bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synthetic Interbody Devices and Traditional Bone Graft Are Associated With a Similar Rate of Surgical Complications After 1-2 Level Anterior Cervical Discectomy and Fusions
Authors: Shukla Geet , Matur Abhijith V. , Tao Xu , Khalid Syed , Garner Rebecca , Gibson Justin , Cass Daryn , Wu Andrew , Street Seth , Garcia-Vargas Julia , Mehta Jay , Childress Kelly , Duah Henry O. , Motley Benjamin , Cheng Joseph , Adogwa Owoicho 
Published: September 2023

Study Design:
Retrospective cohort.

Objective:
To compare the rates of all-cause surgical complications of synthetic interbody devices versus allograft or autograft in patients undergoing 1-2 levels anterior cervical discectomy and fusion (ACDF) procedures.

Summary of Background Data:
Cervical degenerative disorders affect up to 60% of older adults in the United States. Both traditional allograft or autograft and synthetic interbody devices (polyetheretherketone or titanium) are used for decompression and arthrodesis, with increasing utilization of the latter. However, the differences in their postsurgical complication profiles are not well-characterized.

Patients and Methods:
Patients who underwent 1-2 level ACDFs for cervical radiculopathy or myelopathy between 2010 and 2022 were identified using the PearlDiver Mariner all-claims insurance database. Patients undergoing surgery for nondegenerative pathologies, such as tumors, trauma, or infection, were excluded. 1:1 exact matching was performed based on factors that were significant predictors of all-cause surgical complications in a linear regression model. The primary outcome measure was the development of all-cause surgical complications after 1-2 level ACDFs. The secondary outcome was all-cause medical complications.

Results:
1:1 exact matching resulted in two equal groups of 11,430 patients who received treatment with synthetic interbody devices or allograft/autograft. No statistically significant difference in all-cause surgical complications was found between the synthetic cohort and the allograft or autograft cohort after 1-2 level ACDFs (Relative Risk: 0.86, 95% confidence interval: 0.730–1.014, P = 0.079). No significant differences were observed regarding any specific surgical complications except for pseudoarthrosis (Relative Risk: 0.73, 95% confidence interval: 0.554–0.974, P = 0.037), which was higher in the allograft/autograft cohort.

Conclusion:
After 1:1 exact matching to control for confounding variables, the findings of this study suggest that all-cause surgical complications are similar in patients undergoing ACDFs with synthetic interbody devices or allograft/autographs. However, the rate of pseudarthrosis appears to be higher in patients with allograft/autographs. Future prospective studies are needed to corroborate these findings.
DermaClose: A Case Series in the Management of Large Soft Tissue Defects in Diabetic Foot Infection
Authors: Brannigan Kathryn , Yao Susie Zhi Jie , Gee Edward 
Published: September 2023

Abstract:
Diabetic foot infection poses a complex problem due to several interrelated issues, including rapidly spreading infection, poor vascular supply, and reduced healing ability. Management may require multiple operative procedures and prolonged treatment with a high risk of morbidity, such as amputation, and mortality.
Debridement of infection commonly creates large wounds and soft tissue defects, with limited soft tissue reconstructive options due to adverse local and systemic factors. In this setting, treatment often consists of protracted periods of secondary wound healing by granulation, de-tensioning the tissues by removing bone, and minor or major amputation. Flaps and grafts may be considered but often carry unacceptable rates of failure. We present 3 cases in which DermaClose, an automated wound management system, was employed by a joint Orthopedic and Plastic Surgery team with excellent results and rapid closure of large soft tissue defects.

Level of Evidence:
Level IV.
Prevalence and Risk Factors for Weaning Failure From Venovenous Extracorporeal Membrane Oxygenation in Patients With Severe Acute Respiratory Insufficiency*
Authors: Gerhardinger Felix , Fisser Christoph , Malfertheiner Maximilian V. , Philipp Alois , Foltan Maik , Zeman Florian , Stadlbauer Andrea , Wiest Clemens , Lunz Dirk , Müller Thomas , Lubnow Matthias 
Published: September 2023

OBJECTIVE:
Analysis of the prevalence and risk factors for weaning failure from venovenous extracorporeal membrane oxygenation (VV-ECMO) in patients with severe acute respiratory insufficiency.

DESIGN:
Single-center retrospective observational study.

SETTING:
Sixteen beds medical ICU at the University Hospital Regensburg.

PATIENTS:
Two hundred twenty-seven patients with severe acute respiratory insufficiency requiring VV-ECMO support between October 2011 and December 2017.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Patients meeting our ECMO weaning criteria (Spo
2 ≥ 90% with Fio
2 ≤ 0.4 or Pao
2/Fio
2 > 150 mm Hg, pH = 7.35–7.45, positive end-expiratory pressure ≤ 10 cm H2O, driving pressure < 15 cm H2O, respiratory rate < 30/min, tidal volume > 5 mL/kg, ECMO bloodflow ≈ 1. 5 L/min, sweep gas flow ≈ 1 L/min, heart rate < 120/min, systolic blood pressure 90–160 mm Hg, norepinephrine < 0.2 µg/[kg*min]) underwent an ECMO weaning trial (EWT) with pausing sweep gas flow. Arterial blood gas analysis, respiratory and ventilator parameters were recorded prior, during, and after EWTs. Baseline data, including demographics, vitals, respiratory, ventilator, and laboratory parameters were recorded at the time of cannulation. One hundred seventy-nine of 227 (79%) patients were successfully decannulated. Ten patients (4%) underwent prolonged weaning of at least three failed EWTs before successful decannulation. The respiratory rate (19/min vs 16/min, p = 0.002) and Paco
2 (44 mm Hg vs 40 mm Hg, p = 0.003) were higher before failed than successful EWTs. Both parameters were risk factors for ECMO weaning failure (Paco
2: odds ratio [OR] 1.05; 95% CI, 1.001–1.10; p = 0.045; respiratory rate: OR 1.10; 95% CI, 1.04–1.15; p < 0.001) in multivariable analysis. The rapid shallow breathing index [42 (1/L*min), vs 35 (1/L*min), p = 0.052) was higher before failed than successful EWTs. The decline of Sao
2 and Pao
2/Fio
2 during EWTs was higher in failed than successful trials.

CONCLUSIONS:
Seventy-nine percent of patients were successfully decannulated with only 4% needing prolonged ECMO weaning. Before EWT only parameters of impaired ventilation (insufficient decarboxylation, higher respiratory rate) but not of oxygenation were predictive for weaning failure, whereas during EWT-impaired oxygenation was associated with weaning failure.
Factors associated with the efficacy of mature oocyte production after dual-trigger controlled ovarian stimulation using a GnRH antagonist protocol
Authors: New Geok Huey , Wu Wen-Bin , Chen Hsuan-Ting , Lin Jun-Jie , Lai Tsung-Hsuan 
Published: September 2023

Background:
The number of mature oocytes retrieved plays a significant role in determining embryo development and pregnancy outcomes of in vitro fertilization (IVF). However, studies investigating factors predictive of the efficacy of mature oocyte production (EMOP) after dual-trigger controlled ovarian stimulation (COS) are rare. This study aims to identify key predictors of EMOP during dual-trigger COS with a gonadotropin-releasing hormone (GnRH) antagonist protocol for IVF.

Methods:
This retrospective cohort study included 359 first-time IVF patients undergoing dual-trigger COS with a GnRH antagonist protocol. EMOP was defined as the ratio of metaphase II (MII) oocyte count to antral follicle count (AFC). Based on EMOP results, patients were divided into two groups: group A (EMOP <70%; n = 232) and group B (EMOP ≥70%; n = 127).

Results:
Multivariate logistic regression analysis revealed that day-2 follicle-stimulating hormone (FSH), stimulation duration, and total oocyte count were the most significant predictors of EMOP (p < 0.05; odds ratios: 1.637, 3.400, and 1.530, respectively). Receiver operating characteristic analysis demonstrated that total oocyte count <9.5 (area under the curve [AUC], 0.782; sensitivity, 76.2%; specificity, 69.2%; p < 0.001) and stimulation duration <9.5 days (AUC, 0.725; sensitivity, 63.5%; specificity, 66.7%; p < 0.001) significantly predicted EMOP <70%. Stimulation duration combined with total oocyte count exhibited the highest power in predicting EMOP <70% (AUC, 0.767; sensitivity, 92.3%; specificity, 42.4%).

Conclusion:
Stimulation duration combined with total oocyte count was identified as the most important factor associated with the EMOP during dual-trigger COS in IVF using a GnRH antagonist protocol.
Control Attitudes Scale-Revised–Brazilian Version
Authors: de Araujo Kaji Priscila , de Lucena Ferretti-Rebustini Renata Eloah , Bosco Aprile Daniele Cristina , de Lima Lopes Juliana , Batista Santos Vinicius , Takao Lopes Camila 
Published: September 2023

Background
Heart failure demands self-care skills and behaviors that can be negatively impacted by a low level of perceived control (PC), a belief about having the necessary resources to deal with negative events. Having valid and reliable instruments to measure PC is important to support interventions that improve self-care and related outcomes. The Control Attitudes Scale-Revised (CAS-R) was developed in the United States to measure PC in cardiac conditions. In Brazil, there are no instruments available to measure this construct.

Objective
The aims of this study were to translate and adapt the CAS-R to the Brazilian population and to assess the content validity of the adapted version.

Methods
The CAS-R was translated, back-translated, and assessed by an expert committee for linguistic equivalences. An agreement > 80% was considered adequate. Content validity (clarity, theoretical relevance, and practical pertinence) was assessed by both an expert professional panel (n = 6–8) and a panel of patients with heart failure (n = 40). A content validity coefficient > 0.70 was considered acceptable.

Results
The translations to Brazilian Portuguese were considered consistent with the original CAS-R. In the third round of linguistic equivalence assessment, all items achieved acceptable agreement, except for 2 items. After modifications to the instrument to achieve adequate equivalences, the adapted version had a final content validity coefficient of 0.93. Most patients were able to understand the instrument.

Conclusions
The CAS-R–Brazilian version is equivalent to the original CAS-R and has satisfactory evidence of content validity. Additional psychometric testing will be performed to allow for the assessment of PC in individuals with heart failure in Brazil.
How we can improve the appropriateness of ambulatory gastrointestinal endoscopy: the lesson of the COVID-19 outbreak
Authors: Tursi Antonio , Palieri Antonio Pio , Lattarulo Vincenzo , Elefante Antonio , Gigliobianco Andrea , Spinazzola Domenico , Elisei Walter , Papa Alfredo 
Published: September 2023

Background
The coronavirus disease 2019 (COVID-19) outbreak has significantly modified hospital and outpatient activities.

Aims
To assess the pandemic’s impact on the appropriateness of outpatient gastrointestinal (G.I.) endoscopy in a southern Italy Region.

Methods
Between 1 January 2019 and 31 December 2022, we compared the number, the type of activities, and the appropriateness of the G.I. endoscopy procedures in the four territorial gastroenterology and digestive endoscopy services of the Apulia region.

Results
In 2019, 11 173 outpatient procedures were provided, which dropped by about 44% (P < 0.05) during 2020. The endoscopic activity was slightly reduced during 2020 (−18.77%), while every other activity dropped significantly. During 2021–2022, the overall activities slightly increased but remained below the number of activities provided before the pandemic (P < 0.05). However, the endoscopic activity increased by +6.86% from 2019 to 2022, mainly due to more colonoscopies. During the 4 years analysed, the overall appropriateness rate of the endoscopic examinations increased during 2020 (2019: 67%; 2020: 81%) while dropping again in the following years (2021: 75%; 2022; 69%).

Conclusion
The appropriateness of the G.I. endoscopic procedures in the territorial gastroenterology services in the Apulia Region has improved during the acute phase of the COVID-19 pandemic, dropping again in the following years. Overall, the appropriateness of endoscopic procedures remains suboptimal; thus, educational activities are needed to improve the appropriateness rate to optimise the limited resources.
Predictive value of SUVmax in visceral pleural invasive lung adenocarcinoma with different diameters
Authors: Sun Xiaoyan , Chang Cheng , Xie Chun , Zhu Jiahao , Ni Xuping , Xie Wenhui , Wang Yuetao 
Published: September 2023

Objectives
This study aimed to investigate predictive visceral pleural invasion (VPI) occurrence value of the maximum standardized uptake value (SUVmax) in patients with lung adenocarcinoma (LA).

Patients and methods
A total of 388 LA patients were divided into D1ab, D1c, D1, D2, D2a, D2b, D3, and all patient groups based on their tumor diameter (D). Patients were also classified into negative VPI (VPI-n) and positive VPI (VPI-p) groups according to VPI presence. SUVmax of patients was measured with 18F-fluorodeoxyglucose (FDG) by PET/computed tomography (18F-PET/CT). Receiver operating characteristic (ROC) analysis and the area under curve (AUC) of SUVmax were applied to determine optimal cut-off value for predicting VPI occurrence.

Results
There were significant differences in SUVmax between VPI-n and VPI-p groups (P < 0.05) at the same tumor diameter. SUVmax cut-off value and sensitivity (Se,%) of VPI occurrence in each group were following: D1ab was 3.79 [AUC = 0.764, P < 0.001], Se86.11%; D1c was 5.47 (AUC = 0.706, P < 0.001), Se 93.75%; D1 was 5.49 (AUC = 0.731, P < 0.001), Se 79.76%; D2 was 7.36 (AUC = 0.726, P < 0.001), Se81.67%. All patient group was 7.26 (AUC = 0.735, P < 0.001), Se74.19%.

Conclusion
In LA patients with the same diameter, SUVmax of the VPI-p group was significantly higher than that of the VPI-n group. The cut-off value of SUVmax for predicting VPI of T1 stage, T1 substages, and T2 stage LA could be determined through ROC curve. SUVmax measurement by PET/CT scan in stratified tumor size is helpful for predicting VPI occurrences of the physician.
Retrospective Evaluation of Poisoning Cases Followed Up in Pediatric Intensive Care Unit—A 12-Year Experience in a Single Center
Authors: Boyraz Merve , Botan Edin , Yuce Servet , Erdem Torun Şeyma 
Published: September 2023

Abstract

Objectives
Poisonings constitute an important part of preventable morbidity and mortality in pediatric intensive care units (PICUs) and hospitalizations. However, information on poisoning requiring intensive care is limited. This study aimed epidemiological evaluation of poisoning cases treated in the PICU in a single center.

Methods
The records of 504 patients admitted to the PICU due to acute poisoning between 2010 and 2022 were retrospectively reviewed. Data were evaluated using descriptive methods and the χ2 test, and statistical differences with P value <0.05 were considered significant.

Results
The age range of the patients ranged from 1 month to 216 months (18 years), and the rate of girls was 53.2% (n = 268), whereas the rate of boys was 46.8% (n = 236). The mean age was 4.4 ± 4.3 years for boys, 6.7 ± 5.8 years for girls, and 5.6 ± 5.3 years for all patients. It was determined that 79.6% of the cases were poisoned by accident and 20.4% by suicide. A total of 76.7% of the patients who were poisoned for suicide were girls and 23.3% were boys. The mean age of these patients was 14.3 ± 3.0 years. On the other hand, 47.1% of the children who were accidentally poisoned were girls and 52.9% were boys, and the mean age of these children was 3.4 ± 2.9 years. Although 79.9% of poisonings occurred at home, the causative agent was oral poisoning in 97.4% of the cases. Approximately two thirds (69.2%) of the cases were drug-related, whereas 30.8% were related to nondrug substances. In drug-related poisonings, central nervous system drugs (35.8%) were the most common agent, followed by analgesic/antipyretic (20.9%) agents, whereas among the nonpharmaceutical factors, insecticides (agricultural pesticides, rat poison, pesticides, etc) were the most common, followed by poisonous herbs (beetleweed, widow's weed, cannabis, etc). The mean admission time of the patients to the hospital was 6.3 ± 8.4 hours, and the mean length of stay in the intensive care unit was 1.6 ± 1.3 days. In the 12 years of our study, only 3 patients died due to poisoning, and our mortality rate was 0.5%. Four patients (0.7%) were referred to the Alcohol and Drug Addicts Treatment and Research Center.

Conclusions
In this study, in which we retrospectively analyzed the profiles of poisoning cases hospitalized in the PICU for 12 years, we determined that poisonous weeds were the major factor in accidental poisonings, and suicidal poisonings were above the expected rates even at the young age group such as 8–12 years old. These results show the importance of determining the poisoning profile of the health care service area.
Mandibular Canal Branching Assessed With Cone-Beam Computed Tomography
Authors: Khojastepour Leila , Nasiri Mohammad Mehdi , Hashemi Khadijeh , Ahrari Farzaneh 
Published: September 2023

This study aimed to evaluate the prevalence and type of mandibular canal branching in a sample of the Iranian population through cone-beam computed tomography (CBCT) images.
This cross-sectional study was performed on CBCT records of 300 patients (112 males and 188 females; mean age 30.14 ± 10.96 y). The presence of mandibular canal branch (MCB) was evaluated by reconstructing multiple panoramic views and buccolingual cross-sections, according to Naitoh’s classification. The prevalence of MCB, the type of MCB, and the demographic information of all patients were recorded. The maximum number of branching and the maximum type of branching were also registered for each patient.
Mandibular canal branching was observed in 131(43.7%) of 300 CBCT images without side or sex differences (P > 0.05). The most frequent type was dental, followed by the retromolar, forward, and buccolingual types, respectively. There was a statistically higher frequency of retromolar canal in females than in males (odds ratio: 1.14 ± 4.25; P = 0.013). About 46% of patients with MCB had more than one accessory canal and 29% displayed more than one type of MCB. The coincidence of dental and retromolar canals in a patient was the most prevalent combination.
Considering the relatively high prevalence of MCB (43.7%), it is recommended to keep in mind the possibility of anatomical variations of the inferior alveolar nerve during dental procedures to avoid postsurgical complications. The high possibility of observing multiple numbers and types of branching in the patients should also be considered during preoperative assessments.
Perceived Age and Gender Perception Using Facial Recognition Software Following Facial Feminization Surgery
Authors: Alper David P. , Almeida Mariana N. , Hosseini Helia , De Baun Heloise M. , Moscarelli Jake , Hu Kevin G. , Parikh Neil , Ihnat Jacqueline M.H. , Alperovich Michael 
Published: September 2023

Measures of success for facial feminization surgery (FFS) have previously included improved rates of external gender perception as female and patient-reported outcome measures. In this study, we used artificial intelligence facial recognition software to objectively evaluate the effects of FFS on both perceived gender and age among male-to-female transgender patients, as well as their relationship with patient facial satisfaction. Standardized frontal preoperative and postoperative images of 27 transgender women undergoing FFS were analyzed by Amazon’s AI facial recognition software to determine gender, femininity confidence score, and perceived age. Female gender-typing, improvement in gender-typing (preoperatively to postoperatively), and femininity confidence scores were analyzed. To assess patient satisfaction, FACE-Q modules were completed postoperatively. Preoperatively, FFS images were perceived as female 48.1% of the time, and postoperatively, this improved to 74.1% (P=0.05). Femininity confidence scores improved from a mean score of 0.04 preoperatively to 0.39 postoperatively (P=0.003). FFS was associated with a decrease in perceived age relative to the patient’s true age (−2.4 y, P<0.001), with older patients experiencing greater reductions. Pearson correlation matrix found no significant relationship between improved female gender typing and patient facial satisfaction. Undergoing surgery at a younger age was associated with higher overall facial satisfaction (r=−0.6, P=0.01). Transfeminine patients experienced improvements in satisfaction with facial appearance, perceived gender, and decreases in perceived age following FFS. Notably, patient satisfaction was not directly associated with improved AI-gender typing, suggesting that other factors may influence patient satisfaction.
Rhinoplasty for Sinonasal Deformities in Granulomatosis with Polyangiitis: A Systematic Review and Meta-Analysis
Authors: Alanazi Farhan , Alenezi Mazyad , Alanazy Sultan , Yahya Buthaina 
Published: September 2023

Background:
Granulomatosis with polyangiitis (GPA) is a vasculitis that affects respiratory and kidney vessels. It primarily involves the nose and sinuses but can progress systemically. Granulomatosis with polyangiitis causes severe nasal deformities, impacting aesthetics and breathing. Literature focuses on rhinoplasty for saddle nose deformities in non-GPA patients, but its suitability for GPA patients remains uncertain.

Aim:
Our study aims to assess the effectiveness and safety of rhinoplasty in GPA patients by analyzing the existing literature.

Methods:
Four databases were searched; 2 reviewers independently screened the retrieved references, then relevant data for our study were extracted. Categorical outcomes were analyzed using pooled proportions and 95% CI. Statistical heterogeneity was assessed using the I
2 statistics χ2 test with a P-value lower than 0.1 indicating heterogeneity.

Results:
In our systematic review and meta-analysis, we incorporated 16 studies encompassing 136 patients who underwent nasal reconstruction as part of their treatment for GPA. The collective findings indicate a favorable success rate for rhinoplasty, with a pooled ratio of 89% (95% CI: 84%, 95%). The rate of revision surgeries was relatively low, with a pooled rate of 19% (95% CI: 12%, 26%). Furthermore, rhinoplasty demonstrated comparatively lower rates of recurrence (pooled rate: 22%, 95% CI: 3%, 42%) and complications (pooled rate: 12%, 95% CI: 7%, 18%).

Conclusion:
Rhinoplasty benefits GPA patients with saddle nose deformity and septal perforation with high success rates and low recurrence, revision, and complication outcomes. However, more research is needed for validation and refinement.