bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiological updates of post-traumatic related limb osteomyelitis in china: a 10 years multicenter cohort study
Authors: Ren YouLiang , Liu Lei , Sun Dong , Zhang ZhengDong , Li Meng , Lan Xu , Ni JiangDong , Yan MingMing , Huang Wei , Liu ZiMing , Peng Aqin , Zhang YanLong , Jiang Nan , Song KeGuan , Huang ZhiPeng , Bi Qing , Zhang Jun , Yang Qun , Yang Jun , Liu Yi , Fu Wei , Tian XiaoBin , Wang YuanZheng , Zhong WanRun , Song XingHua , Abudurexiti Abuduxukuer , Xia ZhiLin , Jiang Qing , Shi HongFei , Liu XiMing , Wang GuoDong , Hu YunSheng , Zhang YunFei , Yin GuoYong , Fan Jin , Feng ShiQing , Zhou XianHu , Li ZhengDao , He WenBin , Weeks Jason , Schwarz Edward M. , Kates Stephen L. , Huang Lei , Chai YiMin , Yu Bin , Xie Zhao , Deng ZhongLiang , Xie Chao 
Published: May 2023

Background:
Post-traumatic related limb osteomyelitis (PTRLO) is a complex bone infection. Currently, there are no available microbial data on a national scale that can guide appropriate antibiotic selection, and explore the dynamic changes in dominant pathogens over time. This study aimed to conduct a comprehensive epidemiological analysis of PTRLO in China.

Methods:
The study was approved by the Institutional Research Board (IRB), and 3,526 PTRLO patients were identified from 212,394 traumatic limb fracture patients at 21 hospitals between January 1st, 2008- December 31st, 2017. A retrospective analysis was conducted to investigate the epidemiology of PTRLO, including changes in infection rate (IR), pathogens, infection risk factors, and antibiotic resistance and sensitivity.

Results:
The IR of PTRLO increased gradually from 0.93%–2.16% (Z=14.392, P<0.001). Monomicrobial infection (MI, 82.6%) was significantly higher than polymicrobial infection (PI, 17.4%) (P<0.001). The IR of Gram-Positive (GP) & Gram-Negative (GN) pathogens showed a significant increase from the lowest 0.41% to the highest 1.15% (GP) or 1.62% (GN), respectively. However, the longitudinal trend of GP versus GN’s composition did not show any significance (Z=+/-1.1918, P>0.05). The most prevalent Gram-positive strains were MSSA (17.03%), MRSA (10.46%), E. faecalis (5.19%), and S. epidermidis (4.87%). In contrast, the dominant strains Gram-negative strains were Pseudomonas Aeruginosa (10.92%), E. cloacae (10.34%), E.coli (9.47%), Acinetobacter Baumannii (7.92%) and Klebsiella Pneumoniae (3.33%). In general, the high-risk factors for PI include opened-fracture (odds ratio, 2.223), hypoproteinemia (odds ratio, 2.328), and multiple fractures (odds ratio, 1.465). It is important to note that the antibiotics resistance and sensitivity analysis of the pathogens may be influenced by complications or comorbidities.

Conclusions:
This study provides the latest data of PTRLO in China and offers trustworthy guidelines for clinical practice. (China Clinical Trials.gov number, ChiCTR1800017597).
Effect of anatomical liver resection for hepatocellular carcinoma: a systematic review and meta-analysis
Authors: Shin Seong Wook , Kim Tae-Seok , Ahn Keun Soo , Kim Yong Hoon , Kang Koo Jeong 
Published: May 2023

Background:
Despite retrospective studies comparing anatomical liver resection (AR) and nonanatomical liver resection (NAR), the efficacy and benefits of AR for hepatocellular carcinoma (HCC) remain unclear.

Materials and Methods:
We systemically reviewed MEDLINE, Embase, and Cochrane Library for propensity score matched (PSM) cohort studies that compared AR and NAR for HCC. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS). Secondary outcomes were recurrence patterns and perioperative outcomes.

Results:
Overall, 22 PSM studies (AR, n=2,496; NAR, n=2,590) were included. AR including systemic segmentectomy was superior to NAR regarding the 3- and 5-year OS. AR showed significantly better 1-, 3-, and 5-year RFS than NAR, with low local and multiple intrahepatic recurrence rates. In the subgroup analyses of tumor diameter ≤5 cm and tumors with microscopic spread, the RFS in the AR group was significantly better than that in the NAR group. Patients with cirrhotic liver in the AR group showed comparable 3- and 5-year RFS with the NAR group. Postoperativeoverall complications were comparable between AR and NAR.

Conclusions:
This meta-analysis demonstrated that AR showed better OS and RFS with a low local and multiple intra-hepatic recurrence rate than NAR, especially in patients with tumor diameter ≤5 cm and non-cirrhotic liver.
Safety and Outcomes of Outpatient Pleural Drainage in Symptomatic Postoperative Cardiac Surgery Patients
Authors: Gilbert Christopher R. , Meggyesy Austin M. , Bograd Adam J. , Chiu Shih Ting , Wilshire Candice L. , Gorden Jed A. 
Published: May 2023

Background:
Symptomatic pleural effusions and anticoagulant/antiplatelet medication use in postoperative cardiac surgery are common. Guidelines and recommendations are currently mixed regarding medication management related to invasive procedure performance. We aimed to describe the outcomes of postoperative cardiac surgery patients referred for outpatient, symptomatic pleural effusion management.

Methods:
A retrospective study of post-cardiac surgery patients undergoing outpatient thoracentesis from 2016 to 2021 was performed. Demographics, operative details, pleural disease characteristics, outcomes, and complications were collected. Odds ratios with confidence intervals were estimated and adjusted by multivariate logistic regression to investigate the association with multiple thoracenteses.

Results:
A total of 110 patients underwent 332 thoracenteses. The median age was 68 years and most common operation was coronary artery bypass. Anticoagulation or antiplatelet use was identified in 97%. Thirteen complications were identified, with all major complications (n=3) related to bleeding. The amount of fluid present at the time of initial thoracentesis (>1500 milliliters) was associated with increased odds ratio of subsequent multiple thoracentesis (Unadjusted odds ratio, 6.75 (CI – 1.43 to 31.9). No other variables had a significant association with the need for multiple procedures.

Conclusion:
Within a postoperative cardiac surgery population presenting with symptomatic pleural disease, we observed that thoracentesis performed on antiplatelet and/or anticoagulant medication is relatively safe. We also identified that many patients can be managed as outpatients and that most pleural effusions remain self-limited. The presence of larger amounts of pleural fluid at initial thoracentesis may be associated with increased odds for additional drainage.
Efficacy of Urinary Kallidinogenase Plus Intravenous Recombinant Tissue Plasminogen Activator for Stroke Patients With Extended Window
Authors: Li Xueyuan , Zhang Xin , Yang Ying , Wang Hongzhi , Zhang Jingbo 
Published: May 2023

Background:
To assess the outcome of human urinary kallidinogenase (HUK) plus recombinant tissue plasminogen activator (rT-PA) intravenous thrombolysis for stroke patients with an extended time window(4.5 to 9 h).

Methods:
A total of 92 acute ischemic stroke patients who fulfilled the criteria were included in this study. All patients received basic treatment and intravenous rT-PA, and 49 patients received additional injections of HUK (HUK group) once a day for 14 consecutive days. Outcomes were indicated by the thrombolysis in cerebral infarction score as the primary endpoint and the National Institute of Health Stroke Scale, modified Rankin Scale, and Barthel Index as the secondary endpoints. The safety outcomes were the rate of symptomatic intracranial hemorrhage, bleeding, angioedema, and mortality.

Results:
The National Institute of Health Stroke Scale scores were significantly lower in the HUK group at hospital discharge (4.55 ± 3.78 vs 7.88 ± 7.31, P = 0.009) and day 90 (4.04 ± 3.51 vs 8.12 ± 9.53, P = 0.011). The improvements in the Barthel Index scores were more obvious in the HUK group. Patients in the HUK group achieved favorable functional independence (67.35% vs 46.51%; odds ratio: 2.37; 95% CI: 1.01-5.53) at 90 days. The recanalization rate of the HUK group was 64.10%, whereas that was 41.48% in the control group (P = 0.050). The complete reperfusion rates were 42.9% and 23.3% in the HUK group and the control group, respectively. No significant differences were observed for adverse events between the two groups.

Conclusions:
Combination therapy of HUK plus rT-PA in patients with acute ischemic stroke with an extended time window can safely improve their functional outcomes.
Early veno-venous extracorporeal membrane oxygenation is an effective strategy for traumatically injured patients presenting with refractory respiratory failure
Authors: Powell Elizabeth K. , Reynolds Tyler S. , Webb James K. , Kundi Rishi , Cantu Jody , Keville Meaghan , O’Connor James V. , Stein Deborah M. , Hanson Matthew P. , Taylor Bradley S. , Scalea Thomas M. , Galvagno Samuel M. 
Published: May 2023

BACKGROUND
Venovenous extracorporeal membrane oxygenation (VV ECMO) is used for respiratory failure when standard therapy fails. Optimal trauma care requires patients be stable enough to undergo procedures. Early VV ECMO (EVV) to stabilize trauma patients with respiratory failure as part of resuscitation could facilitate additional care. As VV ECMO technology is portable and prehospital cannulation possible, it could also be used in austere environments. We hypothesize that EVV facilitates injury care without worsening survival.

METHODS
Our single center, retrospective cohort study included all trauma patients between January 1, 2014, and August 1, 2022, who were placed on VV ECMO. Early VV was defined as cannulation ≤48 hours from arrival with subsequent operation for injuries. Data were analyzed with descriptive statistics. Parametric or nonparametric statistics were used based on the nature of the data. After testing for normality, significance was defined as a p < 0.05. Logistic regression diagnostics were performed.

RESULTS
Seventy-five patients were identified and 57 (76%) underwent EVV. There was no difference in survival between the EVV and non-EVV groups (70% vs. 61%, p = 0.47). Age, race, and gender did not differ between EVV survivors and nonsurvivors. Time to cannulation (4.5 hours vs. 8 hours, p = 0.39) and injury severity scores (34 vs. 29, p = 0.74) were similar. Early VV survivors had lower lactic acid levels precannulation (3.9 mmol/L vs. 11.9 mmol/L, p < 0.001). A multivariable logistic regression analysis examining admission and precannulation laboratory and hemodynamic values demonstrated that lower precannulation lactic acid levels predicted survival (odds ratio, 1.2; 95% confidence interval, 1.02–1.5; p = 0.03), with a significant inflection point of 7.4 mmol/L corresponding to decreased survival at hospital discharge.

CONCLUSION
Patients undergoing EVV did not have increased mortality compared with the overall trauma VV ECMO population. Early VV resulted in ventilatory stabilization that allowed subsequent procedural treatment of injuries.

LEVEL OF EVIDENCE
Therapeutic Care/Management; Level III.
The last days: The medical response of United States and allied military teams during the Afghanistan Exodus
Authors: Bozzay Joseph D. , Murphy Timothy P. , Baird Michael D. , Dingle Marvin E. , Rokayak Omar A. , Renninger Chris , Boomsma Shawn E. , Milam Brian P. , Horrell Timothy J. , Rittenhouse Bradley A. , McGlone Patrick J. , Kashtan Harris W. , Buzzelli Mark , How Remealle A. , Lynch Bruce A. , Heyda Lauren , Humphries Ashley E. , Jessie Elliot M. , Patel Jigarkumar A. , Hardin Ronald , Nelson Kenneth J. , D’Alleyrand Jean-Claude G. , Bradley Matthew J. , Potter Benjamin K. , Gurney Jennifer M. 
Published: May 2023

OBJECTIVES
The objective of this study is to describe the United States and allied military medical response during the withdrawal from Afghanistan.

BACKGROUND
The military withdrawal from Afghanistan concluded with severe hostilities resulting in numerous civilian and military casualties. The clinical care provided by coalition forces capitalized on decades of lessons learned and enabled unprecedented accomplishments.

METHODS
In this retrospective, observational analysis, casualty numbers, and operative information was collected and reported from military medical assets in Kabul, Afghanistan. The continuum of medical care and the trauma system, from the point of injury back to the United States was captured and described.

RESULTS
Prior to a large suicide bombing resulting in a mass casualty event, the international medical teams managed distinct 45 trauma incidents involving nearly 200 combat and non-combat civilian and military patients over the preceding 3 months. Military medical personnel treated 63 casualties from the Kabul airport suicide attack and performed 15 trauma operations. US air transport teams evacuated 37 patients within 15 hours of the attack.

CONCLUSION
Lessons learned from the last 20 years of combat casualty care were successfully implemented during the culmination of the Afghanistan conflict. Ultimately, the effort, teamwork, and system adaptability exemplify not only the attitudes and character of service members who provide modern combat casualty care but also the paramount importance of the battlefield learning health care system. A continued posture to maintain military surgical preparedness in unique environments remain crucial as the US military prepares for the future.
Retrospective observational analysis

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level V.
Peripapillary Vitreous Traction Syndrome: Expanding the Spectrum of Anterior Optic Neuropathies
Authors: Chan Jane W. , Liu Henry , Ma Elise L. , Sadun Alfredo A. , Sadda Srinivas R. 
Published: May 2023

Background:
Peripapillary vitreous traction (PVT) occurring without any underlying eye disease has been contemplated as a distinct entity from nonarteritic ischemic optic neuropathy (NAION) for many years and is sometimes difficult to differentiate from classical NAION. We report 6 new cases to analyze the clinical features of PVT syndrome that would expand the clinical spectrum of anterior optic neuropathies.

Methods:
Prospective case series.

Results:
PVT syndrome seems to affect optic discs with a small area with a small cup-to-disc (C/D) ratio. The C/D ratio does not significantly increase in the chronic stage, as in NAION. Vitreous traction without detachment can either lead to mild retinal nerve fiber layer (RNFL) injury with attendant ganglion cell layer/inner plexiform layer (GCL/IPL) thinning in 29% or no injury at all in 71%. Eighty-six percent had good visual acuity (VA) and had no relative afferent pupillary defect (RAPD), whereas 14% had a transient RAPD; 71% had no color defect. Vitreous detachment after a period of severe and persistent traction can lead to more damage to the optic nerve head and RNFL that may look like NAION. Our hypothesized mechanically induced injury to the superficial optic nerve head may not lead to much visual impairment. In our study, no further therapeutic interventions were required.

Conclusions:
Based on our analysis of previously published cases and our own prospective case series of 6 patients, the PVT syndrome falls within the spectrum of anterior optic neuropathies, often affecting small optic discs with a small C/D ratio. Vitreous traction can lead to a partial or complete anterior optic neuropathy. The PVT syndrome may be a “more” anterior optic neuropathy distinct from classical NAION.
Neuro-ophthalmic Complications in Pediatric Leukemia
Authors: Rothfield Lindsay , Falcone Michelle M. , Gaier Eric D. , Heidary Gena , Gise Ryan 
Published: May 2023

Background:
Optic neuropathy in childhood leukemia occurs through multiple direct and indirect mechanisms, including leukemic infiltration of the optic nerve, infection, blood dyscrasias, or adverse effects of treatment. We aimed to characterize visual outcomes in pediatric patients with leukemia-associated neuro-ophthalmic manifestations.

Methods:
We retrospectively identified patients with leukemia and optic nerve pathology over 13 years by diagnostic billing codes. We collected information on demographics, presentation, treatment course, and visual outcomes directly from medical records.

Results:
Of the 19 patients who met inclusion criteria, 17 (89.5%) had pseudotumor cerebri and 2 had direct optic nerve infiltration. Causes of increased intracranial pressure included central nervous system infiltration (6 of 17), hyperviscosity/leukemia (2 of 17), venous sinus thrombosis (3 of 17), medication induced (5 of 17), and bacterial meningitis (1 of 17). 47.1% (8 of 17) had papilledema at the time of leukemia diagnosis, and 94.1% (16 of 17) of patients with pseudotumor cerebri were treated with acetazolamide. At presentation, 3 patients had decreased vision secondary to macular ischemia, subhyaloid vitreous hemorrhage, or steroid induced glaucoma. Following treatment of pseudotumor cerebri, binocular visual acuity was ≥20/25 in all patients. One patient with optic nerve infiltration had a final visual acuity of count fingers in the affected eye.

Conclusions:
In our chart review, the most common mechanism of neuro-ophthalmic involvement in pediatric leukemia was elevated intracranial pressure from a myriad of causes. Visual outcomes from patients with elevated intracranial pressure were excellent. Understanding the mechanisms by which leukemia can cause optic nerve disease in pediatric patients can facilitate earlier diagnosis and treatment and potentially improve visual outcomes.
Monitoring the fabric of nature: using allometric trophic network models and observations to assess policy effects on biodiversity
Authors: Navarrete Sergio A. , Ávila-Thieme M. Isidora , Valencia Daniel , Génin Alexandre , Gelcich Stefan 
Published: May 2023

Species diversity underpins all ecosystem services that support life. Despite this recognition and the great advances in detecting biodiversity, exactly how many and which species co-occur and interact, directly or indirectly in any ecosystem is unknown. Biodiversity accounts are incomplete; taxonomically, size, habitat, mobility or rarity biased. In the ocean, the provisioning of fish, invertebrates and algae is a fundamental ecosystem service. This extracted biomass depends on a myriad of microscopic and macroscopic organisms that make up the fabric of nature and which are affected by management actions. Monitoring them all and attributing changes to management policies is daunting. Here we propose that dynamic quantitative models of species interactions can be used to link management policy and compliance with complex ecological networks. This allows managers to qualitatively identify ‘interaction-indicator’ species, which are highly impacted by management policies through propagation of complex ecological interactions. We ground the approach in intertidal kelp harvesting in Chile and fishers' compliance with policies. Results allow us to identify sets of species that respond to management policy and/or compliance, but which are often not included in standardized monitoring. The proposed approach aids in the design of biodiversity programmes that attempt to connect management with biodiversity change.
This article is part of the theme issue ‘Detecting and attributing the causes of biodiversity change: needs, gaps and solutions’.
Drivers of the changing abundance of European birds at two spatial scales
Authors: Gregory Richard D. , Eaton Mark A. , Burfield Ian J. , Grice Philip V. , Howard Christine , Klvaňová Alena , Noble David , Šilarová Eva , Staneva Anna , Stephens Philip A. , Willis Stephen G. , Woodward Ian D. , Burns Fiona 
Published: May 2023

Detecting biodiversity change and identifying its causes is challenging because biodiversity is multifaceted and temporal data often contain bias. Here, we model temporal change in species' abundance and biomass by using extensive data describing the population sizes and trends of native breeding birds in the United Kingdom (UK) and the European Union (EU). In addition, we explore how species’ population trends vary with species' traits. We demonstrate significant change in the bird assemblages of the UK and EU, with substantial reductions in overall bird abundance and losses concentrated in a relatively small number of abundant and smaller sized species. By contrast, rarer and larger birds had generally fared better. Simultaneously, overall avian biomass had increased very slightly in the UK and was stable in the EU, indicating a change in community structure. Abundance trends across species were positively correlated with species’ body mass and with trends in climate suitability, and varied with species' abundance, migration strategy and niche associations linked to diet. Our work highlights how changes in biodiversity cannot be captured easily by a single number; care is required when measuring and interpreting biodiversity change given that different metrics can provide very different insights.This article is part of the theme issue ‘Detecting and attributing the causes of biodiversity change: needs, gaps and solutions’.
Effectiveness of BNT162b2 mRNA vaccine third doses and previous infection in protecting against SARS-CoV-2 infections during the Delta and Omicron variant waves; the UK SIREN cohort study September 2021 to February 2022
Authors: Hall Victoria J , Insalata Ferdinando , Foulkes Sarah , Kirwan Peter , Sparkes Dominic , Atti Ana , Cole Michelle , Lacy Elen de , Price Lesley , Corrigan Diane , Brown Colin S , Islam Jasmin ,   The SIREN Study Group Andre Charlett, Charlett Andre , Hopkins Susan 
Published: May 2023

ABSTRACTThird doses of COVID-19 vaccines were widely deployed following primary vaccine course waning and emergence of the Omicron-variant. We investigated protection from third-dose vaccines and previous infection against SARS-CoV-2 infection during Delta-variant and Omicron-variant (BA.1 & BA.2) waves in our frequently PCR-tested cohort of healthcare-workers.
A consolidated and geolocated facility list in Senegal from triangulating secondary data
Authors: Gueye Daouda M , Ly Alioune Badara , Gueye Babacar , Ndour Papa Ibrahima , Fullman Nancy , Liu Patrick Y , Mbaye Khadim , Diallo Aliou , Diatta Ibrahima , Diatta Saly Amos , Mane Mouhamadou Moustapha , Ikilezi Gloria , Sarr Moussa 
Published: May 2023

AbstractHaving a geolocated list of all facilities in a country – a “master facility list” (MFL) – can provide critical inputs for health program planning and implementation. To the best of our knowledge, Senegal has never had a centralized MFL, though many data sources currently exist within the broader Senegalese data landscape that could be leveraged and consolidated into a single database – a critical first step toward building a full MFL. We collated 12,965 facility observations from 16 separate datasets and lists in Senegal, and applied matching algorithms, manual checking and revisions as needed, and verification processes to identify unique facilities and triangulate corresponding GPS coordinates. Our resulting consolidated facility list has a total of 4,685 facilities, with 2,423 having at least one set of GPS coordinates. Developing approaches to leverage existing data toward future MFL establishment can help bridge data demands and inform more targeted approaches for completing a full facility census based on areas and facility types with the lowest coverage. Going forward, it is crucial to ensure routine updates of current facility lists, and to strengthen government-led mechanisms around such data collection demands and the need for timely data for health decision-making.