bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the comparative efficacy and safety of surgical strategies for long bone defects: a network meta-analysis
Authors: Shen Yuanli , Yang Qihong , Cheng Hui , Feng Yitian , Liu Yuan , Hu Jun 
Published: January 2025

Abstract
To evaluate the safety and efficacy of various surgical treatments for long bone defects. Despite numerous observational studies, randomized controlled trials (RCTs), and meta-analyses, the optimal surgical treatment for long bone defects remains undetermined.

Methods:
A network meta-analysis (NMA) was conducted. PubMed, Embase, and the Cochrane Library were searched for articles published between 1 January 2000, and 12 January 2023, on surgical treatments for long bone defects. RCTs and observational studies comparing five surgical treatments were selected: the Masquelet technique (MT), bone transport (BT), vascularized bone graft (VBG), non-VBG (NVBG), and bone tissue engineering (BTE). Data were extracted by two independent reviewers. The NMA aggregated direct and indirect evidence. Treatments were ranked using the surface under the cumulative ranking curve (SUCRA) scores. Data are presented as mean differences and 95% confidence intervals. The primary outcomes were the postoperative healing rate, with subgroup analysis based on defect size (4–8 cm and >8 cm). The secondary outcomes included postoperative complications.

Results:
This NMA included 23 studies (3 RCTs and 20 observational studies) with 930 participants (median age, 35 years). There were no significant differences in clinical outcomes among the treatments. VBG (SUCRA, 75.1%) was rated as optimal for healing, and BTE (SUCRA, 28.5%) was the least effective. BTE had the highest complication rate (SUCRA, 90.9%), whereas NVBG had the lowest complication rate (SUCRA, 27.6%). Subgroup analysis showed reduced heterogeneity: for 4–8 cm defects, VBG (SUCRA, 80.4%) was optimal, and for >8 cm defects, BT (SUCRA, 76.2%) was optimal.

Conclusions:
VBG and BT may offer superior clinical outcomes for long bone defects compared to MT, NVBG, and BTE. However, BTE is associated with a high risk of complications. Further high-quality, large-sample RCTs are required to confirm these findings.
Individualized blood pressure regulation and acute kidney injury in older patients having major abdominal surgery: a pilot randomized trial
Authors: Pang Zhaohua , Liang Shuang , Zhou Nannan , Zhu Xiaoyan , Guo Qulian , Sessler Daniel I. , Zou Wangyuan 
Published: January 2025

Background:
Acute kidney injury (AKI) is a common postoperative complication, and hypotension may contribute. We therefore tested the primary hypothesis that individualized intraoperative blood pressure regulation reduces postoperative AKI in older surgical patients.

Methods:
We enrolled patients ≥60 years old scheduled for elective major abdominal surgery with invasive arterial pressure monitoring. All had goal-directed fluid management based on stroke volume variation and cardiac output, and administration of a starch. Participants were randomly assigned to: 1) individualized blood pressure management targeting a systolic blood pressure (SBP) within −20% and + 10% if baseline SBP was ≥ 130 mmHg or diastolic blood pressure was ≥ 80 mmHg, or otherwise, to target SBP within ± 10% of the baseline value; 2) maintenance of SBP ≥ 90 mmHg and MAP ≥ 65 mmHg. Metaraminol was used to achieve the blood pressure target. AKI incidence was assessed by Kidney Disease Improving Global Outcomes criteria during the initial 7 postoperative days.

Results:
192 patients were assigned to individualized (n = 96) or routine (n = 96) pressure management. 179 patients were included in the intention-to-treat analysis. Age averaged 68 ± 5 (SD) yr and 64% were male. Randomization to the individualized management reduced the area under MAP <65 mmHg [median difference: − 37 (−47 to −25) mmHg-min, P < 0.001]. The incidence of the AKI was 11% in patients assigned to individualized management versus 16 % in those assigned to routine management: relative risk 0.72 [95% CI 0.34 to 1.54], P = 0.396. Patients assigned to individualized pressure management had more urine output, a shorter postoperative mechanical ventilation duration, and faster recovery of bowel function.

Conclusion:
Individualized blood pressure management markedly reduced hypotension. As expected in a pilot trial, the 28% reduction in AKI was not statistically significant. However, the reduction was clinically meaningful and suggests that a full trial is warranted.
Acellular Dermal Matrices in Reconstructive Pediatric Complex Lower Limb Trauma: An Observational Study
Authors: Adegboye Oluwatobi , Pillay Kamlen , Adams Saleigh 
Published: January 2025

BACKGROUND:
Contemporary research has shown that acellular dermal matrices can benefit adult lower extremity traumatic injuries; however, its use in children has not been explored.

OBJECTIVE:
This study aims to explore the use of acellular dermal matrices in pediatric complex lower extremity trauma.

METHODS:
This single-center retrospective observational cohort study of children with complex lower extremity trauma treated with Pelnac™, commercial acellular dermal matrices, was conducted at a tertiary hospital in South Africa from 2010 to 2017. Demographic and clinical data were collected from medical records. The primary outcome was the rate and type of acellular dermal matrices-related complications. Secondary outcomes included the usage of negative pressure wound therapy.

RESULTS:
A total of 54 children were studied; 30 (55%) were male, and the median age was six. Forty-five children healed without complications, while nine experienced complications – four acute and five chronic. Four patients had complete loss of acellular dermal matrices, and three developed acute infections. More than 30 days post-acellular dermal matrices application, five patients had hypertrophic scarring, four had joint contractures, and two had non-healing wounds. All patients who healed without complication received negative pressure wound therapy (n = 45), while those who did not (n = 5) developed complications. Three of the five patients without negative pressure wound therapy had acute acellular dermal matrices loss, compared to only one of the 49 patients who received negative pressure wound therapy.

CONCLUSION:
Our findings suggest that acellular dermal matrices may be an effective and safe reconstructive adjunct or alternative when used with negative pressure wound therapy.
The Effectiveness of Budesonide Once Daily as Maintenance Treatment of Eosinophilic Esophagitis
Authors: Raymenants Karlien , Wauters Lucas , Tack Jan , Vanuytsel Tim 
Published: January 2025

Background:
Swallowed topical corticosteroids (STC) are an effective first-line therapy for patients with eosinophilic esophagitis (EoE), both for induction and maintenance of remission. All interventional trials with STC used twice-daily dosing regimens. However, in other inflammatory gastrointestinal disorders, corticosteroids are given once daily (OD) with equal outcomes and improved compliance.

Goals:
To evaluate the effectiveness of topical budesonide maintenance treatment in a once-daily dosing schedule.

Study:
Retrospective analysis of confirmed patients with EoE, treated with topical budesonide as maintenance therapy OD, with adequate follow-up available. Patients currently treated with budesonide were contacted to fill out online questionnaires regarding symptoms and health-related quality of life (HRQOL). The primary end point was histologic remission, defined as peak eosinophil count (PEC) <15 eosinophils per high power field (HPF) after >12 weeks of budesonide OD.

Results:
We included 29 patients on STC OD (1 mg, N=28; 0.5 mg, N=1), either budesonide orodispersible tablet (BOT, Jorveza, Dr. Falk Pharma; N=12) or budesonide viscous solution (BVS; N=17). After a median follow-up of 767 days on OD dosing (range: 103 to 2396), 86% of patients were in histologic remission. Four patients had histologic disease activity, of which one was treated with BOT. Two patients experienced a slight increase in PEC after dose reduction of BVS to OD (to PEC of 25 and 35/HPF, respectively). However, after switching the formulation to BOT OD they achieved histologic remission.

Conclusions:
In this retrospective study, we demonstrated favorable results in the majority of patients treated with budesonide 1 mg OD as maintenance treatment for eosinophilic esophagitis.
A 14-year-old child with a benign osteoma tumor in the external ear canal: a rare case report
Authors: Othman Abdulrahman Ahmad , Ismaeil Samah Khirou , Nasser Sabine Ali , Al Mahmoud Hala Akef , Alhussain Aya Yasser , Alshikha Mohammad Nasoh , Hmrawy Batool Ayman , Haydar Ali Housein , Mousa Ayham Ameen , Alsaudi Mona Mahmoud , Sleiay Bilal 
Published: January 2025

Introduction:
A benign osteoma is a non-cancerous bone tumor in the external ear canal that can cause hearing loss. Treatment may require surgery if symptoms arise.

Case presentation:
A 14-year-old child severed right ear pain, thick discharge, and hearing loss for a week after unsuccessful treatment elsewhere. Examination showed swollen ear canal and purulent discharge. After antibiotic treatment, thick debris remained. The osteoma was excised through its pedicle to minimize the risk of recurrence.

Clinical discussion:
Osteomas are benign ear growths that can cause hearing loss and blockage. Severe symptoms may require surgery, with the endoscopic transcanal method being effective for osteomas. Blockage can also occur from wax buildup or foreign bodies, potentially leading to cholesteatoma. Osteomas are typically asymptomatic and identified through CT scans, predominantly located in the external auditory canal (EAC). Surgery is advised for symptomatic cases, while regular check-ups are recommended for asymptomatic patients.

Conclusion:
Additional research is necessary to fully comprehend the causes and optimal treatment strategies for benign osteoma in the EAC.
Persistent Oscillating Vertigo From Extracranial Venous Compression
Authors: Cha Yoon-Hee , Gharib Mahmood , Chan Kayla , Karam Joseph 
Published: January 2025

Background:
Persistent oscillating vertigo (POV) can be triggered by motion, when it is called mal de débarquement syndrome (MdDS) but can also occur from nonmotion triggers such as neck injury, inflammation, or homeostatic derangements (nonmotion POV [nmPOV]). The pathology underlying MdDS and nmPOV is unknown but shared symptoms include rocking/bobbing/swaying vertigo, headache, cognitive slowing, and fatigue.

Methods:
We present a case series of patients with MdDS and nmPOV whose symptoms were relieved after treatment of extracranial venous compression in the neck and thoracic outlet.

Results:
POV, regardless of the trigger, was associated with compressions at one or more of the following locations: 1) internal jugular vein (IJV) between the transverse process of the atlas and the styloid process, 2) IJV under the sternocleidomastoid muscle (SCM), and 3) subclavian vein at the thoracic outlet. Compressions were typically bilateral and in tandem. Catheter venography showed dynamic obstruction and shunting of venous blood to the petrosal sinuses around the inner ear and the vertebral veins. Relief of these obstructions with styloidectomy, stenting, neurotoxin to SCM and anterior scalene, SCM partial myotomy, and thoracic outlet decompression significantly relieved POV even with unilateral decompression.

Conclusions:
Oscillatory perceptions of POV whether MdDS or nmPOV may be from the detection of low amplitude pulsations induced by venous outflow obstruction in areas of high freedom of motion (occipito-atlanto junction, mid-neck, and thoracic outlet). Impaired venous outflow and raised venous pressure around the inner ear could lead to continuous peripheral stimulation of the vestibular system and downstream central effects.
Smoking’s Impact on 30-Day Complications in Mesh and Nonmesh Prolapse Surgery
Authors: Marczak Tara D. , Anand Mallika , Hsieh Yi , Ajayi Ayodele , Hacker Michele R. , Winkelman William D. 
Published: January 2025

Importance
Tobacco smoking is linked to poor surgical outcomes, leading many physicians to avoid synthetic implants like mesh in smokers due to concerns about impaired healing. While long-term outcomes for smokers have been studied, the effect of smoking on 30-day postoperative complications, especially related to surgical mesh, is less understood.

Objectives
This study aimed to quantify the association between tobacco smoking and risk of postoperative infection, readmission, and reoperation within 30 days of minimally invasive apical prolapse repair. We also examined whether these associations differed based on whether mesh was used.

Study Design
We conducted a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database for patients who underwent minimally invasive apical pelvic organ prolapse repair from 2012 to 2022. Smoking in the last year was the exposure. Outcomes included postoperative infection, unplanned readmission, and reoperation within 30 days. We calculated adjusted risk ratios for complications and stratified results based on mesh use.

Results
Of 67,235 cases, 5,518 (8.2%) patients smoked in the past year. Smokers had a significantly higher likelihood of infection and unplanned readmission. Smoking did not increase the risk of unplanned reoperation. The association between smoking and 30-day complications did not differ based on mesh use (all P for interaction ≥0.24).

Conclusions
Tobacco use was associated with an increase in postoperative complications within 30 days, though the absolute risk was low. There was no evidence of effect modification by mesh use; suggesting that mesh-augmented repairs could be considered in smokers who receive appropriate counseling.
Association of memory function with COVID-19 outcomes in adults aged 50 years and older: Analysis of three prospective cohorts
Authors: Shi Juanjuan , Shen Xin , Tian Yan , Lu Rui , Li Jia , Geng Xiaozhen , Zhai Song , Jia Xiaoli , Ji Fanpu , Dang Shuangsuo , Wang Wenjun 
Published: January 2025

AbstractBackgroundPatients with Alzheimer’s disease or dementia are at increased risk for COVID-19 hospitalization and mortality. However, no study has examined whether memory function is associated with COVID-19 outcomes in general older adults.MethodsData were obtained from SHARE (the Survey of Health, Ageing and Retirement in Europe), HRS (the Health and Retirement Study), and ELSA (the English Longitudinal Study of Ageing), three prospective and representative cohorts of non-institutionalized adults aged 50 years and older in 25 European countries plus Israel, the United States, and the United Kingdom, respectively. Memory function was measured with immediate and delayed 10-words recall tests. Associations of 10-words recall with COVID-19 hospitalization and mortality were assessed using logistic models adjusted for age, sex, race, body mass index, smoking, physical activity, household income, education level, and chronic conditions.ResultsA total of 4062 participants with COVID-19 infection from SHARE, 1349 from HRS, and 278 from ELSA were included in the analysis. 610 (15.0%) in SHARE, 142 (10.5%) in HRS, and 39 (14.0%) in ELSA were hospitalized, and 102 (2.5%) died of COVID-19 or related complications in SHARE. The adjusted odds ratios (aORs) for COVID-19 hospitalization were 1.15 (95% CI, 1.09-1.22) in SHARE, 1.07 (95% CI, 0.94-1.21) in HRS, and 1.34 (95% CI, 1.02-1.77) in ELSA, per word decrease in immediate 10-words recall. For delayed 10-words recall, the corresponding aORs were 1.11 (95% CI, 1.06-1.17), 1.12 (95% CI, 1.01-1.24), and 1.25 (95% CI, 1.01-1.55), respectively. The aORs for COVID-19 mortality were 1.07 (95% CI, 0.94-1.21) and 1.14 (95% CI, 1.01-1.28) per word decrease in immediate and delayed 10-words recall in SHARE, respectively. Results were relatively robust to missing data of covariates, exclusion of cases based on symptoms alone, or exclusion of cases with Alzheimer’s disease or dementia.ConclusionsThis study shows that low memory performance, as measured by 10-words recall, is independently associated with an increased risk of COVID-19 hospitalization and mortality in adults aged 50 years and older.
The genetics of TDP43-Type-C neurodegeneration: a whole genome sequencing study
Authors: Nassan Malik , Ayala Ivan Alejandro , Sloan Jennifer , Bonfitto Anna , Stark Bobbi , Song Serena , Naymik Marcus , Geula Changiz , Gefen Tamar , Barbieri Elena , Piras Ignazio S. , Mesulam M-Marsel , Huentelman Matt J. 
Published: January 2025

AbstractFrontotemporal lobar degeneration-TDP Type C (TDP-C) is a unique neurodegenerative disease that starts by attacking the anterior temporal lobe leading to language and/or behavioral syndromes. Current literature on the genetic associations of TDP-C, which we have reviewed here, is uneven and lacks a discernible corpus of robust findings. In our study, we completed genome wide hypothesis-free analyses utilizing artificial Intelligence (AI) to identify rare and common variants associated with TDP-C. We then investigatedANXA11andTARDBPin a hypothesis-driven analysis, since it was recently shown that TDP-43 and Annexin A11 co-aggregate in all TDP-C cases.1) Whole genome sequencing was completed to identify pathogenic rare variants prioritized with Illumina’s AI-based Emedgene software on 37 confirmed or probable TDP-C cases from the Northwestern-University Cohort. 2) A genome wide association study was then completed to identify common variants associated with TDP-C cases vs 290 controls. 3) Next, common and rare variants inTARDBP, and ANXA11were investigated in TDP-C vs controls.These analyses identified novel genetic associations betweenFIG4,UBQLN2,INPP5A, andANXA11with TDP-C. Of theseFIG4, UBQLN2 and ANXA11have been associated previously with Amyotrophic lateral sclerosis (ALS). To further assess the observed potential genetic overlap between ALS and TDP-C, we leveraged Mendelian randomization (MR) to assess if the ALS genetic load is associated with TDP-C risk, and found evidence supporting this association.The genetic association ofANXA11with TDP-C is particularly interesting in view of the recently discovered role ofAnnexin A11in forming heterodimers with TDP-43 in all abnormal precipitates, a feature not found in TDP-A or TDP-B, which have no similar predilection for the anterior temporal lobe. In addition to the observed overlap between ALS genetics/ genetic load and TDP-C, it is worth mentioning thatFIG4, INPP5A and ANXA11have been implicated in the inositol metabolism pathway, a feature that remains to be elucidated mechanistically. Our TDP-C genetic literature review identified a surprising paucity of neuropathologically confirmed cases in published investigations. Nonetheless, the literature offers support for some of our findings and reemphasizes the absence of dominant or major pathogenic genes for TDP-C, another feature that sets this neuropathologic entity apart from TDP-A and TDP-B.
Long COVID affects working memory: Assessment using a single rapid online test
Authors: Asghar Aziz UR , Yuen Hong Kiu , Aksoy Murat , Salawu Abayomi , Baseler Heidi A 
Published: January 2025

AbstractLong COVID, or post-COVID-19 syndrome, is characterized by persistent symptoms following SARS-CoV-2 infection, including cognitive impairments such as brain fog that adversely affects quality of life. The aim of this study was to evaluate the impact of long COVID on working memory using a single rapid online anonymous survey and working memory quiz. We analyzed working memory scores in relation to long COVID status (clinically diagnosed, self-reported, and non-long COVID), age, number of COVID-19 infections and long COVID duration, and subjective ratings of brain fog severity and overall life impact of symptoms. The study recruited 1064 participants aged 16 to over 85 years (83% from the United Kingdom) with 39% reporting long COVID. The results demonstrate that long COVID significantly impairs working memory, with the greatest deficits observed in clinically diagnosed cases. In addition, we found that working memory declined with age and multiple COVID-19 infections particularly in the diagnosed long COVID group. Moreover, individuals in the diagnosed long COVID group reported experiencing the most severe brain fog and the greatest impact of long COVID symptoms on their lives, and both of these factors were strongly correlated with lower memory scores. Participants who had been living with long COVID for a longer duration had lower memory scores. However, this relationship was likely influenced by the SARS-CoV-2 variant, as individuals with prolonged long COVID symptoms were more likely to have been infected with earlier variants (alpha and wild-type) which are linked to more severe disease outcomes. Our results suggest that long COVID is associated with significant working memory impairments, emphasizing the need for targeted interventions and support strategies for those with long COVID to address memory problems.
Schizophrenia versus Healthy Controls Classification based on fMRI 4D Spatiotemporal Data
Authors: Huan Pham Tieu Hoang , Wu Yihren , Ikuta Toshikazu , John Majnu 
Published: January 2025

AbstractA wide array of machine learning approaches have been employed for differentiating patients with mental health disorders from healthy controls using neuroimaging data. However, almost all such methods have been applied on inputs based on connectivity matrices or features derived from the neuroimaging data. Only a few papers recently have considered such classification based on the original voxel-based spatiotemporal data. In this paper, we report the performance of a few cutting edge machine learning algorithms on voxel-based fMRI data to classify healthy controls and patients with schizophrenia. The methods that we employed included convolutional neural networks, convolutional recurrent neural networks with long short-term memory and a transfer learning approach for classification based on Wasserstein generative adversarial networks. In order to reduce the computational burden to fit in with available hardware, we had to reduce the original 4-dimensional data to 3-dimensional inputs for almost all architectures. Our results indicate that the relatively simpler architecture based on convolutional neural networks showed reasonable unambiguity in grouping patients from healthy controls. In contrast, the performance of the other two more complex architectures that we employed were comparatively poorer.