bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interobserver Variability in the International Study Group for Pancreatic Surgery (ISGPS)-Defined Complications After Pancreatoduodenectomy
Authors: Hendriks Tessa E. , Balduzzi Alberto , van Dieren Susan , Suurmeijer J. Annelie , Salvia Roberto , Stoop Thomas F. , Del Chiaro Marco , Mieog Sven D. , Nielen Mark , Zani Sabino , Nussbaum Daniel , Hackert Thilo , Izbicki Jakob R. , Javed Ammar A. , Hewitt D. Brock , Koerkamp Bas Groot , de Wilde Roeland F. , Miao Yi , Jiang Kuirong , Nakata Kohei , Nakamura Masafumi , Jang Jin-Young , Lee Mirang , Ferrone Cristina R. , Shrikhande Shailesh V. , Chaudhari Vikram A. , Busch Olivier R. , Siriwardena Ajith K. , Strobel Oliver , Werner Jens , Bonsing Bert A. , Marchegiani Giovanni , Besselink Marc G. ,   for the International Study Group for Pancreatic Surgery (ISGPS)
Published: August 2024

Objective:
To determine the interobserver variability for complications of pancreatoduodenectomy as defined by the International Study Group for Pancreatic Surgery (ISGPS) and others.

Background:
Good interobserver variability for the definitions of surgical complications is of major importance in comparing surgical outcomes between and within centers. However, data on interobserver variability for pancreatoduodenectomy-specific complications are lacking.

Methods:
International cross-sectional multicenter study including 52 raters from 13 high-volume pancreatic centers in 8 countries on 3 continents. Per center, 4 experienced raters scored 30 randomly selected patients after pancreatoduodenectomy. In addition, all raters scored 6 standardized case vignettes. This variability and the “within centers” variability were calculated for 2-fold scoring (no complication/grade A vs grade B/C) and 3-fold scoring (no complication/grade A vs grade B vs grade C) of postoperative pancreatic fistula, postpancreatoduodenectomy hemorrhage, chyle leak, bile leak, and delayed gastric emptying. Interobserver variability is presented with Gwet AC-1 measure for agreement.

Results:
Overall, 390 patients after pancreatoduodenectomy were included. The overall agreement rate for the standardized cases vignettes for 2-fold scoring was 68% (95% CI: 55%–81%, AC1 score: moderate agreement), and for 3-fold scoring 55% (49%–62%, AC1 score: fair agreement). The mean “within centers” agreement for 2-fold scoring was 84% (80%–87%, AC1 score; substantial agreement).

Conclusions:
The interobserver variability for the ISGPS-defined complications of pancreatoduodenectomy was too high even though the “within centers” agreement was acceptable. Since these findings will decrease the quality and validity of clinical studies, ISGPS has started efforts aimed at reducing the interobserver variability.
Optical Coherence Tomography Angiography Retinal Imaging Associations With Burden of Small Vessel Disease and Amyloid Positivity in the Brain
Authors: Bermudez Camilo , Lesnick Timothy G. , More Swati S. , Ramanan Vijay K. , Knopman David S. , Rabinstein Alejandro A. , Cogswell Petrice M. , Jack Clifford R. , Vemuri Prashanthi , Petersen Ronald C. , Graff-Radford Jonathan , Chen John J. 
Published: August 2024

Background:
Alzheimer disease (AD) and other dementias are associated with vascular changes and amyloid deposition, which may be reflected as density changes in the retinal capillaries. These changes may can be directly visualized and quantified with optical coherence tomography angiography (OCTA), making OCTA a potential noninvasive preclinical biomarker of small vessel disease and amyloid positivity. Our objective was to investigate the feasibility of retinal imaging metrics as noninvasive biomarkers of small vessel disease and amyloid positivity in the brain.

Methods:
We investigated associations between OCTA and neuroimaging and cognitive metrics in 41 participants without dementia from the Mayo Clinic Study of Aging and Alzheimer’s Disease Research Center. OCTA metrics included superficial, deep, and full retina capillary density of the fovea, parafovea, and macula as well as the area of the foveal avascular zone (FAZ). Neuroimaging metrics included a high burden of white matter hyperintensity (WMH), presence of cerebral microbleeds (CMB), lacunar infarcts, and amyloid positivity as evidenced on positron emission tomography (PET), whereas cognitive metrics included mini-mental status examination (MMSE) score. We performed generalized estimating equations to account for measurements in each eye while controlling for age and sex to estimate associations between OCTA metrics and neuroimaging and cognitive scores.

Results:
Associations between OCTA and neuroimaging metrics were restricted to the fovea. OCTA showed decreased capillary density with high burden of WMH in both the superficial (P = 0.003), deep (P = 0.004), and full retina (P = 0.01) in the fovea but not the parafovea or whole macula. Similarly, participants with amyloid PET positivity had significantly decreased capillary density in the superficial fovea (P = 0.027) and deep fovea (P = 0.03) but higher density in the superficial parafovea (P = 0.038). Participants with amyloid PET positivity also had a significantly larger FAZ (P = 0.031), whereas in those with high WMH burden the difference did not reach statistical significance (P = 0.075). There was also a positive association between MMSE and capillary density of the full retina within the fovea (P = 0.037) and in the superficial parafovea (P = 0.046). No associations were found between OCTA metrics and presence of CMB or presence of lacunar infarcts.

Conclusions:
The associations of lower foveal capillary density with cerebral WMH and amyloid positivity suggest that further research is warranted to evaluate for shared mechanisms of disease between small vessel disease and AD pathologies.
Novel Gammapapillomavirus type in the nasal cavity of a wild red colobus (Piliocolobus tephrosceles)
Authors: Weary Taylor E. , Mehta Kavi P.M. , Goldberg Tony L. 
Published: August 2024

Papillomaviruses (PVs) are double-stranded, circular, epitheliotropic DNA viruses causing benign warts (papillomas) or inducing dysplasia that can progress to cancer. Although they have been identified in all vertebrate taxa, most classified types are human PVs (HPVs); relatively little is known about PVs in other species. Here we characterize a novel Gammapapillomavirus type, PtepPV1, from a nasal swab of a wild red colobus (Piliocolobus tephrosceles) in Kibale National Park, Uganda. The virus has a genome of 6,576 bases, encoding the seven canonical early (E) ORFs (E6, E7, E1, E2, E4, E1^E4, and E8^E2) and two late (L) ORFs (L1 and L2) of the gammapapillomaviruses, and is 81.0% similar to HPV-mSK_118, detected in a cutaneous wart from an immunocompromised human patient, in the L1 gene at the amino acid level. Alphapapillomaviruses (genus Alphapapillomavirus) cause anogenital carcinomas such as cervical cancer and have been described previously in several nonhuman primates. However, the first gammapapillomavirus (genus Gammapapillomavirus), which cause transient cutaneous infections, was not described until 2019 in a healthy rhesus macaque (Macaca mulatta) genital swab. The new virus from red colobus, PtepPV1, has many genomic features encoded by high-risk oncogenic PVs, such as the E7 gene LXSXE and CXXC motifs, suggesting potential for pRb and zinc-finger binding, respectively. To our knowledge, PtepPV1 is also the first reported nonhuman primate PV found in the nasal cavity. PtepPV1 expands the known host range, geographic distribution, tissue tropism, and biological characteristics of nonhuman primate PVs.
The Energetics of Maintaining the Lateral Balance Are Terrain-Specific; a Normal Lookahead Significantly Reduces Active Balance Maintenance Work
Authors: Hosseini-Yazdi Seyed-Saleh 
Published: August 2024

AbstractHumans must actively control their lateral balance through frontal plane work or adjusting lateral foot placement. With constant muscle efficiency and considering the energetic consequences of Center of Mass (COM) work variability, we estimated the metabolic cost of lateral balance maintenance and compared it with the Workman model. Like the Workman model, we found that lateral balance energetics were mainly associated with terrain amplitude. Increased walking speed’s effect on step transition work might be offset by reduced step width. A significant rise in lateral work magnitude (+157.1%) with restricted lookahead was potentially linked to wider steps. Comparing mechanical work with the Workman model, we found significant differences in magnitudes, suggesting that the Workman model included additional costs such as force rate generation, muscle coactivation, or posture maintenance not reflected in the COM lateral work and its variability.Practitioner SummaryLateral balance maintenance during walking requires active regulation, yet it is not studied mechanically. Our study found that lateral control costs are terrain-specific and increase with restricted lookahead. With age, only variability increases. We assume associated energetics rise with both work and variability.
Lipoprotein retention and inflammation due to regurgitant blood flow as part of the natural history of degenerative ascending aortic aneurysms
Authors: Freiholtz David , Lång Karin , Bergman Otto , Olsson Christian , Granbom Koski Malin , Dismorr Michael , Österholm Cecilia , Caidahl Kenneth , Franco-Cereceda Anders , Eriksson Per , Gisterå Anton , Björck Hanna M 
Published: August 2024

AbstractBACKGROUNDAn abnormal accumulation of immune cells and a disrupted lipoprotein metabolism has previously been described as part of the pathogenesis of ascending aortic aneurysm in patients with tricuspid aortic valves. The factor driving the accumulation of immune cells remains unclear; however, it may be considered in light of the observation that proximal aortic dilatation often occurs alongside aortic regurgitation but rarely with aortic stenosis. In the present study we aim to investigate the natural history of ascending aortic aneurysm in patients with tricuspid aortic valves by assessing the association between aortic regurgitation and vascular deterioration.MATERIAL AND METHODSPatients tricuspid aortic valves undergoing elective open- heart surgery for ascending aortic- and/or aortic valve replacement were included. Aortic specimens from organ donors were obtained through the University of Miami Tissue Bank, USA. Protein expression/localization and differences in aortic intima-media gene expression were assessed using immunohistochemistry and transcriptomics, respectively. Ten-year aortic growth was measured using echocardiography. In total 142 patients were included across experiments (mRNA expression n=44, immunohistochemistry n=49, 10-year follow-up n=49).RESULTSAortic regurgitation was associated with the presence of oxidized apolipoprotein B-containing lipoproteins and infiltrating CD68+ cells in the non-dilated ascending aortic media, which was not observed in aortas of patients with aortic stenosis. Assessing factors influencing lipoprotein retention showed increased levels of genes encoding core proteins of proteoglycans (HSPG2, CSPG4, ACAN, andBGN) in patients with regurgitant valves, compared with aortas from patients with stenotic valves. Moreover, dilated aortas of patients with aortic regurgitation exhibited higher levels of the receptor for oxidized low-density lipoprotein,OLR1, which correlated positively with inflammatory markers in both dilated and non-dilated aortas. Surgical replacement of regurgitant aortic valves mitigated long-term aortic growth, in contrast to replacement of stenotic valves, which was associated with continuous aortic dilation.CONCLUSIONSThe natural history of ascending aortic aneurysm in patients with tricuspid aortic valves involves medial lipoprotein retention and oxidation with subsequentOLR1-driven pathological inflammation, and can be mitigated by replacement of the regurgitant aortic valve.
Emergency Department Discharge Center Program Evaluation from a “Learning Organization” lens: Methods, Lessons Learned, and Future Directions
Authors: Razack Bibi S. , Mahabir Naya , Iyeke Lisa , Jordan Lindsay , Hope Roland , Diaz Emily , Barcia Lyze , Fuzailov Diana , Willis Helena , Gizzi-Murphy Marina , Davis Frederick , Berman Adam , Richman Mark , Kwon Nancy 
Published: August 2024

AbstractOur ED’s Discharge Center (EDDC) facilitates appointments and paper-based social determinants of health (SDoH) screening. No criteria guide EDDC utilization. The ED’s provider-administrator-run, patient-satisfying follow-up call program contacts only ∼25% of discharges. We describe Learning Organization-principle-guided evaluation of EDDC efficiency, aiming to create EDDC time to expand the follow-up program.We reviewed appointment-making, SDoH-screening, and follow-up program data. We surveyed patients to determine whether adopting SHOUT tool criteria (no home, no primary care physician, or insurance) might yield more-judicious EDDC utilization.EDDC staff’s 20 minutes/patient yielded fewer ED returns and admissions. Most patients improved post-discharge and made appointments themselves; 6% met SHOUT criteria for EDDC assistance; 4.5% would benefit from SDoH screening.Adopting SHOUT criteria would create significant time for EDDC-staffed follow-up program expansion. QR-code-accessible SDoH surveys would screen thousands more patients, minimizing EDDC staff involvement, saving 95% of the effort while retaining 100% of the benefit.
Genomic epidemiology reveals 2022 mpox epidemic in New York City governed by heavy-tailed sexual contact networks
Authors: Pekar Jonathan E. , Wang Yu , Wang Jade C. , Shao Yucai , Taki Faten , Forgione Lisa A. , Amin Helly , Clabby Tyler , Johnson Kimberly , Torian Lucia V. , Braunstein Sarah L. , Pathela Preeti , Omoregie Enoma , Hughes Scott , Suchard Marc A. , Vasylyeva Tetyana I. , Lemey Philippe , Wertheim Joel O. 
Published: August 2024

AbstractThe global mpox epidemic in 2022 was likely caused by transmission of mpox virus (MPXV) through sexual contact networks, with New York City (NYC) experiencing the first and largest outbreak in the United States. By performing a phylogeographic and epidemiological analysis of MPXV, we identify at least 200 introductions of MPXV into NYC and 84 leading to onward transmission. Through a comparative analysis with human immunodeficiency virus (HIV) in NYC, we find that both MPXV and HIV genomic cluster sizes are best fit by scale-free distributions and that people in MPXV clusters are more likely to have previously received an HIV diagnosis (odds ratio=1.58;p=0.012) and be a member of a recently growing HIV transmission cluster, indicating overlapping sexual contact networks. We then model the transmission of MPXV through sexual contact networks and show that highly connected individuals would be disproportionately infected at the start of an epidemic, thereby likely resulting in the exhaustion of the most densely connected parts of the sexual network. This dynamic explains the rapid expansion and decline of the NYC outbreak, as well as the estimated cumulative incidence of less than 2% within high-risk populations. By synthesizing the genomic epidemiology of MPXV and HIV with epidemic modeling, we demonstrate that MPXV transmission dynamics can be understood by general principles of sexually transmitted pathogens.
An Interpretable Machine Learning Tool for In-Home Screening of Agitation Episodes in People Living with Dementia
Authors: Bafaloukou Marirena , Schalkamp Ann-Kathrin , Fletcher-Lloyd Nan , Capstick Alex , Walsh Chloe , Sandor Cynthia , Kouchaki Samaneh ,   CR&T Group, Nilforooshan Ramin , Barnaghi Payam 
Published: August 2024

AbstractBackgroundAgitation affects around 30% of people living with dementia (PLwD), increasing carer burden and straining care services. Agitation screening typically relies on subjective clinical scales and direct patient observation, which are resource-intensive and challenging to incorporate into routine care. Clinical applicability of data-driven methods for agitation screening is limited by constraints such as short observational periods, data granularity, and lack of interpretability and generalisability. Current interventions for agitation are primarily medication-based, which may lead to severe side effects and lack personalisation. Understanding how real-world factors affect agitation within home settings offers a promising avenue towards identifying potential personalised non-pharmacological interventions.MethodsWe used longitudinal data (32,896 person-days from n=63 PLwD) collected using in-home monitoring devices. Employing machine learning techniques, we developed a screening tool to determine the weekly risk of agitation. We incorporated a traffic-light system for risk stratification to aid clinical decision-making and employed the SHapley Additive exPlanations (SHAP) framework to increase interpretability. We designed an interactive tool that enables the exploration of personalised non-pharmacological interventions, such as modifying ambient light and temperature.ResultsLight Gradient-boosting Machine (LightGBM) achieved the highest performance in identifying agitation with a sensitivity of 71.32±7.38% and specificity of 75.28%. Implementing the traffic-light system for risk stratification increased specificity by 15% and improved all metrics. Significant contributors to agitation included low nocturnal respiratory rate, heightened alertness during sleep, and increased indoor illuminance, as revealed by statistical and feature importance analysis. Using our interactive tool, we identified that adjusting indoor lighting levels and temperature were promising and feasible interventions within our cohort.ConclusionsOur interpretable framework for agitation screening, developed using data from a dementia care study, showcases significant clinical value. The accompanying interactive interface allows for thein-silicosimulation of non-pharmacological interventions, facilitating the design of personalised interventions that can improve in-home dementia care.
Association of METS-IR Index with Type 2 Diabetes: A Cross-sectional Analysis of National Health and Nutrition Examination Survey Data from 2009 to 2018
Authors: Hou Yisen , Li Rui , Xu Zhen , Chen Wenhao , Li Zhiwen , Jiang Weirong , Meng Yong , Han Jianli 
Published: August 2024

AbstractBackgroundWith rising global diabetes prevalence, precise early identification and management of diabetes risk are critical research areas. The METS-IR, a novel non-insulin-based tool, is gaining attention for quantifying insulin resistance using multiple metabolic parameters. Despite its potential in predicting diabetes and its precursors, evidence on its specific relationship with diabetes is limited, especially in large-scale population validation and mechanistic exploration.ObjectiveThis study aims to analyze the association between METS-IR and type 2 diabetes (T2DM) in American adults.MethodsWe conducted a cross-sectional analysis of NHANES data from 2009 to 2018. Participants aged 20 years and above were included, excluding individuals with missing data on BMI, fasting blood glucose (FBG), high-density lipoprotein cholesterol (HDL-C), glycated hemoglobin (HbA1c) and diabetes status. Logistic regression analysis, subgroup analysis, and restricted cubic spline analysis were used to assess the association between METS-IR and T2DM, controlling for potential confounding factors.ResultsAfter adjusting for age, gender, race, education level, smoking status, drinking habits, depression, physical activity, hypertension, and hyperlipidemia, we found a positive association between METS-IR and the risk of T2DM. Specifically, each unit increase in METS-IR was associated with a 7% increase in the risk of T2DM (OR=1.07, 95% CI: 1.06, 1.08). Subgroup analysis showed that the association between METS-IR and T2DM incidence was significantly positive in the highest quartile group, particularly among Mexican Americans over 40 years old and those diagnosed with depression, hypertension, or hyperlipidemia.ConclusionOur study revealed a significant positive association between METS-IR and the prevalence of T2DM, indicating that this relationship persists even after controlling for various confounding factors. Therefore, monitoring METS-IR may provide a valuable tool for the early identification of individuals at risk of glucose metabolism disorders. Further research should focus on the applicability of METS-IR in different populations and its potential impact on clinical practice.
Topical Probiotics Decrease the Severity of Atopic Dermatitis. A Systematic Review and Meta-Analysis of Double-Blind, Randomized, Placebo Control Trials
Authors: Flint Elliot , Ahmad Nabeel , Rowland Kevin , Hildebolt Charles , Raskin David 
Published: August 2024

ABSTRACTAtopic Dermatitis (AD) is a chronic skin disease that commonly appears during childhood but can present at any age. There are many reports showing that probiotics relieve AD symptoms in children. This systematic review and meta-analysis sought to determine the efficacy of topical probiotic treatment for AD in adult populations. A database search was conducted of peer-reviewed, double-blind clinical trials, and studies underwent a systematic exclusion and inclusion process, yielding four that met the criteria. Disease severity, as measured by a standardized scoring tool (SCORAD), was collected, and compared to placebo at two-week and four-week time points. All studies showed improvement in SCORAD in the treatment groups compared to baseline at all time points. Two showed significant decreases in SCORAD after two weeks of treatment, and three studies showed long-lasting improvement after four weeks of treatment. Interestingly, while each study showed a reduction in severity of AD at the two- and four-week time points, a pooled meta-analysis did not show a statistically significant difference between treatment and control at four weeks of treatment. Clinically, there may be benefits to topical probiotic usage as evidenced by the individual studies, more studies need to be performed including adults to show statistical significance.