bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing response to stressful emotions: a controlled crossover study using pupillometry
Authors: Noronha Ana Carolina , Castro Mendes Francisca , Carvalho Pedro , Fonseca Mafalda , Paciência Inês , Moreira André 
Published: January 2025

Abstract

Background:
Fear and horror induce autonomic protective responses, acting as “survival intelligence.” Pupillometry is an innovative method that captures real-time autonomic nervous system reactions to stress.

Objective:
To evaluate the feasibility of pupillometry to assess the acute response to a passive real-life stressor—viewing a truthful war scene.

Methods:
Thirteen medical students (10 women) with an average age of 20.4 years were enrolled in a nonrandomized controlled crossover trial. Selected clips from two different audiovisual stimuli (M1: Saving Private Ryan as a fear and horror inducer and M2: Life Is Beautiful as a control) were watched for 15 minutes, separated by a washout period of 48–72 hours. The differences in pupillometry parameters between the exposure movie and the assessment time (T0 and T1 for M1 and T0 and T1 for M2) were evaluated using a Wilcoxon test. The Wilcoxon test was also used to assess the difference between M1 and M2 within each assessment time point (T0 and T1).

Results:
A significant difference in response to acute fear and horror-induced stress was observed in pupillometry parameters {baseline [6.90 (5.95; 7.40) vs. 6.60 (5.55; 7.10), P = 0.030] and final pupil diameter [4.50 (3.90; 5.20) vs. 4.10 (3.50; 4.60), P = 0.012]} between M1 and M2 in T1, suggesting the acute increase in sympathetic parameters. Although not significant, there was also a difference in pupillometry parameters (final pupil diameter [P = 0.060], average constriction velocity [P = 0.059]) after watching M1 compared with T0.

Conclusion:
Our proof-of-concept study suggests that pupillometry may be used to evaluate changes in the activity of the autonomic nervous system induced by an acute passive stress stimulus.
Systematic Review and Meta-Analysis of 24-Hour Ambulatory Blood Pressure Monitoring in Pregnancy and Postpartum Periods
Authors: Sommer Sadie B. , Muchira James M. , Garrison Etoi A. , Walden Rachel L. , Chinni Riya , van der Eerden Joshua H. , Mogos Mulubrhan F. 
Published: January 2025

Purpose:
Early detection and management of hypertensive disorders during pregnancy and postpartum are essential. This systematic review and meta analysis aimed: (1) to examine the state of 24-hour ambulatory blood pressure (ABP) use, and (2) in a subset of studies, evaluate 24-hour ABP parameters in the prediction and identification of Hypertensive Disorders of Pregnancy (HDP).

Methods:
A comprehensive literature search was conducted in March of 2022 for English language studies published after 2000. In a subset of studies in this review, we conducted a meta analysis summarizing 24-hour, day, and night standardized mean difference (hedge’s g) in systolic and diastolic blood pressure during pregnancy for individuals later diagnosed with HDP and those without.

Results:
A total of 69 articles met all established criteria and were included in this systematic review, and a subgroup of studies that reported HDP outcomes (n=14) were included in the meta analysis. Out of the 69 studies, 31 (45.61%) used 24-hour ABP devices that are not validated for pregnant individuals. Birthing individuals diagnosed with HDP had elevated 24-hour, day, and night systolic and diastolic blood pressure during second and third trimesters of pregnancy.

Conclusion:
A noticeable gap exists in the utilization of validated 24-hour ABP devices for pregnant and postpartum populations. Variations exist regarding the timing of 24-hour ABP measurements, particularly across trimesters.

Implications for practice:
24-hour ABP monitoring could serve as one of the tools to identify and manage pregnant individuals at risk of HDP and ultimately reverse the current trend in maternal mortality.
Management of hip fracture patients on direct oral anticoagulants: a survey of orthopaedic trauma surgeons, systematic review, and meta-analysis
Authors: Spitler Clay , Rutz Robert , Blackwood Nigel , Wally Meghan , Johnson Joseph , Krause Peter , Ahn Jaimo , Mohammed Zuhair , McClure Mark , Billings Rebecca , Yu Ziqing , Yeager Matthew ,   Orthopaedic Trauma Association's Evidence-Based Quality Value and Safety Committee
Published: January 2025

Abstract

Objectives:
This systematic review examined the literature regarding management of fracture patients who take direct oral anticoagulant (DOAC) medications, with a focus on delay in surgical treatment, and need for transfusions. In addition, a survey of orthopaedic trauma surgeons was conducted to gain insight on current practices.

Data Sources:
A review of PubMed, Cochrane, Embase, and Scopus databases was performed from inception through March 2024, including English language publications.

Study Selection:
Studies were included if they reported time to surgery and transfusion rates among fracture patents who were taking DOAC medications. Additional data points were collected on an “if-reported” basis, including mortality, venous thromboembolism, and bleeding complications.

Data Extraction:
In all, 4546 abstracts were screened. Full-text review was conducted on 86 publications, and 25 articles were included in the final analysis. Each article was independently screened by 2 reviewers, with disputes settled by a third reviewer. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) tool.

Data Synthesis:
Descriptive statistics are reported for overall study findings. Meta-analysis was performed for the variables “time to surgery” and “transfusion rate.”

Conclusions:
Our findings indicate that fracture patients taking DOACs experience longer delays before surgery but have equivalent transfusion rates compared with nonanticoagulated patients. Survey results indicate that surgeons do not delay operating on emergent or percutaneous cases, regardless of anticoagulant medications. In circumstances when they do delay, they are more likely to do so for patients taking DOAC medications.

Level of Evidence:
Level III, systematic review and meta-analysis of Level II and III articles.
Safety and efficacy of switching to 4-weekly albuvirtide plus daily dolutegravir in virologically suppressed HIV-1 adults: a 24-week study
Authors: xie Xiaoxin , Fu Yanhua , Gan Lin , yang Xiaoyan , Song Yebing , Song Chunli , Sun Fangfang , Guo Lei , Long Hai 
Published: January 2025

Objectives:
Albuvirtide (ABT) is a long-acting fusion inhibitor. This study assessed switching to ABT 640 mg every 4 weeks plus daily Dolutegravir (DTG) in virologically suppressed adults with HIV-1.

Design and methods:
In this open-label, single-arm study, 10 participants with HIV-1 RNA <50 copies/mL switched to ABT plus DTG for 24 weeks. Safety, pharmacokinetics, viral load, and CD4+ T cell counts were assessed.

Results:
No serious adverse events occurred. Albuvirtide's steady-state trough concentration was 31.1 times higher than PA-IC90. All participants maintained virological suppression. CD4+ T-cell counts increased significantly after 24 weeks (P = 0.0462).

Conclusion:
Switching to 4-weekly ABT plus daily DTG demonstrated good safety, favorable pharmacokinetics, maintained virological suppression, and improved immune recovery. These findings support ABT's potential as a long-acting agent for simplifying HIV treatment.
Men’s voices on Long-acting Pre-Exposure Prophylaxis (LA PrEP) delivery modalities: Acceptability and Preferences among Cis-gender men and men who have sex with men in South Africa
Authors: Atujuna Millicent , Nyamaizi Alinda M. , Duby Zoe , Minnis Alexandra , Diaz Miranda , Palanee-Phillips Thesla , Tenza Siyanda , Reddy Krishnaveni , Nkomana Nqaba , Bekker Linda-Gail , Montgomery Elizabeth 
Published: January 2025

Introduction:
In sub-Saharan Africa (SSA), cisgender men—in particular men who have sex with women (MSW) and, to a lesser degree, men who have sex with men (MSM)—are often under-represented in HIV prevention research, despite their own HIV risk and role in transmission cycles. As HIV prevention research on long-acting pre-exposure prophylaxis (LA PrEP) options expands in SSA, it is essential to engage these populations to ensure their acceptability. We investigated perceptions of implants and intramuscular injectables as LA PrEP delivery among MSW and MSM.

Methods:
In-depth interviews were conducted between October 2020 and March 2021with 40 MSW (n=20) and MSM (n=20), aged 18-35 years, self-reported as HIV-negative, sexually-active, and residing in resource-restricted communities in Cape Town and Johannesburg, South Africa. We explored factors influencing LA PrEP attitudes. Data analysis followed a thematic framework approach.

Results:
MSW and MSM found LA PrEP administration modes more acceptable than daily oral PrEP because they offered longer-lasting protection while reducing frequent clinic visits for refills. MSW voiced hesitancy around the use of ‘foreign products’, fearing infertility and congenital-disabilities in their future children. Both subgroups acknowledged the convenience of implants with long-dosing duration, but injections were deemed to be more discreet and familiar. Both groups described Implant use as potentially stigmatizing, with a greater chance of causing tissue scarring from insertion and removal procedures.

Conclusions:
Evidence relating to men’s engagement in HIV prevention and acceptable modalities of HIV prevention is limited. We found that both groups were enthusiastic about LA PrEP, informing the development of our subsequent clinical study to provide further insight into using placebo versions of LA PrEP and future implementation of LA PrEP options.

One-Sentence Summary:
LA PrEP acceptability and preference among men
The Use of Acellular Dermal Matrix May Not Increase 30-Day Complications in Direct-to-Implant Breast Reconstruction
Authors: Knoedler Samuel , Klimitz Felix J. , Friedrich Sarah , Schemet Lena , Broer P. Niclas , Cherubino Mario , Könneker Sören , Kim Bong-Sung , Pomahac Bohdan , Kauke-Navarro Martin 
Published: January 2025

Background
Direct-to-implant (DTI) breast reconstruction offers immediate aesthetic and psychological benefits, but the role of acellular dermal matrix (ADM) remains debated. Using a multi-institutional database, this study evaluates and compares outcomes between ADM-assisted and non-ADM DTI procedures.

Methods
The American College of Surgeons National Surgical Quality Improvement Program database from 2008 to 2022 was queried to identify female patients who underwent DTI breast reconstruction for oncological purposes. Patients were divided into 2 groups: DTI breast reconstruction with ADM and without. Thirty-day postoperative complications were compared using multivariate analysis and propensity score matching.

Results
Among 10,177 patients, 45% (n = 4605) underwent ADM-assisted DTI, while 55% (n = 5572) had non-ADM DTI. While both groups showed comparable mean ages (ADM: 52 ± 12 years vs non-ADM: 51 ± 11 years; P = 0.190), ADM patients were significantly less likely to present with comorbidities such as obesity (ADM: 21.5% vs non-ADM: 26%; P < 0.001), hypertension (20.5% vs 2.6%; P = 0.01), diabetes (4.8% vs 5.1%; P = 0.002), and smoking history (6.4% vs 10.1%; P < 0.001). Still, surgical complication rates were comparable (ADM: 4.7%, non-ADM: 5.5%; P = 0.08), including superficial infections (2.0% vs 2.4%; P = 0.19), deep infections (0.6% vs 0.9%; P = 0.17), wound dehiscence (0.8% vs 1.0%; P = 0.24), and bleeding (0.6% vs 0.7%; P = 0.54). Medical complications were generally rare and also showed no significant differences (ADM: 1.4%, non-ADM: 1.7%; P = 0.27). Confounder-adjusted multivariable analysis and propensity score matching confirmed no increased risk of surgical (odds ratio 0.93, 95% confidence interval 0.75–1.16, P = 0.52) or medical complications (odds ratio 0.87, 95% confidence interval 0.59–1.26, P = 0.46).

Conclusions
The use of ADM in DTI breast reconstruction is not associated with a higher risk of short-term complications, supporting its continued use in clinical practice. This information is crucial for surgeons and patients in making informed decisions regarding the incorporation of ADM in DTI breast reconstruction.
Validation of a Pretransplant Risk Prediction Model for Early Allograft Dysfunction After Living-donor Liver Transplantation
Authors: Li Zhihao , Raptis Dimitri , Rammohan Ashwin , Gunasekaran Vasanthakumar , Hong Suyoung , Chen Itsuko Chih-Yi , Kim Jongman , Hervera Marquez Kris Ann , Hsu Shih-Chao , Kirimker Elvan Onur , Akamatsu Nobuhisa , Shaked Oren , Finotti Michele , Yeow Marcus , Genedy Lara , Braun Julia , Yebyo Henock , Dutkowski Philipp , Nadalin Silvio , Boehnert Markus U. , Polak Wojciech G. , Bonney Glenn K. , Mathur Abhishek , Samstein Benjamin , Emond Jean C. , Testa Giuliano , Olthoff Kim M. , Rosen Charles B. , Heimbach Julie K. , Taner Timucin , Wong Tiffany CL. , Lo Chung-Mau , Hasegawa Kiyoshi , Balci Deniz , Cattral Mark , Sapisochin Gonzalo , Selzner Nazia , Jeng Long-Bin , Joh Jae-Won , Chen Chao-Long , Suh Kyung-Suk , Rela Mohamed , Broering Dieter , Clavien Pierre-Alain 
Published: January 2025

Background.
Early allograft dysfunction (EAD) affects outcomes in liver transplantation (LT). Existing risk models developed for deceased-donor LT depend on posttransplant factors and fall short in living-donor LT (LDLT), where pretransplant evaluations are crucial for preventing EAD and justifying the donor’s risks.

Methods.
This retrospective study analyzed data from 2944 adult patients who underwent LDLT at 17 centers between 2016 and 2020. We developed a logistic regression model to predict EAD based on this development cohort. We used data from 1020 patients at the King Faisal Transplant Center for external validation.

Results.
In the development cohort, 321 patients (10.9%) experienced EAD. These patients had poorer health status, more liver decompensation, and higher requirements of hospitalization than those without EAD. Multivariable logistic regression identified independent pretransplant predictors of EAD: laboratory Model for End-Stage Liver Disease score (odds ratio [OR], 1.08; 95% confidence interval [CI], 1.06-1.09), the necessity for hospitalization at the time of transplant (OR, 2.58; 95% CI, 2.00-3.30), and graft weight in kilogram (OR, 0.27; 95% CI, 0.17-0.45). Using these predictors, we developed the model for EAD after LDLT, which demonstrated strong discriminative ability in the development cohort with an area under the curve (AUC) of 0.71 (95% CI, 0.68-0.74). The model maintained high discrimination during internal validation (AUC, 0.70; 95% CI, 0.67-0.73) and showed a modest reduction in discriminative power in external validation (AUC, 0.65; 95% CI, 0.61-0.68).

Conclusions.
EAD post-LDLT is influenced by the recipient’s pretransplant health condition and the graft weight. Integrating the model for EAD after LDLT into the pretransplant process of pairing donors and recipients can enhance the safety and efficacy of LDLT.
Lower Limb Compartment Syndrome Among Colorectal Patients: Risk Factors and Proposed Guidelines
Authors: Suresh Reena S , Stem Miloslawa , Winland Ama J , Tassinari Stefano , Obias Vincent J , Gabre-Kidan Alodia , Gearhart Susan L , Najjar Peter A 
Published: January 2025

Background:
Lower limb compartment syndrome (LLCS) is a rare but potentially devastating complication of prolonged lithotomy positioning in colorectal surgery. The mechanisms appear to be related to prolonged pressure on muscle compartments, leading to hypoperfusion followed by reperfusion injury. This study aims to identify the incidence of LLCS after colorectal surgery and identify associated risk factors to inform evidence-based prevention strategies.

Study Design:
Adults from the American College of Surgeons-National Surgical Quality and Improvement Program (2006-2022) undergoing colorectal surgery were included. The primary outcome was postoperative compartment syndrome leading to fasciotomy. Patients with concurrent vascular procedures and embolism diagnoses were excluded. The association between operative time and fasciotomy was assessed using multivariable logistic regression.

Results:
Among 773,981 patients, 35 underwent fasciotomy within 2 days of their colorectal procedure. The median operative time was 388 minutes (IQR 165, 539) for the fasciotomy group and 162 minutes (IQR 113,320) for the non-fasciotomy group (p<0.001). Adjusted multivariable analysis demonstrated a time-response relationship between operative time and fasciotomy as the odds of fasciotomy was 3.5-fold higher after 3-5 hours and increased with longer operative time. In addition, other factors associated with fasciotomy included age <50 years, ASA IV-V, and preoperative transfusion.

Conclusions:
Providers should exercise caution when operating on younger patients in lithotomy position with an operative time over 3-5 hours, as prolonged operative time is associated with an increased risk of fasciotomy. Improving awareness alongside the development of guidelines for routine intraoperative lower extremity assessment can facilitate early recognition and prevention of LLCS.
Use of Small Bowel Follow Through in Management of Small Bowel Obstruction
Authors: Soult Alexa , Van Horn Alexandra , Sturm Emily , Sternick Molly , Burgess Jessica , Britt Rebecca 
Published: January 2025

Background:
Small bowel obstructions (SBO) are a burden to healthcare. Despite a common disease, significant inconsistencies exist within management, specifically use of small bowel follow through (SBFT). We evaluated patients who had SBFT and the early versus late use of SBFT on outcomes.

Study Design:
A retrospective chart review was performed for 799 SBO patients admitted between 2012 and 2019. Patients between 18 and 89 were included and those that required emergent operations on admission were excluded. The groups were evaluated by having SBFT compared to not, and further delineated on SBFT performance before (early) or after (late) 48 hours.

Results:
Of the 799 patients with a SBO, 757(94.7%) patients had SBFT and 42(5.2%) patients did not. Of those 757, 476(62.8%) performed early and 281(37.1%) completed late. In patients that received SBFT, the length of stay (LOS) was shorter (p<0.003). If patients were admitted to the surgical service, they were more likely to receive a SBFT (p<0.0042). When SBFT early, patients were more frequently admitted to an academic institution (p<0.0001) and to a surgical service (p<0.0001), had decreased LOS (p<0.001), decreased readmissions (p<0.0001), less likely to require surgery (p<0.0009), decreased time to operation (p<0.0001), and quicker operation to discharge (p<0.0005).

Conclusions:
The use of SBFT for SBO resulted in improved outcomes, especially if performed early. This is supportive of surgical service admission with more frequent early SBFT with decreased LOS. There is a propensity for those patients with prior operations to have SBFT later in hospital stay and may correlate with increased need for surgery, and the use of early SBFT may help resolve SBO. Implementing early SBFT may improve outcomes and an area of future endeavors.
Spatial gene expression of human coronary arteries revealed the molecular features of diffuse intimal thickening in explanted hearts
Authors: Li Boaz , Leung Samuel , Elishaev Maria , Cheng Wan Hei , Mocci Giuseppe , Björkegren Johan L.M. , Lai Chi , Singh Amrit , Wang Ying 
Published: January 2025

AbstractBackgroundDiffuse intimal thickening (DIT) is a pre-clinical stage of atherosclerosis characterized by thickened intima. The molecular basis of its susceptibility to atherogenesis is unknown, and mechanistic investigations cannot be performed in commonly used mouse models, in which DIT does not exist. Vascular smooth muscle cells (SMCs) are the predominant cell type that occupies the intima and media of DIT. The molecular differences between these two layers may reveal the earliest phenotypic changes in SMCs to promote atherosclerosis.MethodsWe benchmarked the RNA quality of human coronary arteries from autopsies (n=7) and freshly explanted hearts (n=7) and performed Visium spatial gene expression on tissue sections with DIT. SMC-enriched intima and media were compared to find differentially expressed genes. The gene ontology features of SMC-enriched intima in this study were also compared to those in the atherosclerotic lesions, as previously revealed by single-cell RNA-sequencing studies.ResultsAlthough autopsy samples met the RNA quality standard for Visium (DV200 ≥ 30%), only arteries from freshly explanted hearts exhibited reliable performance. Genes enriched in TGF-β-mediated remodeling of the extracellular matrix were overrepresented in the intima, including versican and biglycan. SMCs enriched in the intima are dedifferentiated, but unlike those in the lesions, they are not proinflammatory.ConclusionsOur findings indicate that autopsy samples are not ideal to distinguish subtle differences among cell phenotypes. Dedifferentiated SMCs in the DIT are distinct from the proinflammatory SMCs in atherosclerotic lesions. SMCs in thickened intima may lead to lipid retention but not necessarily the onset of atherosclerosis.Research Perspective:1) What is New?Postmortem coronary arteries, which are frequently collected by biobanks, have degraded RNA, which are not suitable for identifying subtle differences in the transcriptome profiles.Coronary arteries from explanted hearts allow for more faithful representation of spatial gene expression across the vessel wall as compared to ones from autopsy hearts.Thickened intima in diffuse intimal thickening, which exists in everyone, is unlikely to undergo atherogenesis without additional stimuli such as inflammation.2) What Question Should be Addressed Next?The current RNA quality standard of spatial transcriptomics needs to be carefully benchmarked in biobank samples to control sequencing performance and meaningful data interpretation.How inflammation changes smooth muscle cell phenotypes may explain why everyone has diffuse intimal thickening, but those with chronic inflammatory disease have a high risk of coronary artery disease.Future research should focus on the interplay between smooth muscle cell phenotypes and the extracellular matrix to understand the etiology of coronary artery disease.