bluuebunny/crossref_metadata_2025_split huggingface dataset:
A240 SOCIOECONOMIC STATUS AS A RISK FACTOR FOR ERCP OUTCOMES: A RETROSPECTIVE COHORT STUDY
Authors: Mahjoob M , Khalaf K , Mokhtar A , Na C , Tham D , Sabrie N , Chon J , Meleka M , Abal S , Chopra D , Malipatil S , Gupta S , Jugnundan S , Mhalawi W , Gimpaya N , Mosko J , Teshima C , May G , Grover S , Causada Calo N 
Published: February 2025

Abstract

Background
Endoscopic Retrograde Cholangiopancreatography (ERCP) has one of the highest adverse event rates among endoscopic procedures, close to 10%, including pancreatitis, bleeding, and perforation. To minimize complications and improve procedure success, understanding risk factors of adverse events is critical. Socioeconomic variables such as income, housing and education can influence health outcomes through access to resources, however, there is a literature gap regarding the effect of these variables on ERCP outcomes.

Aims
The purpose of this study is to investigate socioeconomic predictors of ERCP outcomes.

Methods
This study analyzed 6105 patients (51.4% female) who underwent ERCP at a tertiary care center between January 1, 2011 and December 31, 2020. Patient postal codes were translated to 2016 census division unique identifier codes which linked them to median monthly housing costs, household income, education levels, considered proxies for socioeconomic status. Multivariable logistic regression models were built to identify predictors of procedure success (achieving intended diagnostic or therapeutic goals) and adverse events (perforation, abdominal pain, pancreatitis, delayed/immediate bleeding). Data was analyzed using the “glm” package on R studio (Version 2023.06.1) and the adjusted P-value &lt; 0.05 was considered for statistical significance.

Results
The multivariable logistic regression model demonstrated that better access to housing (OR:1.11 [1.01, 1.12], p=0.02) is associated with procedure success. Conversely, older age (OR: 0.86 [0.78, 0.93], p&lt;0.01) and male sex (OR=0.81 [0.69, 0.95], p&lt;0.0001) are associated with lower odds of procedure success. Higher housing costs (OR: 0.86 [0.75, 0.97], p=0.04) are associated with decreased adverse events, after adjusting for age and sex.

Conclusions
The findings of this study suggest socioeconomic differences may influence ERCP outcomes and should be further investigated in prospective studies.

Funding Agencies
None
A scoping review to determine if adverse human health effects are associated with use of pyrethroids for mosquito control
Authors: Kuczynski Lange Suzanne , Connelly C Roxanne , Tai Zoe , Foley Nicole , De Leon Rivera Juan , Lozano Saul , Nett Randall J 
Published: February 2025

Abstract
Mosquito control using pyrethrins and synthetic pyrethroids (PSP) is important for preventing vector-borne diseases. Although the benefits associated with PSP use are well-documented, public concern exists regarding potential human adverse health effects. The aim of this scoping review was to describe adverse human health effects associated with PSP use for community adult mosquito control. A literature search using the databases MEDLINE, EMBASE, Agricultural and Environmental Science Collection, CAB Abstracts, and Scopus obtained 6,154 original peer-reviewed articles published during 1 January 2000 to 22 May 2024. Articles were independently reviewed for inclusion using predetermined exclusion and inclusion criteria. Data were extracted from 10 included articles. Study designs included cohort (n = 5), cross-sectional (n = 2), and risk assessment (n = 4). One article included 2 study designs. Of the cohort studies, one was prospective and the remainder were retrospective. A causal relationship between PSP application for adult mosquito control and adverse human health impacts was not identified. No increases in acute health manifestations were reported. The 4 risk assessments estimated that PSP exposures were not above the regulatory level of concern; a meta-analysis determined the likelihood of PSP exposures exceeding the regulatory level of concern was &lt;0.0001. The limited evidence indicated that PSP applied appropriately for control of nuisance mosquitoes or mosquitoes that transmit arboviruses do not pose acute or chronic human health risks. Continued investigation into potential human health impacts of PSP would help inform guidelines for adult mosquito control and help inform public health decision making.
The pre-exposure prophylaxis personal obstacle scale: measurement properties in English, German, and French
Authors: Ort Alexander , Bardy Tess L C 
Published: February 2025

Abstract

Background
This study aimed to validate the Pre-Exposure Prophylaxis Personal Obstacle Scale (PPOS) across English, German, and French (PPOS-EN/DE/FR) for men who have sex with men (MSM). The PPOS measures perceived barriers related to knowledge and uncertainty surrounding PrEP use, which are particularly important factors in the early stages of the PrEP Care Continuum (PCC).

Methods
The original PPOS was adapted and translated into German and French. Data were collected through an online survey in four European countries (N = 1124). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed the factor structure, while multigroup CFA (MGCFA) tested measurement invariance across language groups and adoption statuses.

Results
EFA revealed a two-factor structure: (i) “Impact of PrEP on personal health” and (ii) “Knowledge about PrEP.” CFA confirmed this structure, and measurement invariance was established across languages and adoption statuses with high reliability (α = 0·82, ω = 0·82).

Conclusions
The PPOS-EN/DE/FR is a valid and reliable tool for assessing personal obstacles to PrEP uptake among MSM across different languages. It supports public health efforts by identifying specific challenges to PrEP adoption, facilitating culturally sensitive interventions to improve uptake and reduce HIV transmission.
Approach to Janus kinase inhibition for juvenile dermatomyositis among CARRA and PReS providers
Authors: Sherman Matthew A , Nicolai Rebecca , Datyner Emily K , Rosina Silvia , Hamilton Angela , Ardalan Kaveh , Bader-Meunier Brigitte , Brown Amanda G , Jansen Marc H A , Kim Susan , Lang Bianca , Campanilho-Marques Raquel , McCann Liza J , Sanner Helga , Veldkamp Saskia R , Wilkinson Meredyth G Ll , Yi Belina Y , Kim Hanna , Tarvin Stacey E , Papadopoulou Charalampia ,   CARRA JDM Therapeutics Workgroup and the PReS JDM Working Party
Published: February 2025

Abstract

Objectives
Janus kinase inhibition (JAKi) has been proposed as a treatment for idiopathic inflammatory myopathies to target increased interferon signalling. Predominantly retrospective reports have demonstrated effectiveness of JAKi in refractory juvenile dermatomyositis (JDM). However, JAKi remains an off-label treatment for JDM and there may be variation in use worldwide. An international survey was conducted to investigate approaches to JAKi for JDM.

Methods
The Childhood Arthritis and Rheumatology Research Alliance (CARRA) JDM Therapeutics workgroup and core members of the Paediatric Rheumatology European Society (PReS) JDM working party devised an electronic survey to assess the use of JAKi in JDM. CARRA and PReS members were invited by email to complete the survey.

Results
There were 229 respondents (18%), with 50% from the US and 29% from Europe. 150 had used JAKi for over 450 patients with JDM; among them, 77% noted clinical improvement in most or all patients and 17% reported side effects. The highest ranked perceived barriers to JAKi use were lack of clinical data and inability to obtain insurance approval. The highest ranked clinical indications for starting JAKi were refractory skin disease, refractory muscle disease, inability to wean steroids, and intolerance to other steroid-sparing agents.

Conclusion
Pediatric rheumatologists use JAKi off-label treatment for refractory JDM. Most providers noted clinical improvement in their patients. Barriers to JAKi use include lack of clinical data and insurance coverage. Clinical trials are needed to provide better data on the efficacy and safety of JAKi.
Radial Inclination and Volar Tilt Following Ulnar Epiphysiodesis for Distal Radius Physeal Arrest
Authors: Mullin Edmund P. , Campbell Tanner R. , Bomar James D. , Edmonds Eric W. 
Published: February 2025

Objective:
Physeal arrest of the distal radius is a known complication after pediatric distal radius fractures. When this occurs, ulnar epiphysiodesis has been shown to prevent further ulnar positive variance. The purpose of this study is to determine any difference in the radial inclination (RI) and volar tilt (VT) of the distal radius pre-ulnar and post-ulnar epiphysiodesis and whether the final distal radius radiographic measurements are associated with clinical outcomes.

Methods:
A review of children who underwent ulnar epiphysiodesis for premature radial physeal closure at a single institution was performed over a 12-year period. Exclusion criteria included patient-reported outcome measures (PROMs) <1 year. Preoperative and final follow-up radiographic measurements were obtained for RI and VT, with interobserver reliability recorded. Cutoffs for acceptable RI and VT were set at >10 degrees and between −10 degrees and 25 degrees, respectively. PROMs were recorded using the quick–disabilities of the arm, shoulder, and hand questionnaire-9 (quickDASH-9) ﻿and Single Assessment Numeric Evaluation (SANE) ﻿scores.

Results:
Forty-six wrists were included (age 13.9 ± 1.2 y) with a mean PROM duration of 5.2 ± 3.4 years (1.0 to 12.3 y). Neither RI (P = 0.123) nor VT (P = 0.305) changed significantly from preoperative to final follow-up. No significant correlation between distal radius measures and quickDASH-9 or SANE scores was observed: RI, P > 0.23, and VT, P > 0.28. Preoperatively, RI was unacceptable in 2 wrists, and VT was unacceptable in 5 wrists. While these 7 wrists became acceptable after ulnar epiphysiodesis, some acceptable wrists became unacceptable after the procedure.

Conclusions:
As predicted, distal radius radiographic parameters did not change after ulnar epiphysiodesis, and PROMs did not appear to correlate with acceptable RI or VT. The PROMs suggest that children do well with this procedure, but based on individual results, there appears to be room for improvement through future study and considerations for patient-specific treatment approaches.

Level of Evidence:
Level IV—cohort study.
Vascularized Proximal Radius Bone Graft for a Massive Elbow Bone Defect: An Anatomic Study and Case Report
Authors: Barrera-Ochoa Sergi , Martínez-Garza Julio A. , Ibañez Maximiliano , Prieto-Mere José A. , Bonilla-Chaperon Melissa , Soldado Francisco 
Published: February 2025

From an anatomic perspective, this paper delineates the proximal radial bone branches of the radial artery (RA). We also report the successful clinical use of a vascularized proximal radius bone graft (VPRBG), supplied by the RA, in a complex case involving a massive osseous elbow defect. In 10 latex-colored upper limbs from fresh human cadavers, RA branches were dissected under ×2.5 loupe magnification, noting all periosteal and osseous branches for the proximal radius. VPRBG length was measured. In the proximal forearm, the RA provides 10 (range: 7 to 14) periosteal and osseous branches to supply the area from the radial head to the proximal diaphysis. A 15 cm (11 to 17) vascularized bone graft can be harvested from the proximal radius, and RA dissection generates a 12 cm (9 to 15) pedicle with a wide arc of rotation, readily capable of reaching the distal part of the humerus. We used a 14 cm long VPRBG for elbow arthrodesis to fill a 12 cm defect, caused by a previous recalcitrant elbow infection in a 68-year-old man. The patient experienced no postoperative complications and successful consolidation was achieved 6 months postoperatively, with flap survival confirmed. After 2 years of follow-up, the contoured dorsal plate was removed, with no signs of infection. Final Disabilities of the Arm, Shoulder, and Hand and Mayo Wrist scores were 23 and 88, respectively. A VPRBG might be a safe and effective surgical option for massive osseous elbow defects, whenever elbow arthrodesis is planned, where it should be combined with a one-bone forearm technique.
Efficacy and Safety of Chimeric Antigen Receptor (CAR)-T Cell Therapy in Patients with Non-Hodgkin Lymphoma
Authors: Jamil Abdur , Qureshi Zaheer , Siddique Rimsha , Altaf Faryal , Akram Hamzah , Jamil Rohma , Aslam Shehroz , Selene Insija I. 
Published: February 2025

Objectives:
Non-Hodgkin lymphomas (NHL) are a diverse group of lymphoproliferative malignancies, often more unpredictable than Hodgkin lymphomas, with a higher likelihood of extranodal spread. NHL’s resistance to standard chemotherapy has increased, leading to a growing interest in personalized treatments like chimeric antigen receptor T-cell therapies (CAR-TCT).

Methodology:
A literature search was conducted across PubMed, ScienceDirect, Google Scholar, and the Cochrane Library for studies on CAR-TCT in NHL treatment published until July 2024. The outcomes assessed included overall survival (OS), event-free survival (EFS), progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs). Data were pooled using RevMan 5.41 and Comprehensive Meta-analysis 3.

Results:
Out of 532 articles, 8 met the inclusion criteria. CAR-TCT significantly improved OS (HR: 0.79; 95% CI: 0.63-1.00; P=0.05) and PFS (HR: 0.46; 95% CI: 0.36-0.58; P<0.00001) compared with standard chemotherapy. However, EFS was not significantly different (HR: 0.54; 95% CI: 0.26-1.09; P=0.09). About 76.6% of NHL patients responded to CAR-TCT, but the ORR was similar between CAR-TCT and standard therapy (MD: 19.23%; 95% CI: −11.34% to 49.80%; P=0.22). Safety analysis found a grade ≥3 AEs incidence comparable to CAR-TCT and standard care. However, CAR-TCT was associated with higher neutropenia risk but lower thrombocytopenia, anemia, and nausea risks.

Conclusion:
CAR-TCT significantly improves OS and PFS in refractory NHL but does not notably impact EFS. While its ORR is comparable to standard chemotherapy, CAR-TCT has a better safety profile, making it a promising treatment option.
Surgical Outcomes Following Distal Nerve Decompression in Patients With Trigeminal Neuralgia
Authors: Hazewinkel Merel H.J. , Knoedler Leonard , Remy Katya , Tseng Sierra , Austen William G. , Gfrerer Lisa 
Published: February 2025

Background:
Patients with headache disorders may present with compression of distal trigeminal nerve branches as well as other head and neck nerve branches such as the occipital nerves. In addition, a coexisting diagnosis of trigeminal neuralgia of proximal origin may be present. This overlap in diagnoses complicates treatment. Therefore, this study aimed to investigate the therapeutic effects of distal nerve decompression surgery in patients with coexisting trigeminal neuralgia from a proximal origin.

Methods:
The charts of 1112 patients who underwent screening for nerve decompression surgery were retrospectively reviewed. Patients with trigeminal neuralgia who underwent nerve decompression surgery were included. Data regarding preoperative and postoperative pain characteristics were collected.

Results:
Seventeen (1.5%) patients met the inclusion criteria and underwent nerve decompression. Fifteen patients (56%) underwent occipital decompression (13 greater occipital nerve decompressions, and 10 lesser occipital nerve decompressions), 5 patients (19%) underwent frontal decompression (supraorbital nerve/supratrochlear nerve decompression), and 6 patients (22%) underwent temporal decompression (4 zygomaticotemporal decompressions and 2 auriculotemporal nerve decompressions). Among the patients who underwent occipital decompression, 11 (73%) patients reported ≥80% pain relief, 1 (6.7%) patient reported ≥50% pain relief, and 3 (20%) patients reported ≤20% pain relief. For frontal and/or temporal decompression, only 2 (28%) patients achieved substantial pain relief (100% and 50%), whereas 5 (71%) patients experienced ≤20% pain relief.

Conclusions:
Our results demonstrate that occipital nerve decompression is an effective treatment for alleviating occipital neuralgia in individuals with coexisting proximal trigeminal neuralgia. However, the outcomes of frontal and temporal decompression were less favorable.
Hand Surgery in Lebanon 2024: Excellence Despite Existing Gaps
Authors: Bakhach Joseph Y. , Doghman Jana H. , Beaineh Paul T. , Makkawi Kareem W. 
Published: February 2025

Background:
Lebanon has always offered advanced hand surgery services in the Middle East. However, the acknowledgment of hand surgery as an independent entity is yet to be recognized, impacting the hand care services provided. This article analyzes the landscape of hand surgery in Lebanon in 2024.

Methods:
A list of registered plastic and orthopedic surgeons was obtained from the Lebanese Order of Physicians. Data on registered surgeons’ work settings and hand surgery subspecialty focus were obtained from the Lebanese Society of Plastic, Reconstructive, and Aesthetic Surgery, and the Lebanese Orthopaedic Society. Data on hand surgeons worldwide were extracted through direct contact with society presidents and from the most recent published records.

Results:
The work environment of the active surgeons fell into 3 categories: working full time in Lebanon, splitting work between Lebanon and abroad, and exclusively working abroad. The ratio of Lebanese surgeons practicing basic hand surgery is 3.28 per 100,000 people compared with a ratio of 0.1 per 100,000 people for specialized hand surgeons—well below the recommended ratio of 0.8. Seven other countries also experience a shortage in hand surgeons, 5 have a nearly adequate supply, and 5 have an oversupply.

Conclusions:
There is a shortage of specialized hand surgeons in Lebanon, compounded by a lack of recognition of this specialty at the public and private levels of the country. Implementation of strategies is needed to bridge this gap and add to the already offered contributions by existing expertise.
Identifying Contextual Workplace Stressors in a Division of Plastic and Reconstructive Surgery
Authors: Goodacre Viola , Adapa Karthik , Kwong Elizabeth , Vizer Lisa M. , Liu Chao-Chin , Charguia Nadia , Greenberg Caprice , Damitz Lynn A. , McHugh Damian , Mazur Lukasz M. 
Published: February 2025

Background:
Healthcare professionals in plastic and reconstructive surgery (PRS) face unique stressors that contribute to burnout, increasing the risk of errors and compromising patient care. Despite this, there is limited research on PRS burnout in the United States. This study aimed to measure burnout rates and identify high-impact improvement targets within a PRS division at a US academic medical center.

Methods:
A sequential mixed-methods study was conducted, involving systems analysis and contextual design methods. All surgeons (n = 5) and nonsurgeons (n = 9) were invited to participate (total n = 14). Burnout rates were measured, and workplace stressors were identified using surveys, focus groups, and contextual inquiries. High-impact, low-effort improvement targets were determined through impact-effort matrices.

Results:
Survey data from 13 respondents revealed an 85% burnout rate. Three focus groups and 14 contextual inquiries were conducted. After 13 participants validated and prioritized 2 affinity diagrams and provided 24 high-priority stressors, 8 respondents completed 2 surveys that yielded 6 high-impact/low-effort targets for organizational improvement efforts.

Conclusions:
This study highlights the high prevalence of burnout in PRS and identifies specific improvement targets for both surgeons and nonsurgeons. Findings suggest strategies such as improving respect and recognition for surgeons and streamlining clinic flow for nonsurgeons. Implementing these targeted improvements can enhance the well-being of healthcare professionals and ultimately improve patient care. The study’s methods can be replicated by other healthcare organizations to identify and address burnout-related issues effectively.
Loss of mitochondrial amidoxime-reducing component 1 (mARC1) prevents disease progression by reducing fibrosis in multiple mouse models of chronic liver disease
Authors: Coyne Erin S. , Nie Yilin , Lee Darwin , Pandovski Sentibel , Yang Tiffany , Zhou Heather , Rosahl Thomas W. , Carballo-Jane Ester , Abdurrachim Desiree , Zhou Yongqi , Hendra Christopher , Ali Asad Abu Bakar , Meyers Stacey , Blumenschein Wendy , Gongol Brendan , Liu Yang , Zhou Yingjiang , Talukdar Saswata 
Published: February 2025

Background:
Metabolic dysfunction–associated steatotic liver disease is a prevalent disease that affects nearly one-third of the global population. Recent genome-wide association studies revealed that a common missense variant in the gene encoding mitochondrial amidoxime reducing component 1 (mARC1) is associated with protection from metabolic dysfunction–associated steatotic liver disease, all-cause cirrhosis, and liver-related mortality suggesting a role for mARC1 in liver pathophysiology; however, little is known about its function in the liver. In this study, we aimed to evaluate the impact of mARC1 hepatoprotective variants on protein function, the effect of loss of mARC1 on cellular lipotoxic stress response, and the effect of global or hepatocyte-specific loss of mARC1 in various mouse models of metabolic dysfunction–associated steatohepatitis and liver fibrosis.

Methods﻿ and Results:
Expression and characterization of mARC1 hepatoprotective variants in cells and mouse liver revealed that the mARC1 p.A165T exhibited lower protein levels but maintained its mitochondrial localization. In cells, the knockdown of mARC1 improved cellular bioenergetics and decreased mitochondrial superoxide production in response to lipotoxic stress. Global genetic deletion and hepatocyte-specific knockdown of mARC1 in mice significantly reduced liver steatosis and fibrosis in multiple mouse models of metabolic dysfunction–associated steatohepatitis and liver fibrosis. Furthermore, RNA-seq analysis revealed that the pathways involved in extracellular matrix remodeling and collagen formation were downregulated in the liver, and the plasma lipidome was significantly altered in response to the loss of mARC1 in mice.

Conclusions:
Overall, we have demonstrated that loss of mARC1 alters hepatocyte response to lipotoxic stress and protects mice from diet-induced MASH and liver fibrosis consistent with findings from human genetics.