bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic Use of Negative Pressure Wound Therapy in High-risk Patients Undergoing Oncoplastic and Reconstructive Breast Surgery
Authors: Vidya Raghavan , Khosla Muskaan , Baek Kim , Vinayagam R. , Thekkinkattil Dinesh , Laws Siobhan , Douvetzemis Stergios , Sircar Tapan , Mullapudi Amulya , Murphy John 
Published: December 2023

Background:
Negative pressure wound therapy (NPWT) has emerged as an adjunct to reduce wound complication rates in many surgical domains. This study investigated the prophylactic use of PICO NPWT in high-risk patients undergoing oncoplastic and reconstructive breast surgery.

Methods:
This was a prospective multicenter national audit. The findings were compared against Association of Breast Surgery/British Association of Plastic, Reconstructive and Aesthetic Surgeons (ABS/BAPRAS) Oncoplastic Guidelines for best practice.

Results:
Data from 267 patients were included from seven centers. All patients had at least one high-risk factor for postoperative wound complications, whereas 78 patients (29.2%) had more than one. Thirty-six patients (13.5%) developed postoperative wound complications. An estimated 16 (6%) developed skin flap necrosis, wound dehiscence occurred in 13 patients (4.9%), and 15 patients (5.6%) developed postoperative wound infection. Eleven patients (4.1%) required further surgery due to wound complications. In total, 158 patients underwent mastectomy with immediate implant reconstruction. Postoperative wound complication rate was comparable in this subgroup (n = 22; 13.9%). Implant loss rate was 3.8%, which was within the 5% target mentioned in the ABS/BAPRAS guidelines. The estimated total cost saving was US $105,600 (£84,613) and US $395.50 (£316.90) per patient. Wound infection rate (5.6%) was much lower than the 25% reported by both iBRA study and National Mastectomy and Breast Reconstruction Audit.

Conclusions:
Our study suggests that prophylactic use of NPWT in oncoplastic and reconstructive breast surgery results in low rates of wound-related complications with associated healthcare cost benefits in patients with high-risk factors for wound-related complications. However, a prospective randomized control trial is required.
Nationwide Study: Public Adults’ Perception of Cosmetic Surgery in Saudi Arabia
Authors: Alsubhi Mohammed Naif , Albalawi Ibrahim Abdullah S. , Almaraih Mai Jamal , Alqarni Abdulrhman Mohammed Salem , Alzahrani Maha Ahmed , Alghamdi Hisham 
Published: December 2023

Background:
Knowing what influences people to pursue cosmetic surgery can aid current and aspiring cosmetic surgeons as they develop their techniques and enhance their market practice. This study aimed to evaluate Saudi adults’ perceptions of cosmetic surgery using the three subscales of the Acceptance of Cosmetic Surgery Scale, namely Social, Consider, and Intrapersonal.

Methods:
This cross-sectional, nationwide study involved members of the public from all provinces of Saudi Arabia. The inclusion criteria were being a Saudi resident over 18 years old and consenting to participate; those who did not meet the criteria were excluded. The study was implemented between October 25 and December 16, 2022. The electronic survey was composed of a demographic characteristics section and a previously constructed questionnaire modified for Arabic speakers to assess the population’s perceptions of cosmetic surgery. Statistical analysis was conducted using the SPSS 22 statistical package.

Results:
Of the 8006 Saudi adults who participated in the study, 5551 (69.3%) were women, and 2245 (30.7%) were men. We found that intrapersonal factors were the primary motivator, followed by factors addressed by the Consider and Social subscales. However, attitudes differed by gender, age, and other demographic characteristics: men and younger individuals (18–29) showed the lowest score for likelihood to pursue cosmetic surgery, whereas women and older individuals (40–50) ranked the highest on total scale scores. Overall, the Saudi adult population showed diminished perceptions of cosmetic surgery nationwide.

Conclusion:
The results confirmed the authors’ hypothesis that there is a diminished perception of cosmetic surgery among adults in Saudi Arabia.
Recommendations for patient education in the management of persistent pelvic pain: a systematic review of clinical practice guidelines
Authors: Mardon Amelia K. , Leake Hayley B. , Szeto Kimberley , Moseley G. Lorimer , Chalmers K. Jane 
Published: December 2023

Abstract
Patient education has a critical role in the management of pain. There is considerable heterogeneity in patient education for females with persistent pelvic pain (PPP), and it remains unclear what is considered best clinical practice. Therefore, this systematic review identified and summarised recommendations for patient education in the management of benign gynaecological and urological conditions associated with PPP, as endorsed by international guidelines. Academic and relevant guideline databases were searched from inception to May 2022. Included guidelines were those for the management of benign gynaecological and urological conditions associated with PPP in adult females published in English, of any publication date, and endorsed by a professional organisation or society. Two independent reviewers screened 3097 records; 17 guidelines were included in the review. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) tool. Recommendations were pooled using descriptive synthesis. Persistent pelvic pain guideline quality was generally poor. Three guidelines were classified as “excellent” (The NICE, RANZCOG, and ESHRE endometriosis guidelines) and therefore recommended for use. Eleven guidelines (64.7%) recommended patient education for females with PPP. Recommendations for education content were variable, however most frequently covered treatment strategies and pelvic pain diagnoses. For education delivery, the most frequent recommendations were for support groups and written/printed materials. Further research into tailored education interventions is needed for females with PPP.
Artificial Intelligence–Based Emphysema Quantification in Routine Chest Computed Tomography: Correlation With Spirometry and Visual Emphysema Grading
Authors: Wiedbrauck Damian , Karczewski Maciej , Schoenberg Stefan O. , Fink Christian , Kayed Hany 
Published: December 2023

Objective
The aim of the study is to assess the correlation between artificial intelligence (AI)–based low attenuation volume percentage (LAV%) with forced expiratory volume in the first second to forced vital capacity (FEV1/FVC) and visual emphysema grades in routine chest computed tomography (CT). Furthermore, optimal LAV% cutoff values for predicting a FEV1/FVC < 70% or moderate to more extensive visual emphysema grades were calculated.

Methods
In a retrospective study of 298 consecutive patients who underwent routine chest CT and spirometry examinations, LAV% was quantified using an AI-based software with a threshold < −950 HU. The FEV1/FVC was derived from spirometry, with FEV1/FVC < 70% indicating airway obstruction. The mean time interval of CT from spirometry was 3.87 ± 4.78 days. Severity of emphysema was visually graded by an experienced chest radiologist using an established 5-grade ordinal scale (Fleischner Society classification system). Spearman correlation coefficient between LAV% and FEV1/FVC was calculated. Receiver operating characteristic determined the optimal LAV% cutoff values for predicting a FEV1/FVC < 70% or a visual emphysema grade of moderate or higher (Fleischner grade 3–5).

Results
Significant correlation between LAV% and FEV1/FVC was found (ϱ = −0.477, P < 0.001). Increasing LAV% corresponded to higher visual emphysema grades. For patients with absent visual emphysema, mean LAV% was 2.98 ± 3.30, for patients with trace emphysema 3.22 ± 2.75, for patients with mild emphysema 3.90 ± 3.33, for patients with moderate emphysema 6.41 ± 3.46, for patients with confluent emphysema 9.02 ± 5.45, and for patients with destructive emphysema 16.90 ± 8.19. Optimal LAV% cutoff value for predicting a FEV1/FVC < 70 was 6.1 (area under the curve = 0.764, sensitivity = 0.773, specificity = 0.665), while for predicting a visual emphysema grade of moderate or higher, it was 4.7 (area under the curve = 0.802, sensitivity = 0.766, specificity = 0.742). Furthermore, correlation between visual emphysema grading and FEV1/FVC was found. In patients with FEV1/FVC < 70% a high proportion of subjects had emphysema grade 3 (moderate) or higher, whereas in patients with FEV1/FVC ≥ 70%, a larger proportion had emphysema grade 3 (moderate) or lower. The sensitivity for visual emphysema grading predicting a FEV1/FVC < 70% was 56.3% with an optimal cutoff point at a visual grade of 4 (confluent), demonstrating a lower sensitivity compared with LAV% (77.3%).

Conclusions
A significant correlation between AI-based LAV% and FEV1/FVC as well as visual CT emphysema grades can be found in routine chest CT suggesting that AI-based LAV% measurement might be integrated as an add-on functional parameter in the evaluation of chest CT in the future.
Performance of three predictive scores to avoid delayed diagnosis of significant blunt bowel and mesenteric injury. A 12-year retrospective cohort study
Authors: Agri Fabio , Pache Basile , Bourgeat Mylène , Darioli Vincent , Demartines Nicolas , Schmidt Sabine , Zingg Tobias 
Published: December 2023

Abstract

Background
Avoiding missed diagnosis and therapeutic delay for significant blunt bowel and mesenteric injuries (sBBMI) after trauma is still challenging despite the widespread use of computed tomography. Several scoring tools aiming at reducing this risk have been published. The purpose of the present work was to assess the incidence of delayed (>24 h) diagnosis for sBBMI patients and to compare the predictive performance of three previously published scores using clinical, radiological and laboratory findings: the “Bowel Injury Prediction Score” (BIPS) and the scores developed by Raharimanantsoa (RS) and by Faget (FS).

Methods
Population-based retrospective observational cohort study of adult trauma patients after road traffic crashes (RTC) admitted to Lausanne University Hospital, Switzerland, between 2008 and 2019 (n = 1258) with reliable information about sBBMI status (n = 1164) and for whom all items for score calculation were available (n = 917). The three scores were retrospectively applied on all patients to assess their predictive performance.

Results
The incidence of sBBMI after RTC was 3.3% (38/1164) and in 18% (7/38) there was a diagnostic and treatment delay of more than 24 hours. The diagnostic performance of the FS, the RS and the BIPS to predict sBBMI, expressed as the area under the receiver operating characteristic (ROC) curve, were 95.3% (95% CI: 92.7%-97.9%), 89.2% (95% CI: 83.2%-95.3%) and 87.6% (95% CI: 81.8%-93.3%) respectively.

Conclusion
The present study confirms that diagnostic delays for sBBMI still occur despite the widespread use of abdominal CT. When CT findings during the initial assessment are negative or equivocal for sBBMI, using a score may be helpful to select patients for early diagnostic laparoscopy. The FS had the best individual diagnostic performance. However, the BIPS or the RS, relying on clinical and laboratory variables, may be helpful to select patients for early diagnostic laparoscopy when there are unspecific CT signs of bowel or mesenteric injury.

Level of evidence and study type
Level III, Prognostic/Epidemiological
The role of gravity in naturalness versus consistency: strong-
CP
and dark energy
Authors: Dvali Gia 
Published: December 2023

There is an ongoing debate on how seriously one should take the naturalness puzzles as the guidelines to new physics. In this debate gravity is often put aside, as an insignificant spectator force. However, this attitude misses the entire essence of the story. Through its

S

-matrix formulation, gravity promotes certain puzzles, such as the cosmological constant and strong-

C
P

problems, into the consistency issues. The respective consistency requirements make the theory highly predictive. In particular, the cosmological vacuum energy must be zero. This has fundamental implications both for strong-

C
P

and for dark energy puzzles. QCD must include an axion as an intrinsic part of the gauge redundancy, without the need of any global symmetry. This gives

ϑ
¯

=
0

to all orders in operator expansion. Applied to cosmology, the

S

-matrix implies that the energy budget of the Universe cannot come from a constant. Correspondingly, the dark energy is an unambiguous signal of new physics around the Hubble scale.

This article is part of the theme issue ‘The particle-gravity frontier’.
After the Higgs boson discovery: a turning point in particle physics
Authors: Pokorski Stefan 
Published: December 2023

The discovery of the Higgs particle has completed the Standard Model of elementary interactions which is stunningly successful in describing most of the elementary processes observed so far in the laboratories. Nevertheless, it is not the Theory of Everything. Its structure faces some theoretical puzzles and, even more importantly, it leaves unexplained neutrino masses and several fundamental astrophysical observations. Thus, the quest for a deeper theory is at present the main experimental and theoretical challenge in particle physics. However, contrary to the past research characterized by certain continuity and clear goals, we are now in a turning point surfing into totally unknown territory beyond the Standard Model physics. Precision measurements of the Higgs particle properties is one of the promising directions in the search for extensions to the existing theory.
This article is part of the theme issue ‘The particle-gravity frontier’.
Molecular landscapes of oral cancers of unknown etiology
Authors: Deneuve Sophie , Fervers Béatrice , Senkin Sergey , Bouaoun Liacine , Pérol Olivia , Chavanel Bérénice , Lu Lingeng , Coste Isabelle , Renno Toufic , Zavadil Jiri , Virard François 
Published: December 2023

AbstractThe incidence of the mobile tongue cancer in young patients has been rising. This oral cancer (OC) type has no identified risk factors (NIRF), no established molecular markers and is not yet recognized as a distinct clinical entity.To understand this emerging malignancy, we innovatively analyzed the public head and neck cancer multi-omics data. We identified mutational signatures that successfully stratified 307 OC and 109 laryngeal cancer cases according to their clinico-pathological characteristics. The NIRF OCs exhibited significantly increased activities of endogenous clock-like and APOBEC-associated mutagenesis, alongside specific cancer driver gene mutations, distinct methylome patterns and prominent antimicrobial transcriptomic responses. Furthermore, we show that mutational signature SBS16 in OCs reflects the combined effects of alcohol drinking and tobacco smoking.Our study characterizes the unique disease histories and molecular programs of the NIRF OCs revealing that this emerging cancer subtype is likely driven by increased endogenous mutagenesis correlated with responses to microbial insults.
Calling for diversity: improving transfusion safety through high-throughput blood group microarray genotyping
Authors: Wittig Michael , Steiert Tim Alexander , ElAbd Hesham , Degenhardt Frauke , Valenti Luca , Prati Daniele , Ronzoni Luisa , Bujanda Luis , Banales Jesus M. , Blay Natalia , Invernizzi Pietro , Buti Maria , Albillos Agustín , Fernández Javier , Sacchi Nicoletta , Julià Antonio , Latiano Anna , de Cid Rafael , D’Amato Mauro , Asselta Rosanna , Laudes Matthias , Lieb Wolfgang , Juhl David , Gassner Christoph , Franke Andre 
Published: December 2023

ABSTRACTBlood transfusions, conducted between donors compatible in their red blood cell (RBC) antigens, play a life-saving role in transfusion medicine. Genetic differences at blood group loci between ethnicities result in diversity and altered frequency of RBC antigens that need to be considered in blood transfusion. Consequently, comprehensive, and accurate blood group antigen typing is especially relevant for inter-ethnic blood transfusions and for minorities underrepresented in the donor population. Blood group microarray genotyping is a cost-efficient and scalable method for comprehensive blood group typing. Previously, however, microarray typing has been challenging for the clinically important blood group systems Rh and MNS, as these feature highly paralogous genomic loci leading to mixed signals. We here present an approach for accurately typing blood group systems, including Rh and MNS variations, that we benchmarked in an ethnically diverse cohort. We tested its performance using gold-standard, diagnostic-grade MALDI-TOF data from 1,052-samples, including 334 CEPH diversity samples and applied the approach to 4,999 samples of a COVID-19 genetics study. Overall, we obtained a 99.95% benchmarking concordance and 99.65% call rate. In summary, we provide a highly accurate and cost-efficient high-throughput genotyping method for comprehensive blood group analysis that is also suitable for ethnically diverse sample sets.
Inference of causal and pleiotropic effects with multiple weak genetic instruments: application to effect of adiponectin on type 2 diabetes
Authors: McKeigue Paul M , Iakovliev Andrii , Spiliopoulou Athina , Erabadda Buddhiprabha , Colhoun Helen M 
Published: December 2023

AbstractCurrent methods for Mendelian randomization (MR) analyses are restricted to single SNP instruments, and cannot reliably infer causality with instruments that are mostly weak and pleiotropic. We describe methods to overcome these limitations: key innovations are construction of scalar instruments from multiple SNPs, use of a regularized horseshoe prior, and hypothesis tests based on the marginal likelihood of the causal effect parameter. To demonstrate the approach, we constructed genotypic instruments from unlinkedtrans-pQTLs detected in two large GWAS studies of plasma proteins, and tested the top 20 genes for which the aggregated effects of the instruments was associated with type 2 diabetes in the UK Biobank cohort. The only protein with clear evidence of a causal effect on type 2 diabetes was adiponectin, encoded byADIPOQ: standardized log odds ratio -0.34 (95% CI -0.44 to -0.24) using UK Biobank instruments. These results have implications for the design and analysis of Mendelian randomization studies. Where the exposure under study is expression of a gene, restricting the instruments tocis-acting variants is likely to miss causal effects. Tests based on the marginal likelihood should supersede other methods of testing for causality in the presence of pleiotropy.
Disproportionate increase in cannabis use among individuals with serious psychological distress and association with psychiatric hospitalization and outpatient service use in the National Survey on Drug Use and Health 2009-2019
Authors: Hyatt Andrew S , Flores Michael William , Cooke Benjamin Lê 
Published: December 2023

ABSTRACTAimsEstimate trends in levels of cannabis use among adults with and without serious psychological distress (SPD) in the United States from 2009-2019, and to ascertain whether cannabis use among individuals with SPD was associated with inpatient psychiatric hospitalization and outpatient mental health care.DesignUsing multivariable logistic regression models and predictive margin methods, we estimated linear time trends in levels of cannabis use by year and SPD status and rates of psychiatric hospitalization and outpatient service use.SettingThe United States: National Survey on Drug Use and Health (NSDUH), an annual cross-sectional survey, 2009-19 public use files.Participants447,228 adults aged ≥ 18 years.MeasurementsIn the past year, self-report of any and greater-than-weekly cannabis use, any inpatient psychiatric hospitalization, and any outpatient mental health care.FindingsRates of any and weekly-plus cannabis use increased similarly among individuals with SPD compared to those without from 2009-2014 but more rapidly in SPD from 2015-2019 (p<0.001). Among individuals with SPD, probability of psychiatric hospitalization was greater among individuals with less than weekly (5.2%, 95% CI 4.4-5.9%, p=0.011), and weekly-plus cannabis use (5.4%, 95% CI 4.6-6.1, p=0.002) compared to no use (4.1%, 95% CI 3.8-4.4%). For outpatient mental health care, no use was associated with a 27.4% probability (95% CI 26.7-8.1%) of any outpatient care, significantly less than less than weekly use (32.7% probability, 95% CI 31.3-34.1% p<0.001) and weekly-plus use (29.9% probability, 95% CI 28.3-31.5% p=0.006).ConclusionsCannabis use is increasing more rapidly among individuals with SPD than the general population, and is associated with increased rates of psychiatric hospitalization as well as increased outpatient service use. These findings can inform policy makers looking to better tailor regulations on advertising for medical and adult use cannabis and develop public health messaging on the use of cannabis in people with mental illness.
The Trend of Ischemic Evaluation, Intervention, and In-Hospital Mortality and Outcomes among Patients with Acute Myocardial Infarction and Atrial Fibrillation
Authors: Baig Mirza Faris Ali 
Published: December 2023

AbstractBackgroundAtrial fibrillation (AF) is associated with increased cardiovascular mortality. Data regarding the relationship between coronary artery disease (CAD) and AF is mixed. It is uncertain if AF directly increases the risk for future coronary events and if such patients are appropriately evaluated for CAD.MethodsThis is a cross-sectional study performed on hospitalized patients with AMI and concurrent AF in 2019 using National Inpatient Sample from HCUP. Patients with missing information and type II non-ST elevation myocardial infarction (NSTEMI) were excluded. Using STATA 18, In-hospital mortality, ischemic evaluation, percutaneous treatment, rates of ventricular tachycardiac (VT), ventricular fibrillation (VF), cardiogenic shock, cardiac arrest, average length of stay (LOS), and total hospitalization charges were studied. Regression models were used for data analyses.ResultsA total of 600,645 patients met inclusion criteria (219,660 females [36.5%], 428,755 Caucasian [71%], 65,870 African American [10.9%], 51,155 Hispanic [8.5%]; mean [SD] age, 66.7 [0.5] years), including 166,680 (28%) STEMI and 433,965 (72%) NSTEMI patients. 109,520 (18%) patients with AMI had AF. For patients with AMI and AF, the adjusted odds of mortality increased by 23% (adjusted Odds ratio [aOR], 1.23; CI, 1.15-1.32; p<0.001). AF patients were less likely to undergo ischemic evaluation (aOR, 0.77; CI, 0.74-0.80; p<0.001) and ischemic intervention (aOR, 0.64; CI, 0.62-0.66; p<0.001). AF patients had higher odds of VT (aOR, 1.41; CI, 1.33-1.49; p<0.001), VF (aOR, 1.44; CI, 1.33-1.57; p<0.001), cardiogenic shock (aOR, 1.43; CI, 1.35-1.52; p<0.001), and cardiac arrest (aOR, 1.35; CI, 1.24-1.47; p<0.001). AF patients had longer LOS (mean, 1.39; SCD, 1.29-1.48; p<0.001) and higher total hospital charges (mean $22,188; 19,311-25,064, p<0.001).ConclusionAF was independently associated with increased mortality in patients admitted with AMI. AF was associated with higher rates of cardiac complications. Patients with AF were less likely to receive ischemic evaluation or percutaneous intervention and had overall higher healthcare resource utilization. This study encourages AF to be viewed as an independent risk factor for CAD and suggests more efforts to diagnose CAD in such patients.Clinical PerspectiveWhat is newPatients with acute myocardial infarction and atrial fibrillation have higher odds of mortality.AMI patients with AF are subjected to lesser odds of undergoing ischemic evaluation and intervention.Healthcare resource utilization is higher in this cohort.What are the clinical implicationsAF should be considered as an independent risk factor for increased mortality in AMI.Early ischemic evaluation should be considered to diagnose coronary artery disease in this cohort.Increased awareness to recognize all risk factors of coronary artery disease.