bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nasal Reconstruction With Forehead Flap: Our 12 Years’ Experience
Authors: D’Antonio Santolo , Castellaneta Francesco , Rullo Vincenzo , De Rosa Anna , Turco Piergiorgio , Grieco Michele Pio , Fabrizio Tommaso 
Published: February 2025

Background:
The nose is the part of the face that is most exposed to trauma, sunlight, and other environmental factors. From the aesthetic and functional point of view, reconstruction of the defects occurring after skin cancer removal creates a great challenge for the surgeon. In this retrospective study, we present the success rates achieved in the past 12 years with paramedian forehead flaps used for large nasal defect repairing.

Methods:
Seventy-seven patients were included who underwent paramedian forehead flaps due to nasal skin tumor basal cell carcinoma and squamous cell carcinoma at the division of plastic surgery of IRCCS-Centro di Riferimento Oncologico di Basilicata in Rionero in Vulture from 2010 to 2022. Data on follow-up time, patients’ age and sex, defect sizes, and tumor histology were obtained retrospectively from patient files, histopathologic examination results, and patient photographs. Additional diseases such as diabetes, hypertension, and coronary artery disease that could compromise flap success were noted.

Results:
Of 77 patients enrolled in our cohort, 42 were men and 35 were women. The average age was 68.3 years for male patients and 72.8 years for female patients. The mean follow-up period was 65 months. Of 77 patients, 45 (59.2%) were operated on for basal cell carcinoma and 31 (40.8%) for squamous cell carcinoma. Six patients (5.3%) had recurrence in their follow-up periods. There was no loss of the paramedian forehead flap.

Conclusions:
The paramedian forehead flap is a reliable option in the reconstruction of larger defects of the nose, even in smokers and older patients who have comorbid diseases.
Reducing Rates of Endophthalmitis from Intravitreal Injections – strategies and areas of controversy
Authors: Durrani Asad F. , Chaudhary Varun , Garg Sunir J. 
Published: February 2025

Purpose of review
Post-injection endophthalmitis (PIE) is the most concerning complication that accompanies intravitreal injections. This review discusses the recent literature in endophthalmitis prophylaxis including types of antisepsis, the use of topical antibiotics, methods of anesthesia, masking, and office-based versus operating room-based injections.

Recent findings
Povidone iodine (PI) remains the gold standard for PIE prophylaxis. Chlorhexidine gluconate (CHG) is an alternative antiseptic agent utilized in other areas of medicine with similar broad spectrum antibacterial activity. Recent clinical trials have demonstrated that the rate of endophthalmitis is similar with CHG prophylaxis compared to PI prophylaxis while offering improved patient comfort at a similar cost. Routine use of topical antibiotics should be avoided as they do not appear to reduce endophthalmitis risk and may promote bacterial resistance. All methods of anesthesia appear to be acceptable. In-office injections are not associated with an increased rate of endophthalmitis compared to operating room injections.

Summary
The rate of post-injection endophthalmitis is extremely low due to a myriad of measures employed by retina specialists. Topical antisepsis is the most important tool to combat post-injection endophthalmitis. CHG is emerging as an alternative to PI due to its efficacy and enhanced patient comfort.
Frequency and Intensity of Depressive Symptoms and Frequency of Prescribed Opioid Use Among Older Adults in the United States
Authors: Zhu Xingmei , Ge Song , Ma Weixia , Wu Liang , Ma Haixia , Hu Jiale , Lu Haidong , Lin Xuechun 
Published: February 2025

Abstract

Background
As part of the opioid crisis, opioid overuse is increasing in U.S. older adults. However, research on granular measures of depressive symptoms and opioid use exclusively in this population are limited.

Methods
Using data from the 2020 National Health Interview Survey, we constructed multivariate logistic and multinomial logistic regression models to examine the association of frequency and intensity of depressive symptoms with frequency of prescribed opioid use.

Results
The study population consisted of 8,637 participants with a mean age of 74.3 (SD = 6.4) years. Sixteen percent of the participants used prescribed opioids. Compared with participants who never felt depressed, those who felt depressed daily (OR = 1.796, 95% CI [1.371, 2.337]), weekly (OR = 1.579, 95% CI [1.236, 2.003]), or a few times a year (OR = 1.237, 95% CI [1.077, 1.418]) had increased odds of prescribed opioid use. Compared with participants who felt a little depressed, those who felt depressed somewhere in between a little and a lot (OR = 1.538, 95% CI [1.283, 1.842]) and those who felt depressed a lot (OR = 1.784, 95% CI [1.336, 2.274]) had increased odds of prescribed opioid use. Compared with participants who never felt depressed, those who felt depressed weekly (OR = 2.295, 95% CI [1.012, 5.204]) and those who felt depressed monthly (OR = 2.385, 95% CI [1.051, 5.409]) had increased OR of using prescribed opioid every day from using prescribed opioid some days.

Conclusion
Frequency and intensity of depressive symptoms were independently and positively associated with prescribed opioid use.
Epidemiology and practice patterns of achalasia in Taiwan: A nationwide population-based cohort study
Authors: Lin Kai-Liang , Lin Wei-Yu , Wang Yen-Po , Luo Jiing-Chyuan , Hou Ming-Chih , Lang Hui-Chu , Lu Ching-Liang 
Published: February 2025

Background:
Achalasia is a rare disease of gastrointestinal motility characterized by impaired esophageal peristalsis and reduced esophageal sphincter relaxation. However, data on its epidemiology and outcomes in Taiwan are limited. This study aimed to assess the incidence, characteristics, and clinical management of achalasia in Taiwan.

Methods:
Patients who were newly diagnosed with achalasia between 2001 and 2013 were recruited from the Taiwan National Health Insurance Research Database. The study obtained data on the age, sex, urbanization, socioeconomic status, area of residence, diagnostic methods, and interventional management of the patients. Incidence, diagnostic modalities, treatment methods, malignancy, and mortality outcomes were analyzed.

Results:
In total, 206 new achalasia cases were identified. The mean annual incidence in Taiwan was 1.64 (95% confidence interval 1.22–2.05) per 100,000 persons. The mean age of the patients at diagnosis was 51.8 years. The age-specific incidence of achalasia peaked in patients aged between 70–80 years and above 80 years. For achalasia diagnosis, endoscopy, computed tomography (CT), barium studies, and manometry were performed in 123 (59.71%), 97 (47.09%), 49 (23.79%), and 11 patients (5.34 %), respectively. During long-term follow-up, seven patients (3.39%) developed esophageal cancer, and 39 patients (18.93%) died. The median survival was 10.65 years after achalasia diagnosis, with a 10-year survival rate of 76.22%.

Conclusion:
This is the first population-based epidemiological study on achalasia in Taiwan, revealing the incidence of achalasia before the era of high-resolution manometry. Clinicians should be vigilant about the development of esophageal cancer and mortality during long-term follow-ups. There is also room to enhance the utilization of various diagnostic tools for achalasia.
Insights on Song Dynasty Medical Exams from Tai Yi Ju Zhu Ke Cheng Wen Ge (《太医局诸科程文格》 Examination Answers and Standards of the Imperial Medical Bureau)
Authors: HU Lingbai , ZHANG Xuedan 
Published: February 2025

Abstract:
The medical education of the Song dynasty constitutes a pivotal aspect within the broader framework of ancient Chinese medical education. The advent of the imperial examination system coincided with the emergence of a medical examination system, which served as the cornerstone for the subsequent evolution of medical education. According to historical records, the Song government established dedicated medical departments, along with comprehensive systems encompassing medical professors, students, and examinations. By examining extant medical historical documents, such as Tai Yi Ju Zhu Ke Cheng Wen Ge (《太医局诸科程文格》 Examination Answers and Standards of the Imperial Medical Bureau), researchers and readers can obtain a comprehensive understanding of the medical system that prevailed in the Song dynasty. While the intricate details of medical education during this era are not explicitly documented in historical records, modern researchers have the opportunity to uncover the entire view of medical education, particularly the medical examination system, through rigorous analysis of these extant historical medical documents. Such studies offer valuable insights into the developmental trajectory of the ancient Chinese medical examination system and provide crucial references for contemporary medical education. By conducting in-depth literature research and analysis of Tai Yi Ju Zhu Ke Cheng Wen Ge, this study endeavors to reconstruct the authentic scenario of medical examinations in the Song dynasty, as presented in the document, for the benefit of modern readers and researchers.
Role of genomics in liver transplantation for cholangiocarcinoma
Authors: Soliman Nadine , Maqsood Anaum , Connor Ashton A. 
Published: February 2025

Purpose of review
The purpose of this review is to summarize the current knowledge of cholangiocarcinoma molecular biology and to suggest a framework for implementation of next-generation sequencing in all stages of liver transplantation. This is timely as recent guidelines recommend increased use of these technologies with promising results.

Recent findings
The main themes covered here address germline and somatic genetic alterations recently discovered in cholangiocarcinoma, particularly those associated with prognosis and treatment responses, and nascent efforts to translate these into contemporary practice in the peri-liver transplantation period.

Summary
Early efforts to translate molecular profiling to cholangiocarcinoma care demonstrate a growing number of potentially actionable alterations. Still lacking is a consensus on what biomarkers and technologies to adopt, at what scale and cost, and how to integrate them most effectively into care with the ambition of increasing the number of patients eligible for liver transplantation and improving their long-term outcomes.
Interfacility Transfer and Admission to PICUs in the United States: Survey of Referral Communications in 2023
Authors: Cifra Christina L. , Lin Olivia , Gonzales Celestine L. , Pantekidis Irene , Chegondi Madhuradhar , Graciano Ana Lia , Gradidge Eleanor , Malone Matthew P. , Marx Matthew H. M. , Parikh Nehal R. , Woods-Hill Charlotte Z. , Landrigan Christopher P. ,   on behalf of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
Published: February 2025

Objectives:
Poor communication during interfacility transfer to the PICU can harm critically ill children. Structured handoff communication can prevent harm; however, the landscape of interfacility referral communication practices across PICUs is unknown. Our objective was to describe interfacility referral communication practices among U.S. PICUs to begin identifying potential improvement opportunities.

Design:
Mixed methods study including a cross-sectional survey and semi-structured interviews.

Setting:
U.S. PICUs with greater than or equal to 10 beds in 2023.

Participants:
Clinical/administrative PICU leaders.

Interventions:
None.

Measurements and Main Results:
Sixty surveys with greater than 70% completed questions were returned from 170 invited participants (35% response rate). Respondents were mainly pediatric critical care medicine division chiefs (48%) or PICU medical directors (32%). PICUs in all U.S. continental regions were represented, which had a median of 1200 (interquartile range [IQR], 1000–1500) admissions per year, of which 29.5% (IQR, 15–39%) were patients directly transferred from other institutions. In 93% of PICUs, a verbal interfacility handoff occurs between the referring clinician and a PICU physician; however, only 24% were always guided by a standard communication tool. In 72% of PICUs, medical records were only sometimes available before patient arrival. Semi-structured interviews with seven volunteer respondents revealed the following themes: 1) standardizing communication can result in organized and efficient handoffs but may also result in inefficiencies, 2) trained staff dedicated to interfacility referrals will improve communication quality, 3) integration of handoff information into the electronic health record will improve dissemination and decrease PICU physicians’ workload, and 4) implementing a structured process will require staff support to change current workflows.

Conclusions:
Referral communication for interfacility patient transfers to the PICU occurred mainly through unstructured verbal handoffs between referring clinicians and PICU physicians. PICU leaders identified several potential benefits and challenges of standardizing interfacility referral communication.
The role of the gut microbiome in Alzheimer's disease pathophysiology
Authors: Borrego-Ruiz Alejandro , Borrego Juan J. 
Published: February 2025

Purpose of review
The present review aims to provide an overview of the existing understanding of the role of the gut microbiome in the Alzheimer's disease pathophysiology.

Recent findings
Recent research has highlighted the significant role of the gut microbiome in the pathogenesis of Alzheimer's disease via the gut-brain axis. However, the precise mechanisms by which gut microbiome and its microbial metabolites influence brain function are not clearly understood. Various factors, such as diet, drugs, lifestyle, stress, and microbial infections can provoke an imbalance in the gut microbiome homeostasis, known as dysbiosis. This dysbiosis impacts intestinal and blood-brain barrier permeability, elevating pro-inflammatory cytokines and contributing to neurodegeneration. Moreover, the gut microbiome generates neurotransmitters, amyloids, neurotoxins, and metabolites, which may play a role in systemic inflammation and in the disruption of physiological barriers.

Summary
In the past decade, advancements in microbiome analysis technologies and bioinformatics have significantly enhanced our understanding of the role of the gut microbiome in Alzheimer's disease. The gut microbiome plays a pivotal regulatory role in the progression of Alzheimer's disease, and closely interacts with its pathogenesis, encompassing inflammation, amyloidosis, neurodegeneration, tauopathy, and co-pathologies.
Appraisal of the Impact of the Race-Neutral Estimated Glomerular Filtration Rate Waiting Time Modification on Transplant Wait Time and Outcomes for Black Kidney Candidates: Importance of Transplant Readiness on the Waitlist
Authors: Ebadinejad Amir , Cobar Juan P , Cyr-Long Pamela L , Dar Wasim , Emmanuel Bishoy , Morgan Glyn , Serrano Oscar K 
Published: February 2025

Background:
In July 2022, the Organ Procurement Transplant Network (OPTN) mandated race-neutral eGFR calculations when evaluating kidney transplant (KT) candidates, replacing historic race-based estimates. This modification also required transplant programs to identify KT candidates on their waitlist who would have benefitted from an earlier waitlist qualification date using race-neutral calculations.

Study Design:
This retrospective study analyzed Black patients listed for KT at our center between 2000 and 2023, recalculating their eGFR using race-neutral formulas. KT recipients with modified wait times (N=26) were compared to two control groups: Black recipients without modifications (N=21) and non-Black recipients (N=89). Postoperative outcomes, including complications and readmission rates, were analyzed across groups.

Results:
Of 126 Black patients evaluated, 60.3% qualified for wait time modifications, with a median gain of 570 days (1.6 years) per patient, totaling 62,057 days (180.7 years). Within 6 months of receiving additional time, 26 patients (34%) were transplanted, mostly from deceased donors (92%) with a median kidney donor profile index (KDPI) of 66%. Black KT recipients with modifications had significantly higher BMI, diabetes, and peripheral vascular disease compared to controls. Readmission rates were higher among Black KT recipients with modifications, though no significant differences in graft loss or mortality were observed.

Conclusions:
Race-neutral eGFR recalculations substantially improved Black KT candidates' ability to receive a KT, addressing historical disparities in KT. However, higher comorbidities and readmissions among these patients suggest the need for thorough transplant readiness evaluations prior to waitlist activation.
A Multimodal Sleep Foundation Model Developed with 500K Hours of Sleep Recordings for Disease Predictions
Authors: Thapa Rahul , Kjær Magnus Ruud , He Bryan , Covert Ian , Moore Hyatt , Hanif Umaer , Ganjoo Gauri , Westover Brandon M. , Jennum Poul , Brink-Kjær Andreas , Mignot Emmanuel , Zou James 
Published: February 2025

ABSTRACTSleep is a fundamental biological process with profound implications for physical and mental health, yet our understanding of its complex patterns and their relationships to a broad spectrum of diseases remains limited. While polysomnography (PSG), the gold standard for sleep analysis, captures rich multimodal physiological data, analyzing these measurements has been challenging due to limited flexibility across recording environments, poor generalizability across cohorts, and difficulty in leveraging information from multiple signals simultaneously. To address this gap, we curated over 585,000 hours of high-quality sleep recordings from approximately 65,000 participants across multiple cohorts and developed SleepFM, a multimodal sleep foundation model trained with a novel contrastive learning approach, designed to accommodate any PSG montage. SleepFM produces informative sleep embeddings that enable predictions of future diseases. We systematically demonstrate that SleepFM embeddings can predict 130 future diseases, as modeled by Phecodes, with C-Index and AUROC of at least 0.75 on held-out participants (Bonferroni-corrected p<0.01). This includes accurate predictions for death (C-Index: 0.84 [95% CI: 0.81–0.87]), heart failure (C-Index: 0.80 [95% CI: 0.77–0.83]), chronic kidney disease (C-Index: 0.79 [95% CI: 0.77–0.81]), dementia (C-Index: 0.85 [95% CI: 0.82–0.87]), stroke (C-Index: 0.78 [95% CI: 0.76–0.81]), atrial fibrillation (C-Index: 0.78 [95% CI: 0.75–0.81]), and myocardial infarction (C-Index: 0.81 [95% CI: 0.78–0.84]). The model’s generalizability was further validated through strong performance on the Sleep Heart Health Study (SHHS), a dataset unseen during pre-training. Additionally, SleepFM demonstrates strong performance on traditional sleep analysis tasks, achieving competitive results in both sleep staging (mean F1 scores: 0.70–0.78) and sleep apnea diagnosis (AUROC: 0.90–0.94). Beyond these standard applications, our analysis reveals that specific sleep stages and physiological signals carry distinct predictive power for different diseases. This work demonstrates how foundation models can leverage sleep polysomnography data to uncover the extensive relationship between sleep physiology and future disease risk.
Global metabolite profiling in feces, serum, and urine yields insights into energy balance phenotypes induced by diet-driven microbiome remodeling
Authors: Igudesman Daria , Yu GongXin , Dutta Tumpa , Carnero Elvis A. , Krajmalnik-Brown Rosa , Smith Steven R. , Corbin Karen D. 
Published: February 2025

AbstractBackground.Preclinical literature and behavioral human data suggest that diet profoundly impacts the human gut microbiome and energy absorption—a key determinant of energy balance. To determine whether these associations are causal, domiciled controlled feeding studies with precise measurements of dietary intake and energy balance are needed. Metabolomics—a functional readout of microbiome modulation—can help identify putative mechanisms mediating these effects. We previously demonstrated that a high-fiber, minimally processed Microbiome Enhancer Diet (MBD) fed at energy balance decreased energy absorption and increased microbial biomass relative to a calorie-matched fiber-poor, highly processed Western Diet (WD).Objective.To identify metabolic signatures distinguishing MBD from WD feeding and potential metabolomic mechanisms mediating the MBD-induced negative energy balance.Methods.We deployed global metabolomics in feces, serum, and urine using samples collected at the end of a randomized crossover controlled feeding trial delivering 22 days of an MBD and a WD to 17 persons without obesity. Samples were collected while participants were domiciled on a metabolic ward and analyzed using Ultrahigh Performance Liquid Chromatography-Tandem Mass Spectroscopy. Linear mixed effects models tested metabolite changes by diet. Weighted gene network correlation analysis identified metabolite modules correlated with energy balance phenotypes.Results.Numerous metabolites consistently altered in the feces, fasting serum, and/or urine may serve as putative dietary biomarkers of MBD feeding. Fecal diet-microbiota co-metabolites decreased by an MBD correlated with reduced energy absorption and increased microbial biomass. An MBD shifted the urinary metabolome from sugar degradation to ketogenesis—evidence of negative energy balance.Conclusions.Precisely controlled diets disparate in microbiota-accessible substrates led to distinct metabolomic signatures in feces, fasting serum, and/or urine. These diet-microbiota co-metabolites may be biomarkers of a “fed” (MBD) or “starved” (WD) gut microbiota associated with energy balance. These findings lay the foundation for unveiling causal pathways linking diet-microbiota co-metabolism to energy absorption.
Decoding continuous goal-directed movement from human brain-wide intracranial recordings
Authors: Ottenhoff Maarten C. , Verwoert Maxime , Goulis Sophocles , Tousseyn Simon , van Dijk Johannes P. , Shanechi Maryam M. , Sani Omid G. , Kubben Pieter , Herff Christian 
Published: February 2025

AbstractReaching out your hand is an effortless yet complex behavior that is indispensable in daily life. Restoring arm functionality is therefore rated a top priority by people with tetraplegia. Recently, neural correlates of movement have been observed and decoded beyond the motor cortex, but the degree and granularity of movement representation is not fully understood. Here, we explore the neural content of brain-wide movement-related neural activity by decoding neural correlates into 12 different kinematics of goal-directed reaching behavior. Eighteen participants implanted with stereotactic electroencephalography electrodes performed a gamified 3D goal-directed movement task. We demonstrate that continuous movement kinematics can be decoded from distributed recordings using low, mid and high frequency information in all participants using preferential subspace identification (PSID). The neural correlates of movement were distributed throughout the brain, including deeper structures such as the basal ganglia and insula. Moreover, we show that hand position could only be decoded using a goal-directed reference frame, indicating that widespread low-frequency activity is involved in higher-order processing of movements. Our results strengthen the evidence that widespread motor-related dynamics exist across numerous brain regions and can be used to continuously decode movement. The results may provide new opportunities for motor brain-computer interfaces for individuals with a compromised motor cortex, e.g. after stroke, or for control signals in adaptive closed-loop systems.