bluuebunny/crossref_metadata_2025_split huggingface dataset:
The correlation of intraoperative oliguria with acute kidney injury after noncardiac surgery: a systematic review and meta-analysis
Authors: Pang Zhaohua , Liang Shuang , Xing Manyu , Zhou Nannan , Guo Qulian , Zou Wangyuan 
Published: March 2023

Background:
Acute kidney injury (AKI) occurs commonly after major surgery and is correlated with increased in-hospital morbidity and mortality. There is no consensus on whether intraoperative oliguria affects postoperative AKI. We conducted a meta-analysis to systematically assess the correlation of intraoperative oliguria with postoperative AKI.

Methods:
PubMed, Embase, Web of Science, and Cochrane Library databases were searched to identify reports on the relationship between intraoperative oliguria and postoperative AKI. Quality was assessed using the Newcastle–Ottawa Scale. The primary outcomes were the unadjusted and multivariate-adjusted odds ratios (ORs) for intraoperative oliguria to correlate with postoperative AKI. The secondary outcomes included intraoperative urine output in the AKI and non-AKI groups, the demand for postoperative renal replacement therapy (RRT), in-hospital mortality, and length of hospital stay in the oliguria and non-oliguria groups.

Results:
Nine eligible studies with 18 473 patients were included. The meta-analysis revealed that patients with intraoperative oliguria had a considerably greater risk of postoperative AKI (unadjusted OR: 2.03, 95% CI: 1.60–2.58, I
2=63%, P<0.00001; multivariate-adjusted OR: 2.00, 95% CI: 1.64–2.44, I
2=40%, P<0.00001). Further subgroup analysis did not find differences between different oliguria criteria or surgical types. Furthermore, the AKI group’s pooled intraoperative urine output was less (mean differences: −0.16, 95% CI: −0.26 to −0.07, P<0.001). Intraoperative oliguria was associated with increased demand for postoperative RRT (risk ratios: 4.71, 95% CI: 2.83–7.84, P<0.001) and in-hospital mortality (risk ratios: 1.83, 95% CI: 1.24–2.69, P=0.002), but not with prolonged length of hospital stay (mean differences: 0.55, 95% CI: −0.27 to 1.38, P=0.19).

Conclusions:
Intraoperative oliguria was significantly associated with a higher incidence of postoperative AKI, as well as increased in-hospital mortality and demand for postoperative RRT, but not with prolonged hospitalization.
Correction of the High Fold in Difficult Secondary Blepharoplasty Through Retro-Orbicularis Oculi Fat Transposition and Augmentation in Asians
Authors: Wang Huili , Liu Ning , Li Xinxin , Zhu Ziwei , Wen Ting , Liu Yufeng 
Published: March 2023

Background
Secondary blepharoplasty to correct a high crease is considered challenging for most surgeons, especially in patients who show overly excessive removal of eyelid tissue in Asians. Therefore, we define a typical difficult secondary blepharoplasty as when patients present too high eyelid fold with excessive tissue resection and preaponeurotic fat deficiency. This study provides the technique of retro-orbicularis oculi fat (ROOF) transferring and volume augmentation to reconstruct eyelid anatomical structure on the base of a series of difficult secondary blepharoplasty cases in Asians and assess the effectiveness of the method in the meanwhile.

Method
This was a secondary blepharoplasty cases–based retrospective observational study. From October 2016 to May 2021, a total of 206 cases were performed blepharoplasty revision surgery to correct high folds. Among them, a total of 58 cases (6 men, 52 women) diagnosed with difficult blepharoplasty were applied ROOF transferring and volume augmentation to correct high folds and were followed up on time. Depending on the distribution of ROOF of different thicknesses, we designed 3 different methods of harvesting and transferring ROOF flaps. The mean follow-up for patients in our study was 9 months, a range of 6 to 18 months. The postoperative results were reviewed, graded, and analyzed.

Result
Most patients (89.66%) were satisfied. No postoperative complications were observed, such as infection, dehiscence of incision, tissue necrosis, levator dysfunction, or multiple creases. The mean height of the mid, medial, and lateral eyelid folds decreased from 8.96 ± 0.43, 8.21 ± 0.58, and 7.96 ± 0.53 mm to 6.77 ± 0.55, 6.27 ± 0.57, and 6.65 ± 0.61 mm, respectively.

Conclusions
Retro-orbicularis oculi fat transposition or/and its enhancement contributes significantly to the reconstruction of the physiology of the eyelid structure and provides an available surgical option for the correction of too high folds in blepharoplasty.
Treatment of Chronic Hypertrophic Burn Scars With a Fractional CO2 Laser Is Well Tolerated in an Outpatient Clinic Setting
Authors: Donnellan Kimberly A. , Hinson Chandler S. , Blevins Addison C. , Weaver Katrina L. , Lintner Alicia C. , Butts Charles C. , Williams Ashley Y. , Lee Yann-leei L. , Simmons Jon D. , Bright Andrew C. 
Published: March 2023

Introduction
The necessity of treating hypertrophic burn scars has expanded significantly with increased burn survivorship. Ablative lasers, such as carbon dioxide (CO2) lasers, have been the most common nonoperative option for improving functional outcomes in severe recalcitrant hypertrophic burn scars. However, the overwhelming majority of ablative lasers used for this indication require a combination of systemic analgesia, sedation, and/or general anesthesia due to the painful nature of the procedure. More recently, the technology of ablative lasers has advanced and is more tolerable than their first-generation counterparts. Herein, we hypothesized that refractory hypertrophic burn scars can be treated by a CO2 laser in an outpatient clinic.

Methods
We enrolled 17 consecutive patients with chronic hypertrophic burn scars that were treated with a CO2 laser. All patients were treated in the outpatient clinic with a combination of a topical solution (23% lidocaine and 7% tetracaine) applied to the scar 30 minutes before the procedure, Cryo 6 air chiller by Zimmer, and some patients received a mixture of N2O/O2. Laser treatments were repeated every 4 to 8 weeks until the patient's goals were met. Each patient completed a standardized questionnaire to assess tolerability and patient satisfaction of functional results.

Results
All patients tolerated the laser well in the outpatient clinic setting, with 0% indicating “not tolerable,” 70.6% “tolerable,” and 29.4% “very tolerable.” Each patient received more than 1 laser treatment for the following complaints: decreased range of motion (n = 16, 94.1%), pain (n = 11, 64.7%), or pruritis (n = 12, 70.6%). Patients were also satisfied with the results of the laser treatments (“no improvement or worsened” = 0%, “improved” = 47.1%, and “significant improvement” = 52.9%). The age of patient, type of burn, location of burn, presence of skin graft, or age of scar did not significantly affect the tolerability of treatment or satisfaction of outcome.

Conclusions
The treatment of chronic hypertrophic burn scars with a CO2 laser is well tolerated in an outpatient clinic setting in select patients. Patients reported a high level of satisfaction with notable improvement in functional and cosmetic outcomes.
Volumetric Analysis of Unilateral Alveolar Bone Defect Using Modified Subtraction in Older Chinese Patients
Authors: Li Kongying , Li Silei , Liu Bing , Wang Yongqian 
Published: March 2023

A large number of older patients (≥13 y old) with alveolar clefts missed the optimal alveolar bone grafting time period in China. This study aimed to determine the accuracy and repeatability of modified computer-aided engineering subtraction for volumetric measurement of these patients. In addition, the study aimed to determine whether the volume of defect is correlated with cleft type (cleft lip and alveolus, cleft lip and palate), cleft location, age, and sex. Preoperative computed tomography data from 100 patients of unilateral alveolar cleft patients without secondary alveolar bone grafting were measured using 2 methods. The maxillary resin model around the alveolar cleft was printed using the 3-dimensional (D) printing method, and the volume of the defect was measured using the drainage method. In the modified subtraction method, Mimics software was used to simulate fracture filling by layer drawing, and the defect volume was determined by subtracting the preoperative fracture template from the filled 3D skull template. The mean time taken to calculate an alveolar cleft defect volume by modified subtraction method was 3.2 minutes. The average defect volume measured using the 3D printing and modified subtraction methods were 1.58±0.41 and 1.55±0.42 cm3, respectively. Findings suggest that cleft location and age do not affect the defect volume of older patients with alveolar cleft, unlike cleft type and sex. The modified computer-aided subtraction method provides good accuracy, consistency, and reproducibility in measuring alveolar ridge defect volume. Moreover, this method is more efficient and cost-effective than the 3D-printed model method.
Implementation of Staging Guidelines in Early Esophageal Cancer
Authors: Reza Joseph A. , Raman Vignesh , Vekstein Andrew , Grau-Sepulveda Maria , Burfeind William P. , Chin Kristine , Petrov Roman , Erkmen Cherie P. 
Published: March 2023

Objective:
To evaluate the adoption and clinical impact of endoscopic resection (ER) in early esophageal cancer.

Background:
Staging for early esophageal cancer is largely inaccurate. Assessment of the impact of ER on staging accuracy is unknown, as is the implementation of ER.

Methods:
We retrospectively reviewed 2608 patients captured in the Society of Thoracic Surgeons General Thoracic Surgery Database between 2015 and 2020. Patients with clinical T1 and T2 esophageal cancer without nodal involvement (N0) who were treated with upfront esophagectomy were included. Staging accuracy was assessed by clinical-pathologic concordance among patients staged with and without ER. We also sought to measure adherence to National Comprehensive Cancer Network staging guidelines for esophageal cancer staging, specifically the implementation of ER.

Results:
For early esophageal cancer, computed tomography/positron emission tomography/endoscopic ultrasound (CT/PET/EUS) accurately predicts the pathologic tumor (T) stage 58.5% of the time. The addition of ER to staging was related to a decrease in upstaging from 17.6% to 10.8% (P=0.01). Adherence to staging guidelines with CT/PET/EUS improved from 58.2% between 2012 and 2014 to 77.9% between 2015 and 2020. However, when ER was added as a staging criterion, adherence decreased to 23.3%. Increased volume of esophagectomies within an institution was associated with increased staging adherence with ER (P=0.008).

Conclusions:
The use of CT/PET/EUS for the staging of early esophageal cancer is accurate in only 56.3% of patients. ER may increase staging accuracy as it is related to a decrease in upstaging. ER is poorly utilized in staging of early esophageal cancer. Barriers to the implementation of ER as a staging modality should be identified and corrected.
The final decision among the injured elderly, to stop or to continue? Predictors of withdrawal of life supporting treatment
Authors: Bhogadi Sai Krishna , Magnotti Louis J. , Hosseinpour Hamidreza , Anand Tanya , El-Qawaqzeh Khaled , Nelson Adam , Colosimo Christina , Spencer Audrey L. , Friese Randall , Joseph Bellal 
Published: March 2023

BACKGROUND
There is a paucity of data on factors that influence the decision regarding withdrawal of life supporting treatment (WLST) in geriatric trauma patients. We aimed to identify predictors of WLST in geriatric trauma patients.

METHODS
This retrospective analysis of the American College of Surgeons- Trauma Quality Improvement Program (2017–2019) included all severely injured (Injury Severity Score >15) geriatric trauma patients (≥65 years). Multivariable logistic regression was performed to identify independent predictors of WLST.

RESULTS
There were 155,583 patients included. Mean age was 77 ± 7 years, 55% were male, 97% sustained blunt injury, and the median Injury Severity Score was 17 [16–25]. Overall WLST rate was 10.8%. On MLR analysis, increasing age (adjusted odds ratio [aOR], 1.35; 95% confidence interval [CI], 1.33–1.37; p < 0.001), male sex (aOR, 1.14; 95% CI, 1.09–1.18; p < 0.001), White race (aOR, 1.44; 95% CI, 1.36–1.52; p < 0.001), frailty (aOR, 1.42; 95% CI, 1.34–1.50; p < 0.001), government insurance (aOR, 1.27; 95% CI, 1.20–1.33; p < 0.001), presence of advance directive limiting care (aOR, 2.55; 95% CI, 2.40–2.70; p < 0.001), severe traumatic brain injury (aOR, 1.80; 95% CI, 1.66–1.95; p < 0.001), ventilator requirement (aOR, 12.73; 95% CI, 12.09–13.39; p < 0.001), and treatment at higher level trauma centers (Level I aOR, 1.49; 95% CI, 1.42–1.57; p < 0.001; Level II aOR, 1.43; 95% CI, 1.35–1.51; p < 0.001) were independently associated with higher odds of WLST.

CONCLUSION
Our results suggest that nearly one in 10 severely injured geriatric trauma patients undergo WLST. Multiple patient and hospital related factors contribute to decision making and directed efforts are necessary to create a more standardized process.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
Conserving Biodiversity in Coffee Agroecosystems: Insights from a Herpetofauna Study in the Colombian Andes with Sustainable Management Proposal
Authors: Ríos-Orjuela Juan Camilo , Falcón-Espitia Nelson , Arias-Escobar Alejandra , Plazas-Cardona Dennys 
Published: March 2023

ABSTRACTAmphibians and reptiles are important indicators of ecosystem health, yet their populations are declining worldwide due to habitat loss and climate change. Agroecosystems, such as coffee plantations, can provide important habitat for these species. We conducted field surveys in the Sumapaz region of Colombia to identify the microclimatic variables that influence the diversity and abundance of herpetofauna in coffee crops. The canonical correspondence analysis revealed that leaf litter abundance, crop area, and age category were the most important structural variables for determining herpetofauna diversity. Our findings suggest that coffee plantations function similarly to secondary vegetation, and maintaining a thick layer of leaf litter is critical for establishing complex and structured animal communities. This study proposes a set of sustainable agricultural management principles to promote the existence of amphibians and reptiles in coffee crops. By adopting these practices, it is possible to prevent the decline in the population of amphibians and reptiles due to the expansion of the agricultural frontier, as seen in other coffee-growing regions. The findings of this study contribute to a better understanding of how to balance agricultural production and biodiversity conservation in the context of agroecosystems.*Una versión en español de este documento puede ser encontrada como material suplementario/ a Spanish version of this paper can be found as supplementary material.
Spinal Cord Stimulation using time-dynamic pulses achieves faster and longer reversal of allodynia compared to tonic pulses in a rat model of neuropathic pain
Authors: Edhi Muhammad , Zhu Changfang , Jeong Ki-Soo , Rogness Victoria , Esteller Rosana , Saab Carl 
Published: March 2023

AbstractSpinal cord stimulation (SCS) utilizing time-dynamic pulses (TDPs) is an emergent field of neuromodulation that continuously and automatically modulates pulse parameters. We previously demonstrated that TDPs delivered for 60 min at sub-paresthesia amplitudes significantly reversed allodynia in a rat model of neuropathic pain. Because we observed these anti-allodynic effects persisted post-cessation, we investigated the extended temporal dynamics of SCS-induced analgesia. We hypothesized that TDPs achieve a longer duration of analgesia than tonic stimulation. Both TDPs and tonic stimulation reversed PWT to near pre-chronificiation levels within 30 minutes. Most TDPs exhibited significantly slower ramp-up slope (analgesia ‘wash-in’ rates) compared to tonic stimulation (amplitude modulation: 0.16±0.03 min-1, pulse width modulation: 0.18±0.05 min-1, stochastic modulation: 0.17±0.04 min-1, tonic: 0.31±0.06 min-1). All TDPs showed slower wind-down slopes (analgesia ‘wash-out’ rates) compared to tonic (-0.29±0.07 min-1), with pulse width modulation (-0.11±0.02 min-1) reaching significance. Extending SCS from 60 to 90 minutes revealed all TDPs maintain analgesic efficacy longer than tonic stimulation, which decreased significantly at both 75 and 90 minutes (from 13.8±0.5 g to 12.3±0.9 g and to 11.0±0.5 g, respectively). Although TDPs and tonic stimulation comparably mitigated allodynia, TDPs generally exhibited slower temporal dynamics, suggesting longer-lasting analgesic effects and potentially different mechanisms of action.
InstaPrism: an R package for fast implementation of BayesPrism
Authors: Hu Mengying , Chikina Maria 
Published: March 2023

AbstractComputational cell-type deconvolution is an important analytic technique for modeling the compositional heterogeneity of bulk gene expression data. A conceptually new Bayesian approach to this problem, BayesPrism, has recently been proposed and has subsequently been shown to be superior in accuracy and robustness against model misspecifications by independent studies. However, given that BayesPrism relies on Gibbs sampling, it is orders of magnitude more computationally expensive than standard approaches. Here, we introduce the InstaPrism algorithm which re-implements BayesPrism in a derandomized framework by replacing the time-consuming Gibbs sampling steps in BayesPrism with a fixed-point algorithm. We demonstrate that the new algorithm is effectively equivalent to BayesPrism while providing a considerable speed advantage. InstaPrism is implemented as a standalone R package with C++ backend.
Drosophilaantennae are dispensable for gravity orientation
Authors: Kladt Nikolay , Reiser Michael B. 
Published: March 2023

AbstractThe nearly constant downward force of gravity has powerfully shaped the behaviors of many organisms [1]. Walking flies readily orient against gravity in a behavior termed negative gravitaxis. InDrosophilathis behavior is studied by observing the position of flies in vials [2–4] or simple mazes [5–9]. These assays have been used to conduct forward-genetic screens [5, 6, 8] and as simple tests of locomotion deficits [10–12]. Despite this long history of investigation, the sensory basis of gravitaxis is largely unknown [1]. Recent studies have implicated the antennae as a major mechanosensory input [3, 4], but many details remain unclear. Fly orientation behavior is expected to depend on the direction and amplitude of the gravitational pull, but little is known about the sensitivity of flies to these features of the environment. Here we directly measure the gravity-dependent orientation behavior of flies walking on an adjustable tilted platform, that is inspired by previous insect studies [13–16]. In this arena, flies can freely orient with respect to gravity. Our findings indicate that flies are exquisitely sensitive to the direction of gravity’s pull. Surprisingly, this orientation behavior does not require antennal mechanosensory input, suggesting that other sensory structures must be involved.
Neural and computational underpinnings of biased confidence in human reinforcement learning
Authors: Ting Chih-Chung , Salem-Garcia Nahuel , Palminteri Stefano , Engelmann Jan B. , Lebreton Maël 
Published: March 2023

AbstractWhile navigating a fundamentally uncertain world, humans and animals constantly produce subjective confidence judgments, thereby evaluating the probability of their decisions, actions or statements being correct. Confidence typically correlates with neural activity positively in a ventromedial-prefrontal (VMPFC) network and negatively in a dorsolateral and dorsomedial prefrontal network. Here, combining fMRI with a reinforcement-learning paradigm, we leverage the fact that humans are more confident in their choices when seeking gains than avoiding losses to reveal a functional dissociation: whereas the dorsal prefrontal network correlates negatively with a condition-specific confidence signal, the VMPFC network positively encodes task-wide confidence signal incorporating the valence-induced bias. Challenging dominant neuro-computational models, we found that decision-related VMPFC activity better correlates with confidence than with option-values inferred from reinforcement-learning models. Altogether, these results identify the VMPFC as a key node in the neuro-computational architecture that builds global feeling-of-confidence signals from latent decision variables and contextual biases during reinforcement-learning.
MicroCT-based imaging of microvasculature within bone and peri-implant tissues
Authors: Haberthür David , Khoma Oleksiy-Zakhar , Hoessly Tim , Zoni Eugenio , Julio Marianna Kruithof-de , Ryan Stewart D. , Grunewald Myriam , Bellón Benjamin , Sandgren Rebecca , Handschuh Stephan , Pippenger Benjamin E. , Bosshardt Dieter , Djonov Valentin , Hlushchuk Ruslan 
Published: March 2023

AbstractAngiogenesis is essential for skeletal development, bone healing, and regeneration. Improved non-destructive, three-dimensional (3D) imaging of the vasculature within bone tissue would benefit many research areas, especially implantology and tissue engineering.X-ray microtomography (microCT) is a well-suited non-destructive 3D imaging technique for bone morphology. For microCT-based detection of vessels, it is paramount to use contrast enhancement. Limited differences in radiopacity between perfusion agents and mineralized bone make their distinct segmentation problematic and have been a major drawback of this approach. A decalcification step resolves this issue but inhibits the simultaneous assessment of bone microstructure and vascular morphology. The problem of contrasting becomes further compounded in samples with metal implants.This study describes μAngiofil-enhanced microCT-based visualization of vasculature within bone tissue in small and large animal models, with and without decalcification. We present simultaneous microvascular and bone imaging in murine tibia, a murine bone metastatic model, the pulp chamber, gingiva, and periodontal ligaments. In a large animal model (minipig), we perform visualization and segmentation of different tissue types and vessels in the hemimandible containing metal implants. Moreover, we show the potential of the dual-energy approach in facilitating the distinction between bone tissue and the applied contrast agent.Our manuscript introduces the first non-destructive approach for 3D imaging of the vasculature within soft and hard tissues in the vicinity of metal implants in a large animal model.