bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Inexpensive 3D Printed Mouse Model of Successful, Complication-free Long Bone Distraction Osteogenesis
Authors: Tevlin Ruth , Shah Harsh N. , Salhotra Ankit , Di Iorio Sarah E. , Griffin Michelle , Januszyk Michael , Wan Derrick C. , Longaker Michael T. 
Published: February 2023

Background:
Distraction osteogenesis (DO) is used for skeletal defects; however, up to 50% of cases exhibit complications. Previous mouse models of long bone DO have been anecdotally hampered by postoperative complications, expense, and availability. To improve clinical techniques, cost-effective, reliable animal models are needed. Our focus was to develop a new mouse tibial distractor, hypothesized to result in successful, complication-free DO.

Methods:
A lightweight tibial distractor was developed using CAD and 3D printing. The device was fixed to the tibia of C57Bl/6J mice prior to osteotomy. Postoperatively, mice underwent 5 days latency, 10 days distraction (0.15 mm every 12 hours), and 28 days consolidation. Bone regeneration was examined on postoperative day 43 using micro-computed tomography (μCT) and Movat’s modified pentachrome staining on histology (mineralized volume fraction and pixels, respectively). Costs were recorded. We compared cohorts of 11 mice undergoing sham, DO, or acute lengthening (distractor acutely lengthened 3.0 mm).

Results:
The histological bone regenerate was significantly increased in DO (1,879,257 ± 155,415 pixels) compared to acute lengthening (32847 ± 1589 pixels) (P < 0.0001). The mineralized volume fraction (bone/total tissue volume) of the regenerate was significantly increased in DO (0.9 ± 0.1) compared to acute lengthening (0.7 ± 0.1) (P < 0.001). There was no significant difference in bone regenerate between DO and sham. The distractor was relatively low cost ($11), with no complications.

Conclusions:
Histology and µCT analysis confirmed that the proposed tibial DO model resulted in successful bone formation. Our model is cost-effective and reproducible, enabling implementation in genetically dissectible transgenic mice.
Customized corneal crosslinking with excimer laser–assisted epithelium removal for progressive keratoconus: 1-year results
Authors: Gil João Q. , Rosa Andreia M. , Costa Esmeralda , Quadrado Maria J. , Murta Joaquim N. 
Published: February 2023

Purpose:
To evaluate the 1-year visual and tomographic results of customized crosslinking using excimer laser–assisted epithelium removal and topography-guided irradiation in the treatment of progressive keratoconus.

Setting:
Coimbra Ophthalmology Unit, Private Practice, Coimbra, Portugal.

Design:
Prospective nonrandomized clinical trial.

Methods:
Eyes with documented progressive keratoconus were enrolled. After de-epithelialization with phototherapeutic keratectomy, customized UV irradiation was performed, designed as 3 concentric circular areas centered on the thinnest point (Mosaic System). Energy exposure was 5.4 J/cm2 in the outer circle and then increased centripetally to 7.2 J/cm2 and 10 J/cm2. Corrected distance visual acuity (CDVA), refractive outcomes, and Scheimpflug tomographies (Allegro Oculyzer) were assessed at baseline, and 6 months, and 12 months postoperatively.

Results:
37 eyes of 32 patients were enrolled in this prospective study. The mean diameter for treated areas was 6.17 ± 0.80 mm, 4.45 ± 0.47 mm, and 2.58 ± 0.14 mm for the outer, medium, and inner circle, respectively. At the 1-year follow-up, the mean CDVA improved significantly from 0.38 ± 0.19 to 0.20 ± 0.16 logMAR (P < .01), with 34 (91.89%) of the 37 eyes retaining or improving CDVA. The mean preoperative minimum pachymetry decreased from 449.26 ± 41.62 to 443.26 ± 41.06 μm (P = .02). The maximum keratometry decreased significantly from 58.50 ± 7.84 to 57.05 ± 7.27 diopters (P < .01). After 1 year, 34 eyes (91.89%) showed no signs of progression.

Conclusions:
1 year postoperatively, patients showed a significant improvement in visual acuity while achieving stabilization of disease progression.
Comparison of cataract surgery outcomes in patients with type 1 vs type 2 diabetes mellitus and patients without diabetes mellitus
Authors: Xia Julia L. , Patnaik Jennifer L. , Lynch Anne M. , Christopher Karen L. 
Published: February 2023

Purpose:
To report outcomes of cataract surgery in type 1 diabetes mellitus (T1DM) compared with type 2 diabetes mellitus (T2DM) and patients without diabetes mellitus (DM).

Setting:
Academic tertiary referral university hospital eye center, Aurora, Colorado.

Design:
Retrospective chart review using the University of Colorado Cataract Outcomes Database for all cataract surgeries between 2014 and 2020.

Methods:
Demographics, ocular history, and postoperative outcomes were compared across groups using general linear and logistic regression modeling with estimating equations to account for some patients having 2 eyes included.

Results:
8117 patients and 13 383 eyes were included. Compared with T2DM eyes undergoing cataract surgery (n = 3115), T1DM eyes (n = 233) were more likely to have a history of diabetic retinopathy (DR) (60.5% vs 23.6%, P < .0001), of which proliferative DR was the most common (63.1% vs 42.4%, P < .0001). T1DM eyes were also more likely to have a history of retinal detachment (RD) (9.0% vs 2.9%, P < .0001) and prior vitrectomy surgery (12.9% vs 4.0%, P < .0001). Despite having similar preoperative corrected distance visual acuity (CDVA) as T2DM eyes (logMAR 0.52 vs 0.44, P = .092), T1DM eyes had worse CDVA after cataract surgery (logMAR 0.27 vs 0.15, P = .0003). In a multivariate analysis, a history of proliferative DR and prior RD were significant predictors of worse postoperative CDVA (P < .0001) but type of DM was not (P = .894).

Conclusions:
T1DM eyes have worse visual outcomes after cataract surgery compared with T2DM eyes. Worse postoperative visual acuity was associated with worse preoperative DR and history of RD rather than type of DM.
Endoscopic-Assisted Decompression of the Greater Occipital Nerve for Treatment of Migraines, Occipital Neuralgia, and New Daily Persistent Headaches
Authors: Amirlak Bardia , Lu Karen B. , Chung Michael , Sanniec Kyle 
Published: February 2023

Summary:
In the occipital trigger site for migraine, the greater occipital nerve (GON) is thought to be irritated by surrounding structures, including the semispinalis capitus muscle and occipital artery (OA), producing headaches in the back of the neck. Thus, standard decompression involves removal of surrounding tissue and dissection away from the vessel. We noticed a consistent pattern between the GON and OA more distally: the OA approaching laterally and diving under GON, the OA looping back over GON, intertwining of OA and the medial branch of the GON, and lastly traveling parallel to the GON. The technique described uses a modified endoscopic approach using a counter incision, endoscopic assistance, and radical artery lysis to address distal sites in addition to the standard release. At the counter incision, distal intertwining between vessel and nerve were released. An HD endoscope was used to address dynamic compression points more proximally, including hidden areas where the vessel dives under the GON, as well as facilitate cautery and removal of the vessel. Without the use of an endoscope and counter incision, it is difficult to achieve complete decompression of the nerve distally without injury to the proximal body of the nerve.
Outcomes of Abdominal Wall Reconstruction with a Bovine Versus a Porcine Acellular Dermal Matrix: A Propensity Score-Matched Analysis of 725 Patients
Authors: Hassan Abbas M. , Asaad Malke , Brook Derek S. , Shah Nikhil R. , Kumar Saloni C. , Liu Jun , Adelman David M. , Clemens Mark W. , Selber Jesse C. , Butler Charles E. 
Published: February 2023

Background:
Abdominal wall reconstruction (AWR) is one of the most commonly performed procedures, yet large comparative studies comparing outcomes of AWR using bovine acellular dermal matrix (BADM) and porcine acellular dermal matrix (PADM) are lacking.

Methods:
In this retrospective cohort study of patients who underwent AWR from March 2005 to June 2019, the primary comparative outcome measure was hernia recurrence with BADM versus PADM. The secondary outcome was the incidence of surgical site occurrence (SSO) and surgical site infection (SSI). Propensity score matching approach was applied to compare the clinical outcomes between the two study groups.

Results:
We identified 725 patients who underwent AWR using BADM (50.5%) or PADM (49.5%). Their mean (± SD) age was 59.8 ± 11.5 years, mean body mass index was 31.4 ± 6.7 kg/m 2, and mean follow-up time was 42 ± 29 months. With propensity score matching, 219 matched pairs were identified. Hernia recurrence rates in BADM (11.4%) and PADM (13.7%) groups did not differ significantly (P = .793). SSOs (26.5% versus 29.2%; P = .518) and SSIs (13.2% versus 11%; P = .456) rates did not differ significantly in the PADM and BADM groups, respectively. Conditional logistic regression model and marginal Cox proportional hazards regression model determined that type of ADM was not significantly associated with SSOs (adjusted OR=1.11, 95%CI=0.74-1.70, p=0.589) or hernia recurrence (adjusted HR=0.85, 95% CI=0.50-1.42, p=0.52).

Conclusion:
Both BADMs and PADMs provide durable, long-term outcomes. The hernia recurrence and postoperative surgical complication rates were not significantly different between BADM and PADM.
Patient-Reported Data Augment Health Record Data for Prediction Models of Persistent Opioid Use after Elective Upper Extremity Surgery
Authors: Giladi Aviram M. , Shipp Michael M. , Sanghavi Kavya K. , Zhang Gongliang , Gupta Samir , Miller Kristen E. , Belouali Anas , Madhavan Subha 
Published: February 2023

Background:
Opioids play a role in pain management after surgery, but prolonged use contributes to developing opioid use disorder. Identifying patients at risk of prolonged use is critical for deploying interventions that reduce or avoid opioids; however, available predictive models do not incorporate patient-reported data (PRD) and it remains unclear if PRD can predict post-operative use behavior. We used a machine learning (ML) approach leveraging preoperative PRD and electronic health record (EHR) data to predict persistent opioid use after upper extremity (UE) surgery.

Methods:
Included patients underwent UE surgery, completed preoperative PRD questionnaires, and were prescribed opioids after surgery. We trained models using a 2018 cohort and tested in a 2019 cohort. Opioid use was determined by patient report and filled prescriptions up to 6 months after surgery. We assessed model performance using AUROC, sensitivity, specificity, and Brier score.

Results:
Among 1656 patients, 19% still used opioids at 6 weeks, 11% at 3 months, and 9% at 6 months. The XGBoost model trained on PRD plus EHR data achieved AUROC 0.73 at 6 months. Factors predictive of prolonged opioid use included income, education, tobacco, drug or alcohol abuse, cancer, depression, and race. Protective factors included preoperative PROMIS Global Physical Health and preoperative PROMIS Upper Extremity scores.

Conclusion:
This opioid use prediction model using pre-intervention data had good discriminative performance. PRD variables augmented EHR-based ML algorithms in predicting post-surgical use behaviors and were some of the strongest predictors. PRD should be used in future efforts to guide proper opioid stewardship.
Carbon fiber ankle-foot orthoses in impaired populations: A systematic review
Authors: Grunst Megan M. , Wiederien Robert C. , Wilken Jason M. 
Published: February 2023

Background:Carbon fiber is increasingly being used in ankle-foot orthoses (AFOs). Orthotic devices and carbon fiber-containing devices have been shown to reduce pain and improve function in multiple patient populations. Although the number of publications and interest in carbon fiber AFOs is growing, a systematic evaluation of their effects is lacking.Objectives:To characterize the effects of carbon fiber AFOs in impaired individuals.Study design:Qualitative systematic review.Methods:Systematic searches in PubMed, Embase, CINAHL, and Cochrane Library were completed in July 2020. The results were deduplicated, screened, and assessed for quality by independent reviewers. Articles were excluded if they had nonhuman subjects, only healthy subjects, or included active control systems, motors, or other power sources.Results:Seventy-eight articles were included in the qualitative synthesis. Most articles were of low to moderate methodological quality. Five commonly used devices were identified: the Intrepid Dynamic Exoskeletal Orthosis, ToeOff, WalkOn, Neuro Swing, and Chignon. The devices have unique designs and are associated with specific populations. The Intrepid Dynamic Exoskeletal Orthosis was used in individuals with lower-limb trauma, the Neuro Swing and ToeOff in individuals with neurological disorders, the Chignon in individuals with hemiplegia and stroke, and the WalkOn in people with hemiplegia and cerebral palsy. Each device produced favorable outcomes in their respective populations of interest, such as increased walking speed, reduced pain, or improved balance.Conclusions:The mechanical characteristics and designs of carbon fiber AFOs improve outcomes in the populations in which they are most studied. Future literature should diligently report patient population, device used, and fitting procedures.
Acute retroviral syndrome is associated with lower CD4+ T cell nadir and delayed viral suppression, which are blunted by immediate antiretroviral therapy initiation
Authors: Gabert Rose , Lama Javier R. , Valdez Rogelio , Dasgupta Sayan , Cabello Robinson , Sanchez Hugo , Leon Mey , Huamani Javier Valencia , MacRae John , Montalban Esmelda , Pasalar Siavash , Ignacio Rachel Bender , Duerr Ann 
Published: February 2023

Objectives:
To describe the prevalence of acute retroviral syndrome (ARS) and associated findings during primary HIV, and explore the relationship of ARS to clinical, virological, and immunological outcomes within a longitudinal screen, retest and treat study that minimized ascertainment bias.

Design:
We evaluated ARS symptoms and signs among 216 persons with acute and early incident HIV within the Sabes study of timing of antiretroviral therapy (ART) initiation during primary HIV in Peru.

Methods:
We evaluated patient reported symptoms and signs during primary HIV and used logistic regression and generalized linear models to evaluate associations with CD4+ and CD8+ T cell counts, HIV viral load, and a panel of 23 soluble markers of immune activation.

Results:
Sixty-one percent of participants had at least one ARS finding and 35% had at least 3. More ARS findings were reported in those enrolled within a month of estimated date of detectable infection (EDDI). Having more ARS signs/symptoms was associated with increased risk of CD4+ cell decrease below 350 cells/ml within the first 24 weeks, failure to suppress HIV viral load, and was most strongly associated with elevated IP-10. Immediate ART blunted effects on symptoms, CD4+ cell count and viral load, as associations were strongest in the arm that started ART after 24 weeks. Detrimental associations of ARS with CD4+ counts, and CD4+/CD8+ ratio were not maintained at 2 or 4 years.

Conclusions:
ARS has marked associations with short-term immunologic function and virologic suppression, which were mitigated in participants randomized to initiate ART immediately during primary infection.
3D-printing and cylinder buckling: challenges and opportunities
Authors: Cooley S. A. , Yang H. , Virgin L. N. 
Published: February 2023

Cylinder buckling is notoriously sensitive to small geometric imperfections. This is an underlying motivation for the use of knock-down factors in the design process, especially in circumstances in which minimum weight is a key design goal, an approach well-established at NASA, for example. Not only does this provide challenges in the practical design of this commonly occurring structural load-bearing configuration, but also in the carefully controlled laboratory setting. The recent development of 3D-printing (additive manufacturing) provides an appealing experimental platform for conducting relatively high-fidelity experiments on the buckling of cylinders. However, in addition to geometric precision, there are a number of shortcomings with this approach, and this article seeks to describe the challenges and opportunities associated with the use of 3D-printing in cylinder buckling in general, and probing the robustness of equilibrium configurations in particular.
This article is part of the theme issue ‘Probing and dynamics of shock sensitive shells’.
Gametic Selection and Mating Systems show Mutually Dependent Evolution
Authors: Scott Michael F , Immler Simone 
Published: February 2023

AbstractCompetition among pollen or sperm (gametic selection) can cause evolution. Mating systems shape the intensity of gametic selection by determining the competitors involved, which can in turn cause mating system evolution. We model the bidirectional relationship between gametic selection and mating systems, focussing on variation in female mating frequency (monandry-polyandry) and self-fertilisation (selfing-outcrossing). First, we find that mating systems affect evolutionary responses to gametic selection, with more effective gametic selection when fertilisation success depends on haploid genotypes, rather than the diploid genotype of the father. Monandry and selfing both reduce the efficacy of gametic selection despite creating intense selection among pollen/sperm from heterozygous males with haploid expression. This effect means selfing can increase mutation load, in contrast to classic predictions where selfing purges deleterious mutations. Second, we show that mating systems can evolve via their effect on gametic selection, with polyandry evolving because it removes deleterious alleles more efficiently and increases offspring fitness. Our population genetic models reveal that this ‘good sperm’ effect could plausibly give a selective advantage for polyandry over monandry of only around 1%. Selection for polyandry is lessened further if some loci experience balancing selection and is likely to be overwhelmed by any direct fitness effects of mating systems. Similarly, the indirect benefits from manipulating gametic selection have a weak influence on the evolution of selfing, which is dominated by ‘automatic selection’ and inbreeding depression in our model. Nevertheless, gametic selection can be potentially decisive for selfing evolution because it significantly reduces inbreeding depression, which favours selfing. One test of the predicted interactions between gametic selection and mating system evolution would be to compare evolutionary rates in genes with different expression patterns across different mating systems.
Overestimation of anticoagulant benefit in patients with atrial fibrillation and low life expectancy: evidence from 12 randomized trials
Authors: Shah Sachin J. , van Walraven Carl , Jeon Sun Young , Boscardin W. John , Hobbs FD Richard , Connolly Stuart , Ezekowitz Michael , Covinsky Kenneth E. , Fang Margaret C. , Singer Daniel E. 
Published: February 2023

ABSTRACTBackgroundPatients with atrial fibrillation (AF) have a high rate of all-cause mortality that is only partially attributable to vascular outcomes. While the competing risk of death may affect expected anticoagulant benefit, guidelines do not account for it. We sought to determine if using a competing risks framework materially affects the guideline-endorsed estimate of absolute risk reduction attributable to anticoagulants.MethodsWe conducted a secondary analysis of 12 RCTs that randomized patients with AF to oral anticoagulants or either placebo or antiplatelets. For each participant, we estimated the absolute risk reduction (ARR) of anticoagulants to prevent stroke or systemic embolism using two methods. First, we estimated the ARR using a guideline-endorsed model (CHA2DS2-VASc) and then again using a Competing Risk Model that uses the same inputs as CHA2DS2-VASc but accounts for the competing risk of death and allows for non-linear growth in benefit over time. We compared the absolute and relative differences in estimated benefit and whether the differences in estimated benefit varied by life expectancy.Results7933 participants had a median life expectancy of 8 years (IQR 6, 12), determined by comorbidity-adjusted life tables. 43% were randomized to oral anticoagulation (median age 73 years, 36% women). The guideline-endorsed CHA2DS2-VASc model estimated a larger ARR than the Competing Risk Model (median ARR at 3 years, 6.9% vs. 5.2%). ARR differences varied by life expectancies: for those with life expectancies in the highest decile, 3-year ARR difference (CHA2DS2-VASc model – Competing Risk Model 3-year risk) was −1.2% (42% relative underestimation); for those with life expectancies in the lowest decile, 3-year ARR difference was 5.9% (91% relative overestimation).ConclusionAnticoagulants were exceptionally effective at reduced stroke risk. However, anticoagulant benefits were misestimated with CHA2DS2-VASc, which does not account for the competing risk of death nor decelerating treatment benefit over time. Overestimation was most pronounced in patients with the lowest life expectancy and when benefit was estimated over a multi-year horizon.
Proteolytic cleavage and inactivation of the TRMT1 tRNA modification enzyme by SARS-CoV-2 main protease
Authors: Zhang Kejia , Eldin Patrick , Ciesla Jessica H. , Briant Laurence , Lentini Jenna M. , Ramos Jillian , Cobb Justin , Munger Joshua , Fu Dragony 
Published: February 2023

AbstractNonstructural protein 5 (Nsp5) is the main protease of SARS-CoV-2 that cleaves viral polyproteins into individual polypeptides necessary for viral replication. Here, we show that Nsp5 binds and cleaves human tRNA methyltransferase 1 (TRMT1), a host enzyme required for a prevalent post-transcriptional modification in tRNAs. Human cells infected with SARS-CoV-2 exhibit a decrease in TRMT1 protein levels and TRMT1-catalyzed tRNA modifications, consistent with TRMT1 cleavage and inactivation by Nsp5. Nsp5 cleaves TRMT1 at a specific position that matches the consensus sequence of SARS-CoV-2 polyprotein cleavage sites, and a single mutation within the sequence inhibits Nsp5-dependent proteolysis of TRMT1. The TRMT1 cleavage fragments exhibit altered RNA binding activity and are unable to rescue tRNA modification in TRMT1-deficient human cells. Compared to wildtype human cells, TRMT1-deficient human cells infected with SARS-CoV-2 exhibit reduced levels of intracellular viral RNA. These findings provide evidence that Nsp5-dependent cleavage of TRMT1 and perturbation of tRNA modification patterns contribute to the cellular pathogenesis of SARS-CoV-2 infection.