bluuebunny/crossref_metadata_2025_split huggingface dataset:
Customized 3-dimensional–printed Vertebral Implants for Spinal Reconstruction After Tumor Resection
Authors: Hirase Takashi , Vemu Sree M. , Boddapati Venkat , Ling Jeremiah F. , So Matthew , Saifi Comron , Marco Rex A.W. , Bird Justin E. 
Published: April 2023

Study Design:
Systematic review.

Objective:
To examine the outcomes of customized 3-dimensional (3D) printed implants for spinal reconstruction after tumor resection.

Summary of Background Data:
Various techniques exist for spinal reconstruction after tumor resection. Currently, there is no consensus regarding the utility of customized 3D-printed implants for spinal reconstruction after tumor resection.

Materials and Methods:
A systematic review was registered with PROSPERO and performed according to “Preferred Reporting Items for Systematic Reviews and Meta-analyses” guidelines. All level I–V evidence studies reporting the use of 3D-printed implants for spinal reconstruction after tumor resection were included.

Results:
Eleven studies (65 patients; mean age, 40.9 ± 18.1 y) were included. Eleven patients (16.9%) underwent intralesional resections with positive margins and 54 patients (83.1%) underwent en bloc spondylectomy with negative margins. All patients underwent vertebral reconstruction with 3D-printed titanium implants. Tumor involvement was in the cervical spine in 21 patients (32.3%), thoracic spine in 29 patients (44.6%), thoracolumbar junction in 2 patients (3.1%), and lumbar spine in 13 patients (20.0%). Ten studies with 62 patients reported perioperative outcomes radiologic/oncologic status at final follow-up. At the mean final follow-up of 18.5 ± 9.8 months, 47 patients (75.8%) had no evidence of disease, 9 patients (14.5%) were alive with recurrence, and 6 patients (9.7%) had died of disease. One patient who underwent C3–C5 en bloc spondylectomy had an asymptomatic subsidence of 2.7 mm at the final follow-up. Twenty patients that underwent thoracic and/or lumbar reconstruction had a mean subsidence of 3.8 ± 4.7 mm at the final follow-up; however, only 1 patient had a symptomatic subsidence that required revision surgery. Eleven patients (17.7%) had one or more major complications.

Conclusion:
There is some evidence to suggest that using customized 3D-printed titanium or titanium alloy implants is an effective technique for spinal reconstruction after tumor resection. There is a high incidence of asymptomatic subsidence and major complications that are similar to other methods of reconstruction.

Level of Evidence:
Level V, systematic review of level I–V studies.
Burden of multiple myeloma in China: an analysis of the Global Burden of Disease, Injuries, and Risk Factors Study 2019
Authors: Liu Jiangmei , Liu Weiping , Mi Lan , Cai Cai , Gong Tiejun , Ma Jun , Wang Lijun 
Published: April 2023

Abstract

Background:
There is limited data to comprehensively evaluate the epidemiological characteristics of multiple myeloma (MM) in China; therefore, this study determined the characteristics of the disease burden of MM at national and provincial levels in China.

Methods:
The burden of MM, including incidence, mortality, prevalence, and disability-adjusted life years (DALYs), with a 95% uncertainty interval (UI), was determined in China following the general analytical strategy used in the Global Burden of Disease, Injuries, and Risk Factors Study 2019. The trends in the burden of MM from 1990 to 2019 were also evaluated.

Results:
There were an estimated 347.45 thousand DALYs with an age-standardized DALY rate of 17.05 (95% UI, 12.31–20.77) per 100,000 in 2019. The estimated number of incident case and deaths of MM were 18,793 and 13,421, with age-standardized incidence and mortality rates of 0.93 (95% UI, 0.67–1.15) and 0.67 (95% UI, 0.50–0.82) per 100,000, respectively. The age-specific DALY rates per 100,000 increased to more than 10.00 in the 40 to 44 years age group reaching a peak (93.82) in the 70 to 74 years age group. Males had a higher burden than females, with approximately 1.5 to 2.0-fold sex difference in age-specific DALY rates in all age groups. From 1990 to 2019, the DALYs of MM increased 134%, from 148,479 in 1990 to 347,453 in 2019.

Conclusion:
The burden of MM has doubled over the last three decades, which highlights the need to establish effective disease prevention and control strategies at both the national and provincial levels.
Astragaloside in cancer chemoprevention and therapy
Authors: Wang Yaning , Zhang Zhuo , Cheng Zhaohua , Xie Wei , Qin Hanjiao , Sheng Jiyao 
Published: April 2023

Abstract
Tumor chemoprevention and treatment are two approaches aimed at improving the survival of patients with cancers. An ideal anti-tumor drug is that which not only kills tumor cells but also alleviates tumor-causing risk factors, such as precancerous lesions, and prevents tumor recurrence. Chinese herbal monomers are considered to be ideal treatment agents due to their multi-target effects. Astragaloside has been shown to possess tumor chemoprevention, direct anti-tumor, and chemotherapeutic drug sensitization effects. In this paper, we review the effects of astragaloside on tumor prevention and treatment and provide directions for further research.
Acral Speckled Hypomelanosis: A Case Report and a Review of Literature
Authors: Azzazi Yousra , Korany Mona Mostafa , El-Nabarawy Eman Ahmed 
Published: April 2023

Background:
Acral speckled hypomelanosis is a very rare pigmentation disorder that appears early in life with hypopigmented macules on background of normal skin, occurring on the acral parts.

Case report:
We report a 9-year-old female patient with a 3-year duration of progressive, hypopigmented, confetti-like macules occurring symmetrically on the dorsum of both hands and feet. Biopsy showed normal number of melanocytes with no evidence of macromelanosomes using special stains for melanocytes.

Conclusion:
Acral speckled hypomelanosis is a relatively, recently, discovered entity, with only 9 cases reported to date, and our case is the 10th. The exact etiopathogenesis is not yet known.
Use of HBV RNA and to predict change in serological status and disease activity in CHB
Authors: Ghany Marc G. , King Wendy C. , Hinerman Amanda S. , Lok Anna SF. , Lisker-Melman Mauricio , Chung Raymond T. , Terrault Norah , Janssen Harry L.A. , Khalili Mandana , Lee William M. , Lau Daryl T.Y. , Cloherty Gavin A. , Sterling Richard K. 
Published: April 2023

Background and Aims:
Predicting changes in disease activity and serological endpoints is necessary for the management of patients with chronic hepatitis B (CHB). We examined whether HBV RNA and hepatitis B core-related antigen (HBcrAg), two specialized virological markers proposed to reflect the activity of covalently closed circular DNA, may improve the ability to predict not sustained inactive carrier phase, spontaneous alanine aminotransferase (ALT) flare, HBeAg loss, and HBsAg loss.

Approach and Results:
Among eligible participants enrolled in the North American Hepatitis B Research Network Adult Cohort Study, we evaluated demographic, clinical, and virologic characteristics, including HBV RNA and HBcrAg, to predict not sustained inactive carrier phase, ALT flare, HBeAg loss, and HBsAg loss through a series of Cox proportional hazard or logistic regression models, controlling for antiviral therapy use. Among the study population, 54/103 participants experienced not sustained inactive carrier phase, 41/1006 had a spontaneous ALT flare, 83/250 lost HBeAg, and 54/1127 lost HBsAg. HBV RNA or HBcrAg were predictive of all 4 events. However, their addition to models of the readily available host (age, sex, race/ethnicity), clinical (ALT, use of antiviral therapy), and viral factors (HBV DNA), which had acceptable-excellent accuracy (e.g., AUC = 0.72 for ALT flare, 0.92 for HBeAg loss, and 0.91 for HBsAg loss), provided only small improvements in predictive ability.

Conclusion:
Given the high predictive ability of readily available markers, HBcrAg and HBV RNA have a limited role in improving the prediction of key serologic and clinical events in patients with CHB.
Differential central integration of left versus right baroreceptor afferent input in spontaneously hypertensive rats
Authors: Salman Ibrahim M. , Ameer Omar Z. , McMurray Sheridan , Hassan Sarah F. , Sridhar Arun , Lewis Stephen J. , Hsieh Yee-Hsee 
Published: April 2023

Background:
The blood pressure (BP) regulatory impact of the arterial baroreflex has been well established in health and disease. Under normotensive conditions, we have previously demonstrated functional differences in the central processing of the left versus right aortic baroreceptor afferent input. However, it is unknown if lateralization in aortic baroreflex function remains evident during hypertension.

Method:
We therefore, investigated the effects of laterality on the expression of baroreflex-driven cardiovascular reflexes in a genetic model of essential hypertension, the spontaneously hypertensive rat (SHR). Anesthetized male SHRs (total n = 9) were instrumented for left, right, and bilateral aortic depressor nerve (ADN) stimulation (1–40 Hz, 0.2 ms, and 0.4 mA for 20 s) and measurement of mean arterial pressure (MAP), heart rate (HR), mesenteric vascular resistance (MVR), and femoral vascular resistance (FVR).

Results:
Left right, and bilateral ADN stimulation evoked frequency-dependent decreases in MAP, HR, MVR, and FVR. Left and bilateral ADN stimulation evoked greater reflex reductions in MAP, HR, MVR, and FVR compared with right-sided stimulation. Reflex bradycardia to bilateral stimulation was larger relative to both left-sided and right-sided stimulation. Reflex depressor and vascular resistance responses to bilateral stimulation mimicked those of the left-sided stimulation. These data indicate a left-side dominance in the central integration of aortic baroreceptor afferent input. Furthermore, reflex summation due to bilateral stimulation is only evident on the reflex bradycardic response, and does not drive further reductions in BP, suggesting that reflex depressor responses in the SHRs are primarily driven by changes in vascular resistance.

Conclusion:
Together, these results indicate that lateralization in aortic baroreflex function is not only evident under normotensive conditions but also extends to hypertensive conditions.
Traffic-Related Air Pollution and Risk of Lung, Breast, and Urinary Tract Cancer in Halifax, Nova Scotia
Authors: Dummer Trevor J. B. , Yu Xing , Cui Yunsong , Nauta Laura , Saint-Jacques Nathalie , Sweeney Magee Molly , Rainham Daniel G. C. 
Published: April 2023

Objectives
We assessed the association of traffic-related air pollution (TRAP) with the incidence of lung, breast, and urinary tract cancer in Halifax, Nova Scotia.

Methods
Our case-control study included 2315 cancers and 8501 age-sex–matched controls. Land-use regression was used to estimate TRAP concentrations. Logistic regression was used to assess cancer risk in relation to TRAP, adjusting for community social and material deprivation.

Results
There was no association between the risk of lung, breast, or urinary tract cancer in relation to TRAP. Lung cancer risk was significantly increased in the most deprived communities, whereas breast cancer risk was highest in the least deprived communities.

Conclusions
In a city characterized by low levels of ambient air pollution, there was no evidence of a linear increased lung, breast, or urinary tract cancer risk in relation to TRAP.
Post-cholecystectomy major bile duct injury: ideal time to repair based on a multicentre randomized controlled trial with promising results
Authors: Omar Mohammed A. , Kamal Ayman , Redwan Alaa A. , Alansary Marwa N. , Ahmed Emad Ali 
Published: April 2023

Background:
Bile duct injury (BDI) is one of the serious complications of cholecystectomy procedures, which has a disastrous impact on long-term survival, health-related quality of life (QoL), healthcare costs as well as high rates of litigation. The standard treatment of major BDI is hepaticojejunostomy (HJ). Surgical outcomes depend on many factors, including the severity of the injury, the surgeons’ experiences, the patient’s condition, and the reconstruction time. The authors aimed to assess the impact of reconstruction time and abdominal sepsis control on the reconstruction success rate.

Methods:
This is a multicenter, multi-arm, parallel-group, randomized trial that included all consecutive patients treated with HJ for major post-cholecystectomy BDI from February 2014 to January 2022. Patients were randomized according to the time of reconstruction by HJ and abdominal sepsis control into group A (early reconstruction without sepsis control), group B (early reconstruction with sepsis control), and group C (delayed reconstruction). The primary outcome was successful reconstruction rate, while blood loss, HJ diameter, operative time, drainage amount, drain and stent duration, postoperative liver function tests, morbidity and mortality, number of admissions and interventions, hospital stay, total cost, and patient QoL were considered secondary outcomes.

Results:
Three hundred twenty one patients from three centres were randomized into three groups. Forty-four patients were excluded from the analysis, leaving 277 patients for intention to treat analysis. With univariate analysis, older age, male gender, laparoscopic cholecystectomy, conversion to open cholecystectomy, failure of intraoperative BDI recognition, Strasberg E4 classification, uncontrolled abdominal sepsis, secondary repair, end-to-side anastomosis, diameter of HJ (< 8 mm), non-stented anastomosis, and major complications were risk factors for successful reconstruction. With multivariate analysis, conversion to open cholecystectomy, uncontrolled sepsis, secondary repair, the small diameter of HJ, and non-stented anastomosis were the independent risk factors for the successful reconstruction. Also, group B patients showed decreased admission and intervention rates, decreased hospital stay, decreased total cost, and early improved patient QoL.

Conclusion:
Early reconstruction after abdominal sepsis control can be done safely at any time with comparable results for delayed reconstruction in addition to decreased total cost and improved patient QoL.
High-Dose Insulin for Hyperkalemic Cardiac Arrest
Authors: Shikhooun Mohammed A. , Abdulhadi Loai A. , Yafes Wael M. , Saleh Moataz R. , Corsentino Sue Anne , Pantin Enrique J. 
Published: April 2023

Abstract:
Hyperkalemic cardiac arrest diagnosis can be elusive and management difficult as the cardiac rhythm restoration is often not achieved until the potassium level decreases to a relatively normal level for the patient who suffers the arrest. Current treatment modalities can take hours to achieve this goal. We describe two patients who survived a witnessed hyperkalemic cardiac arrest after being managed with conventional advanced cardiac life support and unconventionally high doses of intravenous insulin.
Methodologic Approaches for Using Electronic Medical Records to Identify Experiences of Violence in Transgender and Cisgender People: Closing the Gap Between Diagnostic Coding and Lived Experiences
Authors: Alpert Ash Blythe , Sayegh Sabrina Jamileh , Strawderman Myla , Cunliffe Scott , Griggs Jennifer J. , Cerulli Catherine 
Published: April 2023

Background:
Transgender people experience extreme rates of violence and the electronic medical record (EMR) remains a mostly untapped resource to study the medical sequelae of such experiences.

Objectives:
To develop and test a method for identifying experiences of violence using EMR data.

Research Design:
Cross-sectional study utilizing EMR data.

People:
Transgender and cisgender people seen at a regional referral center in Upstate New York.

Measures:
We tested the utility of keyword searches and structured data queries to identify specific types of violence at various ages and in various contexts among cohorts of transgender and cisgender people. We compared the effectiveness of keyword searches to diagnosis codes and a screening question, “Are you safe at home?” using McNemar’s test. We compared the prevalence of various types of violence between transgender and cisgender cohorts using the χ2 test of independence.

Results:
Of the transgender cohort, 47% had experienced some type of violence versus 14% of the cisgender cohort (χ2
P value <0.001). Keywords were significantly more effective than structured data at identifying violence among both cohorts (McNemar P values all <0.05).

Conclusions:
Transgender people experience extreme amounts of violence throughout their lives, which is better identified and studied using keyword searches than structured EMR data. Policies are urgently needed to stop violence against transgender people. Interventions are also needed to ensure safe documentation of violence in EMRs to improve care across settings and aid research to develop and implement effective interventions.
Proximal tubule responses to injury: interrogation by single-cell transcriptomics
Authors: Cippà Pietro E. , McMahon Andrew P. 
Published: April 2023

Purpose of review
Acute kidney injury (AKI) occurs in approximately 10–15% of patients admitted to hospital and is associated with adverse clinical outcomes. Despite recent advances, management of patients with AKI is still mainly supportive, including the avoidance of nephrotoxins, volume and haemodynamic management and renal replacement therapy. A better understanding of the renal response to injury is the prerequisite to overcome current limitations in AKI diagnostics and therapy.

Recent findings
Single-cell technologies provided new opportunities to study the complexity of the kidney and have been instrumental for rapid advancements in the understanding of the cellular and molecular mechanisms of AKI.

Summary
We provide an update on single-cell technologies and we summarize the recent discoveries on the cellular response to injury in proximal tubule cells from the early response in AKI, to the mechanisms of tubule repair and the relevance of maladaptive tubule repair in the transition to chronic kidney disease.
Deficits in our understanding of natural killer cell development in mouse and human
Authors: Schorr Christopher , Krishnan Maya Shraddha , Capitano Maegan 
Published: April 2023

Purpose of review
Natural killer (NK) cells are a type of immune cell that play a crucial role in the defense against cancer and viral infections. The development and maturation of NK cells is a complex process, involving the coordination of various signaling pathways, transcription factors, and epigenetic modifications. In recent years, there has been a growing interest in studying the development of NK cells. In this review, we discuss the field's current understanding of the journey a hematopoietic stem cell takes to become a fully mature NK cell and detail the sequential steps and regulation of conventional NK leukopoiesis in both mice and humans.

Recent findings
Recent studies have highlighted the significance of defining NK development stages. Several groups report differing schema to identify NK cell development and new findings demonstrate novel ways to classify NK cells. Further investigation of NK cell biology and development is needed, as multiomic analysis reveals a large diversity in NK cell development pathways.

Summary
We provide an overview of current knowledge on the development of NK cells, including the various stages of differentiation, the regulation of development, and the maturation of NK cells in both mice and humans. A deeper understanding of NK cell development has the potential to provide insights into new therapeutic strategies for the treatment of diseases such as cancer and viral infections.
Matrix Metalloproteinase-7 and Osteopontin Serum Levels as Biomarkers for Biliary Atresia
Authors: Aldeiri Bashar , Si Tengfei , Huang Zhenlin , Torner Núria , Ma Yun , Davenport Mark , Hadzic Nedim 
Published: April 2023

Objectives:Matrix metallopeptidase-7 (MMP-7) and osteopontin (OPN) are important components in the pathophysiology of fibrosis in biliary atresia (BA). There has been much recent interest in MMP-7 serum level in the diagnosis of BA. We aimed to assess the diagnostic accuracy and prognostic value of both MMP-7 and OPN in a Western BA study.Methods:Diagnostic value was assessed by comparison of serum MMP-7 and OPN levels in infants with BA and age-matched cholestatic controls. Prognostic value was assessed through subsequent clearance of jaundice (COJ) and need for liver transplantation (LT).Results:Serum was assessed from 32 BA and 27 controls. Median MMP-7 was higher in BA (96.4 vs 35 ng/mL;P< 0.0001) with an optimal cut-off value of 69 ng/mL. Sensitivity and specificity was 68% and 93%, respectively [negative predictive value (NPV) = 71%]. Similarly, median OPN was higher in BA (1952 vs 1457 ng/mL;P= 0.0001) and an optimal cut-off of 1611 ng/mL. Sensitivity and specificity was 84% and 78%, respectively (NPV = 81%). MMP-7 level correlated positively with Ishak liver fibrosis score (r= 0.27,P= 0.04). Neither MMP-7 (70 vs 100 ng/mL;P= 0.2) nor OPN (1969 vs 1939 ng/mL;P= 0.3) were predictive of COJ, or need for LT (99 vs 79 ng/mL;P= 0.7, and 1981 vs 1899 ng/mL;P= 0.2), respectively.Conclusions:MMP-7 and OPN may have contributory value in the diagnosis of BA, but remain far of the “gold standard” role. Much more prospective data are required and collaborative multi-center initiatives should be the next logical steps.
Effect of Storytelling and Empathy Training to Support Affective Learning in Undergraduate Nursing Students
Authors: Roberts Michele Livich , Kaur Tresa 
Published: April 2023

Background:
Empathy is a desired characteristic in nurses, but its development is often overlooked in nursing simulation.

Purpose:
This study evaluated the effect of a storytelling and empathy training intervention to enhance empathy development in simulation-based learning.

Methods:
A quasi-experimental control group design was used to evaluate differences in self-perceived and observed empathy in undergraduate nursing students (N = 71). Relationships between self-perceived and observed empathy were also assessed.

Results:
Repeated-measures analysis of variance revealed a statistically significant increase in self-perceived empathy, and higher, but nonstatistically significant differences in observed empathy for subjects in the treatment condition. No relationship between self-perceived and observed empathy was observed.

Conclusions:
Storytelling and empathy training may augment simulation-based learning experiences to promote empathy development in undergraduate nursing students.