bluuebunny/crossref_metadata_2025_split huggingface dataset:
FIGO Good Practice Recommendations on Cervical Cerclage for Prevention of Preterm Birth
Authors: Shennan A. , Story L. , Jacobsson B. , Grobman W.A. 
Published: February 2023

(Int J Gynaecol Obstet. 2021;155:19–22)
Cervical cerclage, a suture preventing dilation, is an intervention commonly used on women at increased risk of preterm birth and second-trimester fetal loss. Evidence-based recommendations derived from randomized controlled trials (RCTs) and meta-analyses help determine which patients would benefit from cervical cerclage. Pregnant women with obstetric or gynecologic history of increasing preterm birth risk; ultrasound suggesting cervical shortening; and presence of an already open cervix with fetal membrane exposure have the recommendation to undergo cervical cerclage. History-indicated cerclage indications are mid-trimester loss and/or 3 or more preterm deliveries. Ultrasound-indicated cerclage indications are cervical length <25 mm with a history of mid-trimester loss or at least one spontaneous preterm birth. Parturient women with exposed, prolapsed membranes should be offered cervical cerclage on a case-by-case basis. Vaginal cerclage does not increase the risk of preterm labor, rupture of membranes, cesarean section, or chorioamnionitis. Cervical cerclage placement technique and timing of removal should be under the discretion of a trained surgeon, though removal at 36 to 37 weeks is typical. Stitches should be placed as high as realistically possible, and anesthesia use is needed for insertion but may not be necessary for removal.
Quality of Labor Analgesia With Dural Puncture Epidural Versus Standard Epidural Technique in Obese Parturients: A Double-blind Randomized Controlled Study
Authors: Tan H.S. , Reed S.E. , Mehdiratta J.E. , Diomede O.I. , Landreth R. , Gatta L.A. , Weikel D. , Habib A.S. 
Published: February 2023

(Anesthesiology. 2022;136:678–687)
Dural puncture epidural technique is a nested needling procedure wherein a spinal needle is passed through the epidural needle and through the dura, without the injection of intrathecal (IT) medications. Delivery of neuraxial analgesia is initiated only through the epidural catheter. Even in the absence of additional medication, dural puncture’s purported advantage over standard epidural placement is the unambiguous return of cerebrospinal fluid (CSF) through the spinal needle, confirming midline placement. Dural puncture may also facilitate the transfer of epidural drugs through the dural breach to help establish onset and quality of analgesia. Evidence for the efficacy of this approach is limited with some mixed data showing no clear clinical advantage. Obese parturients are particularly susceptible to epidural failure, and also at higher risk for emergency cesarean delivery wherein well-initiated neuraxial analgesia would be a further asset to avoid general anesthesia. The ostensible advantage of improved analgesic effect with the use of dural puncture vs standard epidural technique is investigated in obese patients who have the potential to draw strong benefit from an enhanced success rate for quality analgesia given the challenges inherent to this patient population.
The Analgesic Efficacy of Intravenous Dexamethasone for Postcesarean Pain: A Systematic Review With Meta-analysis and Trial Sequential Analysis
Authors: Singh N.P. , Makkar J.K. , Yadav N. , Goudra B.G. , Singh P.M. 
Published: February 2023

(Eur J Anaesthesiol. 2022;39:498–510)
Pain management during and following cesarean delivery (CD) has been a topic of interest due to its impact on maternal outcomes, yet the efficacy of intravenous dexamethasone for post-CD analgesia requires more analysis. This systematic review and meta-analysis investigated the association of dexamethasone administration and pain following CD compared with a control group.
To Operate or Not? Balancing Advanced Imaging, Machine Learning, and the Doctor–Patient Relationship in Complex Clinical Decision Making
Authors: Subramanian Tanvi , Pocivavsek Luka , Alverdy John C. 
Published: February 2023

Advances in high-resolution, cross-sectional imaging have changed the practice of medicine. These innovations have clearly benefited patient care yet have also led to a decreased dependence on the art of medicine, with its emphasis on obtaining a thoughtful history and thorough physical examination to elicit the same diagnosis that imaging provides.
What remains to be determined is how physicians can balance these technological advances with their own ability to use clinical experience and judgment. This can be seen not only with the use of high-level imaging but also with the increasing use of machine-learning models throughout medicine. The authors contend that these should be seen not as a replacement for the physician, but as another tool in their arsenal in determining management decisions. These issues are salient for surgeons, who, given the serious undertaking required to operate on a person, must develop trust-based relationship with their patients.
Navigating this new field brings with it several ethical conundrums that must be addressed, with the final goal being to provide optimal patient care without sacrificing the human element involved, from either the physician or the patient. The authors examine these less-than-simple challenges, which will continue to develop as physicians use the increasing amount of machine-based knowledge available to them.
Aligning Healthcare's Mission With Corporate Social Responsibility Action
Authors: Dowling Michael J. 
Published: February 2023

Amid many challenges, health systems and hospitals are striving to improve the health of their communities with varying degrees of commitment. While many have recognized the importance of the social determinants of health, most have not responded aggressively to the global climate crisis that is sickening and killing millions of people worldwide—and getting worse. As the largest healthcare provider in New York, Northwell Health is committed to keeping our communities well in the most socially responsible way. That means engaging with partners to enhance well-being, expand access to equitable care, and take environmental responsibility.
Healthcare organizations have a special obligation to broaden their efforts to prevent further damage to the planet and limit the human toll of that damage. For this to happen, their governing boards must support tangible environmental, social, and governance (ESG) strategies and put in place the administrative structures for their C-suites that are necessary to ensure compliance. At Northwell Health, governance is the engine that drives accountability for ESG.
Same-Day Discharge After Left Bundle Area Pacing
Authors: Kadado Anis John , Gobeil Kyle , Pervaiz Abdullah , Pundlik Shayal , Pritham Ryan , Obeidat Yasin , Fatima Anum , Sawalha Khalid , Chalhoub Fadi 
Published: February 2023

Background:
Left bundle area pacing (LBAP) has emerged as an area that appears to be an attractive alternative to other forms of physiological pacing owing to its ease and favorable pacing parameters. Same-day discharge after conventional pacemakers, implantable cardioverter defibrillators, and more recently leadless pacemakers have become routine, especially after the COVID-19 pandemic. With the advent of LBAP, the safety and feasibility of same-day discharge remain unclear.

Methods:
This is a retrospective, observational case series of consecutive, sequential patients undergoing LBAP at Baystate Medical Center, an academic teaching hospital. We included all patients who underwent LBAP and were discharged on the same day of procedure completion. Safety parameters included any procedure-related complications including pneumothorax, cardiac tamponade, septal perforation, and lead dislodgement. Pacemaker parameters included pacing threshold, R-wave amplitude, and lead impedance pre-discharge the following day of implantation and up to 6 months of follow-up.

Results:
A total of 11 patients were included in our analysis, the average age was 70.3 ± 6.74 years. The most common indication for pacemaker insertion was AV block (73%). No complications were seen in any of the patients. The average time between the procedure and discharge was 5.6 hours. Pacemaker and lead parameters were stable after 6 months of follow-up.

Conclusions:
In this case series, we find that same-day discharge after LBAP for any indication is a safe and feasible option. As this mode of pacing becomes increasingly more common, larger prospective studies evaluating the safety and feasibility of early discharge after LBAP will be needed.
Erythrocyte Indices in Patients With Takotsubo Syndrome
Authors: Braschi Annabella , Frasheri Arian , Lombardo Renzo M. , Abrignani Maurizio G. , Lo Presti Rosalia , Vinci Daniele , Traina Marcello 
Published: February 2023

Background:
Although the prognosis of patients with Takotsubo syndrome (TTS) is relatively favorable, serious complications may occur. This study aimed to investigate the relationship between blood parameters and the occurrence of in-hospital complications.

Methods:
Clinical charts of 51 patients with TTS were retrospectively evaluated, and data regarding blood parameters assessed during the first 24 hours of hospitalization were studied.

Results:
Levels of hemoglobin less than 13 g/dL in men and 12 g/dL in women (P < 0.01), levels of mean corpuscular hemoglobin concentration (MCHC) less than 33 g/dL (P = 0.01), and levels of red blood cell distribution width-coefficient of variation higher than 14.5% (P = 0.01) were significantly associated to the occurrence of major adverse cardiovascular events (MACE). Markers, such as, platelets to lymphocytes ratio, lymphocytes to monocytes ratio, neutrophils to lymphocytes ratio, and white blood cell count to mean platelet volume, were unable to differentiate patients with and without complications (P > 0.05). MCHC and estimated glomerular filtration rate were independent predictors of MACE.

Conclusions:
Blood parameters may have a role in the stratification risk of patients with TTS. Patients showing low levels of MCHC and decreased estimated glomerular filtration rate were more likely to have in-hospital MACE. This should encourage physicians to closely monitor blood parameters in patients with TTS.
Perioperative versus postoperative calcium and vitamin D supplementation to prevent symptomatic hypocalcemia after total thyroidectomy: a randomized placebo controlled trial
Authors: Sittitrai Pichit , Ruenmarkkaew Donyarat , Klibngern Hanpon , Ariyanon Tapanut , Hanprasertpong Nutthiya , Boonyaprapa Somkamon , Sreesawat Maysayawan 
Published: February 2023

Background:Hypocalcemia is the most common complication following total thyroidectomy. This study aimed to evaluate the efficacy of perioperative combined calcium and vitamin D supplementation compared to postoperative combined calcium and vitamin D supplementation in reducing symptomatic hypocalcemia.Materials and methods:A prospective randomized placebo-controlled trial was carried out in patients undergoing total or completion thyroidectomy from June 2017 to May 2022. Eligible patients were assigned to receive either calcium carbonate and alfacalcidol or placebo 3 days before surgery, and both groups were given calcium carbonate and alfacalcidol for 14 days after surgery. Clinical outcomes (signs and symptoms of hypocalcemia, requirement of intravenous calcium, and medication-induced hypercalcemia) and laboratory results (calcium and parathyroid hormone levels) were compared between the two groups.Results:One hundred and thirty-four patients were included in the analysis, 68 were in perioperative oral calcium and vitamin D supplementation group, and 66 were in postoperative oral calcium and vitamin D supplementation group. Symptomatic hypocalcemia rates were significantly lower in the perioperative group than in the postoperative group (8.8 and 22.7%, respectively,P=0.033). All symptomatic hypocalcemia cases in the perioperative group occurred in the first 24 hours after surgery. Mean calcium levels were significantly higher in the perioperative group at 24 and 48 hours after surgery. Intravenous calcium requirement rate was lower in the perioperative group but the difference was insignificant (2.9 and 12.1%,P=0.053). Mean parathyroid hormone levels were within the normal range and did not differ between groups. No medication-induced hypercalcemia was detected in either group.Conclusion:Perioperative oral calcium and vitamin D supplementation significantly decreased the risks of symptomatic and biochemical hypocalcemia compared to postoperative oral calcium and vitamin D supplementation. The perioperative supplementation also shortened the recovery period of symptomatic hypocalcemia to within 24 hours.
Active coping, resilience, post-traumatic growth, and psychiatric symptoms among early and late liver transplant survivors
Authors: Lieber Sarah R. , Baldelli Luke , Kim Hannah P. , Nash Rebekah P. , Noriega Ramirez Alvaro , Magee Gabrielle , Barritt Alfred S. , Evon Donna M. , Singal Amit G. 
Published: February 2023

Understanding survivorship experiences at different stages postliver transplantation (poat-LT) is essential to improving care. Patient-reported concepts including coping, resilience, post-traumatic growth (PTG), and anxiety/depression, have been implicated as important predictors of quality of life and health behaviors after LT. We aimed to descriptively characterize these concepts at different post-LT survivorship stages. This cross-sectional study featured self-reported surveys measuring sociodemographic, clinical characteristics, and patient-reported concepts including coping, resilience, PTG, anxiety, and depression. Survivorship periods were categorized as early (1 y or below), mid (1–5 y), late (5–10 y), and advanced (10 y or above). Univariable and multivariable logistic and linear regression modeling examined factors associated with patient-reported concepts. Among 191 adult LT survivors, the median survivorship stage was 7.7 years (interquartile range: 3.1–14.4) and median age was 63 years (range: 28–83); most were male (64.2%) and Caucasian (84.0%). High PTG was more prevalent in the early survivorship period (85.0%) than late survivorship (15.2%). High trait resilience was only reported by 33% of survivors and associated with higher income. Lower resilience was seen among patients with longer LT hospitalization stays and late survivorship stages. About 25% of survivors had clinically significant anxiety and depression, which was more frequent among early survivors and females with pre-LT mental health disorders. In multivariable analysis, factors associated with lower active coping included survivors ≥65 years, non-Caucasian race, lower levels of education, and nonviral liver disease. In a heterogeneous cohort including early and late LT survivors, there was variation in levels of PTG, resilience, anxiety, and depression at different survivorship stages. Factors associated with positive psychological traits were identified. Understanding determinants of LT survivorship has important implications for how we should monitor and support LT survivors.
Complement detection in kidney biopsies – utility and challenges
Authors: Tomaszewski Kristen , Herlitz Leal 
Published: February 2023

Purpose of review
This review discusses the important role of staining for components of the complement cascade in both native and transplant kidney biopsies. The use of complement staining as a marker of prognosis, disease activity, and as a potential future tool in identifying patients who may benefit from complement-targeted therapies is discussed.

Recent findings
While staining for C3, C1q and C4d can yield valuable information about complement activation in kidney biopsies, to adequately assess complement activation and potential therapeutic targets, expanded staining panels looking at multiple split products and complement regulatory proteins are needed. Recent progress has been made in identifying markers of disease severity in C3 glomerulonephritis and IgA nephropathy, such as Factor H-related Protein-5, which may serve as future tissue biomarkers. In the transplant setting, the limitation of relying on C4d staining to identify antibody mediated rejection is giving way to molecular diagnostics, including The Banff Human Organ Transplant (B-HOT) panel, which includes numerous complement complement-related transcripts, with the classical, lectin, alternative, and common pathways.

Summary
Staining for complement components in kidney biopsies to understand how complement is activated in individual cases may help to identify patients who may benefit from complement-targeted therapies.
Management of antineutrophil cytoplasmic antibody-associated vasculitis: a changing tide
Authors: Krishnan Anoushka , Walsh Michael , Collister David 
Published: February 2023

Purpose of review
Antineutrophil cytoplasmic antibody associated vasculitis (AAV) is a group of autoimmune disorders of small blood vessels. While outcomes in AAV have improved with the use of glucocorticoids (GC) and other immunosuppressants, these treatments are associated with significant toxicities. Infections are the major cause of mortality within the first year of treatment. There is a move towards newer treatments with better safety profiles. This review reflects on recent advances in the treatment of AAV.

Recent findings
The role of plasma exchange (PLEX) in AAV with kidney involvement has been clarified with new BMJ guideline recommendations following the publication of PEXIVAS and an updated meta-analysis. Lower dose GC regimens are now standard of care. Avacopan (C5a receptor antagonist) was noninferior to a regimen of GC therapy and is a potential steroid-sparing agent. Lastly, rituximab-based regimens were noninferior to cyclophosphamide in two trials for induction of remission and superior to azathioprine in one trial of maintenance of remission.

Summary
AAV treatments have changed tremendously over the past decade with a drive towards targeted PLEX use, increased rituximab use and lower GC dosing. Striking a crucial balance between morbidity from relapses and toxicities from immunosuppression remains a challenging path to navigate.
Recent updates in kidney risk prediction modeling: novel approaches and earlier outcomes
Authors: Hundemer Gregory L. , Sood Manish M. , Canney Mark 
Published: February 2023

Purpose of reviewRecent years have witnessed the development of kidney risk prediction models which diverge from traditional model designs to incorporate novel approaches along with a focus on earlier outcomes. This review summarizes these recent advances, evaluates their pros and cons, and discusses their potential implications.Recent findingsSeveral kidney risk prediction models have recently been developed utilizing machine learning rather than traditional Cox regression. These models have demonstrated accurate prediction of kidney disease progression, often beyond that of traditional models, in both internal and external validation. On the opposite end of the spectrum, a simplified kidney risk prediction model was recently developed which minimized the need for laboratory data and instead relies primarily on self-reported data. While internal testing showed good overall predictive performance, the generalizability of this model remains uncertain. Finally, there is a growing trend toward prediction of earlier kidney outcomes (e.g., incident chronic kidney disease [CKD]) and away from a sole focus on kidney failure.SummaryNewer approaches and outcomes now being incorporated into kidney risk prediction modeling may enhance prediction and benefit a broader patient population. However, future work should address how best to implement these models into practice and assess their long-term clinical effectiveness.
Arterialized Vein Bypass Graft Recipient Vessel in Free Tissue Transfer Covering Diabetic Foot Ulcers Complicated by Critical Limb Ischemia
Authors: Tran Ryu , Haffner Zoė K. , Slamin Robert P. , Akbari Cameron M. , Evans Karen K. 
Published: February 2023

Abstract
Limb salvage options are limited in diabetic patients with critical limb ischemia. Soft tissue coverage remains technically demanding with limited recipient vessels for free tissue transfer. These factors make revascularization alone challenging. When open bypass revascularization is possible, venous bypass graft is optimal and functions as a recipient vessel for staged free tissue transfer.
The authors present 2 cases using a combination approach of staged venous bypass graft revascularization followed by free tissue transfer with anastomosis to the venous bypass graft resulting in successful limb preservation.
Free tissue transfer to a native vessel has limited application in severe peripheral vascular disease patients because early vascular compromise threatens flap survival. In both presented cases, venous bypass graft alone was insufficient to treat their nonhealing wounds, and preoperative angiogram revealed dismal options for free tissue transfer reconstruction. However, previous venous bypass graft provided an operable vessel for free tissue transfer anastomosis. The combination of venous bypass graft and free tissue transfer proved to be ideal for successful limb preservation by providing vascularized tissue to previously ischemic angiosomes, ensuring optimal wound healing capacity. Venous bypass graft is advantageous to native arterial grafts, and its combination with free tissue transfer likely increases graft patency and flap survival. We demonstrate that end-to-side anastomosis to a venous bypass graft is a viable option in these highly comorbid patients with favorable flap outcomes.
Coronavirus disease 2019 infection and cerebrovascular diseases: an update on the pathophysiology and management
Authors: May Brandon , Wang David Z. 
Published: February 2023

Purpose of review
COVID-19 is an ongoing global pandemic since it was first discovered in 2020. Cerebral vascular disease and stroke are among the most common and devastating neurological manifestations of COVID-19. This review offers an up-to-date information on the possible underlying mechanism of COVID-19-related stroke, its diagnosis, and management.

Recent findings
The thromboembolism associated with COVID-19 infection is likely related to the cytokine storm with innate immune activation, pulmonary disease leading to hypoxia-induced ischemia, thrombotic microangiopathy, endothelial damage and multifactorial activation of the coagulation cascade. Currently, there is no clear guidelines on the use of antithrombotics for the prevention and treatment of this phenomenon.

Summary
COVID-19 infection can directly cause a stroke or facilitate the formation of thromboembolism in the presence of other medical conditions. Physicians treating patients with COVID-19 should stay vigilant about the signs and symptoms of stroke, detect and treat early.
Phased nanopore assembly with Shasta and modular graph phasing with GFAse
Authors: Lorig-Roach Ryan , Meredith Melissa , Monlong Jean , Jain Miten , Olsen Hugh , McNulty Brandy , Porubsky David , Montague Tessa , Lucas Julian , Condon Chris , Eizenga Jordan , Juul Sissel , McKenzie Sean , Simmonds Sara E. , Park Jimin , Asri Mobin , Koren Sergey , Eichler Evan , Axel Richard , Martin Bruce , Carnevali Paolo , Miga Karen , Paten Benedict 
Published: February 2023

AbstractAs a step towards simplifying and reducing the cost of haplotype resolvedde novoassembly, we describe new methods for accurately phasing nanopore data with the Shasta genome assembler and a modular tool for extending phasing to the chromosome scale called GFAse. We test using new variants of Oxford Nanopore Technologies’ (ONT) PromethION sequencing, including those using proximity ligation and show that newer, higher accuracy ONT reads substantially improve assembly quality.