bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cataract surgery in setting of ocular surface disease
Authors: Sarnicola Enrica , Sarnicola Caterina , De Bernardo Maddalena , Rosa Nicola , Sarnicola Vincenzo 
Published: November 2023

Purpose of review
The purpose of this article is to review the available strategies to successfully identify and manage ocular surface disease (OSD) pre, intra and post-cataract surgery.

Recent findings
Cataract surgery and OSD have an intricate relationship: the surgical procedure can induce or exaggerate OSD symptoms, while OSD can negatively impact surgical refractive outcomes and increase the rate of postoperative complications.

Summary
Improving the health and stability ocular surface is the key to enhance post cataract surgery refractive outcomes and avoid complications. This is pivotal for patients affected by severe OSD, but is also important for patients with minimal signs or symptoms. A correct diagnosis and a stepwise approach are the keys to improve the quality of life of such patients.
Noninvasive Computed Tomography–Based Deep Learning Model Predicts In Vitro Chemosensitivity Assay Results in Pancreatic Cancer
Authors: Kanda Taishu , Wakiya Taiichi , Ishido Keinosuke , Kimura Norihisa , Nagase Hayato , Yoshida Eri , Nakagawa Junichi , Matsuzaka Masashi , Niioka Takenori , Sasaki Yoshihiro , Hakamada Kenichi 
Published: November 2023

Objectives
We aimed to predict in vitro chemosensitivity assay results from computed tomography (CT) images by applying deep learning (DL) to optimize chemotherapy for pancreatic ductal adenocarcinoma (PDAC).

Materials and Methods
Preoperative enhanced abdominal CT images and the histoculture drug response assay (HDRA) results were collected from 33 PDAC patients undergoing surgery. Deep learning was performed using CT images of both the HDRA-positive and HDRA-negative groups. We trimmed small patches from the entire tumor area. We established various prediction labels for HDRA results with 5-fluorouracil (FU), gemcitabine (GEM), and paclitaxel (PTX). We built a predictive model using a residual convolutional neural network and used 3-fold cross-validation.

Results
Of the 33 patients, effective response to FU, GEM, and PTX by HDRA was observed in 19 (57.6%), 11 (33.3%), and 23 (88.5%) patients, respectively. The average accuracy and the area under the receiver operating characteristic curve (AUC) of the model for predicting the effective response to FU were 93.4% and 0.979, respectively. In the prediction of GEM, the models demonstrated high accuracy (92.8%) and AUC (0.969). Likewise, the model for predicting response to PTX had a high performance (accuracy, 95.9%; AUC, 0.979).

Conclusions
Our CT patch–based DL model exhibited high predictive performance in projecting HDRA results. Our study suggests that the DL approach could possibly provide a noninvasive means for the optimization of chemotherapy.
“Splainin” Health and Nutrition Science to a Doubtful Public
Authors: Rowe Sylvia , Alexander Nick 
Published: November 2023

It is hardly a secret that the health, nutrition, and other science communication environment has over the past few years become ever-more problematic. The authors of the present article have repeatedly documented the challenges posed to public understanding of science by the rise of social media and other internet communication “tools” and the diminishing influence of such media as journals, legacy news organizations, and other traditional conduits of scientific information.
Various remedies have been proposed for facilitating greater public appreciation and comprehension of science. In the current article, the authors offer a bold, if not surprising, new proposal: initiate or broaden public exposure to the true nature of the scientific method/process. They suggest that health and science communicators not hold back in extolling the noisy and highly contentious process by which hypotheses are explored and eventually accepted or rejected. If communicators, they argue, convince audiences of the messy, even argumentative, way in which science actually evolves, it may be easier to encourage a greater open-mindedness toward previously unpopular, even uncomprehended, dreaded, or despised, scientific ideas. The issue is of paramount importance, especially now, as keeping the public focus on science, not individual scientists, is critical.
MELD score predicts short-term outcomes after surgical management of proximal humerus fractures: a matched analysis
Authors: Shi Brendan Y. , Upfill-Brown Alexander , Li Alan , Wu Shannon Y. , Ahlquist Seth , Hart Christopher M. , Kremen Thomas J. , Lee Christopher , Stavrakis Alexandra I. 
Published: November 2023

AbstractObjective:We aimed to evaluate the difference in 30-day outcomes after surgical management of proximal humerus fractures (PHFs) between patients with and without chronic liver disease as defined by a MELD score greater than 10.Design:This was a retrospective database review.Setting:All centers participating in the American College of Surgeons National Surgical Quality Improvement Program database were included.Patients/Participants:Patients with proximal humerus fractures who (1) underwent ORIF, HA, or SA and (2) had calculable MELD scores were included.Intervention:Open reduction and internal fixation, hemiarthroplasty, or shoulder arthroplasty was used for treatment.Main outcome measurements:Thirty-day complications, mortality, readmission, and reoperation rates were measured.Results:Of the total 1732 PHF patients identified, 300 had a MELD score higher than 10. After propensity matching by significant covariates, MELD score higher than 10 was found to be significantly associated with higher rates of 30-day mortality, 30-day readmission, transfusion within 72 hours, and systemic complications. Among patients with a MELD score higher than 10, treatment with SA or HA instead of ORIF was associated with a higher rate of transfusion and longer operative time. There were no significant differences between treatment cohorts regarding mortality, reoperation, readmission, or complications.Conclusions:A MELD score higher than 10 is associated with higher risk of surgical complications, transfusion, and death in patients undergoing surgery for proximal humerus fractures. Among patients with a MELD score higher than 10, ORIF was associated with a lower transfusion rate and shorter operative time than arthroplasty or hemiarthroplasty.Level of Evidence:Prognostic Level III.
Management of Children With Uncomplicated Cellulitis in Emergency and Hospital Settings
Authors: St. Cyr Grace , Jaffe Jana , McMahon Maxwell , Florin Todd A. , Verre Michael C. , Chua Wee-Jhong 
Published: November 2023

Objective
The aim of the study is to establish consensus recommendations on features used to determine the route of antibiotic administration and disposition for children with uncomplicated cellulitis.

Methods
Modified Delphi methodology was performed with 2 rounds of confidential surveys of Emergency medicine and hospital medicine (HM) providers at Lurie Children's Hospital to assess cellulitis management in children (ages 6 months–18 years) without signs of sepsis or abscess formation. Using a 9-point Likert scale, emergency medicine providers ranked features by perceived level of importance when deciding initial antibiotic route and HM providers ranked features on importance when transitioning to oral antibiotics. Responses were grouped as not important (1–3), neutral (4–6), and important (7–9) and re-evaluated in the second round to reach consensus, defined as ≥70% agreement.

Results
Emergency medicine providers (n = 17) reached consensus on 15 of 16 features (93.8%), 10 deemed important. Participants reached greatest consensus (100%) on fevers/chills, lymphangitis, and functional impairment as considerations for initiating intravenous antibiotics. HM providers (n = 15) reached consensus on 9 of 11 factors (81.8%), with 7 considered important when deciding on readiness for oral antibiotics. Providers indicated that stability, rather than reduction, of erythematous margins is sufficient to consider transition and de-escalation of therapy at less than 24 hours if all other clinical improvement criteria are met.

Conclusions
This study achieved consensus on important features for treatment and disposition of children with uncomplicated cellulitis in both emergency and inpatient contexts. These features have the potential to aid in decision making and improve standardization of clinical practice.
Health Care Provider Bias in Estimating the Health Literacy of Caregivers in a Pediatric Emergency Department
Authors: Dorsey Bridget F. , Cook Lawrence J. , Katz Adam D. , Sapiro Heather K. , Kadish Howard A. , Holsti Maija 
Published: November 2023

BackgroundHealth literacy is a growing concern because of its effects on communication and health outcomes. One aspect of this communication is the ability of the health care provider to estimate the health literacy of a patient or their caregiver. The objectives of this study are to quantify misestimation of caregiver health literacy by providers and identify potential descriptive or demographic factors that might be related to those misestimations.MethodsProviders were asked to perceive descriptive factors and estimate the health literacy of caregivers in a pediatric Emergency Department. Then, the health literacy of the caregiver was tested using the Short Assessment of Health Literacy, and cross-tabulated with provider estimates.ResultsProviders correctly estimated the health literacy of the caregivers 60% of the time, and misestimates were often underestimates (27.7%) rather than overestimates (12.3%). Providers overestimated the health literacy of 24.1% of fathers and only 9.8% of mothers (P= 0.012). They correctly estimated the health literacy of 63.9% of English-speaking caregivers compared with 30.6% of Spanish-speaking caregivers, and underestimated the health literacy of 50% of Spanish-speaking caregivers and 24.8% of English-speaking caregivers (P< 0.001). Providers correctly estimated the health literacy of 34.4% of racially and ethnically diverse caregivers compared with 71.5% of White/non-Hispanic caregivers. They underestimated the health literacy of 52.1% of these racially and ethnically diverse caregivers and 16.8% of White/non-Hispanic caregivers (P< 0.001).ConclusionsProviders often overestimate and underestimate the health literacy of parents in the pediatric emergency department. Misestimates are related to race, caregiver role, and language spoken by the caregiver. When providers misestimate health literacy, they may use words or phrases that are above or below the health literacy level of the caregiver. These results suggest a need for further health literacy research and interventions in provider education and clinical practice.
Optimizing Outcomes in Lymphedema Reconstruction
Authors: Garza Rebecca M. , Wong Daniel , Chang David W. 
Published: November 2023

Learning Objectives:
After studying this article, the participant should be able to: 1. Describe current surgical techniques for treating primary and secondary lymphedema. 2. Optimize the surgical care of patients with lymphedema.

Summary:
Over the past decade, significant advances have been made in the surgical treatment of lymphedema. The most notable changes have been the reintroduction and evolution of physiologic techniques, including lymphovenous bypass—sometimes referred to as lymphovenous anastomosis in the literature—and vascularized lymph node transplant. These surgical modalities are now often used as first-line surgical options or may be combined with nonphysiologic approaches, including direct excision and suction-assisted lipectomy. Surgeons continue to debate the most appropriate sequence and combination of surgical treatment, particularly for patients at both extremes of the severity spectrum. Furthermore, debate remains around the need to apply different treatment approaches for patients with upper versus lower extremity involvement and primary versus secondary cause. In this article, we provide a summary of the surgical techniques currently used for both primary and secondary lymphedema and provide our recommendations for optimizing the surgical care of patients with lymphedema.
Levator Ani Avulsion in Ultrasound Increases Recurrence in Sacrospinous Fixation
Authors: Maluenda Andrea , Santis-Moya Fernanda , Arévalo Diego , Pohlhammer Dominga , Blumel Bernardita , Guzmán-Rojas Rodrigo , Pizarro-Berdichevsky Javier 
Published: November 2023

Importance
Pelvic floor translabial ultrasound (TLUS) can identify levator ani muscle (LAM) avulsion and ballooning, which some studies have shown to be possible risk factors for prolapse recurrence. Our group uses TLUS to counsel patients preoperatively. If any of these risk factors exist, we offer sacrocolpopexy over vaginal repair. However, some patients, even though they have these possible risk factors, prefer to undergo vaginal surgery.

Objective
The objective of this study was to determine if TLUS LAM avulsion and/or ballooning are risk factors for composite outcome recurrence in patients undergoing sacrospinous ligament fixation for pelvic organ prolapse.

Study design
This was a retrospective observational study. All patients with vaginal apical repair with sacrospinous ligament fixation with preoperative TLUS were included. Demographics, clinical characteristics, and follow-up were analyzed. Multivariable logistic regression analysis was performed for composite outcome that included TLUS risk factors, age, Pelvic Organ Prolapse Quantification System measurements and stage, and variables with P < 0.1 in the univariate analysis.

Results
Eighty-two patients were included. All patients had symptomatic vaginal bulge; 65.4% had stage III prolapse. Concomitant hysterectomy was performed in 54.3%. Median follow-up was 20 months (interquartile range, 8–35 months); 19.8% had LAM avulsion, and 43.2% had ballooning. Anatomic recurrence rate was 23.5%, symptomatic was 22.2%, and reoperation was 1.2%. The composite recurrence rate was 29.6%. In the multivariable logistic regression analysis, unilateral/bilateral avulsion in TLUS was found to be a significant risk factor for composite outcome with an odds ratio of 4.33 (confidence interval, 1.219–15.398; P = 0.023).

Conclusions
Composite outcome of recurrence in our study was 29.6%. Avulsion on TLUS increased the risk of recurrence of pelvic organ prolapse by fourfold.
The Immediate Impact of App-Based Psychotherapeutic Exercises on Anxiety: An RCT
Authors: Kahl Fabian , Sandkühler Julia Fabienne , Sadurska Magda Zena , Brietbart Peter , Greenberg Spencer , Brauner Jan 
Published: November 2023

AbstractBackgroundDespite the growing integrative trend in psychotherapy, few studies have examined the potential for immediate anxiety relief of many different psychotherapeutic exercises side by side under the same conditions. This information might be important to enhance engagement and self-efficacy, stop negative feedback loops, and prevent avoidant or destructive behaviour during crises. Technology-based psychotherapeutic exercises are of particular interest because they are accessible and scalable.MethodsThis parallel, double-blind, randomised trial (N=1092) compared twelve psychotherapeutic exercises of the Mind Ease app against a reading control and a measurement-only control. Efficacy was measured with a custom scale validated against the state subscale of the State-Trait Anxiety Inventory.ResultsEach of the twelve exercises significantly reduced anxiety more than controls (p = 0.018 to <.001, η2P= .06 to .37, d = 0.5 to 1.5, d [95% CI] for all exercises together vs reading control = 0.8 [0.6; 1.0], and vs measurement-only control = 0.8 [0.6; 1.0]). Exercises employing cognitive restructuring had effect sizes d [95% CI] of 0.5 [0.2; 0.8], 0.7 [0.3; 1.0], and 0.9 [0.6; 1.2], diaphragmatic breathing of 0.6 [0.3; 0.9], gratitude practice of 0.8 [0.5; 1.1], positive expressive writing of 1.1 [0.7; 1.4], progressive muscle relaxation of 1.3 [0.9; 1.6], guided imagery of 1.3 [1.0; 1.6], and mindfulness of 0.9 [0.6; 1.2], 1.0 [0.7; 1.3], 1.2 [0.9; 1.5], and 1.5 [1.2; 1.9]. Twenty-eight comparisons between exercises (42%) had p < .05, nine met the Bonferroni-adjusted threshold of p < .0008.ConclusionsThe twelve psychotherapeutic exercises proved effective at immediately mitigating anxiety. Differences between exercises were substantial even within categories. Mindfulness tended to have a larger effect than cognitive restructuring.Trial registrationThe trial was prospectively registered (clinicaltrials.govidentifier:NCT05850975,https://osf.io/36ukh).
Influence of amino acid substitutions in capsid proteins of coxsackievirus B5 on free chlorine and thermal inactivation
Authors: Torii Shotaro , Gouttenoire Jérôme , Kumar Kiruthika , Antanasijevic Aleksandar , Kohn Tamar 
Published: November 2023

AbstractThe sensitivity of enteroviruses to disinfectants varies among genetically similar variants and coincides with amino acid changes in capsid proteins, though the effect of individual substitutions remains unknown. Here, we employed reverse genetics to investigate how amino acid substitutions in coxsackievirus B5 (CVB5) capsid proteins affect its sensitivity to free chlorine and heat treatment. Of ten amino acid changes hypothesized to coincide with free chlorine resistance, none significantly reduced the chlorine-sensitivity, indicating a minor role of the capsid composition in chlorine sensitivity of CVB5. Conversely, we observed reduced heat sensitivity in mutants with substitutions at the C-terminal region of the viral protein 1. Cryo-electron microscopy revealed that these changes affect the assembly of intermediate viral states (particle A and E), suggesting that the mechanism for reduced heat sensitivity could be related to improved molecular packing of CVB5, resulting in greater stability and/or altered dynamics of virus uncoating during infection.
Microencapsulation of mesenchymal stromal cells in covalent alginate hydrogels for cell therapy
Authors: Ambrosino Mathilde , Nativel Fabien , Boyer Cécile , Lagneau Nathan , Loll François , Halgand Boris , Djouad Farida , Renard Denis , Tessier Arnaud , Guicheux Jérôme , Delplace Vianney , Le Visage Catherine 
Published: November 2023

AbstractOsteoarthritis (OA) is the most common inflammatory joint disease and currently lacks an effective curative treatment. Intra-articular injection of mesenchymal stromal cells (MSCs) has gained attention as a relevant therapeutic approach for OA treatment due to the MSC’s ability to secrete anti-inflammatory and immunomodulatory factors. Given their limited viability post-intraarticular injection and the potential leakage of cells out of the injection site, encapsulating MSCs in hydrogels is considered a promising strategy to protect them and provide a suitable 3D microenvironment to support their biological activities. Calcium-cross-linked alginate hydrogels are commonly used for MSC encapsulation, but their long-term in vivo stability remains uncertain. On the other hand, alginate cross-linking by the strain-promoted azide-alkyne cycloaddition (SPAAC) reaction would create a network unaffected by an ionic environment. Hence, this study aimed to develop an alginate-based hydrogel cross-linked via stable and cytocompatible covalent bonds for cell encapsulation. We established for the first time the formation of covalent alginate hydrogels between two SPAAC precursors, namely alginate-BCN and alginate-N3. These hydrogels exhibited in vitro stability and enabled the diffusion of molecules of interest. We then generated alginate-based SPAAC microgels of 170 μm in mean diameter, suitable for intra-articular injection. We next encapsulated human adipose MSCs (hASCs) in these alginate-based SPAAC microgels and confirmed their cytocompatibility, with over 90 % of cells remaining viable after 14 days in culture. Finally, the microencapsulated hASCs maintained their biological properties and were able to secrete anti-inflammatory factors (IDO, PGE2, and HGF) when exposed to pro-inflammatory cytokines (TNF-α and IFN-γ). In the end, human activated lymphocytes were cultured in contact with microencapsulated hASCs, and CD3+ T cell proliferation was quantified by flow cytometry. We demonstrated that the encapsulation process did not impair the hASC immunomodulatory activity. Overall, our findings show the potential of alginate-based SPAAC hydrogels for microencapsulating hASCs for cell therapy.
A simple agent-based hybrid model to simulate the biophysics of glioblastoma multiforme cells and the concomitant evolution of the oxygen field
Authors: Saucedo-Mora Luis , Sanz Miguel Ángel , Montáns Francisco Javier , Benítez José María 
Published: November 2023

AbstractBackground and objectives: Glioblastoma multiforme (GBM) is one of the most aggressive cancers of the central nervous system. It is characterized by a high mitotic activity and an infiltrative ability of the glioma cells, neovascularization and necrosis. GBM evolution entails the continuous interplay between heterogeneous cell populations, chemotaxis, and physical cues through different scales. In this work, an agent-based hybrid model is proposed to simulate the coupling of the multiscale biological events involved in the GBM invasion, specifically the individual and collective migration of GBM cells and the concurrent evolution of the oxygen field and phenotypic plasticity. An asset of the formulation is that it is conceptually and computationally simple but allows to reproduce the complexity and the progression of the GBM micro-environment at cell and tissue scales simultaneously. Methods: The migration is reproduced as the result of the interaction between every single cell and its micro-environment. The behavior of each individual cell is formulated through genotypic variables whereas the cell micro-environment is modeled in terms of the oxygen concentration and the cell density surrounding each cell. The collective behavior is formulated at a cellular scale through a flocking model. The phenotypic plasticity of the cells is induced by the micro-environment conditions, considering five phenotypes. Results: The model has been contrasted by benchmark problems and experimental tests showing the ability to reproduce different scenarios of glioma cell migration. In all cases, the individual and collective cell migration and the coupled evolution of both the oxygen field and phenotypic plasticity have been properly simulated. This simple formulation allows to mimic the formation of relevant hallmarks of glioblastoma multiforme, such as the necrotic cores, and to reproduce experimental evidences related to the mitotic activity in pseudopalisades. Conclusions: In the collective migration, the survival of the clusters prevails at the expense of cell mitosis, regardless of the size of the groups, which delays the formation of necrotic foci and reduces the rate of oxygen consumption.