bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cell-Based Therapy by Autologous Bone Marrow-Derived Mononuclear Cells for Bone Augmentation of Plate-Stabilized Proximal Humeral Fractures: A Multicentric, Randomized, Open Phase IIa study
Authors: Seebach Caroline , Nau Christoph , Henrich Dirk , Verboket Rene , Bellen Marlene , Frischknecht Nadine , Moeck Vivien , Eichler Kathrin , Horlohé Kay Hajo Schmidt , Hoffmann Reinhard , Bonig Halvard , Seifried Erhard , Frank Johannes , Marzi Ingo 
Published: November 2023

Abstract
Proximal humerus fractures are common in an aging population. The standard operative treatment is open reduction internal fixation (ORIF) using an angular stable plate. However, this procedure has complications such as a relatively high rate of secondary dislocation, humeral head necrosis or nonunion caused by delayed bony consolidation. Autologous bone marrow mononuclear cells (BMC) combined with a β-TCP scaffold could support bone healing and is considered clinically safe.
This multicentric, randomized, open phase IIa clinical trial (Clinical Trials. Gov Identifier: NCT02803177, Eudra CT No: 2015-001820-51) evaluated whether autologous BMC with β-TCP in addition to ORIF reduces the incidence of secondary dislocations in patients with proximal humerus fracture. Ninty-four patients equally divided between verum group (BMC+β-TCP) and control group (ß-TCP only) were targeted and calculated. At the time of planned interim evaluation, ie, enrolment of 56 patients, no statistical difference in secondary dislocations or complications was demonstrated in either group after an observation period of 12 weeks. Radiographic bone healing and DASH score to determine shoulder function were comparable between both groups. Bone marrow harvest and BMC transplantation did not result in any severe adverse events. Therefore, the study was terminated after the interim analysis, as no other result could be expected. From the study results, it can be concluded that the application of autologous BMC is well tolerated, and bone healing can be achieved. Augmentation of bone defects with β-TCP could be shown to be feasible and might be considered in other clinical situations.
BrAIST-Calc
Authors: Dolan Lori A. , Weinstein Stuart L. , Dobbs Matthew B. , Flynn John M. (Jack) , Green Daniel W. , Halsey Matthew F. , Hresko M. Timothy , Krengel Walter F. , Mehlman Charles T. , Milbrandt Todd A. , Newton Peter O. , Price Nigel , Sanders James O. , Schmitz Michael L. , Schwend Richard M. , Shah Suken A. , Song Kit , Talwalkar Vishwas 
Published: November 2023

Study Design.
Prospective multicenter study data used for model derivation; externally-validated using retrospective cohort data.

Objective.
Derive and validate a prognostic model of benefit from bracing for adolescent idiopathic scoliosis (AIS).

Summary of Background Data.
The Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) demonstrated superiority of bracing over observation to prevent curve progression to surgical threshold; 42% of untreated subjects had a good outcome and 28% progressed to surgical threshold despite bracing, likely due to poor adherence. To avoid over-treatment and to promote patient goal setting and adherence, bracing decisions (who and how much) should be based on physician and patient discussions informed by individual-level data from high-quality predictive models.

Methods.
Logistic regression was used to predict curve progression to <45 degrees at skeletal maturity (good prognosis) in 269 BrAIST subjects who were observed or braced. Predictors included age, sex, body mass index (BMI), Risser stage, Cobb angle, curve pattern and treatment characteristics (hours of brace wear and in-brace correction). Internal and external validity were evaluated using jackknifed samples of the BrAIST dataset and an independent cohort (n=299) via estimates of discrimination and calibration.

Results.
The final model included age, sex, BMI, Risser stage, Cobb angle and hours of brace wear/day. The model demonstrated strong discrimination (c-statistics 0.83 - 0.87) and calibration in all datasets. Classifying patients as low risk (high probability of a good prognosis) at the probability cut point of 70% resulted in a specificity of 92% and positive predictive value of 89%.

Conclusion.
This externally-validated model can be used by clinicians and families to make informed, individualized decisions about when, and how much, to brace to avoid progression to surgery. If widely adopted, this model could decrease over-bracing of AIS, improve adherence and most importantly, decrease the likelihood of spinal fusion in this population.
Prediction of Pathologic Complete Response for Rectal Cancer Based on Pre-treatment Factors Using Machine Learning
Authors: Chen Kevin A. , Goffredo Paolo , Butler Logan R. , Joisa Chinmaya U. , Guillem Jose G. , Gomez Shawn M. , Kapadia Muneera R. 
Published: November 2023

BACKGROUND:
Pathologic complete response after neoadjuvant therapy is an important prognostic indicator for locally advanced rectal cancer and may give insights into which patients might be treated nonoperatively in the future. Existing models for predicting pathologic complete response in the pre-treatment setting are limited by small datasets and low accuracy.

OBJECTIVE:
We sought to use machine learning to develop a more generalizable predictive model for pathologic complete response for locally advanced rectal cancer.

DESIGN:
Patients with locally advanced rectal cancer who underwent neoadjuvant therapy followed by surgical resection were identified in the National Cancer Database from years 2010-2019 and were split into training, validation, and test sets. Machine learning techniques included random forest, gradient boosting, and artificial neural network. A logistic regression model was also created. Model performance was assessed using area under the receiver operating characteristic curve.

SETTINGS:
This study used a national, multicenter dataset.

PATIENTS:
Patients with locally advanced rectal cancer who underwent neoadjuvant therapy and proctectomy.

MAIN OUTCOME MEASURES:
Pathologic complete response defined as T0/xN0/x.

RESULTS:
The dataset included 53,684 patients. 22.9% of patients experienced pathologic complete response. Gradient boosting showed the best performance with area under the receiver operating characteristic curve of 0.777 (95% CI, 0.773 - 0.781), compared with 0.684 (95% CI, 0.68 - 0.688) for logistic regression. The strongest predictors of pathologic complete response were no lymphovascular invasion, no perineural invasion, lower CEA, smaller size of tumor, and microsatellite stability. A concise model including the top 5 variables showed preserved performance.

LIMITATIONS:
The models were not externally validated.

CONCLUSIONS:
Machine learning techniques can be used to accurately predict pathologic complete response for locally advanced rectal cancer in the pretreatment setting. After fine-tuning on a dataset including patients treated nonoperatively, these models could help clinicians identify the appropriate candidates for a watch and wait strategy
Loop Ileostomy Closure as a 23-Hour Stay Procedure With Preoperative Efferent Limb Enteral Stimulation: A Randomized Controlled Trial
Authors: Charbonneau Janyssa , Morin Genevieve , Paré Xavier , Frigault Jonathan , Drolet Sebastien , Bouchard Alexandre , Rouleau-Fournier François , Bouchard Philippe , Thibault Claude , Letarte François 
Published: November 2023

BACKGROUND:
Loop ileostomy closure is a common procedure in colorectal surgery. Often seen as a simple operation associated with low complication rates, it still leads to lengthy hospitalizations. Reducing postoperative complications and ileus rates could lead to a shorter length of stay and even ambulatory surgery.

OBJECTIVES:
This study aimed to assess the safety and feasibility of ileostomy closure performed in a 23-hour hospitalization setting using a standardized enhanced recovery pathway.

DESIGN:
Randomized controlled trial.

SETTINGS:
Two high-volume colorectal surgery centers.

PATIENTS:
Healthy adults undergoing elective ileostomy closure, from July 2019 to January 2022.

INTERVENTION:
All patients were enrolled in a standardized enhanced recovery pathway specific to ileostomy closure including daily irrigation of efferent limb with a nutritional formula for 7 days prior to surgery. Patients were randomly allocated to either conventional hospitalization (n = 23) or a 23-hour stay (n = 24).

MAIN OUTCOME MEASURES:
Primary outcome was total length of stay and secondary outcomes were 30-day rates of readmission, postoperative ileus, surgical site infections, postoperative morbidity and mortality.

RESULTS:
A total of 47 patients were ultimately randomized. Patients in the 23-hour hospitalization arm had a shorter median length of stay (1 day vs. 2 days, p = 0.02) and similar rates of readmission (4% vs. 13%, p = 0.35), postoperative ileus (none in both arms), surgical site infection (0 vs. 4%, p = 0.49), postoperative morbidity (21% vs. 22%, p = 1.00) and mortality (none in both arms).

LIMITATIONS:
Due to COVID-19, access to surgical beds was greatly limited, leading to a shift toward ambulatory surgery for ileostomy closure. The study was terminated early, which affected its statistical power.

CONCLUSION:
Loop ileostomy closures as 23-hour stay procedures are feasible and safe. Ileus rate might be reduced by preoperative intestinal stimulation with nutritional formula through stoma’s efferent limb, although specific RCTs are needed to confirm this association
A Comparison Between Hyaluronic Acid Filler and Dermofat Grafts With or Without Tie-Over Dressing for Lip Augmentation
Authors: Ince Bilsev , Zuhour Moath , Kadiyoran Cengiz , Avunduk Mustafa Cihat , Dadaci Mehmet 
Published: November 2023

BACKGROUND
There are many different autologous grafts used for lip augmentation, such as fat, fascia, or dermofat grafts (DFG). However, filling with synthetic materials such as hyaluronic acid (HA) fillers is the most preferred method.

OBJECTIVE
The authors aimed to compare DFG with HA fillers regarding cost, permanence, complication rate, gained volume, and satisfaction rate. The authors investigated the effect of tie-over dressings on the viability of DFG.

PATIENTS AND METHODS
Patients who received hyaluronic acid fillers were referred to as Group H. Patients who received grafts without tie-over and with tie-over dressings formed Groups D1 and D2, respectively. The lip index (LI) was used for volume comparisons. The viable area of the grafts was measured using ultrasound imaging.

RESULTS
At postoperative month 6, the only significant difference was found between Group D1 and Group D2 (p < .05). At the postoperative first year, Groups D1 and D2 had a statistically higher LI value compared with Group H. Group D2 had a higher viable area than Group D2 (p < .05). Group H and Group D2 showed higher satisfaction scores than Group D1 (p < .05).

CONCLUSION
Dermofat grafts with or without tie-over dressings can be considered a reliable and inexpensive choice for patients who seek a more permanent procedure. Tie-over dressings increase the predictability of DFG and reduce the need for overcorrection.
Lysophosphatidic acid receptor 1 antagonist (EPGN2154) causes regression of NASH in preclinical NASH models
Authors: Bhattacharjee Jashdeep , Beaton Graham , Ravula Satheesh B. , Lee Suk Joong , Bacon Kevin B. , Jenkinson Celia P. , Warren Mikako , Tucci Fabio C. , Kohli Rohit 
Published: November 2023

Background:
NASH causes a tremendous health care burden in the United States. A glucagon-like peptide-1 agonist, semaglutide (Sema), treatment resulted in hepatic steatosis reduction in clinical trials of NASH. Lysophosphatidic acid receptor 1 antagonists are known to have antifibrotic effects in several organs. We tested Sema and a novel lysophosphatidic acid receptor 1 antagonist, EPGN2154, individually and in combination to evaluate their efficacy for NASH remission in preclinical models.

Methods:
In the present study, we used (1) C57Bl6/J wild-type mice fed on a high-fat, high-carbohydrate (HFHC) diet for 16 weeks and (2) leptin-deficient mice (ob/ob) fed on an Amylin liver NASH diet for 16 weeks. After 16 weeks, the mice were randomly distributed in equal numbers in (1) no-drug, (2) EPGN2154, (3) Sema, and (4) EPGN2154+Sema treatment groups for 8 additional weeks at a dosage of 10 mg/kg body weight for EPGN2154 (oral gavage, 5 days a week) and 6.17 μg/kg body weight of Sema (subcutaneous injection every alternate day, 3 days a week).

Results:
In the wild-type-high-fat, high-carbohydrate model, we observed the most body weight loss in the EPGN2154+Sema combination group compared to the other treatment groups. All groups led to a significant reduction in alanine transaminase levels when compared to high-fat, high-carbohydrate–fed wild type. However, no significant difference in alanine transaminase levels was observed among the treatment groups. In the ob/ob mice study, Sema did not cause body weight loss. Moreover, the EPGN2154 and the combination groups had a lower NAFLD Activity Score and incidence of advanced-stage hepatic fibrosis than the Sema group.

Conclusions:
EPGN2154 demonstrated a hepato-protective effect independent of body weight loss in preclinical NASH models.
Evaluation of 10 Different Pipelines for Bacterial Single-Nucleotide Variant Detection
Authors: Hu Zi-Hao , Wang Ying , Yang Long , Cao Qing-Yi , Ling Ming , Meng Xiao-Hua , Chen Yao , Ni Shu-Jun , Chen Zhi , Liu Cheng-Zhi , Su Kun-Kai 
Published: November 2023

Abstract
Bacterial genome sequencing is a powerful technique for studying the genetic diversity and evolution of microbial populations. However, the detection of genomic variants from sequencing data is challenging due to the presence of contamination, sequencing errors and multiple strains within the same species. Several bioinformatics tools have been developed to address these issues, but their performance and accuracy have not been systematically evaluated. In this study, we compared 10 variant detection pipelines using 18 simulated and 17 real datasets of high-throughput sequences from a bundle of representative bacteria. We assessed the sensitivity of each pipeline under different conditions of coverage, simulation and strain diversity. We also demonstrated the application of these tools to identify consistent mutations in a 30-time repeated sequencing dataset of Staphylococcus hominis. We found that HaplotypeCaller, but not Mutect2, from the GATK tool set showed the best performance in terms of accuracy and robustness. CFSAN and Snippy performed not as well in several simulated and real sequencing datasets. Our results provided a comprehensive benchmark and guidance for choosing the optimal variant detection pipeline for high-throughput bacterial genome sequencing data.
Obstructive Sleep Apnea Associated With Increased Failure Rate of Ptosis Repair
Authors: Nirmalan Aravindh , Tran Meagan T. , Tailor Prashant , Hodge David , Bradley Elizabeth A. , Wagner Lilly H. , Bartley George B. , Tooley Andrea A. 
Published: November 2023

Purpose:
This study investigates how Obstructive sleep apnea (OSA) affects the outcomes of ptosis repair. We hypothesized that patients with OSA have an increased rate of reoperation after ptosis repair.

Methods:
This retrospective cohort study included patients age >18 from the Mayo Clinic who underwent ptosis repair by levator advancement or Müller muscle-conjunctiva resection between 2018 and 2021. Outcomes were measured at 1 to 3 months of follow-up with surgical failure defined as asymmetry or unsatisfactory eyelid height requiring revision surgery within 1 year.

Results:
A total of 577 patients met the inclusion criteria. There was a statistically significant difference in surgical failure between patients with OSA and those without (20.5% vs. 13.1%, p = 0.02). Patients with OSA showed a statistically significant difference in risk of revision by a factor of 1.70 (95% CI: 1.06–2.07). Revisions were attributed to unsatisfactory eyelid height in 72.6% of patients and eyelid asymmetry in 21.1%. All patients who had revision surgery had satisfactory outcomes. On logistic regression analysis, when adjusting for age and sex, OSA was significantly associated with ptosis revision (p = 0.007).

Conclusions:
OSA increases risk of surgical failure and need for revision surgery in patients undergoing blepharoptosis repair but is not a sole risk factor.
Attaining the optimal flange technique for transscleral capsular bag stabilization using iris hooks
Authors: Schlatter Andreas , Kronschläger Martin , Ruiss Manuel , Bayer Natascha , Blouin Stéphane , Findl Oliver 
Published: November 2023

Purpose:To investigate the flange properties of different iris hooks.Setting:Vienna Institute for Research in Ocular Surgery (VIROS), Hanusch Hospital, Vienna, Austria.Design:Laboratory study.Methods:The flanging properties of 4 different iris hooks made from polypropylene (PP), elastic polymer (EP), and nylon were investigated with different heating distances and both with and without forceps gripping. The maximum diameter of the flanges was measured, and the shape of the flanges was evaluated.Results:Although both nylon and EP iris hooks had too small flange diameters for intrascleral fixation, PP iris hooks had a sufficient flange diameter (>330 μm) and mushroom-like shape. Furthermore, in PP hooks, heating distance was directly proportional to flange diameter.Conclusions:The findings of this study suggest that only PP iris hooks are suitable for flanged intrascleral fixation, which is off-label, to secure adequate fixation.
Global facial rejuvenation with one treatment of incobotulinumtoxinA, hyaluronic acid, and calcium hydroxyapatite results in long-term patient-reported satisfaction
Authors: Lu Jasmine Thai , Lee Kachiu C. 
Published: November 2023

Background:
Global facial rejuvenation using injectables (neuromodulators and fillers) has reported patient satisfaction after 2 treatments: an initial and touch-up treatment at 2–4 weeks afterward. In practice, patients typically receive only 1 treatment and do not return for a touch-up treatment within a month.

Objective:
The purpose of this study was to assess patient-reported satisfaction after only 1 treatment, thus mimicking real-world scenarios.

Methods:
Patients with facial photoaging (Glogau facial aging scale ≥2) were treated with calcium hydroxyapatite, hyaluronic acid 22.5 mg/mL, and incobotulinumtoxinA injections for full facial rejuvenation, with no touch-up treatments. Patients completed the FACE-Q Satisfaction with Facial Appearance survey at baseline and 1- and 3-month post-treatment. The treating physician completed the Global Aesthetic Improvement Scale at 1- and 3-month post-treatment.

Results:
Twenty-two patients were enrolled in the study, with 1 patient lost to follow-up. There was a significant improvement in mean FACE-Q scores at 1-month (80.1, P = .01) and 3-month (77.9, P = .02) compared to baseline (71.4). Mean Global Aesthetic Improvement Scale scores at 1-month (2.1) and 3-month (2.2) were not statistically significant, indicating sustained improvement at 3 months. The product amount used per patient varied and was not correlated with either score. Limitations included a lack of a control group and follow-up ending at 3 months. Strengths included assessment of patient satisfaction after only 1 treatment, compared to other studies allowing 2 treatments.

Limitations:
Limitations include a small sample size and lack of a control group.

Conclusion:
Global full facial rejuvenation using 1 treatment of calcium hydroxyapatite, hyaluronic acid 22.5 mg/mL, and incobotulinumtoxinA provides sustained patient-reported satisfaction at 3 months.
Multifactorial chylomicronemia syndrome
Authors: Chait Alan 
Published: November 2023

Purpose of review
The aim of this review was to understand the role of multifactorial chylomicronemia syndrome (MFCS) as a cause of severe hypertriglyceridemia; to distinguish it from other causes of severe hypertriglyceridemia; and to provide a rational approach to treatment.

Recent findings
There have been advances in understanding the genetic underpinning of MFCS, and a better appreciation as to how to differentiate it from the much rarer familial chylomicronemia syndrome, in which there are substantial differences in the approach to their treatment. New approaches to triglyceride lowering will help reduce the risk of pancreatitis, the major complication of MFCS.

Summary
MCSF is a condition in which plasma triglyceride levels are severely elevated, usually to due exacerbation of common genetic forms of hypertriglyceridemia by secondary causes of hypertriglyceridemia and/or triglyceride-raising drugs. Triglyceride-induced pancreatitis can be prevented by markedly reducing triglyceride levels by treating secondary causes and/or eliminating of triglyceride-raising drugs, and by using triglyceride-lowering drugs, especially fibrates. MFCS also increases cardiovascular disease risk, for which lifestyle measures and drugs are required.
Knowledge and practice regarding cancer screening in Nepal: a systematic review and meta-analysis
Authors: Adhikari Ayush , Kashyap Basant , Acharya Subi , Sharma Supriya , Gurung Shekhar , Yadav Rupesh Kumar , Budhathoki Pravash 
Published: November 2023

Background:
Cancer screening utilization can aid in the early diagnosis and treatment of cancer. However, the current scenario of the knowledge and practice regarding cancer screening remains unclear as the authors do not have sufficient studies. Hence, the authors conducted this systematic review and meta-analysis to assess the situation of cancer screening utilization and knowledge.

Methods:
A systematic literature review was conducted to identify all studies on knowledge and practice regarding cancer screening in the Nepalese population. Data extraction and analysis were done with SPSS and CMA-3.

Results:
The authors identified a total of 5238 studies after database searching, and 19 studies were included in a narrative synthesis. Lack of awareness and knowledge was the major barrier in cervical, breast, and testicular cancer screening. In cervical cancer screening, the most common reason for screening was the advice of health personnel in 85% of respondents, and the barrier was lack of awareness in 49.33% of participants.

Conclusion:
The knowledge and practice of cancer screening is lacking in Nepal, as shown by our review. More educational and awareness programs, easy access to screening services, and elimination of sociocultural barriers are necessary to increase the utilization of screening services.
Systematic Review on Characteristics and Effects of Leadership Development Interventions for Nursing Students
Authors: Akdeniz Canberk , Duygulu Sergül 
Published: November 2023

Background:
Effective nursing leadership improves health care quality, patient well-being, and nursing staff outcomes. Newly graduated nurses face challenges in transitioning into leadership roles. Thus, examining the leadership development interventions for nursing students is critical.

Purpose:
This systematic review examined the characteristics and effectiveness of leadership development interventions designed for and implemented with undergraduate nursing students.

Methods:
A comprehensive search covered Scopus, CINAHL Ultimate, ScienceDirect, MEDLINE, WOS Core Collection, Journals@Ovid, JSTOR Journals, and ERIC databases. Included studies were assessed using the Mixed Methods Appraisal Tool.

Results:
The final review comprised 19 studies showcasing positive impacts on leadership development. The interventions varied in leadership approach, design and content, structure, qualifications, student involvement, and outcomes.

Conclusions:
Leadership development interventions are effective in enhancing nursing students' leadership. Nevertheless, future interventions should prioritize well-structured content, and studies must incorporate robust methodologies.