bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smartphone Integration of Artificial Intelligence for Automated Plagiocephaly Diagnosis
Authors: Watt Ayden , Lee James , Toews Matthew , Gilardino Mirko S. 
Published: May 2023

Background:
Positional plagiocephaly is a pediatric condition with important cosmetic implications affecting ∼40% of infants under 12 months of age. Early diagnosis and treatment initiation is imperative in achieving satisfactory outcomes; improved diagnostic modalities are needed to support this goal. This study aimed to determine whether a smartphone-based artificial intelligence tool could diagnose positional plagiocephaly.

Methods:
A prospective validation study was conducted at a large tertiary care center with two recruitment sites: (1) newborn nursery, (2) pediatric craniofacial surgery clinic. Eligible children were aged 0–12 months with no history of hydrocephalus, intracranial tumors, intracranial hemorrhage, intracranial hardware, or prior craniofacial surgery. Successful artificial intelligence diagnosis required identification of the presence and severity of positional plagiocephaly.

Results:
A total of 89 infants were prospectively enrolled from the craniofacial surgery clinic (n = 25, 17 male infants [68%], eight female infants [32%], mean age 8.44 months) and newborn nursery (n = 64, 29 male infants [45%], 25 female infants [39%], mean age 0 months). The model obtained a diagnostic accuracy of 85.39% compared with a standard clinical examination with a disease prevalence of 48%. Sensitivity was 87.50% [95% CI, 75.94–98.42] with a specificity of 83.67% [95% CI, 72.35–94.99]. Precision was 81.40%, while likelihood ratios (positive and negative) were 5.36 and 0.15, respectively. The F1-score was 84.34%.

Conclusions:
The smartphone-based artificial intelligence algorithm accurately diagnosed positional plagiocephaly in a clinical environment. This technology may provide value by helping guide specialist consultation and enabling longitudinal quantitative monitoring of cranial shape.
Racial Disparity in Gender Affirming Surgery: A Comparative Study on Plastic Surgeon Social Media Use
Authors: Robinson Samuel G. , Mandel Asher , Nicosia Jeanette , Siegel Jacob , Hamidian Jahromi Alireza 
Published: May 2023

Background:
In the past 5 years, social media use among plastic surgeons has grown to become a common modality used to promote one’s practice. However, surgeons lack the necessary ethical training to understand how their published content impacts patient opinions and behavior. Social media trends among plastic surgeons may contribute to the reduced rate of Black (non-White) patients accessing gender affirming surgery.

Methods:
In total, 250 gender affirming surgeons and 51,698 individual posts from social media platform, Instagram, were manually extracted and analyzed. Posts were assessed for inclusion and categorized by the subject’s skin color (White versus non-White) using the Fitzpatrick scale.

Results:
Of the 3101 included posts, 375 (12.1%) portrayed non-White subjects. Of the 56 included surgeons, White surgeons were found to be 2.3 times less likely to include non-White subjects in their posts, compared with non-White surgeons. Regionally, surgeons practicing in the Northeast had the most racially diverse social media accounts, with over 20% of all posts including a non-White subject. Analyzing data over the past 5 years demonstrated no relative increase in the amount of non-White subjects being displayed on social media, while social media use by gender affirming surgeons had increased by over 200%.

Conclusions:
The low number of non-White individuals portrayed by surgeons on social media perpetuates the racial disparity seen in patients accessing gender affirming surgery. Surgeons must be conscious of the demographic they portray on social media, as a lack of representation may influence patients’ self-identify and decision to utilize gender affirming surgical treatment.
Safety and yield of percutaneous liver biopsy in adults and children with chronic hepatitis B: Results from a prospective, multicenter study
Authors: Ghany Marc G. , Belle Steven H. , Kleiner David E. , Smith Coleman , Kelley Stephanie S. , Rosenthal Philip , Fontana Robert J. ,   for the Hepatitis B Research Network
Published: May 2023

Background:
Prospective data regarding the safety and yield of liver biopsy in both adults and children with chronic hepatitis B are limited. The aim of this study is to report safety, yield, and complication rates among adults and children with chronic hepatitis B undergoing percutaneous liver biopsy.

Methods:
Data on the indication for procedural characteristics and complication rate for liver biopsies performed as part of the Hepatitis B Research Network were prospectively recorded on a study case report form and analyzed in aggregate.

Results:
Among 2506 adult and pediatric subjects enrolled in the Hepatitis B Research Network between 2011 and 2018, 465 (19%) underwent 491 liver biopsies for clinical or research reasons. Adequate liver tissue was obtained in 98% of the procedures. In total, there were 32 complications reported for 24 biopsies: 23 biopsies with 30 complications in adults and 1 biopsy with 2 complications in children. Pain (n=19) and vasovagal reaction (n=6) were the most common complications. There were 7 serious adverse events, including an arterioportal venous fistula, a pneumothorax, 4 cases of bleeding, and severe pain with no associated condition. There were no deaths.

Conclusions:
These data demonstrate that percutaneous liver biopsy is associated with a high yield of tissue (98%) and a rate of serious complications of 1.4% in both children and adults with chronic HBV. These results support the focused use of liver biopsy in the evaluation of novel treatments in development for chronic hepatitis B.
IL1β, IL-6, and TNF-α cytokines cooperate to modulate a complicated medical condition among COVID-19 patients: case-control study
Authors: Faraj Shalaw Sardar , Jalal Paywast Jamal 
Published: May 2023

Background:
The cytokine storm is a complication related to SARS-CoV-2 infection worldwide. This study aimed to address the level of three cytokines which were interleukin-1-beta (IL-1β), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-α), with different blood parameters to the formation of cytokine storm or any complication among COVID-19 patients.

Method and material:
A total of 104 serum samples were included for this purpose, and they were divided into three categories the healthy control group (n=30), mild COVID-19 patients (n=23), and severe cases of COVID-19 patients (n=51). The cytokine concentration was measured by enzyme-linked immunosorbent assays (ELISA). Serum ferritin, C-reactive protein (CRP) levels, and erythrocyte sedimentation rate were also evaluated and compared with the concentration of the proinflammatory cytokines.

Result:
The data analysis showed a significant relationship between the serum IL-6 level with serum ferritin and CRP and the progression to the severity of SARS-CoV-2 infection. The IL-6 level was increased in mild COVID-19 patients and was significantly elevated in severe COVID-19 patients. Patients in the severe group had significantly higher serum ferritin, CRP, and erythrocyte sedimentation rate levels than those in the mild and healthy groups. The IL-1β and TNF-α were not significantly different in the groups compared with the healthy control group.

Conclusion:
This study revealed that the proinflammatory cytokines and biochemical laboratory tests are promising biomarkers for detecting the severity of COVID-19 cases.
Cancer type, major determinant of mental distress in gyneco-mammary cancer patients undergoing antineoplastic treatment: cross-sectional analysis
Authors: Aquil Amina , Guerroumi Maroua , EL Kherchi Ouassil , Mouallif Mustapha , Yacouti Aicha , Ait Bouighoulidne Salma , Benider Abdellatif , Elgot Abdeljalil 
Published: May 2023

Introduction:
Mental health disorders are common in cancer patients. However, these disorders are still underestimated in oncology. The aim of the present study is to examine the effect of breast cancer and gynecological cancer on mental health disorders in women who have undergone nonsurgical antineoplastic treatment for gyneco-mammary cancer and to investigate the predictors of these mental disorders.

Material and Methods:
A cross-sectional study was carried out on Moroccan women treated with nonsurgical treatment for breast or gynecological cancer (N=200). The Hospital Anxiety and Depression Scale, Body Image Scale, Pittsburgh Sleep Quality Index, Rosenberg’s Self-Esteem Scale, and Multidimensional Scale of Perceived Social Support, were used.

Results:
The type of cancer had a significant effect on mental health disorders but not the age. Women with breast cancer had significantly more mental health problems than women with gynecological cancer (P-values ​​<0.01). The predictive model of anxiety included the effects of the following variables: having a lower school level and an advanced tumor stage. While the predictive model of depression included advanced tumor stage and disease recurrence. For poor sleep quality, the variables included were: not having an occupation and having a lower monthly income. The variables that predicted body image dissatisfaction were: being younger, being unmarried, and living in a rural area.

Conclusion:
High mental distress in women with breast cancer and gynecological cancer is favored by several predictive factors. The implementation of a protocol for the assessment and management of distress is necessary in oncology departments.
Epithelioid angiosarcoma of the adrenal gland with metastasis: a case report and literature review
Authors: Noman Mahmoud , Zeer Almotazbellah M.M , Zeer Zahraa M.M. , Daas Raed , Hamamra Yousef 
Published: May 2023

Introduction:
Primary adrenal epithelioid angiosarcoma is an exceptionally rare condition, with only 51 cases reported in the literature since 1988.

Case presentation:
We report a case of a 59-year-old male patient who presented with a 4-month history of left flank pain and anemia. Radiographic imaging identified a 14 cm mass lesion in the left suprarenal region, which showed heterogeneous enhancement. The patient underwent total adrenalectomy with tumor-free surgical margins. Histological sections showed features consistent with an epithelioid tumor, and immunohistochemical staining confirmed the diagnosis of epithelioid angiosarcoma of the left adrenal gland.

Discussion:
Primary adrenal epithelioid angiosarcoma is a very rare entity. It was first described by Kareti et al. in 1998. The most common presentation is an abdominal mass associated with pain. As there are no specific imaging findings for this tumor, histology combined with immunohistochemistry is the most definitive diagnostic method. Surgery with adjuvant chemotherapy is the management reported for previous cases.

Conclusion:
In cases of rare malignancies, interdisciplinary collaboration is crucial for determining the optimal management strategy.
Comorbidity of asthma in patients with attention-deficit/hyperactivity disorder (ADHD) aged 4–12 years in Iran: a cross-sectional study
Authors: Kiani Arezou , Houshmand Hamidreza , Houshmand Gholamreza , Mohammadi Yasin 
Published: May 2023

Introduction:
Attention-deficit/hyperactivity disorder (ADHD) is defined as a stable pattern of attention deficits or impulsive hyperactivity that can interfere with the functioning, growth, and development of individuals. It is believed that both the type of asthma and the medications used to treat it exacerbate the symptoms of ADHD.

Methods and Materials:
The present study was a cross-sectional analytical study conducted to investigate the incidence of asthma in ADHD patients aged 4–12 years who were referred to Urmia University of Medical Sciences clinics and hospitals. In this study, ADHD patients were diagnosed through a psychiatric interview and based on a paediatric asthma questionnaire (approved by asthma and allergy organizations and scientific institutions), and individuals with suspected asthma were selected. All 101 ADHD patients referred to these clinics during the specified period were examined. Five patients were excluded from the study because of lack of cooperation or incomplete information. Then, the selected subjects were divided into two age groups of less than 5 years and between 5 and 12 years. The final diagnosis of asthma was made by clinical findings and demographic questionnaire in subjects younger than 5 years, while it was made by spirometry in subjects between 5 and 12 years. Data analysis was conducted using SPSS software.

Results:
The mean age of the 96 samples included in the study was 7.67 years with a standard deviation of 7.214. Sixteen of them (16.7%) were under 5 years of age and eighty of them (83.3%) were between 5 and 12 years of age. Asthma was diagnosed in 7 children under 5 years of age (7.3%) and in 14 children (14.6%) between 5 and 12 years of age. A total of 21 (21.9%) were diagnosed as having asthma after screening. On the basis of these results, the frequency of asthma according to classified age was significant (P=0.020). The frequency of asthma based on sex and birth rank was also examined, and none of these factors showed a significant association with asthma. Medications taken by the ADHD patients were also examined in this study. The most commonly used medications in both groups of patients with asthma and no asthmatic patients were a combination of risperidone and atomoxetine or risperidone alone. The prevalence of asthma in the target population was also assessed in terms of parental smoking.

Conclusions:
According to the results of this study, the incidence of asthma in ADHD patients aged 4–12 years is high, and this case is more frequent in subjects younger than 5 years than in subjects aged 5–12 years. It should be noted that according to the results of the present study, there was no significant association between birth rank, parental smoking, ADHD medication, and the frequency of asthma.
Postpartum ovarian vein thrombosis: a case report
Authors: El Mawla Zeinab , Damen Bilal 
Published: May 2023

Introduction:
Ovarian vein thrombosis (OVT) is a rare condition most frequently seen in the immediate postpartum period. Typical symptoms include pelvic pain, fever, and abdominal mass. Although a rare diagnosis, OVT can potentially cause fatal complications; thus, early recognition and prompt treatment is important.

Case presentation:
We present a case of a 30-year-old lady, G4P3A0, previously healthy, who presented at 29+3 weeks to the hospital for preterm premature rupture of membrane. The patient had a Cesarean section (C-section), which was complicated with uterine atony and massive bleeding controlled by emergent intrauterine balloon tamponade and uterine artery embolization. The next day, the patient complained of new-onset right lower quadrant abdominal pain, for which she had an abdominal and pelvic computed tomography (CT) scan that showed OVT. Thus, she was started on anticoagulants, and discharged home.

Conclusion:
OVT is a rare disorder that has been described as occurring mainly during the postpartum period, after pelvic surgery, or in women with gynecological malignancies. Clinical features of OVT include fever, abdominal pain and tenderness, and a palpable abdominal mass. Diagnosis can be obtained using CT, magnetic resonance (MR), or ultrasound (US) Doppler. Treatment includes a combination of anticoagulants and antibiotics. Mortality is low nowadays.
Long-Term Effectiveness of Ear Molding and Factors Affecting Outcomes
Authors: Chen Lili , Li Chenlong , He Aijuan , Tong Hua , Yu Jinchao , Cui Chunxiao , Fu Yaoyao , Zhang Tianyu 
Published: May 2023

Background:
The EarWell System offers an opportunity for babies born with ear anomalies. However, the long-term effectiveness of ear molding remains unclear. This study aimed to explore the long-term effectiveness of this novel technique and to determine the risk factors for recurrence.

Methods:
This retrospective, population-based cohort study was performed from 2017 to 2021. Infants who completed ear molding therapy and were followed for more than 6 months were enrolled. The main outcomes were immediate and long-term efficacy, which were graded by two blinded plastic surgeons.

Results:
A total of 226 infants with 334 ears were recruited. The most common anomalies included helical deformities [113 ears (33.8%)], and the rarest deformities were cryptotia [5 ears (1.5%)] and conchal crus [5 ears (1.5%)]. The age of initiation treatment was a factor affecting both immediate (p=0.004) and long-term effectiveness (p=0.009). The type of anomaly also influenced long-term molding outcomes. For cup ears, the success rate of long-term outcomes (76.0%) was significantly lower than that of immediate outcomes (98.7%) (p< 0.001). Prominent ear, cup ear, and microtia were found to be the most likely to relapse during long-term follow-up. The results of logistic regression also demonstrated age, duration time, and the type of anomaly were risk factors of ear molding effects.

Conclusions:
The EarWell System was shown to be a secure and effective method for congenital ear anomalies. Some infants’ ears recurred after successful immediate results. The age of initiation treatment and the type of anomaly were predictors of long-term outcomes.
“The Effects of Gingivoperiosteoplasty and Cleft Palate Repair on Facial Growth.”
Authors: Park Jenn J. , Kalra Aneesh , Parsaei Yassmin , Rochlin Danielle H. , Verzella Alexandra , Grayson Barry H. , Cutting Court B. , Shetye Pradip R. , Flores Roberto L. 
Published: May 2023

Purpose:
Gingivoperiosteoplasty (GPP) can avoid secondary alveolar bone graft in up to 60% of patients. The effects of GPP on maxillary growth are a concern. However, palatoplasty can also negatively impact facial growth. This study quantifies the isolated effects of GPP and cleft palate repair on maxillary growth at the age of mixed dentition.

Methods:
A single institution, retrospective study of all patients undergoing primary reconstruction for unilateral cleft lip and alveolus (CLA) or cleft lip and palate (CLP) was performed. Study patients had lateral cephalograms at age of mixed dentition. Patients were stratified into four groups: CLA with GPP (CLA+GPP), CLA without GPP (CLA-GPP), CLP with GPP (CLP+GPP), and CLP without GPP (CLP-GPP). Cephalometric measurements included: sella-nasion-point A (SNA), sella-nasion-point B (SNB), and A point-nasion-B point (ANB). Landmarks were compared between patient groups and to Eurocleft Center D data.

Results:
110 patients met inclusion criteria: 7 CLA-GPP, 16 CLA+GPP, 24 CLP-GPP, and 63 CLP+GPP patients. There were no significant differences in SNA, SNB, and ANB between CLA+GPP and CLA-GPP, or between CLP+GPP and CLP-GPP groups. In patients who did not receive GPP, SNA was significantly lower in patients with a cleft palate compared to patients with an intact palate (p < 0.05). There were no significant differences in SNA or SNB of CLP-GPP or CLP+GPP groups when compared to Eurocleft data.

Conclusion:
When controlling for the effects of cleft palate repair, GPP does not appear to negatively affect midface growth at the age of mixed dentition.
Performance of cellular senescence measure, p16, and DNA methylation clocks in a clinically relevant model of age acceleration
Authors: Sedrak Mina S. , Knecht Anne , Strum Susan L. , Sun Canlan , Ding Yuan Chun , Ji Jingran , White Thomas A. , Nyrop Kirsten , LeBrasseur Nathan K. , Neuhausen Susan L. , Mitin Natalia , Muss Hyman 
Published: May 2023

ABSTRACTCellular senescence and DNA methylation are primary aging mechanisms emerging as a potential means of monitoring human aging and evaluating interventions thought to either accelerate or slow an individual’s aging trajectory. However, it is largely unknown whether cellular senescence and signatures of methylation of the specific CpG islands that comprise various epigenetic clocks correlate in humans. We have measured the cellular senescence biomarker, p16 and the five most used epigenetic aging clocks in 251 patients with breast cancer, 49 age-matched non-cancer controls, and 48 patients undergoing cytotoxic chemotherapy treatment. Chemotherapy, a known clinically-relevant inducer of aging, increased expression of p16 but not levels of the most common epigenetic clocks (DNAm-Horvath, PhenoAge, GrimAge, mPoA), with the exception of DNAm-Hannum. Chemotherapy-induced changes in p16 were associated with increased levels of a subset of SASPs, PARC, TNFRII, ICAM1, and TNFa. Cross-sectionally, there was weak to no correlation between p16 expression and epigenetic clocks in cancer patients or non-cancer controls. GrimAge and PhenoAge were the most correlated with p16 (r<0.3), with no correlation between p16 and the pace of aging epigenetic clock. Together, these data show that there is a general discordance between measures of cellular senescence and epigenetic clocks with the senescence marker p16 but not epigenetic clocks of aging responding to a clinically relevant inducer of human aging, cytotoxic chemotherapy.
Predictor of neoplasms and body composition with machine learning models
Authors: Fuentes Sebio Mª Jesús 
Published: May 2023

AbstractBackgroundThe tissue microenvironment of neoplastic diseases differs from that of normal cells. Their extracellular matrix, innervation, metabolism, as well as interstitial fluid and intercellular interconnections mark clear physical differences between normal and cancerous cellular ecosystems. Detecting these physical changes early without using diagnostic methods that are harmful and uncomfortable for the patient is a major challenge for the medical-scientific community. Electrical bioimpedance supported by machine learning techniques can provide clues to incipient preneoplastic tissue changes.MethodsIn this study, 7 predictive machine learning models were developed using a database with bioimpedanciometric data from a group of healthy individuals and another group of patients who had or were suffering from cancer at the time of measurement.ResultsTheRandom Forestwas the model that reported the best Accuracy, reaching over 90% of hits.ConclusionsThese results open the door to future research linking changes in body composition and pretumoral tissue environments using machine learning tools.
Personalizing the Pressure Reactivity Index for Neurocritical Care Decision Support
Authors: Briggs Jennifer K. , Stroh J.N. , Foreman Brandon , Park Soojin ,   the TRACK-TBI Study Investigators, Bennetty Tellen D. , Albersy David J. 
Published: May 2023

AbstractNeurocritical care patients may benefit from personalized treatment based on their cerebral autoregulatory function. The pressure reactivity index is an important, prevalent metric used to estimate the state of a patient’s cerebral autoregulation and guide clinical decision-making. However, the pressure reactivity index is highly sensitive to hyperparameter choices and intrapatient variability. In this manuscript, we develop a new personalized pressure reactivity index methodology (pPRx) that increases robustness and reduces the noise of the pressure reactivity index calculation. Using data from traumatic brain injury patients and simulated data, we first show that pressure reactivity index sensitivity to hyperparameters and interpatient variability is large enough to influence clinical interpretation of cerebral autoregulatory function. We identify that patient heart rate is closely related to errors in the pressure reactivity index, which has vital implications for extending the use of PRx to patients with different regular heart rates, such as pediatric populations. We then remove this heart rate-specific sensitivity in the pPRx methodology by adjusting for patient heart rate at resolutions of single heartbeats. Implementing the pPRx methodology decreases error, noise, and sensitivity, and allows the pressure reactivity index to be more robust to variability across patient populations. We also leverage our data and analysis to identify ideal averaging windows in the standard method.