bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hotline to Helpline: Reducing On-call Demands
Authors: Harbour Skylar , Mukherjee Hrijeeta , Davison Steven P. , DiLeonardo Michael 
Published: October 2023

Background:
There is a growing societal trend in plastic surgery patients of viewing their medical care as a commodity product rather than as a healthcare service. Our four-provider private plastic surgery practice noticed this phenomenon through our patients’ trend of overusing the emergency after-hours service call line. To affect this behavior, we designed a study educating patients on the emergency service call line’s purpose and how to handle nonurgent issues independently.

Methods:
After a 6-month preintervention phase to categorize after-hours emergency calls, We improved preoperative patient education and implemented in-office protocols for quicker provider responses. Postintervention data were collected for another 6 months and compared statistically with the preintervention data.

Results:
In the preinterventional period, we saw a total of 236 after-hours phone calls. The intervention led to a 22% significant reduction in total calls (P = 0.007). Calls were categorized as nonurgent, urgent, and emergent. While emergent calls remained unchanged (P = 0.56), nonurgent calls significantly decreased (P = 0.005). The most common nonurgent calls were regarding pain, routine postoperative concerns, and drain care, with the intervention resulting in a significant reduction of routine postoperative swelling/bruising/discomfort calls (P = 0.04) but not changing pain (P = 0.23) or drain-related calls (P = 0.78).

Conclusions:
We found that targeted preoperative patient education coupled with a real-time action board in the office, to ensure timely response to patient questions during office hours, can positively impact after-hours call use, and improve overall patient outcomes by catching urgent issues earlier.
Defining Predictors of Future Academic Productivity in Plastic Surgery Residency
Authors: Wickenheisser Victoria A. , Biswas Sonali , Marks Caitlin , Geng Yisong , Phillips Brett T. 
Published: October 2023

Background:
Research is a valued component of applications to plastic surgery residency. No prior studies have explored factors associated with increased resident research productivity. This study aims to compare the academic productivity levels of plastic surgery residency graduates based on their pre- and postresidency experiences.

Methods:
Residents graduating in 2019 and 2020 were identified from integrated programs. Metrics collected included the number of publications in medical school and residency. Descriptive statistics were completed along with linear regressions to evaluate the impact of these on academic productivity.

Results:
A total of 221 residents from the classes of 2019 and 2020 were included. Most residents completed fellowship (75.9%) although less than half went on to academic practice (42.3%). Approximately one in five residents obtained secondary degrees (17.4%). Subjects averaged 3.15 (N = 208, SD = 4.51) publications while in medical school and 8.1 publications during residency (N = 209, SD = 10.0). For h-index calculated at the end of residency, having dedicated medical school research time was the only statistically significant factor (coefficient = 2.96, P = 0.002).

Conclusions:
Plastic surgery residents published more often as first authors and overall during residency than medical school, indicating increased research involvement and leadership. The present study builds upon prior studies by confirming the importance of dedicated medical school research time and its lasting impact. Understanding the associations of academic factors with increased research productivity in residency is relevant for both applicants and programs evaluating residency candidates.
Thromboembolism in Cancer Patients With COVID-19 Infection Compared With Other Infections—A Case Series
Authors: Binkam Mounika , Greene John N. , Oehler Stephanie M. , Thai Christy , Holmström Björn 
Published: October 2023

Abstract
An increased risk of venous thromboembolism (VTE) with COVID-19 infection has been well documented, particularly in critically ill-hospitalized patients. The presence of cancer, in addition to several anticancer treatments, can further elevate the risk of VTE. The following case reports describe an increased risk of extensive thrombosis that can be seen with COVID-19 infection in cancer patients. We report 3 cases of pulmonary embolism and deep vein thrombosis in cancer patients with COVID-19 infection. All 3 cases are unique with the timeline of COVID-19 infection and diagnosis of VTE. The current pandemic has alerted the clinician to the potential increased risk for thrombus formation in cancer patients with COVID-19, even days to months after acute infection.
Fuchs endothelial corneal dystrophy masking an underlying postrefractive surgery ectasia
Authors: Gnanaraj Ramya , Taravella Michael , Davidson Richard 
Published: October 2023

Introduction:
This article describes a case presenting Fuchs endothelial corneal dystrophy (FECD) masking an underlying postrefractive surgery ectasia.

Patient and Clinical Findings:
A 69-year-old woman presented in January 2022 with blurriness, halos, and glare in the left eye. Ocular history included a photorefractive keratectomy performed twice in her left eye in 2007 for hyperopic astigmatism. A diagnosis of asymptomatic Fuchs dystrophy was noted in 2010. She had acute decompensation of the cornea in the left eye because of FECD, and the first Descemet-stripping automated endothelial keratoplasty (DSAEK) with cataract surgery was performed in 2018.

Diagnosis, Intervention, and Clinical Findings:
The patient had a failed DSAEK graft in the left eye. A repeat DSAEK was performed in 2022, and 6 months postoperatively, the patient started showing signs of ectasia in the left eye. The authors believe the ectasia was preexisting but masked by the failed DSAEK graft and FECD and started showing after corneal deturgescence postoperatively.

Conclusions:
The presence of FECD and corneal ectasia can complicate diagnosis because of overlapping clinical and topographic features. This case highlights the importance of preoperative topography with epithelial/stromal thickness mapping in patients with a history of multiple refractive corneal procedures to consider the possibility of ectasia and prevent unforeseen outcomes and complications. Further research is necessary to determine standardized imaging techniques, particularly in cases of concurrent diseases.
Use of a Supplemental Feeding Tube Device and Breastfeeding at 4 Weeks
Authors: Penny Frances , Brownell Elizabeth A. , Judge Michelle , Marshall-Crim Mary , Cartagena Diana , McGrath Jacqueline M. 
Published: October 2023

Abstract

Background:
Mothers having difficulty breastfeeding their infants may use alternative supportive feeding methods. Although a supplemental feeding tube device is commonly used, efficacy for supporting sustained breastfeeding remains unknown.

Purpose:
To describe supplemental feeding tube device use by breastfeeding mothers as an alternative feeding method through exploration of associations between supplemental feeding tube device use and continued breastfeeding at 4 weeks of infant's age.

Method:
Forty mothers participated. They were interviewed during the birth hospitalization and at 4 weeks postpartum. Questions addressed use of supplemental feeding tube devices, breastfeeding issues, and continued breastfeeding relationships. We examined the relationship between LATCH scores at 2 to 3 days of life.

Results:
Breastfeeding mothers who chose to supplement with bottle-feeding instead of use of a supplemental feeding tube device were 30% less likely to continue breastfeeding at a medium/high/exclusive level.

Conclusion:
Use of the supplemental feeding tube device may help avoid the potentially detrimental effect of bottle-feeding on continued breastfeeding.
Case Report: Branch Retinal Vein Occlusion Post mRNA SARS-CoV-2 (COVID-19) Vaccination
Authors: Lee Jing , Ong Kah Wei , Wan Abdul Halim Wan Haslina , Mohd Khialdin Safinaz , Yong Meng Hsien 
Published: October 2023

ABSTRACT

Significance
Systemic thromboembolic complications are well documented to be associated with Coronavirus disease 2019 (COVID-19), however, there has been a growing number of reports regarding ocular complications stemming from COVID-19 vaccinations. This case illustrates a clear temporal and possible causal relationship of COVID-19 vaccination with an ocular microvascular disorder, namely retinal vein occlusion.

Purpose
To report a case of inferotemporal branch retinal vein occlusion after mRNA SARS-CoV-2 vaccination.

Case report
A middle-aged female developed right eye central scotoma two days after COVID-19 vaccination. She had transient hypertension during the first two days post-vaccination. A decrease in visual acuity (6/18) was documented. Initial retinal findings included flame-shaped hemorrhages and cotton wool spots along inferotemporal branch retinal vessels. Optical coherence tomography revealed right eye cystoid macular edema. Laboratory investigation revealed mildly raised erythrocyte sedimentation rate and C-reactive protein. Other systemic examinations were unremarkable. She was treated for right eye inferotemporal branch retinal vein occlusion with cystoid macular edema and was given intravitreal anti-vascular endothelial growth factor monthly in three doses. Her visual acuity improved to 6/6 with resolved cystoid macular edema.

Conclusions
This case illustrates a clear temporal and possible causal relationship between COVID-19 vaccination and retinal vein occlusion. Post vaccination transient hypertension, or the immunological and inflammatory response to the vaccine may have contributed to the venous occlusive event in this case. Eye care providers should remain aware of this possibility. The effectiveness of intravitreal anti-vascular endothelial growth for the treatment of macular edema secondary to branch retinal vein occlusion was demonstrated in this patient.
AI as a New Frontier in Contrast Media Research
Authors: Haubold Johannes , Hosch René , Jost Gregor , Kreis Felix , Forsting Michael , Pietsch Hubertus , Nensa Felix 
Published: October 2023

AbstractArtificial intelligence (AI) techniques are currently harnessed to revolutionize the domain of medical imaging. This review investigates 3 major AI-driven approaches for contrast agent management: new frontiers in contrast agent dose reduction, the contrast-free question, and new applications. By examining recent studies that use AI as a new frontier in contrast media research, we synthesize the current state of the field and provide a comprehensive understanding of the potential and limitations of AI in this context. In doing so, we show the dose limits of reducing the amount of contrast agents and demonstrate why it might not be possible to completely eliminate contrast agents in the future. In addition, we highlight potential new applications to further increase the radiologist's sensitivity at normal doses. At the same time, this review shows which network architectures provide promising approaches and reveals possible artifacts of a paired image-to-image conversion. Furthermore, current US Food and Drug Administration regulatory guidelines regarding AI/machine learning–enabled medical devices are highlighted.
Incidental Detection of Parathyroid Adenoma on 18F-PSMA PET/CT
Authors: Broos Wouter A. M. , van der Zant Friso M. , Knol Remco J. J. 
Published: October 2023

Abstract
A 70-year-old man, diagnosed with prostate cancer, was referred to the Department of Nuclear Medicine for tumor staging with prostate-specific membrane antigen (PSMA) PET/CT. High PSMA uptake was observed in the prostate without PSMA-avid lymph nodes or distant metastases. Coincidentally, a PSMA-avid nodule was observed dorsal to the right thyroid lobe. A complementary 4-dimensional CT showed a round nodule of 18 mm with quick contrast enhancement well demarcated from its surroundings. Blood tests revealed elevated serum calcium and parathyroid hormone consistent with primary hyperparathyroidism. Subsequently, parathyroidectomy was performed, and histopathological examination of the nodule confirmed a parathyroid adenoma.
Atypical Presentation of Liver Metastases of Prostate Cancer in 68Ga-PSMA-11 PET/CT
Authors: Stanzel Susanne , Weitzer Friedrich , Janek Elmar , Plhak Elisabeth , Aigner Reingard M. 
Published: October 2023

Abstract

68Ga-PSMA-11 (68Ga–prostate-specific membrane antigen-11) PET/CT continues to have a great clinical value for staging in prostate cancer. Lymph nodes and bone are the most typical metastatic sites of prostate cancer, whereas liver metastases are rare and usually show focally increased tracer uptake in 68Ga-PSMA-11 PET/CT. Here, we present an 88-year-old man with histologically proven metastatic castration-resistant prostate cancer and extensive PSMA-negative liver metastases identified by 68Ga-PSMA-11 PET/CT. This finding is remarkable because the decreased liver uptake of 68Ga-PSMA-11 may resemble a primary hepatic tumor.
Peptide Receptor Radionuclide Therapy Performed Shortly After Administration of Long-Acting Octreotide
Authors: Low Han Chung , Tay Young Soon , Ong Simon Yew Kuang , Tham Wei Ying , Yan Sean Xuexian 
Published: October 2023

Abstract
We present a case of a 68-year-old man with metastatic small bowel neuroendocrine tumor who underwent 4 cycles of peptide receptor radionuclide therapy with 177Lu-DOTATATE. For his first 3 cycles, therapy was performed approximately 4 weeks after his last dose of octreotide LAR. Because of miscommunication in scheduling, his fourth cycle was performed only 48 hours after his last full dose of octreotide LAR. Despite this, we found that the tumoral uptake was not reduced at all, which may add to the increasing evidence on the nonnecessity of stopping somatostatin analogs before peptide receptor radionuclide therapy.
Intratumoral 99mTc-DPD Uptake on Bone Scintigraphy in a Patient With Invasive Micropapillary Breast Carcinoma: A Pathologic Review
Authors: Koh Namhee , Lee Kyoungyul , Oh Ha Yeun , Chun In Kook 
Published: October 2023

Abstract
Invasive micropapillary carcinoma (IMPC) is a rare and aggressive subtype of breast cancer with a poorer prognosis due to high local recurrence and lymphovascular invasion. Interestingly, IMPC often does not show suspicious patterns of calcifications related to malignancy on mammography. Therefore, the lack of suspicious calcifications makes it difficult to detect breast cancer on mammography. With only nonspecific calcifications on mammography, we observed an unusual intratumoral 99mTc-DPD uptake on whole-body bone scintigraphy in an IMPC breast cancer patient during the initial staging workup, and its characteristics were compared with mammographic findings and the postoperative pathologic features.
Galcanezumab in the Treatment of Migraine: A Narrative Review of Real-World Studies
Authors: Dell Agnello Grazia , Buzzoni Carlotta , Antenori Amalia , Torelli Federico , Altamura Claudia , Vernieri Fabrizio 
Published: October 2023

Objectives
Randomized controlled trials (RCTs) have established the efficacy of galcanezumab, an antibody binding calcitonin gene-related peptide (CGRP) ligand, in the preventive treatment of migraine. The objective was to summarize real-world data evaluating galcanezumab in the preventive treatment of migraine, to complement RCT results with evidence observed in clinical practice.

Methods
A literature search was conducted to identify real-world studies evaluating galcanezumab in the treatment for patients with migraine.

Results
Twenty-five studies were identified; some only evaluated galcanezumab, and others used pooled data from multiple anti-CGRP antibodies. The studies recruited diverse patient populations, including patients who had failed multiple prior preventive therapies. Treatment was associated with significant reductions from baseline in monthly migraine days and monthly headache days by 4.3 to 12.9 and 3.1 to 13.9, respectively. These values were numerically greater than those reported in most galcanezumab RCTs. Significant decreases from baseline were evident within the first month of treatment, and efficacy was maintained throughout the follow-up periods, ranging from 3 to 12 months. Galcanezumab was also associated with improvements in other efficacy end points, including decreased headache pain intensity, reduction in analgesic use, and improvements in daily functioning and quality of life. Functionality scores, as assessed by the Migraine Disability Assessment Scale questionnaire, decreased by 27 to 75 points from baseline at 3 to 12 months. Galcanezumab was associated with a low discontinuation rate and higher rates of persistence compared with standard migraine preventive treatments.

Conclusions
The results provide complementary data that galcanezumab is effective across the diverse patient populations observed in routine clinical practice.
Remote Assessment of Real-World Surgical Safety Checklist Performance Using the OR Black Box: A Multi-Institutional Evaluation
Authors: Riley Max S , Etheridge James , Palter Vanessa , Zeh Herbert , Grantcharov Teodor , Kaelberer Zoey , Sonnay Yves , Smink Douglas S , Brindle Mary E , Molina George 
Published: October 2023

BACKGROUND:
Large-scale evaluation of surgical safety checklist performance has been limited by the need for direct observation. The operating room (OR) Black Box is a multichannel surgical data capture platform that may allow for the holistic evaluation of checklist performance at scale.

STUDY DESIGN:
In this retrospective cohort study, data from 7 North American academic medical centers using the OR Black Box were collected between August 2020 and January 2022. All cases captured during this period were analyzed. Measures of checklist compliance, team engagement, and quality of checklist content review were investigated.

RESULTS:
Data from 7,243 surgical procedures were evaluated. A time-out was performed during most surgical procedures (98.4%, n = 7,127), whereas a debrief was performed during 62.3% (n = 4,510) of procedures. The mean percentage of OR staff who paused and participated during the time-out and debrief was 75.5% (SD 25.1%) and 54.6% (SD 36.4%), respectively. A team introduction (performed 42.6% of the time) was associated with more prompts completed (31.3% vs 18.7%, p < 0.001), a higher engagement score (0.90 vs 0.86, p < 0.001), and a higher percentage of team members who ceased other activities (80.3% vs 72%, p < 0.001) during the time-out.

CONCLUSIONS:
Remote assessment using OR Black Box data provides useful insight into surgical safety checklist performance. Many items included in the time-out and debrief were not routinely discussed. Completion of a team introduction was associated with improved time-out performance. There is potential to use OR Black Box metrics to improve intraoperative process measures.
Environment-driven trends in fish larval abundance predict fishery recruitment in two temperate reef congeners: Mechanisms and implications for fishery recovery under a changing ocean
Authors: Mason Erica T. Jarvis , Watson William , Ward Eric J. , Thompson Andrew R. , Semmens Brice X. 
Published: October 2023

AbstractEnvironmental and biological processes acting on fish larvae can drive fishery cohort strength, but predictive ability oftentimes falls short, and larval abundance is generally considered more useful as a proxy for spawning biomass. Under a changing ocean, studies that relate environmental covariates, larval abundance, and fishery recruitment are worthy of continued research, especially in data-limited contexts. We focus on a popular, recreational-only, multispecies saltwater bass fishery (genusParalabrax)whose population status and recovery potential are uncertain. We used 54 years of ichthyoplankton data (1963-2016) and a species distribution model to 1) deconstruct species-specific standardized indices of larval abundance, 2) test these indices as indicators of adult stock status or predictors of future fishery recruitment, and 3) evaluate spatiotemporal trends in their population dynamics relative to environmental variables. Contrary to expectation, species-specific larval abundance predicted future catch, with recent elevated larval abundance suggesting imminent fishery recovery. Additionally, we identified strong relationships with environmental variables, thereby providing additional tools for predicting fishery recruitment and anticipating population change. Our findings paint a path forward for improving estimates of current and future fishery status under changing natural and anthropogenic influences and the incorporation of ecosystem considerations into fishery management.
Physiological Profiles of Male and Female CrossFit®Athletes
Authors: Hodžić Deni , D’Hulst Gommaar , Leuenberger Rahel , Arnet Janik , Westerhuis Elena , Roth Ralf , Schmidt-Trucksäss Arno , Knaier Raphael , Wagner Jonathan 
Published: October 2023

ABSTRACTObjectiveTo 1) establish extensive physiological profiles of highly-trained CrossFit athletes using gold-standard tests and 2) investigate which physiological markers best correlate with CrossFit®Open performance.MethodsThis study encompassed sixty participants (30 males and 30 females), all within the top 5% of the CrossFit®Open, including 7 CrossFit®Semi-finalists and 3 Games finalists. Isokinetic dynamometers were employed to measure maximum isometric and isokinetic leg and trunk strength. Countermovement jump height and maximum isometric mid-thigh pull strength were assessed on a force plate. V□O2peakwas measured by a cardiopulmonary exercise test, while critical power and W’ were evaluated during a 3-minute all-out test, both on a cycle ergometer.ResultsMale and female athletes’ median (IQR) V□O2peakwas 4.64 (4.43, 4.80) and 3.21 (3.10, 3.29) (L·min-1), critical power 314.5 (285.9, 343.6) and 221.3 (200.9, 238.9) (W) and mid-thigh pull 3158 (2690, 3462) and 2035 (1728, 2347) (N). Linear regression analysis shows strong evidence for associations between different anthropometric variables and CrossFit®Open performance in men and women, whereas for markers of cardiorespiratory fitness such as V□O2peakthis was only true for women but not men. Conventional laboratory evaluations of strength, however, manifest minimal evidence for associations with Open performance across both sexes.ConclusionsThis study provides the first detailed insights into the physiology of high-performing CrossFit®athletes and informs training optimization. Further the results emphasize the advantage of athletes with shorter limbs and suggests potential modifications to Open workout designs to level the playing field for athletes across different anthropometrics characteristics.