bluuebunny/crossref_metadata_2025_split huggingface dataset:
773 Inhalation Injury Severity Score on Admission Predicts Overall Survival in Burn ICU Patients
Authors: Flinn Ashley , Kemp Bohan Phillip , Rauschendorfer Catherine , Le Tuan , Rizzo Julie 
Published: May 2023

Abstract

Introduction
Inhalation injury (II) is identified in about one-third of burn patients and is associated with increased morbidity and mortality. There are multiple scoring systems to grade II; however, no study has compared ability of these scoring systems to predict outcomes of interest such as overall survival. We hypothesized that II grades from each scoring system assessed would correlate strongly and that higher scores (representing higher grade II) would be associated with worse overall survival (OS).

Methods
This was a prospective, observational study that included intubated burn patients who underwent fiberoptic bronchoscopy within 24 hours of admission. II was graded using three scoring systems: Abbreviated Injury Score (AIS), Inhalation Injury Severity Score (I-ISS), and Mucosal Score (MS). All scoring systems use a Likert-type scale (AIS: 0-4; I-ISS and MS: 0-3) with more severe IIs given higher scores. Agreement between scoring systems was assessed with Krippendorff’s Alpha (KA) &gt;0.80 indicating high reliability. Multivariable analyses were used to determine variables independently associated with OS. Significance was set at p&lt; 0.05.

Results
99 patients were included in the analysis. Median percent total body surface area burned and Injury Severity Score (ISS) were 19.5% (interquartile range [IQR] 9-39%) and 25 (13-34), respectively. At admission, median AIS, I-ISS, and MS scores were 2 (1-3) for all scoring systems. Patients who died had higher overall injury burden than those who survived (Table 1). Additionally, patients who died had similar median admission AIS and MS scores, but higher I-ISS scores than those who survived (Table 1). There was strong correlation between the grade of II at admission using the three scoring systems (KA=0.85). On regression analysis, the only II scoring system independently associated with overall survival was I-ISS (score 3 compared to scores 1-2: OR 13.16, 95% CI 1.65-105.07; p=0.02).

Conclusions
Grade of II on admission correlated well between scoring systems, but only I-ISS on admission was independently associated with OS. Progression of injury after initial assessment may contribute to the poor correlation between admission score and overall survival for IIs graded with AIS and MS. Repeated assessment and re-grading II after initial resuscitation may more accurately identify patients at increased risk for mortality.

Applicability of Research to Practice
Grading II is common practice in Burn ICUs. This study demonstrates good reliability between the three most common II scoring systems utilized and that I-ISS on admission can be used to predict risk of mortality, which is useful prognostic information for both burn care providers as well as patients and their families.
A hierarchical modeling approach to predict the distribution and density of Sierra Nevada Red Fox (Vulpes vulpes necator)
Authors: Green David S , Martin Marie E , Matthews Sean M , Akins Jocelyn R , Carlson Jennifer , Figura Pete , Hatfield Brian E , Perrine John D , Quinn Cate B , Sacks Benjamin N , Stephenson Thomas R , Stock Sarah L , Tucker Jody M 
Published: May 2023

Abstract
Carnivores play critical roles in ecosystems, yet many species are declining worldwide. The Sierra Nevada Red Fox (Vulpes vulpes necator; SNRF) is a rare and endangered subspecies of red fox limited to upper montane forests, subalpine, and alpine environments of California and Oregon, United States. Having experienced significant distribution contractions and population declines in the last century, the subspecies is listed as at-risk by relevant federal and state agencies. Updated information on its contemporary distribution and density is needed to guide and evaluate conservation and management actions. We combined 12 years (2009–2020) of detection and nondetection data collected throughout California and Oregon to model the potential distribution and density of SNRFs throughout their historical and contemporary ranges. We used an integrated species distribution and density modeling approach, which predicted SNRF density in sampled locations based on observed relationships between environmental covariates and detection frequencies, and then projected those predictions to unsampled locations based on the estimated correlations with environmental covariates. This approach provided predictions that serve as density estimates in sampled regions and projections in unsampled areas. Our model predicted a density of 1.06 (95% credible interval = 0.8–1.36) foxes per 100 km2 distributed throughout 22,926 km2 in three distinct regions of California and Oregon–Sierra Nevada, Lassen Peak, and Oregon Cascades. SNRFs were most likely to be found in areas with low minimum temperatures and high snow water equivalent. Our results provide a contemporary baseline to inform the development and evaluation of conservation and management actions, and guide future survey efforts.
Smart Iterative Analysis Tool for the Size Distribution of Spherical Nanoparticles
Authors: Guckel Jannik , Görke Marion , Garnweitner Georg , Park Daesung 
Published: May 2023

Abstract
The size of nanoparticles is a critical parameter with regard to their performance. Therefore, precise measurement of the size distribution is often required. While electron microscopy (EM) is a useful tool to image large numbers of particles at once, manual analysis of individual particles in EM images is a time-consuming and labor-intensive task. Therefore, reliable automatic detection methods have long been desired. This paper introduces a novel automatic particle analysis software package based on the circular Hough transform (CHT). Our software package includes novel features to enhance precise particle analysis capabilities. We applied the CHT algorithm in an iterative workflow, which ensures optimal detection over wide radius intervals, to deal with overlapping particles. In addition, smart intensity criteria were implemented to resolve common difficult cases that lead to false particle detection. Implementing these criteria enabled an effective and precise analysis by minimizing detection of false particles. Overall, our approach showed reliable particle analysis results by resolving common types of particle overlaps and deformation with only negligible errors.
Competition on presynaptic resources enhances the discrimination of interfering memories
Authors: Fung Chi Chung Alan , Fukai Tomoki 
Published: May 2023

Abstract
Evidence suggests that hippocampal adult neurogenesis is critical for discriminating considerably interfering memories. During adult neurogenesis, synaptic competition modifies the weights of synaptic connections nonlocally across neurons, thus providing a different form of unsupervised learning from Hebb’s local plasticity rule. However, how synaptic competition achieves separating similar memories largely remains unknown. Here, we aim to link synaptic competition with such pattern separation. In synaptic competition, adult-born neurons are integrated into the existing neuronal pool by competing with mature neurons for synaptic connections from the entorhinal cortex. We show that synaptic competition and neuronal maturation play distinct roles in separating interfering memory patterns. Furthermore, we demonstrate that a feedforward neural network trained by a competition-based learning rule can outperform a multilayer perceptron trained by the backpropagation algorithm when only a small number of samples are available. Our results unveil the functional implications and potential applications of synaptic competition in neural computation.
Treatment of axial spondyloarthritis with biologic and targeted synthetic DMARDs: British Society for Rheumatology guideline scope
Authors: Zhao Sizheng Steven , Harrison Stephanie R , Chan Antoni , Clarke Nick , Davis Charlotte , Eddison Joe , Gregory William J , Jones Gareth T , Marzo-Ortega Helena , Murphy Daniel J , Sandhu Virinderjit , Sengupta Raj , Siebert Stefan , Thompson Ben , Webb Dale , Yates Max , Gaffney Karl 
Published: May 2023

Abstract
Pharmacological management has advanced considerably since the 2015 British Society for Rheumatology axial spondyloarthritis (axSpA) guideline to incorporate new classes of biologic DMARDs (bDMARDs, including biosimilars), targeted synthetic DMARDs (tsDMARDs) and treatment strategies such as drug tapering. The aim of this guideline is to provide an evidence-based update on pharmacological management of adults with axSpA (including AS and non-radiographic axSpA) using b/tsDMARDs. This guideline is aimed at health-care professionals in the UK who care directly for people with axSpA, including rheumatologists, rheumatology specialist nurses, allied health professionals, rheumatology specialty trainees and pharmacists; people living with axSpA; and other stakeholders, such as patient organizations and charities.
Impact of Corporate Subsidies on Borrowing Costs of Local Governments: Evidence from Municipal Bonds
Authors: Chava Sudheer , Malakar Baridhi , Singh Manpreet 
Published: May 2023

Abstract
We analyze the impact of $40 billion of corporate subsidies given by US local governments on their borrowing costs. We find that winning counties experience a 15.2 basis points (bps) increase in bond yield spread as compared to the losing counties. The increase in yields is higher (18–26 bps) when the subsidy deal is associated with a lower jobs multiplier or when the winning county has a lower debt capacity. However, a high jobs multiplier does not seem to alleviate the debt capacity constraints of local governments. Our results highlight the potential costs of corporate subsidies for local governments.
Vitamin D Status Is Associated With Immune Checkpoint Inhibitor Efficacy and Immune-related Adverse Event Severity in Lung Cancer Patients: A Prospective Cohort Study
Authors: You Wen , Liu Xinyu , Tang Hao , Lu Bo , Zhou Qingyang , Li Yue , Chen Minjiang , Zhao Jing , Xu Yan , Wang Mengzhao , Qian Jiaming , Tan Bei 
Published: May 2023

Vitamin D (VitD) is potentially immunomodulatory, so here we aimed to explore the relationships between serum VitD levels, immune checkpoint inhibitor (ICI) efficacy, and immune-related adverse events (irAEs). Serum 25-hydroxyvitamin D [25(OH)D] levels were quantified before and after ICI treatment in prospectively enrolled patients with advanced lung cancers. Of 77 enrolled patients, 29 developed 42 irAEs. Baseline 25(OH)D levels of partial response (PRs) patients were significantly higher than non-PR patients (19.39±7.16 vs. 16.28±5.99 ng/mL, P=0.04). The area under the curve of 25(OH)D >15.73 ng/mL to identify PR was 0.63 (95% CI, 0.51–0.76, P=0.047), and baseline 25(OH)D levels >15.73 ng/mL (odds ratio: 2.93, 95% CI, 1.10–7.79, P=0.03) and prior targeted therapy (odds ratio: 0.30, 95% CI, 0.10–0.92, P=0.04) were independent predictors of PR as best efficacy by multivariable logistic regression. With respect to irAEs, baseline 25(OH)D levels were higher in grade 1 irAE patients than in grade 2/3/4 irAE patients (20.07±8.64 vs. 15.22±2.30 ng/mL, P=0.02). However, the area under the curve was only 0.56 (95% CI, 0.42–0.70, P=0.39) for a baseline 25(OH)D of 20.99 ng/mL for predicting irAE occurrence. There was a direct monotonic relationship and U-shaped relationship between baseline 25(OH)D levels and ICI efficacy and irAE occurrence, respectively. Overall survival was significantly different between VitD sufficient, insufficient, and deficient patients (log-rank P=0.01), which remained after adjustment in Cox proportional hazards regression models. Baseline 25(OH)D levels seem to be associated with ICI efficacy and prognosis, it might be helpful to assess the baseline VitD status, and supplementation with VitD might bring some benefit to enhance ICI efficacy and reduce moderate-severe irAEs.
Cartilage Tissue Engineering for Nasal Alar and Auricular Reconstruction: A Critical Review of the Literature and Implications for Practice in Dermatologic Surgery
Authors: Himeles Jaclyn R. , Ratner Désirée 
Published: May 2023

BACKGROUND
Reconstructing defects requiring replacement of nasal or auricular cartilage after Mohs micrographic surgery can at times be challenging. While autologous cartilage grafting is considered the mainstay for repair, it may be limited by cartilage quality/quantity, donor site availability/morbidity, and surgical complications. Tissue-engineered cartilage has recently shown promise for repairing properly selected facial defects.

OBJECTIVE
To (1) provide a comprehensive overview of the literature on the use of tissue-engineered cartilage for nasal alar and auricular defects, and (2) discuss this technology's advantages and future implications for dermatologic surgery.

MATERIALS AND METHODS
A literature search was performed using PubMed/MEDLINE and Google Scholar databases. Studies discussing nasal alar or auricular cartilage tissue engineering were included.

RESULTS
Twenty-seven studies were included. Using minimal donor tissue, tissue-engineered cartilage can create patient-specific, three-dimensional constructs that are biomechanically and histologically similar to human cartilage. The constructs maintain their shape and structural integrity after implantation into animal and human models.

CONCLUSION
Tissue-engineered cartilage may be able to replace native cartilage in reconstructing nasal alar and auricular defects given its ability to overcome several limitations of autologous cartilage grafting. Although further research is necessary, dermatologic surgeons should be aware of this innovative technique and its future implications.
Using Google Trends for Evaluation of Public Interest in Female Genital Aesthetic Procedures
Authors: Ergul Aslıhan , Caglar Ufuk , Yuksel Bahar , Ozgor Faruk 
Published: May 2023

BACKGROUND
Genital aesthetics is a treatment that is increasing in popularity.

OBJECTIVE
To clarify public interest in genital aesthetic procedures among women between 2004 and 2022.

MATERIALS AND METHODS
In total, 12 terms including labiaplasty, vaginoplasty, perineoplasty, laser vaginal rejuvenation, labia cosmetic surgery, vaginal cosmetic surgery, vaginal tightening, genital bleaching, hymenoplasty, clitoroplasty, labiaplasty cost, and vaginal laser were reviewed. To evaluate public attention to female genital aesthetic procedures between January 1, 2004, and January 1, 2022, three 6-year periods were compared about the abovementioned 12 terms.

RESULTS
Public attention to labiaplasty and hymenoplasty was significantly higher in 2010 to 2016 than in 2004 to 2010 and 2016 to 2022. Vaginoplasty, laser vaginal rejuvenation, and labia cosmetic surgery terms were researched significantly less in 2010 to 2016 and 2016 to 2022 than in 2004 to 2010 (p = .001). Public interest in vaginal tightening and labiaplasty cost significantly increased from 2004 to 2022. Finally, the term vaginal laser was researched most between 2016 and 2022 (p = .001).

CONCLUSION
This study found that public attention to labiaplasty cost and vaginal tightening continuously increased between 2004 and 2022. In addition, public interest in the term vaginal laser significantly increased after 2016. By contrast, vaginoplasty, laser vaginal rejuvenation, and labia cosmetic surgery terms were researched significantly less after 2010.
Antiviral therapy substantially reduces HCC risk in patients with chronic hepatitis B infection in the indeterminate phase
Authors: Huang Daniel Q. , Tran Andrew , Yeh Ming-Lun , Yasuda Satoshi , Tsai Pei-Chien , Huang Chung-Feng , Dai Chia Yen , Ogawa Eiichi , Ishigami Masatoshi , Ito Takanori , Kozuka Ritsuzo , Enomoto Masaru , Suzuki Takanori , Yoshimaru Yoko , Preda Carmen M. , Marin Raluca I. , Sandra Irina , Tran Sally , Quek Sabrina X.Z. , Khine Htet Htet Toe Wai , Itokawa Norio , Atsukawa Masanori , Uojima Haruki , Watanabe Tsunamasa , Takahashi Hirokazu , Inoue Kaori , Maeda Mayumi , Hoang Joseph K. , Trinh Lindsey , Barnett Scott , Cheung Ramsey , Lim Seng Gee , Trinh Huy N. , Chuang Wan-Long , Tanaka Yasuhito , Toyoda Hidenori , Yu Ming-Lung , Nguyen Mindie H. 
Published: May 2023

Background and Aims:
HCC risk in chronic hepatitis B (CHB) is higher in the indeterminate phase compared with the inactive phase. However, it is unclear if antiviral therapy reduces HCC risk in this population. We aimed to evaluate the association between antiviral therapy and HCC risk in the indeterminate phase.

Approach and Results:
We analyzed 855 adult (59% male), treatment-naïve patients with CHB infection without advanced fibrosis in the indeterminate phase at 14 centers (USA, Europe, and Asia). Inverse probability of treatment weighting (IPTW) was used to balance the treated (n = 405) and untreated (n = 450) groups. The primary outcome was HCC development. The mean age was 46±13 years, the median alanine transaminase was 38 (interquartile range, 24–52) U/L, the mean HBV DNA was 4.5±2.1 log10 IU/mL, and 20% were HBeAg positive. The 2 groups were similar after IPTW. After IPTW (n = 819), the 5-, 10-, and 15-year cumulative HCC incidence was 3%, 4%, and 9% among treated patients (n = 394) versus 3%, 15%, and 19%, among untreated patients (n = 425), respectively (p = 0.02), with consistent findings in subgroup analyses for age >35 years, males, HBeAg positive, HBV DNA>1000 IU/mL, and alanine transaminase<upper limit of normal. In multivariable Cox proportional hazards analysis adjusted for age, sex, HBeAg, HBV DNA, alanine transaminase, diabetes, and platelets, antiviral therapy remained an independent predictor of reduced HCC risk (adjusted HR = 0.3, 95% CI: 0.1–0.6, p = 0.001).

Conclusions:
Antiviral therapy reduces HCC risk by 70% among patients with indeterminate-phase CHB. These data have important implications for the potential expansion of CHB treatment criteria.
Tacrolimus for immunosuppression in patients with non-infectious intermediate, posterior, or panuveitides
Authors: Jabs Douglas A. , Thorne Jennifer E. , Wilkins Carl S. , Habbu Karishma A. , Berkenstock Meghan K. , Burkholder Bryn M. , Chaon Benjamin C. , Deobhakta Avnish 
Published: May 2023

ABSTRACT

Purpose:
To evaluate the effectiveness of tacrolimus in patients with non-infectious intermediate, posterior, or panuveitis needing a two-immunosuppressive-agent regimen.

Methods:
Design: Retrospective cohort study. Setting: Two tertiary-care uveitis practices at academic medical centers. Patient population: 32 patients with non-infectious intermediate, posterior, or pan-uveitides in whom single agent immunosuppression was inadequate to effect successful corticosteroid sparing. Intervention: tacrolimus, added as the second immunosuppressive agent. Main outcome measure: successful corticosteroid sparing, defined as inactive uveitis at a dose of prednisone <7.5 mg/day.

Results:
Active uveitis was present in 65.6% of patients at initiation of tacrolimus, and the median time to inactive uveitis was 1.5 months (95% confidence interval [CI] 1.2, 4.08). The median time to successful corticosteroid sparing was 3.9 months (95% CI 1.41, 6.67), and by 6 months of follow-up successful corticosteroid sparing was achieved in 75% of patients. Tacrolimus was discontinued for side effects in 5 patients, 3 for tremor and 2 for hyperglycemia. All side effects were reversible with tacrolimus discontinuation.

Conclusions:
Tacrolimus appears to have efficacy as a second immunosuppressive agent in two-immunosuppressive drug regimens, when a single agent does not permit successful corticosteroid sparing. Side effects were reversible with tacrolimus discontinuation.
New exploration of ions and fatty acids in hydrophilic acrylic intraocular lens calcification
Authors: Liu Xiaomin , Dai Yuhai , Huang Yusen , Zheng Simeng , Wei Yufen , Teng Yingli , Wu Xiaoming 
Published: May 2023

Purpose:
To conduct a new exploration and analysis of the ion and fatty acid levels of a medium in which calcified hydrophilic intraocular lenses (IOLs) are present.

Setting:
Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China.

Design:
Retrospective, laboratory observational case series.

Methods:
11 patients (11 eyes) who had implantation of foldable hydrophilic acrylic posterior IOLs were found to have opacification of the IOLs. In vivo and in vitro analyses included the evaluation of patients' clinical characteristics, microscopy, histological staining, energy dispersive X-ray spectroscopy (EDS), the ion level of the aqueous humor (AH) and preserving fluid (PF), and the fatty acid content of AH.

Results:
10 of 11 cases were female with unilateral opacification, and 7 cases had both-eye cataract surgery, including 1 first eye and 6 second eyes with IOL opacification. 4 types of similar serial numbers were counted. The analysis of AH showed that the concentrations of phosphorus and silicon were elevated but that of calcium decreased, and an increased level of silicon was detected in 3 random PFs. The palmitic (C16:0) and stearic (C18:0) fatty acids were higher than the others in the AH. The EDS confirmed that the IOL surface deposits were composed of calcium, phosphate, and a small amount of silicon.

Conclusions:
More silicon and higher C16:0 and C18:0 were found in the AH of patients with IOL opacification. New ideas and avenues have been proposed in the study of IOL opacification.
Lower urinary tract symptoms as an independent predictor of aortic regurgitation in women with cardiac symptoms
Authors: Fan Yu-Hua , Cheng Wei-Ming , Huang Yen-Chang 
Published: May 2023

Background:
Very few studies have focused on the correlation between structural heart disease and lower urinary tract symptoms. In this study, we applied echocardiography to explore the correlation between lower urinary tract symptoms and structural heart disease.

Methods:
In this single-center, prospective, cross-sectional study, we enrolled adult women undergoing echocardiography for suspected cardiac abnormalities causing cardiac symptoms between February 1, 2021, and March 31, 2021. All participants completed a questionnaire regarding demographic information and lower urinary tract symptoms, which were assessed according to the International Prostate Symptom Score.

Results:
A total of 165 women aged 69.96 ± 10.20 years were enrolled. The prevalence of moderate-to-severe aortic regurgitation in patients with moderate-to-severe lower urinary tract symptoms was significantly higher than that in patients with mild lower urinary tract symptoms (33.3% vs 13.6%, p = 0.008). The prevalence of other echocardiographic abnormalities was not associated with severity of lower urinary tract symptoms. Multivariable logistic regression analyses revealed that moderate-to-severe lower urinary tract symptoms predicted moderate-to-severe aortic regurgitation (p = 0.007; odds ratio: 3.560; 95% confidence interval: 1.409-8.993). Furthermore, the International Prostate Symptom Score storage subscore (p = 0.001; odds ratio: 1.285; 95% confidence interval: 1.111–1.486), except the voiding subscore, was an independent predictor of moderate-to-severe aortic regurgitation.

Conclusion:
Moderate-to-severe lower urinary tract symptoms, especially storage symptoms, are an independent predictor of the co-existence of moderate-to-severe aortic regurgitation in women with cardiac symptoms. Early cardiological referral of patients with moderate-to-severe lower urinary tract symptoms and cardiac symptoms may improve their general health.