bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multivariate Sequential Analytics for Cardiovascular Disease Event Prediction
Authors: Hsu William , Warren Jim , Riddle Patricia 
Published: December 2022

AbstractBackground Automated clinical decision support for risk assessment is a powerful tool in combating cardiovascular disease (CVD), enabling targeted early intervention that could avoid issues of overtreatment or undertreatment. However, current CVD risk prediction models use observations at baseline without explicitly representing patient history as a time series.Objective The aim of this study is to examine whether by explicitly modelling the temporal dimension of patient history event prediction may be improved.Methods This study investigates methods for multivariate sequential modelling with a particular emphasis on long short-term memory (LSTM) recurrent neural networks. Data from a CVD decision support tool is linked to routinely collected national datasets including pharmaceutical dispensing, hospitalization, laboratory test results, and deaths. The study uses a 2-year observation and a 5-year prediction window. Selected methods are applied to the linked dataset. The experiments performed focus on CVD event prediction. CVD death or hospitalization in a 5-year interval was predicted for patients with history of lipid-lowering therapy.Results The results of the experiments showed temporal models are valuable for CVD event prediction over a 5-year interval. This is especially the case for LSTM, which produced the best predictive performance among all models compared achieving AUROC of 0.801 and average precision of 0.425. The non-temporal model comparator ridge classifier (RC) trained using all quarterly data or by aggregating quarterly data (averaging time-varying features) was highly competitive achieving AUROC of 0.799 and average precision of 0.420 and AUROC of 0.800 and average precision of 0.421, respectively.Conclusion This study provides evidence that the use of deep temporal models particularly LSTM in clinical decision support for chronic disease would be advantageous with LSTM significantly improving on commonly used regression models such as logistic regression and Cox proportional hazards on the task of CVD event prediction.
The Association of Patient and Procedural Factors on Improved Outcomes: A Cluster Analysis on 853 Total Knee Arthroplasty Patients
Authors: Hampp Emily , Shi Sarah , Scholl Laura , Taylor Kelly B. , Marchand Kevin B. , Kahan Michael E. , Chen Zhongming , Marchand Robert C. , Mont Michael A. 
Published: December 2022

AbstractMany studies involving robotic-assisted total knee arthroplasty (RATKA) have demonstrated superiority regarding soft tissue balance and consistency with alignment target achievement. However, studies investigating whether RATKA is associated with improved patient outcomes regarding physical function and pain are also important. Therefore, we performed a cluster analysis and examined factors that contributed to differences in patient-reported outcome measures (PROMs). Specifically, we analyzed: (1) reduced WOMAC (rWOMAC) scores regarding pain and function; (2) usage of RATKA; (3) common patient comorbidities; as well as (4) patient demographic factors. The rWOMAC score is an abbreviated PROM that includes pain and physical function domains. This study analyzed 853 patients (95 conventional and 758 robotic-assisted) who had completed preoperative, 6-month, and 1-year postoperative rWOMAC surveys. Two clusters were constructed using rWOMAC pain and function scores at 1 year. Cluster 1 included 753 patients who had better outcomes at 1 year (mean rWOMAC pain = 0.9, mean rWOMAC function = 1.4), and cluster 2 included 100 patients who had worse outcomes at 1 year (mean rWOMAC pain = 7.7, mean rWOMAC function = 10.4). The clusters were compared to determine (1) how scores improved and (2) what patient characteristics were significantly different between clusters. Cluster 1 demonstrated greater improvement from preoperative to 6 months or 1 year (p = 0.0013 for pain preoperative to 6 months, p< 0.0001 for other measures) and 6 months to 1 year (p< 0.0001). Comparisons demonstrated that cluster 1 had older patients (67 vs. 65 years, p = 0.0479) who had lower body mass index or BMIs (31.8 vs. 33.9 kg/m2, p = 0.0042) and no significant differences in sex (p = 0.7849). Cluster 1 also had a significantly higher percentage of RATKA patients (90 vs. 79%, p< 0.001). Cluster analyses provided differentiating factors which were associated with improved postoperative rWOMAC pain and function scores at 1 year. Patients undergoing robotic-assisted TKA were associated with better rWOMAC pain and function scores from preoperative to 6 months and 1 year.
When Do We Perform Elective Total Knee Arthroplasty? General and Demographic-Specific Trends of Preoperative Pain and Function among 10,327 Patients
Authors: Soares Rui W. , Emara Ahmed K. , Orr Melissa , Klika Alison K. , Rullán Pedro J. , Pumo Thomas J. , Krebs Viktor E. , Molloy Robert M. , Piuzzi Nicolas S. 
Published: December 2022

AbstractTotal knee arthroplasty (TKA) is the sole disease-modifying intervention for end-stage osteoarthritis. However, the temporal trends and stratification of age and patient demographics of pain and function levels at which surgeons perform TKA have not been characterized. The present investigation aimed to analyze the temporal trends of preoperative pain and functional patient-reported outcomes measures (PROMs) over the past 5 years when stratifying patient demographics. A prospective cohort of all patients who underwent primary elective TKA between January 2016 and December 2020 at a North American integrated tertiary health care system was retrospectively reviewed. The primary outcome was quarterly baseline (preoperative) pain and function PROM values before primary elective TKA. Evaluated PROMs included Knee Osteoarthritis Outcome Score (KOOS)-pain and KOOS-physical function shortform (PS) for the 5-year study period and were stratified by patient demographics (age, sex, race, and body mass index [BMI]). A total of 10,327 patients were analyzed. Preoperative pain levels remained unchanged over the study period for patients in the 45- to 64-year category (P-trend = 0.922). Conversely, there was a significant improvement in preoperative pain levels in the 65+ years group. Sex-stratified trends between males and females did not demonstrate a significant change in pre-TKA baseline pain over the study period (P-trend = 0.347 and P-trend = 0.0744). Both white and black patients demonstrated consistent KOOS-pain levels throughout the study period (P-trend = 0.0855 and P-trend = 0.626). Only white patients demonstrated improving preoperative KOOS-PS (P-trend = 0.0001), while black and “other” patients demonstrated consistent lower preoperative functional levels throughout the study period (P-trend = 0.456 and P-trend = 0.871). All BMI categories demonstrated relatively consistent preoperative KOOS-pain and KOOS-PS except for overweight and obese patients who demonstrated progressive improvement in preoperative KOOS-PS over the study period. Patients and surgeons are electing to perform primary TKA at higher levels of preoperative function. Stratification by race showed black patients did not experience a similar trend of improving function and exhibited a consistently lower functional level versus white patients. This disparity is likely to be multifactorial but may indicate underlying barriers to TKA access.
Gastrointestinal Bleeding Caused by Atrioesophageal Fistula Secondary to Atrial Fibrillation Ablation
Authors: Tejerizo-García Laura , Meníndez-Ramos Ana , Villar-Lucas Carmen , Velasco-Guardado Antonio 
Published: December 2022

AbstractWe present the case of a patient with upper gastrointestinal bleeding caused by an atrioesophageal fistula secondary to radiofrequency ablation for the treatment of refractory atrial fibrillation. Atrioesophageal fistula is a rare but serious complication. The endoscopic treatment is not established in the case of vascular-enteric fistulas and is still a challenge for endoscopists, which requires in most cases a multidisciplinary approach.
Endoscopic Submucosal Dissection for Esophageal Squamous Cell High-grade Dysplasia in a Patient with Plummer Vinson Syndrome
Authors: Patil Gaurav , Vadgaonkar Amol , Dalal Ankit , Parekh Sanil , Shah Animesh , Haridas Poorva , Gupte Prajakta , Vora Sehajad , Maydeo Amit 
Published: December 2022

AbstractA 35-year female with Plummer Vinson syndrome (PVS) presented with a history of progressive dysphagia over six months, not responding to iron therapy and endoscopic dilatations. Her upper gastrointestinal endoscopy showed a post-cricoid web dilated using a Savary-Gilliard dilator. On NBI, a long segment circumferential lesion with abnormal microvascular architecture was noted in the mid esophagus. Biopsy showed high-grade dysplastic squamous epithelium. The patient underwent minimally invasive, circumferential endoscopic submucosal dissection (ESD) and received oral prednisolone to prevent stricture formation. Resected margins were free of dysplasia. At follow-up there was no evidence of recurrence or stricture formation. To our knowledge, this is the first case of PVS with squamous proliferation with high-grade dysplasia that was successfully treated with circumferential ESD. Screening endoscopy helps in the downstaging of early cancer, and timely intervention helps to treat this with a minimally invasive approach like ESD.
Lower Eyelid Management in Facial Paralysis
Authors: Jowett Nate 
Published: December 2022

AbstractCorrection of lower eyelid retraction is necessary to restore adequate blink in paralytic lagophthalmos. A plethora of static and dynamic surgical techniques have been described for lower eyelid repositioning. This article provides an approach to management of the paralytic lower eyelid, including a summary of existing techniques, case examples, and surgical technique for in-office lower eyelid suspension using a palmaris longus tendon graft.
Impact of the Location of Nasal Septal Deviation on the Nasal Airflow and Air Conditioning Characteristics
Authors: Na Yang , Kwon Kyung Won , Jang Yong Ju 
Published: December 2022

AbstractThe location of nasal septal deviation (NSD) directly impacts nasal physiology. The objective is to examine, using computational fluid dynamics (CFD), the difference in the airflow and air conditioning characteristics according to the location of NSD. Twenty patients with septal deviation were divided into two: 10 caudal septal deviation (CSD) and 10 posterior septal deviation (PSD). Physiological variables were compared and numerical models for nasal cavity were created with CT scans. Cases with CSD had distinctive features including restricted airflow partition, larger nasal resistance, and decreased surface heat flux in the more obstructed side (MOS), and lower humidity and air temperature in the lesser obstructed side (LOS). Physiological differences were observed according to the location of septal deviation, CSD cases exhibit significantly more asymmetric airflow characteristics and air conditioning capacity between LOS and MOS.
Emerging Health Disparities during the COVID-19 Pandemic
Authors: Mheidly Nour , Fares Nadine Y. , Fares Mohamad Y. , Fares Jawad 
Published: December 2022

AbstractThe coronavirus disease 2019 (COVID-19) pandemic has underscored social and racial discrimination in global health, showing that health equity is still a goal to be achieved. Understanding the impact of COVID-19 on public health potential is vital to present a fair opportunity for people of different backgrounds to be as healthy as possible. As such, this communication discusses the emerging health disparities in light of the COVID-19 pandemic and analyzes their implications. Original research, effective health communication, and promotion strategies ought to be leveraged to step closer toward national and international health equity.
COVID-19 and science advice on the ‘Grand Stage’: the metadata and linguistic choices in a scientific advisory groups’ meeting minutes
Authors: Baker Hannah , Concannon Shauna , Meller Matthias , Cohen Katie , Millington Alice , Ward Samuel , So Emily 
Published: December 2022

AbstractScience advice for governments attracted great scrutiny during the COVID-19 pandemic, with the public spotlight on institutions and individual experts—putting science advice on the ‘Grand Stage’. A review of the academic literature identified transparency, a plurality of expertise, the science and policy ‘boundary’, and consensus whilst addressing uncertainty as key themes. The Scientific Advisory Group for Emergencies (SAGE) has been the primary provider of coordinated scientific and technical advice to the UK Government during emergencies since 2009. Using the first 89 of SAGE’s meeting minutes (study period: 22 January 2020–13 May 2021), the ‘metadata’ and linguistic choices are analysed to identify how SAGE’s role and protocols are communicated. This includes understanding which experts were regularly taking part in discussions, the role of scientific experts in the science advisory system and their influence on policy choices, and the degree of consensus and uncertainty within this group of experts—all of which relate to the degree of transparency with the public. In addition, a temporal analysis examines how these practices, such as linguistically marking uncertainty, developed over the period studied. Linguistic markers indexing certainty and uncertainty increased, demonstrating a commitment to precise and accurate communication of the science, including ambiguities and the unknown. However, self-references to SAGE decreased over the period studied. The study highlights how linguistic analysis can be a useful approach for developing an understanding of science communication practices and scientific ambiguity. By considering how SAGE presents to those outside the process, the research calls attention to what remains ‘behind the scenes’ and consequently limits the public’s understanding of SAGE’s role in the COVID-19 response.
Hirschsprung Disease for the Practicing Surgical Pathologist
Authors: Matsukuma Karen , Gui Dorina , Saadai Payam 
Published: December 2022

AbstractObjectivesHirschsprung disease (HD) is a congenital condition defined by the absence of ganglion cells in the distal-most portion of the gastrointestinal tract. Biopsies and resections for HD can be adrenaline inducing for the general surgical pathologist because specimens are infrequent; HD is 1 of only a few neuroanatomic diseases that general surgical pathologists diagnose; numerous preanalytic factors (eg, biopsy adequacy, surgeon sampling protocol, processing artifacts) can affect histologic interpretation; and most importantly, the diagnosis has high stakes.MethodsWe provide a comprehensive overview of the background, relevant clinical procedures, and pathologic assessment of HD. Grossing and frozen section protocols, an algorithmic approach to diagnosis, and histologic pearls and pitfalls are also discussed.ResultsEvaluation and recognition of the features of HD have evolved significantly in the past 2 decades with the discovery of the value of calretinin immunohistochemistry in the late 2000s and the recent development of straightforward and reproducible histologic criteria for identification of the HD transition zone.ConclusionsThese advancements have substantially improved the pathologist’s ability to reliably evaluate for HD. Nonetheless, as with any high-stakes surgical pathology specimen, clear communication with the clinical team is essential.
God Became Human So That Humans Could Become Posthuman?
Authors: Parks Benjamin N 
Published: December 2022

AbstractTaking a cue from Teilhard de Chardin's Christologically inflected speculation, the key question in this issue is whether the project of transhumanism is compatible with Christianity and the Incarnation of Christ. Two articles focus on theological anthropology and the limits, if any, of human perfection in light of Christ's perfection. Another article examines the ontological claims about human nature in transhumanism and its incompatibility with a Christian ontology. The last two turn from more abstract concerns to consider how the use of technology can inhibit or help human moral and spiritual development.
Tirzepatide and prevention of chronic kidney disease
Authors: Bosch Catalina , Carriazo Sol , Soler María José , Ortiz Alberto , Fernandez-Fernandez Beatriz 
Published: December 2022

ABSTRACT
Tirzepatide is a twincretin recently approved to improve glycemic control in type 2 diabetes mellitus (T2DM). More specifically, tirzepatide is an agonist of both the glucose-dependent insulinotropic polypeptide (GIP) and the glucagon-like peptide-1 (GLP1) receptors. In recent clinical trials in persons with obesity or overweight with associated conditions, tirzepatide decreased body weight and other cardiorenal risk factors (blood pressure, low-density lipoprotein cholesterol, glycated hemoglobin and albuminuria). Moreover, in a post hoc analysis of the SURPASS-4 randomized clinical trial, tirzepatide decreased albuminuria and total estimated glomerular filtration rate (eGFR) slopes and nearly halved the risk of a pre-specified composite kidney endpoint (eGFR decline ≥40%, renal death, kidney failure or new-onset macroalbuminuria) in participants with T2DM and high cardiovascular risk when compared with insulin glargine. Similar to other kidney-protective drugs, tirzepatide, alone or combined with sodium-glucose co-transporter 2 inhibitors, caused an early dip in eGFR. Moreover, tirzepatide also decreased eGFR slopes in participants with eGFR &gt;60 mL/min/1.73 m2 or with normoalbuminuria. We now review the potential kidney health implications of tirzepatide, addressing its structure and function, relationship to current GLP1 receptor agonists, impact of recent results for the treatment and prevention of kidney disease, and expectations for the future.
Medical cannabis for pain management in patients undergoing chronic hemodialysis: randomized, double-blind, cross-over, feasibility study
Authors: Bassat Orit Kliuk Ben , Schechter Meir , Ashtamker Natalia , Yanuv Ilan , Rozenberg Aliza , Hirshberg Boaz , Grupper Ayelet , Vaisman Nachum , Brill Silviu , Mosenzon Ofri 
Published: December 2022

Abstract

Background
Chronic pain is prevalent but difficult to treat in patients undergoing hemodialysis (HD). Effective and safe analgesics are limited in this patient population. Our aim of this feasibility study was to evaluate the safety of sublingual oil based medical cannabis for pain management in patients undergoing HD.

Methods
In a prospective randomized double-blind cross-over design, patients undergoing HD with chronic pain were assigned to one of 3 arms: BOL-DP-o-04-WPE Whole-plant extract (WPE), BOL-DP-o-04 cannabinoid extraction (API) or placebo. WPE and API contained trans-delta9-‏tetrahydrocannabinol (THC) and Cannabidiol (CBD) in 1:6 ratio (1:6, THC: CBD). Patients were treated for 8 weeks, with subsequent 2-weeks wash out, followed by a cross-over to a different arm. The primary endpoint was safety.

Results
Eighteen patients were recruited and 15 were randomized. Three did not complete drug titration period due to adverse events (AEs) and one patient died during titration due to sepsis (WPE). Of those who completed at least one treatment period, 7 patients were in WPE arm, 5 in API and 9 in placebo. Most common AEs were sleepiness, which improved after dose reduction or patient adaptation. Most AEs were mild to moderate and resolved spontaneously. Serious AEs considered related to study drug included one episode of accidental overdose (WPE) leading to hallucinations. Liver enzymes were stable during cannabis treatment.

Conclusions
Short term medical cannabis use in patients treated with HD was generally well tolerated. The safety data supports further studies to assess the overall risk-benefit of a treatment paradigm utilizing medical cannabis to control pain in this patient population.
Efficacy and safety of P2Y12 inhibitor monotherapy after complex PCI: a collaborative systematic review and meta-analysis
Authors: Nicolas Johny , Dangas George , Chiarito Mauro , Pivato Carlo A , Spirito Alessandro , Cao Davide , Giustino Gennaro , Beerkens Frans , Camaj Anton , Vogel Birgit , Sartori Samantha , Yamamoto Ko , Kimura Takeshi , Kim Byeong-Keuk , Baber Usman , Mehran Roxana 
Published: December 2022

AbstractAimsComplex percutaneous coronary intervention (C-PCI) is associated with an increased risk of ischaemic and bleeding complications. We aimed to assess the safety and efficacy of a 1–3-month dual antiplatelet therapy (DAPT) regimen followed by P2Y12 inhibitor monotherapy after C-PCI.Methods and resultsWe conducted a meta-analysis of randomized trials comparing a 1–3-month DAPT regimen followed by P2Y12 inhibitor monotherapy with standard (≥12 months) DAPT in patients undergoing C-PCI. C-PCI criteria and the co-primary bleeding and ischaemic outcomes were determined according to each trial. Secondary outcomes included major bleeding, all-cause death, myocardial infarction, and stent thrombosis. All outcomes were evaluated at 12 months after randomization. We used hazard ratios (HRs) and 95% confidence interval (CI) as a metric of choice for treatment effects with random-effects models. Among 8299 screened studies, five randomized trials fulfilled the eligibility criteria. In the pooled population of 34 615 patients, 8818 (25.5%) underwent C-PCI. As compared with standard DAPT, a 1–3-month DAPT regimen followed by P2Y12 inhibitor monotherapy reduced the bleeding risk in C-PCI (HR:0.66, 95% CI:0.44–0.98) and non-C-PCI (HR:0.60, 95% CI:0.45–0.79) patients (P-interaction = 0.735). Furthermore, the risk for the primary ischaemic endpoint was similar in patients randomized to either arm, with significant effect modification by PCI complexity showing an enhanced benefit of 1–3-month DAPT in patients undergoing C-PCI (C-PCI, HR:0.69, 95% CI:0.48–1.00; non-C-PCI, HR:1.04, 95% CI:0.84–1.30; P-interaction = 0.028).ConclusionAs compared with a standard DAPT, a 1–3-month DAPT regimen followed by P2Y12 inhibitor monotherapy reduced bleeding complications after C-PCI without increasing the risk of ischaemic events.PROSPERO-registered (CRD42021259271)
Iron Minerals Influence the Assembly of Microbial Communities in a Basaltic Glacial Catchment
Authors: Dunham Eric C , Keller Lisa M , Skidmore Mark L , Mitchell K Rebecca , Boyd Eric S 
Published: December 2022

Abstract
The influence of mineralogy on the assembly of microbial communities in glacial environments has been difficult to assess due to complications in isolating mineralogy from other variables. Here we assess the abundance and composition of microbial communities that colonized defined minerals incubated for 12 months in two meltwater streams (N and S) emanating from Kaldalónsjökull (Kal), a basalt-hosted glacier in Iceland. The two streams shared similar meltwater geochemistry as well as bedrock and proglacial sediment elemental compositions. Yet genomic DNA and PCR-amplifiable 16S rRNA genes were detected only in Kal S. The amount of recoverable DNA was highest for hematite incubated in Kal S and the composition of 16S rRNA genes recovered from Kal S sediments was most like those recovered from hematite and magnetite, an effect driven largely by similarities in the relative abundance of the putative hydrogenotrophic iron reducer Rhodoferax. We suggest this is attributable to comminution and weathering reactions involving exposed iron silicate minerals that generate and release hydrogen and Fe(III) that can be coupled to support microbial metabolism in Kaldalónsjökull, and possibly other basaltic habitats. The low abundance of cells in Kal N could be due to low availability of Fe(III) or another substrate.