bluuebunny/crossref_metadata_2025_split huggingface dataset:
Repetitive transcranial magnetic stimulation for fibromyalgia: are we there yet?
Authors: Lapa Jorge Dornellys da Silva , da Silva Valquíria Aparecida , Ciampi de Andrade Daniel 
Published: January 2025

Abstract
Repetitive transcranial magnetic stimulation (rTMS) has increasingly been used to modify cortical maladaptive plastic changes shown to occur in fibromyalgia (FM) and to correlate with symptoms. Evidence for its efficacy is currently inconclusive, mainly due to heterogeneity of stimulation parameters used in trials available to date. Here, we reviewed the current evidence on the use of rTMS for FM control in the format of a narrative review, in which a systematic dissection of the different stimulation parameters would be possible. We conducted a search in Medline and Embase for controlled trials on rTMS in people with FM with at least 10 participants in each treatment arm, and treatment/follow-up of at least 3 weeks. The search identified 482 abstracts, of which 45 were screened to full review, and 11 met inclusion criteria. Six out of 11 trials were positive. The dorsolateral prefrontal cortex was the target in 218 patients (49.2%), and the primary motor cortex (M1) in 225 (50.8%). Studies targeting M1 at 10 Hz, with stimulation current delivered in the posterior-anterior, were systematically positive, frequently showing that maintenance sessions delivered weekly, and biweekly were able to maintain the analgesic effects seen after daily induction sessions. Studies assessing the effects of rTMS for FM are still marked by heterogeneity in stimulation petameters, choice of primary outcomes, and inclusion criteria. The selection of the stimulation parameters associated with significant analgesic effects is likely to benefit following larger multicenter trials and improve the overall management of pain and associated symptoms in people with FM.
Fibromyalgia: do I tackle you with pharmacological treatments?
Authors: Perrot Serge 
Published: January 2025

Abstract
Pharmacological approaches are frequently proposed in fibromyalgia, based on different rationale. Some treatments are proposed to alleviate symptoms, mainly pain, fatigue, and sleep disorder. Other treatments are proposed according to pathophysiological mechanisms, especially central sensitization and abnormal pain modulation. Globally, pharmacological approaches are weakly effective but market authorization differs between Europe and United States. Food and Drug Administration–approved medications for fibromyalgia treatment include serotonin and noradrenaline reuptake inhibitors, such as duloxetine, and pregabalin (an anticonvulsant), which target neurotransmitter modulation and central sensitization. Effect of analgesics, especially tramadol, on pain is weak, mainly on short term. Low-dose naltrexone and ketamine are gaining attention due their action on neuroinflammation and depression modulation, but treatment protocols have not been validated. Moreover, some treatments should be avoided due to the high risk of abuse and severe side effects, especially opioids, steroids, and hormonal replacement.
Spatiotemporal gait parameters influencing functional mobility of people with lower limb amputation
Authors: Kristal Anat , Gaunaurd Ignacio , Kirk-Sanchez Neva , Gard Steven , Clark Natali , Da Silva Emika , Stieg Forrest , Gailey Robert 
Published: January 2025

Background:
Walking speed is a measure of functional mobility that is relatively easy to quantify. In people with lower limb amputation, reduced walking speed has been linked with specific atypical spatiotemporal gait parameters. However, the influence of atypical spatiotemporal gait parameters on the walking speed of people with unilateral transtibial amputation (TTA) and transfemoral amputation (TFA) remains unclear.

Objectives:
To identify spatiotemporal gait parameters influencing walking speed of people with unilateral TTA or TFA.

Study design:
Cross-sectional.

Methods:
The 10-meter walk test (10mWT) was used to measure walking speed, and an instrumented walkway was used to record spatiotemporal gait parameters. Regression analyses were used to determine the best subset of spatiotemporal gait parameters that influence the walking speed of people with TTA and TFA.

Results:
The study included 43 people with TTA and 49 with TFA. In the TTA group, spatiotemporal gait parameters accounted for 65.5% of the variance in walking speed, with prosthetic single limb support accounting for 52.2%, prosthetic terminal double limb support accounting for 8.9%, and stride width accounting for 4.4%. In the TFA group, intact swing accounted for 46.7% of the variance in walking speed. There was no significant difference in walking speed between the TTA and the TFA groups (p > 0.05).

Conclusions:
The study's results highlight specific spatiotemporal gait parameters that affect the walking speed of people with unilateral TTA and TFA. In addition, results suggest that walking speed over short distances is not confounded by amputation level (i.e., TTA and TFA).
The Value of Multidisciplinary Neuro-oncological Tumor Boards to Increase the Accuracy of FET PET for Identifying Brain Tumor Relapse
Authors: Ceccon Garry S. , Werner Jan-Michael , Ruge Maximilian I. , Goldbrunner Roland , Celik Eren , Baues Christian , Deckert Martina , Brunn Anna , Rongen Manuel Montesinos , Büttner Reinhard , Dunkl Veronika , Nogova Lucia , Schlamann Marc , Kabbasch Christoph , Rueß Daniel , Hampl Jürgen , Wollring Michael M. , Rosen Elena K. , Tscherpel Caroline , Stoffels Gabriele , Lohmann Philipp , Mottaghy Felix M. , Fink Gereon R. , Langen Karl-Josef , Galldiks Norbert 
Published: January 2025

Purpose
Especially in Europe, amino acid PET is increasingly integrated into multidisciplinary neuro-oncological tumor boards (MNTBs) to overcome diagnostic uncertainties such as treatment-related changes. We evaluated the accuracy of MNTB decisions that included the O-(2-[18F]-fluoroethyl)-L-tyrosine (FET) PET information compared with FET PET results alone to differentiate tumor relapse from treatment-related changes.

Patients and Methods
In a single academic center, we retrospectively evaluated 180 MNTB decisions of 151 patients with CNS WHO grade 3 or 4 gliomas (n = 122) or brain metastases (n = 29) presenting equivocal MRI findings following anticancer treatment. All patients underwent FET PET imaging besides MRI before MNTB discussion. Additionally, the patient’s clinical status and pretreatment were considered for decision-making. The diagnostic performance was calculated for FET PET findings alone and MNTB decisions that included FET PET results using 2 × 2 contingency tables. MNTB decisions were validated using the neuropathological result in 43% (n = 78) or clinicoradiologically in 57% (n = 102).

Results
FET PET results alone yielded an accuracy of 87% (sensitivity, 90%; specificity, 65%; positive predictive value, 95%). When integrating FET PET results for decision-making in the MNTB setting, the accuracy increased to 95% (sensitivity, 99%; specificity, 70%; positive predictive value, 96%; P = 0.002). In MNTB decisions concerning glioblastoma patients, the median survival was 2.4 times longer when FET PET suggested treatment-related changes (15.6 vs 6.4 months; P = 0.009).

Conclusions
Our results suggest that MNTB discussion further enhances the FET PET value for identifying brain tumor relapse. A prospective evaluation of FET PET results with and without integration in an MNTB is warranted.
Effect of Older Age on Postoperative Urinary Retention After Prolapse Surgery
Authors: McLarty Kristiana B. , Zuo Stephanie W. , Warner Kristina J. , Orris Steven R. , Nguyen Tien C. , Meckes Nicole A. , Mumford Brigid S. , Bellam Kavya , Rayen Richael , Ackenbom Mary F. 
Published: January 2025

Importance
Postoperative urinary retention (POUR) is common after reconstructive pelvic surgery. Little is known about the relationship between older age (≥70 years) and POUR after pelvic organ prolapse surgery.

Objectives
We aimed to investigate the relationship between age ≥70 years and POUR. Secondarily, we aimed to determine if duration of urinary catheterization differed by age in women with POUR.

Study Design
This was a secondary analysis of a dual-center retrospective study on perioperative adverse events in biologic females aged ≥61 years undergoing prolapse surgery. The primary outcome was POUR, defined as a failed retrograde voiding trial requiring bladder catheterization. The secondary outcome was duration of temporary bladder catheterization. We developed a stepwise multivariable logistic regression model, which included relevant variables with P < 0.10 on univariate analyses and a forced age variable.

Results
In this cohort of 2,665 women, mean ± standard deviation age was 71.2 ± 6.7 years, and 54.6% were ≥70 years, POUR occurred in 830 (31.1%) patients. Women with POUR had a lower body mass index and were more likely to have undergone a vaginal prolapse surgery and concomitant hysterectomy/incontinence procedure (P < 0.05). They had higher estimated blood loss (75 vs 50 mL, P < 0.001). On multivariable logistic regression, age ≥70 years was not associated with POUR (adjusted odds ratio 1.02, 95% CI [0.83–1.26]). Age ≥70 years was associated with longer duration of catheterization (5 vs 4 days, P < 0.01).

Conclusion
Age was not associated with POUR when controlling for other clinical factors (body mass index, surgical approach, concomitant hysterectomy/incontinence surgery, and estimated blood loss). These factors may affect POUR in older women and should be considered in perioperative management.
Phenotypes of Pelvic Organ Prolapse
Authors: Sayler Zoe , Weston Katie , Johnson Colin M. , Cunningham Victoria , Bradley Catherine S. , Kenne Kimberly A. , Wendt Linder , Ten Eyck Patrick , Kowalski Joseph T. 
Published: January 2025

Importance
The Pelvic Organ Prolapse Quantification (POP-Q) stages do not correlate with symptoms or characterize important prolapse subtypes.

Objectives
We hypothesize that clinically meaningful prolapse “phenotypes” utilizing POP-Q measurements can be defined. The primary aim was to define the phenotypes and their frequency. Secondary aims were to compare demographics, medical characteristics, and symptoms between phenotypes.

Study Design
Patients who previously underwent prolapse surgery were retrospectively categorized into 1 of 8 phenotypes based on 2 principles: (1) prolapse exists when the anterior or posterior vaginal wall descend to the hymen or the apex descends half total vaginal length, and (2) prolapse may exist in anterior, posterior, and/or apical compartments. Demographics, medical characteristics, and Pelvic Floor Distress Inventory-20 (PFDI-20) responses were compared. Linear and logistic regression models were used for comparisons.

Results
The AC (anterior-predominant and apical) phenotype was most common (231 of 501 patients, 46.1%) and served as the reference for comparisons. The no prolapse, P (isolated posterior), C (isolated apical), and PC (posterior-predominant and apical) phenotypes were younger. The A (isolated anterior) phenotype was older. P, PC, and APC (anterior and posterior and apical) phenotypes had greater body mass index. The P phenotype Colorectal-Anal Distress Inventory scores were higher. Similarly, the PC phenotype had higher scores for bowel splinting and rectal prolapse. Conversely, the C phenotype total PFDI-20 scores were lower (P = 0.01). Only the APC phenotype had no significant differences in any PFDI-20 question compared with the AC phenotype.

Conclusion
These phenotypes may allow for improved understanding, communication, and counseling about prolapse and prolapse treatment.
Impact of Non-Hepatectomy Opioid Reduction Efforts on Post-Hepatectomy Opioid Prescriptions: Analysis of 2,005 Patients
Authors: Fields Brittany C , Newhook Timothy E , Prakash Laura R , Arvide Elsa M , Li Zhouxuan , Tran Cao Hop S , Maxwell Jessica E , Perrier Nancy D , Katz Matthew HG , Vauthey Jean-Nicolas , Tzeng Ching-Wei D 
Published: January 2025

Introduction:
Pathway-driven, post-pancreatectomy opioid reduction interventions have proven effective and sustainable and may have a “halo effect” on other major abdominal cancer operations. This study’s aim was to analyze the sequential effects of expanding opioid reduction efforts from pancreatectomy on opioids prescribed after hepatectomy.

Methods:
This is a retrospective cohort study utilizing data from the electronic health record and a prospective quality improvement database for consecutive hepatectomy patients (09/2016-02/2024). Cohorts were based on 5 distinct eras (E) of opioid-related protocol updates (E1/pre-intervention historical baseline: 09/2016-03/2017, E2/introduction of 5x-multiplier: 04/2017-09/2018, E3/departmental opioid education program: 10/2018-12/2019, E4/initial post-hepatectomy pathways: 01/2020-06/2022, E5/updated pancreatectomy pathways influencing hepatectomy care: 07/2022-02/2024).

Results:
Of 2005 patients, 31% underwent major hepatectomy, 14% intermediate, 46% minor, and 9% combination surgery/other. Most (79%) were performed via open approach. Median hospital stay decreased from 5 to 4 days between E1-E5. Both intraoperative (E1:80mg, E5:37mg; p<0.001) and total inpatient (E1:181mg, E5:86mg; p<0.001) median oral morphine equivalents (OME) were reduced >50%. A 73% reduction in discharge OME was observed between E1 (225mg) and E5 (60mg; p<0.001), with clinically similar median pain scores at discharge (score 1-2 of 10). Concurrent universal adoption of routine 3-drug non-opioid discharge prescriptions (E1:70%, E5:98%) correlated with proportion of patients discharged opioid-free (E1:8%, E5:43%; p<0.001).

Conclusions:
Directed opioid reduction efforts for pancreatectomy influenced clinically meaningful post-hepatectomy reductions in inpatient and discharge opioid volumes. A “halo effect” of intradepartmental opioid reduction efforts is attainable and corresponds to measurable increases in opioid-free or nearly opioid-free discharges after major abdominal cancer surgery.
Impact of Disease Etiology and Indication for Colectomy on Postoperative Outcomes: A NSQIP Colectomy-Targeted Database Study
Authors: Podder Sourav K , Doermann Allison , Ibrahim George , Bowen Matthew , Koeneman Scott H , Schleider Christine , Shindle Kathleen , Cowan Scott W , Yeo Charles J , Hanna Nader 
Published: January 2025

Background:
The ACS-NSQIP Colectomy-Targeted database provides valuable metrics on surgical outcomes by utilizing clinical data to enhance quality improvement efforts. However, the quality measures offered in the ACS-NSQIP semiannual report do not stratify for the indication for colectomy. We aim to compare postoperative outcomes in patients undergoing colectomy for colon cancer, infectious causes, and inflammatory bowel disease (IBD).

Study Design:
A retrospective review of patients undergoing colectomy was performed using the ACS-NSQIP Colectomy-Targeted database from 2012-2022. Logistic regression models were used to compare the 30-day postoperative outcomes of patients who underwent colectomy for colon cancer, infectious causes, and IBD while adjusting for pre-operative risk factors.

Results:
There were 158,560 patients who underwent colectomy for colon cancer, 90,827 patients for infectious causes, and 30,548 patients for IBD. In unadjusted analysis, patients undergoing colectomy for infectious causes had the highest rates of mortality (2.6%) and morbidity (27.6%). After adjusting for covariates, IBD patients undergoing colectomy had significantly higher odds of morbidity compared to those undergoing colectomy for colon cancer (OR 1.3, 95% CI [1.1, 1.4]) and infectious causes (OR 1.3, [1.2, 1.4]). Furthermore, IBD patients had significantly higher odds of experiencing venous thromboembolism, surgical site infections, prolonged ileus, and readmission within 30 days compared to both colon cancer and infectious causes patients.

Conclusions:
This study demonstrates that the indication for colectomy impacts postoperative outcomes. Reporting risk-adjusted outcomes based on the underlying disease etiology could lead to identifying high-risk patients, improving benchmarking outcomes, and developing targeted quality initiatives.
Breast Conservation Surgery for Breast Cancer in Men
Authors: Den Jennifer , Nelson Nicole , Khanipov Kamil , Klimberg V Suzanne 
Published: January 2025

Background:
Male breast cancer (MBC) is a rare disease, accounting for 1% of all breast cancers diagnosed in the United States. The rarity of MBC has limited the development of treatment algorithms specific to men. Thus, the standard of care has been mastectomy. The safety and feasibility of breast-conserving surgery (BCS) in MBC are unclear. This study assessed whether overall survival outcomes, local recurrence, and postoperative complications differed between MBC patients who underwent conservative surgery or mastectomy.

Study Design:
A retrospective search for men aged ≥18 years diagnosed with breast cancer was conducted using the TriNetX network. Cohort 1 included patients who underwent BCS. Cohort 2 included patients who underwent mastectomy. Propensity score matching was conducted using age, BMI, tobacco use, cancer stage and tumor size (T1-T4), radiation, chemotherapy, hormonal therapy, genetics, and comorbidities. Outcomes of interest were 5-year overall survival (OS), local recurrence (LR), and postoperative complications.

Results:
423 patients underwent BCS, and 1,101 patients underwent mastectomy. After matching, 401 patients per cohort were identified. There was no difference in 5-year OS with the Kaplan-Meier analysis (Cohort 1: 84% vs Cohort 2: 86%, log-rank test p=0.412) or with LR (11% vs 13%, p=0.384). The mastectomy cohort was more likely to have postoperative complications, with a risk of 24% compared with 17% in the BCS cohort (p=0.011).

Conclusions:
There is no difference in the 5-year OS and LR rate between MBC patients who undergo BCS or mastectomy. The postoperative complication rate was higher with mastectomies. We conclude that BCS for unicentric male breast cancer is feasible and preferred for T1 and T2 cancers.
Novel Use of Objective Sensor Technology: Creation of Individualized Education Plans to Develop Operative Mastery
Authors: Korndorffer James R , Schultz Cameron , Perumalla Calvin , Perrone Kenneth , Pugh Carla 
Published: January 2025

Background:
Motion-tracking has been shown to correlate with expert and novice performance but has not been used for skill development. For skill development, performance goals must be defined. We hypothesize that using wearable sensor technology, motion tracking outcomes can be identified in those deemed practice-ready and used as benchmarks for precision learning.

Study Design:
At the ACS Clinical Congress, surgeons and surgeons in-training volunteered to wear motion-tracking sensors while performing intracorporeal suturing and knot-tying, laparoscopic pattern-cutting and simulated laparoscopic cholecystectomy. Coach raters evaluated the subjects using a modified SIMPL scale. Subjects were divided into two groups based on coach ratings, practice-ready and not practice-ready. Motion results were compared. Benchmark performance for each motion-tracking outcome of the simulated laparoscopic cholecystectomy was set at the median(+/-MAD) of the practice-ready cohort. For all subjects, each motion-tracking outcome was compared to the benchmark.

Results:
94 subjects were recruited. 53 were rated at practice-ready. Differences between groups were identified in 2 of 10 metrics for intracorporeal suturing and knot-tying, 4 of 10 metrics for pattern-cutting, and 5 of 10 metrics for the laparoscopic cholecystectomy. Set benchmarks for the metrics were compared to each subjects’ score for all individual metrics. A not practice-ready individual was less likely to achieve the benchmarks.(χ2 = 55.48 p <.00001).

Conclusion:
Wearable sensor technology can identify differences between surgeons rated practice-ready and not practice-ready. More importantly, motion metric results can be used to develop benchmarks for training endpoints. This will allow for development of an individualized report card and training protocol focused on areas in need of improvement instead of the current model of generalized training. Implementing such focused training may expedite competency and mastery of surgical skills.
Bimanual upper limb task practice and Transcutaneous electrical stimulation enhance spinal plasticity and hand function after chronic cervical spinal cord injury
Authors: Capozio Antonio , Chowdhury Samma T , Chakrabarty Samit , Delis Ioannis , Horne Maria , Sivan Manoj , Gad Parag , Holt Raymond , Ichiyama Ronaldo , Astill Sarah L 
Published: January 2025

AbstractInjuries to the spinal cord at the cervical level can lead to loss of upper limb function. Recent work suggests that combining functional task practice with Transcutaneous electrical stimulation of the spinal cord (TCES) can increase strength and upper limb function in people living with chronic cervical spinal cord injury (cSCI). Participants (n= 5) were randomly assigned to: Group_1 (n= 3) receiving one month of upper limb task practice (ULTP) followed by one month of upper limb task practice paired with spinal stimulation (ULTP+TCES); Group_2 (n= 2) receiving one month of ULTP+TCES followed by one month of ULTP. Changes in hand function (assessed via the Graded Redefined Assessment of Strength, Sensibility), independence and quality of life were investigated after each intervention and at three-months follow-up. In addition, we assessed cortical (via Transcranial Magnetic Stimulation) and spinal (via single-pulse TCES) excitability at those same time points. For Group_1: improvements in hand function from baseline were observed after ULTP+TCES (p<0.001) and at follow-up (p=0.017); quality of life increased between baseline and after ULTP (p=0.002), ULTP+TCES (p<0.001) and at follow-up (p=0.013); spinal excitability increased from baseline to after ULTP+TCES (p<0.001). For Group_2: improvements in hand function from baseline were observed after ULTP+TCES (p<0.001), ULTP (p<0.001) and at follow-up (p<0.001); corticospinal excitability increased from baseline to after ULTP (p=0.013); spinal excitability increased from baseline to after ULTP+TCES (p<0.001) and the increase persisted 3 months later at follow-up (p=0.04). Our findings demonstrate that non-invasive spinal stimulation paired with task practice can improve hand function more than task practice alone in people living with a cSCI. In addition, we suggest that spinal plasticity induced by spinal stimulation is a potential neural substrate for the attained improvements in hand function.
Cell-autonomous and non-cell-autonomous effect of TRIM72 on ALS disease progression
Authors: Zhang Xue , He Ji , Song Ning , Li Xipeng , Wang Weizhe , Hu Yueting , Li Qing , Hu Yiqing , Yin Chunmu , Zhao Peng , Jiang Xinyi , Piao Xuejiao , Meng Dawei , Cheng Hongmei , Chen Zhaohui , Huang Xusheng , Yu Pan , Qi Xinming , Ren Jin , Luo Li , Peng Lin , Guo Wei , Wang Tong , Gong Haipeng , Fan Dongsheng , Jia Yichang 
Published: January 2025

AbstractDysfunction of RNA-binding proteins, including TDP-43 and FUS, has been associated with amyotrophic lateral sclerosis (ALS); however, the underlying mechanisms are largely unknown. Here, we reported that a neuronal upregulation of TRIM72 (Tripartite Motif Containing 72) in FUS mutation knockin ALS models slows disease progression. TRIM72 interacts with Commander, a protein complex for recycling of membrane proteins, facilitating membrane repair and antioxidation. Exosomal TRIM72 is detected in ALS patient cerebrospinal fluid (CSF) and extracellular application of exosomal TRIM72 protects cell from membrane damage. In a sporadic ALS cohort, CSF TRIM72 level associates ALS disease progression. AAV-mediated neuronal expression of TRIM72 slows down the disease progressions in ALS models and in an ALS patient without adverse effects over a year treatment course. Taken together, our results suggest a universal neuronal protection of a TRIM family protein in cell-autonomous and non-cell-autonomous manners in ALS.