bluuebunny/crossref_metadata_2025_split huggingface dataset:
Discrimination, Reliability, Sensitivity, and Specificity of Robotic Surgical Proficiency Assessment With Global Evaluative Assessment of Robotic Skills and Binary Scoring Metrics: Results From a Randomized Controlled Trial
Authors: De Groote Ruben , Puliatti Stefano , Amato Marco , Mazzone Elio , Larcher Alessandro , Farinha Rui , Paludo Artur , Desender Liesbeth , Hubert Nicolas , Cleynenbreugel Ben Van , Bunting Brendan P. , Mottrie Alexandre , Gallagher Anthony G. ,   On behalf of the Junior ERUS/ YAU working group on robot-assisted surgery of the European Association of Urology and the ERUS Education Working Group. Collaborators:, Rosiello Giuseppe , Uvin Pieter , Decoene Jasper , Tuyten Tom , D’Hondt Mathieu , Chatzopoulos Charles , De Troyer Bart , Turri Filippo , Dell’Oglio Paolo , Liakos Nikolaos , Andrea Bravi Carlo , Lambert Edward , Andras Iulia , Di Maida Fabrizio , Everaerts Wouter 
Published: August 2023

Objective:
To compare binary metrics and Global Evaluative Assessment of Robotic Skills (GEARS) evaluations of training outcome assessments for reliability, sensitivity, and specificity.

Background:
GEARS–Likert-scale skills assessment are a widely accepted tool for robotic surgical training outcome evaluations. Proficiency-based progression (PBP) training is another methodology but uses binary performance metrics for evaluations.

Methods:
In a prospective, randomized, and blinded study, we compared conventional with PBP training for a robotic suturing, knot-tying anastomosis task. Thirty-six surgical residents from 16 Belgium residency programs were randomized. In the skills laboratory, the PBP group trained until they demonstrated a quantitatively defined proficiency benchmark. The conventional group were yoked to the same training time but without the proficiency requirement. The final trial was video recorded and assessed with binary metrics and GEARS by robotic surgeons blinded to individual, group, and residency program. Sensitivity and specificity of the two assessment methods were evaluated with area under the curve (AUC) and receiver operating characteristics (ROC) curves.

Results:
The PBP group made 42% fewer objectively assessed performance errors than the conventional group (P < 0.001) and scored 15% better on the GEARS assessment (P = 0.033). The mean interrater reliability for binary metrics and GEARS was 0.87 and 0.38, respectively. Binary total error metrics AUC was 97% and for GEARS 85%. With a sensitivity threshold of 0.8, false positives rates were 3% and 25% for, respectively, the binary and GEARS assessments.

Conclusions:
Binary metrics for scoring a robotic VUA task demonstrated better psychometric properties than the GEARS assessment.
Screening for Caregiver-Reported Feeding Concerns in Children with Autism Spectrum Disorder in a Tertiary-Care Clinic
Authors: Kuschner Emily S. , Sivathasan Shalini , McQueen Emma , Berry Rashelle C. , Pulver Stormi L. , Sharp William G. , Klaiman Cheryl 
Published: August 2023

ABSTRACT:

Objective:
Feeding concerns, primarily food selectivity, are commonly observed in children with autism spectrum disorder (ASD). Prevalence rates suggest that at least half of autistic youth have feeding difficulties.

Methods:
A retrospective chart review examining records of a large cohort of autistic children (N = 746) referred for ASD evaluation was conducted. Families completed a survey regarding feeding concerns in their children before a diagnostic evaluation.

Results:
Post hoc analyses based on retrospective chart review revealed approximately 30% of caregivers reported significant difficulty feeding their child. Young age, food selectivity, and concerns about weight were associated with increased likelihood of reported feeding difficulties. There was clear overlap between overall feeding difficulties and specific food selectivity; however, 1 in 5 children whose caregivers did not report feeding difficulties endorsed food selectivity.

Conclusion:
Findings highlight the need for multipronged approaches to screening to facilitate service prioritization by pediatric providers.
Histologic Comparison of the Fascicular Area of Processed Nerve Allograft Versus Cabled Sural Nerve Autograft
Authors: Leversedge Fraser J. , Safa Bauback , Lin Walter C. , Iorio Matthew L. , Merced-O’Neill Orlando , Tajdaran Kasra 
Published: August 2023

Background:
The use of multiple cables of sural nerve autograft is common for peripheral nerve reconstruction when injured nerve caliber exceeds the nerve graft caliber. Although the optimal matching of neural to nonneural elements and its association with functional outcomes are unknown, it is reasonable to consider maximizing the neural tissue structure available for nerve regeneration. No prior studies have compared directly the cross-sectional fascicular area between cabled nerve autografts and size-selected nerve allografts. This study evaluated the cross-sectional fascicular area between native nerve stumps and two reconstructive nerve grafting methods: cabled sural nerve autograft (CSNA) and processed nerve allograft (PNA).

Methods:
CSNA from matched cadaveric specimens and PNA were used to reconstruct nerve defects in the median and ulnar nerves of six pairs of cadaveric specimens. Nerve reconstructions were done by fellowship-trained hand surgeons. The total nerve area, fascicular area, and nonfascicular area were measured histologically.

Results:
The CSNA grafts had significantly less fascicular area than PNA and caliber-matched native nerve. The PNA grafts had a significantly higher percent fascicular area compared with the intercalary CNSA graft.

Conclusions:
Fascicular area was significantly greater in PNA versus CSNA. The PNA consistently demonstrated a match in fascicular area closer to the native nerve stumps than CSNA, where CSNA had significantly smaller fascicular area compared with native nerve stumps.
Six Years of Complaints Issued by Patients at a Laser Treatment Center in a Plastic Surgery Hospital
Authors: Ding Bo , Su Xueshang , Zhuang Jun , Cai Na , Ou Yangxue , Jiang Haixia , Jiang Hanyi , Hu Jintian 
Published: August 2023

Background:
Patient complaints can provide valuable feedback regarding the objective deficiencies of medical services. There are few studies on the complaints of patients receiving photoelectric therapy, so this study aims to understand the expectations and requirements of patients by analyzing the complaints of patients receiving photoelectric therapy.

Methods:
The complaints of patients who underwent photoelectric therapy were retrospectively examined. Authors plan to analyze treatment items, complaint contents, appeals, time trend regarding the number of complaints, and economic compensation.

Results:
Fifty-four patients were involved in the study in total, and all of them were included. According to the standardized coding classification of complaints by Reader et al., the number of clinical, management and relationship complaints were 36 (59.02%), 14 (22.95%), and 11 (18.03%), respectively. These were divided among the categories of quality (31.15%), safety (27.87%), institutional issues (22.95%), communication (8.20%), and humaneness/caring (9.84%); with the most common subcategories involving treatment (31.15%) and safety incidents (24.59%). The patients' demands involved 20 cases (32.26%) requesting a refund of their medical expenses, 16 (25.81%) issuing a warning, 15 (24.19%) requesting compensation for loss, 10 (16.13%) requiring free repair or consultation, and 1 (1.61%) demanding an apology. Eventually, financial compensation was provided to the patients in eight of the cases. At a significance level of P = 0.05, even if the number of annual complaints increased over time, the increasing trend was not significant.

Conclusions:
Patient complaints in photoelectric therapy were most commonly clinical in nature. Specifically, quality and safety concerns are the main complaints.
Truth or DARE (Digital Anal Rectal Examination): Gynecologist Viewpoints on Anal Cancer Screening
Authors: Gaydos Laura M. , Blemur Danielle , Perry Tahira , Stier Elizabeth A. , Khan Michelle J. , Flowers Lisa 
Published: August 2023

Objective
The objective of this study is to assess knowledge and prevention practices for anal cancer among gynecologists.

Methods
We conducted a survey for practicing gynecologists recruited through academic institutions, professional societies, and professional groups on social media resulting in 196 respondents. The survey, fielded between January and June 2022, included questions on knowledge, attitudes, training, and practices regarding anal cancer prevention (ACP). Descriptive statistics and χ2 analysis were completed.

Results
In terms of knowledge regarding ACP, over 80% of respondents identified certain clinical indications for anal cancer screening. However, only 36% respondents selected the 3 correct ACP screening tools. Twenty-seven (13.9%) respondents reported receiving training on ACP in medical school, whereas 50 (25.9%) reported receiving training during residency. Only 21% of respondents reported that they perform anal cytology, and 32% reported that they perform digital anal rectal examinations. One hundred thirty-six respondents (75.56%) affirmed that they needed additional training on ACP to be able to provide this service to their patients, and 95 (53.1%) stated they were extremely likely to participate in ACP training if given the opportunity.

Conclusion
Although a limited proportion of practicing gynecologists with trained in ACP, there is willingness to participate in training if it were made available and to incorporate ACP into their practices.
Risk Factors for the Development of Bilateral Ménière's Disease
Authors: Phillips John , Murdin Louisa , Grant Kelly , Shepstone Lee , Sims Erika , Rea Peter , Harcourt Jonny 
Published: August 2023

Objective
To identify key risk factors for the development of bilateral Ménière's disease.

Study Designs
Observational study.

Setting
Four NHS Trusts and four independent hospitals or clinics, within three distinct urban and rural regions within the United Kingdom (Norfolk, Leicestershire, and London).

Methods
Patients with Ménière's disease were identified at ENT or audiovestibular medicine secondary/tertiary care and specialist private clinics. A range of patient-reported data, questionnaire data, and clinical data (audiometric, radiological, and specialist balance testing data) was inputted into a bespoke database. A logistic regression model was used to identify potential risk factors for bilateral Ménière's disease compared with unilateral Ménière's disease.

Results
A total of 411 participants were recruited into this study, 263 from NHS Trusts and 148 from independent hospitals or clinics. In our cohort of patients, 22% of individuals were identified as having bilateral Ménière's disease. Two statistically significant independent variables were identified as risk factors for the development of bilateral Ménière's disease: the presence of psoriasis and a history of ear infections.

Conclusions
Psoriasis and a history of ear infection have been identified as key risk factors for the development of bilateral Ménière's disease. It is anticipated that further work based on this finding will allow a better understanding of the underlying pathophysiological mechanisms that predispose to the development of Ménière's disease symptoms.
Enhanced Mitophagy in Cholesteatoma Epithelial Cells
Authors: Li Quan-Cheng , Wang Shu-Qi , Cao Zai-Zai , Zhou Shui-Hong 
Published: August 2023

Hypothesis
Mitophagy may have a potential role in the pathogenesis of acquired cholesteatoma.

Background
Enhanced mitophagy has been proven to be involved in various cancers. However, its role in the pathogenesis of cholesteatoma, which shares some common features with cancer, is controversial. This study investigated mitophagy in cholesteatoma epithelial cells.

Methods
The autophagy protein markers LC3-II and p62 and mitophagy proteins BNIP3, Parkin, and PINK1 were analyzed in cholesteatoma epithelial cells and external auditory canal epithelium cells by immunoblotting. The results were confirmed by immunohistochemistry. Adenovirus Ad-mCherry-GFP-LC3B and Ad-GFP-LC3B were used to evaluate autophagic activity. Transmission electron microscopy was used to observe and analyze autophagosomes.

Results
LC3-II expression was increased in cholesteatoma cells, whereas soluble and insoluble p62 levels were decreased. The expressions of BNIP3, Parkin, and PINK1 were higher in total protein and mitochondrial protein of cholesteatoma cells compared with normal external auditory canal epithelium cells. Autophagic activity was increased in cholesteatoma cells compared with normal external auditory canal epithelium cells.

Conclusion
Mitophagy was enhanced in cholesteatoma epithelial cells and may have a potential role in the pathogenesis of acquired cholesteatoma.
The Natural History of Observed SDHx-Related Head and Neck Paragangliomas Using Three-Dimensional Volumetric Tumor Analysis
Authors: Tooker Evan L. , Wiggins Richard H. , Espahbodi Mana , Naumer Anne , Buchmann Luke O. , Greenberg Samantha E. , Patel Neil S. 
Published: August 2023

Objective
Characterize the natural history and clinical behavior of head and neck paragangliomas (HNPGLs) in subjects with succinate dehydrogenase (SDHx) pathogenic variants using volumetric tumor measurements.

Study Design
Cohort study.

Setting
Tertiary academic referral center.

Patients
Subjects with SDHx HNPGLs under observation for at least 6 months with 2 or more magnetic resonance imaging or computed tomography scans.

Intervention(s)
Diagnostic interventions include next-generation sequencing, magnetic resonance imaging, and computed tomography. Therapeutic interventions include microsurgical resection or stereotactic radiosurgery.

Main Outcome Measure(s)
Radiographic progression was defined as a 20% or greater increase in volume. Cranial nerve (CN) functional outcomes were assessed using clinical documentation.

Results
A total of 19 subjects with 32 tumors met the inclusion criteria. Median radiographic follow-up was 2.2 years, and the median volumetric growth rate was 0.47 cm3/yr. Kaplan-Meier estimated rates of survival free of radiographic progression for all SDHx tumors at 1, 2, and 3 years were 69, 50, and 22%, respectively. No tumors developed new CN palsies during the period of observation.

Conclusions
Over intermediate-term follow-up, observation of treatment-naive SDHx-related HNPGLs did not result in new cranial neuropathy. Although indefinite observation is only appropriate for select cases, these data support an interval of observation to characterize growth rate in asymptomatic to minimally symptomatic patients, who are at high risk of treatment-related morbidity. Given the early age at diagnosis and high risk of bilateral multifocal phenotypes in SDHx HNPGL mutation carriers, these data may aid in optimizing patient tumor control and CN functional preservation. Further studies are necessary to determine whether pretreatment growth rate is correlated with clinical outcomes.
Influence of Visual Feedback on Roll Tilt Perceptual Training
Authors: Wagner Andrew R. , Merfeld Daniel M. 
Published: August 2023

Hypothesis
We hypothesized that the addition of visual feedback during roll tilt perceptual training would yield a significant reduction in vestibular perceptual thresholds relative to a control group.

Background
We previously showed that roll tilt vestibular thresholds could be improved through a perceptual training protocol that used a simple auditory cue. Variability in training outcomes within the treatment group suggested that an auditory cue alone may be suboptimal for improving self-motion perception.

Methods
In 10 healthy adults, roll tilt vestibular thresholds, quantifying the smallest motion that can be reliably perceived, were measured before (“pretraining”) and after (“posttraining”) a training protocol designed to improve roll tilt perception. The protocol included 1,300 trials of 0.5 Hz whole-body roll tilt over 5 days, with participants being given both an auditory cue (“correct’ vs. “incorrect’) and visual feedback (viewing a stationary visual scene) after indicating their perceived direction of tilt. A control group (N = 10) underwent only the “pretraining” and “posttraining” assessments.

Results
The training group showed an average decrease in roll tilt vestibular thresholds of 1.7% ± 56%, with training outcomes varying widely. Three individuals showed an average increase in roll tilt thresholds of 69.7%, whereas the remaining seven adults showed an average decrease in thresholds of 32.3%.

Conclusion
These data show that visual feedback during roll tilt perceptual training leads to heterogenous outcomes, but in a subset of individuals, it may lead to improvements in perceptual precision. Additional work is needed to define the optimal training parameters, including feedback schema, before investigating potential clinical applications.
Realist Approach to Qualitative Data Analysis
Authors: Putri Arcellia Farosyah , Chandler Colin , Tocher Jennifer 
Published: August 2023

Background
A realist approach has gained popularity in evaluation research, particularly in understanding causal explanations of how a program works (or not), the circumstances, and the observed outcomes. In qualitative inquiry, the approach has contributed to better theoretically based explanations regarding causal interactions.

Objective
The aim of this study was to discuss how we conducted a realist-informed data analysis to explore the causal interactions within qualitative data.

Methods
We demonstrated a four-step realist approach of retroductive theorizing in qualitative data analysis using a concrete example from our empirical research rooted in the critical realism philosophical stance. These steps include (a) category identification, (b) elaboration of context-mechanism-outcome configuration, (c) demi-regularities identification, and (d) generative mechanism refinement.

Results
The four-step qualitative realist data analysis underpins the causal interactions of important factors and reveals the underlying mechanisms. The steps produce comprehensive causal explanations that can be used by related parties—especially when making complex decisions that may affect wide communities.

Discussion
The core process of realist data analysis is retroductive theorizing. The four-step qualitative realist data analysis facilitates this theorizing by allowing the researcher to identify (a) patterns, (b) fluctuation of patterns, (c) mechanisms from collected data, and (d) to confirm proposed mechanisms.
Do Saliva-Saturated Spit Hoods Interfere With Ventilation?
Authors: Kroll Mark W. , Hail Stacey L. , Brave Michael A. 
Published: August 2023

Abstract
Spit hoods are used by law enforcement, officers in correctional facilities, and medical personnel during the restraint of agitated subjects that are actively spitting to prevent the transmission of droplet-transmitted pathogens. We could find no studies reporting on the time course of normal breathing to clear saliva from such a saturated spit hood. We purchased samples of 3 popular spit hood models and applied a section over the output of a pneumatic test system. We used a digital anemometer, digital manometer, and an inline controllable fan for back pressure and flow. The pressure was 3 mm Hg to match quiet breathing. The tested area was saturated with artificial saliva, and air pressure was applied while we recorded the pressure and airflow. Within 5 seconds, the spit hoods all cleared sufficient artificial saliva to allow 1 m/s of airflow, which exceeds that of an N95 mask with similar pressure. Commonly used spit hoods offer very low resistance to breathing even after being initially saturated with artificial saliva. Our results do not support the hypothesis that a saliva-filled spit hood might contribute to death.
A Narrative Review of Eye-Tracking (ET) Assessment of Esthetic Endpoints in Plastic, Reconstructive, and Craniofacial Surgery
Authors: Atiyeh Bishara , Emsieh Saif , Hakim Christopher , Chalhoub Rawad , Habal Mutaz 
Published: August 2023

Abstract:
Reporting of esthetic outcomes in plastic surgery relies classically on ill-defined endpoints and subjective measures very often from the patients’ and/or providers’ perspectives that are notoriously characterized by subjectivity and questionable solid scientific validation. With the recent trend of increasing demand for all types of esthetic medical and surgical interventions, there is an urgent need for reliable and objective outcome measures to quantitate esthetic outcomes and determine the efficacy of these interventions. The current review is intended to analyze available evidence regarding advantages as well as limitations of eye-tracking (ET) technology in objectively documenting esthetic outcomes of plastic, reconstructive, and craniofacial interventions. Although gaze pattern analysis is gaining more attention, ET data should be interpreted with caution; how a specific visual stimulus directly influences one’s sense of esthetics is still not clear. Furthermore, despite its great potentials, it is still too early to confirm or deny ET usefulness. Nevertheless, patient-reported outcomes being most indicative of an esthetic intervention success, measurement of patients’ satisfaction by ET technology could offer a major breakthrough in objective assessment of esthetic outcomes that need further in-depth investigation.

Evidence level:
Level III.
Validity and reliability of inertial measurement units in active range of motion assessment in the hip joint
Authors: Stołowski Łukasz , Niedziela Maciej , Lubiatowski Przemysław , Piontek Tomasz 
Published: August 2023

AbstractMeasuring joint range of motion has traditionally occurred with a universal goniometer, inclinometer, or expensive laboratory systems. The popularity of the inertial measuremen unit (IMU) is growing, enabling the small even single portable device to measure the range of motion. Until now, they were not used to assess hip joint range of motion. Our study aimed to check the validity of IMU in assessing a hip range of motion and compare them to other measurement devices - universal goniometer and inclinometer. Twenty participants completed three hip movements (flexion in standing and prone internal and external rotation) on both hips. Two testers independently assessed each movement with a goniometer, digital inclinometer, and IMU at different time points. To assess the agreement of active hip ROM between devices, Intraclass Correlation Coefficient (ICC) and Bland-Altman analysis were used. Furthermore, inter-rater and intra-rater reliability were also assessed by using ICC and Bland-Altman analysis. Limits of agreement (LOA) were calculated using Bland-Altman plots. IMU showed good to excellent validity compared with the goniometer and digital inclinometer for all tested movements with ICCs ranging from 0.87-0.99 and LOAs <9°. Intra-rater reliability was good-to-excellent for all tested movements for all devices, with ICCs ranging from 0.87 to 0.99 and LOAs < 7°. Inter-rater reliability was lower and comparable for all measurement methods: moderate flexion (ICC: 0.58-0.59), LOAs <22,4 and poor for both rotations (ICC:-0.33-0.04), and LOAs < 7.8°). The present study shows that a single inertial measurement unit (RSQ Motion) could be successfully used to assess the active hip range of motion in healthy subjects with comparable to other methods accuracy.