bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thyroid Surgery, Voice and the Laryngeal Examination—Time for Increased Awareness and Accurate Evaluation
Authors: Mihai Radu , Randolph Gregory W 
Published: March 2010

ABSTRACT
The low risk of recurrent laryngeal nerve (RLN) injury frequently quoted to patients before thyroid surgery derives from expert series which are selectively reported. Rates of postoperative RLN paralysis increase substantial when postoperative laryngeal exam is performed routinely as opposed to selectively. Only routine pre- and postoperative laryngoscopy would allow individual surgeons/centers to know the exact incidence of RLN injury in their own practice. A surgeon knowing his own results, a clinical setting encouraging honest regular assessment/estimate of postoperative morbidity and an informed patient are all important contributors to improved outcome and diminished litigation after thyroid surgery.
A New Legal Standard for Medical Malpractice
Authors: Aaron Daniel G. , Robertson Christopher T. , King Louise P. , Sage William M. 
Published: February 2025

ImportancePatients in the US have persistent needs for safe, evidence-based care. Physicians in the US report fear of liability risk and the need to practice “defensive medicine.” In 2024, the American Law Institute revised the legal standard for assessing medical negligence. Understanding the implications of this change is crucial for balancing patient safety, physician autonomy, and the legal system’s role in health care.ObservationsThe updated standard from the American Law Institute shifts away from the traditional reliance on customary practice toward a more patient-centered concept of reasonable medical care. Although this revised standard still includes elements of prevailing medical practice, it defines reasonable care as the skill and knowledge regarded as competent among similar medical clinicians under comparable circumstances and acknowledges that, in some cases, juries can override customary practices if they fall short of contemporary standards. The restatement also embraces evidence-based practice guidelines, while leaving questions open about the variations in the quality of those guidelines. The restatement makes additional recommendations regarding informed consent and other aspects of physician-patient communication.Conclusions and RelevanceThe new standard of care from the American Law Institute represents a shift away from strict reliance on medical custom and invites courts to incorporate evidence-based medicine into malpractice law. Although states may adopt the recommendations from the American Law Institute at different times and to varying degrees, the restatement offers health professionals and the organizations in which they practice an opportunity to reconsider how medical negligence will be assessed, and to focus more directly on promoting patient safety and improving care delivery. Nonetheless, physicians should recognize that, at least for now, many courts will continue to rely significantly on prevailing practice in assessing medical liability.
Race and Ethnicity, Lifestyle, Diet, and Survival in Patients With Prostate Cancer
Authors: Wang Anqi , Van Blarigan Erin L. , Cheng Iona , Chan June M. , Wan Peggy , Park Song-Yi , Xiong Wei , Hamilton Ann S. , Chen Fei , Le Marchand Loic , Wilkens Lynne R. , Conti David V. , Kenfield Stacey A. , Haiman Christopher A. 
Published: February 2025

ImportanceProstate cancer (PCa) remains a leading cause of cancer-related death among men in the US.ObjectiveTo evaluate the association of healthy lifestyle and dietary behaviors with survival after a nonmetastatic PCa diagnosis in a multiethnic population.Design, Setting, and ParticipantsThis prospective cohort study was conducted among men aged 45 to 75 years enrolled between 1993 and 1996 in the Multiethnic Cohort study. Participants with nonmetastatic PCa completed a questionnaire after diagnosis (2003-2008) and were followed up until death or loss to follow-up. Data were analyzed from January 10, 2023, to May 20, 2024.ExposuresLifestyle and dietary patterns were assessed after diagnosis using 3 PCa behavior scores and 13 dietary indices (4 prioritized scores: the Healthy Eating Index–2015, Healthful Plant-Based Diet Index, Dietary Inflammatory Index, and Empirical Dietary Index for Hyperinsulinemia).Main Outcomes and MeasuresCox proportional hazards models were used to evaluate multivariable-adjusted associations of each PCa behavior score with all-cause, cardiovascular disease (CVD), and PCa-specific mortality.ResultsA total of 2603 men with nonmetastatic PCa (mean [SD] age, 69.6 [7.1] years) were followed up, and 1346 deaths were documented, including 356 (24.6%) from CVD and 197 (14.6%) from PCa. The median (IQR) follow-up was 10.9 (IQR, 6.8-12.7) years from questionnaire return and 14.5 (IQR, 11.8-18.0) years from diagnosis. The 2021 PCa Behavior Score was associated with reduced risks of all-cause (hazard ratio [HR] per point, 0.69; 95% CI, 0.63-0.77) and CVD-related (HR, 0.67; 95% CI, 0.56-0.79) mortality. This score was also associated with a lower risk of PCa-specific mortality among African American men (HR, 0.46; 95% CI, 0.24-0.88) but not in the other racial and ethnic groups. Comparing quintile 5 (highest score) with 1 (lowest score), the Empirical Dietary Index for Hyperinsulinemia was positively associated with all-cause (HR, 1.37; 95% CI, 1.02-1.84) and CVD-related (HR, 1.96; 95% CI, 1.15-3.33) mortality, whereas the Healthful Plant-Based Diet Index was associated with a reduced risk of all-cause (HR, 0.75; 95% CI, 0.58-0.97); findings for CVD-related mortality were not statistically significant (HR, 0.67; 95% CI, 0.44-1.03). No associations were found between lifestyle or dietary patterns and PCa mortality.Conclusions and RelevanceIn this multiethnic cohort of patients with nonmetastatic PCa, healthier lifestyles were associated with improved overall survival but not with PCa-specific survival. Given the predominance of non–PCa-specific deaths, these findings support the need for health behavior counseling to treat comorbidities in men with PCa.
Genetic Variants and Clinical Features of Patients With Glycogen Storage Disease Type Ib
Authors: Xia Yu , Sun Yu , Du Taozi , Sun Chengkai , Xu Ying , Ge Wensong , Liang Lili , Wang Ruifang , Sun Manqing , Xiao Bing , Qiu Wenjuan 
Published: February 2025

ImportanceGlycogen storage disease type Ib (GSDIb) is a rare metabolic disorder characterized by impaired glucose-6-phosphate transporter function with limited descriptions.ObjectiveTo describe the genetic and clinical features of Chinese patients with GSDIb.Design, Setting, and ParticipantsThis retrospective cohort study retrieved the medical records of 113 Chinese patients with GSDIb treated at a single institution in Shanghai from November 1, 2000, to June 30, 2024.Main Outcomes and MeasuresBiochemical parameters and clinical features (infections, inflammatory bowel disease [IBD], kidney and cardiovascular issues, growth and puberty) at baseline and the last follow-up, all-cause mortality, and mental and social development were assessed.ResultsA total of 113 patients (96 children [85%]; 67 males [59%]) had GSDIb genetically diagnosed at a median age of 1.4 (range, 0.0-35.5) years. Thirty-eight novel SLC37A4 variants were identified. Hypoglycemia and metabolic derangements were the primary concerns in patients aged 2 years or younger (45%). Short stature (75%), infections (75%), and recurrent epistaxis (31%) became more prevalent in patients aged 2.1 to 5.0 years. The frequency of respiratory tract infection decreased after a median age of 7.0 (IQR, 3.5-10.5) years. Forty-four patients (46%) developed IBD at a median age of 6.0 (IQR, 3.0-12.0) years, 14% of whom developed IBD-associated arthritis at a median age of 10.5 (IQR, 5.8-19.6) years. The mean (SD) difference between the z scores of actual height and target height (Δ height z scores) at the final visit (−2.11 [1.76]) did not significantly increase even after uncooked cornstarch treatment. The mean (SD) Δ height z scores of the patients with IBD (−2.99 [1.70]) were significantly lower than those without IBD (mean [SD], −1.36 [1.44]) (P &amp;lt; .001). Ten patients (9%) died due to complications of GSDIb, including metabolic derangements, sepsis, and/or severe pneumonia (n = 8), IBD (n = 1), and pulmonary hypertension (n = 1).Conclusions and RelevanceIn this cohort study, the genetic and clinical spectra of GSDIb were broadened, suggesting associations between GSDIb and bowel, growth, and survival outcomes. To date, no previous study reported IBD-associated arthritis.
Implicit Racial Bias and Unintentional Harm in Vascular Care
Authors: Kalbaugh Corey A. , Beidelman Erika T. , Howard Kerry A. , Witrick Brian , Clark Ashley , McGinigle Katharine L. , Minc Samantha , Alabi Olamide , Hicks Caitlin W. , Gonzalez Andrew A. , Cené Crystal W. , Cykert Samuel 
Published: February 2025

ImportanceImplicit bias may influence physician treatment decisions and contribute to Black-White health disparities. There are limited data linking implicit bias with actual care delivery and outcomes.ObjectiveTo determine whether implicit racial bias is associated with potentially harmful surgical treatment selection for a cohort of patients with peripheral artery disease–related claudication.Design, Setting, and ParticipantsThis survey study, linked with observational registry data, included eligible clinicians who participate in the Vascular Quality Initiative (VQI) among 960 centers. The VQI includes academic medical centers, teaching hospitals, community hospitals, and private practices. Eligible participants included all vascular specialist VQI members (N = 2512), of whom 218 completed the race implicit association test (IAT) and were linkable to procedure-level data. The study was conducted between October 2021 and October 2022.ExposureRace IAT.Main Outcomes and MeasuresClinician-level implicit bias results were linked to patient-level registry data of peripheral revascularization procedures performed for claudication. The adjusted odds of performance of any infrapopliteal procedure by specialist implicit bias and patient race were measured via mixed-effects logistic regression models. Implicit bias as a moderator of the association of infrapopliteal procedures for claudication and patient race with 1-year amputation was assessed as a secondary outcome.ResultsAmong 218 vascular specialists (mean [SD] age, 46 [9] years; 160 [73%] male), 157 (72%) had a pro-White bias. Black patients treated by a physician with pro-White bias had a significant increase in the odds of receiving an infrapopliteal procedure compared with the total sample (adjusted odds ratio [AOR], 1.67; 95% CI, 1.12-2.48). When treated by a specialist with pro-White bias, Black patients had increased odds of 1-year amputation, regardless of anatomic location treated, compared with White patients (AOR, 2.34; 95% CI, 1.20-4.55). Conversely, Black patients treated by a specialist with no bias had similar odds of an infrapopliteal procedure (AOR, 0.93; 95% CI, 0.68-1.26) as the full patient sample and similar odds of 1-year amputation (AOR, 1.29; 95% CI, 0.33-4.99) as White patients.Conclusions and RelevanceThese findings indicate that implicit bias is associated with potentially harmful infrapopliteal procedures for Black patients and contributes to Black-White outcome disparities in the US. These results suggest the need for system-level interventions that transparently identify and warn of procedures not aligned with best practices to reduce the negative influence of implicit bias.
Comparing Community‐Level Social Determinants of Health with Patient Race in Total Hip Arthroplasty Outcomes
Authors: Mehta Bella , Yiyuan Yi , Pearce‐Fisher Diyu , Ho Kaylee , Goodman Susan M. , Parks Michael L. , Wang Fei , Fontana Mark A. , Ibrahim Said , Cram Peter , Caruana Rich 
Published: February 2025

ObjectiveSocial determinants of health (SDOH) including race have a key role in total hip arthroplasty (THA) disparities. We compared the collective influence of community‐level SDOH to individual factors such as race on THA outcomes.MethodsThis retrospective cohort study of the Pennsylvania Health Care Cost Containment Council Database ‐ 2012 to 2018 included 105,336 patients undergoing unilateral primary elective THA. We extracted “community” factors from the US census by geocoding patient zip codes including walkability index, household income, foreign‐born, English proficiency, computer/internet access, unpaid family workers, those lacking health insurances, and education. We trained an explainable boosting machine, a modern form of generalized additive models to predict 90‐day readmission, 90‐day mortality, 1‐year revision, and length of stay (LOS). Mean absolute scores were aggregated to measure variable importance (i.e. variables that contributed most to the prediction).ResultsThe rates of readmission, revision, and mortality were 8%, 1.5%, and 0.3% respectively, with a median LOS of 2 days. Predictive performance measured by area under receiver operating characteristic was 0.76 for mortality, 0.66 for readmission, and 0.57 for 1‐year revision. For LOS, root mean squared error was 0.41 (R2=0.2). The top three predictors of mortality were “community”, discharge location, and age; for readmission they were discharge location, age, and comorbidities; for revision they were community, discharge location, and comorbidities and for LOS they were discharge location, community, and comorbidities.ConclusionCommunity‐level SDOH were significantly more important than individual race in contributing to the prediction of THA outcomes, especially for 90‐day mortality.
Ultra‐Fast Non‐Volatile Resistive Switching Devices with Over 512 Distinct and Stable Levels for Memory and Neuromorphic Computing
Authors: Xiao Ming , Hellenbrand Markus , Strkalj Nives , Bakhit Babak , Sun Zhuotong , Barmpatsalos Nikolaos , Joksas Dovydas , Dou Hongyi , Hu Zedong , Lu Ping , Karki Samip , Kunwar Sundar , Major Jonathan D. , Chen Aiping , Wang Haiyan , Jia Quanxi , Mehonic Adnan , MacManus‐Driscoll Judith L. 
Published: February 2025

AbstractLow‐current multilevel programmability with inherent non‐volatility and high stability of resistance states is required for both multi‐bit memory storage and deep learning accelerators but is difficult to achieve. Here, in a resistive switching system, this work realizes >512 (>9 bits) distinct non‐volatile conductance levels with stable retention for each state with current levels down to the nanoampere range, highly promising for potential integration with small processing nodes with ultra‐low power consumption requirements. This is achieved by demonstrating a new thin film design concept that encompasses three key features: an ultra‐thin epitaxial oxygen ionic switching layer that provides a tunable energy barrier at the bottom electrode, an overcoat amorphous layer that acts as an ion migration barrier for stable state retention, and a partial conductive filament as a localized electronic transport channel to the epitaxial switching layer. A large dynamic resistance range of up to seven orders of magnitude is achieved with reset‐free transitions among intermediate states, and programmability is demonstrated with ultra‐fast (20 ns) pulses. Artificial neural network (ANN) simulations, based on the experimental performance and its non‐idealities, demonstrate close‐to‐ideal inference accuracies for various Modified National Institute of Standards and Technology (MNIST) data sets.
Artificial Modulation of the Hydrogen Evolution Reaction Kinetics via Control of Grain Boundaries Density in Mo2C Through Laser Processing
Authors: Hyeong Seok‐Ki , Moon Byung‐Joon , Lee Aram , Im Min Ji , Yang Hee Yun , Choi Ji‐Hee , Kim Seung‐Il , Moon Ji‐Yun , Park Seoungwoong , Jang Sung Kyu , Kim Tae‐Wook , Lee Jae‐Hyun , Bae Sukang , Lee Seoung‐Ki 
Published: February 2025

AbstractMo2C‐based electrocatalysts have emerged as promising alternatives to Pt noble metals for hydrogen production, owing to their high catalytic activity. However, the catalytic efficiency of Mo2C is highly sensitive to factors such as surface termination, morphology, and support. Therefore, it is crucial to develop systematic crystal structure engineering methods to precisely modulate the activity, thereby enhancing both catalytic efficiency and stability. In this study, laser‐based material processing is employed to modulate the microstructure of Mo2C catalysts, with a focus on grain size control and developing a grain boundary (GB)‐rich structure to enhance the kinetics of hydrogen evolution reaction (HER). Laser‐based thermal control promoted the formation of fine and uniformly distributed Mo2C grains (15.6 ± 5 nm) and high‐density GBs (130 µm−1). High‐angle GBs, which occupy most Mo2C GBs, enhance electrochemically active sites, facilitate electron transfer, and shift the work function to 5.10 eV, thereby reducing hydrogen adsorption energy. In addition, electrochemical tests reveal a significant decrease in overpotential (148 mV at 10 mA cm−2) and improve Tafel slopes (67.6 mV dec−1), confirming the enhanced kinetics of the HER. This laser‐induced GB engineering strategy opens a new pathway for designing high‐performance Mo2C‐based electrocatalysts, advancing next‐generation hydrogen production technologies.
Bimetallic MnZnSX Nanotheranostics for Self‐Activatable Chemo‐Immunotherapy of Hepatocellular Carcinoma via H₂S‐Triggered Arsenic Prodrug Activation and Binary cGAS‐STING Pathway Modulation
Authors: Cheng WeiYi , Peng Xuqi , He Li , Ren WeiYe , Chen JingQuan , Tang XiaoQian , Bao Dandan , Liu Gang , Jiang Lai , Piao Ji‐Gang 
Published: February 2025

AbstractArsenic trioxide (As2O3) has long been utilized in traditional Chinese medicine due to its therapeutic properties. While it exhibits potent anticancer activity, its clinical application is hindered by systemic toxicity and limited tissue specificity. In this study, an advanced therapeutic approach is developed using arsenic prodrug‐loaded bimetallic sulfide MnZnSX nanorods (As‐MnZnSX NRs) to enhance both the efficacy and safety of As2O3 in hepatocellular carcinoma treatment. These nanorods are engineered to release Mn2+ and H2S within the tumor microenvironment, facilitating binary‐cooperative activation of the cGAS‐STING pathway. This dual activation mechanism enhances immune responses while converting the arsenic prodrug into its cytotoxic form, AsIII. The results demonstrate that Mn2+ amplifies the cGAS‐STING pathway by inducing TBK1 phosphorylation and IRF3 activation, leading to dendritic cell maturation and improved tumor antigen cross‐presentation. Simultaneously, H2S promotes prodrug conversion and enhances immune activation, collectively driving binary stimulation of the cGAS‐STING pathway. This strategy significantly augments the antitumor efficacy of As2O3 by integrating immune modulation with targeted cytotoxic effects. Furthermore, MnZnSX nanorods enable in vivo MRI, allowing real‐time monitoring of treatment progression. This study represents a substantial advancement in liver cancer therapy by integrating chemoimmunotherapy with diagnostic imaging, thereby improving therapeutic precision while minimizing systemic toxicity.
The Phase‐Transited Lysozyme Coating Modified Small Intestinal Submucosa Membrane Loaded with Calcium and Zinc Ions for Enhanced Bone Regeneration
Authors: Yang Yilin , Tong Tianyi , Li Xin , Zheng Hong , Yao Shiyu , Deng Jiayin , Zhang Qi , Liu Zihao , Huang Xin , Li Hongjie , Mu Yuzhu , Ma Shiqing 
Published: February 2025

AbstractBone defects caused by severe trauma, tumors, infections and diseases remain a global challenge due to limited natural regeneration capacity of bone tissue in large‐scale or complex injuries. Guided bone regeneration (GBR) has emerged as a pivotal technique in addressing these issues, relying on barrier membranes to facilitate osteoprogenitor cell infiltration. Current clinical GBR membranes function solely as physical barriers, lacking antibacterial and osteoinductive properties, which underscores the need for advanced alternatives. This study focuses on resorbable GBR membranes made from small intestinal submucosa (SIS), known for biocompatibility and tissue regeneration but hindered by low mechanical strength and rapid degradation. In addition, SIS lacks both antibacterial properties and strong osteogenic capabilities. Enhancements involve crosslinking treatment and dual incorporation of calcium (Ca2+) and zinc (Zn2+), which address the physical property shortcomings and synergistically boost osteoinductivity by activating osteogenic signaling pathways. Additionally, phase‐transited lysozyme (PTL) nanofilm technique enables efficient ion loading and controlled release, while offering antibacterial properties. In this study, a multifunctional SIS membrane is constructed by PTL‐ions layers, providing a potential solution to the challenge of clinical bone defects.
Radioactive Diselenide Bonded Covalent Organic Framework
Authors: Zhang Liang , Wang Shuo , Yang Qi‐Chao , Song An , Wang Yuan‐Yuan , Wang Wen‐Da , Zhang Meng‐Jie , Li Hao , Sun Zhi‐Jun , Deng Hexiang 
Published: February 2025

AbstractCovalent organic frameworks (COFs) are porous crystals of high potential in biomedical applications. The chemical bonds within COF structures are critical for the overall therapeutic performance. Here, the design and synthesis of radioactive COF are reported by introducing labile diselenide bonds into the structure backbone. This diselenide bonded COF, PorSe‐CuPt, constructed from Cu and Pt ion porphyrin units, is capable of bond cleavage upon irradiation, thus releasing the drug molecule, CBL0137, carried in the pores. Concerted with the promotion of X‐ray absorption by Pt2⁺ and the enrichment of oxygen by Cu2⁺, robust PANoptosis is achieved as well as improved immunosuppressive tumor microenvironment, thereby drastically enhancing the overall effectiveness of radiotherapy. The integration of diselenide bonds into the COF backbone demonstrates the possible application of clip‐off chemistry in the search for highly responsible and compatible biomaterials.
Advancements in Understanding the Physicochemical Properties of Reticular Materials: An In Situ and Operando Spectroscopic Perspective
Authors: Baumgartner Bettina , Wach Anna , Ye Xinwei , Ploetz Evelyn , Weckhuysen Bert M. 
Published: February 2025

AbstractThe application of in situ and operando spectroscopic techniques has significantly advanced the understanding of reticular materials, particularly metal–organic frameworks (MOFs) and covalent organic frameworks (COFs). These techniques offer real‐time insights into the dynamic structural, electronic, and chemical changes that occur within these materials during various processes, such as catalysis, sorption, and material synthesis. This review offers a comprehensive overview of key in situ and operando techniques used to investigate the formation, functionalization, and catalytic behavior of reticular materials. How these techniques have elucidated the roles of active sites, reaction intermediates, and structural transformations under reaction conditions, especially in single‐site catalysis, electrocatalysis, and photocatalysis, is highlighted. The review also discusses the challenges and opportunities that lie ahead in integrating advanced spectroscopic methods with reticular materials, aiming to foster further innovation in the design and application of these versatile materials.