bluuebunny/crossref_metadata_2025_split huggingface dataset:
Childhood-Onset Sacroiliitis
Authors: Avar-Aydin Pinar Ozge , Ozcakar Zeynep Birsin , Kaynak Sahap Seda , Aydin Fatma , Cakar Nilgun , Arslanoglu Ceyda , Yalcinkaya Fatos , Fitoz Suat 
Published: March 2023

Objective
The aims of this study were to describe disease associations of magnetic resonance imaging (MRI)–confirmed and clinically symptomatic sacroiliitis in pediatric patients with rheumatic diseases and to examine the relationship between patient characteristics and MRI findings of the sacroiliac joint (SIJ).

Methods
Demographic and clinical data were extracted from the electronic medical records of the patients with sacroiliitis followed in the last 5 years. Active inflammatory and structural damage lesions of the SIJ-MRI were examined by the modified Spondyloarthritis Research Consortium of Canada scoring system, and correlation analysis of these results with clinical characteristics was evaluated.

Results
A total of 46 symptomatic patients were found to have MRI-proven sacroiliitis of 3 different etiologies: juvenile idiopathic arthritis (JIA) (n = 17), familial Mediterranean fever (FMF) (n = 14), and chronic nonbacterial osteomyelitis (CNO) (n = 8). Seven patients, FMF and JIA (n = 6) and FMF and CNO (n = 1), had a co-diagnosis that might cause sacroiliitis. Although inflammation scores and structural damage lesions did not statistically differ between the groups, capsulitis and enthesitis on the MRI were more frequently detected in the CNO group. There was a negative correlation between symptom onset and inflammation scores of bone marrow edema. Disease composite scores and acute phase reactants were correlated with MRI inflammation scores.

Conclusions
We demonstrated that JIA, FMF, and CNO were the major rheumatic causes of sacroiliitis in children originating from the Mediterranean region. Quantitative MRI scoring tools can be used to assess the inflammation and damage of the SIJ in rheumatic diseases, show discrepancies between them, and have an important correlation with various clinical and laboratory features.
68Ga-FAPI04 Versus 68Ga-DOTATATE PET/CT in a Patient With Multiple Meningioma
Authors: Denizmen Dilara , Isik Emine Goknur , Buyukkaya Fikret , Kuyumcu Serkan 
Published: March 2023

Abstract
We present the 68Ga-DOTATATE and 68Ga-FAPI (fibroblast activation protein inhibitor) PET/CT findings of a 61-year-old man diagnosed with atypical World Health Organization grade II multiple meningiomas. The patient has been stable for 2 years following multiple surgeries and external radiotherapy because of recurring disease until he recently described frequent headaches, and a follow-up examination confirmed new meningioma lesions on MRI. However, the patient was inoperable and was referred for 68Ga-DOTATATE PET/CT to determine eligibility for salvage peptide receptor radionuclide therapy. He also underwent fibroblast activation protein–targeted imaging using 68Ga-FAPI04 PET/CT, which revealed heterogeneous, low to mild fibroblast activation protein expression across multiple meningioma lesions.
Modified Frailty Index Identifies Increased Risk of Postoperative Complications in Geriatric Patients After Open Reduction Internal Fixation for Distal Radius and Ulna Fractures
Authors: Dave Dattesh R. , Zeiderman Matthew , Li Andrew I. , Pereira Clifford 
Published: March 2023

Background
Open reduction internal fixation (ORIF) of distal radius and ulnar fractures (DRUFs) is one of the most common fracture surgeries for hand surgeons. Few studies have evaluated how frailty contributes to outcomes in geriatric hand surgery patients. This study hypothesizes that geriatric patients scoring higher on the modified Frailty Index 5 (mFI-5) are at greater risk of postoperative complications following DRUF fixation.

Methods
The American College of Surgeons National Surgical Quality Improvement Project database was reviewed for ORIF for DRUFs from 2005 to 2017. Statistically significant differences for demographics, comorbidities, mFI-5, and postoperative complications between geriatric and nongeriatric patients were evaluated with multivariate logistic regression analysis.

Results
A total of 17,097 ORIF for DRUFs were collected by the National Surgical Quality Improvement Project 2005–2017, with 5654 patients older than 64 years (33.2%). Average age for geriatric patients undergoing ORIF for DRUFs was 73.7 years. Within geriatric patients, an mFI-5 score >2 confers 1.6-times increased risk of returning to the operating room following ORIF for DRUF (adjusted odds ratio, 1.6; P = 0.02), whereas an increase in mFI-5 score >2 confers a 3.2-times increased risk of deep vein thrombosis among geriatrics (adjusted odds ratio, 3.2 P < 048).

Conclusion
Frailty among geriatric patients confers increased risk of deep vein thrombosis postoperatively. Geriatric patients with higher frailty scores carry a significantly increased risk of returning to the operating room within 30 days. Hand surgeons can use the mFI-5 to screen geriatric patients with DRUF patients to guide perioperative decision-making.
Mechanisms and Treatments of Peripheral Nerve Injury
Authors: Liu Xiaoyu , Duan Xuchu 
Published: March 2023

Abstract
Peripheral nerve injury is a common injury disease. Understanding of the mechanisms of periphery nerve repair and regeneration after injury is an essential prerequisite for treating related diseases. Although the biological mechanisms of peripheral nerve injury and regeneration have been studied comprehensively, the clinical treatment methods are still limited. The bottlenecks of the treatments are the shortage of donor nerves and the limited surgical precision. Apart from the knowledge regarding the fundamental characteristics and physical processes of peripheral nerve injury, numerous studies have found that Schwann cells, growth factors, and extracellular matrix are main factors affecting the repair and regeneration process of injured nerves. At present, the therapeutical methods of the disease include microsurgery, autologous nerve transplantation, allograft nerve transplantation and tissue engineering technology. Tissue engineering technology, which combines seed cells, neurotrophic factors, and scaffold materials together, is promising for treating the patients with long-gapped and large nerve damage. With the development of neuron science and technology, the treatment of peripheral nerve injury diseases will continue being improved.
Prognostic Factors and Outcomes of Cutaneous Malignant Melanoma
Authors: Matrakool Piyawat , Chaisrisawadisuk Sarut , Vongviriyangkoon Tara 
Published: March 2023

Background
Malignant melanoma is a common skin cancer among Asians. However, some features, such as tumor type and initial stages, are not comparable with those found in Western countries. We audited a large cohort of patients at a single tertiary referral hospital in Thailand to identify factors affecting the prognosis.

Methods
A retrospective study was conducted of patients diagnosed with cutaneous malignant melanoma between 2005 and 2019. Details of demographic data, clinical characteristics, pathological reports, treatments, and outcomes were collected. Statistical analyses of overall survival and factors affecting survival were investigated.

Results
The study enrolled 174 patients (79 men and 95 women) with pathologically confirmed cutaneous malignant melanoma. Their mean age was 63 years. The most common clinical presentation was a pigmented lesion (40.8%), with the plantar area being the most common site (25.9%). The mean duration of onset and hospitalization was 17.5 months. The 3 most common types of melanoma were acral lentiginous (50.7%), nodular (28.9%), and superficial spreading (9.9%). Eighty-eight cases (50.6%) had concomitant ulceration. Pathological stage III was the most common (42.1%). The 5-year overall survival was 43%, and the median survival time was 3.91 years. Multivariate analysis showed that clinically palpable lymph nodes, distant metastasis, a Breslow thickness ≥ 2 mm, and evidence of lymphovascular invasion were poor prognostic factors for overall survival.

Conclusions
In our study, most patients with cutaneous melanoma presented with a higher pathological stage. Independent factors affecting survival are palpable lymph nodes, distant metastases, Breslow thickness, and the presence of lymphovascular invasion. The overall 5-year survival rate was 43%.
The Medical Student Race to Research
Authors: Maisner Rose S. , Patel Ishani , Cadwell Joshua B. , Song Amy , Ong Melody , Goydos Christopher , Subramanian Shyamala , Kapadia Kailash , Lee Edward S. 
Published: March 2023

Background
Abstract presentations increase research output and facilitate networking for medical students applying to plastic surgery. We aim to determine predictors of increased medical student presentation at national plastic surgery conferences, identifying disparities in access to research opportunities.

Methods
Abstracts presented at the 2 most recent meetings of the American Society of Plastic Surgeons, American Association of Plastic Surgeons, and Plastic Surgery Research Council were extracted from online archives. Presenters without MDs or other professional credentials were classified as medical students. Presenter gender, medical school ranking, plastic surgery division/department, National Institutes of Health funding, number of total and first-author publications, H-index, and research fellowship completion status were recorded. Students with 3 or more (>75th percentile) presentations were compared with those with less by χ
2 tests. Univariate and multivariable regressions identified factors associated with 3 or more presentations.

Results
Of 1576 abstracts, 549 (34.8%) were presented by 314 students. The gender distribution was 46.5% male and 53.5% female. Most were from the Northeast (36.9%), 35% came from top 20 medical schools, and 85% attended schools with home plastic surgery programs. While 61.8% presented once, 14.6% presented 3 or more times. Those who previously presented, completed research fellowships or had more publications or higher H-indices were likely to present more (P ≤ 0.007). On multivariable-adjusted analysis, completing research fellowships (odds ratio [OR], 2.34–2.52; P = 0.028–0.045), affiliation with institutions having higher National Institutes of Health funding (OR, 3.47–3.73; P = 0.004–0.006), or having more total number of publications (OR, 3.81; P = 0.018) or first-author publications (OR, 3.84; P = 0.008) was associated with 3 or more presentations. Presenter gender, geographic region, medical school ranking, home program status, and H-indices were not significant predictors on multivariable analysis.

Conclusions
There are several potential inequities in access to research opportunities for medical students, disadvantaging those with less well-funded plastic surgery programs and existing research experience. Improving the equitability of these opportunities is crucial for limiting bias in trainee recruitment and diversifying representation in the field.
Rhinoplasty Technique for Improving Nasal Base Aesthetics
Authors: Cabbarzade Cavid 
Published: March 2023

Background
One of the most important factors in nasal base aesthetics is symmetry. In the age of social media, the expectations of rhinoplasty patients and the rate of requests for a more symmetrical nose have increased. In this article, a lateral columellar grafting technique that can be applied to augment the more defective side of the columella and obtain a more symmetrical nasal base is presented.

Methods
A total of 86 patients (women, 79; men, 7) were included in this study. The surfaces of the right and left lateral margins of the columella were evaluated from the basal view at the final stage of surgery, and a lateral columellar graft was placed on the more defective side. All patients who were included in the study were assessed with the Rhinoplasty Outcome Evaluation questionnaire before and 1 year after surgery.

Results
The median age of the patients was 28.3 years (range, 18–56 years). Eighty-two patients were primary rhinoplasty patients, and 4 patients were secondary rhinoplasty patients. The median Rhinoplasty Outcome Evaluation score was 68.3 points before surgery and 92.3 points 1 year after surgery, showing a significant increase (P = 0.003). Patient satisfaction was found to be excellent in 93% of the included patients.

Conclusions
Using the lateral columellar grafting technique, greater symmetry of the columella and nostrils can be obtained by augmenting the more defective side of the lateral columellar surface.
Large library docking for cannabinoid-1 receptor agonists with reduced side effects
Authors: Tummino Tia A. , Iliopoulos-Tsoutsouvas Christos , Braz Joao M. , O’Brien Evan S. , Stein Reed M. , Craik Veronica , Tran Ngan K. , Ganapathy Suthakar , Liu Fangyu , Shiimura Yuki , Tong Fei , Ho Thanh C. , Radchenko Dmytro S. , Moroz Yurii S. , Rosado Sian Rodriguez , Bhardwaj Karnika , Benitez Jorge , Liu Yongfeng , Kandasamy Herthana , Normand Claire , Semache Meriem , Sabbagh Laurent , Glenn Isabella , Irwin John J. , Kumar Kaavya Krishna , Makriyannis Alexandros , Basbaum Allan I. , Shoichet Brian K. 
Published: March 2023

SUMMARYLarge library docking can reveal unexpected chemotypes that complement the structures of biological targets. Seeking new agonists for the cannabinoid-1 receptor (CB1R), we docked 74 million tangible molecules, prioritizing 46 high ranking ones forde novosynthesis and testing. Nine were active by radioligand competition, a 20% hit-rate. Structure-based optimization of one of the most potent of these (Ki= 0.7 µM) led to‘4042, a 1.9 nM ligand and a full CB1R agonist. A cryo-EM structure of the purified enantiomer of‘4042(‘1350) in complex with CB1R-Gi1confirmed its docked pose. The new agonist was strongly analgesic, with generally a 5-10-fold therapeutic window over sedation and catalepsy and no observable conditioned place preference. These findings suggest that new cannabinoid chemotypes may disentangle characteristic cannabinoid side-effects from their analgesia, supporting the further development of cannabinoids as pain therapeutics.
Influence of Body Position on the Motor Development of Preterm Infants: A Randomized Clinical Trial
Authors: de Morais Cardoso Rodrigues Vitória Regina , Cordovil Rita , de Andrade Brunherotti Marisa Afonso , Andrade Brunherotti Marisa Afonso 
Published: March 2023

AbstractBackgroundTo analyze the influence of body position on the motor development of preterm infants in the first year of life corrected for prematurity.MethodsThis controlled, randomized, open trial included 30 preterm infants randomly assigned to one of the following three groups: prone group (n = 9), supine group (n = 10), and control group (n = 11). Intervention: Motor development was assessed at four time points using the Alberta Infant Motor Scale: first outpatient visit and at 4, 8 and 12 months corrected age.ResultsIn the third assessment at 8 months corrected age, the supine group exhibited better motor development than the other groups (p = 0.02). In the control group, the number of infants with normal development decreased from 11 (100%) in the first assessment to 5 (45.45%) in the last assessment. Most infants of mothers who received guidance on body positioning achieved normal motor development in the first year of life (63.1%). Greater dispersion from normal Alberta Infant Motor Scale scores was observed in infants at 8 and 12 months of age.ConclusionsGuidance on body positioning of preterm infants at home appears to have a positive influence in the first year of life. Child care strategies after hospitalization should be supported to permit full development of the child.What’s NewThis study reinforces home care programs with specialized orientation for motor development of preterm newborns. By the end of the first year of life most infants in the experimental groups (supine and prone positions) achieved a normal motor development, which did not happen in the control group.
AI chatbots not yet ready for clinical use
Authors: Yeung Joshua Au , Kraljevic Zeljko , Luintel Akish , Balston Alfred , Idowu Esther , Dobson Richard J , Teo James T 
Published: March 2023

AbstractAs large language models (LLMs) expand and become more advanced, so does the natural language processing capabilities of conversational AI, or ‘chatbots’. OpenAI’s recent release, ChatGPT, uses a transformer-based model to enable human-like text generation and question-answering on general domain knowledge, while a healthcare-specific Large Language Model (LLM) such as GatorTron has focused on the real-world healthcare domain knowledge. As LLMs advance to achieve near human-level performances on medical question and answering benchmarks, it is probable that Conversational AI will soon be developed for use in healthcare. In this article we discuss the potential and compare the performance of two different approaches to generative pretrained transformers – ChatGPT, the most widely used general conversational LLM, and Foresight, a GPT (generative pretrained transformer) based model focused on modelling patients and disorders. The comparison is conducted on the task of forecasting relevant diagnoses based on clinical vignettes. We also discuss important considerations and limitations of transformer-based chatbots for clinical use.
Hippocampal Glutamate, Resting Perfusion and the Effects of Cannabidiol in Psychosis Risk
Authors: Davies Cathy , Bossong Matthijs G. , Martins Daniel , Wilson Robin , Appiah-Kusi Elizabeth , Blest-Hopley Grace , Allen Paul , Zelaya Fernando , Lythgoe David J. , Brammer Michael , Perez Jesus , McGuire Philip , Bhattacharyya Sagnik 
Published: March 2023

ABSTRACTBackgroundPreclinical and human data suggest that the onset of psychosis involves hippocampal glutamatergic dysfunction, driving hyperactivity/hyperperfusion in a hippocampal-midbrain-striatal circuit. Whether glutamatergic dysfunction is related to cerebral perfusion in patients at Clinical High Risk (CHR) for psychosis, and whether cannabidiol (CBD) has ameliorative effects on glutamate or its relationship with blood flow remains unknown.MethodsUsing a double-blind, parallel-group design, 33 CHR patients were randomised to 600mg CBD or placebo; 19 healthy controls did not receive any drug. Proton magnetic resonance spectroscopy was used to measure glutamate concentrations in left hippocampus. We examined differences relating to CHR status (controls vs placebo), effects of CBD (placebo vs CBD) and linear between-group effects, such that placebo>CBD>controls or controls>CBD>placebo. We also examined group x glutamate x cerebral perfusion (measured using arterial spin labelling) interactions.ResultsCompared to controls, CHR-placebo patients had significantly lower hippocampal glutamate (p=.015) and a significant linear relationship was observed across groups, such that glutamate was highest in controls, lowest in CHR-placebo and intermediate in patients under CBD (p=.031). There was also a significant interaction between group (controls vs CHR-placebo), hippocampal glutamate and perfusion in the putamen and insula (pFWE=.012), driven by a strong positive correlation in the CHR-placebo group vs a negative correlation in controls.ConclusionsOur findings suggest that hippocampal glutamate is lower in CHR patients and may be partially normalised by CBD treatment. Furthermore, we provide the firstin vivoevidence of an abnormal relationship between hippocampal glutamate and resting perfusion in the striatum and insula in these patients.
Daily biofeedback to modulate heart rate oscillations affects structural volume in hippocampal subregions targeted by the locus coeruleus in older adults but not younger adults
Authors: Yoo Hyun Joo , Nashiro Kaoru , Dutt Shubir , Min Jungwon , Cho Christine , Thayer Julian F. , Lehrer Paul , Chang Catie , Mather Mara 
Published: March 2023

AbstractUsing data from a clinical trial, we tested the hypothesis that daily sessions modulating heart rate oscillations affect older adults’ volume of a region-of-interest (ROI) comprised of adjacent hippocampal subregions with relatively strong locus coeruleus (LC) noradrenergic input. Younger and older adults were randomly assigned to one of two daily biofeedback practices for 5 weeks: 1) engage in slow-paced breathing to increase the amplitude of oscillations in heart rate at their breathing frequency (Osc+); 2) engage in self-selected strategies to decrease heart rate oscillations (Osc-). The interventions did not significantly affect younger adults’ hippocampal volume. Among older adults, the two conditions affected volume in the LC-targeted hippocampal ROI differentially as reflected in a significant condition x time-point interaction on ROI volume. These condition differences were driven by opposing changes in the two conditions (increased volume in Osc+ and decreased volume in Osc-) and were mediated by the degree of heart rate oscillation during training sessions.
Low-attenuation Coronary Plaque Volume and Cardiovascular Events in Patients with Distinct Metabolic Phenotypes
Authors: Otsuka Kenichiro , Ishikawa Hirotoshi , Shimada Kenei , Hojo Kana , Yamaura Hiroki , Kono Yasushi , Kasayuki Noriaki , Fukuda Daiju 
Published: March 2023

AbstractBackgroundThis study aimed to investigate the association between diabetes mellitus (DM), high-risk coronary plaque burden, and risk of cardiovascular outcomes across metabolic phenotypes in patients with suspected coronary artery disease (CAD) who underwent coronary computed tomography angiography (CCTA).MethodsWe included 530 patients who underwent CCTA. Metabolic syndrome (MetS) was defined as the presence of a visceral adipose tissue area ≥ 100 cm2in patients with DM (n = 58), or two or more MetS components excluding DM (n = 114). Remaining patients were categorized into non-MetS patients with DM (n = 52) and non-MetS patients without DM (n = 306). CCTA-based high-risk plaque was defined as low-attenuation plaque (LAP) volume > 4 %. Primary endpoint was presence of a major cardiovascular event (MACE), which was defined as a composite of cardiovascular death, acute coronary syndrome, and coronary revascularization.ResultsIncidence of MACE was highest in the non-MetS with DM group, followed hierarchically by the MetS with DM, MetS without DM, and non-MetS without DM groups. In the multivariable Cox hazard model analysis, DM as a predictor was associated with MACE independent of LAP volume > 4 % (hazard ratio, 2.68; 95% confidence interval, 1.16–6.18; p = 0.02), although MetS did not remain an independent predictor. LAP volume > 4 % remained a predictor of MACE independent of each metabolic phenotype or DM.ConclusionsThis study demonstrated that DM, rather than MetS, is a predictor of coronary events independent of high-risk plaque volume in patients who underwent CCTA.Clinical PerspectiveWhat Is New?This study investigated the association between diabetes mellitus (DM), high-risk coronary plaque burden, and major adverse cardiovascular events (MACE) across metabolic phenotypes stratified by the presence or absence of metabolic syndrome (MetS) and DM in patients with suspected coronary artery disease (CAD) who underwent coronary computed tomography angiography (CCTA).Among the four metabolic phenotypes, incidence of MACE was highest in the non-MetS with DM group, followed hierarchically by the MetS with DM, MetS without DM, and non-MetS without DM groups. Low-attenuation coronary plaque (LAP) volume > 4% was a robust predictor of MACE among the metabolic phenotypes. Furthermore, DM, independent of LAP volume > 4%, was a predictor of MACE, while MetS did not show a significant predictive value.What Are the Clinical Implications?Our results demonstrate that individuals with DM alone have a significantly higher risk of developing cardiovascular events than those with MetS, indicating that DM is an independent predictor of cardiovascular events irrespective of the presence of obstructive CAD or LAP volume greater than 4%.