bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interventions to reintroduce or increase assisted vaginal births: a systematic review of the literature
Authors: Torloni Maria Regina , Opiyo Newton , Altieri Elena , Sobhy Soha , Thangaratinam Shakila , Nolens Barbara , Geelhoed Diederike , Betran Ana Pilar 
Published: February 2023

ObjectiveTo synthesise the evidence from studies that implemented interventions to increase/reintroduce the use of assisted vaginal births (AVB).DesignSystematic review.Eligibility criteriaWe included experimental, semi-experimental and observational studies that reported any intervention to reintroduce/increase AVB use.Data sourcesWe searched PubMed, EMBASE, CINAHL, LILACS, Scopus, Cochrane, WHO Library, Web of Science, ClinicalTrials.gov and WHO.int/ictrp through September 2021.Risk of biasFor trials, we used the Cochrane Effective Practice and Organisation of Care tool; for other designs we used Risk of Bias for Non-Randomised Studies of Interventions.Data extraction and synthesisDue to heterogeneity in interventions, we did not conduct meta-analyses. We present data descriptively, grouping studies according to settings: high-income countries (HICs) or low/middle-income countries (LMICs). We classified direction of intervention effects as (a) statistically significant increase or decrease, (b) no statistically significant change or (c) statistical significance not reported in primary study. We provide qualitative syntheses of the main barriers and enablers for success of the intervention.ResultsWe included 16 studies (10 from LMICs), mostly of low or moderate methodological quality, which described interventions with various components (eg, didactic sessions, simulation, hands-on training, guidelines, audit/feedback). All HICs studies described isolated initiatives to increase AVB use; 9/10 LMIC studies tested initiatives to increase AVB use as part of larger multicomponent interventions to improve maternal/perinatal healthcare. No study assessed women’s views or designed interventions using behavioural theories. Overall, interventions were less successful in LMICs than in HICs. Increase in AVB use was not associated with significant increase in adverse maternal or perinatal outcomes. The main barriers to the successful implementation of the initiatives were related to staff and hospital environment.ConclusionsThere is insufficient evidence to indicate which intervention, or combination of interventions, is more effective to safely increase AVB use. More research is needed, especially in LMICs, including studies that design interventions taking into account theories of behaviour change.PROSPERO registration numberCRD42020215224.
Basilar tip morphology: impact on mechanical thrombectomy for acute distal basilar artery occlusion
Authors: Baik Sung Hyun , Jung Cheolkyu , Kim Byung Moon , Kim Dong Joon 
Published: February 2023

BackgroundThe morphology of the basilar artery tip (BAT) varies between patients. The morphologic anatomy of the BAT could affect the efficacy of mechanical thrombectomy (MT).Methods108 patients with acute distal basilar artery occlusion (dBAO) who underwent MT from January 2013 to December 2021 were retrospectively analyzed. These patients were divided into two groups based on their BAT morphology: those with symmetrical cranial or caudal fusion of the BAT (symmetric group) and those with asymmetrical fusion of the BAT (asymmetric group). Morphological variables and angiographic and clinical outcomes were compared between the two groups.ResultsOf the 108 enrolled patients, 42 were in the asymmetric group. Compared with the symmetric group, the asymmetric group had significantly larger BAT diameter (mean 3.5±1.0 mm vs 4.3±1.1 mm, P=0.001) and basilar artery tip/trunk ratio (1.2±0.2 vs 1.7±0.2, P<0.001). The asymmetric group showed a significantly lower rate of complete reperfusion (71.2% vs 40.5%, P=0.002) and first pass effect (FPE) (51.5% vs 21.4%, P=0.002) than the symmetric group. The BAT asymmetry was an independent predictor of failed FPE (OR 0.299, 95% CI 0.098 to 0.918, P=0.035) and failed complete reperfusion (OR 0.275, 95% CI 0.087 to 0.873, P=0.029).ConclusionsThe efficacy of MT for dBAO differs according to the anatomic morphology of the BAT. The asymmetric BAT was frequently encountered in dBAO patients and was independently associated with a reduced likelihood of complete reperfusion and FPE.
Occurrence and relative risks for non-vertebral fractures in patients with ankylosing spondylitis compared with the general population: a register-based study from Sweden
Authors: Bengtsson Karin , Askling Johan , Lorentzon Mattias , Rosengren Björn , Deminger Anna , Klingberg Eva , Jacobsson Lennart , Forsblad-d'Elia Helena 
Published: February 2023

ObjectivesTo estimate the incidence of non-vertebral fractures in ankylosing spondylitis (AS) compared with the general population.MethodsNationwide register-based cohort study including patients with AS (n=11 611, 65% men, mean age 48 years), and matched general population controls (n=58 050). Five prespecified fracture outcomes: (1) non-vertebral; (2) fracture of the proximal humerus, distal forearm or hip; (3) proximal humerus; (4) distal forearm and (5) hip) were identified through register linkages with follow-up 2007–2016. We used Poisson regression to calculate incidence rates (IRs), number of fractures per 1000 person-years at risk and IR ratios (IRRs), overall and by sex and age. IRRs were adjusted for history of any prior fracture.ResultsIRs (men/women) for non-vertebral fracture in AS were 11.9 (95% CI 11.0 to 12.9)/14.5 (95% CI 13.1 to 16.1) and in controls 10.0 (95% CI 9.7 to 10.4)/11.8 (95% CI 11.1 to 12.4), IRR (men/women) 1.2 (95% CI 1.1 to 1.3)/1.2 (95% CI 1.1 to 1.4). IRs (men/women) for fractures of the humerus, forearm or hip in AS were 4.0 (95% CI 3.5 to 4.6)/6.3 (95% CI 5.4 to 7.3) and in controls 2.7 (95% CI 2.5 to 2.9)/5.5 (95% CI 5.1 to 6.0), IRR (men/women) 1.5 (95% CI 1.3 to 1.7)/1.1 (95% CI 0.9 to 1.3). IRRs were statistically significantly elevated in men with AS versus controls for forearm fracture (1.4 (95% CI 1.1 to 1.7)) and hip fracture (1.8 (95% CI 1.4 to 2.3)), whereas not in women with AS where the IRRs were 1.1 (95% CI 0.9 to 1.4) and 1.0 (95% CI 0.6 to 1.4). For humerus fracture, IRRs were 1.4 (95% CI 0.99 to 1.9) in men with AS versus controls and 1.1 (95% CI 0.8 to 1.6) in women.ConclusionsBoth men and women with AS have a slightly higher risk of non-vertebral fractures than the general population. A statistically significantly higher risk of fractures of the proximal humerus, distal forearm or hip was found in men with AS in comparison to general population, where the relative risk was especially pronounced for hip fracture.
Assessing in vitro anti-cancer efficacy of sulfonated water-soluble phthalocyanine on breast and prostate cancer cells
Authors: Ozkan Asuman Deveci , Betts Zeynep , Yuksel Burcu , Alimudin Janiah , Aydin Duygu , Guzel Emre 
Published: February 2023

Since cancer is one of the leading causes of death worldwide, the development of new anticancer drugs has become important. Phthalocyanines (Pcs) as anticancer agents have attracted particular attention in recent years. Especially water-soluble sulfonated phthalocyanines have been used consistently for both the diagnosis and treatment of many different types of cancer, such as small lung tumors. Motivated by these facts, since the anti-cancer activity of sulfonated water-soluble cobalt phthalocyanine in prostate and breast cancer without photoactivation is not known before, we aimed to investigate the in vitro anti-cancer effectiveness (cyto- and genotoxic effect) of alpha-substituted water-soluble cobalt phthalocyanine (WS-CoPc) complex on prostate and breast cancer cells for the first time. For this purpose ROS production, cell death, and DNA damage levels, changes in nuclear and cell morphology, and the expression of apoptosis and ROS-related genes were determined. WS-CoPc exhibited anti-cancer effects with cytotoxic and genotoxic features in both prostate and breast cancer cells also the anti-cancer efficacy is more prominent in prostate cancer cells. Therefore our results demonstrated that this Pc has high cytotoxic and genotoxic effects, especially in prostate cancer cells in vitro and further studies are needed to reveal the current anticancer potential of this Pc without photoactivation.
Physics-Informed Deep Neural Network for Backward-in-Time Prediction: Application to Rayleigh–Bénard Convection
Authors: Hammoud Mohamad Abed El Rahman , Alwassel Humam , Ghanem Bernard , Knio Omar , Hoteit Ibrahim 
Published: February 2023

Abstract
Backward-in-time predictions are needed to better understand the underlying dynamics of physical fluid flows and improve future forecasts. However, integrating fluid flows backward in time is challenging because of numerical instabilities caused by the diffusive nature of the fluid systems and nonlinearities of the governing equations. Although this problem has been long addressed using a nonpositive diffusion coefficient when integrating backward, it is notoriously inaccurate. In this study, a physics-informed deep neural network (PI-DNN) is presented to predict past states of a dissipative dynamical system from snapshots of the subsequent evolution of the system state. The performance of the PI-DNN is investigated using several systematic numerical experiments and the accuracy of the backward-in-time predictions is evaluated in terms of different error metrics. The proposed PI-DNN can predict the previous state of the Rayleigh–Bénard convection with an 8-time-step average normalized
error of less than 2% for a turbulent flow at a Rayleigh number of 105.
Ocean Surface Warming Pattern Inhibits El Niño–Induced Atmospheric Teleconnections
Authors: Hao Xin , Wang Huijun , Zhou Botao , Li Jiandong , Wei Jiangfeng , Han Tingting 
Published: February 2023

Abstract
The ocean surface temperature has warmed dramatically over most of the globe in recent decades, which shows the west warmed faster than the east (“La Niña–like” warming) in the equatorial Pacific. It differs from the simulated “El Niño–like” warming in existing studies that discussed the El Niño–induced teleconnection response to global warming. Some studies have indicated that El Niño teleconnections are sensitive to the ocean surface warming patterns, but the mechanisms are still elusive. Here, reanalysis data and numerical experiments were analyzed to investigate how winter El Niño atmospheric teleconnections respond to the historical ocean surface warming. We show that the inhibited effect of the El Niño on the North African winter climate through the suppressed Walker circulation over Atlantic–Africa–Indian Ocean sectors under the ocean surface warming matches the observed changes. Also, the model reproduces the observed weakening of the El Niño–induced Pacific–North American wave and its suppressed downstream propagation in the ocean surface warming scenario because of the reduction in contributions of the vortex stretching to the El Niño–induced wave sources in the subtropical jet streams. Our findings demonstrate the important role of ocean surface warming patterns in the projections of the El Niño–induced atmospheric teleconnection.
Intraoperative Parathyroid Hormone Monitoring Is of Limited Usefulness in Guiding Autotransplantation in Reoperative or Subtotal Parathyroidectomy for Primary Hyperparathyroidism
Authors: Richards Bradley A. , Vierkant Robert A. , Dy Benzon M. , Foster Trenton R. , McKenzie Travis J. , Lyden Melanie L. 
Published: February 2023

Introduction Patients with primary hyperparathyroidism (1HPT) undergoing reoperative or subtotal parathyroidectomy (PTX) may undergo autotransplantation (ATX) when the viability of remaining tissue is unknown. This study aims to identify whether intraoperative parathyroid hormone levels (IOPTH) can determine ATX candidacy. Methods Patients with 1HPT who underwent PTX with ATX at our institution were identified. IOPTH and PTH values within 24 h, 2-4 weeks, and >1 month postoperative were analyzed. Patients were classified as either a candidate for ATX (low PTH after 2-4 weeks) or not a candidate based on postoperative PTH (normal PTH after 2-4 weeks). Associations of ATX candidate status with demographic and clinical attributes were studied. Results 268 had a reoperative (49%) or subtotal PTX with ATX. 151 had data for PTH analysis, and 21 (14%) were identified as candidates for ATX. The mean % decline in IOPTH from baseline to 20 min post-excision was 51% in noncandidates vs 73% in candidates (P = .002). The mean change in IOPTH from baseline to final was 52% in noncandidates and 83% in candidates (P = .009). A decrease in IOPTH from baseline to 20 min post-excision of 23.4% or greater or a final PTH of 52 pg/mL or less would be an indication for ATX. Of the 21 who needed an ATX, it failed in 10. Conclusion Parathyroid ATX is frequently unnecessary, and the viability is less than expected. While candidates for ATX have a greater IOPTH % decline at all points during surgery and a lower final IOPTH, the clinical practicality of using IOPTH to determine ATX candidacy is limited.
The Use of Sequential Surveys to Shorten Implementation Time for Healthcare System-Level Enhanced Recovery After Surgery (ERAS) Pathways
Authors: Adams Ursula C. , Moulthrop Amy J. , Malay Brendan , Straube Lacey E. , McNaull Peggy P. , McGinigle Katharine L. , Phillips Michael R. 
Published: February 2023

Background Enhanced Recovery After Surgery (ERAS) pathways improve healthcare quality, safety, and cost-effectiveness. We hypothesized that the RAND Method (a hybrid Delphi approach), involving anonymous sequential surveys and face-to-face meetings, would allow for more rapid agreement and initiation of new ERAS pathways. Methods Using the ERAS Society guidelines for cesarean section as a baseline, our institution’s ERAS Leadership Team (ELT) compiled published literature and institutional practices to design a 32-component survey that was sent to obstetricians, nurse midwives, anesthesiologists, pharmacists, and nurses. Components that did not reach 90% consensus were included in a second survey the following week, and meetings were held to review results. At the conclusion of this process, time to agreement was retrospectively compared to the colorectal ERAS pathway process at this institution. Results ERAS pathway components were compiled and reviewed by 121 stakeholders at 7 hospitals using iterative surveys with review meetings over a 13-week period. Survey response rates were 61% and 50% in the initial and follow-up surveys, respectively. There was agreement on 28/32 and 32/32 items on the initial and follow-up surveys. Using the RAND Method, time to agreement decreased by 54.1% (24 vs 13 weeks) compared to prior system-wide efforts to standardize the colorectal surgery ERAS pathway. Discussion With rapidly expanding healthcare systems, effective methods to gain consensus and adopt ERAS pathways are critical to implementation of ERAS guidelines. We demonstrate that the RAND Method allows for a transparent and efficient means of agreement across a diverse group of clinicians practicing in several settings.
Effect of Smoking History on 30-Day Morbidity Following Bariatric Surgery
Authors: Fuentes Nicolas , Reyes Jose A. , Souferi Benjamin , Khan Ayda , Kuo Yen-Hong , Bates Andrew T. , Davis John M. , Gadaleta Dominick , Pechman David M. 
Published: February 2023

Introduction Smoking and postoperative complications are well documented across surgical specialties. Preoperative smoking cessation is frequently recommended by surgeons. In this study, we assessed to what degree documented smoking history increased a patient’s risk of postoperative complications. Methods The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database for the years 2015-2018 was used. Patients were included if they underwent primary sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (LRYGB). Patients with a documented smoking history were assigned to the “SH” cohort and patients without smoking history were assigned to the “NSH” cohort. Patients without documentation regarding smoking history, missing variables, younger than 18, with prior surgery, or lost to follow-up were excluded. 30-day morbidity and mortality data were assessed. Multiple logistic regression analysis was made based on all available patient characteristics and perioperative factors, continuous variables were analyzed using Student’s t-test and categorical variables were compared using the chi-square test. Results After evaluation of 760,076 patients on the MBSAQIP database, 650,930 patients underwent non-revisional bariatric surgery, including 466,270 SG and 184,660 LRYGB. Of the total patients included in the study, 44,606 patients were assigned to the SH cohort and 479,601 were assigned to the NSH cohort. 4628 of patients did not have documented smoking status. Within 30 days SH patients had higher rates of readmission (4.2% vs 3.7%, P < .0001), reoperation (1.3% vs 1.1%, P < .0001), unplanned intubation (.2% vs .1%, P = .0212), and unplanned ICU admission (.7% vs .0.6%, P = .0022). Conclusion SH patients undergoing bariatric surgery were at significantly increased risk of readmission and reoperation within 30 days of procedure. In addition, SH patients were more likely to have unplanned intubation and unplanned ICU admission. Given the higher rates of complications in smoking patients, this study would suggest that preoperative smoking cessation in patients prior to primary bariatric surgery might be beneficial. Further study is warranted to compare short-term cessation vs long-term cessation preoperatively, which was not assessed in our study.
Short- and Long-Term Outcomes of the Minimal Proximal Resection Margin in Total Gastrectomy for Siewert II Adenocarcinoma of the Esophagogastric Junction
Authors: Guo Wei , Hao Jinguo , Mei Xianghuang , Wang Yangyang , He Zhipeng , Su Shi , Zhang Ke , Guan Xiaoqi , Yang Jingcheng , Lv Jiake 
Published: February 2023

Objective This study aimed to investigate the feasibility of the minimal proximal resection margin (PRM) in total gastrectomy (TG) for Siewert II adenocarcinoma of the esophagogastric junction (AEG). Methods This study finally included 178 Siewert II advanced AEG patients who underwent TG from January 2017 to September 2020. According to the PRM length, patients were divided into 20-25 mm group and 30-35 mm group. Intraoperative, short-, and long-term postoperative outcomes were compared between two groups. Results The PRM of the 20-25 mm group had significantly less operation time compared with the PRM of the 30-35 mm group ( P < .001), but the amount of blood loss, management of the diaphragmatic crura, and the incidence of positive resection margin were not significantly different between two groups (P > .05). In short-term postoperative outcomes, first gas-passing time, gastric-tube removal time, start time of diet, hospitalization, postoperative complications, and body weight loss were similar between two groups (P > .05). During the follow-up, the 3-year overall survival rates and the recurrence rates were not significantly different between the PRM of 20-25 mm and 30-35 mm groups (81.2% vs 83.5%, P = .695; 18.8% vs 15.5%, P = .812, respectively). Conclusion With less operation time and more preserved esophagus, the minimal PRM length of 20-25 mm could be an appropriate option in TG for patients with Siewert II advanced AEG.
Effect of Antiplatelet and Anticoagulant Agents on Outcomes Following Emergent Surgery for Traumatic Brain Injuries
Authors: Bazzi Rola , Sharp Victoria , Hecht Jason 
Published: February 2023

Purpose Traumatic brain injury (TBI) is the largest cause of death from injury in the United States. This study utilized the Michigan Trauma Quality Improvement Program (MTQIP) database to determine the effect that antiplatelets and anticoagulants (AP/AC) have on outcomes following emergent surgery for TBI patients. Basic Procedures Patients were included with age ≥18 years, maximum head/neck abbreviated injury score (AIS) ≥2, and underwent a neurosurgical procedure within 24 hours. Patients were excluded if they had an AIS ≥3 in other body region or no signs of life at initial evaluation. Main Findings Within the 1,932 patients analyzed, 139 (8.74%) were in the warfarin with or without (+/-) aspirin cohort, 101 (6.35%) in the direct oral anticoagulants (DOAC) +/− aspirin cohort, 169 (10.62%) in the clopidogrel +/− aspirin cohort, and 1,182 (74.29%) in the no AP/AC cohort (control group). After controlling for demographic and clinical characteristics, no significant difference in mortality rates was observed in the treatment groups ( P > 0.05). However, our subgroup analysis did reveal a significantly higher mortality rate within the warfarin and aspirin subgroup when compared to the control group (odds ratio [OR], 2.368; confidence interval [CI], 1.306-4.294, P = 0.005). With regards to hospital complications, there was a significant increase in this outcome within the DOAC +/− aspirin (OR, 1.825; CI, 1.143-2.915, P = 0.012) and clopidogrel +/− aspirin (OR, 1.82; CI, 1.244-2.663, P=0.002) groups. Conclusion Patients on AP/AC who experience a TBI requiring an emergent operation do not have an increased risk of mortality compared to patients not on AP/AC.
Reintervention Rate After Pigtail Catheter Insertion Compared to Surgical Chest Tubes
Authors: Mortman Keith D. , Tanenbaum Mira T. , Cavallo Kathryn M. , Kelley Devon , Bonitto Stephano S. , Sadur Alana , Amdur Richard , Sarin Shawn , Napolitano Michael A. 
Published: February 2023

Background Prior studies suggest similar efficacy between large-bore chest tube (CT) placement and small-bore pigtail catheter (PC) placement for the treatment of pleural space processes. This study examined reintervention rates of CT and PC in patients with pneumothorax, hemothorax, and pleural effusion. Methods This retrospective study examined patients from September 2015 through December 2020. Patients were identified using ICD codes for pneumothorax, hemothorax, or pleural effusion. Use of a pigtail catheter (≤14Fr) or surgical chest tube (≥20Fr) was noted. The primary outcome was overall reintervention rate within 30 days of tube insertion. Patients who died with a pleural drainage catheter in place, unrelated to complications from chest tube placement, were excluded. Results There were 1032 total patients in the study: 706 CT patients and 326 PC patients. The PC group was older with more comorbidities and more likely to have effusion as the indication for pleural drainage. Patients with PC were 2.35 times more likely to have the tube replaced or repositioned ( P < .0001), 1.77 times more likely to require any reintervention ( P = .001) and 2.09 times more likely to remain in the hospital >14 days ( P < .0001) compared to patients with CT. Conclusion PCs have a significantly higher reintervention rate compared to CT for the treatment of pneumothorax, hemothorax, and pleural effusion. Although PC are believed to cause less pain and tissue trauma, they do not necessarily drain the pleural space as well as CT. Decisions on which method of draining the chest should be made on a case-by-case basis.