bluuebunny/crossref_metadata_2025_split huggingface dataset:
A retrospective cohort study of differential attainment, COVID and Chaos: taking the difference out of a terrible trinity
Authors: James Osian P. , Mellor Katie , Luton Oliver , Robinson David , Walsh Leona , Hemington-Gorse Sarah , Egan Richard J. , Lewis Wyn G. 
Published: May 2023

Background:
This study aimed to evaluate Core Surgical Training (CST) differential attainment related to COVID-19, gender, and ethnicity. The hypothesis was that COVID-19 adversely influenced CST outcomes.

Methods:
A retrospective cohort study of 271 anonymised CST records was undertaken at a UK Statutory Education Body. Primary effect measures were: Annual Review of Competency Progression Outcome (ARCPO), Membership of the Royal College of Surgeons (MRCS) examination pass, and Higher Surgical Training National Training Number (NTN) appointment. Data was collected prospectively at ARCP and analysed with non-parametric statistical methods in SPSS®.

Results:
CSTs numbering 138 completed training pre- and 133 peri-COVID. ARCPO 1,2&6 were 71.9% pre- vs. 74.4% peri-COVID (P=0.844). MRCS pass rates were 69.6% pre- versus 71.1% peri-COVID (P=0.968) but NTN appointment rates diminished (pre- 47.4% vs. peri- 36.9%, P=0.324); none of the above varied by gender or ethnicity. Multivariable analyses by three models revealed: ARCPO was associated with gender (m: f 1:0.87, OR 0.53, P=0.043) and CST theme (Plastics vs. General OR 16.82, P=0.007); MRCS pass with theme (Plastics vs. General OR 8.97, P=0.004); NTN with the Improving Surgical Training run-through program (OR 5.00, P<0.001). Program retention improved peri-COVID (OR 0.20, P=0.014) with pan University Hospital rotations performing better than Mixed or District General-only rotations (OR 6.63, P=0.018).

Conclusion:
Differential attainment profiles varied 17-fold, yet COVID-19 did not influence ARCPO or MRCS pass rates. NTN appointment fell by one fifth peri-COVID, but overall training outcome metrics remained robust despite the existential threat.
Analysis of prognostic factors and establishment of prognostic model for primary mediastinal germ cell tumors: a case controlled study
Authors: Leng Changsen , Cui Yingying , Mai Zihang , Chen Rui , Yuan Jianye , Wang Kexi , Wen Jing , Fu Jianhua , Liu Qianwen 
Published: May 2023

Background:
The overall prognosis of primary mediastinal germ cell tumors (PMGCTs) is poor and the associated prognostic factors are not fully understood. Our goal was to investigate the prognostic factors of PMGCTs and to develop a validated prognostic prediction model.

Materials and Methods:
A total of 114 PMGCTs with specific pathological types were included in this study. Clinicopathological characteristics of non-seminomatous PMGCTs and mediastinal seminomas were compared using Chi-square or Fisher’s exact test. Independent prognostic factors of non-seminomatous PMGCTs screened using the univariate and multivariate Cox regression analysis were then used to generate a nomogram. The predictive performance of the nomogram was evaluated using the concordance index, decision curve and the area under the receiver operating characteristic curve (AUC) and validated by bootstrap resampling. The Kaplan-Meier curves of independent prognostic factors were analyzed.

Results:
This study included 71 cases of non-seminomatous PMGCTs and 43 cases of mediastinal seminomas. The 3-year overall survival rates for non-seminomatous PMGCTs and mediastinal seminomas patients were 54.5% and 97.4%, respectively. The overall survival prognostic nomogram for non-seminomatous PMGCTs was established by integrating independent prognostic factors, including the Moran-Suster stage, white blood cell, hemoglobin, and platelet-lymphocyte ratio. The nomogram demonstrated good performance with a concordance index of 0.760 and the 1-year and 3-year AUC values of 0.821 and 0.833, respectively. These values were better than those of the Moran-Suster stage system. The bootstrap validation had an AUC of 0.820 (0.724–0.915) and showed a well-fitting calibration curve. Besides, patients with mediastinal seminomas showed favorable clinical outcomes and all the 9 patients received neoadjuvant therapy and postoperative surgery achieved pathological complete response.

Conclusion:
A nomogram based on staging and blood routine examination results was established to accurately and consistently predict the prognosis of patients with non-seminomatous PMGCTs.
White blood cell count combined with LDL cholesterol as a valuable biomarker for coronary artery disease
Authors: Liu Zhiyun , Yan Yongjin , Gu Shunzhong , Lu Yang , He Hao , Ding Hongsheng 
Published: May 2023

Objective
Inflammation and dyslipidemia are important pathophysiological bases for the occurrence and development of coronary artery disease (CAD); however, combination of these two entities is rarely used to diagnose CAD and its severity. Our aim was to determine whether the combination of white blood cell count (WBCC) and LDL cholesterol (LDL-C) can serve as a biomarker for CAD.

Methods
We enrolled 518 registered patients and measured serum WBCC and LDL-C on admission. The clinical data were collected, and the Gensini score was used to assess the severity of coronary atherosclerosis.

Results
WBCC and LDL-C levels in the CAD group were higher than in the control group (P < 0.01). Spearman correlation analysis showed that WBCC combined with LDL-C was positively correlated with the Gensini score (r = 0.708, P < 0.01) and the number of coronary artery lesions (r = 0.721, P < 0.01). Receiver operating characteristic curve analysis revealed that WBCC combined with LDL-C had a higher predictive value for CAD, severe CAD, and three-vessel CAD [area under the curve (AUC) values were 0.909, 0.867, and 0.811, respectively] than WBCC (AUC values were 0.814, 0.753, 0.716, respectively) and LDL-C (AUC values were 0.779, 0.806, 0.715, respectively) alone (all P < 0.05).

Conclusion
WBCC combined with LDL-C is correlated with the degree of coronary artery lesion. It had high sensitivity and specificity in the diagnosis of CAD, severe CAD, and three-vessel CAD.
Impact of Direct-acting Antivirals on Hepatocellular Carcinoma and Mortality Among Medicaid Beneficiaries With Hepatitis C
Authors: Jiang Xinyi , Song Hyun Jin , Chang Ching-Yuan , Wilson Debbie L. , Lo-Ciganic Wei-Hsuan , Park Haesuk 
Published: May 2023

Objective:
The effects of all-oral direct-acting antivirals (DAAs) on hepatocellular carcinoma (HCC) and liver-related and all-cause mortality were assessed among Medicaid beneficiaries with hepatitis C virus (HCV).

Subjects:
This cohort study used 2013–2019 Arizona Medicaid data from beneficiaries with HCV aged 18–64 years.

Methods:
Risks of HCC and liver-related and all-cause mortality were compared between patients with or without DAA treatment, stratified by liver disease severity, using inverse probability of treatment weighted multivariable Cox proportional hazards regression models.

Results:
Of 29,289 patients, 13.3% received DAAs. Among patients with compensated cirrhosis (CC), DAA treatment was associated with a lower risk of HCC [adjusted hazard ratio (aHR), 0.57; 95% CI, 0.37–0.88] compared with untreated patients although this association was not statistically significant for patients without cirrhosis or with decompensated cirrhosis (DCC). Compared with untreated patients, DAA treatment was associated with decreased risk of liver-related mortality for patients without cirrhosis (aHR: 0.02; 95% CI: 0.004–0.11), with CC (aHR: 0.09; 95% CI: 0.06–0.13), or with DCC (aHR: 0.20; 95% CI: 0.14–0.27). Similarly, compared with untreated patients, DAA treatment was associated with lower all-cause mortality for patients without cirrhosis (aHR: 0.10; 95% CI: 0.08–0.14), with CC (aHR: 0.07; 95% CI: 0.05–0.10), or with DCC (aHR: 0.15; 95% CI: 0.11–0.20).

Conclusions:
Among Arizona Medicaid beneficiaries with HCV, DAA treatment was associated with decreased risk of HCC for patients with CC but not for patients without cirrhosis or with DCC. However, DAA treatment was associated with decreased risk of liver-related and all-cause mortality.
Soft Tissue Filler for Secondary Nasal Deformities
Authors: Rohrich Rod J. , Novak Matthew , Cason Roger , Trost Jeffrey 
Published: May 2023

Summary:
One common indication for soft tissue filler in the nose, or “liquid rhinoplasty,” is the temporary treatment of secondary nasal deformities after rhinoplasty. When applied in this manner, there are multiple aspects of the patient evaluation, timing with respect to the prior rhinoplasty and planned revision, and procedural principles and steps that must be carefully considered. Ultimately, when appropriately implemented, the procedure can help avoid unnecessary patient angst and displeasure preceding a formal revision rhinoplasty. The following article reviews the principles and application of soft tissue filler for secondary nasal deformities.
Graft Survival and Acute Rejection in Cross-Sex Solid Organ Transplants: A Systematic Review and Meta-Analysis to Inform Vascularized Composite Allotransplantation Practice
Authors: Barrow Brooke , Diep Gustave K. , Berman Zoe P. , Boczar Daniel , Lee Olive , Salinero Lauren , Howard Rachel , Trilles Jorge , Rodriguez Colon Ricardo , Rodriguez Eduardo D. 
Published: May 2023

Background:
Out of nearly 90 hand and 50 face transplant recipients, only 5 have received a cross-sex vascularized composite allotransplantation (CS-VCA) to date. CS-VCA has the potential to expand the donor pool and has been shown to be anatomically feasible and ethically acceptable in previous cadaveric and survey studies. However, there is a lack of immunologic data. This study aims to evaluate the immunologic feasibility of CS-VCA through analysis of the solid organ transplant (SOT) literature, given the paucity of CS-VCA data. We hypothesize the rates of acute rejection (AR) and graft survival (GS) in CS vs. same-sex (SS)-SOT to be similar.

Methods:
A systematic review and meta-analysis of the PubMed, EMBASE, and Cochrane databases were performed in accordance with PRISMA guidelines. Studies comparing GS or AR episodes in CS- and SS- adult kidney (KT) and liver transplant (LT) populations were included. Odds ratios were calculated for overall GS and AR for all SS and CS transplant combinations (male-to-female (MTF), female-to-male (FTM) and overall).

Results:
A total of 693 articles were initially identified and 25 studies were included in the meta-analysis. No significant difference in GS was noted between SS-KT vs. CS-KT (OR 1.04 [1.00, 1.07]; P=0.07), SS-KT vs. MTF-KT (OR 0.97 [0.90, 1.04]; P=0.41) and SS-LT vs. MTF-LT (OR 0.95 [0.91, 1.00]; P=0.05). No significant difference in AR was noted between SS-KT vs. MTF-KT (OR 0.99 [0.96, 1.02]; P=0.57), SS-LT vs. CS-LT (OR 0.78 [0.53, 1.16]; P=0.22) and SS-LT vs. FTM-LT (OR 1.03 [0.95, 1.12]; P=0.47). For the remaining pairings, GS was significantly increased and AR was significantly decreased in the SS transplants.

Conclusions:
Published data suggest immunologic feasibility of CS-KT and CS-LT, with the potential for generalization to the VCA population. In theory, CS-VCA could expand the potential donor pool, leading to decreased wait times for recipients.
Safely Implementing a Program of Pure Laparoscopic Donor Right Hepatectomy: The Experience From a Southeast Asian Center
Authors: Law Jia-Hao , Tan Chun Han Nigel , Tan Kah Hwee Jarrod , Gao Yujia , Pang Ning Qi , Bonney Glenn Kunnath , Iyer Shridhar Ganpathi , Soubrane Olivier , Kow Wei Chieh Alfred 
Published: May 2023

Background:
Laparoscopic donor right hepatectomy (LDRH) is a technically challenging procedure. There is increasing evidence demonstrating the safety of LDRH in high-volume expert centers. We report our center’s experience in implementing an LDRH program in a small- to medium-sized transplantation program.

Methods:
Our center systematically introduced a laparoscopic hepatectomy program in 2006. We started with minor wedge resections followed by major hepatectomies with increasing complexities. In 2017, we performed our first laparoscopic living donor left lateral sectionectomy. Since 2018, we have performed 8 cases of right lobe living donor hepatectomy (laparoscopy-assisted: 4 and pure laparoscopic: 4).

Results:
The median operative time was 418 (298–540) min, whereas the median blood loss was 300 (150–900) mL. Two patients (25%) had surgical drain placed intraoperatively. The median length of stay was 5 (3–8) d, and the median time to return to work was 55 (24–90) d. None of the donors sustained any long-term morbidity or mortality.

Conclusions:
Small- to medium-sized transplant programs face unique challenges in adopting LDRH. Progressive introduction of complex laparoscopic surgery, a mature living donor liver transplantation program, appropriate patient selection, and the invitation of an expert to proctor the LDRH are necessary to ensure success.
Differential effect of panic on the DNA methylation of the glucocorticoid receptor gene exon 1F in chronic subjective tinnitus with distress
Authors: Fransen Erik , Cassiers Laura L.M. , Chubar Viktoriia , Gilles Annick , Van Rompaey Vincent , van der Werf Ilse , Van de Heyning Paul , Claes Stephan , Sabbe Bernard , Kooy Frank R. , Van Den Eede Filip 
Published: May 2023

Objective
Tinnitus can be regarded as a chronic stressor, leading to dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis. There is important comorbidity with anxiety, particularly panic, potentially associated with differences in HPA axis functioning and methylation patterns of HPA axis-related genes. This study examines DNA methylation of the glucocorticoid receptor gene (NR3C1) exon 1F in adults with chronic subjective tinnitus and the possible differential effect of panic.

Methods
In a well characterized tinnitus sample (n = 22, half of which had co-occurring panic attacks), and unaffected controls (n = 31) methylation patterns of the CpG sites were determined using pyrosequencing and compared between groups through linear mixed models. Gene expression was determined using quantitative PCR on mRNA.

Results
Comparing the combined tinnitus groups to the control group, no DNA methylation differences were observed; however, the tinnitus group with panic attacks showed consistently higher mean methylation values across all CpGs compared to the tinnitus-only and the control group (P = 0.03 following Tukey correction), which became even more pronounced when accounting for childhood trauma (P = 0.012). Moreover, a significant positive correlation was found between methylation of the CpG7 site and the Beck Anxiety Inventory total score (P = 0.001) in the total population. NR3C1-1F expression was not significantly different between the three groups.

Conclusion
Panic is associated with higher DNA methylation of the NR3C1 exon 1F in adults with chronic subjective tinnitus, consistent with the reduced negative glucocorticoid feedback and HPA axis hyperfunction observed in individuals with panic disorder.
Integrated multi-omics analysis identifies epigenetic alteration related to neurodegeneration development in post-traumatic stress disorder patients
Authors: Bolouki Ayeh , Rahimi Moosa , Azarpira Negar , Baghban Fatemeh 
Published: May 2023

Introduction
Post-traumatic stress disorder (PTSD), is associated with an elevated risk of neurodegenerative disorders, but the molecular mechanism was not wholly identified. Aberrant methylation status and miRNA expression pattern have been identified to be associated with PTSD, but their complex regulatory networks remain largely unexplored.

Methods
The purpose of this study was to identify the key genes/pathways related to neurodegenerative disorder development in PTSD by evaluating epigenetic regulatory signature (DNA methylation and miRNA) using an integrative bioinformatic analysis. We integrated DNA expression array data with miRNA and DNA methylation array data - obtained from the GEO database- to evaluate the epigenetic regulatory mechanisms.

Results
Our results indicated that target genes of dysregulated miRNAs were significantly related to several neurodegenerative diseases. Several dysregulated genes in the neurodegeneration pathways interacted with some members of the miR-17 and miR-15/107 families. Our analysis indicated that APP/CaN/NFATs signaling pathway was dysregulated in the peripheral blood samples of PTSD. Besides, the DNMT3a and KMT2D genes, as the encoding DNA and histone methyltransferase enzymes, were upregulated, and DNA methylation and miRNA regulators were proposed as critical molecular mechanisms. Our study found dysregulation of circadian rhythm as the CLOCK gene was upregulated and hypomethylated at TSS1500 CpGs S_shores and was also a target of several dysregulated miRNAs.

Conclusion
In conclusion, we found evidence of a negative feedback loop between stress oxidative, circadian rhythm dysregulation, miR-17 and miR-15/107 families, some essential genes involved in neuronal and brain cell health, and KMT2D/DNMT3a in the peripheral blood samples of PTSD.
Reliability of force plate-based measures of standing balance in the sub-acute stage of post-stroke recovery
Authors: Aryan Raabeae , Inness Elizabeth , Patterson Kara K. , Mochizuki George , Mansfield Avril 
Published: May 2023

ABSTRACTBackgroundDifficulty controlling balance is one of the major contributors to the increased risk of falls among individuals with stroke. It is important to use reliable and objective measures to evaluate balance impairments post-stroke to inform more effective post-stroke rehabilitation.ObjectivesTo examine the relative and absolute reliabilities of force plate-based balance measures in quiet standing, in the sub-acute stage of stroke recovery.MethodsTwenty-four people with sub-acute stroke (mean age=61 years) performed two trials of quiet standing, each 30 seconds long. Sixteen force plate-based balance measures in the time, frequency, or nonlinear domains were calculated. Within-session test-retest reliabilities were investigated using intraclass correlation coefficient (ICC), standard error of measurement, and minimal detectable change.ResultsMean speed of displacements of the centre of pressure along the anterior-posterior axis (ICC=0.91; CI95%=[0.83, 0.95]), and directional weight-bearing asymmetry (ICC=0.91; CI95%=[0.82, 0.95]) demonstrated high relative reliabilities, followed by the speed-based symmetry index and absolute weight-bearing asymmetry (both ICCs=0.86; CI95%=[0.74, 0.93]).ConclusionsMean speeds of centre of pressure, directional weight-bearing asymmetry, and speed-based symmetry index are the most reliable measures that can be included in the balance assessments of individuals within the sub-acute stage of post-stroke recovery. These findings can better inform clinicians about the specific balance problems experienced by people in this population.
Improvement of language function after Contralateral Seventh Cervical Nerve Transfer in hemiplegic patients combined with post-stroke aphasia: a prospective observational cohort study
Authors: Feng Juntao , Li Tie , Lv Minzhi , Xu Miaomiao , Yang Jingrui , Su Fan , Hu Ruiping , Li Jie , Shen Yundong , Xu Wendong 
Published: May 2023

AbstractBackgroundWhile the contralateral seventh cervical nerve (CC7) cross transfer was designed to reconstruct paralyzed arm function after stroke, improvement in language function was found in patients combined with aphasia.ObjectiveTo evaluate the effect of improvement in language function after CC7 cross transfer in stroke patients with chronic aphasia and explore its potential mechanism.MethodsIn a prospective observative cohort, patients diagnosed with hemiplegia combined with aphasia were included. The language function was evaluated through the changes of Aphasia Quotient evaluated by Western Aphasia Battery (WAB-AQ) as well as its four subtests from baseline to 1 week and 6 months after the surgery. Patients also received oral agility test by Boston Diagnostic Aphasia Examination (BDAE-OA). Resting-state functional MRI (rs-fMRI) was scanned before and over 6 months after the surgery to explore the potential central mechanism in language improvements.ResultsThe average increase of WAB-AQ was 8.08 points from baseline to 1 week post-operatively (P<0.001, 95%CI: 5.05-11.10), and 9.51 from baseline to 6-month (P<0.001, 95%CI: 6.75-12.27). In 8 patients who participant in BDAE-OA, the average increase was 3.7 points (95%CI: 0.56-6.84; corrected P =0.023) from baseline to 1-week follow-up, and 5.3 points from baseline to 6 months follow-up. Significant higher local activity was detected at right precentral cortex, right gyrus rectus, and right anterior cingulate cortex after the surgery from rs-fMRI.ConclusionsImmediate and stable improvement in language function was detected after CC7 cross transfer in hemiplegic patients combined with aphasia, which may be realized through enhanced function of language network in the bilateral hemisphere.
Synthetic data for privacy-preserving clinical risk prediction
Authors: Qian Zhaozhi , Callender Thomas , Cebere Bogdan , Janes Sam M , Navani Neal , van der Schaar Mihaela 
Published: May 2023

ABSTRACTSynthetic data promise privacy-preserving data sharing for healthcare research and development. Compared with other privacy-enhancing approaches - such as federated learning - analyses performed on synthetic data can be applied downstream without modification, such that synthetic data can act in place of real data for a wide range of use cases. However, the role that synthetic data might play in all aspects of clinical model development remains unknown. In this work, we used state-of-the-art generators explicitly designed for privacy preservation to create a synthetic version of the UK Biobank before building prognostic models for lung cancer under several data release assumptions. We demonstrate that synthetic data can be effectively used throughout the modelling pipeline even without eventual access to the real data. Furthermore, we show the implications of different data release approaches on how synthetic data could be deployed within the healthcare system.