bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laboratory testing consolidation and total laboratory automation improves service efficiency and effectiveness: a study of a medical center in Taiwan
Authors: Tseng Chih-Wei , Li Ying-Chun , Lee Herng-Sheng , Tseng Yang-Ming 
Published: June 2024

Abstract

Background
Test consolidation and total laboratory automation (TLA) were implemented in a core laboratory with a high volume of specimens in a medical center in Taiwan to reduce the costs of laboratory services and improve laboratory workflow and performance.

Methods
Using a retrospective research approach, 5 stat and 7 routine tests were used to analyze the in-laboratory to report turnaround time (IR-TAT). Mean, SD, medium, 90th percentile, outlier percentage of IR-TAT, full-time equivalents, productivity, tube touch moment (TTM), and financial impact were determined and compared pre- and post-TLA.

Results
The mean IR-TAT of overall stat chemical tests for inpatient and outpatient were 32.8% and 11.9% reductions, respectively. The productivity of each medical technologist increased by 32.4% per month, and there was a reduction of 5 medical technologists compared with the number required to complete the same tests before consolidation. The TTM of staff per year post-TLA decreased by 74.1% tube touches.

Conclusion
The efficiency of laboratory services was improved by consolidation to the core laboratory along with TLA implementation coupled with logic rules such as delta-check and autoverification. Effectiveness was improved as measured by an increase in productivity, labor reduction, staff safety, and cost reduction.
Sloshing and spiral structures breeding a putative radio mini-halo in the environment of a cool-core cluster, Abell 795
Authors: Kadam S K , Salunkhe Sameer , Vagshette N D , Paul Surajit , Sonkamble S S , Pawar P K , Patil M K 
Published: June 2024

ABSTRACT
Spiral structures and cold fronts in X-rays are frequently observed in cool-core galaxy clusters. However, studies on radio mini-haloes associated with such spirals and their physical connections are rare. Here, we present the detection of an extended diffuse radio emission entrained in the X-ray spiral structure in a known cool-core cluster, Abell 795. Though the cool core is a sign of the relaxed nature, our re-analysed 30-ks Chandra X-ray data of Abell 795 confirm the presence of an interesting log spiral structure of an X-ray deficit region complemented by an X-ray excess counter spiral in the residual map, exposing its dynamical activity. Our new analysis of 150- and 325-MHz Giant Metrewave Radio Telescope archival data confirms the detection of a ∼180-kpc ultra-steep (α ∼ −2.7) diffuse radio structure, previously reported as a candidate radio mini-halo from low-sensitive survey maps. This emission spans the entire spiral structure, enclosed by two previously reported cold fronts. Furthermore, optical spectra from the Sloan Digital Sky Survey Data Release 13 and far-ultraviolet data from the Galaxy Evolution Explorer show a considerably low total star formation rate of 2.52 M⊙ yr−1 with no significant variation in metallicity distribution. We argue that the two-phase (hot and cold) plasma at the core with differential velocity has plausibly caused the spiral formation and has redistributed the secondary electrons from the brightest cluster galaxy or the pre-accelerated electrons, which have been (re-)accelerated by the sloshing turbulence to form the observed candidate radio mini-halo structure. This is supported by a few previous studies indicating that spiral formation and sloshing turbulence quenches star formation and facilitates smooth metallicity distribution by mixing the gas in the core.
Community-based HIV Self-testing for Persons Who Use Drugs Can Contribute to Reaching Ending the HIV Epidemic in the US (EHE) Goals
Authors: Assoumou Sabrina A , Bonilla Haley V , Ruiz-Mercado Glorimar , Von Lossnitzer Meg , Baker Richard , Crawford Natalie D , Bernstein Judith A 
Published: June 2024

Abstract
In a pilot study providing HIV self-testing to persons who use drugs (N = 40), we identified 3 new HIV cases when partnering with a community-based organization. Most (82%) participants were interested in preexposure prophylaxis. HIV self-testing could contribute to efforts to Ending the HIV Epidemic in the United States.
ClinicalTrials.gov registration: NCT05528562
A Survey of Judicial Effectiveness: The Last Quarter Century of Empirical Evidence
Authors: Bosio Erica 
Published: June 2024

AbstractCourts around the world are often perceived to be ineffective in the delivery of justice. The resolution of cases takes too long, costs too much, and is biased in favor of the rich and politically connected. These stylized facts motivate judicial reform. With the benefit of a quarter century of empirical research, this paper finds that judicial reform is successful in improving court effectiveness when it coincides with or is motivated by periods of extraordinary politics. We study the four most discussed ingredients of judicial effectiveness—independence, access, efficiency, and quality—and find that transformative judicial reform is most likely to succeed in countries emerging from conflict and violence or those that are pursuing accession to regional or international groups. Absent such conditions, reformers are better off focusing on the adoption of procedural rules that increase the effectiveness of the existing judicial system. The survey highlights procedural reforms that deliver better outcomes.
Assessing Correlations and Demographic Interactions Between PROMIS25 and SRS30 in Pediatric Patients With Spinal Deformity
Authors: Niknam Kian , Less Justin T. , Swarup Ishaan 
Published: June 2024

Introduction:
Historically, patient-reported outcome measures (PROMs) have been measured using anatomy-specific instruments. However, these instruments may be influenced by the presence of concomitant illnesses not associated with the orthopaedic condition. As such, standardized PROM tool, such as PROMIS25, have been developed to assess patient outcomes. In this study, we aim to compare the correlation and association between 2 common PROMs used for pediatric patients with spinal deformity.

Methods:
This study included patients younger than 21 years who were indicated for spinal deformity surgery at our institution. All patients were invited to complete SRS-30 and PROMIS-25 instruments through an automated, electronic patient-reported outcome platform before surgery. Patient demographics were recorded and Spearman correlations were calculated between the various PROMIS and SRS domains. Correlations were compared between different baseline characteristics and demographics using a rho-to-z transformation method. Ceiling and floor effects were also investigated.

Results:
A total of 207 patients were enrolled in this study. The majority of PROMIS and SRS domains had moderate to strong correlations, with higher correlations observed when each instrument tried to capture the same construct. For example, there was strong correlation between PROMIS raw pain and SRS pain (ρ=−0.86, P<0.01), and PROMIS Depression and SRS Mental Health (ρ=−0.76, P<0.01). Ceiling effects ranged from 1.0 to 16.9% in SRS and 0.5 to 28.5% is PROMIS. Floor effects ranged from 0.5 to 1.5% in SRS and 0.5 to 29.0% in PROMIS. There were significant differences in the correlation between SRS Mental Health and PROMIS Depression when comparing between different sexes (male: ρ=−0.74, female: ρ=−0.59, P=0.04). In addition, there were significant differences in the correlation between SRS Mental Health and PROMIS Anxiety when comparing between different insurance payors (commercial: ρ=−0.86, female: ρ=−0.75, P=0.03).

Conclusions:
There is strong correlation between SRS and PROMIS domains in pediatric patients with spinal deformity. These correlations can differ by baseline characteristics and demographics. Providers should consider these differences when interpreting PROMs in diverse patient populations.

Level of Evidence:
Level III; Retrospective comparative study
Assessment of Surgical Complications Strengthen the Relationship Between Spine Surgery Procedure Intensity and Chronic Opioid Use After Surgery
Authors: Rhon Daniel I. , Greenlee Tina A. , Lawson Bryan K. , McCafferty Randall R. , Gill Norman W. 
Published: June 2024

Study Design.
Prospective cohort using routinely collected health data.

Objective.
To compare opioid use based on surgery intensity (low or high).

Summary of Background Data.
Many factors influence an individual’s experience of pain. The extent to which postsurgical opioid use is influenced by the severity of spine surgery is unknown.

Methods.
The participants were individuals undergoing spine surgery in a large military hospital. Procedures were categorized as low intensity (eg, microdiscectomy and laminectomy) and high intensity (eg, fusion and arthroplasty). The Surgical Scheduling System and Military Health System Data Repository were queried for healthcare utilization the 1 year before and after surgery. We compared opioid use after surgery between groups, adjusting for prior opioid use and surgical complications.

Results.
A total of 342 individuals met the inclusion criteria, with mean age 45.4 years (SD 10.9), and 33.0% were women. Of these, 221 (64.6%) underwent a low-intensity procedure and 121 (35.4%) underwent a high-intensity procedure. Mean postoperative opioid prescription fills were greater in the high- versus low-intensity group (9.0 vs. 5.7; P<0.001), as were the mean total days’ supply (158.9 vs. 81.8; P<0.001). Median morphine milligram equivalents (MMEs) were not significantly different (40.2 vs. 42.7; P=0.287). Of the cohort, 26.3% were chronic opioid users after surgery. Adjusted rates of long-term opioid use were not different between groups when only accounting for prior opioid use but significantly higher for the high-intensity group when adjusting for surgical complications (OR=2.08; 95% CI 1.09–3.97). Of the entire cohort, 52.5% was still filling opioid prescriptions after 6 months.

Conclusions.
Higher-intensity procedures were associated with greater postoperative opioid use than lower-intensity procedures. Chronic opioid use was not significantly different between surgical intensity groups when considering only prior opioid use. Chronic opioid use was significantly higher among higher intensity procedures when accounting for surgical complications. The presence of surgical complications is a stronger predictor of postsurgical long-term opioid use in high-intensity surgeries than history of opioid use alone.

Level of Evidence.
Level III.
Efficacy of Biphasic Calcium Phosphate Ceramic With a Needle-Shaped Surface Topography Versus Autograft in Instrumented Posterolateral Spinal Fusion
Authors: Stempels Hilde W. , Lehr A. Mechteld , Delawi Diyar , Hoebink Eric A. , Wiljouw Inge A.A.A. , Kempen Diederik H.R. , van Susante Job L.C. , Kruyt Moyo C. ,   on behalf of the Dutch Clinical Spine Research Group
Published: June 2024

Study Design.
A multicenter randomized controlled noninferiority trial with intrapatient comparisons.

Objective.
The aim of this study was to determine noninferiority of a slowly resorbable biphasic calcium phosphate with submicron microporosity (BCP<μm, MagnetOs Granules) as an alternative for autograft in instrumented posterolateral fusion (PLF).

Summary of Background Data.
Successful spinal fusion with a solid bone bridge between the vertebrae is traditionally achieved by grafting with autologous iliac bone. However, the disadvantages of autografts and unsatisfactory fusion rates have prompted the exploration of alternatives, including ceramics. Nevertheless, clinical evidence for the standalone use of these materials is limited.

Methods.
Adults indicated for instrumented PLF (1 to 6 levels) were enrolled at 5 participating centers. After bilateral instrumentation and fusion-bed preparation, the randomized allocation side (left or right) was disclosed. Per segment 10 cc of BCP<μm granules (1 to 2 mm) were placed in the posterolateral gutter on one side and 10 cc autograft on the contralateral side. Fusion was systematically scored on 1-year follow-up CT scans. The study was powered to detect >15% inferiority with binomial paired comparisons of the fusion performance score per treatment side.

Results.
Of the 100 patients (57 ± 12.9 y, 62% female), 91 subjects and 128 segments were analyzed. The overall posterolateral fusion rate per segment (left and/or right) was 83%. For the BCP<μm side only the fusion rate was 79% versus 47% for the autograft side (difference of 32 percentage points, 95% CI, 23-41). Analysis of the primary outcome confirmed the noninferiority of BCP<μm with an absolute difference in paired proportions of 39.6% (95% CI, 26.8-51.2; p < 0.001).

Conclusion.
This clinical trial demonstrates noninferiority and indicates superiority of MagnetOs Granules as a standalone ceramic when compared to autograft for posterolateral spinal fusion. These results challange the belief that autologous bone is the most optimal graft material.
Deciphering HIV-associated inflammation: microbiome's influence and experimental insights
Authors: Lippincott Ricky A. , O’Connor John , Neff Charles P. , Lozupone Catherine , Palmer Brent E. 
Published: June 2024

Purpose of review
To review novel experimental approaches for studying host:microbe interactions and their role in intestinal and systemic inflammation in people living with HIV (PLWH).

Recent findings
Inflammation in PLWH is impacted by interactions between the microbiome, the intestinal epithelium, and immune cells. This complex interplay is not fully understood and requires a variety of analytical techniques to study. Using a multiomic systems biology approach provides hypothesis generating data on host:microbe interactions that can be used to guide further investigation. The direct interactions between host cells and microbes can be elucidated using peripheral blood mononuclear cells (PBMCs), lamina propria mononuclear cells (LPMC's) or human intestinal organoids (HIO). Additionally, the broader relationship between the host and the microbiome can be explored using animal models such as nonhuman primates and germ-free and double humanized mice.

Summary
To explore complex host:microbe relationships, hypotheses are generated and investigations are guided by multiomic data, while causal components are identified using in-vitro and in-vivo assays.
Incidence of Orbital Mucocele following Orbital Floor Fracture Repair
Authors: Nachabe Adeem M. , Messa Genevieve E. , Boraski Jonathan C. 
Published: June 2024

Summary:
Mucoceles can often present as a complication after prior sinus surgery or maxillofacial trauma when mucosal drainage is obstructed. Their presence in the orbit following orbital wall fracture and subsequent repair represent an exceedingly rare complication whose occurrence is limited to a few reported cases in the literature. In these patients, continuous cyst expansion and subsequent mass effect may lead to ophthalmic symptoms, including orbital pain, proptosis, diplopia, and globe dystopia. We report the discovery of an orbital mucocele after orbital floor fracture repair and its possible association with the nonporous reconstruction plate utilized for fixation. When a patient with history of orbital wall reconstruction presents with new-onset ocular symptoms, an orbital mucocele should be considered as a potential diagnosis.
Nontopical Nitrates in Flap Perfusion and Delay Phenomenon
Authors: Izadpanah Amin , Jansen David A. , Chaffin Abigail E. , Alt Eckhard U. , Izadpanah Reza 
Published: June 2024

Background:
Topical nitrates have demonstrated efficacy in improving flap perfusion. However, evidence for nontopical nitrates in modulation of flap perfusion dynamics has yet to be consolidated. Here, we review evidence regarding the use of intravascular, sublingual, and oral nitrates in modulating flap perfusion.

Methods:
We performed a review of the literature for evidence linking nontopical nitrates and flap perfusion, and included clinical studies, animal studies, and in vitro studies.

Results:
Evidence suggests that intravascular, sublingual, and oral nitrates exert vasodilatory properties, which may be harnessed for identification of perforators and improved flap perfusion. We also found evidence suggesting nitrates may facilitate ischemic preconditioning while reducing ischemia–reperfusion injury.

Conclusions:
Nitrates delivered intravascularly, sublingually, or orally may increase flap perfusion and serve as a method for ischemic preconditioning, particularly in the intraoperative setting.
ORAL CURCUMIN TO REDUCE RISK OF PROLIFERATIVE VITREORETINOPATHY FOLLOWING RHEGMATOGENOUS RETINAL DETACHMENT REPAIR
Authors: Zheng Yuxi , Valikodath Nita , Woodward Richmond , Allen Ariana , Grewal Dilraj S. , Fekrat Sharon 
Published: June 2024

Purpose:
To evaluate outcomes of patients who underwent rhegmatogenous retinal detachment repair and were started on oral curcumin for proliferative vitreoretinopathy (PVR) prevention.

Methods:
Retrospective, observational case series of eyes of patients undergoing high-risk rhegmatogenous retinal detachment repair that was started on curcumin postoperatively. Recommended dosage was 500 mg twice daily for 30 days followed by 500 mg daily for 60 days. The primary outcome was recurrent PVR-related rhegmatogenous retinal detachment within 6 months and a single-surgery retinal reattachment rate. Secondary outcomes included epiretinal membrane formation, visual acuity, and curcumin safety profile.

Results:
Thirty-two eyes of 31 patients met the study inclusion criteria. Postoperatively, 2 eyes developed a PVR-related detachment (6.3%), and 2 eyes redetached due to new breaks without PVR (6.3%). Overall, single-surgery retinal reattachment rate was 87.5%. Single-surgery retinal reattachment rate without silicone oil was 92.6% (25/27). Of the 12 cases with Grade C PVR-related retinal detachment, the single-surgery retinal reattachment rate was 91.7%. Postoperatively, 7 eyes developed an epiretinal membrane (21.9%), of which 3 underwent epiretinal membrane removal (9.4%). No patient had gastrointestinal upset or anemia.

Conclusion:
This proof-of-concept clinical study suggests that oral curcumin is well tolerated and warrants further investigation for its potential to reduce the risk of PVR after rhegmatogenous retinal detachment repair in eyes at higher risk of PVR.
Comparing a Head-Mounted Smartphone Visual Field Analyzer to Standard Automated Perimetry in Glaucoma: A Prospective Study
Authors: Wang Sean K. , Tran Elaine M. , Yan William , Kosaraju Reshma , Sun Yang , Chang Robert T. 
Published: June 2024

Précis:
Wang et al compare an FDA-registered head-mounted smartphone device (PalmScan VF2000) with standard automated perimetry (SAP) in glaucoma patients and find that the head-mounted device may not fully recapitulate SAP testing.

Purpose:
This study prospectively compared visual field testing using the PalmScan VF2000 Visual Field Analyzer, a head-mounted smartphone device, with standard automated perimetry (SAP).

Methods:
Patients with glaucoma undergoing Humphrey Field Analyzer SAP testing were asked to complete in-office PalmScan testing using a Samsung S5 smartphone in a virtual reality-style headset. Glaucoma severity was defined as SAP mean deviation (MD) >−6 dB for mild, between −6 and −12 dB for moderate, and <−12 dB for severe. Global parameters MD and pattern SD from PalmScan and SAP were compared using t-tests and Bland-Altman analyses. Bland-Altmann analyses of PalmScan and SAP MD were conducted for the superonasal, superotemporal, inferonasal, and inferotemporal visual field quadrants. The repeatability of PalmScan was assessed using Spearman’s correlations and intraclass correlation coefficients (ICCs).

Results:
Fifty-one patients (51 eyes) completed both SAP and PalmScan testing and met the criteria for analysis. Compared with SAP, global MD and pattern SD measurements from PalmScan differed by an average of +0.62±0.26 dB (range: −3.25 to +4.60 dB) and −1.00±0.24 dB (range: −6.03 to +2.77 dB), respectively, while MD scores from individual visual field quadrants differed by as much as −6.58 to +11.43 dB. The agreement between PalmScan and SAP in classifying glaucoma severity was 86.3% across all eyes. PalmScan and SAP identified the same quadrant as having the worst visual field defect in 66.7% of eyes.

Conclusions:
Despite advantages in cost and accessibility, the PalmScan head-mounted perimetry device may not be able to fully recapitulate SAP testing.
Challenging diagnosis and repair of an extensive cyclodialysis cleft
Authors: Braudo Sharon , Neuman Gil , Shitrit Noa , Goldberg Mordechai 
Published: June 2024

Introduction:
This report describes a challenging case involving the diagnosis and surgical repair of an extensive cyclodialysis cleft (CDC) in a young, phakic patient.

Patient and Clinical Findings:
A 25-year-old man presented with ocular pain, visual impairment, eyelid hematoma, subconjunctival hemorrhage, and Berlin edema after blunt trauma to the right eye. Initial conservative treatment with medications was converted to surgery due to hypotony-induced maculopathy.

Diagnosis, Intervention, and Outcomes:
Ultrasound biomicroscopy (UBM) and gonioscopy revealed extensive supraciliary and suprachoroidal fluid and a CDC whose dimensions were inconclusive. However, consequent intraoperative UBM provided precise real-time anatomical evidence of an extensive CDC extending 8 clock hours and mandating closure with a direct cycloplexy approach. Layered scleral dissection and direct suturing of the ciliary body to the sclera were performed with 8-0 nylon sutures, resulting in CDC resolution, supraciliary and suprachoroidal fluid absorption, visual acuity improvement, and intraocular pressure stabilization.

Conclusions:
This case highlights the innovative use of intraoperative UBM as a critical tool, offering real-time guidance in managing an extensive CDC. The successful closure and improved visual outcomes in this case further validate the efficacy of direct cycloplexy for extensive CDCs.