bluuebunny/crossref_metadata_2025_split huggingface dataset:
16s RNA-based metagenomics reveal previously unreported gut microbiota associated with reactive arthritis and undifferentiated peripheral spondyloarthritis
Authors: Ahmed Sakir , Mahapatra Soumendu , Mishra Rasmita , Murmu Krushna Chandra , Padhan Prasanta , Prasad Punit , Misra Ramnath 
Published: March 2024

Abstract

Objectives
Reactive arthritis (ReA) provides a unique opportunity to comprehend how a mucosal infection leads to inflammatory arthritis at a distant site without the apparent invasion of the pathogen. Unfortunately, conventional stool cultures after ReA provide limited information, and there is a dearth of metagenomic studies in ReA. The objective of this study was to identify gut microbiota associated with the development of ReA.

Methods
Patients with ReA or undifferentiated peripheral spondyloarthritis (UpSpA) were included if they presented within 4 weeks of the onset of the current episode of arthritis. Metagenomic DNA was extracted from the stools of these patients and of 36 age- and sex-similar controls. Sequencing and analysis were done using a standard 16S ribosomal pipeline.

Results
Of 55 patients, there was no difference between the gut microbiota of postdiarrheal ReA (n = 20) and of upSpA (n = 35). Comparing the gut microbiota of patients vs healthy controls, the patients had significantly higher alpha and beta diversity measures. After stringency filters, Proteobacteria had high abundance while Firmicutes had lesser as compared with the controls. Six families were overexpressed in patients, while another five were overexpressed in controls. Sixteen genera and 18 species were significantly different between patients and controls. At the species level there was strong association of Staphylococcus aureus, Clostridium septicum Klebsiella pneumoniae, Escherichia coli, Empedobacter brevis, Roseburia hominis, Bacillus velezensis and Crassaminicella with ReA.

Conclusion
The microbiota of classical gut-associated ReA and upSpA is similar. Patients have higher diversities in their gut microbiota compared with healthy controls. Both known and previously unreported species associated with ReA/upSpA were identified.
Effect of creep feeding pelleted starter diet, liquid milk replacer and a liquid mixture of starter diet and milk replacer to suckling pigs on their growth and medication usage
Authors: Arnaud Elisa A , Gardiner Gillian  E , Chombart Matthieu , O’ Doherty John V , Sweeney Torres  , Lawlor Peadar G 
Published: March 2024

AbstractThe aim of this study was to assess the effect of creep-feeding solid starter diet, liquid milk replacer, and a liquid mixture of starter diet and milk replacer to suckling pigs on their growth and medication usage up to target slaughter weight (approximately 120 kg). Ninety-one sows and their litters were randomly assigned to one of four post-farrowing treatments at day 107 of gestation; (1) no creep feed provided to weaning at day 28 of age (CONTROL; n = 20), (2) dry pelleted starter diet provided as creep feed from day 10 of age to weaning (DPS; n = 25), (3) liquid milk replacer provided as creep feed from day 3 of age to weaning (LMR; n = 23), and (4) liquid milk replacer provided from days 3 to 6 of age followed by a mixture of liquid milk replacer with an increasing proportion of liquid starter diet to weaning provided as creep feed (LMR + S; n = 23). Pig weight and dry matter disappearance (DMd) were recorded during lactation and postweaning until pigs reached target slaughter weight (approximately 120 kg). At target slaughter weight, carcass weight and quality were recorded. Medication (antibiotic and anti-inflammatory) usage per pig on a litter basis, and number of injections and clinical cases of disease per litter were recorded from birth to slaughter. At day 5 postweaning, a subset of pigs (n = 40) were sacrificed and intestinal samples were collected for histological analysis. Piglets supplemented with DPS had higher DMd of creep feed than those supplemented with LMR or LMR + S (P &lt; 0.001). Providing LMR + S to suckling piglets reduced the coefficient of variation (CV) for within-litter piglet weaning weight (P &lt; 0.01) compared to DPS and LMR, but the CV of LMR + S was similar to that of CONTROL. Providing DPS or LMR to suckling piglets increased piglet weaning weight compared to CONTROL (P &lt; 0.001) but pig weight was not significantly different from CONTROL at time points thereafter. Gain to feed ratio from weaning to day 6 postweaning was less for LMR pigs compared to all other treatments (P &lt; 0.001). Providing DPS or LMR + S to suckling piglets tended to increase postweaning ileal villus height (P = 0.07). Diarrhea incidence, as well as the number of clinical cases of disease and injections per litter and volume of antibiotic and anti-inflammatory administered per pig pre- and postweaning, were not affected by treatment (P &gt; 0.05). In conclusion, supplementing suckling pigs with liquid milk replacer or dry pelleted starter diet improved growth at weaning, but the benefit did not persist to slaughter.
Do Caregivers and Patients With Early-Onset Scoliosis Share the Same Perspective on Health-Related Quality of Life? A Comparison of 24-item Early-Onset Scoliosis Questionnaire and 22-item Scoliosis Research Society Questionnaire Scores
Authors: Gottlieb Rachel , Smith John , Miyanji Firoz , Rodriguez-Olaverri Juan , El-Hawary Ron , Li Ying ,   Pediatric Spine Study Group
Published: March 2024

Objective:
The 24-item Early-Onset Scoliosis Questionnaire (EOSQ-24) is validated in patients with early onset scoliosis (EOS) aged 0 to 18 years and the 22-item Scoliosis Research Society (SRS-22) questionnaire is validated in idiopathic scoliosis patients 10 years and older. EOSQ-24 is completed by the caregiver and SRS-22 is completed by the patient. A prior study comparing patient-reported outcome measures completed by older pediatric patients and their parents showed a low level of agreement. Our purpose was to compare EOSQ-24 and SRS-22 scores completed at the same time point and at subsequent time points, in patients aged 5 to 18 years with idiopathic or congenital EOS without developmental delay.

Methods:
This was a multicenter retrospective study. We identified pairs of EOSQ-24 and SRS-22 completed on the same day or within 6 months. Some patients had multiple pairs of surveys over time. EOSQ-24 and SRS-22 questions were matched and domain scores for Pain, Function, Mental Health, and Satisfaction were compared. Patients with a change in treatment between surveys were excluded. Pearson correlation coefficients (r) were used to compare domain scores, with r ≥0.7 indicating a strong relationship.

Results:
There were 228 patient-caregiver dyads who completed 411 pairs of EOSQ-24 and SRS-22 on the same day. A strong correlation was found only for the Pain domain (r=0.77). Function, Mental Health, and Satisfaction domains had positive but not strong correlations (r = 0.58, r = 0.50, r = 0.41, respectively). Subanalysis based on age also showed a strong correlation only for Pain. There were 76 patient-caregiver dyads who completed 134 pairs of surveys with SRS-22 completed within 6 months after an EOSQ-24. All domains demonstrated a positive but not strong correlation, with Pain showing the highest correlation (r = 0.64).

Conclusions:
EOSQ-24 and SRS-22 had a strong correlation only for Pain when completed at the same time point. EOSQ-24 and SRS-22 completed within 6 months lacked a strong correlation for all domains. Our findings suggest that parents and children with EOS may not share the same perspective on their health. Self-reported questionnaires should be used when possible to assess health-related quality of life in older children and adolescents with EOS who are developmentally neurotypical.

Level of Evidence:
Level III—diagnostic.
A Modified Delphi Consensus Approach to Define Entrustable Professional Activities for Neurocritical Care Advanced Practice Providers*
Authors: Harrison Daniel S. , Sigman Erika J. , Ch’ang Judy H. , Sarwal Aarti , Celotto Abigale , Malone Alexandra , Nowicki Ariel , Martin Ashley , Boling Bryan , Nobleza Christa O’Hana S. , Reeves Christopher , Greer David M. , McLaughlin Diane , Woods Elizabeth O’B. , Fields Emmaculate , Perets Erica , Jannotta Gemi E. , Mears Jennifer , Twomey Kaitlyn , Rath Kelly A. , Peronti Kelly , Garner Krista M. , Bevers Matthew B. , Morris Nicholas A. , Martinez Paola , Zafar Sahar , Livesay Sarah , Wahlster Sarah , Lawson Thomas , Albin Catherine S.W. 
Published: March 2024

OBJECTIVES:
To define consensus entrustable professional activities (EPAs) for neurocritical care (NCC) advanced practice providers (APPs), establish validity evidence for the EPAs, and evaluate factors that inform entrustment expectations of NCC APP supervisors.

DESIGN:
A three-round modified Delphi consensus process followed by application of the EQual rubric and assessment of generalizability by clinicians not affiliated with academic medical centers.

SETTING:
Electronic surveys.

SUBJECTS:
NCC APPs (n = 18) and physicians (n = 12) in the United States with experience in education scholarship or APP program leadership.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
The steering committee generated an initial list of 61 possible EPAs. The panel proposed 30 additional EPAs. A total of 47 unique nested EPAs were retained by consensus opinion. The steering committee defined six core EPAs addressing medical knowledge, procedural competencies, and communication proficiency which encompassed the nested EPAs. All core EPAs were retained and subsequently met the previously described cut score for quality and structure using the EQual rubric. Most clinicians who were not affiliated with academic medical centers rated each of the six core EPAs as very important or mandatory. Entrustment expectations did not vary by prespecified groups.

CONCLUSIONS:
Expert consensus was used to create EPAs for NCC APPs that reached a predefined quality standard and were important to most clinicians in different practice settings. We did not identify variables that significantly predicted entrustment expectations. These EPAs may aid in curricular design for an EPA-based assessment of new NCC APPs and may inform the development of EPAs for APPs in other critical care subspecialties.
Androgen Receptor Immunohistochemistry is Superior to PRAME for the Differentiation of Sebaceous Carcinoma From Primary Cutaneous Basaloid Mimics
Authors: Wakefield Craig , Russell-Goldman Eleanor 
Published: March 2024

Abstract:
Cutaneous sebaceous neoplasia comprises a spectrum of disease ranging from benign adenomas to malignant carcinomas. The hallmark of these lesions is sebaceous differentiation. However, poorly-differentiated sebaceous carcinoma (SC), which lacks significant overt sebaceous differentiation, can show morphologic overlap with a variety of other basaloid cutaneous neoplasms. The accurate classification of SC is essential not only for diagnosis, but also because of the potential association with Muir-Torre syndrome. Androgen receptor (AR) is a sensitive, but not entirely specific immunohistochemical marker that has been used for the diagnosis of SC. PReferentially expressed Antigen in MElanoma (PRAME) demonstrates strong cytoplasmic labeling of mature sebocytes and has been reported to be expressed in a variety of sebaceous neoplasms, including in the basaloid cell component. Therefore, we sought to compare the diagnostic use of cytoplasmic PRAME expression with that of AR for the distinction of SC from a cohort of basaloid cutaneous mimics; namely basal cell carcinoma, basaloid squamous cell carcinoma, pilomatricoma, cutaneous lymphadenoma, and extra-mammary Paget disease. We report that cytoplasmic PRAME expression is uncommon in poorly differentiated SC, and although specific, it shows very low sensitivity (22%). In contrast, AR was moderately sensitive (66%) and highly specific (92%) for the distinction of SC from basaloid mimics. These attributes, in addition to the nuclear expression of AR in the sebocytic and basaloid components of SC, suggest that AR is superior to PRAME for the diagnosis of SC.
Reference Standards of Cardiorespiratory Fitness Measured With the Cardiopulmonary Exercise Test Using the Treadmill in Chinese Adults Younger Than 60 Years
Authors: Huang Jia , Yin Lianhua , Li Xia , Xie Qiurong , He Youze , Wu Lijuan , Ni Xuling , Liu Zhizhen , Tao Liyuan , Tao Jing , Chen Lidian 
Published: March 2024

Purpose:
Cardiorespiratory fitness (CRF) is a strong predictor of cardiorespiratory diseases and varies by race. The purpose of this study was to provide CRF reference standards and a prediction equation for peak oxygen uptake (V˙O2peak) from treadmill-based cardiopulmonary exercise testing (CPX) in Chinese individuals.

Methods:
Healthy participants (n = 4199) who completed a CPX using a treadmill were studied. The percentiles of V˙O2peak were determined for four age groups (decades). A regression prediction model was developed from the derivation cohort (n = 3361), validated in the independent validation cohort (n = 838), and compared with the widely used Wasserman equation and the Fitness Registry and the Importance of Exercise National Database (FRIEND) equation.

Results:
The mean V˙O2peak values of four age groups (20-29, 30-39, 40-49, and 50-59 yr) were 42.6, 41.2, 38.7, and 35.9 mL/kg/min, respectively, for men, and 37.1, 34.7, 32.0, and 30.3 mL/kg/min, respectively, for women. The 50th percentiles of relative V˙O2peak decreased with age for both sexes. The prediction equation was: Absolute V˙O2peak (mL/min) = 236.68 – (504.64 × sex [male = 0; female = 1]) + (21.23× weight [kg]) – (14.31 × age [yr]) + (9.46 × height [cm]) (standard error of the estimate = 379.59 mL/min, R
2= 0.66, P< .001).
Percentage predicted V˙O2peak for the validation sample was 100.2%. The novel equation performed better than the other two equations.

Conclusion:
This study reports the first CRF reference standards and prediction equation generated from treadmill CPX in China. These reference standards provide a framework for interpreting the CRF of the Chinese population and could be useful information for a global CRF database.
DEEP LEARNING FOR AUTOMATIC PREDICTION OF EARLY ACTIVATION OF TREATMENT-NAIVE NONEXUDATIVE MACULAR NEOVASCULARIZATIONS IN AGE-RELATED MACULAR DEGENERATION
Authors: Crincoli Emanuele , Catania Fiammetta , Sacconi Riccardo , Ribarich Nicolò , Ferrara Silvia , Parravano Mariacristina , Costanzo Eliana , Querques Giuseppe 
Published: March 2024

Background:
Around 30% of nonexudative macular neovascularizations exudate within 2 years from diagnosis in patients with age-related macular degeneration. The aim of this study is to develop a deep learning classifier based on optical coherence tomography (OCT) and OCT angiography (OCTA) to identify nonexudative macular neovascularizations at risk of exudation.

Methods:
Patients with age-related macular degeneration showing OCTA and fluorescein angiography–documented nonexudative macular neovascularization with a 2-year minimum imaging follow-up were retrospectively selected. Patients showing OCT B-scan–documented macular neovascularization exudation within the first 2 years formed the EX GROUP while the others formed the QU GROUP. ResNet-101, Inception-ResNet-v2, and DenseNet-201 were independently trained on OCTA and OCT B-scan images. Combinations of the six models were evaluated with major and soft voting techniques.

Results:
Eighty-nine eyes of 89 patients with a follow-up of 5.7 ± 1.5 years were recruited (35 EX GROUP and 54 QU GROUP). Inception-ResNet-v2 was the best performing among the three single convolutional neural networks. The major voting model resulting from the association of the three different convolutional neural networks resulted in an improvement of performance both for OCTA and OCT B-scan (both significantly higher than human graders' performance). The soft voting model resulting from the combination of OCTA and OCT B-scan–based major voting models showed a testing accuracy of 94.4%. Peripheral arcades and large vessels on OCTA en face imaging were more prevalent in the QU GROUP.

Conclusion:
Artificial intelligence shows high performances in identifications of nonexudative macular neovascularizations at risk for exudation within the first 2 years of follow-up, allowing better customization of follow-up timing and avoiding treatment delay. Better results are obtained with the combination of OCTA and OCT B-scan image analysis.
Immediate Impact on Tear Osmolarity Following the Application of Different Ocular Lubricants in Patients Experiencing Moderate Dry Eye Symptoms
Authors: Muñoz Edwin Correa , Patiño Andrea Ocampo , Marín Daniel Jiménez , Cadavid Laura Martínez , Ortega Quiroga Laura , Gonzalez Lopera Daniel , Donado Gómez Jorge Hernando 
Published: March 2024

Purpose:
This study addresses the growing concern of Dry Eye Disease (DED), which has become increasingly prevalent due to modern lifestyles characterized by prolonged screen usage, global warming, polypharmacy, and extended life expectancy.

Methods:
Grounded in the Dry Eye Workshop II (DEWSII) diagnosis framework, the study focuses on DED as a multifactorial condition affecting the ocular surface's tear film homeostasis. The study evaluates the short-term impact of 5 commercially available ocular lubricants on disrupting the hyperosmolar environment and determine whether these lubricants can offer potential treatment benefits for DED.

Results:
Conducted on 300 eyes (from 150 patients) with 5 preservative-free lubricants compared to a control group, the study reveals that all lubricants effectively reduced tear film osmolarity within 15 minutes of application. Notably, the control group exhibited an increase in average osmolarity (+0.98 mOsm/L) without lubricant use. Siccafluid demonstrated the most substantial osmolarity reduction after 15 minutes, with an average decrease of 11.54 mOsm/L. Statistical significance was observed for Siccafluid, Optive Fusion unique dose (UD), and Systane Ultra UD, while Hyabak and Freegen preservative free (PF) showed lower significance.

Conclusions:
Emphasizing the importance of disrupting the hyperosmolar environment to break the cycle of inflammation, the study concludes that ocular lubricants, at least as an immediate post-application effect, can interrupt this cycle and improve the hyperosmolar environment of the ocular surface.
Real-World Evidence of Antipsychotic Monotherapy Versus Polypharmacy in the Treatment of Schizophrenia Spectrum Disorders
Authors: Korkmaz Şükrü Alperen , Koca Esra , Yilmaz Özge , Özbek Tayfun , Güçlü Muhammed Alperen , Kizgin Sadice 
Published: March 2024

Abstract

Purpose/Background
It is still not well known whether antipsychotic monotherapy versus polypharmacy differs in terms of efficacy in the emergency department (ED) utilization, presentation with agitation/aggression, and rehospitalization in schizophrenia spectrum disorders (SSD) patients. This study aimed to determine the effectiveness of antipsychotic monotherapy and polypharmacy for these outcomes in the real world.

Methods/Procedures
The study was conducted with electronic health records of 669 SSD patients admitted to the ED. Patients were evaluated in 4 groups according to antipsychotic use at the first admission to ED: antipsychotic noncompliance for more than 90 days, antipsychotic noncompliance for 15 to 90 days, antipsychotic monotherapy, and polypharmacy. All patients followed up for at least 1 year after index admission. The primary outcomes determined an association between antipsychotic monotherapy versus polypharmacy and all-cause psychiatric hospitalization between the groups after index admission in the SSD.

Findings/Results
The groups, including patients with antipsychotic noncompliance, had higher ED visits, more hospitalizations, and more admissions with agitation/aggression compared with antipsychotic monotherapy or polypharmacy. However, no differences were found between monotherapy and polypharmacy groups regarding these outcomes. In addition, there was no difference in the risk of hospitalization in monotherapy antipsychotic users compared with polypharmacy users. Patients discharged with monotherapy or polypharmacy also had similar rehospitalization rates at follow-up.

Implications/Conclusions
There is no positive evidence that recommending polypharmacy over antipsychotic monotherapy is superior with regard to the resulting frequency of ED visits, ED admissions with agitation/aggression, hospitalization, and rehospitalization. In this context, antipsychotic monotherapy may be preferred over polypharmacy in patients who are not resistant to treatment.
Routine closed-suction drainage reduces seromas following totally extraperitoneal (TEP) inguinal hernia repair: A meta-analysis
Authors: Prassas Dimitrios , Zaczek Michael , David Stephan Oliver , Knoefel Wolfram Trudo , Vaghiri Sascha 
Published: March 2024

Background:
The value of prophylactic closed-suction drainage in totally extraperitoneal inguinal hernia repair (TEP) is still a matter of controversy. We conducted a meta-analysis of studies examining postoperative seroma rates in patients with or without routine placement of closed-suction drainage tubes.

Methods:
A systematic literature search was conducted for trials comparing the outcome of TEP with or without routine drainage placement. Data regarding postoperative outcomes were extracted and compared by meta-analysis. The odds ratio and standardized mean differences with 95% confidence intervals were calculated.

Results:
Four studies were identified, involving a total of 1626 cases (Drain: n = 1251, no Drain: n = 375). There was a statistically significant difference noted between the 2 groups regarding postoperative seroma formation favoring the Drain group (odds ratio = 0.12; 95% confidence intervals [0.05, 0.29]; P < .001; 4 studies; I
2 = 72%). For the remaining secondary endpoints postoperative urinary retention, recurrence, mesh infection and in-hospital length of stay no statistically significant difference was noted between the 2 study groups.

Conclusion:
Current evidence suggests that patients who underwent TEP with routine closed-suction drain placement developed significantly fewer seromas without any additional morbidity or prolongation of in-hospital stay.