bluuebunny/crossref_metadata_2025_split huggingface dataset:
Race and Sex Disparities in Metabolic/Bariatric Surgery over 20 Years: A Cohort Study
Authors: Grobman Benjamin , He Liyun , Lan Zhou , Nimeri Abdelrahman , Apovian Caroline , Turchin Alexander 
Published: January 2025

Objectives:
To determine how rates of discussion of metabolic and bariatric surgery (MBS) between patients with class 2 obesity and higher and their healthcare providers as well as subsequent progression to MBS have varied by race and sex over the last 20 years.

Background:
Obesity is a growing public health crisis. MBS remains the most effective treatment for long-term management of obesity.

Methods:
Retrospective cohort study of electronic health records from a large tertiary academic health system using a previously validated natural language processing algorithm. The primary outcomes were discussion of MBS between eligible patients and providers and progression to surgery. Multivariable logistic regression was used to determine the association between sociodemographic factors, time, and discussion and receipt of MBS.

Results:
Among 122,487 patients included in the analysis, 11,094 (9.1%) patients discussed MBS with their providers. Of these, 1348 (12.2%) progressed to MBS. Between 2000 and 2020 the annual fraction of patients who had a discussion of MBS with their providers rose from 3.2% to 10.0% (P < 0.001). Black people were equally likely to discuss MBS with providers as non-Black people (9.5 vs 9.0%, P = 0.09) but were less likely to progress to MBS (8.4 vs 12.6%, P < 0.001). These disparities in progression narrowed over the study period (P = 0.044). Men were less likely than women to both discuss (8.1% vs 9.6%, P < 0.001) and receive MBS (7.6% vs 14.6%, P < 0.001), and these disparities increased over the study period.

Conclusions:
Interventions to reduce racial disparities in utilization of MBS should focus on progression from discussion to MBS. Interventions to increase the uptake of MBS among men are required across the care cascade.
Pediatric Supracondylar Humerus and Diaphyseal Femur Fractures: A Comparative Analysis of Chat Generative Pretrained Transformer and Google Gemini Recommendations Versus American Academy of Orthopaedic Surgeons Clinical Practice Guidelines
Authors: Nian Patrick P. , Umesh Amith , Simpson Shae K. , Tracey Olivia C. , Nichols Erikson , Logterman Stephanie , Doyle Shevaun M. , Heyer Jessica H. 
Published: January 2025

Objective:
Artificial intelligence (AI) chatbots, including chat generative pretrained transformer (ChatGPT) and Google Gemini, have significantly increased access to medical information. However, in pediatric orthopaedics, no study has evaluated the accuracy of AI chatbots compared with evidence-based recommendations, including the American Academy of Orthopaedic Surgeons clinical practice guidelines (AAOS CPGs). The aims of this study were to compare responses by ChatGPT-4.0, ChatGPT-3.5, and Google Gemini with AAOS CPG recommendations on pediatric supracondylar humerus and diaphyseal femur fractures regarding accuracy, supplementary and incomplete response patterns, and readability.

Methods:
ChatGPT-4.0, ChatGPT-3.5, and Google Gemini were prompted by questions created from 13 evidence-based recommendations (6 from the 2011 AAOS CPG on pediatric supracondylar humerus fractures; 7 from the 2020 AAOS CPG on pediatric diaphyseal femur fractures). Responses were anonymized and independently evaluated by 2 pediatric orthopaedic attending surgeons. Supplementary responses were, in addition, evaluated on whether no, some, or many modifications were necessary. Readability metrics (response length, Flesch-Kincaid reading level, Flesch Reading Ease, Gunning Fog Index) were compared. Cohen Kappa interrater reliability (κ) was calculated. χ2 analyses and single-factor analysis of variance were utilized to compare categorical and continuous variables, respectively. Statistical significance was set with P <0.05.

Results:
ChatGPT-4.0, ChatGPT-3.5, and Google Gemini were accurate in 11/13, 9/13, and 11/13, supplementary in 13/13, 11/13, and 13/13, and incomplete in 3/13, 4/13, and 4/13 recommendations, respectively. Of 37 supplementary responses, 17 (45.9%), 19 (51.4%), and 1 (2.7%) required no, some, and many modifications, respectively. There were no significant differences in accuracy (P = 0.533), supplementary responses (P = 0.121), necessary modifications (P = 0.580), and incomplete responses (P = 0.881). Overall κ was moderate at 0.55. ChatGPT-3.5 provided shorter responses (P = 0.002), but Google Gemini was more readable in terms of Flesch-Kincaid Grade Level (P = 0.002), Flesch Reading Ease (P < 0.001), and Gunning Fog Index (P = 0.021).

Conclusions:
While AI chatbots provided responses with reasonable accuracy, most supplemental information required modification and had complex readability. Improvements are necessary before AI chatbots can be reliably used for patient education.

Level of Evidence:
Level IV.
Comparison of Outcomes of Deep Sclerectomy, Canaloplasty, and Viscocanaloplasty: A Multi-Centred Study
Authors: Mercieca Karl , Azzopardi Matthew , Vallabh Neeru A. , Cristian Cristina , Prokosch Verena , Dubois Vincent , Hemmerdinger Christopher , De Cillà Stefano , Mathews Divya , Mermoud Andre , Grieshaber Matthias C. , Mégevand Gordana Sunaric , Anand Nitin , Rabiolo Alessandro 
Published: January 2025

Précis:
Deep sclerectomy (DS) and canaloplasty provide better intraocular pressure (IOP) control than viscocanalostomy. DS required less glaucoma medications but more interventions to reach target IOP.

Purpose:
To compare real-world outcomes of three non-penetrating glaucoma surgery (NPGS) techniques.

Methods:
Retrospective, cohort study of consecutive patients undergoing canaloplasty (CP), deep sclerectomy (DS), and viscocanalostomy (VC), across nine European glaucoma units. Four intraocular pressure (IOP) criteria were used to define success at 2-year follow-up: (A)IOP≤21 mmHg and ≥20% reduction; (B)IOP≤18 mmHg and ≥20% reduction; (C)IOP≤15 mmHg and ≥25% reduction; (D)IOP≤12 mmHg and ≥30% reduction. Secondary outcomes included IOP control, BCVA, number of medications over time, risk factors for failure, complications, and post-operative interventions. Success was distinguished as qualified or complete, if reached with or without antiglaucoma medications, respectively.

Results:
600 eyes (545 patients) undergoing standalone CP (201 eyes), DS (200 eyes), and VC (199 eyes) were included. Qualified success rates of CP, DS, and VP at 24 months were, respectively: (Criterion A) 85.1%, 67.6% and 64.6%; (Criterion B) 85.1%, 66.1% and 58.6%; (Criterion C) 76.6%, 55.5% and 39.0%; (Criterion D) 27.7%, 28.5% and 22.1%. Success rates were significantly different across the three techniques (P=0.04 or below), except for complete success according to criterion A (P=0.07). Mean IOP(±SD) reduced from 25.2(±6.9), 20.5(±6.7), and 22.7(±7.2)mmHg pre-operatively to 13.1(±3.1), 12.9(±4.5), and 14.7(±4.6)mmHg at post-operative year 2 in the CP, DS, and VC groups respectively (P<0.001 between pre-operative and post-operative time points for all groups).

Conclusions:
All three NPGS provide sustained IOP reduction, but DS and CP provide better success rates and IOP control. Success rates were low for the most stringent cut-offs, suggesting that other techniques such as trabeculectomy may be indicated when a very low target IOP is demanded.
Patient-reported outcomes in genital gender-affirming surgery
Authors: Odeluga Nkiruka , Fisch Robert , Zhang Tenny R. , Mmonu Nnenaya 
Published: January 2025

Purpose of review
We reviewed the latest articles in patient-reported outcomes as it relates to genital gender-affirming surgery (GGAS) and provide a narrative summary of each article.

Recent findings
The current landscape of patient-reported outcomes measures (PROMs) within GGAS largely consists of various ad hoc questionnaires. Within the last two years, one new PROM, validated within the transgender and gender-diverse (TGD) community, have been described.

Summary
Patient-reported outcomes measures seek to elucidate the questions and answers of particular interest to patients and stakeholders of a particular population. To date, within GGAS, surgeon-reported outcomes and nonvalidated patient-reported outcomes comprise the bulk of the literature on the subject. However, there is growing interest in PROMs developed with TGD collaboration within all phases of the research process. Three new PROMs designed with and for the TGD community, are described which provides hope for continued progression of the field toward patient-centered and patient-collaborative research.
Cervical dysplasia in women with HIV in the modern treat-all era: Elevated risk remains despite long-term ART and normal CD4 count
Authors: Luckett Rebecca , Ramogola-Masire Doreen , Zash Rebecca , Sears Ellen , Lan Jessie , Gompers Annika , Modest Anna , Moloi Thabo , Harris Devon A. , Joshi Avina , Gutfreund Rachel , Moyo Sikhulile , Kashamba Thanolo , Kula Maduke , Dreyer Greta , Masheto Gaerolwe , Botha Matthys H. , Hacker Michele R. , Shapiro Roger L. 
Published: January 2025

Objective:
To evaluate the impact of ART duration and CD4 count on risk for high grade cervical dysplasia in women with HIV (WWH) compared to women without HIV in the treat-all era with integrase strand inhibitors (INSTIs).

Design:
Prospective longitudinal cohort study in Botswana

Methods:
From February 2021 to August 2022, baseline HPV self-sampling was offered to women with and without HIV. Those HPV+ underwent biopsy for histopathological diagnosis. Using women without HIV as reference, risk ratios (RRs) were calculated for HPV, cervical intraepithelial neoplasia (CIN) 2 or worse (CIN2+), and CIN3+, stratified by ART duration and CD4 cell counts.

Results:
Of 3000 women enrolled, 2953(98.4%) underwent HPV testing, which was positive in 823(55.7%) WWH and in 654(44.3%) women without HIV. Histopathology was available for analysis in 1291(87.4%) women (709 WWH, 582 women without HIV). Over 99% of WWH had detectable HIV viral load and 94.4% were on a dolutegravir-based ART regimen. WWH had a higher risk of HPV (RR1.27,95%CI:1.18,1.37), CIN2+ (RR1.52,95%CI:1.16,1.98) and CIN3+ (RR1.75,95%CI:1.25,2.45) compared to women without HIV. There was attenuation of risk for CIN2+ with higher recent CD4 cell count, and those with higher nadir CD4 count had similar risk to those without HIV (nadir CD4≥500 CIN2+ RR1.15[95%CI:0.56,2.37], CIN3+ RR1.81[95% CI:0.86,3.79]; nadir CD4 350-499 CIN2+ RR1.23[95% CI:0.71,2.12], CIN3+ RR1.34[95%CI:0.68,2.64]).

Conclusion:
Although some attenuation of risk for CIN2+ was observed with higher recent and nadir CD4 cell counts, WWH continue to have a higher risk of CIN2+/CIN3+ compared to women without HIV. These findings support tailored cervical screening algorithms for WWH.
The Use of Knives With Versus Without Integrated Water-jet Function During Peroral Endoscopic Myotomy for Patients With Achalasia: A Meta-analysis
Authors: Diab Abdul-Rahman F. , Sujka Joseph A. , Nashit Muhammad , Abdel-Khalek Ameen , Seth Sukriti , Docimo Salvatore , DuCoin Christopher G. 
Published: January 2025

Background:
Peroral endoscopic myotomy (POEM) is a well-established endoscopic treatment for achalasia, utilizing an endoscopic knife for dissection. Recently, new knives with an integrated water-jet (WJ) function have been introduced. This study aims to compare the technical, perioperative, and late postoperative outcomes between WJ knives and conventional (C) knives, which lack the WJ function, through a pairwise meta-analysis of published comparative studies.

Methods:
We conducted a systematic literature review following PRISMA guidelines to identify studies directly comparing knives with versus without a WJ function in POEM for achalasia. A random-effects model was employed, using odds ratios for dichotomous data and mean differences for continuous data as effect size metrics.

Results:
The use of WJ knives demonstrated statistically significant reductions in the mean number of intraoperative instrument exchanges, mean intraoperative use of coagulation forceps, and operative times compared to the use of C knives. There were no significant differences in terms of the incidence of adverse events, subcutaneous emphysema, or mean hospital length of stay (LOS). Clinical success, defined as a postoperative Eckardt score <3, mean postoperative Eckardt scores, and the incidence of GERD requiring proton pump inhibitors (PPI) also showed no significant differences.

Conclusions:
The use of water-jet (WJ) knives demonstrates comparable efficacy to conventional (C) knives, with superior efficiency reflected in reduced operative time and fewer intraoperative instrument exchanges. In addition, in terms of safety, the lower use of coagulation forceps with WJ knives suggests reduced intraoperative bleeding. However, no significant differences were observed between the groups in terms of length of stay (LOS) and adverse events, despite a trend toward reduction. A larger number of studies with greater sample sizes is required to better assess potential differences in safety between the use of WJ and C knives.
Hypoferremia reduces long-term risk of major adverse cardiovascular events after STEMI by averting the myocardial reactive iron storm
Authors: Vera-Aviles M , Kabir S.N , Christodoulou M.D , Mohammad G , Shanmuganathan M , Kotronias R , Cleland J.G.F. ,   OxAMI investigators, Channon KM , Lakhal-Littleton S 
Published: January 2025

ABSTRACTBackground and aimsIron deficiency (ID) is common in patients with acute STEMI. ID has previously been associated with either adverse or favourable effects, depending on the definition of ID, sampling timepoint, outcome measures and follow-up duration. This study systematically addresses the impact of ID on long-term outcomes and explores the underlying mechanisms.MethodsPatients with acute STEMI (n=167) were followed for 4.5 years for major adverse cardiovascular events (MACE), including new HF diagnosis, recurrent MI or cardiac death. Iron markers were sampled at presentation and later timepoints. Myocardial injury was assessed by CMR at 2 days and 6 months. Mechanisms underlying clinical findings were evaluated in a mouse model of MI.ResultsID, by any definition, was common in acute STEMI patients at presentation. Hypoferremia (Tsat<20% or iron<13uM) but not hypoferritinemia (ferritin<100ug/L) predicted lower risk of MACE. Hypoferremia predicted lower troponin, acute myocardial T1, LVESV and LVEDV at 2 days, but lower myocardial salvage at 6 months. Iron status sampled from 6 hours after presentation was no longer associated with MACE.In mice, MI rapidly triggered a myocardial reactive iron storm, early LV remodelling, and eventually HF. These effects were averted by iron restriction.ConclusionsThis study reveals that hypoferremia in acute STEMI exerts both favourable and adverse effects, that nonetheless translate into better long-term clinical outcomes. This research reconciles previous seemingly conflicting reports. It also highlights a potential stepwise approach of acute iron chelation to reduce myocardial injury, followed days later by iron supplementation to promote myocardial salvage.
Radiative decay of the
Th229m
nuclear clock isomer in different host materials
Authors: Pineda S. V. , Chhetri P. , Bara S. , Elskens Y. , Casci S. , Alexandrova A. N. , Au M. , Athanasakis-Kaklamanakis M. , Bartokos M. , Beeks K. , Bernerd C. , Claessens A. , Chrysalidis K. , Cocolios T. E. , Correia J. G. , De Witte H. , Elwell R. , Ferrer R. , Heinke R. , Hudson E. R. , Ivandikov F. , Kudryavtsev Yu. , Köster U. , Kraemer S. , Laatiaoui M. , Lica R. , Merckling C. , Morawetz I. , Morgan H. W. T. , Moritz D. , Pereira L. M. C. , Raeder S. , Rothe S. , Schaden F. , Scharl K. , Schumm T. , Stegemann S. , Terhune J. , Thirolf P. G. , Tunhuma S. M. , Van Den Bergh P. , Van Duppen P. , Vantomme A. , Wahl U. , Yue Z. 
Published: January 2025

A comparative vacuum ultraviolet spectroscopy study conducted at ISOLDE-CERN of the radiative decay of the Th229m nuclear clock isomer embedded in different host materials is reported. The ratio of the number of radiative decay photons and the number of Th229m embedded are determined for single crystalline CaF2, MgF2, LiSrAlF6, AlN, and amorphous SiO2. For the latter two materials, no radiative decay signal was observed and an upper limit of the ratio is reported. The radiative decay wavelength was determined in LiSrAlF6 and CaF2, reducing its uncertainty by a factor of 2.5 relative to our previous measurement. This value is in agreement with the recently reported improved values from laser excitation.

Published by the American Physical Society
2025
Recent advances in pressurized hot water extraction/modification of polysaccharides: Structure, physicochemical properties, bioactivities, and applications
Authors: Li Jiangfei , Ye Guanjun , Wang Junwen , Gong Ting , Wang Jianlong , Zeng Deyong , Cifuentes Alejandro , Ibañez Elena , Zhao Haitian , Lu Weihong 
Published: January 2025

AbstractPressurized hot water, as a green and efficient physical treatment technology, has been widely utilized for the extraction and modification of polysaccharides, with the objective of enhancing the physicochemical properties and biological activities of polysaccharides applied in food systems. This article reviews the recent advances regarding the effects of pressurized hot water treatment (extraction and modification) on polysaccharide extraction rates, structure, physicochemical properties, and bioactivities. The potential modes and mechanisms of polysaccharides subjected to pressurized hot water treatment and the relevant applications of these treated polysaccharides are also thoroughly discussed. Finally, the challenges that it may encounter in commercial applications are analyzed, and the future trends in this field are envisioned. This article will be of great value for the scientific elucidation of polysaccharides treated with pressurized hot water and their potential food applications.
Isolation of Acanthamoeba Species and Bacterial Symbiont Variability in Puna Salt Plains, Argentina
Authors: Mooney Ronnie , Rodgers Kiri , Carnicelli Sandro , Carnevale Matías E. , Farias Maria Eugenia , Henriquez Fiona L. 
Published: January 2025

ABSTRACTAcanthamoeba spp. are widespread protists that feed on bacteria via phagocytosis. This predation pressure has led many bacteria to evolve strategies to resist and survive inside these protists. The impact of this is not well understood, but it may limit detection and allow survival in extreme environments. Three sites in the Puna salt plains, Catamarca province, Argentina, were sampled for Acanthamoeba spp., verified using PCR and Sanger sequencing. The intracellular microbiome was analysed with 16S rRNA gene sequencing and compared to the overall site microbiome. Acanthamoeba were found at all locations, and their intracellular microbiome was similar across samples but differed from the overall site microbiome. Pseudomonas spp., a clinically relevant genus, was most abundant in all isolates. This study suggests Acanthamoeba can protect bacteria, aiding their detection avoidance and survival in harsh conditions.
Short and long‐term effects of experimental varicocele
Authors: Minas Aram , Waked Dunia , Júnior Valter Luiz Maciel , Miyazaki Mika Alexia , Guilharducci Raquel Lozano , Antoniassi Mariana Pereira , Veras Mariana Matera , Bertolla Ricardo Pimenta 
Published: January 2025

AbstractBackgroundVaricocele is associated with a progressive decrease in male fertile potential, but it has yet to be determined if the duration of varicocele is associated with altered sperm functional quality.ObjectivesThis experimental study investigated the time‐dependent effects of varicocele on spermatogenesis, sperm parameters, and sperm functional traits.Materials and methodsThirty‐five mature male Wistar rats (200 ± 25 g) were included. After 2 weeks of adaptation, rats were randomly divided (n = 7/group) into control, 2 months sham (sham‐2), 2 months varicocele (VCL‐2), 4 months sham (sham‐4), and 4 months varicocele (VCL‐4) groups. Cauda epididymides were incised transversally and incubated in Biggers–Whitten–Whittingham media at 37°C for 30 min. Sperm concentration, motility, morphology, viability, mitochondrial activity (3,3′ diaminobenzidine staining), acrosome integrity (PNA‐FITC), and DNA fragmentation (alkaline Comet assay) were determined. Histological analysis on testicular cross‐sections was performed using H&E staining, and Johnsen's score was determined for each sample.ResultsDecreased Johnsen score, sperm count, motility, viability, normal morphology, and mitochondrial activity were observed in VCL‐2 and VCL‐4 groups when compared with sham‐2, sham‐4, and control groups. Higher levels of acrosome damage and DNA fragmentation were observed in VCL‐2 and VCL‐4 groups compared to sham and control groups. A negative correlation was observed between Johnsen scores and acrosome damage (r = –0.7690; p < 0.0001), and a positive correlation was observed between Johnsen scores and sperm DNA fragmentation (r = 0.8333; p < 0.0001). No differences were observed between the VCL‐2 and VCL‐4 groups in any of the analyses.Discussion and conclusionExperimental varicocele leads to decreased semen quality, sperm functional integrity, and Johnsen's scores. Moreover, to our knowledge, this is the first study demonstrating a direct association between spermatogenesis and sperm count, motility, acrosomal integrity, and DNA fragmentation levels in experimental varicocele. Longer periods of varicocele did not potentiate the negative effects, in this study.
Klinefelter Syndrome: A Review
Authors: Blackburn James , Ramakrishnan Anand , Graham Catherine , Bambang Katerina , Sriranglingam Umasuthan , Senniappan Senthil 
Published: January 2025

ABSTRACTBackgroundKlinefelter syndrome (KS) is an uncommonly recognised condition typified by gynaecomastia, small testes and aspermatogenesis. It is caused by a supernumerary X chromosome, resulting in a 47 XXY karyotype. Since its first description, the phenotype of KS has evolved and there is a much greater appreciation of the subtle features of the condition.MethodIn this review, we explore the phenotype of the KS with particular consideration to patients with pre‐natal and early infancy diagnosis, given that this is becoming increasingly common. The current understanding of the genetic mechanisms of KS, caused by supernumerary X chromosome are explored and the genotype‐phenotype correlation are discussed.ResultsThe implications of the condition both in childhood and later development are explored in detail, with particular focus on social and educational implications. Potential treatments, with emphasis on preservation of fertility are discussed. We highlight the optimal therapeutic conditions in which fertility preservation is most likely to be achieved, compared to those which can be more challenging. Finally, we discuss the other health challenges which can be associated with KS. These include poor bone health, diabetes, cardiovascular complications, and malignancy. The challenges in managing these co‐morbid conditions and most up‐to‐date management recommendations are also explored.