with increased odds of receiving these treatments (OR: 1.17-1.59 for incomes >$50,000). Higher education was linked to a higher likelihood of combination therapy (ORs [95% CI] = 1.49 [1.33, 1.68] and 1.18 [1.10, 1.27] in the FH and PFH cohorts, respectively).ConclusionsReal-world data indicate that more aggressive lipid-lowering therapy (ezetimibe and PCSK9i) is more often prescribed to White individuals, individuals with higher income, or those with advanced education, highlighting the need to improve equity in cardiovascular risk reduction for all individuals with FH.Clinical PerspectiveWhat is new?Health disparities exist for individuals with FH, regardless of whether they’ve been diagnosed.The use of ezetimibe and PCSK9i is more likely to occur in individuals who are White, higher income, and advanced education.What are the clinical ImplicationsAddressing health disparities in FH requires a multifaceted approach, including systemic changes to reduce bias in healthcare systems.Ensuring equitable access to expensive lipid medications, such as PCSK9 inhibitors, is crucial for individuals from lower socioeconomic groups.Providing access to case managers and geneticists can enhance health education and support, ultimately improving treatment outcomes for individuals with FH.
Anticoagulation Usage and Thrombolytic Therapy in Subjects with Atrial Fibrillation Associated Ischaemic Stroke
Authors: Harbison J , McCormack J , Brych O , Collins R , O’Connell N , Kelly P , Cassidy T 
Published: July 2024

AbstractAtrial Fibrillation (AF) has been Identified as the single largest cause of ischaemic stroke in the Irish population. Previous research showed that widespread adoption of Direct Oral Anticoagulant (DOAC) prophylaxis had not been associated with a reduction in AF associated stroke prevalence. The Irish National Audit of Stroke (INAS) undertook a more detailed study to determine the characteristics of anticoagulation practice in AF associated stroke particularly adherence to prescribing guidelines and effect on thrombolysis rate.MethodsData from INAS were analysed for the period 2017-2022 inclusive as part of a cross-sectional, cohort study. An enhanced dataset with additional questions about adherence with prescription and International Normalized Ratio (INR) control was collected for 2022 was also considered separately.ResultsComplete AF Data were available on 22485 of 26829 incidents admitted over this period. Of these, 19260 (85.6%) were ischaemic strokes, mean age was 71.8 and 57.1% were male. In 5321 of these cases, the AF was identified and in 2835 (53.3%) recognized before the stroke and 2281 (80.4%) had been prescribed anticoagulation. The population with previously unknown AF were significantly younger on average than those on anticoagulation (76.8 years vs. 79.1 years (p<0.0001, t-test)), Group C; 78.8 years (p<0.0001), they were also much more likely to have received thrombolysis (17.3 % vs. 4.0% (Chi Sq, p<0.0001)).There were 4999 stroke in 2022, 4272 (85.4%) were ischemic and 1270 (29.7%) of these were AF associated. Of the 660 total strokes, 597 (90.5%) anticoagulated at presentation were receiving DOACs, of which 557 were ischaemic. Forty-eight (9.5%) had their anticoagulation paused and 40 admitted to poor compliance (7.9%).ConclusionNearly half of people with AF detected after stroke was previously unknown. Those with known AF were mainly appropriately treated with DOACs and constitute breakthrough strokes. Subjects receiving DOACs were much less likely to receive thrombolytic therapy even than those taking Warfarin.
Metformin Use and Thirty-Day Readmission Among Patients with Bipolar Disorders: A Propensity Score-matching Analysis
Authors: Zhai Ting 
Published: July 2024

AbstractMetformin may affect patients with multi-comorbid bipolar disorder through the integrated stress response. However, the relationship between them remains unclear. This study aimed to explore the relationship between metformin use and early (30-day) readmission in bipolar disorder patients. Data were extracted from the Medical Information Mart for Intensive Care IV database. Adult patients with a documented diagnosis of bipolar disorder were screened. Multivariable logistic regression and propensity score matching were used to investigate potential associations. Data on 1688 patients were included. The crude early (30-day) readmission was significantly higher in patients with metformin use (17/114 vs. 132/1574,p= 0.033). In the extended multivariable logistic models, the hazard ratio (HR) of metformin use was consistently significant in all models (HR range 1.87–2.99,p< 0.05 for all). After propensity score matching, the early (30-day) readmission remained significantly higher in the metformin use group (Mahalanobis matching, |t|>1.96). Although residual confounding cannot be excluded, metformin use is associated with higher readmission.
Sivelestat Sodium in the Treatment of Patients with Acute Respiratory Distress Syndrome Combined with Systemic Inflammatory Response Syndrome
Authors: He Hongli , Huang Xiaobo 
Published: July 2024

AbstractObjectivesNeutrophil elastase (NE) plays an important role in the pathogenesis of acute respiratory distress syndrome (ARDS). Sivelestat sodium, an NE inhibitor, has been approved in Japan for the treatment of patients with ARDS combined with systemic inflammatory response syndrome (SIRS). This trial was designed to evaluate the role of sivelestat sodium in mild-to-moderate ARDS combined with SIRS.MethodsWe conducted a multicentre, double-blind, randomized, placebo-controlled trial enrolling patients diagnosed with mild-to-moderate ARDS combined with SIRS admitted within 72 hours of ARDS onset (clinicaltrials.gov,NCT04909697). Patients were randomized in a 1:1 fashion to sivelestat or placebo. Trial drugs were administrated as a 24-hour continuous intravenous infusion at a rate of 0.2 mg/kg/h for 5 days. The primary outcome was PaO2/FiO2ratio change on day 3 after randomization, which was defined as (PaO2/FiO2ratio on day 3 – baseline PaO2/FiO2ratio)/baseline PaO2/FiO2ratio.ResultsThe study was stopped early at the recommendation of an independent Data and Safety Monitoring Board, which noted a between-group difference in mortality. A total of 162 patients were randomized, of whom 81 were assigned to receive sivelestat sodium and 81 placebo. On day 3, the PaO2/FiO2ratio improved by 36% in the sivelestat group compared to 3% in the placebo group (difference, 0.27; 95% CI, 0.13 to 0.41,p< 0.001). In addition, The invasive mechanical ventilation-free days within 28 days was significantly longer in the sivelestat sodium group compared to the placebo group (median 26.9 days vs. 21.0 days,p= 0.004). The Kaplan-Meier curves showed a significant reduction in 90-day mortality in patients receiving sivelestat compared to those not receiving sivelestat (hazard ratio, 0.51; 95% CI, 0.26 to 0.99; log-rankp= 0.044).ConclusionIn patients with mild-to-moderate ARDS combined with SIRS, sivelestat sodium may improve oxygenation on day3, increase invasive mechanical ventilation-free days, and was associated with improved survival.
Large-scale fMRI dataset for the design of motor-based Brain-Computer Interfaces
Authors: Bom Magnus S , Brak Annette MA , Raemaekers Mathijs , Ramsey Nick F , Vansteensel Mariska J , Branco Mariana P 
Published: July 2024

AbstractFunctional Magnetic Resonance Imaging (fMRI) data is commonly used to map sensorimotor cortical organization and to localise electrode target sites for implanted Brain-Computer Interfaces (BCIs). Functional data recorded during motor and somatosensory tasks from both adults and children specifically designed to map and localise BCI target areas throughout the lifespan is rare. Here, we describe a large-scale dataset collected from 155 human participants while they performed motor and somatosensory tasks involving the fingers, hands, arms, feet, legs, and mouth region. The dataset includes data from both adults and children (age range: 6-89 years) performing a set of standardized tasks. This dataset is particularly relevant to study developmental patterns in motor representation on the cortical surface and for the design of paediatric motor-based implanted BCIs.
Loss of heterozygosity in gastric cancers in a set of Mexican patients
Authors: Larios-Serrato Violeta , Valdez-Salazar Hilda-Alicia , Torres Javier , Camorlinga-Ponce Margarita , Piña-Sánchez Patricia , Minauro-Sanmiguel Fernando , Ruiz-Tachiquín Martha-Eugenia 
Published: July 2024

AbstractWorldwide, gastric cancer (GC) is a common malignancy with the highest mortality rate among digestive system diseases. The present study of GC and loss of heterozygosity (LOH) is relevant to understanding tumor biology and establishing essential aspects of cancer. Here, DNA samples from Mexican patients with diffuse GC (DGC), intestinal GC (IGC), or non-atrophic gastritis (NAG; control) were purified, and whole-genome high-density arrays were performed. Posteriorly, LOH was identified among the tissue samples, and cancer genes and signaling pathways were analyzed to determine the most altered. Detailed bioinformatics analysis was developed to associate LOH with the Hallmarks of Cancer according to their frequency in patient samples, participation in metabolic pathways, network interactions, and enrichment of Cancer Hallmark genes. LOH-genes in GC were PTPR, NDUFS3, PAK3, IRAK1, IKBKG, TKTL1, PRPS1, GNAI2, RHOA, MAPKA, and MST1R. Genes that stand out at NAG involve proliferation and growth; those at IGC trigger genomic instability, tissue invasion, metastasis, and arrest of cell death; and those at DGC involve energy metabolism, the destruction of immune evasion, and replicative immortality. Other events, such as sustained angiogenesis, were similar between NAG-IGC-DGC. Together, these are molecular, cellular, and metabolic events that must be monitored in GC patients. Our findings must be validated to develop molecular tests for diagnosis, prognosis, treatment response, and, most importantly, screening tests.