bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Occupational Exposures and Chronic Obstructive Pulmonary Disease Morbidity
Authors: Rous Jennifer S. , Lees Peter S. J. , Koehler Kirsten , Buckley Jessie P. , Quirós-Alcalá Lesliam , Han MeiLan K. , Hoffman Eric A. , Labaki Wassim , Barr R. Graham , Peters Stephen P. , Paine Robert , Pirozzi Cheryl , Cooper Christopher B. , Dransfield Mark T. , Comellas Alejandro P. , Kanner Richard E. , Drummond M. Bradley , Putcha Nirupama , Hansel Nadia N. , Paulin Laura M. 
Published: March 2023

Objective
The aim of the study is to determine whether aggregate measures of occupational exposures are associated with chronic obstructive pulmonary disease (COPD) outcomes in the Subpopulations and Intermediate Outcome Measures in COPD study cohort.

Methods
Individuals were assigned to six predetermined exposure hazard categories based on self-reported employment history. Multivariable regression, adjusted for age, sex, race, current smoking status, and smoking pack-years determined the association of such exposures to odds of COPD and morbidity measures. We compared these with the results of a single summary question regarding occupational exposure.

Results
A total of 2772 individuals were included. Some exposure estimates, including “gases and vapors” and “dust and fumes” exposures resulted in associations with effect estimates over two times the estimated effect size when compared with a single summary question.

Conclusions
Use of occupational hazard categories can identify important associations with COPD morbidity while use of single-point measures may underestimate important differences in health risks.
Percutaneous management of ureteropelvic junction obstruction
Authors: Kominsky Hal D. , Johnson Brett A. 
Published: March 2023

Purpose of review
The development of endoscopic and minimally invasive techniques has revolutionized the treatment of ureteropelvic junction obstruction (UPJO). Patients can now undergo successful UPJO repair without the morbidity and complications associated with open surgery. Laparoscopic and robotic repair has supplanted open surgery as the gold standard, but percutaneous endoscopic treatment remains a relevant alternative to more invasive surgery. This review will focus on the percutaneous approach for the treatment of UPJO.

Recent findings
Percutaneous endopyelotomy was popularized during the 1980 s due to advances in the field of endourology, allowing for well tolerated and reliable percutaneous access to the kidney. After percutaneous access to the kidney is achieved, the narrowed ureter at the UPJ is incised in a full thickness fashion in the posterolateral position from the ureteral lumen to the periureteral fat. Success rates for this procedure are nearly 90% at high-volume centres. The ideal patient who has success with percutaneous endopyelotomy has a short segment of narrowing less than 2 cm, no crossing vessel, good ipsilateral renal function and mild hydronephrosis.

Summary
Although the development of laparoscopic and robotic approaches to pyeloplasty has produced outcomes that surpass those of percutaneous endopyelotomy, it remains a viable option in the appropriately selected patient, but success rates tend to decrease with longer follow up.
A rare case of fulminant sepsis secondary to postpartum pyomyoma caused by Prevotella bivia: a case report
Authors: Ogawa Tatsuhiko 
Published: March 2023

Introduction and importance:
Pyomyoma is rare but can cause life-threatening sepsis from uterine leiomyoma infection. Curative radical surgery to completely remove all infectious foci is preferable if conservative treatment fails, but for patients with fertility concerns, alternatives to uterine removal should be considered. The author reports a case of postpartum pyomyoma to remind clinicians of this rare disease and the need for rapid intervention to preserve patient fertility.

Case presentation:
A postpartum female with a fever of unknown origin was admitted to a public hospital. The patient’s general condition rapidly worsened, and surgical removal of the pyomyoma was assumed to be necessary for controlling the infection source. The patient initially refused surgery, as she had fertility concerns; however, she developed septic shock and acute respiratory distress syndrome. Subsequently, surgical intervention was considered imperative, and the patient consented to surgery. Normal uterus was carefully differentiated from degenerated intramural pyomyoma, and the endometrium remained intact. In the pyomyoma specimen, Prevotella bivia, an endogenous anaerobic bacterium that can colonize the lower genital tract, was detected.

Clinical discussion:
For patients with postpartum sepsis and leiomyoma, pyomyoma should be considered, even if the patient is immunocompetent and has no risk factors. Pyomyoma can be exacerbated into a fulminant and fatal course after subacute, insidious progression.

Conclusion:
Comprehensive treatment strategies, including source control of infection and uterine preservation, are required for future fertility. Strict vigilance and appropriate and prompt surgical intervention when conservative treatments fail are crucial to save the patient and preserve fertility.
Acute pancreatitis in pregnancy: how was it determined whether it was caused by pregnancy or by COVID-19? A case report
Authors: Bereda Gudisa 
Published: March 2023

Background and importance:Acute pancreatitis is a pancreatic inflammatory condition that has the potential to cause serious morbidity. Acute pancreatitis is a relatively uncommon and potentially fatal pregnancy condition. Abdominal pain, pancreatic damage, or acute pancreatitis may all be related to the coronavirus disease 2019 (COVID-19) infection.Case presentation:On 12 August 2022, a 33-year-old black woman, gravida three, para two, a housewife, was taken to the obstetric care unit at 24 weeks of pregnancy with a 1-week history of lethargy, fever, and a dry cough. Reverse transcriptase-PCR testing on a sample of her nasopharyngeal swab revealed the presence of the severe acute respiratory syndrome coronavirus 2 virus. An abdominal computed tomography scan indicated an atrophic pancreas with broad fatty infiltration, little fluid and fat stranding around the pancreas, and reactive lymph nodes. She received 24-h-long insulin infusion therapy in addition to potassium chloride administered intravenously. She received crystalloid isotonic intravenous fluid to treat her severe pancreatitis and stop the progression of acute respiratory distress syndrome.Clinical discussion:Severe consequences of the severe acute respiratory syndrome coronavirus 2 infection are more likely to affect pregnant women who already have diabetes as concomitant conditions. Acute pancreatitis caused by COVID-19 is uncommon and can occur after a mild infection or even after the viral infection has cleared up. Lipasemia typically manifests following the peak of systemic inflammatory activity that triggers the release of pancreatic enzymes like lipase.Conclusion:Symptoms of the digestive system, including anorexia, nausea, vomiting, stomach pain, and diarrhea, can be brought on by the COVID-19 infection. She had diarrhea as a clinical symptom, showing that the COVID-19 infection was the root cause of her acute pancreatitis. She had also refrained from vomiting, demonstrating that her acute pancreatitis was not related to pregnancy.
Bing Neel Syndrome
Authors: Alexander Abigail L. , Jackson Devon , Donahue John E. , Chirkov Alexander , Banerjee Priya 
Published: March 2023

Abstract
Suicide rapidly increased in the United States by 30% from 2000 to 2020, accounting for more than 800,000 deaths (Neurosci Res Program Bull. 1972; 10: 384–8). Studies have shown that there are a multitude of underlying issues, including mental illness, that elevate an individual's risk of dying by suicide (CDC WONDER: Underlying cause of death, 1999–2019. Atlanta, GA: US Department of Health and Human Services, CDC; 2020). Presented here is a case of Bing Neel syndrome (BNS) found in a 69-year-old man who died by suicide by jumping off a 135′ bridge. His medical history was significant for traumatic brain injury, Waldenstrom macroglobulinemia (WM), major depressive disorder, suicidal ideation, and anxiety. Bing Neel syndrome is a rare central nervous system complication of WM. His wife reported an abrupt mental deterioration starting 5 years before his death, characterized by paranoia, depression, and insomnia. He had been a high-functioning university professor. His decline culminated with the loss of independence in his activities of daily living. At autopsy, it was found that he experienced blunt force injuries related to the fall, causing his death. A neuropathologic examination revealed a brisk and fulminant clonal CD20+/immunoglobulin M+ lymphocytic infiltrate, involving all sampled regions of his brain, consistent with WM. This workup was critical to obtaining an accurate pathologic diagnosis of BNS and understanding his full clinical status before death. Although BNS was not the proximate cause of death, this diagnosis aided the death investigation as a causal factor in his suicidality and was vital to providing his family closure.
Effectiveness for Diagnosis of Malignancy of Bile Pyruvate Kinase M2 in Patients with Indeterminate Biliary Stricture
Authors: Aguilar Olivos Nancy Edith , Oria-Hernández Jesús , Briones Nicole Somerville , Téllez Ávila Félix Ignacio 
Published: March 2023

Background:
Up to 70% of the cases of biliary strictures are cholangiocarcinoma. Cholangiocarcinoma has a late diagnosis and poor outcomes; therefore, effective biomarkers are needed for malignant lesions detection at earlier stages.

Aim:
The aim was to assess the diagnostic utility of bile pyruvate kinase M2 (PKM2) as a biomarker for the detection of malignant biliary strictures in patients with an indeterminate biliary stricture.

Materials and Methods:
This is a prospective study to evaluate the diagnostic value of bile PKM2 for the diagnosis of malignant biliary strictures. Bile samples were collected during Endoscopic Retrograde Cholangio Pancreatography to quantify PKM2 levels and were used to compare their diagnostic value with biliary brush cytology, endoscopic ultrasound-guided fine needle biopsy, or clinical follow-up.

Results:
Forty-six patients were recruited for the study; 19 patients with malignant strictures and 27 with benign biliary strictures. The bile PKM2 levels were elevated in patients with malignant biliary strictures [median 0.045 ng/mL (IQR 0.014 to 0.092)] compared with those with benign strictures [median 0.019 ng/mL (IQR 0.00 to 0.047)]. Bile PKM2 had a receiver-operating characteristic curve of 0.66 (0.49 to 0.83) with a cutoff value of bile PKM2 of 0.0017 ng/mL. The sensitivity and specificity of bile PKM2 for the diagnosis of cholangiocarcinoma were 89% and 26%; the positive and negative predictive values were 46% and 78%, respectively.

Conclusion:
In patients with indeterminate biliary strictures, bile PKM2 may be a potential biomarker for the diagnosis of malignancy.
Exploring the Utility of Neurostimulation Therapies in the Treatment of Borderline Personality Disorder
Authors: Zou Michael , Broadbear Jillian Helen , Rao Sathya 
Published: March 2023

AbstractThe use of electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) in the treatment of people diagnosed with borderline personality disorder (BPD) highlights the need for systematic review of the evidence supporting this practice. A comprehensive literature search identified seven original clinical research studies investigating the use of brain stimulation therapies in people diagnosed with BPD. The lack of consistent study design, diagnostic methodology, treatment parameters, and outcome measures precluded analysis of aggregated study results. There were no ECT studies evaluating BPD symptom outcomes; however, studies of ECT in patients with comorbid BPD and depression suggested that depressive symptoms were less responsive to ECT compared with depression-only patients. The few studies available suggest that TMS may lead to clinically and statistically significant improvements in BPD symptoms and depressive symptoms. Similar overall improvements were reported despite the use of heterogeneous TMS treatment protocols, highlighting the importance of including a sham condition to investigate the contribution of the placebo effect to overall improvement. There is still no clear evidence supporting the use of ECT for treating people with BPD (with or without depression); therefore, the use of ECT in this population should be approached with caution. Although TMS shows early promise, the low numbers of participants in the few available studies suggest the urgent need for larger randomized controlled trials to provide an evidence base for this increasingly popular treatment.
Does malignancy status effect outcomes in patients with large vessel occlusion stroke and cancer that underwent endovascular thrombectomy?
Authors: Shalabi Fatma , Sacagiu Tzvika , Honig Asaf , Molad Jeremy , Itsekson-Hayosh Zeev , Hallevi Hen , Orion David , Aladin Shorooq , Gomori John M. , Cohen Jose E. , Leker Ronen R. 
Published: March 2023

AbstractBackgroundCancer is associated with an increased risk of acute ischemic stroke (AIS) including large vessel occlusions (LVO). Whether cancer status affects outcomes in patients with LVO that undergo endovascular thrombectomy (EVT) remains unknown.Methods and ResultsAll consecutive patients undergoing EVT for LVO were recruited into a prospective ongoing multi-center database and the data was retrospectively analyzed. Patients with active cancer were compared to patients with cancer in remission. Association of cancer status with 90-day functional outcome and mortality were calculated in multivariable analyses. We identified 154 patients with cancer and LVO that underwent EVT (mean age 74±11, 43% men, median NIHSS 15). Of the included patients, 70 (46%) had a remote history of cancer or cancer in remission and 84 (54%) had active disease. Outcome data at 90 days post-stroke was available for 138 patients (90%) and was classified as favorable in 53 (38%). Patients with active cancer were younger and more often smoked but did not significantly differ from those without malignancy in other risk factors, stroke severity, stroke subtype or procedural variables. Favorable outcome rates among patients with active cancer did not significantly differ compared to those seen in patients without active cancer but mortality rates were significantly higher among patients with active cancer on univariate and multivariable analyses.ConclusionsOur study suggests that EVT is safe and efficacious in patients with history of malignancy as well as in those with active cancer at the time of stroke onset although mortality rates are higher among patients with active cancer.Clinical PerspectivesWhat is new?The results of the current study suggest that EVT is safe and efficacious in patients with history of malignancy as well as in those with active cancer at the time of stroke onset although mortality rates are significantly higher and favorable outcome rates tend to be lower among patients with active cancer.What are the clinical implications?The results imply that all cancer patients with LVO stroke should be considered for EVT regardless of cancer status.
Enhanced motor noise in an autism subtype with poor motor skills
Authors: Mandelli Veronica , Landi Isotta , Ceccarelli Silvia Busti , Molteni Massimo , Nobile Maria , D’Ausilio Alessandro , Fadiga Luciano , Crippa Alessandro , Lombardo Michael V. 
Published: March 2023

AbstractEarly motor difficulties are a common in many, but not all, autistic individuals. These difficulties tend to be highly present in individuals carrying rare genetic mutations with high penetrance for autism. Many of these rare genetic mechanisms also cause neurophysiological dysregulation of excitation-inhibition balance (E:I). A predicted downstream consequence of E:I imbalance in motor circuitry would translate behaviorally into enhanced ‘motor noise’ – that is, increased variability in execution of motor actions. Here we tested the hypothesis that autistic individuals with the most pronounced motor difficulties would be most affected by enhanced motor noise. Unsupervised data-driven clustering on a standardized test of motor skills (n=156, age = 3-16 years) identified the presence of two robust and highly stable autism motor subtypes described by relatively intact versus highly impaired motor skills. With motor kinematics data recorded during a simple reach-to-drop task, we observed that enhanced motor noise is a specific characteristic of the autism subtype with highly impaired motor skills. Autistic individuals with poor motor skills may be differentially affected by E:I imbalance within motor circuitry.
Fast ripples reflect increased excitability that primes epileptiform spikes
Authors: Weiss Shennan A , Fried Itzhak , Engel Jerome , Sperling Michael R. , Wong Robert K.S. , Nir Yuval , Staba Richard J 
Published: March 2023

AbstractThe neuronal circuit disturbances that drive interictal and ictal epileptiform discharges remains elusive. Using a combination of extraoperative macro- and micro-electrode interictal recordings in six presurgical patients during non-rapid eye movement (REM) sleep we found that, exclusively in the seizure onset zone, fast ripples (FR; 200-600Hz), but not ripples (80-200 Hz), frequently occur <300 msec before an interictal intracranial EEG (iEEG) spike with a probability exceeding chance (bootstrapping, p<1e-5). Such FR events are associated with higher spectral power (p<1e-10) and correlated with more vigorous neuronal firing than solitary FR (generalized linear mixed-effects model, GLMM, p<1e-3) irrespective of FR power. During the iEEG spike that follows a FR, action potential firing is lower than during a iEEG spike alone (GLMM, p<1e-10), reflecting an inhibitory restraint of iEEG spike initiation. In contrast, ripples do not appear to prime epileptiform spikes. We next investigated the clinical significance of pre-spike FR in a separate cohort of 23 patients implanted with stereo EEG electrodes who underwent resections. In non-REM sleep recordings, sites containing a high proportion of FR preceding iEEG spikes correlate with brain areas where seizures begin more than solitary FR (p<1e-5). Despite this correlation, removal of these sites does not guarantee seizure freedom. These results are consistent with the hypothesis that FR preceding EEG spikes reflect an increase in local excitability that primes EEG spike discharges preferentially in the seizure onset zone and that epileptogenic brain regions are necessary, but not sufficient, for initiating interictal epileptiform discharges.
Anesthesiologists, Certified Registered Nurse Anesthetists and Anesthesiology Assistants: Overvaluation By Providers Or Undervaluation By Payers
Authors: Gupta Deepak 
Published: March 2023

AbstractBackgroundConsidering that National Health Expenditures (NHE) in the United States (U.S.) have mounted to 4,124 billion dollars with 593.1 billion dollars (14.4%) spent on physician services in 2020, it will be interesting to see how specialties fared in terms of percentage of billed dollars approved to reflect on how NHE would have been faring if 100% billed dollars were approved.ObjectivesWhether (and by how much), as compared to other healthcare providers in the U.S., anesthesia providers (anesthesiologists, certified registered nurse anesthetists (CRNAs) and anesthesiology assistants) are being differently reimbursed in terms of approved dollars by Centers for Medicare & Medicaid Services (CMS) as percentages of dollars billed by providers. Materials and Methods: The source of data about approved dollars by CMS as percentages of dollars billed by providers is Denniston Data Inc. at Provider Ranking System (PRS) which provided deidentified cumulative tabulated data sourced from CMS public access reimbursement data for the years 2012-2020 to the author who, as a private citizen, had enrolled for annually renewed subscription to PRS.ResultsAmong the 73 specialties whose data was complete for all the nine years (2012-2020), the top three specialties with highest percentages of billed dollars which were approved (56% to 76%) were almost consistently chiropractic, optometry and clinical psychologist respectively and anesthesiology assistants, CRNAs and anesthesiologists respectively were consistently the bottom three specialties with lowest percentages of billed dollars which were approved (11% to 18%).ConclusionDuring 2012-2020, anesthesia providers got 11%-18% of their billed dollars approved by CMS and yet anesthesiologists averaging almost top 1% wages (99th percentile) nationally with CRNAs averaging top 5% wages (95th percentile) nationally pose the question what their wages would have been if their billed dollars were 100% approved by CMS.
A versatile high-throughput assay based on 3D ring-shaped cardiac tissues generated from human induced pluripotent stem cell derived cardiomyocytes
Authors: Seguret Magali , Davidson Patricia , Robben Stijn , Jouve Charlène , Pereira Céline , Lelong Quitterie , Deshayes Lucille , Cerveau Cyril , Le Berre Maël , Rodrigues Ribeiro Rita S. , Hulot Jean-Sébastien 
Published: March 2023

AbstractWe developed a 96-well plate assay which allows fast, reproducible and high-throughput generation of 3D cardiac rings around a deformable optically transparent hydrogel (PEG) pillar of known stiffness. Human induced pluripotent stem cell-derived cardiomyocytes, mixed with normal human adult dermal fibroblasts in an optimized 3:1 ratio, self-organized to form ring-shaped cardiac constructs. Immunostaining showed that the fibroblasts form a basal layer in contact with the glass, stabilizing the muscular fiber above. Tissues started contracting around the pillar at D1 and their fractional shortening increased until D7, reaching a plateau at 25±1%, that was maintained up to 14 days. The average stress, calculated from the compaction of the central pillar during contractions, was 1.4±0.4 mN/mm2. The cardiac constructs recapitulated expected inotropic responses to calcium and various drugs (isoproterenol, verapamil) as well as the arrhythmogenic effects of dofetilide. This versatile high-throughput assay allows multiple in situ mechanical and structural read-outs.