bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acceptability Among Frontline Staff Toward Distributing an Anonymous Alcohol Survey in Emergency Departments
Authors: Sivertsen Ditte M. , Andersen Karen V. , Becker Ulrik , Lisby Marianne , Andersen Ove , Brünes Nina , Kirk Jeanette W. 
Published: September 2023

Abstract
Emergency departments (EDs) serve as the front line when patients encounter the hospital system. Limited data are available of patients' alcohol habits collected during Danish ED visits, and no studies have, to our knowledge, examined frontline staffs' (registered nurses and medical secretaries) acceptability to deliver anonymous alcohol surveys to patients. We aimed at examining the proportion of survey respondents and the prevalence of patients' alcohol habits and also exploring frontline staff acceptability of the distribution of an anonymous survey regarding patients' alcohol habits in EDs. Intendedly, all eligible patients ≥18 years old entering two EDs in March 2019 should receive a survey based on the Alcohol Use Disorder Identification Test. The study was an explanatory, sequential, mixed methods design, and results were analyzed with descriptive statistics and a deductive content analysis based on the theoretical framework of acceptability. In total, 15% (n = 1,305) of the total 8,679 patients in the EDs returned the survey. Qualitative analysis of interviews (n = 31) with staff showed that they had been reluctant to distribute the survey primarily because of ethical concerns of anonymity, freedom of choice, and being nonjudgmental toward patients. Hence, patients with no obvious alcohol problems were more likely to receive the survey. Still, we found that 23% of the respondents had an Alcohol Use Disorder Identification Test score ≥ 8. Results indicate that frontline staffs' recognition of patients' alcohol use is inadequate, and findings show a low degree of acceptability among staff to deliver an anonymous survey, which is in line with earlier described barriers toward screening activities in EDs.
Risk factors associated with saphenous vein graft aneurysm after coronary artery bypass graft
Authors: Ghosh Bikona , SIbi Krishna Thiyagarajan , Boini Aishwarya , Castillo Miranda Jose C. D. , Sinha Mehul , Bansal Radha , Visconti-Lopez Fabriccio J. , Mesfin Girma Samuel , Aliye Asfaw Yonathan 
Published: September 2023

Introduction:
Saphenous vein graft aneurysm (SVGA) is a rare but life-threatening complication following coronary artery bypass grafting (CABG). The authors aim to identify the potential risk factors that lead to SVGA in post-CABG patients.

Methods:
A systematic review of original studies, observational studies, systematic reviews, meta-analyses, case studies, and case series was conducted using PubMed, Web of Science, Scopus, EMBASE, and Google Scholar involving adult patients (>18) with SVGA after CABG using MESH terminology in a broad search strategy. All searches were performed and analyzed according to PRISMA and duplicates were removed via Rayyan. Two independent investigators extracted and assessed the data involving demographics, and baseline data related to CABG and its manifestations.

Results:
Out of 487 finalized articles, 14 of them matched the inclusion requirements and reported 12 cases of SVGAs following CABG. Atherosclerosis with intimal calcification was the most common risk factor followed by infection. Others included hyperlipidemia, pneumonia, and cardiac pathologies mostly related to the ventricles and valves.

Conclusion:
Atherosclerosis associated with intimal calcification is the most common risk factor. Patient outcomes seem to improve upon early identification and regular follow-up imaging. The exclusion criteria indicated the study’s limits, and future studies that address these constraints may be able to better understand the risk variables involved in the genesis of SVGA.
Methodology for Analyzing Qualitative Data in Multiple Languages
Authors: Dolan Hanne R. , Alvarez Alexis A. , Freylersythe Sarah G. , Crane Tracy E. 
Published: September 2023

Background
Translation strategies are commonly used for qualitative interview data to bridge language barriers. Inconsistent translation of interviews can lead to conceptual inequivalence, where meanings of participants' experiences are distorted, threatening scientific rigor.

Objectives
Our objective is to describe a systematic method developed to analyze multilingual, qualitative interview data while maintaining the original language of the transcripts.

Methods
A literature review of translation strategies, cross-language, and multilingual qualitative research was conducted. Combined with criteria for qualitative content analysis and trustworthiness, the methodology was developed and used for a qualitative descriptive study.

Results
The study had interview data in both English and Spanish. The research team consisted of both native Spanish and English speakers, who were grouped based on language. Verbatim transcription of data occurred in the original languages. All codes were kept in English, allowing the research team to view the data set as a whole. Two researchers within each group coded each transcript independently before reaching a consensus. The entire research team discussed all transcripts, and finally, major themes were determined. Participants' quotes remained in the original language for publication, with an English translation included when needed.

Discussion
Analyzing transcripts in the original language brought forth cultural themes that otherwise may have been overlooked. This methodology promotes conceptual equivalence and trustworthiness that is paramount in cultural, linguistic, and social determinants of health research to advance health equity.
Critical Appraisal of Histologic Grading for Mucoepidermoid Carcinoma of Salivary Gland
Authors: Xu Bin , Alzumaili Bayan , Furlan Karina C. , Martinez German H. , Cohen Marc , Ganly Ian , Ghossein Ronald A. , Katabi Nora 
Published: September 2023

Multiple 3-tiered grading systems exist for mucoepidermoid carcinoma (MEC), leading to controversial results on the frequency and prognostic values of each grade. We aimed to identify prognostic histologic factors and to evaluate grading schemes in this retrospective study of 262 resected primary head and neck MECs. The rate of nodal metastasis was 8.4%. Large tumor size, tumor fibrosis, infiltrative border, lymphovascular invasion, perineural invasion, atypical mitosis, mitotic index (MI) ≥4/2 mm2 (4/10 HPFs), necrosis, and pT4 stage were associated with increased risk of nodal metastasis. The 5-year recurrence-free survival (RFS) was 95%. Significant prognostic factors for RFS included infiltrative border, tumor-associated lymphoid stroma, architectural patterns (macrocystic, microcystic, and noncystic), anaplasia, atypical mitosis, MI, necrosis, lymphovascular invasion, margin, pT stage, and tumor size. Nuclear anaplasia, high mitotic rate, and ≥25% microcystic component were significant independent prognostic factors on multivariate survival analysis. There was no significant difference between low-grade (LG) and intermediate-grade (IG) MECs in terms of risk of nodal metastasis and outcomes using all 4 known grading systems. Rather, high-grade MEC was consistently associated with an increased risk of nodal metastasis at presentation and decreased RFS and distant metastasis–free survival (DMFS) compared with the LG/IG MECs. We therefore recommend simplifying MEC grading to a 2-tiered grading scheme using MI and/or tumor necrosis. Using a 2-tiered grading, high-grade histology independently predict RFS, and is associated with a 25% risk of nodal metastasis, a 5-year RFS of 76%, and a 5-year DMFS of 76%, whereas LG MEC has a nodal metastasis rate of 7.0%, 5-year RFS of 97% and 5-year DMFS of 99%.
Addressing the Gray Zone in Affirmative Mastectomy
Authors: Krakauer Kelsi N. , Balumuka Darius , Meza-Rochin Ana , Rapp Katrina , White Elizabeth , Hansen Juliana 
Published: September 2023

Background
Surgical decision making in gender-affirming mastectomy (GAM) is based on a patient's classification using the Fischer scale. Fischer 1 patients are excellent candidates for periareolar (PA) approach and Fischer 3 patients almost exclusively undergo double incision with free nipple grafting (DIFNG). Fischer 2 patients are in a gray zone in which decision making is more challenging. In this patient population, periareolar approaches can lead to increased complication and revision rates but free grafting procedures seem excessive. We have created a treatment algorithm to address Fischer 2 patients and additionally developed a novel technique, the batwing, to provide patients with more options.

Methods
A retrospective chart review was undertaken to analyze the Fischer classification of all patients undergoing top surgery by a single surgeon at an academic institution from 2014 to 2021. The choice of surgical technique used as well as the outcomes of GAM among Fischer 2 patients was analyzed.

Results
Four hundred four patients underwent GAM, and 51 (11%) had Fischer 2 classification. The surgical techniques used were PA (27%), batwing (39%), nipple-sparing double incision (NSDI, 24%), and DIFNG (10%). Of those, 10% had major complications and 20% requested revision for contour irregularities. Major complication rates for PA, batwing, NSDI, and DIFNG were as follows: 2 of 14 patients (14%), 1 of 20 patients (5%), 1 of 12 patients (8%), and 1 of 5 patients (20%), respectively. The revision rate by technique was PA (36%), batwing (15%), NSDI (17%), and DIFNG (0%).

Conclusions
For Fischer 2 patients, batwing and NSDI techniques avoid the need for free nipple graft while providing better exposure, improved control of nipple-areolar complex position, and decreased rate of revision as compared with the PA technique. The complication rate was not significantly different. We present an algorithm accounting for Fischer grade, unique patient characteristics, and patient desires.
A 10-Year Update of Outcome Measures Used to Assess Results After Surgery for Cubital Tunnel Syndrome
Authors: Delancy Matthew M. , Kozusko Steven D. , Franco Michael J. 
Published: September 2023

Hypothesis
Outcomes reporting for the surgical release of ulnar nerve cubital tunnel entrapment have variability in subjective, objective, and validated measures. The aim of this study is to review the literature to reassess the measures used to report surgical outcomes for ulnar neurolysis at the elbow.

Methods
This study was conducted in accordance with the PRISMA guidelines on systematic reviews. Six electronic databases were queried from the past 10 years using specific search terms and Boolean operators. Two independent reviewers assessed 4290 unique titles and abstracts that were screened for inclusion criteria. Sixty-eight full text articles were included for analysis.

Results
Statistical significance was noted in the number of outcome measures reported between studies from journals of impact factor within the first and third quartiles (P = 0.0086) and first and fourth quartiles (P = 0.0247), although no significance exists in the number of cubital tunnel–specific measures based on impact factor (P = 0.0783). Seventy-nine percent (n = 54) of the included studies report subjective measures; 54% (n = 37) included objective measures. Seventy percent (n = 48) of the studies report disease-specific outcome measures.

Conclusion
There exists a discordance within the literature regarding the most appropriate, descriptive, and translational measures for reporting surgical outcomes of cubital tunnel syndrome. We recommend journal editors implement a requirement that authors reporting outcomes of ulnar nerve decompression must use a standard, validated measure to make comparisons across the literature universal. Furthermore, a minimum of at least 1 subjective and 1 objective measure should be standard.
Using a New Deep Learning Method for 3D Cephalometry in Patients With Hemifacial Microsomia
Authors: Xu Meng , Liu Bingyang , Luo Zhaoyang , Sun Min , Wang Yongqian , Yin Ningbei , Tang Xiaojun , Song Tao 
Published: September 2023

Abstract
Deep learning algorithms based on automatic 3D cephalometric marking points about people without craniomaxillofacial deformities have achieved good results. However, there has been no previous report about hemifacial microsomia (HFM). The purpose of this study is to apply a new deep learning method based on a 3D point cloud graph convolutional neural network to predict and locate landmarks in patients with HFM based on the relationships between points. The authors used a PointNet++ model to investigate the automatic 3D cephalometry. And the mean distance error (MDE) of the center coordinate position and the success detection rate (SDR) were used to evaluate the accuracy of systematic labeling. A total of 135 patients were enrolled. The MDE for all 32 landmarks was 1.46 ± 1.308 mm, and 10 landmarks showed SDRs at 2 mm over 90%, and only 4 landmarks showed SDRs at 2 mm under 60%. Compared with the manual reproducibility, the standard distance deviation and coefficient of variation values for the MDE of the artificial intelligence system was 0.67 and 0.43, respectively. In summary, our training sets were derived from HFM computed tomography to achieve accurate results. The 3D cephalometry system based on the graph convolutional network algorithm may be suitable for the 3D cephalometry system in HFM cases. More accurate results may be obtained if the HFM training set is expanded in the future.
Distinguishing Authentic Voices in the Age of ChatGPT: Comparing AI-Generated and Applicant-Written Personal Statements for Plastic Surgery Residency Application
Authors: Patel Viren , Deleonibus Anthony , Wells Michael W. , Bernard Steven L. , Schwarz Graham S. 
Published: September 2023

Background
ChatGPT, a generative artificial intelligence model, may be used by future applicants in the plastic surgery residency match.

Methods
Ten personal statements (5 generated by ChatGPT, 5 written by applicants) were rated by 10 reviewers, blinded to the source of the essay.

Results
A total of a 100 evaluations were collected. There was no significant difference in ratings for readability, originality, authenticity, and overall quality (all P > 0.05) when comparing computer-generated and applicant essays.

Conclusion
Personal statements prepared by ChatGPT are indistinguishable from essays written by actual applicants. This finding suggests that the current plastic surgery application format be reevaluated to better aid in holistic evaluation of students.
Comparison of Dorsoulnar Artery Perforator, Superficial Palmar Branch of the Radial Artery, and Superficial Circumflex Iliac Artery Perforator Flaps in Volar Finger Defects
Authors: Tatar Burak Ergün , Erçin Burak Sercan 
Published: September 2023

Background
Volar finger defects can sometimes be challenging for plastic surgeons. There are many reconstruction options from local flaps to free flaps. Therefore, the aim of this study was to present a functional and cosmetic comparison of the results of using dorsoulnar artery perforator (DUAP), superficial palmar branch of the radial artery (SPBRA), and superficial circumflex iliac artery perforator (SCIP) flaps for repairing volar finger defects.

Methods
Thirty-two patients were included in the study. The age and sex of the patients, cause of injury, defect location, defect size, and presence or absence of nerve damage were noted. The patients' defects were reconstructed with DUAP, SCIP, or SPBRA flaps. The flap size, flap elevation time, vessels, and early postoperative complications were noted. During the postoperative follow-up period, the Michigan Hand Outcomes Questionnaire scale was used to evaluate hand function, and the modified Vancouver Scar Scale was used to assess aesthetic appearance. Two-point discrimination tests and cold intolerance tests were performed to measure sensory outcomes. Donor site improvements were also noted.

Results
There was no significant difference between the groups in terms of age, defect size, flap size, follow-up time, and 2-point discrimination. It was observed that the elevation time was significantly shorter in the SCIP flap group, and the Michigan Hand Outcomes Questionnaire score was significantly lower in the DUAP flap group compared with the other 2 groups (P < 0.01). In addition, the modified Vancouver Scar Scale score was significantly higher in the DUAP flap group (P < 0.01).

Conclusion
The findings of this study show that the use of SPBRA flaps has more advantages than the use of DUAP and SCIP flaps in many respects.
Enhanced Efficacy of Resveratrol Loaded Silver Nanoparticle in Attenuating Sepsis-Induced Acute Liver Injury: Modulation of Inflammation, Oxidative Stress, and SIRT1 Activation
Authors: ÜSTÜNDAĞ Hilal , DANIŞMAN KALINDEMİRTAŞ Ferdane , DOĞANAY Songül , DEMİR Özlem , KURT Nezahat , TAHİR HUYUT Mehmet , ÖZGERİŞ Betül , KARİPER İshak Afşin 
Published: September 2023

ABSTRACT
Sepsis-induced acute liver injury is a life-threatening condition involving inflammation, oxidative stress, and endothelial dysfunction. In the present study, the preventive effects of resveratrol (RV) alone and resveratrol-loaded silver nanoparticles (AgNPs+RV) against sepsis-induced damage were investigated and compared in a rat model of polymicrobial sepsis induced by cecal ligation and puncture (CLP). Rats were divided into four groups: Sham, CLP, RV, and AgNPs+RV. Pro-inflammatory cytokines (tumor necrosis factor-alpha [TNF-α], interleukin-1 beta [IL-1β], interleukin-6 [IL-6]), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) activation, presepsin, procalcitonin, 8-hydroxy-2'-deoxyguanosine (8-OHDG), vascular endothelial growth factor (VEGF), and Sirtuin-1 (SIRT-1) levels were assessed to determine the treatments' effects. AgNPs+RV treatment significantly reduced pro-inflammatory cytokines, NF-κB activation, presepsin, procalcitonin, 8-OHDG, and VEGF levels compared to the CLP group, indicating attenuation of sepsis-induced liver injury. Both RV and AgNPs+RV treatments increased SIRT1 levels, suggesting a potential role of SIRT1 activation in mediating the protective effects. In conclusion, AgNPs+RV treatment demonstrated extremely enhanced efficacy in alleviating sepsis-induced liver injury by modulating inflammation, oxidative stress, and endothelial dysfunction, potentially mediated through SIRT1 activation. In this study, the effect of AgNPs+RV on sepsis was evaluated for the first time and these findings highlight AgNPs+RV as a promising therapeutic strategy for managing sepsis-induced liver injury, warranting further investigation.
A Randomized Double-blind Study to Assess the Skin Irritation and Sensitization Potential of a Once-weekly Donepezil Transdermal Delivery System in Healthy Volunteers
Authors: Sabbagh Marwan N. , Mathew Philip , Blau Alan 
Published: September 2023

Background:
A once-weekly donepezil transdermal delivery system (TDS; Adlarity; Corium, LLC) is indicated for the treatment of mild, moderate, and severe dementia of the Alzheimer type.

Methods:
In this placebo-controlled, randomized, double-blind phase 1 trial, healthy volunteers aged 40 years or older were randomized to receive a placebo and donepezil TDS and were evaluated for the primary endpoints of skin irritation and sensitization potential. Skin irritation was scored.

Results:
Two hundred fifty-six participants were randomized and received ≥1 dose of any treatment. After the first weekly TDS application, no skin irritation or minimal irritation was evident between donepezil and placebo TDSs. At the third weekly TDS application, for donepezil TDS, the average of the mean combined skin irritation score was 0.55 of a possible maximum of 7, indicating none to minimal skin irritation, and for placebo, the score was 0.19, indicating no skin irritation. Of 198 participants, 4 (2.0%) were considered potentially sensitized to donepezil TDS, and 0 were potentially sensitized to placebo TDS.

Conclusion:
Once-weekly 5-mg/d donepezil TDS demonstrated minimal skin irritation under conditions of use of 3 consecutive weekly patch applications to the same skin site and minimal sensitization potential.
Pan-cancer characterization and clinical outcome of ecDNA-enhancer mediated transcriptional dysregulation
Authors: Zhong Tengwei , zhao Huan , Liu Yupeng , Yan Danyang , Li Yuguo , Guo Zhiyun 
Published: September 2023

AbstractExtrachromosomal circular DNAs (ecDNAs) are extrachromosomal circular DNA elements harboring enhancers that can function as mobile transcriptional enhancers to promote oncogene amplification in diverse human cancers. However, little is known about the mechanism how ecDNA and relevant enhancers influence the transcription control in different cancers. Here, we performed a comprehensive pan-cancer analysis to explore the potential transcriptional regulatory network between ecDNA and enhancer, and the association with clinical outcomes in different human cancers. Firstly, we identified 18,385 enhancers on ecDNA in 1,921 samples of 20 TCGA tumors. By integrating corresponding RNA-seq data, we found that the expression levels of enhancer RNAs (eRNAs) were significantly different between ecDNA regions and corresponding linear chromosomes. This suggested that enhancers on ecDNA may employ eRNA to perform transcriptional regulation. Furthermore, we identified enhancer co-amplification with oncogenes and found that enhancers on ecDNA significantly affect the expression of co-amplified cancer genes and consequently influence the survival of cancer patients. In addition, we found that, compared to corresponding linear chromosomes, enhancers on ecDNA generally have lower levels of methylation, which may be mainly caused by the enhancer co-amplification with oncogenes. Genome-wide analysis of open chromatin regions revealed significantly higher levels of chromatin accessibility and certain chromosomal preferences in ecDNA regions comparing corresponding linear chromosomes. Moreover, we found that the downregulation of antigen presentation genes and the suppression of antigen presentation pathways may cause the tumor immune evasion mediated by ecDNA. Finally, we identified tumor-infiltrating activated mast cells in ecDNA-positive patients, which are associated with poorer prognosis. In summary, through pan-cancer analysis, we illustrate the characteristics and regulatory mechanisms of ecDNA and its enhancers in cancers, providing insights for future cancer treatment.
Epigenetic regulation of p63 blocks squamous-to-neuroendocrine transdifferentiation in esophageal development and malignancy
Authors: Zhang Yongchun , Karagiannis Dimitris , Liu Helu , Lin Mi , Fang Yinshan , Jiang Ming , Chen Xiao , Suresh Supriya , Huang Haidi , She Junjun , Shi Feiyu , Yang Patrick , El-Rifai Wael , Zaika Alexander , Oro Anthony E. , Rustgi Anil K. , Wang Timothy C. , Lu Chao , Que Jianwen 
Published: September 2023

AbstractWhile cell fate determination and maintenance are important in establishing and preserving tissue identity and function during development, aberrant cell fate transition leads to cancer cell heterogeneity and resistance to treatment. Here, we report an unexpected role for the transcription factor p63 (Trp63/TP63) in the fate choice of squamous versus neuroendocrine lineage in esophageal development and malignancy. Deletion ofp63results in extensive neuroendocrine differentiation in the developing mouse esophagus and esophageal progenitors derived from human embryonic stem cells. In human esophageal neuroendocrine carcinoma (eNEC) cells, p63 is transcriptionally silenced by EZH2-mediated H3K27 trimethylation (H3K27me3). Upregulation of the major p63 isoform ΔNp63α, through either ectopic expression or EZH2 inhibition, promotes squamous transdifferentiation of eNEC cells. Together these findings uncover p63 as a rheostat in coordinating the transition between squamous and neuroendocrine cell fates during esophageal development and tumor progression.