bluuebunny/crossref_metadata_2025_split huggingface dataset:
A review of clinical practice guidelines for preventing chlamydial and gonococcal ophthalmia neonatorum
Authors: Sun Ruiyang , Zhu Xiu , Zhang Ting , Lu Hong 
Published: June 2023

Abstract

Background:
Ophthalmia neonatorum poses a significant risk of severe damage to neonatal eyes, including corneal perforation and blindness, if preventive measures are not implemented after birth. While the World Health Organization (WHO) has recommended universal topical ocular prophylaxis, limited evaluations have been conducted regarding the consistency of international and national clinical practice guidelines concerning the prevention of neonatal ophthalmia.

Objective:
The objective of this study is to evaluate and analyze clinical practice guidelines pertinent to the prevention of ophthalmia neonatorum in newborns following delivery. The aim is to offer guidance to medical and nursing staff regarding newborn eye care within the clinical context.

Methods:
WHO, Guidelines International Network (GIN), National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Queensland Clinical Guideline (QCG), Joanna Briggs Institute (JBI), Canada Registered Nurses’ Association of Ontario (RNAO), New Zealand Guidelines Group (NZGG) and Chinese Medlive, professional societies focusing on newborn care, and bibliographic databases such as PubMed, Embase, Web of Science, CNKI, WanFang Database, VIP, and SinoMed were systematically searched. The International Guidelines Evaluation Screening Tool (IGEST) and AGREE II were utilized to assess the quality of the guidelines. Content analysis methodology was employed for summarization, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was applied to determine the quality of evidence and the strength of recommendations.

Results:
A total of eight guidelines pertaining to neonatal ophthalmia were included in the analysis. Among them, guidelines from the National Institute for Health and Care Excellence (NICE) and WHO obtained higher scores (≥80%). Seven guidelines recommended universal topical ocular prophylaxis. Additionally, two guidelines recommended prescreening and pretreatment of pregnant women at risk of exposure to chlamydia and gonococcus. In total, 17 recommendations were summarized. While the quality of specific evidence ranged from “very low” to “low,” the majority (12/17) of the recommendation strengths were classified as “strong”.

Conclusion:
In the clinical context, both universal topical ocular prophylaxis for neonates and screening and treatment of pregnant women and their partners for sexually transmitted diseases (STDs) are recommended.
Comparison of 16 Pediatric Acute Respiratory Distress Syndrome-Associated Plasma Biomarkers With Changing Lung Injury Severity*
Authors: Williams James G. , Jones Rhonda L. , Yunger Toni L. , Lahni Patrick M. , Yehya Nadir , Varisco Brian M. 
Published: June 2023

OBJECTIVES:
Pediatric acute respiratory distress syndrome (PARDS) is a source of substantial morbidity and mortality in the PICU, and different plasma biomarkers have identified different PARDS and ARDS subgroups. We have a poor understanding of how these biomarkers change over time and with changing lung injuries. We sought to determine how biomarker levels change over PARDS course, whether they are correlated, and whether they are different in critically ill non-PARDS patients.

DESIGN:
Two-center prospective observational study.

SETTING:
Two quaternary care academic children’s hospitals

PATIENTS:
Subjects under 18 years of age admitted to the PICU who were intubated and met the Second Pediatric Acute Lung Injury Consensus Conference-2 PARDS diagnostic criteria and nonintubated critically ill subjects without apparent lung disease.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Plasma samples were obtained on study days 1, 3, 7, and 14. The levels of 16 biomarkers were measured using a fluorometric bead-based assay. Compared with non-PARDS subjects, on day 1 PARDS subjects had increased concentrations of tumor necrosis factor-alpha, interleukin (IL)-8, interferon-γ, IL17, granzyme B, soluble intercellular adhesion molecule-1 (sICAM1), surfactant protein D, and IL18 but reduced matrix metalloproteinase 9 (MMP-9) concentrations (all p < 0.05). Day 1 biomarker concentrations and PARDS severity were not correlated. Over PARDS course, changes in 11 of the 16 biomarkers positively correlated with changing lung injury with sICAM1 (R = 0.69, p = 2.2 × 10–16) having the strongest correlation. By Spearman rank correlation of biomarker concentrations in PARDS subjects, we identified two patterns. One had elevations of plasminogen activator inhibitor-1, MMP-9, and myeloperoxidase, and the other had higher inflammatory cytokines.

CONCLUSIONS:
sICAM1 had the strongest positive correlation with worsening lung injury across all study time points suggesting that it is perhaps the most biologically relevant of the 16 analytes. There was no correlation between biomarker concentration on day 1 and day 1 PARDS severity; however, changes in most biomarkers over time positively correlated with changing lung injury. Finally, in day 1 samples, 7 of the 16 biomarkers were not significantly different between PARDS and critically ill non-PARDS subjects. These data highlight the difficulty of using plasma biomarkers to identify organ-specific pathology in critically ill patients.
Robotics in Plastic Surgery: It’s Here
Authors: Henn Dominic , Trotsyuk Artem A. , Barrera Janos A. , Sivaraj Dharshan , Chen Kellen , Mittal Smiti , Mermin-Bunnell Alana M. , Chattopadhyay Arhana , Larson Madelyn R. , Kinney Brian M. , Nachbar James , TerKonda Sarvam P. , Reddy Sashank , Jeffers Lynn , Sacks Justin M. , Gurtner Geoffrey C. 
Published: June 2023

Summary:
Although robotic surgery has been routinely established in other surgical disciplines, robotic technologies have been less readily adopted in plastic surgery. Despite a strong demand for innovation and cutting-edge technology in plastic surgery, most reconstructive procedures, including microsurgery, have continued to necessitate an open approach. Recent advances in robotics and artificial intelligence, however, are gaining momentum and have shown significant promise to improve patient care in plastic surgery. These next-generation surgical robots have the potential to enable surgeons to perform complex procedures with greater precision, flexibility, and control than previously possible with conventional techniques. Successful integration of robotic technologies into clinical practice in plastic surgery requires achieving key milestones, including implementing appropriate surgical education and garnering patient trust.
Functional Outcome of Dual Reinnervation with Cross-Facial Nerve Graft and Masseteric Nerve Transfer for Facial Paralysis
Authors: Kollar Branislav , Weiss Jakob B. W. , Kiefer Jurij , Eisenhardt Steffen U. 
Published: June 2023

Background:
The combination of cross-facial nerve graft (CFNG) and masseteric nerve transfer (MNT) for reinnervation of facial paralysis may provide advantages of both neural sources. However, quantitative functional outcome reports with a larger number of patients are lacking in the literature. Here, the authors describe their 8-year experience with this surgical technique.

Methods:
Twenty patients who presented with complete facial paralysis (duration, <12 months) received dual reinnervation with CFNG and MNT. The functional outcome of the procedure was evaluated with the physician-graded outcome metric eFACE scale. The objective artificial intelligence–driven software Emotrics and FaceReader were used for oral commissure measurements and emotional expression assessment, respectively.

Results:
The mean follow-up was 31.75 ± 23.32 months. In the eFACE score, the nasolabial fold depth and oral commissure at rest improved significantly (P < 0.05) toward a more balanced state after surgery. Postoperatively, there was a significant decrease in oral commissure asymmetry while smiling (from 19.22 ± 6.1 mm to 12.19 ± 7.52 mm). For emotional expression, the median intensity score of happiness, as measured by the FaceReader software, increased significantly while smiling (0.28; interquartile range, 0.13 to 0.64). In five patients (25%), a secondary static midface suspension with fascia lata strip had to be performed because of unsatisfactory resting symmetry. Older patients and patients with greater preoperative resting asymmetry were more likely to receive static midface suspension.

Conclusion:
The authors’ results suggest that the combination of MNT and CFNG for reinnervation of facial paralysis provides good voluntary motion and may lessen the use of static midface suspension in the majority of patients.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Dolutegravir induced neural tube defects in mice are folate responsive
Authors: Tukeman Gabriel L. , Wei Hui , Finnell Richard H. , Cabrera Robert M. 
Published: June 2023

Objectives
In 2018, the Botswana Tsepamo Study reported a nine-fold increased risk of neural tube defects in infants whose mothers were treated with dolutegravir (DTG) from the time of conception. As maternal folate supplementation and status is a well-known modifier of neural tube defect (NTD) risk, we sought to evaluate birth outcomes in mice fed normal and low folic acid diets treated with DTG during pregnancy.

Design
DTG was evaluated for developmental toxicity using pregnant mice fed normal or low folic acid diet.

Methods
CD-1 mice were provided diet with normal (3 mg per kg) or low (0.3 mg per kg) folic acid. They were treated with water, a human therapeutic-equivalent dose, or supratherapeutic dose of DTG from mouse embryonic day E6.5 to E12.5. Pregnant dams were sacrificed at term (E18.5) and fetuses were inspected for gross, internal, and skeletal defects.

Results
Fetuses with exencephaly, an NTD, were present in both therapeutic human equivalent and supratherapeutic exposures in dams fed low folic acid diet. Palate clefts were also found under both folate conditions.

Conclusions
Recommended dietary folic acid levels during mouse pregnancy ameliorate developmental defects that arise from DTG exposure. Since low folate status in mice exposed to DTG increases the risk for NTDs, it is possible that DTG exposures in people living with HIV with low folate status during pregnancy may explain, at least in part, the elevated NTD risk signal observed in Botswana. Based on these results, future studies should consider folate status as a modifier for DTG-associated NTD risk.
High Spatial-Resolution Skull Base Imaging With Photon-Counting Computed Tomography and Energy-Integrating Computed Tomography: A Comparative Phantom Study
Authors: Rajagopal Jayasai R. , Schwartz Fides R. , Solomon Justin B. , Enterline David S. , Samei Ehsan 
Published: June 2023

Abstract
Photon-counting computed tomography (PCCT) offers better high-resolution and noise performance than energy integrating detector (EID) CT. In this work, we compared both technologies for imaging of the temporal bone and skull base. A clinical PCCT system and 3 clinical EID CT scanners were used to image the American College of Radiology image quality phantom using a clinical imaging protocol with matched CTDIvol (CT dose index-volume) of 25 mGy. Images were used to characterize the image quality of each system across a series of high-resolution reconstruction options. Noise was calculated from the noise power spectrum, whereas resolution was quantified with a bone insert by calculating a task transfer function. Images of an anthropomorphic skull phantom and 2 patient cases were examined for visualization of small anatomical structures. Across measured conditions, PCCT had a comparable or smaller average noise magnitude (120 Hounsfield units [HU]) to the EID systems (144–326 HU). Photon-counting CT also had comparable resolution (task transfer function f
25: 1.60 mm−1) to the EID systems (1.34–1.77 mm−1). Imaging results supported quantitative findings as PCCT more clearly showed the 12-lp/cm bars from the fourth section of the American College of Radiology phantom and better represented the vestibular aqueduct and oval and round windows when compared with the EID scanners. A clinical PCCT system was able to image the temporal bone and skull base with improved spatial resolution and lower noise than clinical EID CT systems at matched dose.
FDG Localization in Acellular Dermal Matrix, a Potential Cause of Nonpernicious Uptake Following Breast Reconstruction Surgery
Authors: Nemzow Gabriel , Zuckier Lionel S. 
Published: June 2023

Abstract
A 47-year-old woman with invasive lobular carcinoma of the left breast underwent prophylactic double mastectomy which also incidentally revealed follicular lymphoma of the right breast. Reconstruction was achieved with bilateral silicone implants and acellular dermal matrix (ADM), a biological scaffold material providing mechanical support. Twelve days thereafter, staging PET/CT demonstrated symmetric moderate FDG uptake corresponding to location of the ADM slings, suspected to reflect cellular engraftment onto the ADM and confirmed by near-complete resolution at 3-month follow-up study. FDG uptake related to ADM should be recognized as reflecting expected cellular incorporation into the matrix, rather than recurrent tumor or infection.
Defining the emergency general surgery patient population in the era of ICD-10: Evaluating an established crosswalk from ICD-9 to ICD-10 diagnosis codes
Authors: Dalton Michael K. , Sokas Claire M. , Castillo-Angeles Manuel , Semco Robert S. , Scott John W. , Cooper Zara , Salim Ali , Havens Joaquim M. , Jarman Molly P. 
Published: June 2023

INTRODUCTION
In 2015, the United States moved from the International Classification of Diseases, Ninth Revision (ICD-9), to the International Classification of Diseases, Tenth Revision (ICD-10), coding system. The American Association for the Surgery of Trauma Committee on Severity Assessment and Patient Outcomes previously established a list of ICD-9 diagnoses to define the field of emergency general surgery (EGS). This study evaluates the general equivalence mapping (GEM) crosswalk to generate an equivalent list of ICD-10–coded EGS diagnoses.

METHODS
The GEM was used to generate a list of ICD-10 codes corresponding to the American Association for the Surgery of Trauma ICD-9 EGS diagnosis codes. These individual ICD-9 and ICD-10 codes were aggregated by surgical area and diagnosis groups. The volume of patients admitted with these diagnoses in the National Inpatient Sample in the ICD-9 era (2013–2014) was compared with the ICD-10 volumes to generate observed to expected ratios. The crosswalk was manually reviewed to identify the causes of discrepancies between the ICD-9 and ICD-10 lists.

RESULTS
There were 485 ICD-9 codes, across 89 diagnosis categories and 11 surgical areas, which mapped to 1,206 unique ICD-10 codes. A total of 196 (40%) ICD-9 codes have an exact one-to-one match with an ICD-10 code. The median observed to expected ratio among the diagnosis groups for a primary diagnosis was 0.98 (interquartile range, 0.82–1.12). There were five key issues identified with the ability of the GEM to crosswalk ICD-9 EGS diagnoses to ICD-10: (1) changes in admission volumes, (2) loss of necessary modifiers, (3) lack of specific ICD-10 code, (4) mapping to a different condition, and (5) change in coding nomenclature.

CONCLUSION
The GEM provides a reasonable crosswalk for researchers and others to use when attempting to identify EGS patients in with ICD-10 diagnosis codes. However, we identify key issues and deficiencies, which must be accounted for to create an accurate patient cohort. This is essential for ensuring the validity of policy, quality improvement, and clinical research work anchored in ICD-10 coded data.

LEVEL OF EVIDENCE
Diagnostic Test/Criteria; Level III.
The Role of Apathy in Spontaneous Verbal and Nonverbal Behaviors: A Transdiagnostic Pilot Study in Neurodegeneration
Authors: Horne Kristina S. , Ceslis Amelia , Mosley Philip , Adam Robert , Robinson Gail A. 
Published: June 2023

Background:
Apathy, characterized by a quantifiable reduction in motivation or goal-directed behavior, is a multidimensional syndrome that has been observed across many neurodegenerative diseases.

Objective:
To develop a novel task measuring spontaneous action initiation (ie, a nonverbal equivalent to spontaneous speech tasks) and to investigate the association between apathy and executive functions such as the voluntary initiation of speech and actions and energization (ie, ability to initiate and sustain a response).

Method:
We compared the energization and executive functioning performance of 10 individuals with neurodegenerative disease and clinically significant apathy with that of age-matched healthy controls (HC). We also investigated the association between self-reported scores on the Apathy Evaluation Scale (AES) and performance on energization tasks.

Results:
The individuals with apathy made significantly fewer task-related actions than the HC on the novel spontaneous action task, and their scores on the AES were negatively correlated with spontaneous task-related actions, providing preliminary evidence for the task’s construct validity. In addition, the individuals with apathy performed more poorly than the HC on all of the energization tasks, regardless of task type or stimulus modality, suggesting difficulty in sustaining voluntary responding over time. Most of the tasks also correlated negatively with the AES score. However, the individuals with apathy also performed more poorly on some of the executive function tasks, particularly those involving self-monitoring.

Conclusion:
Our work presents a novel experimental task for measuring spontaneous action initiation—a key symptom of apathy—and suggests a possible contribution of apathy to neuropsychological deficits such as poor energization.
Nitrate reduction capacity of the oral microbiota is impaired in periodontitis: potential implications for systemic nitric oxide availability
Authors: Rosier Bob , Johnston William , Carda-Diéguez Miguel , Simpson Annabel , Cabello-Yeves Elena , Piela Krystyna , Reilly Robert , Artacho Alejandro , Easton Chris , Burleigh Mia , Culshaw Shauna , Mira Alex 
Published: June 2023

AbstractBackgroundThe reduction of nitrate to nitrite by the oral microbiota has been proposed to be important for oral health and results in nitric oxide formation that can improve cardiometabolic conditions, such as hypertension and diabetes. Studies of bacterial composition in subgingival plaque suggest that nitrate-reducing bacteria are associated with healthy conditions, but the impact of periodontitis on nitrate-reducing capacity and therefore nitric oxide availability has not been evaluated. The aim of the current study is to see assess how periodontitis and periodontal treatment affect the nitrate reduction capacity of the oral microbiota.MethodsFirst, 16S rRNA sequencing data of five studies from different countries were analysed with the Dada2 pipeline to compare nitrate-reducing bacteria in health and periodontitis. Additionally, subgingival plaque, saliva and plasma samples from 42 periodontitis patients were collected before and after non-surgical periodontal therapy (NSPT). The subgingival plaque bacterial composition was determined using Illumina sequencing of the 16S rRNA gene and the quantity of the nitrate-reducing biomarker genusRothiawas determined by qPCR. Measurements of nitrate and nitrite in saliva and plasma were performed and the salivary nitrate reduction capacity (NRC) was determined after three hours of incubationin vitroand compared with the NRC of 15 healthy individuals.ResultsNitrate-reducing bacteria were significantly lower in subgingival plaque of periodontitis patients compared with healthy individuals (p < 0.05 in all five datasets). After NSPT, nitrate-reducing bacteria increased in subgingival plaque (p < 0.05) and correlated negatively with periodontitis-associated bacteria (p < 0.001). A post-treatment increase in the genusRothiawas confirmed by qPCR (p < 0.05), as well as an increase in the salivary NRC (p < 0.05). No significant effect was found of NSPT on the plasma nitrate and nitrite levels in this population.ConclusionThe levels of nitrate-reducing bacteria of the subgingival microbiota decrease in periodontitis and both their levels and the salivary NRC increase after NSPT. We hypothesize that an impaired NRC can affect nitric oxide availability and can therefore be an instrumental link between periodontitis and systemic conditions.
Characteristics of ictal thalamic EEG in pediatric-onset neocortical focal epilepsy
Authors: Edmonds Benjamin , Miyakoshi Makoto , Remore Luigi Gianmaria , Ahn Samuel , Phillips H. Westley , Daida Atsuro , Salamon Noriko , Bari Ausaf , Sankar Raman , Matsumoto Joyce H. , Fallah Aria , Nariai Hiroki 
Published: June 2023

ABSTRACTObjective:To characterize ictal EEG change in the centromedian (CM) and anterior nucleus (AN) of the thalamus, using stereoelectroencephalography (SEEG) recordingsMethods:Forty habitual seizures were analyzed in nine patients with pediatric-onset neocortical drug-resistant epilepsy who underwent SEEG (age 2-25 y) with thalamic coverage. Both visual and quantitative analysis was used to evaluate ictal EEG signal in the cortex and thalamus. The amplitude and cortico-thalamic latencies of broadband frequencies at ictal onset were measured.Results:Visual analysis demonstrated consistent detection of ictal EEG changes in both the CM nucleus and AN nucleus with latency to thalamic ictal EEG changes of less than 400ms in 95% of seizures, with low-voltage fast activity being the most common ictal pattern. Quantitative broadband amplitude analysis showed consistent power changes across the frequency bands, corresponding to ictal EEG onset, while while ictal EEG latency was variable from -18.0 seconds to 13.2 seconds. There was no significant difference between detection of CM and AN ictal activity on visual or amplitude analysis. Four patients with subsequent thalamic responsive neurostimulation (RNS) demonstrated ictal EEG changes consistent with SEEG findings.Conclusions:Ictal EEG changes were consistently seen at the CM and AN of the thalamus during neocortical seizures.Significance:It may be feasible to use a closed-loop system in the thalamus to detect and modulate seizure activity for neocortical epilepsy.