bluuebunny/crossref_metadata_2025_split huggingface dataset:
Will synchronous esophageal and lung resection increase the incidence of anastomotic leaks? A multicenter retrospective study
Authors: Liu Yixin , Zhou Jianfeng , Gu Yimin , Hu Weipeng , Lin Haonan , Shang Qixin , Zhang Hanlu , Yang Yushang , Yuan Yong , Chen Longqi 
Published: January 2024

Background:
Reports on combined resection for synchronous lung lesions and esophageal cancer (CRLE) cases are rare and mostly individual cases. Furthermore, the feasibility of CRLE has always been a controversial topic. In the current study, the authors retrospectively analyzed the feasibility of CRLE and established an individualized prediction model for esophageal anastomotic leaks after CRLE by performing a multicenter retrospective study.

Methods:
Patients who underwent esophagectomy between January 2009 and June 2021 were extracted from a four-center prospectively maintained database, and those with CRLE at the same setting were matched in a 1:2 propensity score-matched (PSM) ratio to esophagectomy alone (EA) patients. A nomogram was then established based on the variables involved in multivariate logistic regression analysis. Internal validation of the nomogram was conducted utilizing Bootstrap resampling. Decision and clinical impact curve analysis were computed to assess the practical clinical utility of the nomogram. A prognosis analysis for CRLE and EA patients by Kaplan–Meier curves was conducted.

Results:
Of the 7152 esophagectomies, 216 cases of CRLE were eligible, and 1:2 ratio propensity score-matched EA patients were matched. The incidence of anastomotic leaks following CRLE increased significantly (P=0.035). The results of the multivariate analysis indicated the leaks varied according to the type of lung resection (anatomic>wedge resection, P=0.016) and site of resected lobe (upper>middle/low lobe; P=0.027), and a nomogram was established to predict the occurrence of leaks accurately (area under the curve=0.786). Although no statistically significant difference in overall survival (OS) was observed in the CRLE group (P=0.070), a trend toward lower survival rates was noted. Further analysis revealed that combined upper lobe anatomic resection was significantly associated with reduced OS (P=0.027).

Conclusion:
Our study confirms that CRLE is feasible but comes with a significantly increased risk of anastomotic leaks and a concerning trend of reduced survival, particularly when upper lobe anatomic resections are performed. These findings highlight the need for careful patient selection and surgical planning when considering CRLE.
Precise diagnosis and risk stratification of prostate cancer by comprehensive serum metabolic fingerprints: a prediction model study
Authors: Fei Xiaochen , Du Xinxing , Wang Jiayi , Liu Jiazhou , Gong Yiming , Zhao Zejun , Cao Zhibin , Fu Qibo , Zhu Yinjie , Dong Liang , Dong Baijun , Pan Jiahua , Sun Wenshe , Xie Shaowei , Xue Wei 
Published: January 2024

Objectives:
Prostate cancer (PCa) is one of the most common malignancies in men worldwide and has caused increasing clinical morbidity and mortality, making timely diagnosis and accurate staging crucial. The authors introduced a novel approach based on mass spectrometry for precise diagnosis and stratification of PCa to facilitate clinical decision-making.

Methods:
Matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry analysis of trace blood samples was combined with machine learning algorithms to construct diagnostic and stratification models. A total of 367 subjects, comprising 181 with PCa and 186 with non-PCa were enrolled. Additional 60 subjects, comprising 30 with PCa and 30 with non-PCa were enrolled as an external cohort for validation. Subsequent metabolomic analysis was carried out using Autoflex MALDI-TOF, and the mass spectra were introduced into various algorithms to construct different models.

Results:
Serum metabolic fingerprints were successfully obtained from 181 patients with PCa and 186 patients with non-PCa. The diagnostic model based on the eight signals demonstrated a remarkable area under curve of 100% and was validated in the external cohort with the area under curve of 87.3%. Fifteen signals were selected for enrichment analysis, revealing the potential metabolic pathways that facilitate tumorigenesis. Furthermore, the stage prediction model with an overall accuracy of 85.9% precisely classified subjects with localized disease and those with metastasis. The risk stratification model, with an overall accuracy of 89.6%, precisely classified the subjects as low-risk and high-risk.

Conclusions:
Our study facilitated the timely diagnosis and risk stratification of PCa and provided new insights into the underlying mechanisms of metabolic alterations in PCa.
Reduced Concussion Symptom Burden in Early Adolescent Athletes Using a Head–Neck Cooling Device
Authors: Smith Matthew A. , McNinch Neil L. , Chaney Danielle , Shauver Lisa , Murray Tamara , Kline Peyton , Lesak Alexandria , Franco-MacKendrick Lea , Scott Lora , Logan Kelsey , Ichesco Ingrid K. , Liebig Christopher , Congeni Joseph 
Published: January 2024

Objective:
To determine whether an investigational head–neck cooling device, Pro2cool, can better reduce symptom severity compared with standard postconcussion care in early adolescent athletes after a sports-related concussion.

Design:
Prospective, longitudinal, randomized trial design conducted over a 28-day period.

Setting:
Six pediatric medical centers in Ohio and Michigan.

Participants:
The study enrolled 167 male and female 12- to 19-year-old athletes who experienced a sports-related concussion within 8 days of study enrollment and registering a Sports Concussion Assessment Tool 5 (SCAT5) composite score >7.

Interventions:
Pro2cool, an investigational head–neck cooling therapy device, was applied at 2 postinjury time points compared with postconcussion standard of care only.

Main Outcome Measures:
Baseline SCAT5 composite symptom severity scores were determined for all subjects. Sports Concussion Assessment Tool 5 scores for concussed athletes receiving cooling treatment were analyzed across 6 independent postenrollment time points compared with subjects who did not receive cooling therapy and only standard care. Adverse reactions and participate demographics were also compared.

Results:
Athletes who received Pro2cool cooling therapy (n = 79) experienced a 14.4% greater reduction in SCAT5 symptom severity scores at the initial visit posttreatment, a 25.5% greater reduction at the 72-hour visit posttreatment, and a 3.4% greater reduction at the 10-day visit compared with subjects receiving only standard care (n = 88). Overall, 36 adverse events (increased blood pressure, decreased pulse, and dizziness) were reported, with 13 events associated with the device, of which 3 were classified as moderate in severity.

Conclusions:
This study demonstrates the efficacy and safety of head and neck cooling for the management of concussion symptoms in adolescent athletes of an age group for which little to no prior data are available.
Exploration of useful clinical laboratory values as diagnostic criteria for eosinophilic gastroenteritis
Authors: Kobayashi Takashi , Hayashi Takahiro , Torii-Goto Aya , Aoyagi Mina , Ichinose Takako , Okada Yukako , Senda Noriyasu , Katano Yoshiaki 
Published: January 2024

Background
Eosinophilic gastroenteritis (EGE) is a rare eosinophilic infiltrative disorder. In Japan, EGE is diagnosed using clinical symptoms as well as microscopic, haematologic and histopathological findings. In this study, we examined the usefulness of laboratory data in the diagnosis of EGE.

Methods
Patients who were diagnosed with EGE at Fujita Health University Bantane Hospital between April 2015 and December 2020 were enrolled in this study and their data was retrospectively analysed. We evaluated their medical history, laboratory data including leukocyte count, eosinophil count, immunoglobulin (Ig) E, thymus and activation-regulated chemokine (TARC), C-reactive protein (CRP), etc. and histopathological data were collected from the electronic medical records.

Results
One hundred twelve of 168 patients who were treated for EGE could be analysed. The peripheral eosinophil count was correlated with the duodenal or ascending colon eosinophil count; moreover, the blood lymphocyte count and the TARC were correlated with the transverse colon eosinophil count. Multivariate regression analysis showed correlations only in the oesophagus, stomach and duodenum. Specifically, correlations were noted between blood eosinophils and gastric eosinophils, blood eosinophils and duodenal eosinophils, blood lymphocytes and gastric eosinophils, blood IgE and oesophageal, gastric and duodenal eosinophils and CRP and oesophageal eosinophils.

Conclusion
The extent of blood eosinophil count, lymphocyte count, IgE and CRP elevation together with clinical features and pathology can be incorporated into a diagnostic scoring criteria system to improve the accuracy of diagnosing this uncommon condition in the future.
Advanced chronic renal disease is an independent risk factor for inpatient mortality following transjugular intrahepatic portosystemic shunt procedure
Authors: Li Renxi , Sarin Shawn 
Published: January 2024

Background
Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure used to alleviate portal hypertension in patients with decompensated liver cirrhosis. However, the risks and outcomes associated with TIPS in patients with advanced chronic kidney disease (CKD) remain uncertain. This study aimed to investigate the perioperative outcomes of TIPS procedures in patients with advanced CKD using the National Inpatient Sample (NIS) database, a comprehensive all-payer inpatient database in the US.

Methods
The study identified patients who underwent TIPS procedures in the NIS database from Q4 2015 to 2020. Patients with advanced CKD were identified using specific ICD-10-CM codes, and they were compared to patients without CKD. Preoperative variables, including demographics, indications for TIPS, comorbidities, APR-DRG subclass, primary payer status, and hospital characteristics, were noted. Perioperative outcomes were examined by multivariable logistic regression.

Results
A total of 248 patients with advanced CKD and 5511 patients without CKD undergoing TIPS procedures were identified in the NIS database. Compared to non-CKD, patients with advanced CKD had higher mortality (13.70% vs. 8.60%, aOR = 1.56, P = 0.03), acute kidney injury (51.21% vs. 29.34, aOR = 1.46, P < 0.01), transfer out (25.00% vs. 12.84%, aOR = 1.88, P < 0.01), and length of stay over 7 days (64.11% vs. 38.97%, aOR = 2.34, P < 0.01). However, there was no difference in hepatic encephalopathy (31.85% vs. 27.19%, aOR = 1.12, P = 0.42).

Conclusion
Advanced CKD patients undergoing TIPS are at higher risk of mortality and AKI compared to patients without CKD; HE was mildly elevated but NS. Long-term prognosis of patients with advanced CKD who had TIPS is needed in future studies.
A 4-month-old male with Raghib syndrome: a rare case report from Syria
Authors: Sleiay Mouhammed , Sleiay Bilal , Batrash Obeda , Alabdullah Hadi , Alsmoudi Hasan , AlBaroudi Douha , Almohamed Ahmad , Ali Abshi Mohammad , Takkem Saleh 
Published: January 2024

Introduction and importance:
Raghib syndrome is a rare congenital complication consisting of the termination of the left superior vena cava (LSVC) in the left atrium, an unroofed coronary sinus, and an atrial septal defect most often found in the posterior-inferior angle of the atrial septum. Both a right-to-left and a left-to-right intracardiac shunt exist. In most circumstances, they do not show any symptoms.

Presentation of case:
The patient presented with a persistent left superior vena cava draining into the left atrium, an unroofed coronary sinus, and a secondary atrial septal defect (ASD). Transthoracic echocardiography was used to diagnose the condition, and surgery was applied as the primary treatment.

Clinical discussion:
It was formerly believed that this complex was exclusive to Raghib syndrome; however, cases have been found in which the interatrial connection is the aperture of the unroofed coronary sinus in patients with a normal atrial septum.

Conclusion:
Extracardiac treatment for this illness reduces the load on the left atrial suture and may stop further arrhythmias. There is no possibility of pulmonary vein flow restriction when there are no atrial tunnels.
Estimation of Improvements in Mortality in Spectrum Among Adults With HIV Receiving Antiretroviral Therapy in High-Income Countries
Authors: Trickey Adam , Glaubius Robert , Pantazis Nikos , Zangerle Robert , Wittkop Linda , Vehreschild Janne , Grabar Sophie , Cavassini Matthias , Teira Ramon , d’Arminio Monforte Antonella , Casabona Jordi , van Sighem Ard , Jarrin Inma , Ingle Suzanne M. , Sterne Jonathan A. C. , Imai-Eaton Jeffrey W. , Johnson Leigh F. 
Published: January 2024

Introduction:
Mortality rates for people living with HIV (PLHIV) on antiretroviral therapy (ART) in high-income countries continue to decline. We compared mortality rates among PLHIV on ART in Europe for 2016–2020 with Spectrum's estimates.

Methods:
The AIDS Impact Module in Spectrum is a compartmental HIV epidemic model coupled with a demographic population projection model. We used national Spectrum projections developed for the 2022 HIV estimates round to calculate mortality rates among PLHIV on ART, adjusting to the age/country distribution of PLHIV starting ART from 1996 to 2020 in the Antiretroviral Therapy Cohort Collaboration (ART-CC)'s European cohorts.

Results:
In the ART-CC, 11,504 of 162,835 PLHIV died. Between 1996–1999 and 2016–2020, AIDS-related mortality in the ART-CC decreased from 8.8 (95% CI: 7.6 to 10.1) to 1.0 (0.9–1.2) and from 5.9 (4.4–8.1) to 1.1 (0.9–1.4) deaths per 1000 person-years among men and women, respectively. Non–AIDS-related mortality decreased from 9.1 (7.9–10.5) to 6.1 (5.8–6.5) and from 7.0 (5.2–9.3) to 4.8 (4.3–5.2) deaths per 1000 person-years among men and women, respectively. Adjusted all-cause mortality rates in Spectrum among men were near ART-CC estimates for 2016–2020 (Spectrum: 7.02–7.47 deaths per 1000 person-years) but approximately 20% lower in women (Spectrum: 4.66–4.70). Adjusted excess mortality rates in Spectrum were 2.5-fold higher in women and 3.1–3.4-fold higher in men in comparison to the ART-CC's AIDS-specific mortality rates.

Discussion:
Spectrum's all-cause mortality estimates among PLHIV are consistent with age/country-controlled mortality observed in ART-CC, with some underestimation of mortality among women. Comparing results suggest that 60%–70% of excess deaths among PLHIV on ART in Spectrum are from non-AIDS causes.
Measuring HIV Acquisitions Among Partners of Key Populations: Estimates From HIV Transmission Dynamic Models
Authors: Silhol Romain , Anderson Rebecca L. , Stevens Oliver , Stannah James , Booton Ross D. , Baral Stefan , Dimitrov Dobromir , Mitchell Kate M. , Donnell Deborah , Bershteyn Anna , Brown Tim , Kelly Sherrie L. , Kim Hae-Young , Johnson Leigh F. , Maheu-Giroux Mathieu , Martin-Hughes Rowan , Mishra Sharmistha , Peerapatanapokin Wiwat , Stone Jack , Stover John , Teng Yu , Vickerman Peter , Garcia Sonia Arias , Korenromp Eline , Imai-Eaton Jeffrey W. , Boily Marie-Claude 
Published: January 2024

Background:
Key populations (KPs), including female sex workers (FSWs), gay men and other men who have sex with men (MSM), people who inject drugs (PWID), and transgender women (TGW) experience disproportionate risks of HIV acquisition. The UNAIDS Global AIDS 2022 Update reported that one-quarter of all new HIV infections occurred among their non-KP sexual partners. However, this fraction relied on heuristics regarding the ratio of new infections that KPs transmitted to their non-KP partners to the new infections acquired among KPs (herein referred to as “infection ratios”). We recalculated these ratios using dynamic transmission models.

Setting:
One hundred seventy-eight settings (106 countries).

Methods:

Infection ratios for FSW, MSM, PWID, TGW, and clients of FSW were estimated from 12 models for 2020.

Results:
Median model estimates of infection ratios were 0.7 (interquartile range: 0.5–1.0; n = 172 estimates) and 1.2 (0.8–1.8; n = 127) for acquisitions from FSW clients and transmissions from FSW to all their non-KP partners, respectively, which were comparable with the previous UNAIDS assumptions (0.2–1.5 across regions). Model estimates for female partners of MSM were 0.5 (0.2–0.8; n = 20) and 0.3 (0.2–0.4; n = 10) for partners of PWID across settings in Eastern and Southern Africa, lower than the corresponding UNAIDS assumptions (0.9 and 0.8, respectively). The few available model estimates for TGW were higher [5.1 (1.2–7.0; n = 8)] than the UNAIDS assumptions (0.1–0.3). Model estimates for non-FSW partners of FSW clients in Western and Central Africa were high (1.7; 1.0–2.3; n = 29).

Conclusions:
Ratios of new infections among non-KP partners relative to KP were high, confirming the importance of better addressing prevention and treatment needs among KP as central to reducing overall HIV incidence.
Updated Data and Methods for the 2023 UNAIDS HIV Estimates
Authors: van Schalkwyk Cari , Mahy Mary , Johnson Leigh F. , Imai-Eaton Jeffrey W. 
Published: January 2024

Abstract:Each year, supported by the Joint United Nations Programme on HIV/AIDS (UNAIDS), country teams across the globe produce estimates that chart the state of their HIV epidemics. In 2023, HIV estimates were available for 174 countries, accounting for 99% of the global population, of which teams from 150 countries actively engaged in this process. The methods used to derive these estimates are developed under the guidance of the UNAIDS Reference Group on Estimates, Modeling, and Projections (www.epidem.org). Updates to these methods and epidemiological analyses that inform parameters and assumptions are documented in this supplement.
Amplifying the Effects of Contrast Agents on Magnetic Resonance Images Using a Deep Learning Method Trained on Synthetic Data
Authors: Fringuello Mingo Alberto , Colombo Serra Sonia , Macula Anna , Bella Davide , La Cava Francesca , Alì Marco , Papa Sergio , Tedoldi Fabio , Smits Marion , Bifone Angelo , Valbusa Giovanni 
Published: January 2024

ObjectivesArtificial intelligence (AI) methods can be applied to enhance contrast in diagnostic images beyond that attainable with the standard doses of contrast agents (CAs) normally used in the clinic, thus potentially increasing diagnostic power and sensitivity. Deep learning–based AI relies on training data sets, which should be sufficiently large and diverse to effectively adjust network parameters, avoid biases, and enable generalization of the outcome. However, large sets of diagnostic images acquired at doses of CA outside the standard-of-care are not commonly available. Here, we propose a method to generate synthetic data sets to train an “AI agent” designed to amplify the effects of CAs in magnetic resonance (MR) images. The method was fine-tuned and validated in a preclinical study in a murine model of brain glioma, and extended to a large, retrospective clinical human data set.Materials and MethodsA physical model was applied to simulate different levels of MR contrast from a gadolinium-based CA. The simulated data were used to train a neural network that predicts image contrast at higher doses. A preclinical MR study at multiple CA doses in a rat model of glioma was performed to tune model parameters and to assess fidelity of the virtual contrast images against ground-truth MR and histological data. Two different scanners (3 T and 7 T, respectively) were used to assess the effects of field strength. The approach was then applied to a retrospective clinical study comprising 1990 examinations in patients affected by a variety of brain diseases, including glioma, multiple sclerosis, and metastatic cancer. Images were evaluated in terms of contrast-to-noise ratio and lesion-to-brain ratio, and qualitative scores.ResultsIn the preclinical study, virtual double-dose images showed high degrees of similarity to experimental double-dose images for both peak signal-to-noise ratio and structural similarity index (29.49 dB and 0.914 dB at 7 T, respectively, and 31.32 dB and 0.942 dB at 3 T) and significant improvement over standard contrast dose (ie, 0.1 mmol Gd/kg) images at both field strengths. In the clinical study, contrast-to-noise ratio and lesion-to-brain ratio increased by an average 155% and 34% in virtual contrast images compared with standard-dose images. Blind scoring of AI-enhanced images by 2 neuroradiologists showed significantly better sensitivity to small brain lesions compared with standard-dose images (4.46/5 vs 3.51/5).ConclusionsSynthetic data generated by a physical model of contrast enhancement provided effective training for a deep learning model for contrast amplification. Contrast above that attainable at standard doses of gadolinium-based CA can be generated through this approach, with significant advantages in the detection of small low-enhancing brain lesions.
EEG Source Imaging—Clinical Considerations for EEG Acquisition and Signal Processing for Improved Temporo-Spatial Resolution
Authors: Vogrin Simon J. , Plummer Chris 
Published: January 2024

Summary:
EEG source imaging (ESI) has gained traction in recent years as a useful clinical tool for the noninvasive surgical work-up of patients with drug-resistant focal epilepsy. Despite its proven benefits for the temporo-spatial modeling of spike and seizure sources, ESI remains widely underused in clinical practice. This partly relates to a lack of clarity around an optimal approach to the acquisition and processing of scalp EEG data for the purpose of ESI. Here, we describe some of the practical considerations for the clinical application of ESI. We focus on patient preparation, the impact of electrode number and distribution across the scalp, the benefit of averaging raw data for signal analysis, and the relevance of modeling different phases of the interictal discharge as it evolves from take-off to peak. We emphasize the importance of recording high signal-to-noise ratio data for reliable source analysis. We argue that the accuracy of modeling cortical sources can be improved using higher electrode counts that include an inferior temporal array, by averaging interictal waveforms rather than limiting ESI to single spike analysis, and by careful interrogation of earlier phase components of these waveforms. No amount of postacquisition signal processing or source modeling sophistication, however, can make up for suboptimally recorded scalp EEG data in a poorly prepared patient.