bluuebunny/crossref_metadata_2025_split huggingface dataset:
Active Treatment of Pediatric Ganglia of the Wrist: What is the Risk of Recurrence?
Authors: Cohen-Tanugi Samuel , Dart Scott , Chadderdon Christopher 
Published: September 2023

Background:
Ganglion cysts are the most common soft tissue mass in the hand and wrist in both adults and children. More is known about wrist ganglia and their treatment outcomes in adults than in children. Current literature to guide the management of pediatric wrist ganglia is limited. The purpose of this study is to report on the rates of recurrence of pediatric wrist ganglia after active intervention—aspiration or surgical excision—at a single center, as well as to explore factors associated with recurrence in one of the largest samples to date of pediatric wrist ganglia.

Methods:
In all, 205 pediatric patients with wrist ganglia from our institution with at least 2-year follow up were included. The primary outcome was the recurrence rate after treatment type (aspiration vs. surgery). Secondary outcomes were demographic factors (age, sex, etc.), cyst location (volar vs. dorsal), duration of cyst before intervention, and surgeon specialty training (hand vs. non-hand).

Results:
Recurrence was seen in 58.4% (n=94) of patients undergoing their first aspiration.
Recurrence was seen in 34% (n=97) of patients after the first surgery, but there was a significant difference in recurrence rate based on the surgeon’s fellowship training.

Conclusion:
In conclusion, surgery does appear to offer a higher chance of definitive resolution of pediatric wrist ganglia. Differences in technique among surgeons should be explored as a possible factor to explain the range of recurrence rates described in the limited literature on this topic.

Level of Evidence:
Level III—Retrospective Review.
Negativity and Positivity in the ICU: Exploratory Development of Automated Sentiment Capture in the Electronic Health Record
Authors: Kennedy Chris J. , Chiu Catherine , Chapman Allyson Cook , Gologorskaya Oksana , Farhan Hassan , Han Mary , Hodgson MacGregor , Lazzareschi Daniel , Ashana Deepshikha , Lee Sei , Smith Alexander K. , Espejo Edie , Boscardin John , Pirracchio Romain , Cobert Julien 
Published: September 2023

OBJECTIVES:
To develop proof-of-concept algorithms using alternative approaches to capture provider sentiment in ICU notes.

DESIGN:
Retrospective observational cohort study.

SETTING:
The Multiparameter Intelligent Monitoring of Intensive Care III (MIMIC-III) and the University of California, San Francisco (UCSF) deidentified notes databases.

PATIENTS:
Adult (≥18 yr old) patients admitted to the ICU.

MEASUREMENTS AND MAIN RESULTS:
We developed two sentiment models: 1) a keywords-based approach using a consensus-based clinical sentiment lexicon comprised of 72 positive and 103 negative phrases, including negations and 2) a Decoding-enhanced Bidirectional Encoder Representations from Transformers with disentangled attention-v3-based deep learning model (keywords-independent) trained on clinical sentiment labels. We applied the models to 198,944 notes across 52,997 ICU admissions in the MIMIC-III database. Analyses were replicated on an external sample of patients admitted to a UCSF ICU from 2018 to 2019. We also labeled sentiment in 1,493 note fragments and compared the predictive accuracy of our tools to three popular sentiment classifiers. Clinical sentiment terms were found in 99% of patient visits across 88% of notes. Our two sentiment tools were substantially more predictive (Spearman correlations of 0.62–0.84, p values < 0.00001) of labeled sentiment compared with general language algorithms (0.28–0.46).

CONCLUSION:
Our exploratory healthcare-specific sentiment models can more accurately detect positivity and negativity in clinical notes compared with general sentiment tools not designed for clinical usage.
Major Publications in the Critical Care Pharmacotherapy Literature: 2022
Authors: Gurnani Payal K. , Barlow Brooke , Boling Bryan , Busse Laurence W. , Diaz-Gomez Jose L. , Ford Jenna , Gibson Gabrielle A. , Khanna Ashish K. , Lee Jennifer S. , Rivosecchi Ryan M. , Spezzano Katherine M. , Thornton Nathan , Vallabhajosyula Saraschandra , Witenko Corey J. , Wieruszewski Patrick M. 
Published: September 2023

OBJECTIVES:
A number of trials related to critical care pharmacotherapy were published in 2022. We aimed to summarize the most influential publications related to the pharmacotherapeutic care of critically ill patients in 2022.

DATA SOURCES:
PubMed/Medical Literature Analysis and Retrieval System Online and the Clinical Pharmacy and Pharmacology Pharmacotherapy Literature Update.

STUDY SELECTION:
Randomized controlled trials, prospective studies, or systematic review/meta-analyses of adult critically ill patients assessing a pharmacotherapeutic intervention and reporting clinical endpoints published between January 1, 2022, and December 31, 2022, were included in this article.

DATA EXTRACTION:
Articles from a systematic search and the Clinical Pharmacy and Pharmacology Pharmacotherapy Literature Update were included and stratified into clinical domains based upon consistent themes. Consensus was obtained on the most influential publication within each clinical domain utilizing an a priori defined three-round modified Delphi process with the following considerations: 1) overall contribution to scientific knowledge and 2) novelty to the literature.

DATA SYNTHESIS:
The systematic search and Clinical Pharmacy and Pharmacology Pharmacotherapy Literature Update yielded a total of 704 articles, of which 660 were excluded. The remaining 44 articles were stratified into the following clinical domains: emergency/neurology, cardiovascular, gastroenterology/fluids/nutrition, hematology, infectious diseases/immunomodulation, and endocrine/metabolic. The final article selected from each clinical domain was summarized following a three-round modified Delphi process and included three randomized controlled trials and three systematic review/meta-analyses. Article topics summarized included dexmedetomidine versus other sedatives during mechanical ventilation, beta-blocker treatment in the critically ill, restriction of IV fluids in septic shock, venous thromboembolism prophylaxis in critically ill adults, duration of antibiotic therapy for Pseudomonas aeruginosa ventilator-associated pneumonia, and low-dose methylprednisolone treatment in severe community-acquired pneumonia.

CONCLUSIONS:
This concise review provides a perspective on articles published in 2022 that are relevant to the pharmacotherapeutic care of critically ill patients and their potential impact on clinical practice.
Trends in Incidence and Outcomes of Cardiac Arrest Occurring in Swedish ICUs
Authors: Flam Benjamin , Andersson Franko Mikael , Skrifvars Markus B. , Djärv Therese , Cronhjort Maria , Jonsson Fagerlund Malin , Mårtensson Johan 
Published: September 2023

OBJECTIVE:
To determine temporal trends in the incidence of cardiac arrest occurring in the ICU (ICU-CA) and its associated long-term mortality.

DESIGN:
Retrospective observational study.

SETTING:
Swedish ICUs, between 2011 and 2017.

PATIENTS:
Adult patients (≥18 yr old) recorded in the Swedish Intensive Care Registry (SIR).

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
ICU-CA was defined as a first episode of cardiopulmonary resuscitation and/or defibrillation following an ICU admission, as recorded in SIR or the Swedish Cardiopulmonary Resuscitation Registry. Annual adjusted ICU-CA incidence trend (all admissions) was estimated using propensity score-weighted analysis. Six-month mortality trends (first admissions) were assessed using multivariable mixed-effects logistic regression. Analyses were adjusted for pre-admission characteristics (sex, age, socioeconomic status, comorbidities, medications, and healthcare utilization), illness severity on ICU admission, and admitting unit. We included 231,427 adult ICU admissions. Crude ICU-CA incidence was 16.1 per 1,000 admissions, with no significant annual trend in the propensity score-weighted analysis. Among 186,530 first admissions, crude 6-month mortality in ICU-CA patients was 74.7% (95% CI, 70.1–78.9) in 2011 and 68.8% (95% CI, 64.4–73.0) in 2017. When controlling for multiple potential confounders, the adjusted 6-month mortality odds of ICU-CA patients decreased by 6% per year (95% CI, 2–10). Patients admitted after out-of-hospital or in-hospital cardiac arrest had the highest ICU-CA incidence (136.1/1,000) and subsequent 6-month mortality (76.0% [95% CI, 73.6–78.4]).

CONCLUSIONS:
In our nationwide Swedish cohort, the adjusted incidence of ICU-CA remained unchanged between 2011 and 2017. More than two-thirds of patients with ICU-CA did not survive to 6 months following admission, but a slight improvement appears to have occurred over time.
The Use of MartriDerm in Nail Bed Reconstruction of Thumb Injured by a Pellet
Authors: Al Lahham Salim , Aljassem Ghanem , Al-Khayarin Alreem , Sada Ruba , Mogahed Heba , AlSherawi Abeer 
Published: September 2023

Summary:
Gunshot injuries to the hand and upper extremity can be divided into low and high-energy injuries. Nonballistic firearms such as pellet guns are generally considered low-energy guns but can be associated with serious morbidity and even mortality. Management is tailored according to the severity and type of injured structures. Here, we present the case of a 21-year-old soldier who accidently shot his thumb with an air gun while on a bird hunting trip, whose case was managed with extraction placement of bone graft and collagen matrix to prevent nail deformity. This case was written to increase the awareness about the need for safe use of such guns and to display the authors preferred way of management.
Exploring Factors Associated with Implant Removal Satisfaction in Breast Implant Illness Patients: A PRO BREAST-Q Study
Authors: Bascone Corey M. , McGraw J. Reed , Couto Javier A. , Sulkar Reena S. , Broach Robyn B. , Butler Paris D. , Kovach Stephen J. 
Published: September 2023

Background:Breast implant illness (BII) is a poorly understood heterogeneous disorder treated with implant removal; however, patient-reported symptoms and outcomes after treatment remain unclear.Methods:A retrospective review of patients undergoing bilateral breast implant removal related to BII by two surgeons at an academic medical center between 2018 and 2022 was conducted. Patients were surveyed using the BREAST-Q Reconstruction model with the American Society for Aesthetic Plastic Surgery BII survey extension. Outcomes were analyzed using multivariable logistic regression, adjusted for patient-associated factors.Results:Forty-seven patients were surveyed with a response rate of 51% (n = 24). Of the 20 patients who completed the survey, the majority were White (85%), with 45% (n = 9) having a documented history of psychiatric illness. Six (30%) patients had capsular contracture and four (20%) had documented implant rupture. Most implant removal procedures (n = 12, 60%) were not covered by insurance. Fourteen (70%) patients reported a net improvement in their symptoms after implant removal, most commonly chest discomfort, muscle pain, fever, and headaches. Capsular contracture was predictive of reduced psychosocial, sexual, and breast satisfaction scores (P= 0.015). Self-pay was predictive of increased breast satisfaction scores (P= 0.009), but had no impact on symptomatic improvement. A reduced time to implant removal was predictive of fewer residual symptoms (P= 0.032). Psychiatric illness had no significant impact on the outcomes.Conclusions:In the setting of suspected or diagnosed BII, a reduced time to implant removal may decrease the risk of residual symptoms and improve overall patient satisfaction. In patients with capsular contracture, preoperative counseling should emphasize that implant removal may only improve physical symptoms.
The Influence of Training Pathway, Institution Type, Gender, and a Global Pandemic on Post Graduation Career Plans in Plastic Surgery
Authors: Mukit Muntazim , Sumner Leigh , O’Brien Robert C. , Bhanat Eldrin L. , Walker Marc E. 
Published: September 2023

Background:
Anecdotal statements are often made about what percentage of residents go into fellowship versus private practice versus academia after graduation. However, few objective studies have been completed on this topic. This project is designed to shed light on the career choices of plastic surgery residents immediately after graduation from 2018 to 2022. A secondary objective was to determine whether the COVID-19 pandemic had any measurable impact on postgraduation plans.

Methods:
After obtaining institutional review board approval, publicly available data were obtained from institution websites or via program queries. Comparison between pre-COVID-19 and post-COVID-19 (2018–2019 versus 2020–2022), integrated versus independent, and private versus public cohorts were analyzed using Fisher exact test. A two-sided P value less than 0.01 was considered statistically significant.

Results:
Data were collected for 690 graduates across 64 plastic surgery training programs. Responses were obtained from 60 of 88 (68%) integrated and 30 of 47 (64%) independent programs. Most graduates pursued fellowship training (61%), followed by private practice (28%), academic practice (5%), or military post (1%). Independent residents were more likely to pursue private practice (40% versus 26%, P = 0.001), whereas integrated residents were more likely to pursue fellowship (49% versus 70%, P < 0.0001). Public institution graduates were more likely to go into private practice (37% versus 23%, P = 0.0002), whereas private institution residents were more likely to pursue fellowship (55% versus 72%, P < 0.0001). Public institutions were more likely to graduate women (45% versus 35%, P = 0.009). The COVID-19 pandemic (P = 0.31) had no impact on postgraduation plans.

Conclusions:
This study demonstrates that training pathway and institution type have a significant impact on postgraduation plans, whereas a global pandemic does not. This information can be used by educators, residents, and medical students as they plan for the future.
Evaluation of Different Breast Implant Shapes in the Same Patient: Is There Really a Difference between Round and Anatomical Implants?
Authors: Montemurro Paolo , Mallucci Patrick , Nava Maurizio B. , Hedén Per , Adams William P. , Wagner Johannes M. 
Published: September 2023

Background:
The choice of the right implant shape is one of the most frequent debates in cosmetic breast augmentation. In current literature, the question of whether there is a difference in the appearance of different implant shapes is still an argument of highly controversial discussion. The aim of the present work was, therefore, to analyze whether any difference exists in terms of aesthetic outcome between round and anatomical implants, and if they can be distinguished from each other in a like for like swap, making sure the evaluation was made in exactly similar conditions.

Methods:
Fourteen consecutive patients who underwent aesthetic breast augmentations received primarily an implant of a given volume, projection, and shape (round or anatomical) and then decided to undergo implant replacement to a different shape but maintaining the same volume and projection. At 12-months follow-up, standardized photographs were taken, blinded and randomized. They were evaluated by 10 plastic surgeons and 10 nurses.

Results:
All 20 observers could distinguish between round and anatomical shape in all 14 cases (100%), which was highly significant (P < 0.0001) for each observer.

Conclusions:
The present data indicate that there is a clear difference between anatomical and round-shaped implants in terms of aesthetic appearance, when a comparison is properly performed. With the use of both round and anatomical implant shapes, aesthetically appealing results can be achieved in cosmetic breast augmentation. The right implant choice must be made, based on patients’ anatomy and desires.
Reliability of Measurements Using Ocular Response Analyzer as a Screening Tonometer and Corneal Hysteresis Values in the Presence or Absence of Glaucomatous Changes in Fundus
Authors: Maruyama Katsuhiko , Sugiura Natsumi , Taki Toshie 
Published: September 2023

Précis:
Use of the Ocular Response Analyzer (ORA) as a screening tonometer in clinical practice yielded reliable measurements in over 80% of eyes screened. Including corneal hysteresis (CH) data in screening may improve the accuracy of glaucoma detection.

Purpose:
To examine measurement reliability when the ORA is used as a screening tonometer, and to compare CH measurements in eyes with and those without glaucomatous changes in the fundus.

Patients and Methods:
1488 eyes of 747 patients (mean age: 53.5 ± 20.4 y, range: 6–94 y) underwent intraocular pressure (IOP) measurement using ORA as screening. The percentage of eyes with a waveform score ≥6, the recommended threshold indicating reliability, was calculated. Eyes that had waveform score ≥6 and had undergone fundus photography and optical coherence tomography were assessed for the presence or absence of glaucomatous changes in fundus from optical coherence tomography and fundus images, and CH was compared between the 2 groups.

Results:
Mean ± SD (range) of ORA measurements were: Goldmann-correlated IOP 14.9 ± 4.8 (1.0–63.2) mm Hg, corneal-compensated IOP 16.2 ± 4.7 (3.2–73.6) mm Hg, CH 9.7 ± 1.5 (0.0–20.6) mm Hg, and waveform score 7.3 ± 1.5 (0.1–9.7). Eighty-four percent of eyes had a waveform score ≥6. Among 192 eyes (127 patients, aged 53.5 ± 18.0 y) with waveform score ≥6 and evaluable for glaucomatous changes in the fundus, 53 eyes were determined as positive and 139 eyes as negative. CH was 9.6 ± 1.4 (6.8–13.3) mm Hg in the positive group and 10.2 ± 1.2 (6.9–13.3) mm Hg in the negative group, and was significantly lower in the positive group (P=0.003).

Conclusion:
When using ORA as a screening tonometer, reliable results were obtained in ~80% of the eyes. CH was lower in the glaucomatous change-positive group compared with the glaucomatous change-negative group, but the ranges overlapped between the 2 groups.
The efficacy of different segments fixation for treatment thoracolumbar fractures: A Bayesian network meta-analysis
Authors: He Xiaoyuan , Zhong Zhenhao , Zhou Wenjie , Guo Shasha , Chen Huanxiong , Chen Tao 
Published: September 2023

Background:
We did this network meta-analysis to comprehensively compare the efficacy of different segments [intermediate segment (IS), short segment (SS) and long segment (LS)] in the fixation of thoracolumbar fractures.

Methods:
We searched studies from inception until January 20, 2023 through PubMed, Embase, Web of Science, and the Cochrane Library. All studies comparing different segments in the fixation of thoracolumbar fractures were included in this meta-analysis. Outcomes were anterior vertebral height ratio (AVHR), sagittal Cobb angle (SCA), visual analogue scale score, and implant failure rate. This network meta-analysis was performed by R software with gemtc package.

Results:
Finally, a total of 22 studies were finally included in this network meta-analysis. IS (WMD 2.43, 95% CrI 2.04–2.91) was more effective than SS in terms of the AVHR, and the difference was statistically significant. IS was more effective than LS in reducing SCA (WMD −2.87, 95% CrI −3.79 to −1.96) with statistically significant. Compared with SS, IS significantly reduced the SCA with statistically significant (WMD −2.52, 95% CrI −3.31 to −1.72). IS (WMD −2.87, 95% CrI −3.78 to −1.96) was more effective than LS, and the difference was statistically significant. Moreover, IS (WMD −2.52, 95% CrI −3.31 to −1.72) was more effective than SS, and the difference was statistically significant.

Conclusion:
IS was associated with a significant reduction in SCA, implant failure rate, and visual analogue scale compared to SS and LS, while having the most favorable impact on AVHR among all the treatments assessed.
Whether long-term use of proton pump inhibitor increases the risk of precancerous lesions in the stomach: A systematic review and meta-analysis of randomized controlled trials
Authors: Lv Fangyi , Wang Jincheng , Mao Leiming , Zhou Xiangyu , Zhang Taiwei , Zhou Sufang 
Published: September 2023

Background:
To evaluate through meta-analysis whether long-term use of proton pump inhibitor (PPI) increases the risk of precancerous lesions in the stomach.

Methods:
Randomized controlled trials that compared the occurrence and progression of precancerous lesions in patients receiving PPI treatment versus non-PPI treatment were retrieved from CNKI, VIP, Wanfang, CBM, Pubmed, Embase, Web of Science, and Cochrane Library databases (from database inception to May 1, 2023). The Revman 5.3 and STATA 17.0 software were used for analysis, and subgroup analysis was conducted based on follow-up time (≤12 months and > 12 months) and lesion type (atrophic gastritis, intestinal metaplasia, and epithelial dysplasia).

Results:
Six randomized controlled trials with a total of 1623 cases were included, including 1015 cases in the experimental group and 608 cases in the control group. The meta-analysis results showed that the overall abnormal lesion rate combined with statistical relative risk (RR) = 1.31 (0.85–2.02), P = .23. Subgroup analysis showed that the follow-up time > 12 months combined result was RR = 2.21 (1.47–3.33), P = .0001, the intestinal metaplasia group combined result was RR = 1.96 (0.91–2.47), P = .04.

Conclusion subsections:
During long-term follow-up, patients using PPI exhibited a significantly higher incidence of overall abnormal lesions compared to the control group, particularly with a higher risk observed for intestinal metaplasia. However, there were no statistically significant differences between the 2 groups in terms of short-term follow-up and other types of lesions. It is important to exercise caution when interpreting these findings due to the limited number of nominated investigations included in the meta-analysis.
Effects of remote ischemic preconditioning in severe traumatic brain injury: A single-center randomized controlled trial
Authors: Shen Juan , Zhu Lin , Shan Yan , Wang Yuhai , Liang Changlei 
Published: September 2023

Background:
Traumatic brain injury (TBI) is a significant contributor to global mortality and impairment. Experimental data has shown the advantages of remote ischemic preconditioning (RIPC) in treating brain injury, however, there is a lack of evidence-based medicine regarding its clinical effectiveness and safety.

Materials and methods:
In this study, we investigated whether RIPC could enhance outcomes in patients with severe TBI. Between January 2019 and December 2022, a comprehensive assessment was conducted on 392 individuals with severe TBI. Out of these, 304 patients were initially included and randomly assigned to receive either RIPC treatment (n = 153) or a control treatment (n = 151). The main measures of results included Glasgow Outcome Scale scores at 6 months, the occurrence of cerebral infarction during hospitalization, mortality rate within 30 days, levels of neuron-specific enolase and S-100β, any adverse effects, expenses incurred during hospitalization, and duration of hospital stay.

Results:
The 2 groups did not show any statistically significant differences in baseline clinical data. The Glasgow Outcome Scale scores at 6 months in the RIPC group showed significant improvement when compared with the control group. Additionally, the application of RIPC therapy can reduce the concentrations of neuron-specific enolase and S-100β. There was no notable distinction observed between the 2 groups regarding the adverse reactions of RIPC-induced objective indications of tissue or neurovascular harm. In the RIPC group, there was a significant reduction in both the duration of hospital stays and the expenses associated with hospitalization.

Conclusion:
The results of this study suggest that RIPC has the potential to enhance clinical outcomes, mitigate nerve damage, and reduce both hospital expenses and length of stay in patients with severe TBI. The use of RIPC is a reliable and efficient method for managing severe TBI.