bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Preoperative Duration of Symptoms on Patient Satisfaction, Outcomes and Complications After Lumbar Discectomy
Authors: Andersen Mikkel Ø , Andresen Andreas Killerich , Carreon Leah Y. , Pedersen Casper Friis 
Published: May 2023

Study Design.
Observational study.

Objective.
To identify associations between preoperative symptom duration and postoperative patient satisfaction.

Summary of Background Data.
Sciatica due to lumbar disk herniation (LDH) is a cause of disability and reduced quality life. Patients with severe pain and disability or were recovery is unacceptably slow, surgical intervention can be advised. For these patients, evidence-based recommendations on the timing of the surgical intervention needs to be established.

Methods.
All patients who underwent discectomy at a Spine Centre, due to radicular pain from June 2010 to May 2019 were included. Pre- and postoperative data including demographic data, smoking, consumption of pain medication, comorbidity, back and leg-pain, health-related quality of life as measured by EQ-5D, ODI, previous spine surgery, sick leave, and duration of back and leg-pain before surgery were utilized. The patients were divided into four groups based on their self-reported duration of leg-pain before surgery. To minimize baseline differences between the groups, propensity-score matching was employed in a 1:1 fashion, balancing the groups on all reported preoperative factors.

Results.
Of 1607 patients undergoing lumbar discectomy, four matched cohorts based on their self-reported duration of leg-pain before surgery were created. Each cohort consisted of 150 patients well balanced on preoperative factors. Overall 62.7% of the patients were satisfied with the surgical result ranging from 74.0% in the <3 months group to 48.7% in the >24 months group (P<0.000). The portion of patients achieving a minimum clinically important difference for EQ-5D decreased from 77.4% with early intervention to 55.6% in the late group (P<0.000). The number of surgical complications were not affected by the duration of preoperative leg-pain.

Conclusion.
We found significant difference in patient satisfaction and health-related quality of life in patients related to the duration of preoperative leg-pain due to symptomatic LDH.

Level of Evidence.
3.
Nonsteroidal Anti-inflammatory Drugs in the Acute Post-operative Period Are Associated With an Increased Incidence of Pseudarthrosis, Hardware Failure, and Revision Surgery Following Single-level Spinal Fusion
Authors: Lindsay Sarah E. , Philipp Travis , Ryu Won Hyung A. , Wright Christina , Yoo Jung 
Published: May 2023

Study Design.
Retrospective study.

Summary of Background Data.
Research has shown that the use of NSAIDs and COX-2 inhibitors increases the risk of pseudoarthrosis following spinal fusion surgery. Pseudoarthrosis can lead to complications such as chronic pain and the need for additional surgeries.

Objective.
The purpose of this study was to examine the relationship between NSAID and COX-2 inhibitor use and pseudarthrosis, hardware complications, and revision surgeries in patients undergoing posterior spinal instrumentation and fusion.

Methods.
We queried the PearlDiver database using CPT and ICD-10 codes to identify patients between the ages of 50 and 85 who underwent posterior spinal instrumentation between 2016 and 2019 and experienced pseudarthrosis, hardware failure, or revision surgery. Information regarding age, Charlson Comorbidity Index, tobacco use, osteoporosis, and obesity were extracted from the database along with COX-2 or NSAID use during the first 6-week post-surgery period. Logistic regression was used to identify associations while adjusting for confounders.

Results.
There were 178,758 patients included in the cohort; 9,586 experienced pseudarthrosis (5.36%), 2828 (1.58%) experienced hardware failure, and 10,457 (5.85%) patients underwent revision fusion surgery. Of these patients 23,602 (13.2%) filled NSAID and 5278 (2.95%) filled COX-2 prescriptions. A significantly higher proportion of patients using NSAIDs experienced pseudarthrosis, hardware failure, and revision surgery compared to patients not taking NSAIDs. COX-2 inhibitors were also associated with a significantly higher rate of pseudarthrosis, hardware failure, and revision surgery. Postoperative ketorolac use was not associated with these complications. Regression models demonstrated that both NSAIDs and COX-2 inhibitors were associated with statistically higher pseudarthrosis, hardware failure, and revision surgery rates.

Conclusions.
Both NSAID and COX-2 inhibitor use in the early post-surgical period may be associated with increased rates of pseudarthrosis, hardware failure, and revision surgery in patients undergoing posterior spinal instrumentation and fusion.
Trigeminocardiac Reflex: A Review and Key Implications to Dermatologic Surgery
Authors: Poe Emily , Bosley Rawn , Steele Robert , Chesnut Cameron 
Published: May 2023

BACKGROUND
The trigeminocardiac reflex is a common but underreported occurrence that can vary from benign to life threatening. This reflex can be elicited by placing direct pressure on the globe of the eye or from traction of the extraocular muscles, stimulating the trigeminal nerve.

OBJECTIVE
To provide a review of potential stimuli for the trigeminocardiac reflex within dermatologic surgery and to discuss management options for the treatment of the trigeminocardiac reflex.

METHODS
PubMed and Cochrane were used to identify articles and case reports that established scenarios in which the trigeminocardiac reflex was provoked and subsequently how the reflex was managed.

RESULTS
Within the field of dermatologic surgery, the trigeminocardiac reflex can be stimulated during biopsies, cryoablations, injections, laser treatments, Mohs micrographic surgery, and oculoplastic interventions, most often occurring in an office setting. The most common presentations include significant bradycardia, hypotension, gastric hypermobility, and lightheadedness. The most definitive treatment is cessation of the inciting stimulus, monitoring, and symptomatic management. Glycopyrrolate and atropine are common treatments for severe, intractable cases of the trigeminocardiac reflex.

CONCLUSION
The trigeminocardiac reflex, while underreported and underrepresented in dermatologic literature and dermatologic surgery settings, should be considered in the setting of bradycardia and hypotension during dermatologic procedures.
Association of Heart Failure Patients With and Without Sacubitril–Valsartan Use With Incident Cancer Risk
Authors: Hu Wei-Syun , Lin Cheng-Li 
Published: May 2023

Abstract
This study was to evaluate the association between heart failure (HF) patients with and without sacubitril–valsartan use with incident cancer risk. This study consisted of 18,072 patients receiving sacubitril–valsartan and 18,072 control group participants. In the Fine and Gray model, which extends the standard Cox proportional hazards regression model, we estimated the relative risk of developing cancer between the sacubitril–valsartan cohort and the non–sacubitril–valsartan cohort by using subhazard ratios (SHRs) and 95% confidence intervals (CIs). The incidence rates of cancer were 12.02 per 1000 person-years for the sacubitril–valsartan cohort and 23.31 per 1000 person-years for the non–sacubitril–valsartan cohort. Patients receiving sacubitril–valsartan had a significantly lower risk of developing cancer with an adjusted SHR of 0.60 (0.51, 0.71). Sacubitril–valsartan users were less to be associated with the development of cancer.
Optimal alpha-1 antitrypsin level cutoffs for genotype identification in patients with chronic liver disease
Authors: Prakash Sameer , Murali Arvind R. 
Published: May 2023

Background:
Controversy exists whether alpha-1 antitrypsin (A1AT) genotype testing should be performed as a first-line screening for A1AT heterozygous variants.

Methods:
We calculated the median and interquartile range of A1AT level for each genotype in 4378 patients with chronic liver disease and “miss rate” of MZ genotype identification at various cutoff levels.

Findings:
Significant overlap in A1AT level noted with Pi*MM, MZ, and MS variants. Miss rate of Pi*MZ at a cutoff level <100 was 29%, <110 was 18%, <120 was 8%, and <130 was 4%. We suggest simultaneous measurement of A1AT level and genotype in patients with chronic liver disease.
Telerehabilitation in pulmonary diseases
Authors: Cox Narelle S. , Khor Yet H. 
Published: May 2023

Purpose of review
Telerehabilitation is an alternative delivery model for pulmonary rehabilitation, an evidence-based nonpharmacological intervention, in people with chronic pulmonary disease. This review synthesizes current evidence regarding the telerehabilitation model for pulmonary rehabilitation with an emphasis on its potential and implementation challenges, as well as the clinical experiences from the COVID-19 pandemic.

Recent findings
Different models of telerehabilitation for delivering pulmonary rehabilitation exist. Current studies comparing telerehabilitation to centre-based pulmonary rehabilitation primarily focus on the evaluation in people with stable chronic obstructive pulmonary disease, which demonstrated equivalent improvements in exercise capacity, health-related quality of life and symptoms with improved programme completion rates. Although telerehabilitation may improve access to pulmonary rehabilitation by addressing travel burden, improving schedule flexibility and geographic disparity, there are challenges of ensuring satisfaction of healthcare interactions and delivering core components of initial patient assessment and exercise prescription remotely.

Summary
Further evidence is needed on the role of telerehabilitation in various chronic pulmonary diseases, as well as the effectiveness of different modalities in delivering telerehabilitation programmes. Economic and implementation evaluation of currently available and emerging models of telerehabilitation in delivering pulmonary rehabilitation are needed to ensure sustainable adoption into clinical management for people with chronic pulmonary disease.
Evidence-Based Medicine: Systemic Perioperative Antibiotic Prophylaxis for Prevention of Surgical-Site Infections in Plastic and Reconstructive Surgery
Authors: Klifto Kevin M. , Rydz Alexandria C. , Biswas Sonali , Hultman C. Scott , Erdmann Detlev , Phillips Brett T. 
Published: May 2023

Background:
After nearly a decade of new data, the Evidence-Based Consensus Conference Statement from the AAPS was updated for prophylactic systemic antibiotics to prevent surgical site infections (SSI). Pharmacotherapeutic concepts using antimicrobial stewardships were applied for clinical interpretation and management to optimize patient outcomes and minimize resistance.

Methods:
PRISMA, Cochrane, and GRADE certainty of evidence guidelines were implemented for the structure and synthesis of the review. PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases were systematically and independently searched for randomized controlled trials (RCTs). We included patients that had Plastic and Reconstructive Surgery and were treated with prophylactic systemic antibiotics administered perioperatively (preoperative, intraoperative, postoperative). Comparisons were made between active interventions and/or non-active interventions (placebo) at different prespecified durations to determine the development of an (SSI). Meta-analyses were performed.

Results:
We included 138 RCTs that met eligibility criteria. RCTs consisted of 18 Breast, 10 Cosmetic, 21 Hand/Peripheral Nerve, 61 Pediatric/Craniofacial, and 41 Reconstructive studies. We further examined bacterial data extracted from studies for patients that did and did not take prophylactic systemic antibiotics for prevention of SSI. Clinical recommendations were provided using Level-I evidence.

Conclusions:
Surgeons have long been overprescribing systemic antibiotic prophylaxis in Plastic and Reconstructive Surgery. Evidence supports antibiotic prophylaxis to prevent SSI for specific indications and durations. Prolonged antibiotic use has not been linked to reductions in SSIs and misuse may increase the bacterial diversity of infections. Greater efforts should focus on transitioning from practice-based medicine to pharmacotherapeutic evidence-based medicine.
Identification of anaerobic and aerobic bacteria that can be associated with DFI and their therapeutic in Elnaw teaching hospital
Authors: Ahmed Fathi Sharief , Ibrahim Hiba Siddig , Saeed Mohammed Ibrahim 
Published: May 2023

Diabetic foot infection (DFI) is one of the commonest diabetic complications, it's considered a major public health concern across the world, and its prevalence is rising, especially in developing countries. Globally, adults with diabetes accounted for 463 million in 2019 according to the International Diabetes Federation.Aim of this study was to identify the anaerobic and aerobic bacteria that causing and their therapeutic implications in Elnaw teaching hospital on diabetic clinics -Khartoum stateThe study showed that there was no infection by anaerobic organism while the most frequently isolated was gram negative rods (70%) and recorded (65%) on diabetic patients.S.aureus (30%) was the most isolated organism followed by E.coli (25%) in control group (non-diabetic), while the clinic room swabs revealed that Klebsiella.spp and S.aureus(20%) for each.Early diagnosis, optimal management and effective antibiotic therapy are necessary to prevent DFI and amputation.
Gaoshiqia sediminis gen. nov., sp. nov., isolated from coastal sediment
Authors: Yu Wen-Xing , Liang Qi-Yun , Xuan Xiao-Qi , Du Zong-Jun , Mu Da-Shuai 
Published: May 2023

A Gram-stain-negative, facultative anaerobic, motile, rod-shaped and orange bacterium, designated A06T, was obtained off the coast of Weihai, PR China. Cells were 0.4–0.5×0.6–1.0 µm in size. Strain A06T grew at 20–40 °C (optimum, 33 °C), at pH 6.0–8.0 (optimum, pH 6.5–7.0) and in the presence of 0–8 % NaCl (w/v) (optimum, 2 %). Cells were oxidase and catalase positive. Menaquinone-7 was detected as the major respiratory quinone. The dominant cellular fatty acids were identified as C15:0 2-OH, iso-C15:0, anteiso-C15:0 and iso-C15:1
ω6c. The DNA G+C content of strain A06T was 46.1 mol%. The polar lipids were phosphatidylethanolamine, one aminolipid, one glycolipid and three unidentified lipids. Phylogenetic analysis based on 16S rRNA gene sequences revealed that strain A06T is a member of the family

Prolixibacteraceae

and exhibited the highest sequence similarity to

Mangrovibacterium diazotrophicum

DSM 27148T (94.3 %). Based on its phylogenetic and phenotypic characteristics, strain A06T is considered to represent a novel genus in the family

Prolixibacteraceae

, for which the name Gaoshiqia gen. nov. is proposed. The type species is Gaoshiqia sediminis sp. nov., with type strain A06T (=KCTC 92029T=MCCC 1H00491T). The identification and acquisition of microbial species and genes in sediments will help broaden the understanding of microbial resources and lay a foundation for its application in biotechnology. Strain A06T uses an enrichment method, so the isolation of strain A06T is of great significance to the enrichment of marine microbial resources.
Distinguishing GPT-4-generated Radiology Abstracts from Original Abstracts: Performance of Blinded Human Observers and AI Content Detector
Authors: Ufuk Furkan , Peker Hakki , Sagtas Ergin , Yagci Ahmet Baki 
Published: May 2023

AbstractObjectiveTo determine GPT-4’s effectiveness in writing scientific radiology article abstracts and investigate human reviewers’ and AI Content detectors’ success in distinguishing these abstracts. Additionally, to determine the similarity scores of abstracts generated by GPT-4 to better understand its ability to create unique text.MethodsThe study collected 250 original articles published between 2021 and 2023 in five radiology journals. The articles were randomly selected, and their abstracts were generated by GPT-4 using a specific prompt. Three experienced academic radiologists independently evaluated the GPT-4 generated and original abstracts to distinguish them as original or generated by GPT-4. All abstracts were also uploaded to an AI Content Detector and plagiarism detector to calculate similarity scores. Statistical analysis was performed to determine discrimination performance and similarity scores.ResultsOut of 134 GPT-4 generated abstracts, average of 75 (56%) were detected by reviewers, and average of 50 (43%) original abstracts were falsely categorized as GPT-4 generated abstracts by reviewers. The sensitivity, specificity, accuracy, PPV, and NPV of observers in distinguishing GPT-4 written abstracts ranged from 51.5% to 55.6%, 56.1% to 70%, 54.8% to 60.8%, 41.2% to 76.7%, and 47% to 62.7%, respectively. No significant difference was observed between observers in discrimination performance.ConclusionGPT-4 can generate convincing scientific radiology article abstracts. However, human reviewers and AI Content detectors have difficulty in distinguishing GPT-4 generated abstracts from original ones.
Tissue contamination challenges the credibility of machine learning models in real world digital pathology
Authors: Irmakci Ismail , Nateghi Ramin , Zhou Rujoi , Ross Ashley E. , Yang Ximing J. , Cooper Lee A. D. , Goldstein Jeffery A. 
Published: May 2023

ABSTRACTMachine learning (ML) models are poised to transform surgical pathology practice. The most successful use attention mechanisms to examine whole slides, identify which areas of tissue are diagnostic, and use them to guide diagnosis. Tissue contaminants, such as floaters, represent unexpected tissue. While human pathologists are extensively trained to consider and detect tissue contaminants, we examined their impact on ML models.We trained 4 whole slide models. Three operate in placenta for 1) detection of decidual arteriopathy (DA), 2) estimation of gestational age (GA), and 3) classification of macroscopic placental lesions. We also developed a model to detect prostate cancer in needle biopsies. We designed experiments wherein patches of contaminant tissue are randomly sampled from known slides and digitally added to patient slides and measured model performance. We measured the proportion of attention given to contaminants and examined the impact of contaminants in T-distributed Stochastic Neighbor Embedding (tSNE) feature space.Every model showed performance degradation in response to one or more tissue contaminants. DA detection balanced accuracy decreased from 0.74 to 0.69 +/- 0.01 with addition of 1 patch of prostate tissue for every 100 patches of placenta (1% contaminant). Bladder, added at 10% contaminant raised the mean absolute error in estimating gestation age from 1.626 weeks to 2.371 +/ 0.003 weeks. Blood, incorporated into placental sections, induced false negative diagnoses of intervillous thrombi. Addition of bladder to prostate cancer needle biopsies induced false positives, a selection of high-attention patches, representing 0.033mm2, resulted in a 97% false positive rate when added to needle biopsies. Contaminant patches received attention at or above the rate of the average patch of patient tissue.Tissue contaminants induce errors in modern ML models. The high level of attention given to contaminants indicates a failure to encode biological phenomena. Practitioners should move to quantify and ameliorate this problem.
A Predictive Autoantibody Signature in Multiple Sclerosis
Authors: Zamecnik Colin R. , Sowa Gavin M. , Abdelhak Ahmed , Dandekar Ravi , Bair Rebecca D. , Wade Kristen J. , Bartley Christopher M. , Tubati Asritha , Gomez Refujia , Fouassier Camille , Gerungan Chloe , Alexander Jessica , Wapniarski Anne E. , Loudermilk Rita P. , Eggers Erica L. , Zorn Kelsey C. , Ananth Kirtana , Jabassini Nora , Mann Sabrina A. , Ragan Nicholas R. , Santaniello Adam , Henry Roland G. , Baranzini Sergio E. , Zamvil Scott S. , Bove Riley M. , Guo Chu-Yueh , Gelfand Jeffrey M. , Cuneo Richard , von Büdingen H.-Christian , Oksenberg Jorge R. , Cree Bruce AC , Hollenbach Jill A. , Green Ari J. , Hauser Stephen L. , Wallin Mitchell T. , DeRisi Joseph L. , Wilson Michael R. 
Published: May 2023

AbstractAlthough B cells are implicated in multiple sclerosis (MS) pathophysiology, a predictive or diagnostic autoantibody remains elusive. Here, the Department of Defense Serum Repository (DoDSR), a cohort of over 10 million individuals, was used to generate whole-proteome autoantibody profiles of hundreds of patients with MS (PwMS) years before and subsequently after MS onset. This analysis defines a unique cluster of PwMS that share an autoantibody signature against a common motif that has similarity with many human pathogens. These patients exhibit antibody reactivity years before developing MS symptoms and have higher levels of serum neurofilament light (sNfL) compared to other PwMS. Furthermore, this profile is preserved over time, providing molecular evidence for an immunologically active prodromal period years before clinical onset. This autoantibody reactivity was validated in samples from a separate incident MS cohort in both cerebrospinal fluid (CSF) and serum, where it is highly specific for patients eventually diagnosed with MS. This signature is a starting point for further immunological characterization of this MS patient subset and may be clinically useful as an antigen-specific biomarker for high-risk patients with clinically- or radiologically-isolated neuroinflammatory syndromes.
Genetically influenced tobacco and alcohol use behaviors impact erythroid trait variation
Authors: Shivakumar Shriya , Wilken Madison B , Tsao Victor , Bitarello Bárbara D. , Thom Christopher S 
Published: May 2023

AbstractGenome wide association studies (GWAS) have associated thousands of loci with quantitative human blood trait variation. Blood trait associated loci and related genes may regulate blood cell-intrinsic biological processes, or alternatively impact blood cell development and function via systemic factors and disease processes. Clinical observations linking behaviors like tobacco or alcohol use with altered blood traits can be subject to bias, and these trait relationships have not been systematically explored at the genetic level. Using a Mendelian randomization (MR) framework, we confirmed causal effects of smoking and drinking that were largely confined to the erythroid lineage. Using multivariable MR and causal mediation analyses, we confirmed that an increased genetic predisposition to smoke tobacco was associated with increased alcohol intake, indirectly decreasing red blood cell count and related erythroid traits. These findings demonstrate a novel role for genetically influenced behaviors in determining human blood traits, revealing opportunities to dissect related pathways and mechanisms that influence hematopoiesis.