bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prostate-specific membrane antigen-PET/CT may result in stage migration in prostate cancer: performances, quantitative analysis, and potential criticism in the clinical practice
Authors: Alongi Pierpaolo , Messina Marco , Pepe Alessio , Arnone Annachiara , Vultaggio Viola , Longo Costanza , Fiasconaro Elisa , Mirabile Alessia , Ricapito Rosaria , Blasi Livio , Arnone Gaspare , Messina Carlo 
Published: June 2024

Aim
The early detection of prostate cancer (PCa) metastatic disease with PET imaging leads to stage migration and change of disease management. We aimed to assess the impact on clinical management deriving from prostate-specific membrane antigen (PSMA) imaging with a digital PET/CT during the routine application in the staging and restaging process of PCa.

Material and methods
Eighty consecutive PCa patients underwent 18F-PSMA-1007. Digital PET/CT were retrospectively evaluated and discussed with oncologists to evaluate the impact on clinical management. Performances analysis, correlation among variables also considering semiquantitative parameters have been conducted.

Results
In the whole group of 80 patients at staging (N = 31) and restaging (N = 49), the detection rate of PSMA PET was 85% for all lesions. At staging, the performance analysis resulted in sensitivity 77.6%, specificity 89.5%, negative predictive value (NPV) 77.6%, positive predictive value (PPV) 89.5%, accuracy 85.7%, and area under curve (AUC) 0.87%. The performance of restaging PET in the group of patients with PSA values <1 ng/ml resulted in the following values: sensitivity 66.7%, specificity 92.9%, NPV 85.7%, PPV 81.3%, accuracy 82.6%, and AUC 0.79. Semiquantitative analysis revealed a mean value of SUVmax, metabolic tumor volume, and total lesion PSMA expression with differences in patients with high risk compared to low intermediate. At restaging PET, semiquantitative values of patients with total prostate specific antigen (tPSA) ≤ 1 ng/ml were significantly less than those of the tPSA > 1 ng/ml. A significant impact on clinical management was reported in 46/80 patients (57.5%) based on PSMA PET findings at staging and restaging.

Conclusion
Although PSMA-PET provides optimal performances, its current role in redefining a better staging should be translated in the current clinical scenario about potential improvement in clinical/survival outcomes.
Predictive significance of intraprostatic volumetric parameters derived from early and standard time 68Ga-PSMA PET/CT images in newly diagnosed prostate cancer patients
Authors: Erdogan Ezgi Basak , Tekce Ertugrul , Koca Serhat , Aslan Nesrin , Toluk Ozlem , Aydin Mehmet 
Published: June 2024

Objective
To investigate the relationship between intraprostatic 68Ga-prostate-specific membrane antigen (PSMA) uptake values and volumetric parameters derived from early pelvic and standard-time whole-body 68Ga-PSMA PET/computed tomography (CT) images in untreated prostate cancer (PCa) patients, and to assess the predictive significance of these data in relation to disease prognosis, comparing them with the Gleason score, clinical risk classification and the presence of metastatic disease detected in 68Ga-PSMA PET/CT imaging.

Methods
Eighty-one newly diagnosed PCa patients underwent early phase pelvic imaging at the 5th minute and standard time whole-body imaging at the 60th minute. Various threshold values were used in intraprostatic delineations to compute maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), intraprostatic PSMA tumor volume and intraprostatic total lesion PSMA uptake. Correlations between early and standard time measurements, as well as changes in SUV parameters over time, were examined. The association of these values with Gleason score, clinical risk status (National Comprehensive Cancer Network), and metastatic disease was explored.

Results
SUVmax measurements from both early and standard time images distinguished all three groups (clinical risk scores, Gleason score and metastatic group), with standard imaging demonstrating statistical superiority in receiver operating characteristic analyses. Strong correlations were observed between early and standard-time PET parameters. Changes in intraprostatic SUVmax and SUVmean values over time did not exhibit predictive value.

Conclusion
Although intraprostatic PSMA PET parameters generally aligned at both early and standard times, parameters obtained from standard time images showed more robust correlations with clinical risk scores, Gleason score and metastasis status in newly diagnosed, untreated PCa patients.
The nonsalvageable tibia: amputation and prosthetics
Authors: Rivero Steven , Stevens Nicole M. 
Published: June 2024

Abstract
Mangled extremities are a challenging problem for the orthopaedic surgeon. The decision for salvage versus amputation is multifactorial. Several work groups have attempted to create scoring systems to guide treatment, but each case must be regarded individually. As surgical technique and prosthetics continue to improve, amputations should be seen as a viable reconstructive option, rather than failure. This article reviews scoring systems for the mangled extremity, outcomes on salvage versus amputation, amputation surgical technique, and prosthetic options.
Tibial bone loss
Authors: Schaffler Benjamin C. , Konda Sanjit R. 
Published: June 2024

Abstract
Critical bone loss after open fractures, while relatively uncommon, occurs most frequently in high-energy injuries. Fractures of the tibia account for the majority of open fractures with significant bone loss. A number of different surgical strategies exist for treatment of tibial bone loss, all with different advantages and disadvantages. Care should be taken by the surgeon to review appropriate indications and all relevant evidence before selecting a strategy.
Aerosol Box Use in Reducing Health Care Worker Contamination During Airway Procedures (AIRWAY) Study: Secondary Workload and Provider Outcomes in a Simulation-Based Trial*
Authors: Singer Harel Dana , Lin Yiqun , Lo Carl Y. , Cheng Adam , Davidson Jennifer , Chang Todd P. , Matava Clyde , Buyck Michael , Neveu Guylaine , Collia Natasha , Fayyaz Jabeen , Manshadi Keya , Levy Arielle , Pellerin Stephanie , Pirie Jonathan ,   for the International Network for Simulation-based Pediatric Innovation, Research, and Education Aerosol Generating Medical Procedures (INSPIRE AGMP) Investigators
Published: June 2024

OBJECTIVES:
An aerosol box aims to reduce the risk of healthcare provider (HCP) exposure to infections during aerosol generating medical procedures (AGMPs), but little is known about its impact on workload of team members. We conducted a secondary analysis of data from a prospective, multicenter, randomized controlled trial evaluating the impact of aerosol box use on patterns of HCP contamination during AGMPs. The objectives of this study are to: 1) evaluate the effect of aerosol box use on HCP workload, 2) identify factors associated with HCP workload when using an aerosol box, and 3) describe the challenges perceived by HCPs of aerosol box use.

DESIGN:
Simulation-based randomized trial, conducted from May to December 2021.

SETTING:
Four pediatric simulation centers.

SUBJECTS:
Teams of two HCPs were randomly assigned to control (no aerosol box) or intervention groups (aerosol box).

INTERVENTIONS:
Each team performed three scenarios requiring different pediatric airway management (bag-valve-mask [BVM] ventilation, laryngeal mask airway [LMA] insertion, and endotracheal intubation [ETI] with video laryngoscopy) on a simulated COVID-19 patient. National Aeronautics and Space Administration-Task Load Index (NASA-TLX) is a standard tool that measures subjective workload with six subscales.

MEASUREMENTS AND MAIN RESULTS:
A total of 64 teams (128 participants) were recruited. The use of aerosol box was associated with significantly higher frustration during LMA insertion (28.71 vs. 17.42; mean difference, 11.29; 95% CI, 0.92–21.66; p = 0.033). For ETI, there was a significant increase in most subscales in the intervention group, but there was no significant difference for BMV. Average NASA-TLX scores were all in the “low” range for both groups (range: control BVM 23.06, sd 13.91 to intervention ETI 38.15; sd 20.45). The effect of provider role on workloads was statistically significant only for physical demand (p = 0.001). As the complexity of procedure increased (BVM → LMA → ETI), the workload increased in all six subscales (p < 0.05).

CONCLUSIONS:
The use of aerosol box increased workload during ETI but not with BVM and LMA insertion. Overall workload scores remained in the “low” range, and there was no significant difference between airway provider and assistant.
Social Determinants of Health and Health-Related Quality of Life Following Pediatric Septic Shock: Secondary Analysis of the Life After Pediatric Sepsis Evaluation Dataset, 2014–2017*
Authors: Lenz Kyle B. , McDade Jessica , Petrozzi Mariagrazia , Dervan Leslie A. , Beckstead Rylee , Banks Russell K. , Reeder Ron W. , Meert Kathleen L. , Zimmerman Jerry , Killien Elizabeth Y. 
Published: June 2024

OBJECTIVES:Social determinants of health (SDOH) are associated with disparities in disease severity and in-hospital outcomes among critically ill children. It is unknown whether SDOH are associated with later outcomes. We evaluated associations between SDOH measures and mortality, new functional morbidity, and health-related quality of life (HRQL) decline among children surviving septic shock.DESIGN:Secondary analysis of the Life After Pediatric Sepsis Evaluation (LAPSE) prospective cohort study was conducted between 2014 and 2017.SETTING:Twelve academic U.S. PICUs were involved in the study.PATIENTS:Children younger than 18 years with community-acquired septic shock were involved in the study.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:We assessed associations between race, ethnicity, income, education, marital status, insurance, language, and home U.S. postal code with day 28 mortality, new functional morbidity at discharge per day 28, and HRQL decline using logistic regression. Of 389 patients, 32% (n= 98) of families had household income less than $50,000 per year. Median Pediatric Risk of Mortality (PRISM) score was 11 (interquartile range 6, 17). We found that English language and Area Deprivation Index less than 50th percentile were associated with higher PRISM scores. Mortality was 6.7% (n= 26), new functional morbidity occurred in 21.8% (n= 78) of patients, and HRQL decline by greater than 10% occurred in 31.0% of patients (n= 63). We failed to identify any association between SDOH measures and mortality, new functional morbidity, or HRQL decline. We are unable to exclude the possibility that annual household income greater than or equal to $50,000 was associated with up to 81% lesser odds of mortality and, in survivors, more than three-fold greater odds of HRQL decline by greater than 10%.CONCLUSIONS:In this secondary analysis of the 2014–2017 LAPSE dataset, we failed to identify any association between SDOH measures and in-hospital or postdischarge outcomes following pediatric septic shock. This finding may be reflective of the high illness severity and single disease (sepsis) of the cohort, with contribution of clinical factors to functional and HRQL outcomes predominating over prehospital and posthospital SDOH factors.
Reaching for 90:90:90 in Correctional Facilities in South Africa and Zambia: Virtual Cross-Section of Coverage of HIV Testing and Antiretroviral Therapy During Universal Test and Treat Implementation
Authors: Hoffmann Christopher J. , Herce Michael E. , Chimoyi Lucy , Smith Helene J. , Tlali Mpho , Olivier Cobus J. , Topp Stephanie M. , Muyoyeta Monde , Reid Stewart E. , Hausler Harry , Charalambous Salome , Fielding Katherine 
Published: June 2024

Background:
People in correctional settings are a key population for HIV epidemic control. We sought to demonstrate scale-up of universal test and treat in correctional facilities in South Africa and Zambia through a virtual cross-sectional analysis.

Methods:
We used routine data on 2 dates: At the start of universal test and treat implementation (time 1, T1) and 1 year later (time 2, T2). We obtained correctional facility census lists for the selected dates and matched HIV testing and treatment data to generate virtual cross-sections of HIV care continuum indicators.

Results:
In the South African site, there were 4193 and 3868 people in the facility at times T1 and T2; 43% and 36% were matched with HIV testing or treatment data, respectively. At T1 and T2, respectively, 1803 (43%) and 1386 (36%) had known HIV status, 804 (19%) and 845 (21%) were known to be living with HIV, and 60% and 56% of those with known HIV were receiving antiretroviral therapy (ART). In the Zambian site, there were 1467 and 1366 people in the facility at times T1 and T2; 58% and 92% were matched with HIV testing or treatment data, respectively. At T1 and T2, respectively, 857 (59%) and 1263 (92%) had known HIV status, 277 (19%) and 647 (47%) were known to be living with HIV, and 68% and 68% of those with known HIV were receiving ART.

Conclusions:
This virtual cross-sectional analysis identified gaps in HIV testing coverage, and ART initiation that was not clearly demonstrated by prior cohort-based studies.
Identifying Independent Predictors of Short-Term Postoperative Morbidity in Patients Undergoing Cranioplasty
Authors: Bajaj Anitesh , Khazanchi Rushmin , Sadagopan Nishanth S. , Weissman Joshua P. , Gosain Arun K. 
Published: June 2024

Background:
The present study intends to identify independent predictors of short-term postoperative complications and health utilization in patients undergoing cranioplasty.

Methods:
Demographic, clinical, and intraoperative characteristics were collected for each patient undergoing cranioplasty in the National Surgery Quality Improvement Program database from 2011 to 2020. The 30-day outcomes analyzed were medical complications, wound complications, return to the operating room, extended hospital stay, and non-home discharge. Bivariate analyses were initially used to identify variables that yielded a P value less than 0.2 which were subsequently analyzed in a multivariate logistic regression to identify independent predictors of the aforementioned outcomes.

Results:
In total, 2316 patients undergoing cranioplasty were included in the analysis. Increased operative time and totally dependent functional status significantly increased odds of returning to the operating room. Increased age, operative time, cranioplasty size >5 cm, and various comorbidities were associated with increased odds of non-home discharge. Bleeding disorders were independently associated with increased odds of wound complications. Increased age, operative time, cranioplasty size >5 cm, and several medical history features predisposed to medical complications. Demographic characteristics, including age and race, along with various operative and medical history characteristics were associated with increased odds of extended length of stay.

Conclusions
Identification of risk factors can help guide preoperative risk management in cranioplasty.
Hypoglobus, Exophthalmos, and Interpupillary Distance: Measuring Globe Dystopia in Thyroid Eye Disease
Authors: Saffari Persiana S. , Nesemann John , Katsev Blake , Palileo Bea Martina U. , Yeganeh Amir , Mustak Hamzah , Wang Yi , Rootman Daniel B. 
Published: June 2024

Purpose:
Thyroid eye disease (TED) is characterized by a variety of disfiguring periocular changes. Vertical globe changes affecting the relative position of the eyelids are not well understood in patients with TED. This study seeks to determine the effect of orbital decompression on vertical globe displacement in patients with TED, without TED, and with intraconal tumor (ICT).

Methods:
For this cross-sectional study, a clinical database was used to identify patients with TED. Comparison groups were drawn from separate anonymized databases. Vertical position and interpupillary distance (IPD) were measured from photographs and exophthalmos was measured via Hertel’s exophthalmometer. Primary outcomes were vertical globe position at baseline and postoperatively in patients with TED and ICT. Secondary outcomes included the relationship between vertical globe position, exophthalmos, and IPD.

Results:
Among 269 participants meeting the inclusion criteria, mean vertical globe position was significantly lower in patients with TED following lateral decompression surgery compared to controls, after accounting for race, age, and sex. While patients with ICT had a significant difference in preoperative and postoperative IPD, patients with TED did not. Medial or inferior decompression did not significantly change globe position and lateral decompression did not cause lateral canthal dystopia in patients with TED. No association between postoperative changes in exophthalmometry, IPD, and globe position was found in patients with TED.

Conclusions:
Patients with TED experience hypoglobus that does not improve following decompression surgery. There was no correlation between change in vertical globe position and exophthalmos or IPD among patients with TED. Surgeons should discuss the possibility of hypoglobus as a persistent finding for patients with TED undergoing decompression surgery.
Does Free Fibular Flap Reconstruction Affect the Quality of Life in Pediatric Patients With Various Extend of Mandible Defects?
Authors: Atmodiwirjo Parintosa , Bangun Kristaninta , Rachadian Ramadan Mohamad , Tania Vika , Djohan Michael , Ralena Nadhira Anindita , Amanda Nadira Fildza 
Published: June 2024

Background:
The long-term outcomes in pediatric patients with various extents of mandible defects have not been well-documented.

Methods:
A retrospective case series in which this study looked at pediatric patients under the age of 13 who had mandibular reconstruction with free fibular flap and had not received another operation in the previous 6 months. The eating, swallowing, speech function, and quality of life are evaluated with EORTC QLQ-H&N35 after the mandible growth spurt has occurred.

Results:
A total of 7 patients were included in this study with operation ages ranging from 6 years 1 month to 12 years 2 months. The etiology of malignant tumors was found in 2 patients and benign tumors in 5 patients. The mandibular defect distribution consists of 1 class Ic, 1 class II, 2 class IIc, 2 class III, and 1 class IVc. All patients reported no swallowing or speech difficulties. However, transient eating trouble was seen in 1 patient due to the extensive defect size that causes tooth loss. Only 1 patient received dental rehabilitation. The patients displayed an overall good quality of life with an average score of 2.857.

Conclusions:
Free fibular flap for mandibular reconstruction in children who have not reached their mandibular growth peak have a satisfying outcome, both in their function and quality of life.
Cardenolides in the defensive fluid of adult large milkweed bugs have differential potency on vertebrate and invertebrate predator Na
+
/K
+
-ATPases
Authors: Rubiano-Buitrago P. , Pradhan S. , Aceves A. A. , Mohammadi S. , Paetz C. , Rowland H. M. 
Published: June 2024

Aposematic animals rely on diverse secondary metabolites for defence. Various hypotheses, such as competition, life history and multifunctionality, have been posited to explain defence variability and diversity. We investigate the compound selectivity hypothesis using large milkweed bugs,
Oncopeltus fasciatus
, to determine if distinct cardenolides vary in toxicity to different predators. We quantify cardenolides in the bug’s defensive secretions and body tissues and test the individual compounds against predator target sites, the Na
+
/K
+
-ATPases, that are predicted to differ in sensitivity. Frugoside, gofruside, glucopyranosyl frugoside and glucopyranosyl gofruside were the dominant cardenolides in the body tissues of the insects, whereas the two monoglycosidic cardenolides—frugoside and gofruside—were the most abundant in the defensive fluid. These monoglycosidic cardenolides were highly toxic (IC
50
< 1 μM) to an invertebrate and a sensitive vertebrate enzyme, in comparison to the glucosylated compounds. Gofruside was the weakest inhibitor for a putatively resistant vertebrate predator. Glucopyranosyl calotropin, found in only 60% of bugs, was also an effective inhibitor of sensitive vertebrate enzymes. Our results suggest that the compounds sequestered by
O. fasciatus
probably provide consistency in protection against a range of predators and underscore the need to consider predator communities in prey defence evolution.
Comprehensive Druggable Genome-Wide Mendelian Randomization Reveals Therapeutic Targets for Kidney Diseases
Authors: Su Zhihang , Wan Qijun 
Published: June 2024

AbstractBackgroundKidney diseases, including membranous nephropathy (MN), IgA nephropathy (IgAN), and chronic kidney disease (CKD), pose significant global health challenges due to their high prevalence and severe outcomes. There is still an urgent need to discover new targets for treating kidney diseases. Mendelian randomization (MR) has been widely used to repurpose licensed drugs and discover novel therapeutic targets. Thus, we aimed to identify novel therapeutic targets for Kidney diseases and analyze their pathophysiological mechanisms and potential side effects.MethodsIntegrated with currently available druggable genes, Summary-data-based MR (SMR) analysis was conducted to estimate the causal effects of blood expression quantitative trait loci (eQTLs) on kidney diseases. A study was replicated using distinct blood eQTL and diseases genome-wide association study (GWAS) data sources to validate the identified genes. The eQTL data was obtained from eQTLGen and GTEx v8.0, with sample sizes of 31,684 and 15,201, respectively. The data on kidney diseases was sourced from the Kiryluk Lab, CKDgen, and the Finngen consortium, with sample sizes ranging from 7,979 to 412,181. Subsequently, reverse two-sample MR and colocalization analysis were employed for further validation. Finally, the potential side effects of the identified key genes in treating kidney diseases were assessed using phenome-wide MR and mediation MR.ResultsAfter correcting for the false discovery rate, a total of 20, 23, and 6 unique potential genes were found to have causal relationships with MN, IgAN, and CKD, respectively. Among them, MN showed validated associations with one gene (HCG18), IgAN demonstrated associations with four genes (AFF3, CYP21A2, DPH3, HLA-DRB5), and chronic kidney disease (CKD) displayed an association with one gene (HLA-DQB1-AS1). Several of these key genes are druggable genes. Further phenome-wide MR analysis revealed that certain genes may be associated with diabetes, fat metabolism, and infectious diseases, suggesting that these factors could potentially serve as mediators.ConclusionsThis study presents genetic evidence that supports the potential therapeutic benefits of targeting these key genes for treating kidney diseases. This is significant in prioritizing the development of drugs for kidney diseases.