bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Optimization of Patients Undergoing Orthopedic Foot and Ankle Surgery: A Single Institution Cohort
Authors: Kessel Julia , Cleveland Rebecca J. , Lalli Trapper , Tennant Joshua , Woody Jennifer 
Published: January 2025

Introduction:
Careful preoperative patient preparation for orthopedic foot and ankle surgery can help manage postoperative expectations and avoid suboptimal outcomes. Our quality improvement initiative aimed to reduce emergency department (ED) visits within 30 days postsurgery by enhancing preoperative education.

Methods:
We focused on four outcomes associated with receipt of written preoperative information: (1) related ED visits within 30 days of surgery, (2) average number of patient portal messages, (3) phone calls initiated by patients, and (4) staff team experience survey results. All patients undergoing foot and ankle surgery by two surgeons at one institution from July 2023 to January 2024 were included.

Results:
Through a series of six plan, do, study, act (PDSA) cycles lasting 1 month each, we evaluated 431 patients (55.9% female, 61.4% White, 92.4% English speakers). Patients who received written preoperative information were significantly less likely to present to the ED for related concerns within 30 days of surgery compared with those receiving no written preoperative information (p = .0068). In addition, we observed fewer portal messages and phone calls from patients receiving written preoperative information (p = .3644, p = .0541).

Conclusions:
An increase in the use of standardized written preoperative information yields decreased ED visits and frequency of inquiries from patients through portal messages and phone calls.
Examining Long-Haul Truck Driver Needs and Preferences to Improve the Truck Stop Environment
Authors: McKeown Mackenzie L. , Crizzle Alexander M. 
Published: January 2025

Structured Abstract

Objective
This study examined and compared the truck stop needs and preferences of long-haul truck drivers (LHTD) based on gender.

Methods
LHTD were recruited from various provincial and federal trucking associations and trucking companies across Canada. A sample of 406 drivers completed an online survey that consisted of questions on demographics, health conditions and behaviours, and preferences for truck stop amenities.

Results
LHTD reported that parking, healthy and affordable foods, showers, washrooms, and exercise facilities with basic equipment are the most important amenities needed at truck stops. Compared to men, women were significantly more likely to desire a picnic area at truck stops; all other amenities were consistently desired by both genders.

Conclusions
Improvements to the truck stop environment are needed to support the health and wellness of LHTD.
A Randomized Control Trial Comparing the Effects of N-95 Respirator vs Surgical Mask Use on Resting Metabolic and Respiratory Changes
Authors: Rothstein Alexander , Hirsch Jessie , Hillian Alyssa , DiFrancisco-Donoghue Joanne 
Published: January 2025

ABSTRACT

OBJECTIVE
This study aimed to compare physiological changes when wearing a N95 and surgical mask at rest.

METHODS
42 subjects aged 18-55 (19 males; age 22.98 ± 3.83) were recruited. Respiratory and metabolic data were collected using indirect calorimetry under a hood. VO2, VCO2, and RER were measured. RR, MV, and HR were recorded using Hexoskin Smart Shirt apparatus. Testing consisted of 3 15-minute trials: no mask, surgical mask, and a N95 respirator. RPE was assessed. Results were analyzed using separate repeated measures ANOVAs.

RESULTS
RER, MV, and RPE were significantly higher in both conditions. Highest RPE reported while wearing the N95 mask.

CONCLUSION
The use of a surgical or N95 face mask can cause small metabolic, respiratory, and RPE changes. Minor physiological changes were observed but remained within normally expected physiological parameters at rest.
Epidemiologic survey for work-related idiopathic interstitial pneumonias focusing on idiopathic pulmonary fibrosis in Korea, 2010-2022
Authors: Kang WonYang , Kim Daeho , Kim Mi-Yeon , Kim Eun Young , Choi Sungwon , Cha Wonseok , Choi Byung-Soon 
Published: January 2025

ABSTRACT

Objective
This study aimed to share the process of epidemiologic survey and demonstrate the decisive factors for evaluating work-related Idiopathic interstitial pneumonias (IIPs) in Korea.

Methods
Data and reports of epidemiologic surveys were investigated and completed during 2010–2022.

Results
A total of 228 idiopathic pulmonary fibrosis (IPF) cases requested for an epidemiologic survey, of which 153 (67.1%) were work-related. The level of exposure intensity was more than intermediate and the exposure duration was more than 10 years in the work-related IPF, so the decisive factors for work-related IPF were exposure substances, intensity and duration.
The main factors for work-related acute interstitial pneumonia or cryptogenic organising pneumonia were exposure latency and exposure intensity.

Conclusions
The results of this study indicated the process of the epidemiologic survey and important factors for evaluating work-related IIPs.
Implicit and Explicit Race and Weight Biases Among Physician Assistant Preceptors and Trainees
Authors: Sabin Janice , Nagasawa Pamela , Guenther Grace , Kett Paula , Williams-York Bernadette , Naidu Amee , Frogner Bianca K. 
Published: January 2025

Introduction
As new equity, diversity, and inclusion programs emerge in physician assistant/associate (PA) education, there is a need to assess baseline levels of implicit and explicit biases among PA preceptors’ and trainees. The objectives of this study were (1) to measure implicit and explicit race (Black/White) and weight (fat/thin) biases among PA preceptors and trainees and (2) to identify potential gaps in PA preceptor and trainee education.

Methods
This is a cross-sectional study of PA preceptors and trainees from one program operating in several US states; implicit and explicit race and antifat biases and receipt of prior education were measured.

Results
Preceptor response rate was 6.4% (N = 78) from an eligible population of 1222, and trainee response rate was 25.7% (n = 43) from an eligible population of 167. Sixty-eight preceptor participants (87.2%) and 23 trainees (53.5%) identified as White. Preceptors held strong (Cohen d = 0.81), and trainees held moderate (Cohen d = 0.43) pro-White implicit bias. Overall, preceptors and trainees held little and no explicit race bias (Cohen d = 0.18 and d = 0.0, respectively). Preceptors and trainees held strong implicit antifat bias (Cohen d = 1.24 and Cohen d = 0.76). Preceptors held moderate explicit antifat bias (Cohen d = 0.65); trainees held strong explicit antifat bias (Cohen d = 0.95). Trainees received significantly more education on working with diverse populations compared with preceptors (100% vs. 57.7%, P < 0.001) and working with patients who are overweight (74.4% vs. 41.0%, P < 0.001).

Discussion
Implicit race and antifat bias exists among our sample of PA preceptors and trainees. A gap in education for preceptors on working with diverse populations and patients who are overweight was identified. Future research should address both.
Bridging the Gap: Implementing an Adjunct Faculty as a Remediation Specialist in a Physician Assistant/Associate Program
Authors: Chalmers Erin E. , Malcom Daniel R. 
Published: January 2025

Introduction
Creating a successful remediation plan for physician assistant/associate students comes with its challenges, particularly because of the limited time available for both faculty and students. In an accelerated 24-month program, the pace of the curriculum leaves little time to fall behind in mastering knowledge and skills. One possible solution is appointing an adjunct faculty member to serve as a dedicated Remediation Specialist (RS) to focus solely on student remediation.

Methods
The RS reviews assessments of failing students and develops a review session based on shared areas of weakness among them. This session is promptly offered postassessment to ensure timely review. While required for failing students, the session is open to all didactic students. In addition, students complete a remediation assignment of their choice.

Results
Implementation of a RS demonstrated positive program outcomes. Students requiring remediation receive re-education in areas of deficiency within the curriculum. Furthermore, the time burden is shifted away from the core faculty. Students are remediated in targeted areas.

Discussion
Dedicated remediation specialists are commonly used in health profession education programs. The utilization of these specialists often results in higher examination pass rates, licensure pass rates, and improved clinical skills. While some programs select a candidate training in education and pedagogy, our program's RS is a trained physician assistant/associate and able to provide discipline-specific support.
Prediction Model of the T Cell-mediated Rejection After Liver Transplantation in Children and Adults: A Case-controlled Study
Authors: Ai Chengbo , Song Jiulin , Yuan Chi , Xu Gang , Yang Jian , Lv Tao , Jin Shuguang , Wu Hong , Xiang Bo , Yang Jiayin 
Published: January 2025

Objective:
T cell-mediated rejection (TCMR) is a major concern following liver transplantation (LT), and identifying its predictors could help improve post-transplant prognosis. This study aimed to develop a model to predict the risk of TCMR in children and adults after LT.

Method:
Pre-transplant demographic characteristics, intraoperative parameters, and especially early post-transplant laboratory data for 1221 LT recipients (1096 adults and 125 children) were obtained from the Hospital, University, between 1 January 2015, and 1 January 2022. These data were analyzed to develop the prediction model.

Result:
The incidence of TCMR was higher in pediatric LT recipients than in adults (17.6% vs. 6.4%, P < 0.001). In adult recipients, seven predictors were identified: donor sex, recipient age, recipient height, and post-transplant levels of serum direct bilirubin, urea, platelets, and neutrophil-to-lymphocyte ratio. In pediatric recipients, four predictors were identified: post-transplant levels of serum monocyte percentage, direct bilirubin, albumin, and gamma-glutamyl transferase. The area under the model’s curve incorporating these variables for predicting TCMR after LT was 0.713 (95% confidence interval, CI: 0.655–0.770) in adults and 0.786 (95% CI: 0.675–0.896) in children. Decision curve analyses demonstrated the clinical significance of the model.

Conclusion:
This study developed a prediction model that may be useful in identifying high-TCMR-risk populations in both adult and pediatric LT recipients.
Medication non-adherence in acute coronary syndrome patients in Duhok, Iraqi Kurdistan
Authors: Mohammad Ameen M. , Sulaiman Asmaa M. , Dizaye Kawa F. 
Published: January 2025

Background:
Adherence to long-term secondary preventive therapies is vital for improving outcomes in patients recovering from acute coronary syndrome (ACS). This study aims to quantify the extent of non-adherence to these therapies in Iraq and identify the main factors contributing to this issue, addressing a research gap in the Eastern Mediterranean region.

Methods:
This cross-sectional study was conducted from June 2023 to March 2024 in Cardiology Ward of Azadi Teaching Hospital and the Duhok Heart Center, Duhok, Kurdistan Region of Iraq, enrolling 400 patients diagnosed with (ACS). The Adherence in Chronic Diseases Scale (ACDS) was utilized to categorize patients into high, intermediate, or low adherence groups. The study questionnaire comprised three sections including clinicodemographic data, adherence assessment based on the ACDS, and patient-reported reasons for non-adherence.

Results:
The study revealed that the mean age of the participants was 65.78 ± 11.8 years. Within the sample, 24% reported low adherence, 39% reported medium adherence, and only 37% exhibited high adherence. Significant associations were observed between low adherence and older age (P = 0.026), lower education levels (P = 0.0051), and the presence of endocrine disorders (P = 0.029). Conversely, higher adherence was found among patients taking 3–5 different medication classes (P = 0.0003) and those who underwent coronary interventions (P = 0.014). The primary reason for non-adherence was forgetfulness (89.5%).

Conclusion:
The study concludes that a substantial portion of ACS patients in Iraq show low adherence to secondary preventive therapies. To increase adherence among patients with ACS, strategies should be developed to improve medication adherence and promote healthy behaviors simultaneously, Forgetfulness and lack of follow-up are the primary reasons for non-adherence.
Determining the optimal antibiotic duration for skin and soft tissue infections
Authors: Garau Javier 
Published: January 2025

Purpose of review
Optimal duration of therapy in SSTIs – a heterogeneous group of infections – remains unknown. The advances in knowledge of antibiotic duration of treatment in selected SSTIs that can impact clinical practice and published in the last 18 months are reviewed.

Recent findings
Recent evidence indicates that few patients receive guideline concordant empiric antibiotics and appropriate duration in the United States, although this likely can be extrapolated to other countries. One of the most commonly identified opportunities to improve antibiotic stewardship is duration of therapy more than 10 days. The long-standing debate regarding the significance of abscess size and its impact on clinical response to antibiotics, following proper drainage, is increasingly shifting towards the conclusion that abscess size is not directly associated with cure.
In obese patients with SSTI, there is no benefit to longer antibiotic durations for SSTIs in patients with obesity, and it appears that longer antibiotic duration of therapy was associated with increased treatment failure. In diabetic foot infections (DFO), two randomized studies suggest that in the presence of osteomyelitis, the total duration of antibiotic therapy for patients treated nonsurgically does not need to be more than 6 weeks. In a prospective, randomized, noninferiority, pilot trial, patients with DFO who underwent surgical debridement and received either a 3-week or 6-week course of antibiotic therapy had similar outcomes and antibiotic-related adverse events. In patients with necrotizing soft tissue infections, successive observational studies clearly suggest that short duration of antibiotic treatment after NSTI source control is as well tolerated and effective as a longer course. It appears that 48 h would be enough. The possibility of fixed versus individualized approaches to therapy for common bacterial infections, including SSTIs merits to be considered seriously. Fully individualized therapy may be an ideal approach to maximize the benefits and minimize the harms of antimicrobials. Much more work is needed before this strategy becomes feasible.

Summary
There is increasing evidence that shorter duration of treatment is better in different types of SSTIs. Paradoxically, evaluation of real-life clinical practice indicates that long treatments continue to be commonly given to this population.
A Prototype “Smart” 3-Dimensionally Printed Model Showcasing Interactivity: Implementing Voice Command for the Ventricular and Cisternal Systems
Authors: Fleming Cullen , Mostaghni Navid , Elsayed Iman , Hsiao Sabrina , Taghvaei Raheleh , Arsenault Lauren , Javan Ramin 
Published: January 2025

Abstract
The next step in the evolution of static 3-dimensionally (3D) printed models may be the creation of “smart” models, where subcomponents can be seamlessly interacted with through a feedback mechanism, with potential applications in trainee education and patient counseling. Considering the complexity of the ventricular and cisternal systems, they were chosen for segmentation, using Materialize InPrint with outward hollowing using 2.5-mm wall thickness. After 3D printing, dedicated holes were drilled for placement of wired light emitting diodes (LEDs) in anatomical landmarks and connected to an Arduino Uno microcontroller. This was coupled to a Bluetooth transceiver for communication via an Android cellular device. C++ was used to match each LED to a particular pin number on the Arduino board. When the user verbalizes a structure, the Bluetooth sends a command to the Arduino, where the code looks for the “trigger word,” subsequently sending a signal to illuminate the corresponding LED. The system requires wireless/cellular data for communication with the voice recognition engine on the Google server. The described method may serve as a prototype for when 3D printers are capable of simultaneously printing conductive material or wiring along with the main material within a model to allow for integration of feedback devices.
Combining Low-energy Images in Dual-energy Spectral CT With Deep Learning Image Reconstruction Algorithm to Improve Inferior Vena Cava Image Quality
Authors: Wei Wei , Jia Yongjun , Li Ming , Yu Nan , Dang Shan , Geng Jian , Han Dong , Yu Yong , Zheng Yunsong , Fan Lihua 
Published: January 2025

Objective:
To explore the application of low-energy image in dual-energy spectral CT (DEsCT) combined with deep learning image reconstruction (DLIR) to improve inferior vena cava imaging.

Materials and Methods:
Thirty patients with inferior vena cava syndrome underwent contrast-enhanced upper abdominal CT with routine dose, and the 40, 50, 60, 70, and 80 keV images in the delayed phase were first reconstructed with the ASiR-V40% algorithm. Image quality was evaluated both quantitatively [CT value, SD, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) for inferior vena cava] and qualitatively to select an optimal energy level with the best image quality. Then, the optimal-energy images were reconstructed again using deep learning image reconstruction medium strength (DLIR-M) and DLIR-H (high strength) algorithms and compared with that of ASiR-V40%.

Results:
The objective CT value, SD, SNR, and CNR increased with the decrease in energy level, with statistically significant differences (all P<0.05). The 40 keV images had the highest CT values, SNR, and CNR and good diagnostic acceptability, and 40 keV was selected as the best energy level. Compared with ASiR-V40% and DLIR-M, DLIR-H had the lowest SD, highest SNR and CNR, and subjective score (all P<0.001) with good consistencies between the 2 physicians (all k ≥0.75). The 40 keV images with DLIR-H had the highest overall image quality, showing sharper edges of inferior vena cava vessels and clearer lumen in patients with Budd-Chiari syndrome.

Conclusions:
Compared with the ASiR-V algorithm, DLIR-H significantly reduces image noise and provides the highest CNR and best diagnostic image quality for the 40 keV DEsCT images in imaging inferior vena cava.
Validation of a Deep Learning Tool for Detection of Incidental Vertebral Compression Fractures
Authors: Dai Michelle , Tiu Bryan-Clement , Schlossman Jacob , Ayobi Angela , Castineira Charlotte , Kiewsky Julie , Avare Christophe , Chaibi Yasmina , Chang Peter , Chow Daniel , Soun Jennifer E. 
Published: January 2025

Objective:
This study evaluated the performance of a deep learning-based vertebral compression fracture (VCF) detection tool in patients with incidental VCF. The purpose of this study was to validate this tool across multiple sites and multiple vendors.

Methods:
This was a retrospective, multicenter, multinational blinded study using anonymized chest and abdominal CT scans performed for indications other than VCF in patients ≥50 years old. Images were obtained from 2 teleradiology companies in France and United States and were processed by CINA-VCF v1.0, a deep learning algorithm designed for VCF detection. Ground truth was established by majority consensus across 3 board-certified radiologists. Overall performance of CINA-VCF was evaluated, as well as subset analyses based on imaging acquisition parameters, baseline patient characteristics, and VCF severity. A subgroup was also analyzed and compared with available clinical radiology reports.

Results:
Four hundred seventy-four CT scans were included in this study, comprising 166 (35.0%) positive and 308 (65.0%) negative VCF cases. CINA-VCF demonstrated an area under the curve (AUC) of 0.97 (95% CI: 0.96-0.99), accuracy of 93.7% (95% CI: 91.1%-95.7%), sensitivity of 95.2% (95% CI: 90.7%-97.9%), and specificity of 92.9% (95% CI: 89.4%-96.5%). Subset analysis based on VCF severity resulted in a specificity of 94.2% (95% CI: 90.9%-96.6%) for grade 0 negative cases and a specificity of 64.3% (95% CI: 35.1%-87.2%) for grade 1 negative cases. For grades 2 and 3 positive cases, sensitivity was 89.7% (95% CI: 79.9%-95.8%) and 99.0% (95% CI: 94.4%-100.0%), respectively.

Conclusions:
CINA-VCF successfully detected incidental VCF and even outperformed clinical reports. The performance was consistent among all subgroups analyzed. Limitations of the tool included various confounding pathologies such as Schmorl’s nodes and borderline cases. Despite these limitations, this study validates the applicability and generalizability of the tool in the clinical setting.
Parathyroid Adenoma at the Parapharyngeal Space Detected on 99mTc-Sestamibi SPECT/CT
Authors: Li Wai Ip , Chan Tak Kwong , Kung Boom Ting 
Published: January 2025

Abstract
A 77-year-old woman was diagnosed with primary hyperparathyroidism, and initial cervical ultrasonography found no parathyroid lesion, and she was referred to the nuclear medicine unit for dual-phase 99mTc-sestamibi (MIBI) scan. The scintigraphy unveiled heterogeneous uptake patterns across bilateral thyroid lobes, corresponding to the thyroid nodules, alongside a marked focal uptake with delayed tracer washout in the right oral region. The SPECT/CT pinpointed a MIBI-avid nodule within the right parapharyngeal space, indicative of parathyroid ectopia. An ectopic parapharyngeal parathyroid adenoma is exceptionally rare. MIBI scan plays a pivotal role in detection of ectopic parathyroid adenoma at unexpected sites.
National Trends in Non-Accidental Pediatric Craniofacial Fractures Requiring Inpatient Admission
Authors: Gomez Diego A. , Green Emily A. , Palmer Skyler K. , Yu Jason W. , Irwin Timothy J. , Porras Antonio R. , French Brooke M. , Nguyen Phuong D. , Khechoyan David Y. 
Published: January 2025

Introduction:
Pediatric craniofacial trauma, particularly from non-accidental trauma (NAT), is a significant cause of injury with enduring physical and psychological impacts. This study analyzes demographic patterns, injury characteristics, and trends in NAT-related craniofacial injuries to inform early identification, intervention, and prevention efforts.

Methods:
Analysis of the Healthcare Cost and Utilization Project Kids’ Inpatient Database was performed for the years 2009 to 2019. Patients aged 0 to 17 with craniofacial injuries and a diagnosis of non-accidental trauma were identified based on current procedural codes; demographic and temporal trends were analyzed.

Results:
Overall, 306,115 patients with craniofacial injuries and 20,540 patients with non-accidental trauma (NAT) were identified. Patients with NAT represented 2.6% of all craniofacial injuries, with a greater proportion of males affected. On average, 39% of all NAT cases involved a craniofacial injury. The most common injury patterns were intracranial (50.1%), superficial head injuries (37.7%), and craniofacial fractures (31.9%. Isolated facial fractures were rare, comprising <1% of all cases. Although the average in-hospital mortality was 6.78%, temporal analysis demonstrated significant reductions in in-hospital mortality and length of hospitalization (P<0.001).

Conclusions:
Pediatric craniofacial injuries from NAT remain a significant public health concern. However, the observed decrease in both hospitalization length and in-hospital deaths suggests improvements in early intervention and treatment outcomes. Continued efforts to refine diagnostic strategies, enhance provider awareness, and strengthen prevention initiatives are essential to mitigate the devastating impacts of NAT in the pediatric population.