bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability of a Novel Classification System for Thoracic Disc Herniations
Authors: Farber S. Harrison , Walker Corey T. , Zhou James J. , Godzik Jakub , Gandhi Shashank V. , de Andrada Pereira Bernardo , Koffie Robert M. , Xu David S. , Sciubba Daniel M. , Shin John H. , Steinmetz Michael P. , Wang Michael Y. , Shaffrey Christopher I. , Kanter Adam S. , Yen Chun-Po , Chou Dean , Blaskiewicz Donald J. , Phillips Frank M. , Park Paul , Mummaneni Praveen V. , Fessler Richard D. , Härtl Roger , Glassman Steven D. , Koski Tyler , Deviren Vedat , Taylor William R. , Kakarla U. Kumar , Turner Jay D. , Uribe Juan S. 
Published: May 2023

Study Design.
Cross-sectional survey.

Objective.
To assess the reliability of a proposed novel classification system for thoracic disc herniations (TDHs).

Summary of Background Data.
TDHs are complex entities varying substantially in many factors, including size, location, and calcification. To date, no comprehensive system exists to categorize these lesions.

Methods.
Our proposed system classifies 5 types of TDHs using anatomical and clinical characteristics, with subtypes for calcification. Type 0 herniations are small (≤40% of spinal canal) TDHs without significant spinal cord or nerve root effacement; type 1 are small and paracentral; type 2 are small and central; type 3 are giant (>40% of spinal canal) and paracentral; and type 4 are giant and central. Patients with types 1-4 TDHs have correlative clinical and radiographic evidence of spinal cord compression. Twenty-one US spine surgeons with substantial TDH experience rated 10 illustrative cases to determine the system’s reliability. Interobserver and intraobserver reliability were determined using the Fleiss kappa coefficient. Surgeons were also surveyed to obtain consensus on surgical approaches for the various TDH types.

Results.
High agreement was found for the classification system, with 80% (range 62-95%) overall agreement and high interrater and intrarater reliability (kappa 0.604 [moderate to substantial agreement] and kappa 0.630 [substantial agreement], respectively). All surgeons reported nonoperative management of type 0 TDHs. For type 1 TDHs, most respondents (71%) preferred posterior approaches. For type 2 TDHs, responses were roughly equivalent for anterolateral and posterior options. For types 3 and 4 TDHs, most respondents (72% and 68%, respectively) preferred anterolateral approaches.

Conclusions.
This novel classification system can be used to reliably categorize TDHs, standardize description, and potentially guide the selection of surgical approach. Validation of this system with regard to treatment and clinical outcomes represent lines of future study.
Pediatric Keloids and Review of the Efficacy of Current Treatment Modalities
Authors: Hirsch Yonatan , Waterman Christy L. , Haber Roger 
Published: May 2023

BACKGROUND
Keloids and hypertrophic scars are the result of excessive fibroblast proliferation and collagen deposition in the wound healing process, leaving patients with irritating and cosmetically displeasing lesions. Despite there being numerous modalities for treatment, keloids are notoriously recalcitrant to therapy and recurrence rates are high.

OBJECTIVE
Because many keloids begin to develop during childhood and adolescence, it is important to better understand which treatment options may be best suited toward the pediatric population specifically.

METHODS
We reviewed 13 studies that focus specifically on effectiveness of treatment options for keloids and hypertrophic scars in the pediatric population. These studies cover 545 keloids in 482 patients, all aged 18 and younger.

RESULTS
Many treatment modalities were used, with multimodal treatment being the most common (76%). There were 92 instances of recurrence, with a total recurrence rate of 16.9%.

CONCLUSION
Data from the combined studies suggest that keloid development is less common before adolescence and that higher rates of recurrence are observed among patients who have received monotherapy compared with those who received multimodal treatments. More well-designed studies with standardized ways of assessing outcomes are needed to expand our understanding on how to optimally treat keloids in the pediatric population.
What Physician Assistants Prefer in a Postprofessional Doctorate Program: A Cross-Sectional Rating and Rankings Study
Authors: Gillette Chris , Bodner Gayle B. , Bell Sisson Caroline Grey , Bates Nathan , DeTroye Alisha , Hussaini Sobia S. , Crandall Sonia 
Published: May 2023

Purpose
The physician assistant (PA) literature has focused on the implications of creating an entry-level doctoral degree; however, there is scant primary literature on postprofessional doctorates, which are becoming more popular as the number of institutions offering them increases. The purposes of this project were to: (1) describe interest and motivation of currently practicing PAs to enroll in a postprofessional doctorate program and (2) identify the most- and least-preferred attributes of a postprofessional doctorate program.

Methods
This was a quantitative cross-sectional survey of recent alumni from one institution. Measures included interest in obtaining a postprofessional doctorate, a nonrandomized Best-Worst Scaling (BWS) exercise, and motivators for enrolling in a postprofessional doctorate. The main outcome of interest was the BWS standardized score for each attribute.

Results
The research team received 172 eligible responses (n = 172, response rate = 25.83%). Results indicate that 47.67% of respondents (n = 82) expressed interest in a postprofessional doctorate. The most preferred doctorate program attribute was a clinically based program, ending with a residency, conferring a Doctor of Medical Science (DMSc) degree, with a hybrid course delivery.

Discussion
This sample included various interests, motivations, and preferred program attributes. Understanding these factors may help inform the design and redesign of doctoral programs.
Turning HEADSS: Utilizing Coached Role-Play to Increase Student Self-Efficacy with Adolescent Interviewing Skills
Authors: Fernandez Tanya , Kaul Paritosh 
Published: May 2023

Introduction
Adolescent patients make up a significant number of the primary care population, yet medical training specific to adolescents is inadequate and challenging.
2
Medical trainees report feeling less competent caring for adolescents compared to caring for infants and children.
3
Framed after an adolescent HEADSS (Home, Education/employment, peer group Activities, Drugs, Sexuality and Suicide/depression) interview role-play activity for pediatric clerkship students,
1,2
this study sought to investigate the impact that facilitated role-play would have on physician assistant (PA) students' self-perceived knowledge, skills, and comfort in interviewing adolescents.

Methods
A coached role-play focused on skills used during a HEADSS interview was used to demonstrate the communication skills inherently important to adolescent encounters. Pre- and postintervention surveys were administered.

Results
Data from 2 sequential cohorts (n = 88) showed statistically significant improvement in pre- versus postsession self-perception of knowledge (p ≤ 0.0001) and skills (p ≤ 0.0001), but not in comfort (p = 0.1610).

Discussion
Teaching PA students how best to engage with adolescents can be done effectively via coached role-play.
Cephalic inferior vena cava non-clamping technique versus standard procedure for robot-assisted laparoscopic level II–III thrombectomy: a prospective cohort study
Authors: Zhang Yu , Bi Hai , Fu YunJie , Zhang HongXian , Zhang ShuDong , Liu Ke , Liu Lei , Li Nan , Liu Cheng , Tian XiaoJun , Ma LuLin 
Published: May 2023

Background:
Renal tumour can invade the venous system and ~4–10% patients with renal tumour had venous thrombus. Although the feasibility of robot-assisted laparoscopic inferior vena cava thrombectomy (RAL-IVCT) in patients with inferior vena cava (IVC) thrombus has been validated, the wide application is still a challenge due to the complexity of IVC control. The objective was to describe our novel cephalic IVC non-clamping technique and to compare the outcomes versus standard RAL-IVCT.

Materials and methods:
A prospective single-centre cohort containing 30 patients with level II–III IVC thrombus was established since August 2020. Fifteen patients underwent cephalic IVC non-clamping approach and 15 patients received standard RAL-IVCT. The authors decided the surgical technique according to the echocardiographic assessment of the right heart and IVC.

Results:
The non-clamping group had less operative time (median 148 versus 185 min, P=0.04), and lower Clavien-grade II complication rate (26.7% versus 80.0%, P=0.003). The median intraoperative blood loss were 400 ml [interquartile range (IQR) 275–615 mL] and 800 ml (IQR 350–1300 ml), respectively (P=0.05). The most common complication in standard RAL-IVCT group was liver dysfunction. No gas embolism, hypercapnia or tumour thrombus dislodgment occurred in non-clamping group. After a median follow-up of 17.0 months (IQR 13.5–18.5 months) and 15.5 months (IQR 13.0–17.0 months), two patients (16.7%) in the non-clamping group and 3 patients (20.0%) in the standard RAL-IVCT group died (hazard ratio 0.59, 95% CI 0.10–3.54, P=0.55).

Conclusions:
The cephalic IVC non-clamping technique can be performed safely with acceptable surgical outcomes and short-term oncologic outcomes in patients with level II–III IVC thrombus. Compared with standard procedure, it had less operative time and lower complication rate.
Clinical evaluation of the first semi-active total knee arthroplasty assisting robot made in China: a retrospective propensity score-matched cohort study
Authors: Yang Pengfei , He Rui , Lei Kai , Liu Liming , Yang Liu , Guo Lin 
Published: May 2023

Objective:
The precision of overall alignment and knee morphotype after robot-assisted total knee arthroplasty has been fully confirmed. This study aims to conduct a clinical evaluation of the first China-made semi-active total knee arthroplasty assisting robot.

Methods:
After a 1 : 2 propensity score matching, that is, a matched cohort study, patients were matched to the robot group (52 cases) and the conventional group (104 cases). The robot group received osteotomy according to preoperative planning, while the conventional group adopted preoperative planning based on the full-length radiograph and received conventional osteotomy. Perioperative clinical indicators, such as operation time, tourniquet time, hospitalization days, intraoperative bleeding, and hemoglobin level of the two groups were recorded; radiological indicators of postoperative prosthesis position, including hip-knee-ankle angle, frontal femoral component angle, frontal tibial component angle, lateral femoral component angle, and lateral tibial component angle were also recorded; deviations and outliers of the radiological indicators were calculated.

Results:
Compared with the conventional group, the operation time and tourniquet time of the robot group were longer, and the postoperative hemoglobin level decreased less, the differences were statistically significant; the lateral tibial component angle of the conventional group was 80.9°±3.6°, which was smaller than 86.7 °±2.3° of the robot group, the difference was statistically significant (P<0.001); except for lateral femoral component angle, the absolute deviations of the radiological indicators in the robot group were significantly smaller than that in the conventional group (P≤0.001); the outliers of the radiological indicators in the robot group were significantly smaller than that in the conventional group with a statistical difference (P<0.05).

Conclusion:
Compared with the conventional group, the operation time of the robot group was relatively longer, but the perioperation blood loss was less. The robot group could better control the posterior inclination of the tibial prosthesis, and the absolute deviations and outliers of the prosthesis position were relatively smaller. There was no difference in short-term clinical score between the two groups.
Bibliometric analysis of academic journal recommendations and requirements for surgical and anesthesiologic adverse events reporting
Authors: Sholklapper Tamir N. , Ballon Jorge , Sayegh Aref S. , La Riva Anibal , Perez Laura C. , Huang Sherry , Eppler Michael , Nelson Gregg , Marchegiani Giovanni , Hinchliffe Robert , Gordini Luca , Furrer Marc , Brenner Michael J. , Dell-Kuster Salome , Biyani Chandra Shekhar , Francis Nader , Kaafarani Haytham M.A. , Siepe Matthias , Winter Des , Sosa Julie A. , Bandello Francesco , Siemens Robert , Walz Jochen , Briganti Alberto , Gratzke Christian , Abreu Andre L. , Desai Mihir M. , Sotelo Rene , Agha Riaz , Lillemoe Keith D. , Wexner Steven , Collins Gary S. , Gill Inderbir , Cacciamani Giovanni E. 
Published: May 2023

Background:
Standards for reporting surgical adverse events (AEs) vary widely within the scientific literature. Failure to adequately capture AEs hinders efforts to measure the safety of healthcare delivery and improve the quality of care. The aim of the present study is to assess the prevalence and typology of perioperative AE reporting guidelines among surgery and anesthesiology journals.

Materials and methods:
In November 2021, three independent reviewers queried journal lists from the SCImago Journal & Country Rank (SJR) portal (www.scimagojr.com), a bibliometric indicator database for surgery and anesthesiology academic journals. Journal characteristics were summarized using SCImago, a bibliometric indicator database extracted from Scopus journal data. Quartile 1 (Q1) was considered the top quartile and Q4 bottom quartile based on the journal impact factor. Journal author guidelines were collected to determine whether AE reporting recommendations were included and, if so, the preferred reporting procedures.

Results:
Of 1409 journals queried, 655 (46.5%) recommended surgical AE reporting. Journals most likely to recommend AE reporting were: by category surgery (59.1%), urology (53.3%), and anesthesia (52.3%); in top SJR quartiles (i.e. more influential); by region, based in Western Europe (49.8%), North America (49.3%), and the Middle East (48.3%).

Conclusions:
Surgery and anesthesiology journals do not consistently require or provide recommendations on perioperative AE reporting. Journal guidelines regarding AE reporting should be standardized and are needed to improve the quality of surgical AE reporting with the ultimate goal of improving patient morbidity and mortality.
Efficacy of endoscopic therapy for T1b esophageal cancer and construction of prognosis prediction model: a retrospective cohort study
Authors: Fan Xiangli , Wang Jing , Xia Lingling , Qiu Hu , Tian Yuanyuan , Zhangcai Yutian , Luo Xixi , Gao Yuelan , Li Chen , Wu Yong , Zhao Wensi , Chen Jiamei , Shi Wei , Yuan Jingping , Ke Shaobo , Chen Yongshun 
Published: May 2023

Background:
The efficacy of endoscopic therapy on the long-term survival outcomes of T1b oesophageal cancer (EC) is unclear, this study was designed to clarify the survival outcomes of endoscopic therapy and to construct a model for predicting the prognosis in T1b EC patients.

Methods:
This study was performed using the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2017 of patients with T1bN0M0 EC. Cancer-specific survival (CSS) and overall survival (OS) were compared between endoscopic therapy group, esophagectomy group and chemoradiotherapy group, respectively. Stabilized inverse probability treatment weighting was used as the main analysis method. The propensity score matching method and an independent dataset from our hospital were used as sensitivity analysis. The least absolute shrinkage and selection operator regression (Lasso) was employed to sift variables. A prognostic model was then established and was verified in two external validation cohorts.

Results:
The unadjusted 5-year CSS was 69.5% (95% CI, 61.5–77.5) for endoscopic therapy, 75.0% (95% CI, 71.5–78.5) for esophagectomy and 42.4% (95% CI, 31.0–53.8) for chemoradiotherapy. After stabilized inverse probability treatment weighting adjustment, CSS and OS were similar in endoscopic therapy and esophagectomy groups (P=0.32, P=0.83), while the CSS and OS of chemoradiotherapy patients were inferior to endoscopic therapy patients (P<0.01, P<0.01). Age, histology, grade, tumour size, and treatment were selected to build the prediction model. The area under the curve of receiver operating characteristics of 1, 3, and 5 years in the validation cohort 1 were 0.631, 0.618, 0.638, and 0.733, 0.683, 0.768 in the validation cohort 2. The calibration plots also demonstrated the consistency of predicted and actual values in the two external validation cohorts.

Conclusion:
Endoscopic therapy achieved comparable long-term survival outcomes to esophagectomy for T1b EC patients. The prediction model developed performed well in calculating the OS of patients with T1b EC.
Effects of very low carbohydrate ketogenic diets on skeletal health
Authors: Best Cora M. , Hsu Simon 
Published: May 2023

Purpose of reviewVery low carbohydrate ketogenic diet (KD) therapy has been associated with skeletal demineralization in children with drug-resistant epilepsy, but the cause of this association is unclear. Recently, interest in the KD has grown owing to its potential benefits for other illnesses including cancer, type 2 diabetes, obesity, and polycystic kidney disease. Summaries of the best available evidence regarding effects of a KD on skeletal health are lacking.Recent findingsRecent rodent studies found that a KD can harm the growing skeleton, which corroborates most but not all studies in pediatric patients. Proposed mechanisms include chronic metabolic acidosis and depressed osteoanabolic hormones. Relative to other weight-reducing diets, a weight-reducing KD for treatment of obesity and/or type 2 diabetes in adults has not been associated with adverse skeletal effects. By contrast, recent evidence suggests that adaptation to a eucaloric KD may impair bone remodeling in elite adult athletes. Discrepancies in the literature may relate to differences between study populations and in diet formulation.SummaryAttention to skeletal health is warranted when using KD therapy given the uncertainty in the literature and suggestive harms in certain populations. Future research should focus on potential mechanisms of injury.
Partial central anterior reconstruction of the auricle with one-stage combined retroauricular flaps
Authors: Poissonnet Gilles , Poissonnet Valentine , Dassonville Olivier , Bozec Alexandre , Culié Dorian 
Published: May 2023

Summary:
Basal cell carcinomas of the central anterior area of the auricle, limited to the antihelix and scapha without peripheral infiltration of the helix, are not uncommon. Surgical resection is rarely transfixing but the resection of the underlying cartilage is often required. The complex anatomy of the ear, and the lack of local tissue available makes its reparation challenging. Defects of anthelix and scapha require special reconstructive techniques, taking into account skin structure and the three-dimensional architecture of the ear. Usually, the reconstruction consists of full-thickness skin grafting, or anterior transposition flap requiring an extended skin resection. We describe a one-stage technique that uses a pedicled retroauricular skin flap turned over the anterior defect, followed by immediate closure of the donor site with a transposition or a bilobed retroauricular skin flap. The one-stage combined retroauricular flaps reparation optimizes cosmetic outcome, reduces risks of successive surgeries.
A Review of the Inter-laboratory Variability of Caspofungin Minimum Inhibitory Concentrations for Nakaseomyces glabrata isolates
Authors: Ali Saied , Collison Meadhbh , McNicholas Sinead , McDermott Sinead 
Published: May 2023

Background:
The use of automated broth-microdilution systems for caspofungin antifungal susceptibility testing (AST) for Nakaseomyces glabrata is prone to high inter-laboratory variation. We aim to review caspofungin minimum inhibitory concentrations (MICs) of clinically significant N.glabrata isolates, as reported locally and compare with reference laboratory results for the same isolate.
Methods:
All clinically significant N.glabrata isolates from 2019-2021 inclusive were reviewed. Caspofungin MICs were obtained locally using the VITEK2 system and strains were referred to the Mycology Reference Laboratory for confirmatory testing via E-Tests. MICs were compared using categorical and essential agreement.
Results:
Of the forty-one isolates reviewed, marked discrepancies were noted in interpretative breakpoints between assays, producing 16 Minor and Major Category Errors. Categorical agreement was found to be 22%, with the VITEK2 over-estimating resistance. Doubling dilution differences revealed an essential agreement of 61% within ±1 log2 dilution.
Conclusion:
Performing caspofungin AST using broth-microdilution methods is prone to high inter-laboratory variation, and potentially results in the mis-classification of susceptible isolates as highlighted in our study. The use of E-tests has been shown to be highly reliable and not prone to inter-laboratory variation. It may be worthwhile looking into adopting a similar testing approach locally from an economic and patient-centred view.
The Impact of Peripartum Floor Lockdowns on Newborn Safety
Authors: Neshek Barbara , Bryant David Ray , Hruska Justin , Gupta Deepak 
Published: May 2023

AbstractBackgroundFor the safety of newborns, infrastructural lockdown of peripartum floors may be imperative.Materials and MethodsCumulative data with no identifiers at all was collected from Midas Incident Reporting System reports and Security Logs reports for comparing incidence of newborn abductions four year-period (2015-2018) before the institution of lockdown with four year-period (2019-2022) since the institution of lockdown.ResultsDuring the entire eight years, there was not a single incident of newborn abduction reported in Midas Incident Reporting System and Security Logs.ConclusionThe absent incidence of newborn abductions before and since peripartum floors’ lockdown should not deter keeping safety protocols enhanced and potential loopholes closed thus preemptively treating lax human factors while protecting precious and vulnerable newborns during their stay in peripartum floors.
Multi-Omic Factor Analysis uncovers immunological signatures with pathophysiologic and clinical implications in coronary syndromes
Authors: Pekayvaz Kami , Losert Corinna , Knottenberg Viktoria , van Blokland Irene V. , Oelen Roy , Groot Hilde E. , Benjamins Jan Walter , Brambs Sophia , Kaiser Rainer , Eivers Luke , Polewka Vivien , Escaig Raphael , Joppich Markus , Janjic Aleksandar , Popp Oliver , Petzold Tobias , Zimmer Ralf , Enard Wolfgang , Saar Kathrin , Mertins Philipp , Huebner Norbert , van der Harst Pim , Franke Lude H. , van der Wijst Monique G. P. , Massberg Steffen , Heinig Matthias , Nicolai Leo , Stark Konstantin 
Published: May 2023

AbstractAcute and chronic coronary syndromes (ACS and CCS) are leading causes of mortality. Inflammation is considered to be a key pathogenic driver, but immune states in humans and their clinical implications remain poorly understood. We hypothesized that Multi-Omic blood analysis combined with Multi-Omic Factor Analysis (MOFA) might uncover hidden sources of variance providing pathophysiological insights linked to clinical needs. Here, we compile a single cell longitudinal dataset of the circulating immune states in ACS & CCS (13x103clinical & Multi-Omic variables, n=117 subjects, n=838 analyzed samples) from two independent cohorts. Using MOFA, we identify multilayered factors, characterized by distinct classical monocyte and CD4+& CD8+T cell states that explain a large proportion of inter-patient variance. Three factors either reflect disease course or predict outcome in coronary syndromes. The diagnostic performance of these factors reaches beyond established biomarkers highlighting the potential use of MOFA as a novel tool for multilayered patient risk stratification.