bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can Surgery Be Proposed to Adolescent Idiopathic Scoliosis Patients With Structural Lumbar Curves Associated With Nonreducible Iliolumbar Angle?
Authors: Focsa Laurentiu-Cosmin , Simon Anne-Laure , Finoco Mikael , Krausse Thomas , Ponchelet Louise , Ilharreborde Brice 
Published: January 2025

Background:
Lower instrumented vertebra (LIV) selection for adolescent idiopathic scoliosis (AIS) with structural lumbar curves (Lenke 3, 5, and 6) remains debated. The iliolumbar angle (ILA) measurement is useful for assessing the lumbosacral junction flexibility. If it is nonreducible, surgeons need to make a difficult choice between a potential “imperfect” L4, associated with a residual lumbosacral curve, or a more distal fusion performed later in life due to poorer functional outcomes. The goal of this study was, therefore, to evaluate the postoperative radiographic and functional outcomes of AIS patients with nonreducible ILA.

Methods:
All consecutive AIS patients (2017 to 2022) with a structural lumbar curve and a posterior fusion ending on L4 were retrospectively included. Radiographic and functional outcomes (SRS-30 score) were reported with a minimum 2-year follow-up. Standing low dose stereoradiographs in both erect and maximum lateral bending positions were performed in all patients, and 2 groups of subjects were compared based on preoperative ILA flexibility [reducible group (R) or nonreducible group (NR)].

Results:
A total of 122 patients were included (30% NR and 71% R). At a mean follow-up of 2.3±0.1 years, surgery was efficient in correcting the major curve (77% reduction rate in the R group and 76% in the NR group, P<10-5), and significantly improved coronal balance (R, P<10-5 and NR, P=0.03) as well as the ILA [mean ILA gain 14 degrees (R group), P<10-5 and 16 degrees (NR group), P<10-5]. The proportion of excellent results was higher in the R group, but 97% of outcomes were either excellent or acceptable in the NR group, and only 1 case of poor result (residual ILA >10 degrees) was reported in each group. No significant difference was found in SRS 30 scores between groups, but scores were significantly improved in the NR group for the excellent outcomes’ subgroup [self-image (P=0.04) and satisfaction (P=0.02) domains].

Conclusions:
The current study confirms that posterior fusion ending on L4 can still be proposed to young AIS patients with structural lumbar curves, even if the lumbosacral flexibility is limited.

Level of evidence:
Level III—comparative study.
Effect of Low-Dose Methylprednisolone in Promoting Neurological Function Recovery after Spinal Cord Injury
Authors: Zhang Yu , Xiao Shining , Zhu Liangbo , Gan Xinrong , Huang Yongquan , Dan Fan , Chen Jiangwei , Zhou Rongping , Tang Wen , Liu Jiaming , Liu Zhili 
Published: January 2025

Study Design.
Subgroup analysis of a retrospective clinical and animal trial [Study of different doses of methylprednisolone on functional recovery of spinal cord injury].

Objective.
The aimed to investigate the efficacy of low-dose methylprednisolone regimens in promoting neural repair after SCI.

Summary of Background Data.
Spinal cord injury (SCI) can result in sensory, motor, and autonomic nerve dysfunction, often leading to disability or death. Methylprednisolone (MP) is a preferred medication for clinical treatment of SCI. Low-dose regimen may be a safer and more effective approach.

Methods.
A subgroup comprising 705 patients with traumatic cervical SCI from four medical centers between January 2015 and December 2020 was retrospectively analyzed. Patients were stratified based on treatment regimen: low-dose methylprednisolone, high-dose methylprednisolone, or no methylprednisolone use. All patients underwent spinal decompression surgery. The degree of neurological recovery and the incidence of complications during follow-up were compared among these three groups. Additionally, we investigated the disparities in neurological function recovery, neuronal death, and neural axon regeneration between the low-dose and high-dose methylprednisolone treatment regimens using a SCI rat model.

Results.
Patients receiving the low-dose methylprednisolone regimen exhibited superior neurological recovery compared to those receiving the high-dose regimen and those not receiving methylprednisolone (82.0% vs. 74.0%, P=0.030; 82.0% vs. 63.4%, P=0.001). Moreover, patients in the low-dose methylprednisolone group demonstrated the lowest rates of perioperative pulmonary infections and gastrointestinal bleeding among these three groups. Evaluation of the SCI rat model through Basso-Beattie-Bresnahan (BBB) score, footprint analysis, electrophysiological tests, hematoxylin and eosin (H&E) staining, immunofluorescence staining, and Nissl staining further corroborated that the low-dose methylprednisolone treatment regimen enhanced transport function recovery, reduced neuronal death, and promoted neural axon regeneration.

Conclusion.
The low-dose methylprednisolone regimen may have a more positive therapeutic effect on the recovery of neurological function after SCI than other regimens.
Linking American Spine Registry (ASR) and Medicare Data:an analysis of 8,755 Lumbar Fusion Cases
Authors: Glassman Steven D. , Djurasovic Mladen , Asher Anthony L. , De Ayushmita , Murray Jayson , Safdar Aleeza , Porter Kimberly R. , Bydon Mohamad 
Published: January 2025

Study Design.
Retrospective observational study.

Objective.
To evaluate whether the combined American Spine Registry and Medicare (ASR/CMS) data yields substantially different findings versus ASR data alone with regard to key parameters such as risk stratification, complication rates and readmission rates in lumbar surgery investigated through an analysis of 8,755 spondylolisthesis cases.

Summary of Background Data.
Medicare data correlation has been effective for determining revision rates for other procedures such as total hip replacement. Our aim is to determine whether these findings are translatable in the realm of lumbar spinal surgery investigated through an analysis of 8,755 spondylolisthesis cases.

Methods.
The American Spine Registry (ASR) was queried for Medicare-eligible patients who underwent lumbar spinal fusion for lumbar spondylolisthesis. This cohort was analyzed based upon ASR data alone in comparison to the same patients in the combined ASR/Medicare (ASR/CMS) dataset. The primary outcome of interest was readmission at 30 and 90 days postoperatively.

Results.
There were 8,755 Medicare-eligible cases with a diagnosis of spondylolisthesis within the ASR. The mean age was 72.7 years, 60.8% were female. Medical comorbidities were more frequently detected in the combined ASR/CMS dataset, reflected by a higher mean Charlson Comorbidity Index score (3.49 vs. 3.27, P<0.001). Hospital readmission rates were significantly higher in the combined ASR/CMS dataset at both 30 days (4.89% vs. 1.83%, P<0.001) and 90 days (7.68% vs. 2.66%, P<0.001), with notable increases in readmissions for infections and medical complications. Discharge disposition remained comparable across datasets, with most patients discharged to home or home health care.

Conclusion.
This study demonstrates that integrating patient-identified Medicare data with the ASR provides a more comprehensive assessment of outcomes for lumbar spinal fusion surgery as demonstrated through an analysis of 8,755 spondylolisthesis cases. These findings, establish the importance of multi-source data linkage to overcome the limitations of single-source registries, thereby enhancing data quality for clinical decision-making and quality improvement in spinal surgery.
Alcohol Abuse and Collagen Disruption
Authors: Chiapparelli Erika , Guven Ali , Amoroso Krizia , Lan Ranqing , Evangelisti Gisberto , Kohli Paul , Jan Hambrecht  , Verna Bruno , Tsuchiya Koki , Zhu Jiaqi , Shue Jennifer , Sama Andrew , Girardi Federico P. , Cammisa Frank P. , Hughes Alexander P. 
Published: January 2025

Study Design.
Single-center cross-sectional analysis of a prospectively maintained database.

Background Context.
Alcohol abuse, defined by the NIAAA as excessive consumption leading to health risks, contributes significantly to tissue degeneration through the damaging effects of acetaldehyde. Collagen type I, a critical structural protein in skin and bone, degrades in parallel across tissue types. Recent studies have linked dermal ultrasound (US) echogenicity to bone quality, but evidence supporting its utility as a biomarker for tissue degeneration remains limited. This study hypothesizes that alcohol abuse correlates with increased dermal US echogenicity, decreased skin thickness (ST), and poor tissue quality, supporting the potential use of US for preoperative bone quality assessment.

Objective.
To investigate the relationship between skin US parameters and alcohol abuse in lumbar fusion patients.

Methods.
Patients undergoing lumbar fusion surgery with alcohol abuse (NIAAA criteria: >14 drinks/week in males, >8 in females) were included. Preoperative US measurements at two lumbar locations assessed echogenicity in the average dermal (AD), upper dermal (UD), and lower dermal (LD) layers. ST was measured at three dermal sites. Wilcoxon rank sum, Fisher’s Exact tests, and regression analyses adjusted for age, sex, and BMI were used (P<0.05).

Results.
Among 459 patients (50.5% male; median age 63.67 y; BMI 28.74 kg/m²), females exhibited higher US echogenicity (e.g., AD median 121 vs. 111.75, P<0.0001), while males had greater ST (2.97 vs. 2.65 mm, P<0.0001). Alcohol abuse was associated with increased LD echogenicity (14.86; P=0.038) and decreased ST (−0.35; P=0.034).

Conclusion.
Alcohol abuse correlates with dermal layer degradation, as indicated by increased echogenicity and reduced ST. These findings highlight the potential utility of skin US as a preoperative biomarker for bone quality in lumbar fusion patients, warranting further investigation to enhance clinical applications.
Treatment of Cutaneous Adnexal Carcinoma With Radiotherapy
Authors: Mohamed Nader , Mattessich Sarah , Gelblum Daphna Y. , Lee Nancy Y. , Barker Christopher A. 
Published: January 2025

Objectives:
Cutaneous adnexal carcinomas (CACs) are rare skin cancers with no established treatment guidelines. Given the limited data, this study aims to explore the characteristics and outcomes of patients with CAC treated with radiation therapy (RT).

Methods:
Patients diagnosed with CAC between 2000 and 2020 who received RT were included. Kaplan-Meier methods measured time to local recurrence (LR), regional recurrence (RR), locoregional recurrence (LRR), distant metastasis (DM), and progression-free survival (PFS). Fisher exact test compared frequency distributions.

Results:
Forty-nine patients with an average age of 65 years were studied. Most were White males with head and neck tumors. Common subtypes were adnexal adenocarcinoma, sebaceous carcinoma, and microcystic adnexal carcinoma. Patients received RT diagnosis or recurrence. The median overall survival was 44 months, with a median follow-up of 41 months for surviving patients. For patients with de novo cancer treated with surgery and adjuvant RT (n=22), 2-year PFS, LR, RR, LRR, DM, and OS were 77%, 5%, 0%, 5%, 10%, and 95%, respectively, with all LRR occurring outside the irradiated area. Patients with de novo cancer who received definitive RT (n=9) experienced 2-year PFS, LR, RR, LRR, DM, and OS of 30%, 46%, 13%, 55%, 40%, and 67%, respectively, with all LRR events occurring within the irradiated area. LR within the irradiated volume was associated with immunosuppression (95% CI: 19-99). Patients treated at recurrence had inferior outcomes.

Conclusions:
Surgical resection and adjuvant RT effectively control CAC, while definitive RT shows lower disease control. Novel strategies are needed to improve outcomes in patients receiving definitive RT.
Mentorship in Plastic Surgery: A Systematic Review of the Current Literature and Elucidation of Recurring Themes
Authors: Stone Benjamin K. , Kung Theodore A. , Abbed Turkia , Lin Ines , Rao Vinay 
Published: January 2025

Background:
Mentorship is an integral part of developing competent, passionate, and successful plastic surgeons and is an important element of surgeons’ wellness. Although mentorship programs have been described in the literature, this study aimed to elucidate the specific qualities of an effective mentor in plastic surgery.

Methods:
Preferred Reporting Items for Systematic Reviews and Meta-analyses methodology was utilized to conduct a systematic review of the literature. A search of 3 electronic databases (PubMed including MEDLINE, Embase, and Cochrane Library) was performed for relevant studies up to June 15, 2024, using an advanced search for article titles and abstracts pertaining to plastic surgery and mentorship. Eligibility criteria included primary sources that explicitly commented on the qualities of an effective mentor in plastic surgery. A risk of bias assessment was performed using Joanna Briggs Institute critical appraisal checklists.

Results:
A total of 284 records were identified. After screening, the final sample contained 8 records. Conserved themes across studies included “time investment and accessibility” and “shared identities.” Effective mentors foster leadership, guide and teach mentees, and maintain accessibility. Underrepresented groups are more likely to publish with race-concordant mentors, and female mentees prioritize mentor-mentee concordance more than male mentees.

Conclusions:
Effective mentors are accessible to their mentees and invest time in developing their personal and professional goals. Identity concordances, such as shared values or shared life experiences, may be important in sustaining strong mentor-mentee relationships. The mentorship literature in plastic surgery would benefit from additional primary studies to better optimize mentorship programs.
Hepatocyte-derived liver progenitor-like cells attenuate liver cirrhosis via induction of apoptosis in hepatic stellate cells
Authors: Zhou Xu , Liu Wen-Ming , Sun Han-Yong , Peng Yuan , Huang Ren-Jie , Chen Cai-Yang , Zhang Hong-Dan , Zhou Shen-Ao , Wu Hong-Ping , Tang Dan , Huang Wei-Jian , Wu Han , Li Qi-Gen , Zhai Bo , Xia Qiang , Yu Wei-Feng , Yan He-Xin 
Published: January 2025

Background:
Cell therapy demonstrates promising potential as a substitute therapeutic approach for liver cirrhosis. We have developed a strategy to effectively expand murine and human hepatocyte-derived liver progenitor-like cells (HepLPCs) in vitro. The primary objective of the present study was to apply HepLPCs to the treatment of liver cirrhosis and to elucidate the underlying mechanisms responsible for their therapeutic efficacy.

Methods:
The effects of allogeneic or xenogeneic HepLPC transplantation were investigated in rat model of liver cirrhosis. Liver tissues were collected and subjected to immunostaining to assess changes in histology. In vitro experiments used HSCs to explore the antifibrotic properties of HepLPC-secretomes and their underlying molecular mechanisms. Additionally, proteomic analysis was conducted to characterize the protein composition of HepLPC-secretomes.

Results:
Transplantation of HepLPCs resulted in decreased active fibrogenesis and net fibrosis in cirrhosis models. Apoptosis of HSCs was observed in vivo after HepLPC treatment. HepLPC-secretomes exhibited potent inhibition of TGF-β1-induced HSC activation and promoted apoptosis through signal transducer and activator of transcription (STAT)1-mediated pathways in vitro. Furthermore, synergistic effects between amphiregulin and FGF19 within HepLPC-secretomes were identified, contributing to HSC apoptosis and exerting antifibrotic effects via activation of the janus kinase-STAT1 pathway.

Conclusions:
HepLPCs have the potential to ameliorate liver cirrhosis by inducing STAT1-dependent apoptosis in HSCs. Amphiregulin and FGF19 are key factors responsible for STAT1 activation, representing promising novel therapeutic targets for the treatment of liver cirrhosis.
Discovery of a MET-driven monogenic cause of steatotic liver disease
Authors: e Vairo Filippo Pinto , Zimmermann Michael T. , Wagenknecht Jessica , Jorge Salomão Doria , Tian Shulan , Vierkant Robert A. , Luehrs Anthony C. , Milech de Assunção Thiago , Mathison Angela , Atwal Paldeep S. , Cao Yang , Allen Alina M. , Klee Eric W. , Urrutia Raul , Lazaridis Konstantinos N. 
Published: January 2025

Background & Aims:
Metabolic dysfunction-associated steatotic liver disease (MASLD) affects about a third of adults worldwide and is projected soon to be the leading cause of cirrhosis. It occurs when fat accumulates in hepatocytes and can progress to metabolic dysfunction-associated steatohepatitis (MASH), liver cirrhosis, and hepatocellular carcinoma. MASLD pathogenesis is believed to involve a combination of genetic and environmental risk factors. Single nucleotide polymorphisms have been implicated but non-syndromic monogenic causes are lacking.

Methods:
We identified a novel genetic variant in a familial case of MASH and performed deep variant functional analysis including protein modeling, dynamics, and cell-based assays to assess molecular mechanisms of dysfunction and altered cellular signaling. We analyzed exome sequencing data of 3,904 individuals with steatotic liver disease (SLD) to identify additional cases and establish the link between specific gene variants and SLD diagnosis.

Results:
We discovered and functionally validated the NM_000245.4:c.3505A>T; p.(Ile1169Phe) variant in the MET (mesenchymal epithelial transition) kinase domain as a monogenic cause of SLD. Subsequently, we detected additional ultra-rare, previously un-interpreted, and likely deleterious variants in MET from screening sequencing data. Among individuals with confirmed SLD based on electronic record review, 1.1% (45/3,904) had rare predicted deleterious MET variants. Eight of 45 (17.7%) individuals had predicted deleterious variants in the MET kinase domain confirmed to be functionally like the familial case variant.

Conclusions:
We report the first germline non-malignant rare MET-driven disease, a monogenic form of SLD.
Performance of Optic Disc Optical Coherence Tomography Normative Database in a Large, Diverse, Real-World Cohort
Authors: Ramachandran Rithambara , Lu Ming-Chen , Niziol Leslie M. , Woodward Maria A. , Elam Angela R. , Johnson Leroy , Kershaw Martha , Musch David C. , Bicket Amanda , John Denise , Dougherty Wood Sarah , Zhang Amy , Zhang Jason , O’Brien Joan , Newman-Casey Paula Anne 
Published: January 2025

Precis:
Current optical coherence tomography normative sample data may not represent diverse human optic nerve anatomy to accurately classify all individuals with true glaucomatous optic neuropathy.

Purpose:
To compare optic nerve head (ONH) measurements between published values from an optical coherence tomography (OCT) normative database and a more diverse cohort of healthy individuals.

Patients and Methods:
ONH parameters from healthy participants of the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) program and the Topcon Maestro-1 normative cohort were compared. Chi-square tests compared MI-SIGHT retinal nerve fiber layer (RNFL) quadrant color-code labels with the expected distribution and multinomial logistic regression identified factors associated with label classifications.

Results:
1084 MI-SIGHT and 399 Topcon eyes were evaluated. The MI-SIGHT cohort was older (54 v 46 y), with more individuals identifying as Black (61% v 20%), less as Hispanic (4% v 18%), and spherical equivalents closer to plano (−0.6 v −1.2 diopters) compared to the Topcon cohort (all P<0.001). Black/African American MI-SIGHT participants had larger cup-to-disc ratios and cup volumes, while White MI-SIGHT participants had smaller ONH values, except for rim area and rim volume, compared to Topcon participants (all P<0.001). The MI-SIGHT cohort’s RNFL color codes did not follow the expected distribution (P<0.05); more MI-SIGHT RNFL quadrant measurements were assigned as white (10.6% and 6.3% MI-SIGHT v 5% Topcon) and red codes (2.2% and 1.8% MI-SIGHT v <1% Topcon) than expected in the superior and inferior quadrants respectively.

Conclusion:
OCT normative databases should accurately reflect diverse populations to avoid misclassification by RNFL thickness color codes. Larger datasets should be leveraged to encompass the full spectrum of healthy optic nerve anatomy.
Is Well-being Associated with Burnout? From a Multi-center Cross-sectional Study in Taiwan
Authors: Wu Tse-Wei , Chuang Hung-Yi , Lin Chia-Pin , Lin Fa-Chen , Yang Chen-Cheng , Kazuhiro Watanabe , Kawakami Norito 
Published: January 2025

Abstract

Objective: This article aims to explore the correlation between well-being and burnout and analyze other potential predictors of burnout.

Methods: The analyses included 242 Taiwanese workers with a balanced gender ratio. Our study used the Chinese version of the Workplace PERMA (Positive Emotion, Engagement, Relationship, Meaning, Accomplishment) -Profiler for well-being assessment and the Chinese version of the Copenhagen Burnout Inventory (CBI) to assess the participants' burnout condition. The results of the questionnaire were analyzed for their correlations using linear regression.

Results: The well-being subscales significantly related to personal burnout were Positive Emotion and Engagement. For work-related burnout, the significantly associated well-being subscales were Positive Emotion, Engagement, and Relationships.

Conclusions: The results indicate that workplace well-being indeed correlates significantly with burnout. Different domains of well-being play different roles in burnout of workers.
Fragments of Community: Physician Assistant Student Perspectives on Experience of Community With Faculty
Authors: Romero Kaley , Love Elissa , Keyes Sarah-Ann 
Published: January 2025

Introduction
Burnout is prevalent among both physician assistant (PA) students and faculty in the United States. Theories concerning the root cause of this burnout include a breakdown of community, which, in this context, serves as a framework comprising membership, influence, integration and fulfilment of needs, and shared emotional connection. A community framework has yet to be formally applied to the PA learning environment. The objective of this study was to explore the ways in which PA students experience community with faculty and how this perceived sense of community affects those students’ perceived well-being.

Methods
This was a qualitative study completed using semistructured, one-on-one virtual interviews with PA students of the graduating class of 2024 at one institution devised by using an interview guide created by the investigators based on a community framework. Interviews were recorded and transcribed by Microsoft Teams and analyzed using thematic analysis.

Results
Three major themes were produced from four participant interviews: (1) Students felt interactions with faculty were uniquely positioned to affect their well-being as influenced by their level of vulnerability as a student in a rigorous program; (2) students observed a wide range of faculty actions, values, and personality qualities that promoted a sense of community with faculty; and (3) students perceived a fragmentation between faculty members and the class itself, as well as between the two entities, which impaired their sense of community.

Discussion
PA students are vulnerable community members with a wide range of needs. Faculty interactions are crucial to meeting those needs. Future research can involve the recruitment of additional students, cohorts, or programs for diversified perspectives.