bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine and deep learning in inflammatory bowel disease
Authors: Zulqarnain Fatima , Rhoads S. Fisher , Syed Sana 
Published: May 2023

Purpose of review
The Management of inflammatory bowel disease (IBD) has evolved with the introduction and widespread adoption of biologic agents; however, the advent of artificial intelligence technologies like machine learning and deep learning presents another watershed moment in IBD treatment. Interest in these methods in IBD research has increased over the past 10 years, and they offer a promising path to better clinical outcomes for IBD patients.

Recent findings
Developing new tools to evaluate IBD and inform clinical management is challenging because of the expansive volume of data and requisite manual interpretation of data. Recently, machine and deep learning models have been used to streamline diagnosis and evaluation of IBD by automating review of data from several diagnostic modalities with high accuracy. These methods decrease the amount of time that clinicians spend manually reviewing data to formulate an assessment.

Summary
Interest in machine and deep learning is increasing in medicine, and these methods are poised to revolutionize the way that we treat IBD. Here, we highlight the recent advances in using these technologies to evaluate IBD and discuss the ways that they can be leveraged to improve clinical outcomes.
Perceptions and priorities of perioperative staff and the public for sustainable surgery: a validated questionnaire study
Authors: Gadi Nishita , Lam Kyle , Acharya Amish , Winter Beatty Jasmine , Purkayastha Sanjay 
Published: May 2023

Background:
Surgery is a substantial contributor to healthcare-related emissions. Despite a drive to improve sustainability, few interventions have been adopted. Stakeholder engagement is considered a key barrier to implementation. This study aimed to determine the attitudes and beliefs of the perioperative staff and the public regarding sustainability initiatives in surgery, and whether differences exist between the two groups.

Materials and Methods:
Separate validated healthcare professional and public questionnaires were developed using a stepwise process. A systematic review was undertaken using Medline, Embase and Cochrane to identify key domains pertaining to sustainability and ensure content validity. Initial questionnaires were developed and refined using an iterative process of feedback from focus groups. Psychometric validation was conducted to remove question ambiguity. The final validated questionnaire was distributed to perioperative staff and the public using a multimodal approach involving online tools and in person.

Results:
Only 37.1% of perioperative staff reported the implementation of sustainability initiatives in their departments. Yet, staff (45.7%) and the public (48.2%) somewhat agreed that sustainability should influence a surgeon’s procedural decision-making. Insufficient staff education regarding sustainability was a potential cause for the lack of adoption, with 71.4% reporting they had no formal training. Moreover, discrepancies in the perceived importance of sustainability may have contributed. Staff and the public agreed that outcomes (38.6 vs. 42.7%, P=0.767) and surgeon experience with a technique (28.6 vs. 40.0%, P=0.082) were more important than sustainability. However, 40.9% of the public did not consider operative time an important factor compared to sustainability, while 45.7% of staff would only tolerate procedures 25% longer.

Conclusions:
Engaging stakeholders is central to implementing long-term environmentally sustainable initiatives in surgery without compromising patient outcomes. More work is needed to understand the relative trade-offs considered by perioperative staff and the public, as well as provide both groups with more pertinent education on ecological outcomes.
Bibliometric analysis of COVID-19 research in Morocco: short communication
Authors: Zoukal Sofia , Hassoune Samira , Nani Samira 
Published: May 2023

Introduction:
As a global pandemic, coronavirus disease 2019 (COVID-19) has led to a growing number of related research studies being published worldwide. However, there is no study on the bibliometric analysis of these Moroccan studies. This study aims to provide a general overview of COVID-19 studies in Morocco and may provide a direction for hot topics and future research trends.

Method:
The global literature about COVID-19 published between 2019 and 2022 was scanned in PubMed, the Web of Science collection database, Scopus, and two preprint platforms. ‘COVID-19’, ‘Novel Coronavirus’, ‘2019-nCoV’, and ‘SARS-CoV-2’ were used as the keywords to reach the relevant publications. The VOS viewer was applied to perform the bibliometric analysis of these articles.

Results:
A total of 987 Moroccan publications on the topic of COVID-19 were retrieved. Of all these publications, 166 (61.9%) were original journal articles, 10 (3.7%) were review articles, 514 (8.38%) were letters and 56 (20.9%) were others, such as case reports, notes, or book chapters. Ten original articles (3.7%) had not yet been peer-reviewed and were retrieved from the preprint servers medRxiv and bioRxiv. The highest number of COVID-19 publications was published by Mohammed V University in Rabat (n=45, 16.8%), followed by Hassan II University (n=32, 11.9%) and Mohammed VI University of Health Sciences (n=29, 10.8%). The open-access format was the predominant publishing model (43.2%) and 92.9% were written in English. The main research lines identified in COVID-19 for Morocco are related to the pandemic’s indirect effects: education (11.2%), mental health (6.3%), and the environment (6.3%).

Conclusion:
Moroccan institutions have made a profound contribution to COVID-19 research than that in other African countries, but lags behind compared to that in Arabic countries.
Laparoscopic modified fundus-down cholecystectomy technique: an alternative method for performing a safe laparoscopic cholecystectomy: how to article
Authors: Jearanai Supakool , Wangkulangkul Piyanun , Sakolprakaikit Kanittha , Cheewatanakornkul Siripong 
Published: May 2023

Background:Modified fundus-down cholecystectomy is a surgical procedure used to treat patients diagnosed with benign gallbladder disease. This technique begins with Calot’s triangle dissection and attempts to identify key structures such as the cystic artery and duct. Subsequently, fundus-down dissection is performed to separate the gallbladder from the cystic plate. The cystic artery and duct are the final structures that are clipped and cut. In this study, the authors discuss the success and complication rates of this treatment based on their 10-year experience at a tertiary hospital in southern Thailand.Objectives:This study aimed to compare the operative outcomes of conventional laparoscopic cholecystectomy (LC) and modified fundus-down techniques regarding postoperative complications and consequences.Methods:A retrospective analysis of single-centre data from 2010 to 2022 was conducted at our hospital. All patients with gallstone disease who underwent conventional LC or modified fundus-down cholecystectomy were included in the study. The primary outcomes of this study were the incidence of major bile duct injury and the need for further intervention or surgical correction.Results:From a total of 1993 patients who were surveyed, 1612 patients underwent conventional LC and 381 underwent laparoscopic modified fundus-down cholecystectomy. In terms of conversion rate, estimated blood loss, length of hospital stay, and complication rate, there were no differences between the conventional LC and the modified fundus-down approach. However, modified fundus-down cholecystectomy reduced the operative time. The authors collected data from each patient’s sign-in to extubation time (P<0.001). The postoperative complications (P=0.120) and conversion rates (P=0.904) were similar.Conclusion:Laparoscopic modified fundus-down cholecystectomy can be performed in simple and complex cases, including cases of severe fibrosis of the hepatocystic triangle. The study showed that this alternative technique could reduce operative time compared to the conventional technique with no difference in complications, especially common bile duct injury, postoperative common bile duct stones, and postoperative pancreatitis.
First-line treatment options for advanced gastric/gastroesophageal junction cancer patients with PD-L1-positive: a systematic review and meta-analysis
Authors: Fan Ling , Lu Ning , Zhang Lingmin , Zhang Jie , Li Jie , Cui Manli , Zhang Mingxin 
Published: May 2023

Background:
Lately, many trials have paid much attention on the oncological outcomes of immunotherapy combined with chemotherapy as a first-line treatment. The authors perform a systematic meta-analysis to assess the efficacy and safety of programmed death 1 inhibitor plus chemotherapy for first-line treatment in advanced gastric/gastroesophageal junction cancer.

Materials and methods:
Literature search through major databases in English and Chinese: PubMed, Embase, Cochrane library, web of Science and CNKI updated on 10 March 2023. Randomized controlled trials were selected to investigate chemotherapy plus programmed death 1 inhibitor versus chemotherapy.

Results:
A total of 7 randomised controlled trials including 5788 participants were included. The overall survival (hazard ratio=0.79;95% CI: 0.74–0.85, P<0.01), progression-free survival (hazard ratio=0.72; 95% CI: 0.67–0.77, P<0.01) and objective response rate (risk ratio=1.24,95% CI: 1.18–1.31, P<0.05) were longer than chemotherapy alone in the pooled analysis. For subgroup analyses of overall survival, programmed death 1 inhibitors plus chemotherapy had a significant advantage in patients with combined positive score greater than or equal to 5, in Asia, in men and in those younger than 65 years (P<0.01), as were immune-mediated adverse events (odds ratio=8.86;95% CI: 1.26–62.47,P<0.05) and treatment-related grade 3–5 adverse events (odds ratio=1.40,95% CI:1.20–1.62, P<0.01).

Conclusion:
Programmed death 1 inhibitors plus chemotherapy have significant antitumour activity compared to chemotherapy alone. However, it is riskier in terms of toxicity than chemotherapy. The authors recommend programmed death 1 inhibitors plus chemotherapy as the optimal treatment regimen for patients with positive programmed death ligand 1 expression, in Asia, male and less than 65 years of age. More well-designed studies are needed to investigate the efficacy and safety of different immune plus chemotherapy drug doses and regimens.
Comparing the Detection Performance Between Multiparametric Magnetic Resonance Imaging and Prostate-Specific Membrane Antigen PET/CT in Patients With Localized Prostate Cancer
Authors: Wang Yuh-Feng , Lo Chun-Yu , Chen Li-Yu , Chang Chi-Wei , Huang Ya-Ting , Huang Ya-Yao , Huang Yi-Hsiu 
Published: May 2023

Purpose
Multiparametric MRI (mpMRI) has been promoted as an auxiliary diagnostic tool for prostate biopsy. However, prostate-specific membrane antigen (PSMA) including 68Ga-PSMA-11, 18F-DCFPyL, and 18F-PSMA-1007 applied PET/CT imaging was an emerging diagnostic tool in prostate cancer patients for staging or posttreatment follow-up, even early detecting. Many studies have used PSMA PET for comparison with mpMRI to test the diagnostic ability for early prostate cancer. Unfortunately, these studies have shown conflicting results. This meta-analysis aimed to compare the differences in diagnostic performance between PSMA PET and mpMRI for detecting and T staging localized prostatic tumors.

Methods
This meta-analysis involved a systematic literature search of PubMed/MEDLINE and Cochrane Library databases. The pooling sensitivity and specificity of PSMA and mpMRI verified by pathological analysis were calculated and used to compare the differences between the 2 imaging tools.

Results
Overall, 39 studies were included (3630 patients in total) from 2016 to 2022 in the current meta-analysis and found that the pooling sensitivity values for localized prostatic tumors and T staging T3a and T3b of PSMA PET were 0.84 (95% confidence interval [CI], 0.83–0.86), 0.61 (95% CI, 0.39–0.79), and 0.62 (95% CI, 0.46–0.76), respectively, whereas those of mpMRI were found to be 0.84 (95% 0.78–0.89), 0.67 (95% CI, 0.52–0.80), and 0.60 (95% CI, 0.45–0.73), respectively, without significant differences (P > 0.05). However, in a subgroup analysis of radiotracer, the pooling sensitivity of 18F-DCFPyL PET was higher than mpMRI (relative risk, 1.10; 95% CI, 1.03–1.17; P < 0.01).

Conclusions
This meta-analysis found that whereas 18F-DCFPyL PET was superior to mpMRI at detecting localized prostatic tumors, the detection performance of PSMA PET for localized prostatic tumors and T staging was comparable to that of mpMRI.
FAPI PET Signal in Hibernoma Reflects FAP Expression in Tumor Vasculature Cells
Authors: Hotta Masatoshi , Mona Christine E. , Crompton Joseph G. , Armstrong Wesley R. , Gafita Andrei , Nelson Scott D. , Eilber Fritz C. , Dawson David W. , Calais Jeremie , Benz Matthias R. 
Published: May 2023

Abstract
A 43-year-old man with a growing mass in the right groin, concerned for liposarcoma, underwent MRI and 68Ga–fibroblast activation protein inhibitor (FAPI)-46 PET/CT before surgery. Fibroblast activation protein inhibitor PET/CT demonstrated increased uptake (SUVmax, 3.2) predominantly in the solid portion, where MRI showed gadolinium enhancement. The patient subsequently underwent surgery and was diagnosed with hibernoma. The immunohistochemistry of the tumor revealed the fibroblast activation protein expression in the fibrovascular network and myofibroblastic cells of the tumor. This case suggests that the FAPI uptake can be affected by the vascular cells, and thus, a careful interpretation of the FAPI PET signal may be needed.
Visual Attention, Bias, and Social Dispositions Toward People With Facial Anomalies
Authors: Villavisanis Dillan F. , Workman Clifford I. , Zapatero Zachary D. , Vu Giap H. , Humphries Stacey A. , Blum Jessica D. , Cho Daniel Y. , Swanson Jordan W. , Bartlett Scott P. , Chatterjee Anjan , Taylor Jesse A. 
Published: May 2023

Background
Facial attractiveness influences our perceptions of others, with beautiful faces reaping societal rewards and anomalous faces encountering penalties. The purpose of this study was to determine associations of visual attention with bias and social dispositions toward people with facial anomalies.

Methods
Sixty subjects completed tests evaluating implicit bias, explicit bias, and social dispositions before viewing publicly available images of preoperative and postoperative patients with hemifacial microsomia. Eye-tracking was used to register visual fixations.

Results
Participants with higher implicit bias scores fixated significantly less on the cheek and ear region preoperatively (P = 0.004). Participants with higher scores in empathic concern and perspective taking fixated more on the forehead and orbit preoperatively (P = 0.045) and nose and lips (P = 0.027) preoperativel.

Conclusions
Participants with higher levels of implicit bias spent less visual attention on anomalous facial anatomy, whereas participants with higher levels of empathic concern and perspective taking spent more visual attention on normal facial anatomy. Levels of bias and social dispositions such as empathy may predict layperson gaze patterns toward those with facial anomalies and provide insights to neural mechanisms underlying the “anomalous is bad” paradigm.
Immediate Versus Delayed-Immediate Autologous Breast Reconstruction After Nipple-Sparing Mastectomy
Authors: Barnes Laura L. , Patterson Anne , Lem Melinda , Holland Michael C. , Lentz Rachel , Sbitany Hani , Piper Merisa L. 
Published: May 2023

Introduction
Autologous reconstruction following nipple-sparing mastectomy (NSM) is either performed in a delayed-immediate fashion, with a tissue expander placed initially at the time of mastectomy and autologous reconstruction performed later, or immediately at the time of NSM. It has not been determined which method of reconstruction leads to more favorable patient outcomes and lower complication rates.

Methods
We performed a retrospective chart review of all patients who underwent autologous abdomen-based free flap breast reconstruction after NSM between January 2004 and September 2021. Patients were stratified into 2 groups by timing of reconstruction (immediate and delayed-immediate). All surgical complications were analyzed.

Results
One hundred one patients (151 breasts) underwent NSM followed by autologous abdomen-based free flap breast reconstruction during the defined time period. Fifty-nine patients (89 breasts) underwent immediate reconstruction, whereas 42 patients (62 breasts) underwent delayed-immediate reconstruction. Considering only the autologous stage of reconstruction in both groups, the immediate reconstruction group experienced significantly more delayed wound healing, wounds requiring reoperation, mastectomy skin flap necrosis, and nipple-areolar complex necrosis. Analysis of cumulative complications from all reconstructive surgeries revealed that the immediate reconstruction group still experienced significantly greater cumulative rates of mastectomy skin flap necrosis. However, the delayed-immediate reconstruction group experienced significantly greater cumulative rates of readmission, any infection, infection requiring PO antibiotics, and infection requiring IV antibiotics.

Conclusions
Immediate autologous breast reconstruction after NSM alleviates many issues seen with tissue expanders and delayed autologous reconstruction. Although mastectomy skin flap necrosis occurs at a significantly greater rate after immediate autologous reconstruction, it can often be managed conservatively.
Microvascular Free Flap Reconstruction of Thigh Defects After Tumor Resection in the Setting of Radiation
Authors: Kuruoglu Doga , Bakri Karim , Tran Nho V. , Moran Steven L. , Vijayasekaran Aparna , Carlsen Brian T. 
Published: May 2023

Background
Soft tissue reconstruction of the thigh defects can usually be achieved with local options. Free tissue transfer may be indicated in very large defects with exposed vital structures and/or a history of radiation therapy where the healing potential of local option is poor. In this study, we evaluated our experience on microsurgical reconstruction of oncological and irradiated thigh defects to assess the risk factors for complications.

Methods
Institutional review board–approved retrospective case series study using electronic medical records from 1997 to 2020 was conducted. All patients with irradiated thigh defects derived from oncological resections who underwent microsurgical reconstruction were included. Patient demographics and clinical and surgical characteristics were recorded.

Results
Twenty free flaps were transferred in 20 patients. Mean age was 60 ± 11.8 years, and median follow-up time was 24.3 months (interquartile range [IQR], 71.4–9.2 months). The most common type of cancer was liposarcoma (n = 5). Neoadjuvant radiation therapy was performed in 60%. Most commonly used free flaps were latissimus dorsi muscle/musculocutaneous flap (n = 7) and anterolateral thigh flap (n = 7) Nine flaps were transferred immediately after resection. Overall, 70% of arterial anastomoses were end-to-end, whereas 30% were end-to-side. Deep femoral artery branches were chosen as the recipient artery in the 45%. Median length of hospital stay was 11 days (IQR, 16.0–8.3 days), and median time to start weight-bearing was 20 days (IQR, 49.0–9.5 days). All were successful except for 1 patient who required additional pedicled flap coverage. The overall major-complication rate was 25% (n = 5, hematoma = 2, venous congestion requiring emergent exploration surgery = 1, wound dehiscence = 1, surgical site infection = 1). Cancer recurred in 3 patients. One required amputation due to cancer recurrence. Age (hazard ratio [HR], 1.14; P = 0.0163), tumor volume (HR, 18.8; P = 0.0006), and resection volume (HR, 2.24; P = 0.0019) were statistically significantly associated with having a major complication.

Conclusions
Based on the data, microvascular reconstruction of irradiated post–oncological resection defects shows high flap survival rate and success. Given the large size of flap required, the complex nature and size of these wounds, and history of radiation, wound healing complications are common. Despite this, free flap reconstruction should be considered in irradiated thighs with large defects. Studies with larger cohort and longer follow-up are still required.
What COVID Restrictions Have Taught Us About Visiting Subinternships
Authors: Zitkovsky Helen S. , Kuhn Natalie L. , Guo Lifei 
Published: May 2023

Background
Integrated plastic surgery applicants complete among the highest number of visiting audition rotations of any specialty. In the 2021 match, we observed that the elimination of audition rotations and in-person interviews drastically increased the number of applicants who matched at their home program. We sought to evaluate the effect of applicants participating in one selective visiting subinternship rotation on home program match rates.

Methods
Top 50 plastic surgery residency programs were identified by 2021 Doximity rankings. Publicly available, online plastic surgery match spreadsheets were used to collect available information including matched applicants' medical school, the institution at which they matched, whether they matched at their home institution, and whether they had previous communication with their matched program including research year or visiting subinternship completed.

Results
Fourteen percent of applicants matched at their home institution in 2022, comparable with recent prepandemic rates of 14.1% and 16.7%, versus 24.1% in 2021. The largest effect was observed among the top 25 programs. Separately, approximately 70% of applicants provided self-reported information on whether they completed a subinternship. Among the top 50 programs, 39.0% of applicants completed an audition rotation at the institution at which they eventually matched.

Conclusions
The allowance of medical students to perform only one visiting subinternship in the 2022 match cycle normalized home match rates to the prepandemic baseline, possibly driven by a large proportion of students matching at their visiting rotation institution. Perhaps from both a program and applicant standpoint, 1 away rotation may provide sufficient exposure for eventual match success.