bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of Progressive Collapse in Osteoporotic Vertebral Fractures Using Conventional Statistics and Machine Learning
Authors: Cho Sung Tan , Shin Dong-Eun , Kim Jin-Woo , Yoon Siyeoung , II Lee Hyun , Lee Soonchul 
Published: May 2023

Study Design.
Retrospective cohort study.

Objective.
The objective of this study was to determine prognostic factors for the progression of osteoporotic vertebral fracture (OVF) following conservative treatment.

Summary of Background Data.
Few studies have evaluated factors associated with progressive collapse (PC) of OVFs. Furthermore, machine learning has not been applied in this context.

Materials and Methods.
The study involved the PC and non-PC groups based on a compression rate of 15%. Clinical data, fracture site, OVF shape, Cobb angle, and anterior wedge angle of the fractured vertebra were evaluated. The presence of intravertebral cleft and the type of bone marrow signal change were analyzed using magnetic resonance imaging. Multivariate logistic regression analysis was performed to identify prognostic factors. In machine learning methods, decision tree and random forest models were used.

Results.
There were no significant differences in clinical data between the groups. The proportion of fracture shape (P<0.001) and bone marrow signal change (P=0.01) were significantly different between the groups. Moderate wedge shape was frequently observed in the non-PC group (31.7%), whereas the normative shape was most common in the PC group (54.7%). The Cobb angle and anterior wedge angle at diagnosis of OVFs were higher in the non-PC group (13.2±10.9, P=0.001; 14.3±6.6, P<0.001) than in the PC group (10.3±11.8, 10.4±5.5). The bone marrow signal change at the superior aspect of the vertebra was more frequently found in the PC group (42.5%) than in the non-PC group (34.9%). Machine learning revealed that vertebral shape at initial diagnosis was a main predictor of progressive vertebral collapse.

Conclusion.
The initial shape of the vertebra and bone edema pattern on magnetic resonance imaging appear to be useful prognostic factors for progressive collapse in osteoporotic vertebral fractures.
Racial and Health Insurance Differences in Patient Outcomes after Surgical Treatment for Cauda Equina syndrome
Authors: Corso Katherine , Joo Peter , Ruppenkamp Jill , Holy Chantal E. , Coplan Paul , Mesfin Addisu 
Published: May 2023

Study Design.
Retrospective database evaluation

Objectives.
To study the association between race, healthcare insurance, mortality, postoperative visits, and reoperation within a hospital setting in patients with cauda equina syndrome (CES) undergoing surgical intervention.

Summary of Background Data.
CES can lead to permanent neurological deficits if diagnosis is missed or delayed. Evidence of racial or insurance disparities in CES is sparse.

Methods.
Patients with CES undergoing surgery from 2000-2021 were identified from the Premier Healthcare Database. Six-month postoperative visits and 12-month reoperations within the hospital were compared by race (i.e., White, Black or Other [Asian, Hispanic, or other]) and insurance (i.e., Commercial, Medicaid, Medicare, or Other) using Cox proportional hazard regressions; covariates were used in the regression models to control for confounding. Likelihood ratio tests were used to compare model fit.

Results.
Among 25,024 patients, most were White (76.3%), followed by Other race (15.4% [ 8.8% Asian, 7.3% Hispanic, and 83.9% other]) and Black (8.3%). Models with race and insurance combined provided the best fit for estimating risk of visits to any setting of care and reoperations. White Medicaid patients had the strongest association with higher risk of 6-month visits to any setting of care versus White patients with commercial insurance (HR: 1.36 (1.26,1.47)). Being Black with Medicare had a strong association with higher risk of 12-month reoperations versus White commercial patients (HR: 1.43 (1.10,1.85)). Having Medicaid versus Commercial insurance was strongly associated with higher risk of complication-related (HR: 1.36 (1.21, 1.52)) and ER visits (HR: 2.26 (2.02,2.51)). Medicaid had significantly higher risk of mortality compared to Commercial patients (HR: 3.19 (1.41,7.20)).

Conclusions.
Visits to any setting of care, complication-related, ER visits, reoperation, or mortality within the hospital setting after CES surgical treatment varied by race and insurance. Insurance type had a stronger association with the outcomes than race.

Level of Evidence.
III
Staging System Performance and Clinical Outcomes for Cutaneous Squamous Cell Carcinoma of the Ear: A Single-Center Retrospective Study
Authors: Navarrete-Dechent Cristian , Mori Shoko , Connolly Karen , Shah Kalee , Dusza Stephen W. , Rossi Anthony M. , Lee Erica H. , Busam Klaus J. , Nehal Kishwer S. 
Published: May 2023

BACKGROUND
Cutaneous squamous cell carcinoma (cSCC) of the ear is associated with poor outcomes. No studies have evaluated current staging system performance in this specific location.

OBJECTIVE
Describe clinicopathologic characteristics and outcomes of ear cSCC and evaluate the performance of current staging systems.

METHODS
Retrospective study including cases diagnosed and treated at a cancer center from January 2000 to December 2014. Demographic, clinical, and pathologic data were collected from clinical records. Biopsy slides were rereviewed and patients were staged according to the American Joint Committee on Cancer (AJCC) seventh, eighth, and Brigham Women's Hospital (BWH) staging.

RESULTS
Of 125 patients, the mean age at diagnosis was 71.9 years (SD 12.5), with most men (89.6%, n = 112). Median follow-up was 22.3 months. Local recurrence and survival risk factors were similar to cSCC outside the ear. The Akaike's Information Criterion (AIC) estimates showed that the BWH system better predicted outcomes than the AJCC seventh, and the AJCC eighth, with AIC values of 189.9, 270.5, and 274.1, respectively. Limitations of the study include retrospective design, single center study, and no control group.

CONCLUSION
Current staging systems perform well at stratifying risk in ear cSCC.
Scoping Review of Hydrogel Therapies in the Treatment of Diabetic Chronic Wounds
Authors: Sharma Ayushi D. , Jarman Evan H. , Fox Paige M. 
Published: May 2023

Background:
Chronic diabetic wounds are a significant issue that can be treated with topical hydrogel therapies. The aim of this study was to review the different compositions of hydrogel that have been developed and analyze their clinical relevance in the treatment of chronic diabetic wounds.

Methods:
We conducted a scoping review in which twelve articles were selected for review after applying relevant inclusion and exclusion criteria using a two-reviewer strategy. Data extracted from these studies was used to answer the following research question: What is the composition of hydrogels used to treat chronic diabetic wounds and how effective are they?

Results:
We analyzed five randomized controlled trials, two retrospective studies, three reviews, and two case reports. Hydrogel compositions discussed included mesenchymal stem cell sheets, carbomer, collagen, and alginate hydrogels, as well as hydrogels embedded with platelet-derived growth factor. Synthetic hydrogels, largely composed of carbomers, were found to have high levels of evidence supporting their wound healing properties, though few articles described their routine use in a clinical setting. Collagen hydrogels dominate the present-day hydrogel market in the clinical treatment of chronic diabetic wounds. The augmentation of hydrogels with therapeutic biomaterials is a new field of hydrogel research, with studies demonstrating promising early in vitro and in vivo animal studies demonstrating promising early results for in vitro and in vivo animal investigations.

Conclusions:
Current research supports hydrogels as a promising topical therapy in the treatment of chronic diabetic wounds. Augmenting Food & Drug Administration-approved hydrogels with therapeutic substances remains an interesting early area of investigation.
Level of Eye Care Among Eye Care Providers Themselves
Authors: Sherry Emily G. , Lewis Kathryn E. , Azeez Leen S. , Mojica Daniel , Kheirkhah Ahmad 
Published: May 2023

Objectives:
To assess the prevalence of eye disease and frequency of eye examinations among eye care providers themselves.

Methods:
In this cross-sectional study, an anonymous questionnaire was used to evaluate occurrence of eye disease and frequency of eye examinations among eye care providers including the clinicians (ophthalmologists, ophthalmology residents, and optometrists) as well as the support staff (ophthalmic technicians and eye clinic administrative staff).

Results:
The survey response rate was 98 of 173 (56.6%) including 50 ophthalmic technicians, 27 ophthalmologists, 7 ophthalmology residents, 6 optometrists, and 8 eye clinic administrative staff members. The most common reported ocular condition was dry eye disease (36.7%). Myopia and hyperopia were present in 60 (61.2%) and 13 (13.3%), respectively. Myopia was significantly more prevalent among the clinicians (75.0%) than in the support staff (51.7%, P=0.02). The most recent eye examination was within the past year in 42 (42.9%), 1 to 2 years in 28 (28.6%), 3 to 5 years in 14 (14.3%), and over 5 years in 10 (10.2%). Four (4.1%) had never had an eye examination before. The number of eye examinations received was significantly higher in the support staff compared with the clinicians for the past one year (0.86±0.74 vs 0.43±0.59, respectively, P=0.003) and the past five years (2.81±2.08 vs 1.75±1.78, respectively, P=0.01).

Conclusions:
Dry eye disease and myopia are common among eye care providers. A significant portion of eye care providers do not have regular eye examinations for themselves.
A 5-Year Review of Coinfections in Acanthamoeba keratitis From South India
Authors: Rammohan Ram , Baidwal Shaffie , Venkatapathy Narendran , Lorenzo-Morales Jacob , Raghavan Anita 
Published: May 2023

Purpose:
To ascertain the frequency of coinfections in Acanthamoeba keratitis, the nature of copathogens involved, and to analyze the implications in the context of current research on amoebic interactions.

Methods:
A retrospective case review from a Tertiary Care Eye Hospital in South India. Smear and culture data for coinfections in Acanthamoeba corneal ulcers were collected from records over a 5-year period. The significance and relevance of our findings in the light of current research on Acanthamoeba interactions were analyzed.

Results:
Eighty-five cases of culture-positive Acanthamoeba keratitis were identified over a 5-year period (43 of them being coinfections). Fusarium was most commonly identified species, followed by Aspergillus and the dematiaceous fungi. Pseudomonas spp was the commonest bacterial isolate.

Conclusion:
Coinfections with Acanthamoeba are common at our centre, and account for 50% of Acanthamoeba keratitis. The diverse nature of the organisms involved in coinfections suggest that such amoebic interactions with other organisms are probably more widespread than recognized. To the best of our knowledge, this is the first documentation from a long-term study of pathogen diversity in Acanthamoeba coinfections. It is possible that Acanthamoeba itself may be virulence enhanced and secondary to the co-organism, breaching the ocular surface defenses in an already compromised cornea. However, observations from the existing literature on Acanthamoeba interactions with bacteria and certain fungi are based mainly on nonocular or nonclinical isolates. It would be illuminating if such studies are performed on Acanthamoeba and coinfectors from corneal ulcers—to ascertain whether interactions are endosymbiotic or virulence enhanced through amoebic passage.
Recommendations for terminology and the identification of neuropathic pain in people with spine-related leg pain. Outcomes from the NeuPSIG working group
Authors: Schmid Annina B. , Tampin Brigitte , Baron Ralf , Finnerup Nanna B. , Hansson Per , Hietaharju Aki , Konstantinou Kika , Lin Chung-Wei Christine , Markman John , Price Christine , Smith Blair H. , Slater Helen 
Published: May 2023

Abstract
Pain radiating from the spine into the leg is commonly referred to as “sciatica,” “Sciatica” may include various conditions such as radicular pain or painful radiculopathy. It may be associated with significant consequences for the person living with the condition, imposing a reduced quality of life and substantial direct and indirect costs. The main challenges associated with a diagnosis of “sciatica” include those related to the inconsistent use of terminology for the diagnostic labels and the identification of neuropathic pain. These challenges hinder collective clinical and scientific understanding regarding these conditions. In this position paper, we describe the outcome of a working group commissioned by the Neuropathic Pain Special Interest Group (NeuPSIG) of the International Association for the Study of Pain (IASP) which was tasked with the following objectives: (1) to revise the use of terminology for classifying spine-related leg pain and (2) to propose a way forward on the identification of neuropathic pain in the context of spine-related leg pain. The panel recommended discouraging the term “sciatica” for use in clinical practice and research without further specification of what it entails. The term “spine-related leg pain” is proposed as an umbrella term to include the case definitions of somatic referred pain and radicular pain with and without radiculopathy. The panel proposed an adaptation of the neuropathic pain grading system in the context of spine-related leg pain to facilitate the identification of neuropathic pain and initiation of specific management in this patient population.
How to make the electronic health record your friend
Authors: Lee Jennifer , Patel Shama , Taxter Alysha 
Published: May 2023

Purpose of review
The electronic health record (EHR) has become ubiquitous among healthcare providers. It has revolutionized how we care for patients allowing for instant access to records, improved order entry, and improved patient outcomes. However, it has also been implicated as a source of stress, burnout, and workplace dissatisfaction among its users. The article provides an overview of factors associated with burnout focusing on the pediatrician and pediatric subspecialist workflows and will summarize practical tips based on clinical informatics principles for addressing these factors.

Recent findings
Several metrics related to EHR including training, efficiency and lack of usability have been cited as factors associated with burnout. Organizational, personal, and interpersonal factors as well as work culture are more associated with burnout than EHR use.

Summary
Organizational strategies to address burnout include first monitoring metrics including physician satisfaction and wellbeing, incorporating mindfulness and teamwork, and decreasing stress from the EHR by providing training, standardized workflows, and efficiency tools. All clinicians should feel empowered to customize workflows and seek organizational help for improving EHR use.
Title page.docx
Authors: Khamanarong Kimaporn , Amnatbuddee Siriruthai , Sae-Jung Surachai , Mahiphot Jarupon , Chaisiwamongkol Kowit 
Published: May 2023

<p> </p>
<p><strong>Key Findings:</strong> The aortic bifurcation can be predetermined using the prediction model. The left common iliac artery (LCIA) was longer, more vertical, and closer to the lumbar spine than the right common iliac artery (RCIA). The formula of the diameter of the aorta, RCIA and LCIA is file:///C:/Users/ortho/AppData/Local/Temp/msohtmlclip1/01/clip_image002.png (D, diameter; a, aorta; r, RCIA; l, LCIA). The formula for the angle of aortic bifurcation is file:///C:/Users/ortho/AppData/Local/Temp/msohtmlclip1/01/clip_image004.png. Surgeons can use these formulas to predict and solve the problem when dealing with these arteries.</p>
Patient Safety Education in the Undergraduate Dental Curriculum: Evidence Base and Current Practice in UK Dental Schools
Authors: Dargue Anna , French Kathryn , Fyfe Eithne 
Published: May 2023

Objectives
International consensus advises patient safety education (PSE) for dental undergraduates. A previous systematic review found no articles describing PSE in dentistry. This article aimed to review the evidence base for, and the current practice of, PSE in UK dental schools.

Methods
Literature search and surveys were sent via email to all 16 UK dental schools.

Results
Six articles describing PSE interventions were found: 2 small-scale studies for dental students and 4 interprofessional studies. Patient safety education is effective for undergraduate dental students with significant improvement in knowledge and interest. Interprofessional studies reported improved teamwork skills and more positive attitudes toward interprofessional working.
The 2018 and 2021 surveys had response rates of 56% and 100%, respectively. An increase in integrated formal PSE and assessment in UK dental schools is demonstrated. No barriers to implementation were reported. Forty-six percent of schools deliver interprofessional PSE, 38% deliver human factors, 81% teach communication, 94% teach professionalism, and 31% of schools have a patient safety (PS) champion.

Conclusions
Limited published literature on PSE in dentistry is available. However, the lack of published articles does not mean that PS is not being taught, as many UK dental schools were found to have formal PSE integrated and assessed within their curriculum. Further development is needed in terms of appointing PS champions for leadership and human factors training. Patient safety must form a part of an undergraduate student’s core values.
Association of Housing Status with Types of Operations and Post-Operative Healthcare Utilization
Authors: Decker Hannah C. , Kanzaria Hemal K. , Evans Jennifer , Pierce Logan , Wick Elizabeth C. 
Published: May 2023

Objective:
To analyze the association between housing status and the nature of surgical care provided, healthcare utilization, and operational outcomes.

Background:
Unhoused patients have worse outcomes and higher healthcare utilization across multiple clinical domains. However, little has been published describing the burden of surgical disease in unhoused patients.

Methods:
We conducted a retrospective cohort study of 111,267 operations from 2013-2022 with housing status documented at a single, tertiary care institution. We conducted unadjusted bivariate and multivariate analyses adjusting for sociodemographic and clinical characteristics.

Results:
998 operations (0.8%) were performed for unhoused patients, with a higher proportion of emergent operations than housed patients (56% vs. 22%). In unadjusted analysis, unhoused patients had longer length of stay (18.7 d vs. 8.7 d), higher readmissions (9.5% vs. 7.5%), higher in-hospital (2.9% vs. 1.8%) and one-year mortality (10.1% vs. 8.2%), more in-hospital re-operations (34.6% vs. 15.9%), and higher utilization of social work, physical therapy, and occupational therapy services. After adjusting for age, gender, comorbidities, insurance status, and indication for operation, as well as stratifying by emergent versus elective operation, these differences went away for emergent operations.

Conclusions:
In this retrospective cohort analysis, unhoused patients more commonly underwent emergent operations than their housed counterparts and had more complex hospitalizations on an unadjusted basis that largely disappeared after adjustment for patient and operative characteristics. These findings suggest issues with upstream access to surgical care that, when unaddressed, may predispose this vulnerable population to more complex hospitalizations and worse longer-term outcomes.
Management of Moderate-to-highly Exuding Leg Ulcers with Superabsorbent Wound Dressings versus Foams Dressings in Spanish Settings: An Early-stage Cost-effectiveness and Budget-impact Analyses
Authors: Veličković Vladica , Torra i Bou Joan-Enric , Cegri Francisco , Llatas Federico Palomar 
Published: May 2023

AbstractThis study endeavors to ascertain the cost-effectiveness and utility of employing SAPs in comparison to foam dressings for the management of moderate-to-highly exuding leg ulcers within Spanish healthcare contexts. Furthermore, it aims to conduct an associated budget-impact analysis for the Spanish National Health Service, thereby considering the financial implications relevant to the implementation of these interventions.The economic evaluation and budget impact model adhered to Spanish and international guidelines. with reporting quality of economic evaluation assessed using the CHEERS checklist and the Drummond checklist for ensuring adequate conduct. The evidence synthesis process involved identifying and appraising the most recent and highest level of evidence research. The identified data inputs were adjusted in accordance with recommended practices for research quality and incorporated into a mathematical model that accounted for the natural history of chronic leg ulcers.Based on the results of this preliminary health economic analysis, utilizing SAP wound dressings instead of foam dressings in patients with moderate-to-highly exuding leg ulcers within the Spanish Health Care System is projected to yield favorable outcomes. The analysis predicts an enhanced healing rate of 2.33%, an incremental improvement in health-related quality of life (HRQoL) by 0.129 quality-adjusted life weeks (QALWs), and a total direct cost reduction of €570 per patient over a six-month period. Extrapolating these findings to a scenario where all leg ulcers are treated with SAPs rather than foam dressings, the Spanish NHS could potentially achieve an annual cost savings of €43.46 million.These clinical outcomes align with current treatment guidelines that advocate for superabsorbent wound dressings as the primary choice for managing moderate-to-highly exuding leg ulcers.
Isolation and nitrogen removal characteristics of a novel aerobic denitrifying strainAchromobacter xylosoxidansGR7397
Authors: Gu Ailu , Li Yunlong , Yao Wei , Zhang Anqi , Chai Zimin , Zheng Maosheng 
Published: May 2023

AbstractAerobic denitrifying bacteria have the potential for engineering applications due to the efficient nitrate removal capacity from wastewater. In this study, a novel aerobic denitrifying strain was isolated and identified asAchromobacter xylosoxidansGR7397 from the activated sludge of a wastewater treatment plant, which possessed efficient nitrate removal capacity. Moreover, the denitrification capacity and properties of the strain were investigated in the presence of nitrate as the only nitrogen source. Five denitrification reductases encoding genes were harbored by strain GR7397 determined by electrophoretic analysis of PCR amplification products, consisting of periplasmic nitrate reductase (NAP), nitrate reductase (NAR), nitrite reductase (NIR), nitrous oxide reductase (NOS), and nitric oxide reductase (NOR), demonstrating that the strain has a complete denitrification metabolic pathway. The optimum denitrifying condition of strain GR7397 included sodium acetate adopted as the electron donor, COD/TN ratio at 4, pH at 8, temperature at 30°C, under which condition, the nitrate removal rate reached 14.86 mg · L-1· h-1that theconcentration decreased from 93.90 mg/L to 4.73 mg/L within 6 h with no accumulation of nitrite. In addition, the bioaugmentation performance of strain GR7397 to enhance nitrate removal was evaluated to be effective and stabilized in a sequential batch reactor (SBR). The removal rate ofwas the highest during each cycle with a range of 15.48-28.56 mg·L-1·h-1in the SBR with inoculating 30% of the strain concentrate. The current research demonstrated that strain GR7397 has significant potential for application in enhancing nitrogen removal in wastewater treatment.