bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of mitral valve repair in combination with coronary revascularization for moderate ischaemic mitral regurgitation: a systematic review and meta-analysis of randomized controlled trials
Authors: Li Xin , Hou Biao , Hou Shuwen , Jiang Wenjian , Liu Yuyong , Zhang Hongjia 
Published: March 2024

Background:
The efficacy of mitral valve repair (MVR) in combination with coronary artery bypass grafting (CABG) for moderate ischaemic mitral regurgitation (IMR) remains unclear. To evaluate whether MVR + CABG is superior to CABG alone, the authors conducted a systematic review and meta-analysis of existing randomized controlled trials (RCTs).

Methods:
The authors searched PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials for eligible RCTs from the date of their inception to October 2023. The primary outcomes were operative (in-hospital or within 30 days) and long-term (≥ 1 year) mortality. The secondary outcomes were postoperative stroke, worsening renal function (WRF), and reoperation for bleeding or tamponade. The authors performed random-effects meta-analyses and reported the results as risk ratios (RRs) with 95% CIs.

Results:
Six RCTs were eligible for inclusion. Compared with CABG alone, MVR + CABG did not increase the risk of operative mortality (RR, 1.244; 95% CI, 0.514–3.014); however, it was also not associated with a lower risk of long-term mortality (RR, 0.676; 95% CI, 0.417–1.097). Meanwhile, there was no difference between the two groups in terms of postoperative stroke (RR, 2.425; 95% CI, 0.743–7.915), WRF (RR, 1.257; 95% CI, 0.533–2.964), and reoperation for bleeding or tamponade (RR, 1.667; 95% CI, 0.527–5.270).

Conclusions:
The findings of this meta-analysis suggest that MVR + CABG fails to improve the clinical outcomes of patients with moderate IMR compared to CABG alone.
How to assess the long-term recovery outcomes of patients with cauda equina syndrome before surgery: a retrospective cohort study
Authors: Wang Qiushi , Hou Guangdong , Wen Mengyuan , Ren Zhongwu , Duan Wei , Lei Xin , Yao Zhou , Zhao Shixian , Ye Bin , Tu Zhipeng , Huang Peipei , Xie Fang , Gao Bo , Hu Xueyu , Luo Zhuojing 
Published: March 2024

Background:
Factors influencing recovery after decompression surgery for cauda equina syndrome (CES) are not completely identified. The authors aimed to investigate the most valuable predictors (MVPs) of poor postoperative recovery (PPR) in patients with CES and construct a nomogram for discerning those who will experience PPR.

Methods:
Three hundred fifty-six patients with CES secondary to lumbar degenerative diseases treated at Xijing Hospital were randomly divided into training (N=238) and validation (N=118) cohorts at a 2:1 ratio. Moreover, 92 patients from the 970th Hospital composed the testing cohort. Least Absolute Shrinkage and Selection Operator regression (LASSO) was used for selecting MVPs. The nomogram was developed by integrating coefficients of MVPs in the logistic regression, and its discrimination, calibration, and clinical utility were validated in all three cohorts.

Results:
After 3 to 5 years of follow-up, the residual rates of bladder dysfunction, bowel dysfunction, sexual dysfunction, and saddle anesthesia were 41.9, 44.1, 63.7, and 29.0%, respectively. MVPs included stress urinary incontinence, overactive bladder, low stream, difficult defecation, fecal incontinence, and saddle anesthesia in order. The discriminatory ability of the nomogram was up to 0.896, 0.919, and 0.848 in the training, validation, and testing cohorts, respectively. Besides, the nomogram showed good calibration and clinical utility in all cohorts. Furthermore, the optimal cutoff value of the nomogram score for distinguishing those who will experience PPR was 148.02, above which postoperative outcomes tend to be poor.

Conclusion:
The first pretreatment nomogram for discerning CES patients who will experience PPR was developed and validated, which will aid clinicians in clinical decision-making.
Effect of Vasopressors and Vasodilators on Kidney Medulla Oxygenation
Authors: Honore Patrick M , Blackman Sydney , Perriens Emily , Oueslati Ilann , Al-Sammour Christophe , Bankier David Vidal , Bendoumou Maha , Ramos-Prieto Maya , Bulpa Pierre , Robert Arnaud , Nendumba Gauthier , Vornicu Ovidiu , Evrard Patrick , Dincq Anne-Sophie , Michaux Isabelle 
Published: March 2024

ABSTRACT
This narrative review provides a comprehensive summary of research findings up to 2023 regarding the impact of vasopressors and vasodilators on medullary oxygenation during cardiopulmonary bypass and septic shock. It encompasses a thorough evaluation of all current vasopressors and vasodilators. Among vasodilators, levosimendan demonstrates superior efficacy, particularly in cases of heart failure following cardiac surgery. In the context of hypotension during such procedures, vasopressin emerges as the most effective vasopressor. In cases of hypotensive septic shock, both vasopressin and angiotensin II appear to be superior in preserving medullary oxygenation. However, it is imperative to emphasize the need for more robust data and randomized controlled human trials to validate these initial findings. Currently, it would be premature to offer definitive clinical recommendations on this matter.
Practice Trends among US Gastroenterologists following the 2020 American Gastroenterological Association Guidelines on Gastric Intestinal Metaplasia
Authors: Rouphael Carol , Elkin Baila , El Dahdah Joseph , Moufawad Michelle , Yang Qijun , Bena James , Shah Shailja , Kim Michelle K. 
Published: March 2024

Background and Aims:
Studies show variability in gastroenterologists’ management of gastric intestinal metaplasia (GIM) in the United States. In 2020, the American Gastroenterological Association published GIM guidelines, recommending physician-patient shared decision-making on GIM surveillance based on risk factors. We compared gastroenterologists’ communication trends of a GIM finding and surveillance recommendations before and after 2020 and evaluated patient and provider factors associated with a surveillance recommendation.

Methods:
A sample of patients diagnosed with GIM on biopsies from upper endoscopies performed in 2018 (cohort A) and 2021 (cohort B) were included. Logistic regression analysis assessed the association between patient/provider characteristics and surveillance recommendations in the overall cohort and over time.

Materials:
In all, 347 patients were included: 175 in cohort A and 172 in B. Median age was 65.7 (56.0, 73.4), and 54.5% were females. Communication to patients about GIM findings and surveillance recommendations increased from 24.6% <2020 to 50% >2020 (P<0.001) and 20% <2020 to 41.3% >2020 (P<0.001), respectively. Overall, endoscopy >2020, family history of gastric cancer, autoimmune gastritis, female providers, and gastroenterologists with 10 to 20 years of experience were associated with a surveillance recommendation. The effect of family history of gastric cancer and the effect of the patient’s female sex on surveillance was significantly different between both cohorts [Odds ratio (OR): 0.13, 95% (Confidence interval) CI: 0.02, 0.97 and OR 3.39, 95% CI: 1.12, 10.2, respectively).

Conclusions:
Despite a 2-fold increase in surveillance recommendations after 2020, there was no meaningful effect of any of the patients’ factors on a recommendation for surveillance over time, which raises the question as to whether surveillance is being offered to both average and high-risk patients without thorough risk stratification.
Role of a Nursing Informatics Specialist in a Clinical Simulation Laboratory
Authors: Hall Eric S. , Holt Jo Ellen , Sengstack Patricia 
Published: March 2024

Background:
Technology in health care is pervasive and growing exponentially. Simulation in academic settings also continues to expand with the use of advancing technologies.

Problem:
Technology appropriate usage and implementation can become problematic without experts with the right skills in nursing simulation labs. Gaps in technology utilization, simulation best practices, and data analytics now exist.

Approach:
A school of nursing employed a nurse informaticist in its simulation laboratory to address the complexities of technology usage and aid in data analytics.

Outcomes:
The nurse informaticist was effective at promoting simulation use, increasing faculty and learner usage of the simulation space. The initiation of data capturing was also achieved.

Conclusions:
Highly trained nurse informaticists are ready to address the unique complexities of advanced simulation environments.
Recurrent Tuberous Sclerosis Complex/Mammalian Target of Rapamycin Mutations Define Primary Renal Hemangioblastoma as a Unique Entity Distinct From Its Central Nervous System Counterpart
Authors: Wang Xiao-tong , Fang Ru , He Hui-ying , Zhang Wei , Li Qing , Sun Su-an , Wang Xuan , Zhang Ru-song , Teng Xiao-dong , Zhou Xiao-jun , Xia Qiu-yuan , Zhao Ming , Rao Qiu 
Published: March 2024

Abstract:Renal hemangioblastoma (HB) is a rare subset of HBs arising outside of the central nervous system (CNS), with its molecular drivers remaining entirely unknown. There were no significant alterations detected in previous studies, including von Hippel-Lindau gene alterations, which are commonly associated with CNS-HB. This study aimed to determine the real molecular identity of renal HB and better understand its relationship with CNS-HB. A cohort of 10 renal HBs was submitted for next-generation sequencing technology. As a control, 5 classic CNS-HBs were similarly analyzed. Based on the molecular results, glycoprotein nonmetastatic B (GPNMB) immunohistochemistry was further performed in the cases of renal HB and CNS-HB. Mutational analysis demonstrated that all 10 renal HBs harbored somatic mutations in tuberous sclerosis complex 1 (TSC1, 5 cases),TSC2(3 cases), and mammalian target of rapamycin (2 cases), with the majority classified as pathogenic or likely pathogenic. The CNS-HB cohort uniformly demonstrated somatic mutations in the von Hippel-Lindau gene. GPNMB was strong and diffuse in all 10 renal HBs and completely negative in CNS-HBs, reinforcing the molecular findings. Our study reveals a specific molecular hallmark in renal HB, characterized by recurrentTSC/mammalian target of rapamycinmutations, which defines it as a unique entity distinct from CNS-HB. This molecular finding potentially expands the therapeutic options for patients with renal HB. GPNMB can be considered for inclusion in immunohistochemical panels to improve renal HB identification.
Dollars and Sense
Authors: Gore Amy , Huck Gary , Bongiovanni Soyon , Labagnara Susan , Soto Ilona Jacniacka , Yonclas Peter , Livingston David H. 
Published: March 2024

Objective:
To demonstrate that the creation of a Center for Trauma Survivorship (CTS) is not cost-prohibitive but is a revenue generator for the institution.

Background:
A dedicated CTS has been demonstrated to increase adherence with follow-up visits and improve overall aftercare in severely injured patients discharged from the trauma center. A potential impediment to the creation of similar centers is its assumed prohibitive cost.

Methods:
This pre and post-cohort study examines the financial impact of patients treated by the CTS. Patients in the PRE cohort were those treated in the year before CTS inception. Eligibility criteria are trauma patients admitted who are ≥18 years of age and have a New Injury Severity Score ≥16 or intensive care unit stay ≥2 days. Financial data were obtained from the hospital’s billing and cost accounting systems for a 1-year time period after discharge.

Results:
There were 176 patients in the PRE and 256 in the CTS cohort. The CTS cohort generated 1623 subsequent visits versus 748 in the PRE cohort. CTS patients underwent more follow-up surgery in their first year of recovery as compared with the PRE cohort (98 vs 26 procedures). Each CTS patient was responsible for a $7752 increase in net revenue with a positive contribution margin of $4558 compared with those in the PRE group.

Conclusions:
A dedicated CTS increases subsequent visits and necessary procedures and is a positive revenue source for the trauma center. The presumptive financial burden of a CTS is incorrect and the creation of dedicated centers will improve patients’ outcomes and the institution’s bottom line.
Characterization of Pancreatic Fistula after Post-pancreatectomy Acute Pancreatitis
Authors: Chen Haoda , Wang Weishen , Fu Ningzhen , Xia Wentao , Li Hongzhe , Ji Yuchen , Zhong Jingyu , Wang Jiancheng , Deng Xiaxing , Xu Zhiwei , Weng Yuanchi , Shen Baiyong 
Published: March 2024

Objective:
This study aimed to investigate the clinical significance and risk factors of postoperative pancreatic fistula (POPF) after post-pancreatectomy acute pancreatitis (PPAP) in patients who underwent pancreaticoduodenectomy (PD).

Summary Background Data:
PPAP has been recognized as a critical factor in the pathophysiology of POPF after PD.

Methods:
A total of 817 consecutive patients who underwent elective PD between January 2020 and June 2022 were included. PPAP and POPF were defined in accordance with the International Study Group for Pancreatic Surgery (ISGPS) definitions. Multivariate logistic analyses were performed to investigate the risk factors for POPF. Comparisons between PPAP-associated POPF and non-PPAP-associated POPF were made to further characterize this intriguing complication.

Results:
Overall, 159 (19.5%) patients developed POPF after PD, of which 73 (45.9%) occurred following PPAP, and the remaining 86 (54.1%) had non-PPAP-associated POPF. Patients with PPAP-associated POPF experienced significantly higher morbidity than patients without POPF. Multivariate analyses revealed distinct risk factors for each POPF type. For PPAP-associated POPF, independent risk factors included estimated blood loss >200 mL (OR 1.93), MPD ≤3 cm (OR 2.88), and soft pancreatic texture (OR 2.01), largely overlapping with FRS (Fistula Risk Score) elements. On the other hand, non-PPAP-associated POPF was associated with age >65 years (OR 1.95), male (OR 2.10), and MPD ≤3 cm (OR 2.57). Notably, among patients with PPAP, the incidence of POPF consistently hovered around 50% regardless of the FRS stratification.

Conclusions:
PPAP-associated POPF presents as a distinct pathophysiology in the development of POPF after PD, potentially opening doors for future prevention strategies targeting the early postoperative period.
A two-step penalization and shrinkage approach for binary response data that is jointly separated and correlated: The effects of social networks on diarrheal disease
Authors: Hegde Sonia T. , Eisenberg Joseph , Beesley Lauren J. , Mukherjee Bhramar 
Published: March 2024

ABSTRACTEpidemiologic data often violate common modeling assumptions of independence between subjects due to study design. Statistical separation is also common, particularly in the study of rare binary outcomes. Statistical separation for binary outcomes occurs when regions of the covariate space have no variation in the outcome, and separation can negatively impact the validity of logistic regression model parameters. When data are correlated, we generally use multi-level modeling for parameter estimation, and statistical approached have also been developed for handling statistical separation. Approaches for analyzing data withbothseparation and complex correlation, however, are not well-known. Extending prior work, we demonstrate a two-stage Bayesian modeling approach to account for both separated and highly correlated data through a motivating example examining the effect of social ties on Acute Gastrointestinal Illness (AGI) in rural Ecuador. The two-stage approach involves fitting a Bayesian hierarchical model to account for correlation using priors derived from parameter estimates from a Firth-corrected logistic regression model to account for separation. We compare estimates from the two-stage approach to standard regression methods that only account for either separation or correlation. Our results demonstrate that correctly accounting for separation and correlation when both are present can potentially provide better inference.
Neurodevelopmentally rooted epicenters in schizophrenia:
sensorimotor-association spatial axis of cortical thickness alterations
Authors: Fan Yun-Shuang , Xu Yong , Hettwer Meike Dorothee , Yang Pengfei , Sheng Wei , Wang Chong , Yang Mi , Kirschner Matthias , Valk Sofie Louise , Chen Huafu 
Published: March 2024

Abstract
Pathologic perturbations in schizophrenia have been suggested to propagate
via the functional and structural connectome across the lifespan. Yet how the
connectome guides early cortical reorganization of developing schizophrenia
remains unknown. Here, we used early-onset schizophrenia (EOS) as a
neurodevelopmental disease model to investigate putative early pathologic
origins that propagate through the functional and structural connectome. We
compared 95 patients with antipsychotic-naïve first-episode EOS and 99 typically
developing controls (7–17 years of age, 120 females). Whereas patients showed
widespread cortical thickness reductions, thickness increases were observed in
primary cortical areas. Using normative connectomics models, we found that
epicenters of thickness reductions were situated in association regions linked
to language, affective, and cognitive functions, while epicenters of increased
thickness in EOS were located in sensorimotor regions subserving visual,
somatosensory, and motor functions. Using post-mortem transcriptomic data of six
donors, we observed that the epicenter map differentiated
oligodendrocyte-related transcriptional changes at its sensory apex and the
association end was related to expression of excitatory/inhibitory neurons. More
generally, we observed that the epicenter map was associated with
neurodevelopmental disease gene dysregulation and human accelerated region
genes, suggesting potential shared genetic determinants across various
neurodevelopmental disorders. Taken together, our results underscore the
developmentally rooted pathologic origins of schizophrenia and their
transcriptomic overlap with other neurodevelopmental diseases.
Identification and characterization of human GDF15 knockouts
Authors: Gurtan Allan M. , Khalid Shareef , Koch Christopher , Khan Maleeha Zaman , Lamarche Lindsey B. , Dolan Elizabeth , Carrion Ana M. , Zessis Richard , Clement Matthew E. , Chen Zhiping , Lindsley Loren D. , Chiu Yu-Hsin , Streeper Ryan S. , Denning Daniel P. , Goldfine Allison B. , Doyon Brian , Abbasi Ali , Harrow Jennifer L. , Tsunoyama Kazuhisa , Asaumi Makoto , Kou Ikuyo , Shuldiner Alan R. , Rodriguez-Flores Juan L. , Rasheed Asif , Jahanzaib Muhammad , Mian Muhammad Rehan , Liaqat Muhammad Bilal , Raza Syed Shahzaib , Sultana Riffat , Jalal Anjum , Saeed Muhammad Hamid , Abbas Shahid , Memon Fazal Rehman , Ishaq Muhammad , Dominy John E. , Saleheen Danish 
Published: March 2024

AbstractGrowth differentiation factor 15 (GDF15) is a secreted protein that regulates food intake, body weight, and stress responses in pre-clinical models1. The physiological function of GDF15 in humans remains unclear. Pharmacologically, GDF15 agonism in humans caused nausea without accompanying weight loss2, and the effect of GDF15 antagonism is being tested in clinical trials to treat cachexia and anorexia. Human genetics point to a role for GDF15 in hyperemesis gravidarum, but the safety or impact of complete GDF15 loss, particularly during pregnancy, is unknown3–7. Here, we characterize GDF15 loss-of-function carriers (LOF), including 5 homozygous null carriers (“knockouts”) from 75,018 participants enrolled in the Pakistan Genomic Resource (PGR)8,9. We tested for the association of GDF15 LOF with 97 quantitative traits and binary outcomes. Further, 3 additional knockouts and 59 heterozygous carriers were identified in recall-by-genotype (RBG) studies accompanied by recruitment of family members. GDF15 knockouts ranged in age from 31 to 75 years, were fertile, and showed no consistent overt metabolic dysfunction. Collectively, our data indicate that (i) complete GDF15 loss is compatible with life and fertility, (ii) chronic therapeutic inhibition of GDF15 may be tolerated, and (iii) GDF15 modulation may not significantly impact body weight or metabolic syndrome.
Impaired functional brain-heart interplay sustains emotion dysregulation in depressed individuals
Authors: Catrambone Vincenzo , Mura Francesca , Patron Elisabetta , Gentili Claudio , Valenza Gaetano 
Published: March 2024

AbstractDepression is a leading worldwide cause of mental disorders and disability, strongly affecting emotional processing and regulation. Its dysfunctional psycho-physiological dynamics may be part of the a nervous-system-wise symptomatology, impacting not only patients’ psyche but also significantly influencing functional cardiovascular dynamics. Therefore, depression serves as an exemplary pathological manifestation of the dysfunctional interaction between the central and autonomic nervous systems. While recent literature has been developing specific techniques to quantify such interactions, often referred to as functional Brain-Heart Interplay (BHI), the quantitative role of BHI dynamics in depression is largely unknown. This study aims to experimentally unveil BHI patterns specific to emotional regulation and processing in subjects exhibiting depressive symptoms compared to healthy controls. Results were gathered from a cohort of 72 individuals and indicate that depressive symptoms are associated with a continuous efferent central-to-peripheral hyperactivity and an afferent peripheral-to-central hypoactivity. This hypoactivity appears to be specific to negative emotional processing. This study offers novel insights into the systemic investigation of the neuro-physiological bases of depression.
Parent attention-orienting behavior is associated with neural entropy in infancy
Authors: Williams Cabell L. , Belkowitz Allison R. , Nance Madelyn G. , Mortman Emily T. , Bae Soni , Ahmed Sheher-Bano , Puglia Meghan H. 
Published: March 2024

AbstractParents play a significant role in directing infant’s attention to environmental stimuli via joint attention. We hypothesized that infants whose parents provide more bids for joint attention will display a more complex neural response when viewing social scenes. Sixty-one 8-month-old infants underwent electroencephalography (EEG) while viewing videos of joint-and parallel-play and participated in a parent-infant free play interaction. EEG data was analyzed using multiscale entropy, which quantifies moment-to-moment neural variability. Free play interactions were coded for parent alternating gaze, a behavioral mechanism for directing attention to environmental cues. We found a significant positive association between parent alternating gaze and neural entropy in frontal and central brain regions. These results suggest a relationship between parent behavior and infant neural mechanisms that regulate social attention, underlying the importance of parent cues in the formation of neural networks in infancy.