bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishment and validation of a nomogram for predicting IDH-wildtype glioblastomas in non-enhancing adult-type diffuse gliomas
Authors: He Lei , Fei Fan , Zhou Chengzhi , Bai Xiaoyan , Yu Shuqing , Wang Lei , Xu Ruxiang , Liu Hanjie 
Published: February 2025

Abstract

Background and purpose
Approximately 8.94% to 44.44% of non-enhancing adult-type diffuse gliomas are identified as glioblastomas. Our purpose is to develop a nomogram that can predict glioblastomas from non-enhancing adult-type diffuse gliomas.

Materials and Methods
Non-enhancing adult-type diffuse gliomas were collected from Beijing Tiantan Hospital and TCIA public database. Univariate and multivariate logistic regression were performed to screen features on the training set. The features with P&lt;0.05 in multivariate logistic regression were used to establish the prediction model. The testing and validation sets were used to test the model.

Results
A total of 557 and 67 non-enhancing adult-type diffuse gliomas were collected from Beijing Tiantan Hospital and TCIA, respectively. The T2-FLAIR mismatch sign exhibited 100% specificity but low sensitivity (&lt; 30%) in ruling out glioblastoma. Age, tumor location, rADC(kurtosis), and rADC(median) were identified as independent predictors and employed for developing the prediction model. The AUC of the model was 0.901, 0.861, and 0.945 in the training, testing, and validation set, respectively. The best cutoff value of nomoscore was 138.5, which achieved sensitivity of 0.935, 0.714, and 0.895, specificity of 0.777, 0.782, and 0.8775 in the training, testing, and validation sets, respectively. Survival analysis shown that patients with nomoscore above 138.5 had significantly poorer survival time than those with scores below 138.5.

Conclusions
Positive T2-FLAIR mismatch sign can effectively rule out glioblastoma in non-enhancing adult-type diffuse gliomas with high specificity. Non-enhancing adult-type diffuse gliomas with nomoscore above 138.5 are highly suspicious for glioblastoma or non-glioblastoma with a poor prognosis.
Interpretation of Positive Metagenomic Sequencing Reports Improves the Infection Diagnosis in Patients with Hematological Disorders
Authors: Xu Chunhui , Shen Yuyan , Chen Shulian , Liu Teng , Chen Xin , Yu Yuetian , Liu Li , Ma Runzhi , Zhang Lining , Liu Xin , Zhou Lukun , Zhu Guoqing , Feng Sizhou 
Published: February 2025

Abstract

Background
Metagenomic Next-Generation Sequencing (mNGS) has become a crucial diagnostic tool for infectious diseases in patients with hematological disorders. However, despite the abundant microbial information provided by positive mNGS reports, interpreting these results remains challenging due to the lack of standardized criteria.

Methods
We surveyed 92 clinicians to identify common challenges in understanding mNGS reports. Microbiologists then provided additional ‘Interpretation Reports Cards (RIC)’ for positive mNGS results alongside original reports. RIC aimed to determine whether each detected microorganism was likely cause of infection. After a 3-month period, a panel of clinical experts retrospectively reviewed 281 cases, involving 728 detected microorganisms, to assess RIC accuracy.

Results
In total, 82.6% (76/92) of clinicians experienced difficulties in interpreting mNGS reports. After receiving RIC, clinician satisfaction reached 97.8% (90/92). The overall concordance rates between interpretation and adjudication in the 281 cases was 79.0% (222/281). In 203 cases where multiple microorganisms were detected, 37.9% (77/203) and 37.4% (76/203) were interpreted and adjudicated as mixed infections. Among the 728 microorganisms, interpretation and adjudication revealed concordance rates of 93.9% (154/164), 95.7% (88/92), and 72.3% (339/469) for bacterial, fungal, and viral, respectively. In the cases, mNGS positively influenced pathogen diagnosis in 68.7% (193/281).

Conclusions
Not all microorganisms detected by mNGS are responsible for infection, and appropriate interpretation is essential. The provision of interpretations by microbiologists aids clinicians in accurately utilizing mNGS for infection diagnosis.
The endoplasmic reticulum luminal Ca2+ regulates cardiac Ca2+ pump function
Authors: Bovo Elisa , Nikolaienko Roman , Kahn Daniel , Espinoza-Fonseca L Michel , Zima Aleksey V 
Published: February 2025

Abstract
The type 2a sarcoplasmic/endoplasmic reticulum Ca2+-ATPase (SERCA2a) plays a central role in Ca2+ signaling of cardiomyocytes. The speed at which SERCA2a pumps Ca2+ from the cytosol into the sarcoplasmic reticulum (SR) determines the diastolic relaxation rate. SERCA2a activity also sets SR Ca2+ load, which determines the amplitude of SR Ca2+ release and the systolic contraction strength. While SERCA2a controls the SR luminal [Ca2+] ([Ca2+]SR), less is known about how dynamic changes in [Ca2+]SR affect SERCA2a function. By measuring the endoplasmic reticulum [Ca2+] ([Ca2+]ER) with the Ca2+ sensor R-CEPIA1er, we characterized the function of recombinant human and native mouse SERCA2a. We found that despite low endoplasmic reticulum (ER) Ca2+ gradient, SERCA2a-mediated Ca2+ transport was significantly slower at low [Ca2+]ER than at intermediate [Ca2+]ER. It appears that certain [Ca2+]ER is required for optimal SERCA2a Ca2+ transport. We tested whether negatively charged amino acids within the luminal loop between transmembrane helices M7 and M8 contribute to SERCA2a regulation by [Ca2+]ER. We found that the triple mutation E877L/D878L/E883L in the M7–M8 loop reduces SERCA2a Ca2+ transport particularly at intermediate [Ca2+]ER. Destabilizing the M7–M8 loop by breaking a disulfide bond between cysteines 875 and 887 abolished ER Ca2+ transport. Complementary molecular dynamics simulations showed that the triple mutant E877L/D878L/E883L stabilizes a Ca2+-bound E2 state of the pump, slowing down release of Ca2+ from the transport sites into the ER compared with the wild-type SERCA2a. These results revealed, for the first time, that SERCA2a Ca2+ transport is regulated by the luminal Ca2+ by interacting with the M7–M8 loop.
Building Competencies
Authors: White Tracie , Suttle Becky , Holland Aimee , Dailey Kelly , Hafley Sherrie , Smith Tedra , Bordelon Curry 
Published: February 2025

Abstract
For this simulation experience, doctor of nursing practice students present their proposed quality improvement (QI) projects to an embedded participant. The project requires students to refine their skills in QI design, leadership, critical thinking, team building, and effective communication, crucial for navigating the complexities of modern health care settings. Positive feedback from 11 cohorts underscores the simulation’s efficacy in enhancing preparedness, fostering teamwork, and enhancing communication.
Assessing ChatGPT Responses to Frequently Asked Questions Regarding Pediatric Supracondylar Humerus Fractures
Authors: Li Austin W. , Adelstein Jeremy M. , Li Lambert T. , Sinkler Margaret A. , Mistovich R. Justin 
Published: February 2025

Background:
The internet and standard search engines are commonly used resources for patients seeking medical information online. With the advancement and increasing usage of artificial intelligence (AI) in health information, online AI chatbots such as ChatGPT may surpass traditional web search engines as the next go-to online resource for medical information. This study aims to assess the ability of ChatGPT to answer frequently asked questions regarding pediatric supracondylar humerus (SCH) fractures.

Methods:
Seven (7) frequently asked questions (FAQs) regarding SCH fractures were presented to ChatGPT. Initial responses were recorded and rated as either “excellent requiring no clarification (0 items need clarification),” “satisfactory requiring minimal clarification (1 to 2 items need clarification),” “satisfactory requiring moderate clarification (3 to 4 items need clarification),” or “unsatisfactory requiring substantial clarification (>4 items need clarification or response contains false information).”

Results:
While 4 responses met satisfactory ratings with either moderate (2 responses) or minimal (2 responses) clarification, 3 of the 7 FAQs yielded a response from ChatGPT that were unsatisfactory. There were no responses that required no further clarification.

Conclusions:
ChatGPT provided some satisfactory responses to FAQs regarding pediatric SCH fractures, but required substantial clarification about treatment algorithms, casting and return to sport timelines, and the utility of physical therapy. Therefore, ChatGPT is an unreliable resource for information on treating SCH fractures. Parents of children who experience SCH fractures should continue to communicate with their doctors for the most accurate medical information.

Level of Evidence:
Level V—expert opinion on ChatGPT responses.
Prediction of Intensive Care Length of Stay for Surviving and Nonsurviving Patients Using Deep Learning
Authors: Brochini Ludmila , Liu Xinggang , Atallah Louis , Amelung Pamela , French Robin , Badawi Omar 
Published: February 2025

Objectives:
Length of stay (LOS) models support evaluating ICU care; however, current benchmarking models fail to consider differences in LOS between surviving and nonsurviving patients, which can lead to biased predictions toward the surviving population. We aim to develop a model addressing this as well as documentation bias to improve ICU benchmarking.

Design:
The Critical Care Outcomes Prediction Model (CCOPM) LOS uses patient characteristics, vitals, and laboratories during the first 24 hours of ICU admission to predict LOS in the hospital and ICU using a deep learning framework for modeling time to events with competing risk. Data was randomly divided into training, validation, and test (hold out) sets in a 2:1:1 ratio.

Setting:
Electronic ICU Research Institute database from participating tele-critical care programs.

Patients:
Six hundred sixty-nine thousand eight hundred seventy-six ICU admissions pertaining to 628,815 patients from 329 ICUs in 194 U.S. hospitals, from 2017 to 2019.

Interventions:
None.

Measurements and Main Results:
Model performance was assessed using the coefficient of determination (R
2), concordance index, mean absolute error, and calibration. For individual stays in the test set, the ICU LOS model presented R
2 = 0.29 and 0.23 for surviving and nonsurviving populations, respectively, at the individual level and R
2 = 0.48 and 0.23 at the ICU level. Conversely, hospital LOS model presented R
2 = 0.46 and 0.52 at the individual level and R
2 = 0.71 and 0.64 at the ICU level. In the subset of the test set containing predictions from Acute Physiology and Chronic Health Evaluation (APACHE) IVb, R
2 of ICU LOS for surviving and nonsurviving populations was, respectively, 0.30 and 0.23 for the CCOPM and 0.16 and zero for APACHE IVb. For hospital LOS, the values were R
2 = 0.39 and 0.40 for the CCOPM and 0.27 and zero for APACHE IVb.

Conclusions:
This novel LOS model represents a step forward in achieving more equitable benchmarking across diverse ICU settings with varying risk profiles.
Addressing Ethics in Plastic and Aesthetic Surgery: Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica’s Social Media Policy
Authors: Schonauer Fabrizio , Scarabosio Anna , Tettamanzi Matilde , Zena Monica , Cavaliere Annachiara , Tornambene Roberta , Pozzi Mirco , Tarantino Giulio , Matta Daniele , Macchi Dorina , De Fazio Stefania 
Published: February 2025

Background:
The pervasive influence of social media on plastic surgery necessitates a robust ethical framework to guide professional conduct online. The Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE) recognized the need for an ethical code that addresses the unique challenges posed by social media in the field of plastic surgery.

Methods:
A dedicated group, referred to as the Social Media Chat, was formed within SICPRE in November 2022. The group comprised members with varying levels of expertise, including the SICPRE president, plastic surgeons, professors, and residents. Through a comprehensive review of existing ethical codes and social media policies from 26 national and international plastic surgery societies, the group identified key ethical considerations. Virtual meetings facilitated discussions and the creation of content for SICPRE’s official social channels.

Results:
The analysis revealed that only a few societies had formal social media policies, whereas many had generic ethical codes with minimal guidance on social media use. SICPRE’s ethical code, formulated through collaborative efforts and multiple revisions, includes 10 fundamental points addressing professionalism, transparency, patient privacy, and ethical marketing. The code was integrated into SICPRE’s broader ethical guidelines to ensure consistency and comprehensiveness.

Conclusions:
SICPRE’s ethical code offers a detailed framework for navigating the intersection of plastic surgery and social media, emphasizing honesty, transparency, and respect for patient dignity. By aligning with best practices and addressing gaps in existing policies, this initiative aimed to enhance professional standards and patient trust in the digital age. Future updates will ensure the policy remains relevant amid evolving digital communication landscapes.
Impact of Race and Social Determinants on Operative Management of Distal Radius Fractures in Medicare Patients
Authors: Newman-Hung Nicole J. , Agarwal Amil R. , Paulson Ambika E. , Srikumaran Uma , Laporte Dawn , Wessel Lauren E. 
Published: February 2025

Background:
Operative fixation of distal radius fractures (DRFs) in high-demand patients may provide functional benefit, particularly in the setting of significant displacement. Whether social determinants of health (SDOH) and race impact treatment remain unclear. The purpose of this study was to determine whether adverse SDOH modifiers and race are independent predictors of surgical intervention for DRF.

Methods:
A retrospective analysis was conducted using the Medicare Standard Analytical Files of the PearlDiver database of patients with a DRF from 2007 to 2016. Univariate and multivariable regression analyses were performed to observe whether race and adverse SDOH variables were independent predictors of undergoing open reduction internal fixation (ORIF) within 3 weeks of a new diagnosis of DRF after controlling for age and fracture type.

Results:
The average patient age was 76.3 years. A total of 10,697 (13.1%) patients underwent ORIF. Patients who underwent ORIF were less likely to have negative economic and social modifiers of SDOH and had lower odds of being non-White. Patients who underwent surgery also had higher odds of being younger, White, female, and having a type III open fracture.

Conclusions:
In the Medicare population, non-White race and adverse economic and social modifiers of SDOH were independent predictors of undergoing nonoperative treatment of DRF after controlling for age and fracture type. Future studies are needed to further elucidate the nuanced effects of race and SDOH on the management of DRFs.
Improved Outcomes in Lower Eyelid Reconstruction With Biodegradable Implant: A Comparative Study
Authors: Jonnazarov Eldor , Cervatiuc Maria , Reshetov Igor V. , Saakyan Svetlana V. , Chuchueva Natalia D. 
Published: February 2025

Background:
Eyelid reconstruction is essential for patients who have undergone radical surgery to treat eyelid malignancies. The primary goal of this surgery is to restore both the functional and aesthetic aspects of the eyelid. Traditionally, various grafts from other parts of the body have been used for reconstruction. However, these methods may be limited by the availability of donor sites and the potential for associated complications.

Methods:
The study included 61 patients 58–91 years of age who underwent lower eyelid reconstruction. The patients were divided into 2 groups: a treatment group of 31 patients who received the biodegradable implant in addition to standard surgical techniques and a control group of 30 patients who underwent reconstruction without the implant. All patients were followed up for 1 year.

Results:
The study demonstrated that the use of the biodegradable membrane offered several advantages over the traditional approach without an implant. These advantages included faster healing times, as evidenced by cytological analysis; improved blood flow to the reconstructed eyelid, as measured by laser Doppler flowmetry; and a reduced incidence of eyelid complications, such as ectropion (outward turning of the eyelid). There were no statistically significant differences in tear osmolarity or pH between the 2 groups.

Conclusions:
The findings of this study suggest that the use of a biodegradable implant for lower eyelid reconstruction following malignant tumor surgery is a safe and effective method. It may lead to faster healing, improved blood flow, and fewer complications compared with traditional techniques.
The Four-line Algorithm for the Treatment of Unilateral Cleft Lip
Authors: Paredes Franklin J. , Alvarez Edwar C. , Jones Emily M. , Paredes Valeri K. 
Published: February 2025

Background:
Several factors affect the outcome of a repaired unilateral cleft lip (UCL). Some of these, like the surgeon’s expertise, are hard to evaluate, whereas others can be better evaluated objectively using the cleft severity index and the surgical technique used.

Methods:
This study includes patients of Operation Smile Ecuador and was done in 2 parts. The retrospective part uses the medical records of 298 patients with UCL treated by Operation Smile Ecuador from January 2015 to December 2017. The correlation of the photographed measurements, surgical technique, and evolution of the patients was studied. In the prospective part, the participant surgeons of this article applied the algorithm to 136 patients treated from January 2018 to December 2019.

Results:
In the retrospective study, the resulting symmetry varied significantly among most Unilateral Cleft Asymmetry Index presurgical classifications, and 34% of the results were deficient. The four-line algorithm was developed using the case-technique analysis of the retroactive study. The algorithm was applied in the prospective part, which resulted in no deficient cases and 81% optimal results. There were significantly better results after applying the four-line algorithm for patients classified as Unilateral Cleft Asymmetry Index degrees III and IV (P < 0.001 and P = 0.041, respectively).

Conclusions:
Even though the cleft severity in the UCL is an important prognostic factor, the results of this study show that there are no universal surgical techniques to achieve optimal results. The four-line algorithm proposes to use a case-specific surgical technique to achieve the best functional and aesthetic result for our patients.
Cross-Lagged Associations Among Sleep, Headache, and Pain in Pediatric Mild Traumatic Brain Injury: An A-CAP Study
Authors: Dharsee Safira , Hassan Ali , Noel Melanie , Bender Amy M. , Beauchamp Miriam H. , Craig William , Doan Quynh , Freedman Stephen B. , Gravel Jocelyn , Zemek Roger , Yeates Keith Owen 
Published: February 2025

Objective:
To test cross-lagged associations among sleep, headache, and pain in pediatric mild traumatic brain injury (mTBI).

Setting, Participants, Design:
Children and adolescents aged 8.0 to 16.9 years who sustained a mTBI and presented to 1 of 5 pediatric emergency departments across Canada completed assessments at 1-week, 3 months, and 6 months post-injury as part of a larger prospective cohort study.

Main Measures:
Sleep disturbance was measured using 7 sleep items from the Child Behaviour Checklist. Sleep duration was measured using average weekday and weekend sleep from the Healthy Lifestyle Behaviours Questionnaire. Pain intensity was measured using an 11-point numerical rating scale. Headache severity and associated functional impairment were measured using the Headache Impact Test and 1 item from the Health and Behaviour Inventory. Analyses included trivariate-indicator random-intercept cross-lagged panel models.

Results:
Of 633 recruited children, 563 were included in the current study. Headache showed significant within-person, bidirectional, cross-lagged associations with sleep disturbance and duration, as well as with pain intensity. More specifically, worse headache predicted greater sleep disturbance (1-week to 3 months and 3 months to 6 months: Bs = .47, Ps ≤ .013) and shorter sleep duration (1-week to 3 months: B = −.21, P = .006), while greater sleep disturbance predicted worse headache (1-week to 3 months: B = .08, P = .001). Worse headache also predicted higher pain intensity (1-week to 3 months & 3 months to 6 months: Bs ≥ 1.27, P
s < .001), while higher pain intensity predicted worse headache (3 months to 6 months: Bs ≥ .03, Ps ≤ .042). No cross-lagged associations involving sleep disturbance or duration with pain intensity were significant.

Conclusions:
Significant bi-directional, cross-lagged associations exist between headache and both sleep and pain. The findings suggest that early intervention for headaches may help prevent later sleep disturbance and pain after pediatric mTBI.
Understanding Patient–Provider Relationships: A Qualitative Study of Rural HIV Care in a Low-Prevalence Mountain West State in the United States
Authors: Fertaly Kaitlin , Javorka McKenzie 
Published: February 2025

Abstract
Supportive relationships between people living with HIV (PLWH) and their health care providers are crucial for treatment adherence and communication about health needs. This study explored key elements of patient–provider relationships (PPRs) among PLWH in a predominantly rural, Mountain West state with a low HIV prevalence. We analyzed in-depth interviews conducted with 17 PLWH. We identified 4 key themes related to PPR: (a) providers' limited competencies in HIV and lesbian, gay, bisexual, transgender and queer issues, (b) patients' desire for empathetic and nonjudgmental care, (c) patients' experiences of dismissal or dehumanization by providers or the health care system, and (d) experiences and fear of stigma. Our findings underscore the role that PPR plays in addressing or exacerbating barriers for PLWH in rural areas, emphasizing the need for both interpersonal (e.g., provider-focused) and structural interventions to increase providers' HIV knowledge, decrease stigma, and foster positive PPR.