bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilateral evolution of OCT biomarkers in dry AMD: Long-term follow up study
Authors: Samanta Anindya , Arora Supriya , Jhingan Mahima , Singh Sumit , Amarasekera Sohani , Tucci Davide , Cagini Carlo , Lupidi Marco , Chhablani Jay 
Published: October 2023

Purpose To report the emergence and progress of four late-stage characteristics: incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) and complete RPE and outer retinal atrophy (cRORA), drusen ooze and drusen collapse in eyes with dry age-related macular degeneration (AMD) using Spectral Domain Optical Coherence Tomography (SD-OCT). Methods This was a retrospective analysis of eyes with non-exudative AMD. Multimodal imaging was done at follow up visits ≤ 12 months. OCT volume scan was used to assess and identify the 4 characteristics. Univariate analysis was done for the various demographic and clinical characteristics. Patients with a mean age of 76.7 ± 10 years were followed up for 69.9 ± 20.6 months. iRORA, cRORA, drusen ooze was present in 15.6%, 15.6% and 15.6% of patients at baseline, respectively, and 25.0%, 40.6% and 53.1% of patients at the final follow-up, respectively. At baseline 9.1%, 0% and 9.1% of patients had bilateral drusen ooze, iRORA and cRORA, respectively. By the final follow-up, drusen collapse occurred in 46.9% and 18.8% patients in unilateral and bilateral eyes, respectively. For bilateral cases, the mean interval of time between emergence inthe two eyes for drusen ooze, drusen collapse, iRORA, and cRORA was 5 ± 1.4 years, 2.2 ± 2.2 years, 3.5 ± 0.7 and 1.7 ± 0.6 years, respectively. Conclusions Late-stage OCT biomarkers are seen bilaterally at 21.9% at baseline and at 56.3% at 5.8 years follow-up. Once present in one eye, cRORA had the shortest mean interval before appearance in the other eye.
Patient and provider perspectives on telemedicine use in an outpatient gynecologic clinic serving a diverse, low-income population
Authors: Kulkarni Amita , Monu Ngozi , Ahsan Muhammad D , Orakuwue Chimsom , Ma Xiaoyue , McDougale Auja , Frey Melissa K , Holcomb Kevin , Cantillo Evelyn , Chapman-Davis Eloise 
Published: October 2023

Objective To evaluate patient and provider experiences using telemedicine for gynecologic visits among a diverse, low-income population. Methods Patients attending telemedicine visits at a resident-run gynecology clinic completed a modified Telemedicine Usability Questionnaire and providers completed a survey addressing satisfaction and barriers for each visit. The Telemedicine Usability Questionnaire included six subscales to assess telemedicine usability with 1–5 Likert-scale responses. Statistical analyses included Chi-square, Fisher's exact, Wilcoxon rank sum, Wilcoxon signed-rank, and two-sample t-test. Results Of 192 patients enrolled, 157 (82%) completed the surveys (87% video visits, 13% telephone visits). Most patients were ethnic minorities (non-Hispanic White—16%, Hispanic—32%, Black—28%, Asian—10%), median age was 40 years (range 18–69), and 63% reported income under $40,000. The total mean Telemedicine Usability Questionnaire score was 4.3/5. The reliability subscale score (3.72/5) was lower compared to all other subscales ( p < 0.001). Older respondents were more likely to find telemedicine unreliable (mean age >44 vs <39, p = 0.02). Without telemedicine, 54% would have traveled ≥1 h to appointments, with 46% spending over $35 on travel, and 27% missing ≥ 1 workday. Patients preferred telemedicine for follow-up rather than initial visits (81% vs 33%, p < 0.01). Among providers, residents felt less adequately trained in telemedicine compared to nurse practitioners and fellows (54% vs 46%, p = 0.039). Conclusion Low-income women utilizing telemedicine for outpatient gynecologic care report positive experiences with improved access to healthcare, cost, and time savings compared to in-person visits. Provider experiences were also positive; however, teaching hospitals must evaluate whether trainee providers feel adequately trained to deliver telemedicine visits.
Short-term results after robot-assisted surgery for primary rectal cancers requiring beyond total mesorectal excision in multiple compartments
Authors: Thorgersen Ebbe B. , Solbakken Arne M. , Strøm Tuva K. , Goscinski Mariusz , Spasojevic Milan , Larsen Stein G. , Flatmark Kjersti 
Published: October 2023

Aim: Rectal cancers requiring beyond total mesorectal excision (bTME) are traditionally operated using an open approach, but the use of minimally invasive robot-assisted procedures is increasing. Introduction of minimal invasive surgery for complex cancer cases could be associated with compromised surgical margins or increased complication rates. Therefore, reporting results both clinical and oncological in large series is important. Since bTME procedure reports are heterogeneous, comparing results is often difficult. In this study, a magnetic resonance imaging (MRI) classification system was used to describe the bTME surgery according to pelvic compartments. Methods: Consecutive patients with primary rectal cancer operated with laparoscopic robot-assisted bTME were prospectively included for 2 years. All patients had tumors that threatened the mesorectal fascia, invaded adjacent organs, and/or involved metastatic pelvic lateral lymph nodes. Short-term clinical outcomes and oncological specimen quality were registered. Surgery was classified according to pelvic compartments resected. Results: Clear resection margins (R0 resection) were achieved in 95 out of 105 patients (90.5%). About 26% had Accordion Severity Grading System of Surgical Complications grade 3–4 complications and 15% required re-operations. About 7% were converted to open surgery. The number of compartments resected ranged from one to the maximum seven, with 83% having two or three compartments resected. All 10 R1 resections occurred in the lateral and posterior compartments. Conclusions: The short-term clinical outcomes and oncological specimen quality after robot-assisted bTME surgery were comparable to previously published open bTME surgery. The description of surgical procedures using the Royal Marsden MRI compartment classification was feasible.
Complications in Hand Surgery During Early Independent Practice: A Single Surgeon’s 5-Year Experience
Authors: Samade Richard , Gordon Adam M. , Vaghani Parth , Goyal Kanu S. 
Published: October 2023

Background: The objective of this study was to understand the frequency and types of complications, and the associated postoperative outcomes within the first 5 years of practice after hand and upper extremity surgery fellowship. Methods: This was a retrospective observational study of all patients seen and surgically treated by a single surgeon at a single institution from August 2014 to September 2019. This corresponded to the first 5 years of practice after fellowship. Data collected included patient demographics, perioperative data, complication type, and outcome of the complication (better/same/worse than preoperative status). Complications were classified using the Clavien-Dindo system and a unique, self-derived system. Results: In total, 3301 surgeries were performed during the first 5 years of practice. The overall complication rate was 7.9% (261 complications from 239 patients). The 30-day complication rate was 5.2% (171/3301). Eleven (4.2%) of the 261 complications occurred intraoperatively. The total number of complications significantly declined during the first 5 years of practice as follows: 74, 71, 46, 37, and 33 ( P = .010, R2 = .92). Hand and wrist were the most frequent anatomic locations involved and bone pathology was the predominant indication. Conclusion: The overall surgical complication rate for hand and upper extremity surgery was 7.9%, with a 30-day complication rate of 5.2% (171/3301). The rate of complications after fellowship declined over the first 5 years of independent practice. Superficial infections were the most common complication. More than 90% of patients ultimately improved after addressing the complication. Level of Evidence: IV
Evaluating the safety and efficacy of transvenous embolization for brain arteriovenous malformation: A systematic review and meta-analysis
Authors: Batista Sávio , Almeida Filho José Alberto , Oliveira Leonardo de Barros , Koester Stefan , Pinheiro Agostinho Camara , Dinato Rafael Alonso , Bertani Raphael , Andreão Filipi Fim , Mounayer Charbel 
Published: October 2023

Background Transvenous embolization is a potential therapy for brain arteriovenous malformation, involving the use of microcatheters to guide an ethylene vinyl alcohol coil for vessel occlusion. However, the safety and efficacy of transvenous embolization are not fully established. Objective To evaluate the safety and efficacy of transvenous embolization for brain arteriovenous malformation. Methods A systematic review of the literature of studies investigating the safety and efficacy of transvenous embolization for brain arteriovenous malformation was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Databases, including PubMed, Cochrane Library, Web of Science, and Embase were queried. Results In the final analysis of 16 studies involving 368 brain arteriovenous malformation cases who received transvenous embolization, the complete occlusion was achieved in 91% (95% CI: 88%, 94%; I2 = 43%, p = 0.04) of cases. The overall rate of good outcomes after discharge was high at 89% (95% CI: 82%, 95%; I2 = 60%, p < 0.01). Ischemic complications were reported in 1% of cases (95% CI: 0%, 2%; I2 = 0%, p = 0.96), while hemorrhagic complications occurred in 6% of cases (95% CI: 3%, 8%; I2 = 8%, p = 0.37), and technical complications rate of 8% (95% CI: 4%, 11%; I2 = 8%, p = 0.36). Finally, only one death was related to the procedure. Conclusion Transvenous embolization for brain arteriovenous malformation shows promising safety and effectiveness, with low mortality, a considerable rate of positive outcomes, and a relatively low incidence of complications. The majority of patients achieved complete occlusion, indicating transvenous embolization as a potential option, especially for challenging deep-seated lesions.
Return to play following operative management of anterior shoulder instability in overhead athletes—A systematic review
Authors: Hurley Eoghan T , Lunn Kiera , Bethell Mikhail , Levin Jay , Pasqualini Ignacio , Frangiamore Salvatore , Anakwenze Oke , Klifto Christopher S 
Published: October 2023

Background The purpose of this study was to systematically review the rate and timing of return to play in overhead athletes following operative management of anterior shoulder instability. Methods A systematic literature search based on PRISMA guidelines, utilizing the EMBASE, MEDLINE, and The Cochrane Library Databases. Eligible for inclusion were clinical studies reporting on return to play among overhead athletes following arthroscopic Bankart repair, open Latarjet procedure or Remplissage procedure. Results There are 23 studies included with 961 patients. Among those undergoing arthroscopic Bankart repair, the rate of return to play was 86.2%, with 70.6% returning to the same level of play and the mean time to return to play was 7.1 months. Among those undergoing an open Latarjet procedure, the rate of return to play was 80.9%, with 77.7% returning to the same level of play and the mean time to return to play was 5.1 months. Among those undergoing a Remplissage procedure, the rate of return to play was 70.6%, with 70.0% returning to the same level of play or mean time to return to play. Discussion Overall, there were high rates of return to play following operative management of anterior shoulder instability in overhead athletes.
Trends in telehealth use among a cohort of rural patients during the COVID-19 pandemic
Authors: Pullyblank Kristin , Krupa Nicole , Scribani Melissa , Chapman Amanda , Kern Megan , Brunner Wendy 
Published: October 2023

Objective Rural populations faced unique challenges to healthcare access during the COVID-19 pandemic. This analysis assesses trends in digital health technology use at the onset of the pandemic and describes digital health behaviors among a cohort of patients within a rural integrated healthcare network throughout the first 3 years of the pandemic. Methods We used data from both the electronic health record (EHR) and a patient survey. EHR data was used to longitudinally assess change over time in patient portal use and telehealth visits. Survey responses were used to provide additional context. Results Telehealth appointments peaked in the first quarter of 2020 at 28% of all office visits, before leveling off to 8–10% in 2022. Women and those younger than 65 were more likely to have participated in telehealth appointments. Active patient portal users increased from 34.1% in January 2019 to 63.7% in January 2022. There were no differences noted in portal use trends based on rurality. Conclusions Our findings corroborate previous research, as well as add context regarding digital health technology use throughout the COVID pandemic in a rural patient population. Future research must focus on understanding constraints to digital health expansion in order to continue providing safe, equitable care.
Use of exercise tests in screening for pulmonary arterial hypertension in systemic sclerosis: A systematic literature review
Authors: Madigan Sarah , Proudman Susanna , Schembri David , Davies Huw , Adams Robert 
Published: October 2023

Background and objective: Patients with systemic sclerosis (SSc) and pulmonary arterial hypertension (PAH) have a poor prognosis, accounting for 30% of all SSc-related deaths. Guidelines recommend annual screening for PAH regardless of symptoms, as early treatment improves outcomes. Current protocols include combinations of clinical features, biomarkers, pulmonary function tests, and echocardiography. None include exercise testing, although early-stage PAH may only be evident during exercise. This systematic review assessed the performance of exercise tests in predicting the presence of PAH in patients with SSc, where PAH was confirmed through right heart catheterisation (RHC). Methods: Comprehensive literature searches were performed using MEDLINE, EMBASE, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trails, CINAHL, Scopus and Web of Science from inception to May 2023. Articles were screened for eligibility by two independent reviewers. Eligibility criteria included the use of a non-invasive exercise test to screen adult patients to detect PAH in a population without a previous diagnosis of PAH, with diagnosis confirmed by RHC. Results: Eight studies met the inclusion criteria, describing at least one of three different non-invasive exercise tests: cardiopulmonary exercise test, six-minute walk test and stress Doppler echocardiography. All studies found that exercise tests had some ability to predict the presence of PAH, with sensitivity between 50% and 100% and specificity from 73% to 91%. Conclusion: Exercise tests are infrequently used for screening for PAH in SSc but can predict the presence of PAH. More data are required to establish which tests are most effective.
Direct to Surgery? Surgical Outcomes in Pediatric Patients With Facial Infantile Hemangioma: A Retrospective Case-Control Study
Authors: Shah Pearl , Kumar Anand R. 
Published: October 2023

Background: The effects of medical pre-treatment prior to surgical excision of infantile hemangiomas (IH) remains understudied. We hypothesized that medical pretreatment may improve outcomes after surgical excision. This study aimed to evaluate the difference in surgical outcomes/complications between direct to surgery (NPT) versus medical pre-treatment prior to surgery (PT). Methods: A retrospective study was conducted at a pediatric tertiary center between 2007 and 2018. Children 0 and 18 years who underwent surgical resection (confirmed GLUT-1 positive IH) were included. Visceral and congenital hemangiomas, PHACE, and vascular malformations/neoplasms were excluded. Pre-treatment was the primary predictor for post-surgical complications. Literature meta-analysis was also performed. Results: Our institution identified 185 IH patients, 85 (46%) underwent surgical resection. Of these, n = 28, (32.9%) had pre-treatment (PT) (8.24% propranolol, 9.41% topical timolol, 12.94% steroids, 2.35% laser); n = 57, (67.1%) had no pre-treatment (NPT). Pre-surgical lesion size was comparable ( P = .829). Surgical outcomes between PT and NPT were comparable for wound dehiscence, infection, scarring, and repeat surgery ( P = .162, 1.0, 1.0, 0.483), including pooled complications ( P = .448). Where documented, PT had higher functional improvement ( P = .039). Results were comparable when selecting for beta-blockers versus NPT. Meta-analysis included 7 studies and 169 patients, 39.1% PT and 68.1% NPT. The most common PT was systemic/intralesional steroids. Five received beta-blockers. All patients had functional improvement where recorded. Complications were slightly higher for PT ( P = .041). Conclusion: The incidence of surgical complications is comparable between direct to surgery and medical pre-treatment patients. Early surgical management without pre-treatment was not associated with improved complications/outcomes except select subgroup analysis identified improved functional outcomes with pre-treatment. Future directions include defining appropriate candidates for early direct to surgery versus best candidates for medical pre-treatment using patient specific variables.
RILP inhibits tumor progression in osteosarcoma via Grb10-mediated inhibition of the PI3K/AKT/mTOR pathway
Authors: Wei Zhun , Xia Kezhou , Zheng Di , Gong Changtian , Guo Weichun 
Published: October 2023

Abstract
Background
Rab-interacting lysosomal protein (RILP) contains an alpha-helical coil with an unexplored biological function in osteosarcoma. This study investigated the expression of RILP in osteosarcoma cells and tissues to determine the effect of RILP on the biological behaviors of osteosarcoma cells and the underlying mechanism.

Methods
Tumor Immune Estimation Resource (TIMER) database, The Cancer Genome Atlas (TCGA) database and Gene Expression Omnibus (GEO) database were used for bioinformatic analysis. Co-immunoprecipitation experiment was used to determine whether the two proteins were interacting. In functional tests, cell counting kit-8 (CCK-8) assay, colony formation assay, wound healing assay, transwell invasion assay, Immunofluorescence (IF) assay and immunohistochemical (IHC) assay were performed.

Results
Overexpression of RILP significantly inhibited proliferation and impaired metastasis ability of osteosarcoma cells, while silencing of RILP showed the opposite trend. RNA-seq data analysis was applied in 143B cells and pathway enrichment analysis revealed that differentially expressed genes were mainly enriched in the PI3K/AKT pathway. We further verified that overexpression of RILP restrained the PI3K/AKT/mTOR signaling pathway and induced autophagy in osteosarcoma cells, while the opposite trend was observed when PI3K pathway activator 740Y-P was used. 3-Methyladenine (3-MA), a selective autophagy inhibitor, partially attenuated the inhibitory effect of RILP on the migration and invasion ability of osteosarcoma cells, suggesting the involvement of autophagy in epithelial–mesenchymal transition regulation in osteosarcoma cells. Growth factor receptor binding protein-10 (Grb10), an adaptor protein, was confirmed as a potential target of RILP to restrain the PI3K/AKT signaling pathway. We subcutaneously injected stably overexpressing 143B osteosarcoma cells into nude mice and observed that overexpression of RILP inhibited tumor growth by inhibiting the PI3K/AKT/mTOR pathway.

Conclusion
Our study revealed that the expression of RILP was associated with favorable prognosis of osteosarcoma and RILP inhibits proliferation, migration, and invasion and promotes autophagy in osteosarcoma cells via Grb10-mediated inhibition of the PI3K/AKT/mTOR signaling pathway. In the future, targeting RILP may be a potential strategy for osteosarcoma treatment.
Association of risk perception and transport mode choice during the temporary closure of a major inner-city road bridge: results of a cross-sectional study
Authors: Kemmerer Pascal , Brach Benedikt , Kubiak Thomas , Singer Susanne , Gianicolo Emilio A. L. 
Published: October 2023

Abstract
Background
Since air pollution and physical inactivity pose major public health risks, switching from cars to alternatives like public transport, cycling, and walking is important. Therefore, it is beneficial to identify key events for changes of mode choice.

Methods
We examined the association between risk perception and mode choice during the temporary closure of a road bridge between two major German cities in early 2020 using binary and multinomial regression models.

Results
679 people participated in the survey. We found that 22% of car users switched to alternatives. The higher the perceived health risk from traffic-related air pollution, the more likely car users switched to alternatives (odds ratio [OR] = 1.76, 95% CI [1.14, 2.71]).

Discussion
Attitude, subjective norm and perceived behavioral control were associated with maintaining but not with switching transport modes. In conclusion, the closure of a main road bridge may present a key event. To explain mode choice, risk perception is a potential extension to the theory of planned behavior.
SeqPredNN: a neural network that generates protein sequences that fold into specified tertiary structures
Authors: Lategan F. Adriaan , Schreiber Caroline , Patterton Hugh G. 
Published: October 2023

Abstract
Background
The relationship between the sequence of a protein, its structure, and the resulting connection between its structure and function, is a foundational principle in biological science. Only recently has the computational prediction of protein structure based only on protein sequence been addressed effectively by AlphaFold, a neural network approach that can predict the majority of protein structures with X-ray crystallographic accuracy.
A question that is now of acute relevance is the “inverse protein folding problem”: predicting the sequence of a protein that folds into a specified structure. This will be of immense value in protein engineering and biotechnology, and will allow the design and expression of recombinant proteins that can, for instance, fold into specified structures as a scaffold for the attachment of recombinant antigens, or enzymes with modified or novel catalytic activities.
Here we describe the development of SeqPredNN, a feed-forward neural network trained with X-ray crystallographic structures from the RCSB Protein Data Bank to predict the identity of amino acids in a protein structure using only the relative positions, orientations, and backbone dihedral angles of nearby residues.

Results
We predict the sequence of a protein expected to fold into a specified structure and assess the accuracy of the prediction using both AlphaFold and RoseTTAFold to computationally generate the fold of the derived sequence. We show that the sequences predicted by SeqPredNN fold into a structure with a median TM-score of 0.638 when compared to the crystal structure according to AlphaFold predictions, yet these sequences are unique and only 28.4% identical to the sequence of the crystallized protein.

Conclusions
We propose that SeqPredNN will be a valuable tool to generate proteins of defined structure for the design of novel biomaterials, pharmaceuticals, catalysts, and reporter systems. The low sequence identity of its predictions compared to the native sequence could prove useful for developing proteins with modified physical properties, such as water solubility and thermal stability. The speed and ease of use of SeqPredNN offers a significant advantage over physics-based protein design methods.