bluuebunny/crossref_metadata_2025_split huggingface dataset:
AN UNUSUAL WAY TO INDUCE THE CLOSURE OF A POSTERIOR POLE RETINAL TEAR IN A TRAUMATIC RETINAL DETACHMENT
Authors: Angeli Chiara , Di Leo Laura , Frisina Rino 
Published: May 2024

Purpose.
The authors present a case of both traumatic subluxated lens with zonular dialysis and a traumatic retinal detachment with posterior retinal tear.

Methods.
Some fragments have dropped into the vitreous chamber during phaco-emulsification and one of them has even passed through the retinal tear and has been removed from the subretinal space. A 3-piece intraocular lens with a tension ring supporting the capsular bag was implanted. Pars plana vitrectomy with accurate vitreous base shaving was approached by 23-gauge system. Subretinal fluid was removed by a complete fluid-air exchange. A large macular internal limiting membrane (ILM) peeling was performed and the posterior retinal tear was covered by multiple inverted ILM flaps.

Results.
Postoperatively, retinal reattachment was achieved, the retinal break was flat. The ILM flaps were well positioned within the retinal tear and covered the preoperatively bared RPE.

Conclusions.
The surgical treatment of injuries after a blunt ocular trauma are not standardizable. In this case surgical outcomes suggest the effectiveness of the surgeon’s intraoperative unusual maneuvers.
Longitudinal Renal Function Degradation Among Florida Agricultural Workers
Authors: Chicas Roxana C. , Elon Lisa , Xiuhtecutli Nezahualcoyotl , Liang Donghai , Houser Madelyn C. , Mwarumba Tuzo , Berra Liris , Hertzberg Vicki , Sands Jeff M. , McCauley Linda 
Published: May 2024

Objective
This longitudinal study evaluated renal function and acute kidney injury (AKI) over time in US agricultural workers.

Methods
We followed Florida agricultural workers from January 2020 to August 2022, collecting blood and urine preworkday and postworkday during five visits.

Results
Preworkday estimated glomerular filtration rate function in all participants was lower in summers but relatively consistent over time. In participants who worked almost exclusively in fernery operations (piece-rate compensation), we observed a high incidence of postworkday AKI in 2020 (21%) that increased to 43% by the end of the study. In comparison, 11% of nursery workers (hourly compensation) had AKI, and this rate was fairly stable.

Conclusion
AKI risk over time differs according to the type of agricultural work. Piece rate workers who are incentivized to forgo rest breaks and hydration to earn higher wages demonstrate steadily increasing rates of AKI.
Artificial intelligence-based classification of breast lesion from contrast enhanced mammography: a multicenter study
Authors: Zhang Haicheng , Lin Fan , Zheng Tiantian , Gao Jing , Wang Zhongyi , Zhang Kun , Zhang Xiang , Xu Cong , Zhao Feng , Xie Haizhu , Li Qin , Cao Kun , Gu Yajia , Mao Ning 
Published: May 2024

Purpose:
The authors aimed to establish an artificial intelligence (AI)-based method for preoperative diagnosis of breast lesions from contrast enhanced mammography (CEM) and to explore its biological mechanism.

Materials and methods:
This retrospective study includes 1430 eligible patients who underwent CEM examination from June 2017 to July 2022 and were divided into a construction set (n=1101), an internal test set (n=196), and a pooled external test set (n=133). The AI model adopted RefineNet as a backbone network, and an attention sub-network, named convolutional block attention module (CBAM), was built upon the backbone for adaptive feature refinement. An XGBoost classifier was used to integrate the refined deep learning features with clinical characteristics to differentiate benign and malignant breast lesions. The authors further retrained the AI model to distinguish in situ and invasive carcinoma among breast cancer candidates. RNA-sequencing data from 12 patients were used to explore the underlying biological basis of the AI prediction.

Results:
The AI model achieved an area under the curve of 0.932 in diagnosing benign and malignant breast lesions in the pooled external test set, better than the best-performing deep learning model, radiomics model, and radiologists. Moreover, the AI model has also achieved satisfactory results (an area under the curve from 0.788 to 0.824) for the diagnosis of in situ and invasive carcinoma in the test sets. Further, the biological basis exploration revealed that the high-risk group was associated with the pathways such as extracellular matrix organization.

Conclusions:
The AI model based on CEM and clinical characteristics had good predictive performance in the diagnosis of breast lesions.
Update on the use of long-acting growth hormone in children
Authors: Boguszewski Margaret Cristina da Silva , Boguszewski Cesar Luiz 
Published: May 2024

Purpose of review
After extensive research and many years of waiting, long-acting growth hormone (LAGH) formulations have finally become a reality in clinical practice and emerge as a potential solution to address the challenges of daily injections of recombinant human GH (rhGH). In this review, we present a brief history of the development of LAGH and provide a critical analysis of the existing literature on the five LAGH available and approved to date for treatment in children.

Recent findings
In clinical trials, LAGH therapy has shown noninferiority compared with daily rhGH therapy in promoting linear growth in children with GH deficiency, with similar rates of adverse events.

Summary
In the real world, many questions still need to be answered, such as whether a specific group of patients will benefit most from the weekly injection, whether compliance will be better compared with daily rhGH, whether long-term efficacy, monitoring and safety profile will be the same for the different LAGH compounds, and whether the cost-effectiveness will justify their use in different settings.
“Minimally symptomatic” congenital cytomegalovirus infection: latest data and emerging concepts
Authors: Howard Ashley , Nishikawa Javier K. , Sánchez Pablo J. 
Published: May 2024

Purpose of review
Universal and targeted screening of newborns for congenital cytomegalovirus (CMV) infection is increasing globally. Questions remain concerning the management of infants who have been identified with congenital CMV infection, especially those with “minimally symptomatic” or clinically inapparent infection. Our objective is to discuss current management of CMV-infected neonates with a focus on less affected infants with or without sensorineural hearing loss (SNHL).

Recent findings
Valganciclovir is being prescribed increasingly in neonates with congenital CMV infection for improvement in hearing outcomes through 2 years of age. Treatment initiated in the first month of age is recommended for clinically apparent disease. A recent study showed hearing improvement at 18–22 months of age when therapy was initiated at age 1–3 months in infants with clinically inapparent CMV infection and isolated SNHL.

Summary
Antiviral therapy with either ganciclovir or valganciclovir has shown moderate benefit in prevention of hearing deterioration among infants with clinically apparent CMV infection or isolated SNHL. Sustainability of benefit beyond 2 years of age remains unknown. At present, infants with clinically inapparent CMV infection (normal complete evaluation including hearing) should not receive antiviral therapy. All CMV-infected infants require close audiological and neurodevelopmental follow-up.
The impact of vitamin D treatment on pregnancy rate among endometriosis patients: a systematic review and meta-analysis
Authors: Shrateh Oadi N. , Siam Haneen A. , Ashhab Yasmeen S. , Sweity Raneen R. , Naasan Mashhour 
Published: May 2024

Background:
Vitamin D supplementation is supposed to have an important role in the management of several endometriosis-related aspects, offering potential relief to affected individuals. Herein, the authors aim to evaluate the impact of vitamin D on pregnancy rates and clinical symptoms in women with endometriosis.

Methods:
The authors extensively searched PubMed, Cochrane Library, EMBASE, Ovid MEDLINE, and CINAHL from their inception to 20 July 2023.

Results:
Three randomized controlled trials involving 167 patients were included in this meta-analysis. The findings demonstrated that vitamin D supplementation exhibits efficacy in alleviating dysmenorrhea associated with endometriosis, as evidenced by a meta-analysis showing a significant reduction in dysmenorrhea (mean difference −1.41, 95% CI −2.61 to −0.22, P = 0.02). However, the impact on dyspareunia was inconclusive, with a non-significant mean difference of –0.2 (95% CI −1.62 to 1.22, P = 0.78). In contrast, dyschezia significantly decreased with vitamin D supplementation (mean difference −1.10, 95% CI −2.22 to 0.02, P = 0.05 However, the meta-analysis did not show a significant effect of vitamin D on chronic pelvic pain associated with endometriosis.

Conclusion:
While antioxidant vitamin D supplementation demonstrates general effectiveness in alleviating endometriosis symptoms, such as dysmenorrhea, dyspareunia, and dyschezia, the existing literature lacks direct investigations into the specific impact of vitamin D on enhancing pregnancy rates among endometriosis patients. This observation prompts various hypotheses, suggesting that the positive effects of vitamin D supplementation on endometriosis-related symptoms may indirectly contribute to improved pregnancy outcomes and enhanced fertility.
Retropubic Versus Transobturator Midurethral Slings at Time of Colpocleisis
Authors: Wong Jennifer W.H. , Stram Douglas A. , Patel Minita S. 
Published: May 2024

Importance
This study aimed to evaluate if there is a difference between outcomes when retropubic or transobturator midurethral sling surgery is performed at the time of colpocleisis.

Objectives
The purpose of this study was to compare the surgical outcomes of the retropubic midurethral sling (RP-MUS) versus the transobturator midurethral sling (TO-MUS) in women who underwent concomitant colpocleisis, specifically 2-year MUS failure and 1-year lower urinary tract symptoms (LUTSs). A secondary aim was to identify factors associated with these surgical outcomes.

Study Design
All cases of concomitant MUS and colpocleisis within a closed, integrated health care delivery system were reviewed between April 1, 2010, and March 31, 2020. Postoperative MUS failure was defined as (1) postoperative stress urinary incontinence symptoms and/or (2) additional anti-incontinence surgery. Postoperative LUTSs were defined as (1) MUS lysis and/or (2) overactive bladder requiring management with a new treatment.

Results
Of the 558 women included, 454 (81%) received RP-MUS and 104 (19%) received TO-MUS. Cohort demographics were similar. Neither MUS failure (7% RP-MUS and 9% TO-MUS, P = 0.450) nor LUTSs (7% RP-MUS and 12% TO-MUS, P = 0.171) were significantly different between RP-MUS and TO-MUS. In multivariable analysis, age was found to be significantly associated with LUTSs (odds ratio 0.29, 95% confidence interval 0.09–0.93, P = 0.038 among 70–74-year-olds; odds ratio 0.28, 95% confidence interval 0.09–0.83, P = 0.022 among 75–79-year-olds).

Conclusions
At the time of colpocleisis, both RP-MUS and TO-MUS were highly successful and associated with a low incidence of LUTSs, including MUS lysis. The findings of this large study support RP-MUS and TO-MUS as similarly effective anti-incontinence options at time of colpocleisis.
Trauma patients with type O blood exhibit unique multiomics signature with decreased lectin pathway of complement levels
Authors: Stocker Benjamin W. , LaCroix Ian S. , Erickson Christopher , Gallagher Lauren T. , Ramser Benjamin J. , Thielen Otto , Hallas William , Mitra Sanchayita , Moore Ernest E. , Hansen Kirk , D'Alessandro Angelo , Silliman Christopher C. , Cohen Mitchell J. 
Published: May 2024

BACKGROUND
Patients with type O blood may have an increased risk of hemorrhagic complications because of lower baseline levels of von Willebrand factor and factor VIII, but the transition to a mortality difference in trauma is less clear. We hypothesized that type O trauma patients will have differential proteomic and metabolomic signatures in response to trauma beyond von Willebrand factor and factor VIII alone.

METHODS
Patients meeting the highest level of trauma activation criteria were prospectively enrolled. Blood samples were collected upon arrival to the emergency department. Proteomic and metabolomic (multiomics) analyses of these samples were performed using liquid chromatography–mass spectrometry. Demographic, clinical, and multiomics data were compared between patients with type O blood versus all other patients.

RESULTS
There were 288 patients with multiomics data; 146 (51%) had type O blood. Demographics, injury patterns, and initial vital signs and laboratory measurements were not different between groups. Type O patients had increased lengths of stay (7 vs. 6 days, p = 0.041) and a trend toward decreased mortality secondary to traumatic brain injury compared with other causes (traumatic brain injury, 44.4% vs. 87.5%; p = 0.055). Type O patients had decreased levels of mannose-binding lectin and mannose-binding lectin–associated serine proteases 1 and 2, which are required for the initiation of the lectin pathway of complement activation. Type O patients also had metabolite differences signifying energy metabolism and mitochondrial dysfunction.

CONCLUSION
Blood type O patients have a unique multiomics signature, including decreased levels of proteins required to activate the lectin complement pathway. This may lead to overall decreased levels of complement activation and decreased systemic inflammation in the acute phase, possibly leading to a survival advantage, especially in traumatic brain injury. However, this may later impair healing. Future work will need to confirm these associations, and animal studies are needed to test therapeutic targets.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level IV.
Training for a mass casualty incident: Conception, development, and implementation of a crew-resource management course for forward surgical teams
Authors: de Lesquen Henri , Paris Raphael , Lacheze Solenn , de la Villeon Bruno , Menini William , Lamblin Antoine , Vacher Anthony , Balandraud Paul , Pasquier Pierre , Avaro Jean-Philippe 
Published: May 2024

BACKGROUND
Since 2021, the predeployment training of French FSTs has included a simulation-based curriculum consisting of organizational and human factors. The purpose of this article is to describe the development of a crew-resource management (CRM) training course dedicated for the forward surgical teams (FSTs) of the French Military Health Service.

METHODS
The approach was based on three steps: (1) establishment of a conceptual framework of FSTs deployment; (2) development of an aircrew-like CRM training combining lectures, laboratory exercises, and situational training exercises to consider four fundamental “nontechnical” (cognitive and social) skills for effective and safe combat casualty care: (a) leadership, (b) decision-making, (c) coordination, and (d) situational awareness; (3) Implementation of teamwork evaluation tools.

RESULTS
A multidisciplinary team designed a conceptual framework for FST preparedness, 24 French FSTs completed a high-quality training that takes into account both technical and nontechnical skills to maintain quality of combat care during mass-casualty incidents, FSTs' CRM skills were assessed using an audio/video recording of a simulated mass-casualty incident.
Association of timing and agent for venous thromboembolism prophylaxis in patients with severe traumatic brain injury on venous thromboembolism events, mortality, neurosurgical intervention, and discharge disposition
Authors: Johnson Patrick L. , Dualeh Shukri H. A. , Ward Ayobami L. , Jean Raymond A. , Aubry Staci T. , Chapman Alistair J. , Curtiss William J. , Joseph Jacob R. , Scott John W. , Hemmila Mark R. 
Published: May 2024

BACKGROUND
Trauma patients are at increased risk for venous thromboembolism events (VTEs). The decision of when to initiate VTE chemoprophylaxis (VTEP) and with what agent remains controversial in patients with severe traumatic brain injury (TBI).

METHODS
This comparative effectiveness study evaluated the impact of timing and agent for VTEP on outcomes for patients with severe TBI (Abbreviated Injury Scale head score of 3, 4, or 5). Data were collected at 35 Level 1 and 2 trauma centers from January 1, 2017, to June 1, 2022. Patients were placed into analysis cohorts: no VTEP, low-molecular-weight heparin (LMWH) ≤48 hours, LMWH >48 hours, heparin ≤48 hours, and heparin >48 hours. Propensity score matching accounting for patient factors and injury characteristics was used with logistic regression modeling to evaluate in-hospital mortality, VTEs, and discharge disposition. Neurosurgical intervention after initiation of VTEP was used to evaluate extension of intracranial hemorrhage.

RESULTS
Of 12,879 patients, 32% had no VTEP, 36% had LMWH, and 32% had heparin. Overall mortality was 8.3% and lowest among patients receiving LMWH ≤48 hours (4.1%). Venous thromboembolism event rates were lower with use of LMWH (1.6% vs. 4.5%; odds ratio, 2.98; 95% confidence interval, 1.40–6.34; p = 0.005) without increasing mortality or neurosurgical interventions. Venous thromboembolism event rates were lower with early prophylaxis (2.0% vs. 3.5%; odds ratio, 1.76; 95% confidence interval, 1.15–2.71; p = 0.01) without increasing mortality (p = 1.0). Early VTEP was associated with more nonfatal intracranial operations (p < 0.001). However, patients undergoing neurosurgical intervention after VTEP initiation had no difference in rates of mortality, withdrawal of care, or unfavorable discharge disposition (p = 0.7, p = 0.1, p = 0.5).

CONCLUSION
In patients with severe TBI, LMWH usage was associated with lower VTE incidence without increasing mortality or neurosurgical interventions. Initiation of VTEP ≤48 hours decreased VTE incidence and increased nonfatal neurosurgical interventions without affecting mortality. Low-molecular-weight heparin is the preferred VTEP agent for severe TBI, and initiation ≤48 hours should be considered in relation to these risks and benefits.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
A Contemporary Analysis of Mental Well-being Among Living Donor Kidney Applicants
Authors: Levea Swee-Ling , Prasadh Jai G. , Wang Benjamin K. , Salcedo-Betancourt Juan D. , Matevish Lauren , Sanchez Vivaldi Jorge , Lieber Sarah R. , Shah Jigesh A. , Hwang Christine S. , Wojciechowski David , Vagefi Parsia A. , Patel Madhukar S. 
Published: May 2024

Background.
Living donation is paramount for expanding the donor pool. The aim of this study was to assess changes over time in self-reported mental health of living donor kidney applicants in efforts to inform patient-centered discussions with potential donors.

Methods.
Kidney donor applications from 2017 through 2021 were compiled. Data included age, gender, race, ethnicity, applicant–recipient relationship, medical history, and medications. Trends over time were analyzed and post hoc analyses were performed.

Results.
During the study period, 2479 applicants to the living donor kidney program were evaluated; 73% of applicants were female individuals. More than half of applicants were not related to their intended recipient; this fraction increased from 46% in 2017 to 58% in 2021 (P < 0.01). A similar decline in family relations was not present among Black and Latino applicants. Of all applicants, 18% reported depression and 18% reported anxiety; 20% reported taking antidepressants or anxiolytics. Depression and anxiety increased 170% (P < 0.001) and 136% (P < 0.001) from 2018 to 2019, respectively; antidepressant and anxiolytic use rose 138% (P < 0.001) between 2018 and 2020.

Conclusions.
The profile of living donor applicants has changed in recent years, with approximately 1 in 5 requiring antidepressants or anxiolytics. Predonation counseling and postdonation monitoring are imperative to decrease adverse psychological outcomes for living donors.
Video-Language Models as Flexible Social and Physical Reasoners
Authors: Fleury Daniel 
Published: May 2024

AbstractFrom an early age, humans are challenged with evaluating rich environments full of socially and physically grounded concepts. For example, we might be spectating a rapidly unfolding tennis match, anticipating ball trajectories based on players’ body cues and goals. In another scenario, we may engage with long storylines, juggling the mental states of characters with varying knowledge of an unfolding conflict. The complexity of this learning problem is notable as it can be multimodal, integrate information at varying timescales, and implicitly co-attend to social and physical scene properties for downstream reasoning. Large language-vision models like GPT4-V, LLaMA-3, which use vision-language embeddings, show skills in commonsense psychology and physics, though they only process single images. Models like CLIP and VisualBERT encode visual information in high-level cortical areas but do not inherently capture video-level representations. This paper introduces a novel video-language architecture that incorporates pooled video embeddings into LLMs by first extracting spatiotemporal embeddings and mapping them to the model’s decoder through a learnable linear layer. We enhance the model by training it with video-caption pairs from the ADEPT and AGENT datasets, aimed at quantifying “surprisal” in physical and psychological contexts. Finally, we design separate voxel wise encoding models for videos involving physics and psychology using the hidden states and logits from the LLMs last layer and pre-projected CLIP embeddings. We find that hidden state activations can remarkably explain high variance (R^2 up to ∼70%) across dorsal physics regions and highly distributed, ventral social vision areas. Notably, for models trained to only encode physically surprising stimuli, the hidden states andpre-projected CLIP embeddings explain nearly identical regions of variance across the inferior-parietal lobule. However, when the encoding model is trained to encode only socially surprising events, hidden states explain far more distributed ventral and dorsal activations over pre-projected CLIP embeddings.