bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Strengths and Needs Assessment of Campus Sexual Assault Response
Authors: Miyamoto Sheridan , Bittner Cynthia , Delwiche Jennifer , Ganguli Aishwarya 
Published: February 2024

ABSTRACT

Background
Sexual violence and sexual assault (SA) disproportionately affect the young adult population aged 18–24 years, half of which are enrolled in higher education. Campuses are tasked with providing a safe space for students and enacting an appropriate response to campus SA (CSA).

Aims
As part of a grant-funded program to strengthen SA nurse examiner (SANE) services to those who experience SA on college campuses, we conducted a campus needs assessment and a campus website review for key messaging and analyzed the responses to identify strengths and gaps in campus resources related to CSA. These findings were the basis of individualized Campus Community Summary reports shared with participants from each campus.

Methods
Guided qualitative interviews with interdisciplinary stakeholders across seven campus communities and campus website reviews were used to identify campus resource strengths, gaps, and recommendations for improvement.

Results
Common strengths included awareness of campus programs and community services, leadership support for CSA activities, and community CSA response. Identified opportunities for improvement included strengthening interdisciplinary collaboration, solving transportation issues to obtain care, mental healthcare and advocacy services, awareness and resource messaging, and fighting stigma and bias. Campus websites reviews indicated gaps in key information about SANE care and how to access SANE services.

Conclusions
Numerous gaps and opportunities to strengthen campus SA awareness and coordination and access to a timely response to SA were identified. Addressing these gaps is essential to ensure quality care and services for individuals who experience SA on college campuses.
Using the Stratum-Specific Likelihood Ratio Method to Derive Outcome-Based Hospital Volume Categories for Total Knee Replacement
Authors: Ghomrawi Hassan M.K. , Huang Lynn W. , Hiredesai Annika N. , French Dustin D. 
Published: February 2024

Background:
Evidence of higher hospital volume being associated with improved outcomes for patients undergoing total knee replacement (TKR) is mostly based on arbitrary distribution-based thresholds.

Objective:
We aimed to define outcome-based volume thresholds using data from a national database.

Methods:
We used the MedPAR Limited Data Set inpatient data from 2010-2015 to identify patients who had undergone primary TKR. Surgical and TKR specific complications occurring within the index hospitalization and all-cause readmission within 90 days were considered adverse events. We derived an average annual TKR case volume for each hospital and applied the stratum-specific likelihood ratio method to determine volume categories indicative of a similar likelihood of 90-day post-operative complications. Hierarchical multivariable logistic regression with a random intercept for hospital nested within study year and adjusted for patient and hospital characteristics was performed to determine if these volume thresholds were still associated with the odds of 90-day readmission for complications after adjustment.

Results:
SSLR analysis yielded 4 hospital volume categories based on the likelihood of 90-day postoperative complications: 1–31 (low), 32–127 (medium), 128–248 (high), and 429+ (very high) TKRs performed per year. The results of the hierarchical multivariable logistic regression showed significantly increased odds of 90-day complications at lower volume categories. Sensitivity analyses confirmed our main findings.

Conclusions:
This study is the first to provide national-level volume categories that are evidence-based. Publicizing these thresholds may enhance quality measures available to patients, providers, and payors.
Evaluation of bone marrow invasion on the machine learning of 18F-FDG PET texture analysis in lower gingival squamous cell carcinoma
Authors: Fukushima Yasuhiro , Suzuki Keisuke , Kim Mai , Gu Wenchao , Yokoo Satoshi , Tsushima Yoshito 
Published: February 2024

Objectives
Lower gingival squamous cell carcinoma (LGSCC) has the potential to invade the alveolar bone. Traditionally, the diagnosis of LGSCC relied on morphological imaging, but inconsistencies between these assessments and surgical findings have been observed. This study aimed to assess the correlation between LGSCC bone marrow invasion and PET texture features and to enhance diagnostic accuracy by using machine learning.

Methods
A retrospective analysis of 159 LGSCC patients with pretreatment 18F-fluorodeoxyglucose (FDG) PET/computed tomography (CT) examination from 2009 to 2017 was performed. We extracted radiomic features from the PET images, focusing on pathologic bone marrow invasion detection. Extracted features underwent the least absolute shrinkage and selection operator algorithm-based selection and were then used for machine learning via the XGBoost package to distinguish bone marrow invasion presence. Receiver operating characteristic curve analysis was performed.

Results
From the 159 patients, 88 qualified for further analysis (59 men; average age, 69.2 years), and pathologic bone marrow invasion was identified in 69 (78%) of these patients. Three significant radiological features were identified: Gray level co-occurrence matrix_Correlation, INTENSITY-BASED_IntensityInterquartileRange, and MORPHOLOGICAL_SurfaceToVolumeRatio. An XGBoost machine-learning model, using PET radiomic features to detect bone marrow invasion, yielded an area under the curve value of 0.83.

Conclusion
Our findings highlighted the potential of 18F-FDG PET radiomic features, combined with machine learning, as a promising avenue for improving LGSCC diagnosis and treatment. Using 18F-FDG PET texture features may provide a robust and accurate method for determining the presence or absence of bone marrow invasion in LGSCC patients.
Intracranial Hypertension Associated With Poly-Cranio-Radicular-Neuropathies
Authors: Eaton James E. , Oguz Ipek , Kazimuddin Habeeb , Bagnato Francesca 
Published: February 2024

Introduction:
We present the case of a gentleman who developed rapidly progressive vision loss, ophthalmo-paresis, and flaccid quadriparesis in the context of severe intracranial hypertension. We reviewed the available cases in the literature to increase awareness of this rare clinical entity.
Case Report:
A 36-year-old man developed rapidly progressive vision loss, ophthalmo-paresis, and flaccid quadriparesis. He had an extensive workup, only notable for severe intracranial hypertension, >55 cm of H2O. No inflammatory features were present, and the patient responded to CSF diversion. Few similar cases are available in the literature, but all show markedly elevated intracranial pressure associated with extensive neuroaxis dysfunction. Similarly, these patients improved with CSF diversion but did not appear to respond to immune-based therapies.

Conclusions:
We term this extensive neuroaxis dysfunction intracranial hypertension associated with poly-cranio-radicular-neuropathy (IHP) and distinguish it from similar immune-mediated clinical presentations. Clinicians should be aware of the different etiologies of this potentially devastating clinical presentation to inform appropriate and timely treatment.
The Effectiveness of Public Awareness Initiatives Aimed at Encouraging the Use of Evidence-Based Recommendations by Health Professionals: A Systematic Review
Authors: Tian Esther Jie , Nguyen Cathy , Chung Lilian , Morris Chloe , Kumar Saravana 
Published: February 2024

Objectives
Public awareness initiatives have attracted growing attention globally, as a strategy to reduce low-value care and disinformation. However, knowledge gap remains in determining their effects. The aim of this systematic review was to summarize existing evidence to date on global effectiveness of public awareness initiatives.

Methods
Primary quantitative studies focusing on passive delivery of public awareness initiatives that targeted health professionals were included. Eligible studies were identified through search of MEDLINE, Embase, Emcare, the Cochrane Library, PsycINFO, Business Source Complete, Emerald Insight, and Google (initially on December 19, 2018, followed by updated search between July 8–10, 2019, and then between March 8–9, 2022) and the reference list of relevant studies. Methodological quality of included studies was assessed using modified McMaster critical appraisal tool. A narrative synthesis of the study outcomes was conducted.

Results
Twenty studies from United States, United Kingdom, Canada, Australia, and multicountry were included. Nineteen studies focused on Choosing Wisely initiative and one focused on National Institute of Clinical Excellence reminders. Most studies investigated one recommendation of a specialty. The findings showed conflicting evidence on the effectiveness of public awareness initiatives, suggesting passive delivery has limited success in reducing low-value care among health professionals.

Conclusions
This review highlights the complexity of change in an established practice pattern in health care. As passive delivery of public awareness initiatives has limited potential to initiate and sustain change, wide-ranging intervention components need to be integrated for a successful implementation.
Endosonography Elastography and Magnetic Resonance Imaging in the Restaging and Response Assessment of Rectal Cancer After Neoadjuvant Therapy
Authors: Tang Xuemei , Yuan Hongmei , Mu Xurong , Gu Peng , Kong Pengfei 
Published: February 2024

AbstractThe objective of this academic research is to assess the efficacy of conventional endorectal ultrasound (ERUS), ultrasonic shear wave elastography (SWE), and magnetic resonance imaging (MRI) techniques in evaluating the impact of neoadjuvant therapy (nCRT). Forty-five patients with advanced low rectal cancer (T ≥ 3) were included. Before and after nCRT, ERUS, SWE, and MRI evaluations were conducted. The T staging of ultrasound (uT) and MRI (mT) were evaluated and compared with the pathological T staging (ypT). The accuracy of the 2 diagnostic methods for T staging, and T downstaging was evaluated. The ultrasound elasticity difference and relative elasticity before and after treatment and pathological T downstaging were compared, and its cutoff value and the area under the curve were assessed. In terms of T staging accuracy after chemoradiotherapy, the values for ERUS, ERUS combined with SWE, and MRI were 64.4%, 71.1%, and 62.2%, respectively. No significant difference was observed among these groups (P> 0.05). The accuracy of uT downstaging was 84.4%, and that of mT downstaging was 88.9%. The receiver operating characteristic curve of uLD and elastic differences and relative elasticity of T downstaging after treatment were 0.754, 0.817, and 0.886, respectively (allP< 0.05). Both ERUS and MRI can evaluate ypT downstaging. The indicators for evaluating T downstaging are uLD, elasticity difference, and relative elasticity, providing more reference for clinical assessment of nCRT efficacy.
Update on the Selection Criteria of Plastic Surgery Residents
Authors: Asghari Arya , Hines Eric , Mocharnuk Joseph , Leis Amber , Wang Eric D. 
Published: February 2024

Background
Plastic and reconstructive surgery (PRS) is recognized as a highly competitive specialty. Since the first assessment of resident selection criteria in 2007, PRS residency programs have adopted holistic review processes and adapted to changes such as a decline in medical schools participating in the Alpha Omega Alpha Honor Medical Society as well as the recent transition to pass/fail grading for the United States Medical Licensing Examination (USMLE) step 1 examination (Schultz et al. Plast Reconstr Surg Glob Open. 2020;8:e2892; Tadisina et al. Plast Reconstr Surg. 2017;139:330e–331e). This study was devised to evaluate current PRS residency criteria in light of these changes.

Methods
An anonymous, 12-item, electronic survey was generated and distributed using Alchemer. An email was sent to 171 program directors (PDs) and associate program directors (APDs) of PRS residency programs. Survey questions were developed to collect data regarding respondent demographics and their desired criteria when assessing residency applicants. Complete responses were collected and analyzed with summary statistics and multivariate logistic regression using RStudio (version 1.3.109).

Results
In total, 44 (25.7% response rate) of the 171 PDs and APDs completed the survey. Of the 16 programs (36.4%) with a USMLE cutoff score, 7 (43.8%) reported a range of 230 to 239 and 6 (37.5%) reported a range of 240 to 249. Without a score for step 1, the majority (48.8%) of respondents believe that step 2 scores will replace step 1 scores in terms of assessment criteria, and the content of recommendation letters was selected as the criterion with the greatest increase in weight (66.7%). In addition, 27.3% of programs require a step 2 score at the time of interview. The top 3 academic criteria in order of decreasing importance were the content of recommendation letters, clinical grades, and letter writers, whereas the top 3 nonacademic criteria were subinternship performance, maturity, and interview performance.

Conclusions
Plastic and reconstructive surgery remains a highly competitive specialty for residency applicants. Our findings suggest that Alpha Omega Alpha membership remains diminished in importance, whereas USMLE cutoff scores have increased. With recent changes in the step 1 grading system, PDs and APDs will rely more heavily on step 2 scores and the content of recommendation letters.
ACETATE RINGER'S SOLUTION VERSUS NORMAL SALINE SOLUTION IN SEPSIS: A RANDOMIZED, CONTROLLED TRIAL
Authors: Zhang Jing , Liu Fang , Wu Ziyi , Jiang Jun , Wang Bingqing , Qian Yaoyao , Suo Jinmeng , Li Yiming , Peng Zhiyong 
Published: February 2024

ABSTRACTBackground: Normal saline solution (NSS) and Ringer's acetate solution (RAS) are commonly given to critically ill patients as a fundamental fluid therapy. However, the effect of RAS and NSS on sepsis patient outcomes remains unknown. Methods: We conducted a single-center prospective open-label parallel controlled trial to enroll adult patients (>18 years old) diagnosed with sepsis. Participants received either RAS or NSS for intravenous infusion for 5 days. The primary outcome was the incidence of major adverse kidney events within 28 days (MAKE28). Secondary outcomes included 30−/90-day mortality, acute kidney injury, and hyperchloremia. The patients were then reclassified as NSS-only, RAS-only, and RAS + NSS groups according to the type of fluid they had received before enrollment. Thereafter, a secondarypost hocanalysis was performed. Results: Two hundred fifty-five septic patients were screened, and 143 patients (51.0% in RAS group and 49.0% in NSS group) were enrolled in the study. Each group received a median of 2 L of fluid administration during five interventional days. Of the patients, 39.3% had received 500 mL (500–1,000 mL) of balanced salt solutions (BSSs) before intensive care unit (ICU) admission. There was no statistical difference among the RAS and NSS group on the primary outcome MAKE28 in the initial analysis (23.3% vs. 20.0%; OR, 1.2 [0.6 to 2.2];P= 0.69). MAKE28 was observed in 23.3% of RAS-only versus 27.3% of NSS-only group patients (0.82 [0.35–1.94],P= 0.65) in the secondarypost hocanalysis. The patients in the NSS-only group had a longer invasive mechanical ventilation days and a trend toward the accumulation of serum chloride. Conclusion: This study observed no statistically significant difference on MAKE28 and secondary outcomes among sepsis patients receiving RAS and NSS. However, it is unclear whether the large amount of fluid resuscitation before ICU admission and carrier NSS narrowed the difference between BSSs and NSSs.
Private Equity Investment in Surgical Care
Authors: Sievers Maxwell T. , Neevel Andrew , Diaz Adrian , Rouanet Eva , Sheetz Kyle , Brophy David , Dimick Justin B. , Chhabra Karan R. 
Published: February 2024

Objective:
To characterize the extent of private equity (PE) investment affecting surgical care.

Background:
Over the last decade, investor-backed, for-profit PE groups have invested in health care at an unprecedented rate, but the breadth of these investments affecting surgical practice remains largely unknown.

Methods:
Four nationally representative databases were used to identify all merger/acquisitions involving surgical practices between 2015 and 2019, determine PE investment in those transactions, and link the acquisitions with a physician data set.

Results:
A total of 1542 unique transactions were identified, of which 539 were financed by PE. Fifty-eight transactions were then classified into their respective categories within surgical care: digestive disease, orthopedics, urology, vascular surgery, and plastic/cosmetic surgery. These transactions accounted for 199 practice sites and 1405 physicians, averaging 24.2 physicians per transaction. Acquisition activity peaked in 2017, with a total of 63 practices involved. Digestive disease, urology, and orthopedic surgery accounted for the most activity. General surgeons were involved in a small share of the digestive disease practice acquisitions. Three “surgery-adjacent” categories were also identified: anesthesiology, ambulatory surgery centers, and surgical staffing firms. Among these, anesthesia was the largest category in terms of practices (194) and physicians (2660) involved in transactions across the study period. Medical Service Organizations were a key mechanism through which PE firms invested in surgical care.

Conclusions:
PE has engaged in substantial investment within surgical specialties, creating increased practice consolidation. These investments affect all levels of medical care and have notable implications for patients, practitioners, and policymakers.
Effectiveness and Safety of Flumazenil Augmentation During Electroconvulsive Therapy
Authors: Gistelinck Lennart , Van de Velde Nele , Tandt Hannelore , Verslype Pieter , Lemmens Gilbert 
Published: February 2024

Introduction
Benzodiazepines are considered to negatively affect seizure quality and duration during electroconvulsive therapy (ECT). Several researchers have advocated the use of flumazenil, a competitive benzodiazepine receptor antagonist, for patients treated with benzodiazepines during ECT. However, clinical evidence regarding flumazenil use in ECT remains sparse. The aim of this study is to investigate the effects of flumazenil on seizure duration and adverse effects.

Methods
All patients with depressive disorders, treated with flumazenil during a course of ECT in 2019 in a tertiary hospital, were identified through a retrospective chart review. Seizure duration was recorded before and after flumazenil administration. Effectiveness of ECT was assessed using the Inventory of Depressive Symptomatology and the Bush-Francis Catatonia Rating Scale. Postictal agitation was ascertained by identifying patients who received additional sedatives immediately after ECT or who needed physical restraint.

Results
Twenty-six patients were included, receiving a total of 363 treatments, of which 263 were augmented with flumazenil. Flumazenil administration increased electroencephalogram seizure duration on average with 10.5 seconds comparing ECT with or without flumazenil (P = 0.003). In 21.8% of the cases, no increase in seizure duration was observed. Postictal agitation occurred at least once in 34.6% of the patients receiving flumazenil during their course of ECT.

Conclusion
Our results show that flumazenil increases seizure duration, albeit with limited clinical implications. Noteworthy, the prevalence of postictal agitation is high. When confronted with short seizures, clinicians should therefore deploy other available techniques to lower seizure threshold before considering flumazenil.
Effects of phosphorylation on protein backbone dynamics and conformational preferences
Authors: Bickel David , Vranken Wim 
Published: February 2024

AbstractPhosphorylations are the most common and extensively studied post-translational modification (PTM) of proteins in eukaryotes. They constitute a major regulatory mechanism, modulating protein function, protein-protein interactions, as well as subcellular localization. Phosphorylation sites are preferably located in intrinsically disordered regions and have been shown to trigger structural rearrangements and order-to-disorder transitions. They can therefore have a significant effect on protein backbone dynamics or conformation, but only sparse experimental data are available. To obtain a more general description of how and when phosphorylations have a significant effect on protein behavior, molecular dynamics (MD) currently provides the only suitable framework to study these effects at a large scale in atomistic detail.This study develops a systematic MD simulation framework to explore the influence of phosphorylations on the local backbone dynamics and conformational propensities of proteins. Through a series of glycine-backbone peptides, we studied the effects of amino acid residues including the three most common phosphorylations (Ser, Thr, and Tyr), on local backbone dynamics and conformational propensities. We further extended our study to investigate the interactions of all such residues between positionito positionsi+1,i+2,i+3, andi+4 in such peptides. The final dataset is comprised of structural ensembles for 3,393 sequences with more than 1 µs of sampling for each ensemble. To validate the relevance of the results, the structural and conformational properties extracted from the MD simulations are compared to NMR data from the Biological Magnetic Resonance Data Bank.The systematic nature of this study enables the projection of the gained knowledge onto any phosphorylation-site in the proteome and provides a general framework for the study of further PTMs. The full dataset is publicly available, as a training and reference set.
The impact of complement factor H-related protein gene deletions on kidney transplantation
Authors: Salla Markkinen , Inkeri Lokki A. , Ilkka Helanterä , Jarmo Ritari , Jukka Partanen , Seppo Meri , Kati Hyvärinen 
Published: February 2024

ABSTRACTWe recently reported that a homozygous deletion in the complement factor H-related (CFHR)locus predisposed kidney transplant patients to rejection. As donors carried intact genes, the susceptibility may have resulted from alloimmune reaction to FHR proteins. However, we found no evidence for anti-FH response. It is therefore possible thatCFHRdeletions as such affect the rejection risk. Here, we used MLPA and WGS to fine-map and sequence theCFHRregion in rs7542235-GG patients, a SNP tagging for ΔCFHR311 deletion. Our results confirmed that all patients with this SNP harboured deletions of various sizes encompassingCFHR1. Furthermore, patients with homozygous ΔCFHR311 were homozygous for rs6677604-A, a SNP tagging for deletions of CFHR311 locus, confirming that allele A tags for deletion of bothCFHR3andCFHR1. Proteomics analyses in a larger population demonstrated that rs7542235-G and rs6677604-A associate with expression levels of several proteins involved in regulating alloimmune response. We observed that while increasing the rejection risk, the ΔCFHR311 did not associate to baseline disease or specific clinical characteristics. To conclude, the various deletion types found in patients shared the deletion ofCFHR1gene confirming its association to variant rs7542235. Also, both deletion-tagging alleles are associated with altered expression of FHR proteins.