bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of surgical site infection among women following cesarean delivery in eastern Ethiopia: a prospective cohort study
Authors: Adane Amlak , Gedefa Leta , Eyeberu Addis , Tesfa Tewodros , Arkew Mesay , Tsegaye Setegn , Getachew Tamirat , Debella Adera , Yadeta Elias , Abdisa Lemesa , Dheresa Merga 
Published: March 2023

Background:
Despite the availability of prophylactic antibiotics prior to skin incisions, surgical site infection (SSI) following cesarean section (CS) remains an unresolved health issue. As a result, this study aimed to assess the incidence and predictors of SSI after a CS.

Methods:
The authors conducted a prospective cohort study in eastern Ethiopia. The women were serially enrolled until the desired sample size was reached. A structured questionnaire was used to collect data. Women were followed at the hospital during their weekly visits. Culture-based microbiological methods were used to identify causal agents. A binary logistic regression model was used to identify the predictors of SSI after CS.

Results:
Among serially enrolled women, 336 were followed for 30 days. The incidence of SSI was 7.74% (95% CI: 7.68–7.80). Rupture of the membrane before operation [adjusted odds ratio (AOR)=3.75, 95% CI: 1.85–16.6], labor duration greater than 24 h (AOR=4.04, 95% CI: 1.52–10.79), and postoperative hemoglobin less than 11 g/dl (AOR=3.42, 95% CI: 1.32–8.87) were all significantly associated with SSI. The most common isolated pathogen was Staphylococcus aureus, followed by Escherichia coli.

Conclusions:
Nearly one-tenth of the women developed SSIs. Factors such as rupture of the membrane before the operation, absence of antenatal care, labor duration greater than 24 h, a midline skin incision, and postoperative hemoglobin less than 11 g/dl were the predictors of SSI. To reduce the incidence of SSI, policymakers should consider the importance of high-quality antenatal care, shorten the duration of labor, and maintain women’s hemodynamics in future SSI prevention bundles.
Infant Electrocution Due to Smartphone Charge Cable—A Hidden Public Health Risk
Authors: Dündar Ahmet Sedat , Sarın Abdullah Benna 
Published: March 2023

Abstract
The report examines the autopsy and scene of accident findings of a 9-month-old male infant who died from electric shock when he bit a telephone charge cable plugged into a 3-socket extension lead.
At the time of the incident, the infant's father was working outside and his mother had gone to the bathroom, leaving the infant alone in the sitting room. The infant crawled across the floor, reached a telephone charge cable that was plugged into a 3-socket extension lead, and bit the end of the cable. He was found lying motionless on the floor, holding the cable in his hand. He was sent to center for the medicolegal autopsy, during which burns and electric shock entry wounds were found on his mouth, tongue, and right hand. Histopathological examination of the samples taken from the wounds garnered findings consistent with electric shock and thermal effect.
This article presents findings of an electric shock entry wound on the tongue, which is rarely seen as the result of a domestic accident. Education is needed to increase awareness among parents about accidents in the home involving children and to encourage preference for electrical products that have shown high success in safety tests.
“Montelukast attenuates retraction of expanded flap by inhibiting capsule formation around silicone expander via TGF-β1 signaling.”
Authors: Dong Chen , Yu Zhou , Du Jing , Zhang Yu , liu Wei , Huang Zhaosong , Xiong Shaoheng , Wang Tong , Song Yajuan , Ma Xianjie 
Published: March 2023

Background:
Tissue expansion has tremendous applications in plastic surgery, but flap retraction provides insufficient tissue for use. Inspired by the use of montelukast to suppress capsular contracture, we investigated the effects of montelukast on capsule formation around the expander and retraction of the expanded scalp of the rat.

Methods:
Thirty-six male Sprague Dawley rats were randomly divided into control and montelukast groups. In each group, 12 expanded flaps with or without capsules were harvested for histological and molecular analysis; the six remaining expanded flaps were transferred to repair defects. Myofibroblast and TGF-β1 expression in the capsule was determined using immunofluorescence. Capsule ultrastructure was observed using transmission electron microscopy. Related protein expression in the capsules was detected using Western blot analysis.

Results:
A comparison of control and montelukast groups revealed that areas of the harvested expanded flaps with capsules were greater (2.04 ± 0.11 cm 2 vs. 2.42 ± 0.12 cm 2, respectively; p = 0.04); the retraction rate decreased (41.3 ± 2.16% vs. 28.13 ± 2.17%, respectively; p < 0.01). However, the increased areas and decreased retraction disappeared after capsule removal. The number of myofibroblasts declined. Thin, sparse collagen fibers were observed in the capsules. The expression of COL1, COL3, TGF-β1, EGR1, and phosphorylated ERK1/2 in the capsules decreased. Furthermore, the recipient area repaired by the transferred expanded flap was increased from 4.25 ± 0.39 cm 2 to 6.58 ± 0.31 cm 2（p < 0.01).

Conclusions:
Montelukast attenuates retraction of the expanded flap by inhibiting capsule formation through suppressing TGF-β1 signaling.
Establishing a xenograft model with CD-1 nude mice to study human skin wound repair
Authors: Abbas Darren B. , Griffin Michelle , Fahy Evan J. , Spielman Amanda F. , Guardino Nicholas J. , Pu Adrian , Lintel Hendrik , Lorenz H. Peter , Longaker Michael T. , Wan Derrick C. 
Published: March 2023

Background:
A significant gap exists in the translatability of small animal models to human subjects. One important factor is poor laboratory models involving human tissue. Thus, we have created a viable postnatal human skin xenograft model using athymic mice.

Methods:
Discarded human foreskins were collected following circumcision. All subcutaneous tissue was removed from these samples sterilely. Host CD-1 nude mice were then anesthetized, and dorsal skin was sterilized. A 1.2cm diameter, full-thickness section of dorsal skin was excised. The foreskin sample was then placed into the full-thickness defect in the host mice and sutured into place. Xenografts underwent dermal wounding using a 4 mm punch biopsy after engraftment. Xenografts were monitored for 14 days after wounding and then harvested.

Results:
At 14 days postoperatively, all mice survived the procedure. Grossly, the xenograft wounds showed formation of a human scar at POD-14. H&E and Masson Trichome staining confirmed scar formation in the wounded human skin. Using a novel Artificial Intelligence (AI) algorithm using Picrosirius-Red staining, scar formation was confirmed in human wounded skin compared to the unwounded skin. Histologically, CD31 + immunostaining confirmed vascularization of the xenograft. The xenograft exclusively showed human collagen I, CD26 +, and human nuclear antigen in the human scar without any staining of these human markers in the murine skin.

Conclusion:
The proposed model demonstrates wound healing to be a local response from tissue resident human fibroblasts and allows for reproducible evaluation of human skin wound repair in a preclinical model.
Tubular Secretory Solute Clearance and HIV Infection
Authors: Garimella Pranav S. , Scherzer Rebecca , Kestenbaum Bryan R. , Hoofnagle Andrew N. , Jotwani Vasantha , Gustafson Deborah , Karim Roksana , Sharma Anjali , Cohen Mardge , Dumond Julie , Abraham Alison , Estrella Michelle , Shlipak Michael G. , Ix Joachim H. 
Published: March 2023

Background:Tubular secretion is an important kidney function responsible for the clearance of numerous medications, including antibiotics and antivirals. It is unknown whether persons living with HIV have lower secretion compared with HIV-uninfected persons, which might predispose them to the risk of progressive kidney disease or adverse drug events.Setting and Methods:We evaluated a panel of 6 endogenous secretory solutes in 199 women living with HIV (WLWH) and 100 women without HIV enrolled in the Women's Interagency HIV Study. Secretory clearance was estimated as the urine-to-plasma ratio of each solute, with adjustment for urine tonicity. Using multivariable linear regression analysis, we compared differences in levels of secretory solute clearance between women with and without HIV and evaluated characteristics associated with secretion.Results:WLWH were older (median 40 vs. 38 years) but had similar estimated glomerular filtration rate (eGFR, 96 vs. 100 mL/minute/1.73 m2) compared with those without HIV. African American and Latino race, diabetes, diastolic blood pressure, smoking, hepatitis C, peak HIV viral load, and current and nadir CD4 count were associated with differences in clearance of at least 1 marker after multivariable adjustment. The secretory clearance of 3 solutes (cinnamoylglycine, kynurenic acid, and pyridoxic acid) were on average 10%–15% lower among WLWH compared with those without HIV independent of eGFR, albuminuria and chronic kidney disease risk factors, including HCV, and injection drug use.Conclusions:HIV is associated with reduced secretion among women with preserved eGFR. The implications of these findings for drug dosing and adverse events need to be evaluated.
Effects of Resveratrol Supplementation on Nonalcoholic Fatty Liver Disease Management
Authors: Nemati Arefe , Nikniaz Zeinab , Mota Ali 
Published: March 2023

In this study, we aimed to systematically review the studies that investigated the effect of resveratrol in nonalcoholic fatty liver disease (NAFLD). A systematic search of different databases was conducted until June 2021 and a meta-analysis was completed.
Six trials involving 232 participants were included. The meta-analysis results showed that serum triglycerides (P = .04), interleukin-6 (P = .01), tumor necrosis factor-α (P = .02), and systolic blood pressure (P = .04) levels were decreased significantly in the resveratrol group compared with the placebo group, while other parameters were not changed significantly. Although resveratrol might attenuate NAFLD development, more high-quality trials are required in this field.
Temperatures and Voltages From the Electroconvulsive Therapy Stimulus
Authors: Swartz Conrad , Mirkovich David , Dietze Dominik 
Published: March 2023

Introduction
Brain voltage and temperature during electroconvulsive therapy (ECT) are not widely understood but are commonly mischaracterized as resembling a blast.

Method
To better understand brain voltage and temperature during ECT, basic mathematical structural models were constructed and calculations were made. In addition, thermographic images were recorded before and after ECT stimuli were applied to a pork shoulder.

Results
A basic structural voltage model indicates that the voltage drop across single brain neurons is about 6 mV, with a gradient of 0.6 V/cm. This is an order of magnitude smaller than the action potential. Basic structural temperature models indicate that 100 joules raises skin temperature underneath ECT electrodes no more than 1°C, and within the brain by much less. The average temperature increase at each electrode was 0.70 to 0.94°C.

Conclusions
Voltage gradients and temperatures in the brain during the ECT stimulus are well within the range of ordinary physiological functioning. These results are consistent with previous reports that only a small fraction of the electrical stimulus enters the brain.
Improvement of language function after C7 neurotomy at the intervertebral foramen in patients with chronic post-stroke aphasia: a phase I cohort study
Authors: Feng Juntao , Ma Xingyi , Hu Ruiping , Lv Minzhi , Li Tie , Li Peiyang , Qi Wenjun , Xu Miaomiao , Yang Jingrui , Shen Yundong , Xu Wendong 
Published: March 2023

ABSTRACTBackgroundPost-stroke aphasia is a common but intractable sequela which still needs new and more effective treatments. Evidence from follow-ups after contralateral seventh cervical nerve transfer surgery indicated that nerve transection leads to immediate language improvements in patients with right post-stroke aphasia.ObjectiveThrough a prospective cohort design, this study aims to prove that C7 neurotomy at the intervertebral foramen (NC7) combined with a 3-week intensive speech and language therapy (iSLT) can improve the language function in post-stroke aphasia patients.MethodsIn this study, patients aged over 18 years old and had been diagnosed with post-stroke aphasia for 1 year or longer were included. Primary outcomes were the change in the ability to retrieve personally relevant words in Boston Naming Test (BNT) with follow-up assessment after three-weeks’ iSLT post-operatively. As well as several secondary outcome measures including the Western Aphasia Battery (WAB), daily communication abilities (measured by the Communication Activities of Daily Living Third Edition [CADL-3]) and Fugl-Meyer of upper limb part (UEFM).ResultsThe average increase of BNT score was 11.2 points from baseline to 3 weeks post-operatively (P=0.001, 95%CI: 8.1-14.1). The WAB and CADL-3 assessment showed 9.4, 10.4 points increasing in average (P<0.005, 95%CI: 4.6 to 14.1; P<0.001, 95%CI:6.7 to 14.1) from baseline to 4-week follow-up, respectively. The mean difference from baseline to 3 weeks post-operatively in UEFM score decreased 0.8 points (95% CI: -3.2 to 1.6; p<0.405).ConclusionsNC7 plus iSLT significantly improved the language function in patients with post-stroke aphasia, and did not significantly affect the motor function of the right limb. The mechanism of this surgery needs to be further explored.
Association of Free-Living Diet Composition and Plasma Lipoprotein(a) Levels in Healthy Adults
Authors: Matveyenko Anastasiya , Seid Heather , Kim Kyungyeon , Matienzo Nelsa , Ramakrishnan Rajasekhar , Thomas Tiffany , Reyes-Soffer Gissette 
Published: March 2023

ABSTRACTBackgroundLipoprotein (a) [Lp(a)] is an apoB100-containing lipoprotein with high levels positively associated with atherosclerotic cardiovascular disease (ASCVD). Lp(a) levels are largely genetically determined. Currently, the only approved therapy for patients with extreme elevations of Lp(a) is lipoprotein apheresis, which eliminates apoB100-containing particles including Lp(a). The current study analyzed the association of free-living diet composition with plasma Lp(a) levels.MethodsDietary composition data from 28 diverse participants was collected via a standardized protocol by registered dietitians using 24-hour recalls. Data were analyzed with the Nutrition Data System for Research (Version 2018). Diet quality was calculated using the Healthy Eating Index (HEI) score. Fasting plasma Lp(a) levels were measured via an isoform-independent ELISA.ResultsSubjects self-reported race/ethnicity [Black (n=18); Hispanic (n=7); White (n=3)]. The mean age was 48.3±12.5 years with 17 males. Median level of Lp(a) was 79.9 nmol/L (34.4-146.0) and was negatively associated with absolute (g/d) and relative (percent calories) intake of dietary saturated fatty acid (SFA) (SFA absolute: R= -0.43, p= 0.02, SFA calorie %: R= -0.38, p= 0.04), absolute palmitic acid intake (palmitic absolute: R= -0.38, p= 0.04), and absolute steric acid intake (steric absolute: R= -0.40, p= 0.03). Analyses of associations with HEI when stratified based on Lp(a) levels > or ≤ 100nmol/L revealed no significant associations with any of the constituent factors.ConclusionsWe found a negative relationship between dietary saturated fatty acid intake and Lp(a) levels in a diverse cohort of individuals. The mechanisms underlying this relationship require further investigation.
ACEI or not to ACEI: Review on using ACEI and ARBs on COVID-19 patients: Systemic review
Authors: Walia Ribhav 
Published: March 2023

AbstractPurpose and motivation of this studyAngiotensin-converting enzyme inhibitors (ACEI) and Aldosterone receptor blockers (ARBs) are one most commonly used drugs for the treatment of cardiovascular disease among other comorbidities. As multiple studies have shown that covid virus binds to the ACE2 receptor for entry into the cell. ACEI and ARBs are shown to modulate the ACE2 receptor hence, it is important to see if there are any correlations between the use of medicine and the infectivity of COVID-19. The purpose of this study is to find if the use of ACEI /ARBs can in fact increase or decrease the spread of COVID-19.MethodThis is a systemic review study during which all studies which helped us answer the question, of how the use of ACEI and ARBs can affect the transmission of the COVID-19 virus, were analyzed and reviewed to draw a conclusion about clinical safety and requirements of ACEI and ARBs in COVID-19 patients.ResultAfter a complete review of all the available data very conflicting results were found. Many studies showed an increase in the transmission of COVID-19 while others showed a decreased risk of COVID-19 transmission with ACEI and ARBs use. Both results were statistically significant.ConclusionWith these conflicting results the question we started with comes up again. Should we or should we not use ACEI & ARBs with covid patients? What should be the best clinical response with the use of ACEI & ARBs if it modulates transmission? To answer these, one must look not only at the statistically significant results of studies but also at the disease progression without ACEI & ARBs treatment regimes. Due to the small amount of data, there is currently no clear conclusive evidence to suggest that ACE inhibitors either increase or decrease the risk of COVID-19 transmission or the severity of the disease. Thus, more and larger studies should be developed to find a concrete answer. Until that these medicines should not be discontinued as the morbidities of cardiovascular diseases are high, and the use of ACEI and ARBs is central to the treatment.
Performance of ChatGPT and GPT-4 on Neurosurgery Written Board Examinations
Authors: Ali Rohaid , Tang Oliver Y. , Connolly Ian D. , Zadnik Sullivan Patricia L. , Shin John H. , Fridley Jared S. , Asaad Wael F. , Cielo Deus , Oyelese Adetokunbo A. , Doberstein Curtis E. , Gokaslan Ziya L. , Telfeian Albert E. 
Published: March 2023

AbstractBackgroundInterest surrounding generative large language models (LLMs) has rapidly grown. While ChatGPT (GPT-3.5), a general LLM, has shown near-passing performance on medical student board examinations, the performance of ChatGPT or its successor GPT-4 on specialized exams and the factors affecting accuracy remain unclear.ObjectiveTo assess the performance of ChatGPT and GPT-4 on a 500-question mock neurosurgical written boards examination.MethodsThe Self-Assessment Neurosurgery Exams (SANS) American Board of Neurological Surgery (ABNS) Self-Assessment Exam 1 was used to evaluate ChatGPT and GPT-4. Questions were in single best answer, multiple-choice format. Chi-squared, Fisher’s exact, and univariable logistic regression tests were employed to assess performance differences in relation to question characteristics.ResultsChatGPT (GPT-3.5) and GPT-4 achieved scores of 73.4% (95% confidence interval [CI]: 69.3-77.2%) and 83.4% (95% CI: 79.8-86.5%), respectively, relative to the user average of 73.7% (95% CI: 69.6-77.5%). Question bank users and both LLMs exceeded last year’s passing threshold of 69%. While scores between ChatGPT and question bank users were equivalent (P=0.963), GPT-4 outperformed both (bothP<0.001). GPT-4 answered every question answered correctly by ChatGPT and 37.6% (50/133) of remaining incorrect questions correctly. Among twelve question categories, GPT-4 significantly outperformed users in each but performed comparably to ChatGPT in three (Functional, Other General, and Spine) and outperformed both users and ChatGPT for Tumor questions. Increased word count (odds ratio [OR]=0.89 of answering a question correctly per +10 words) and higher-order problem-solving (OR=0.40,P=0.009) were associated with lower accuracy for ChatGPT, but not for GPT-4 (bothP>0.005). Multimodal input was not available at the time of this study so, on questions with image content, ChatGPT and GPT-4 answered 49.5% and 56.8% of questions correctly based upon contextual context clues alone.ConclusionLLMs achieved passing scores on a mock 500-question neurosurgical written board examination, with GPT-4 significantly outperforming ChatGPT.
Age-specific findings on lifestyle and trajectories of cognitive function from the Korean Longitudinal Study of Aging
Authors: Lim Seungju , Yoo Eunyoung , Hong Ickpyo , Park Jihyuk 
Published: March 2023

ABSTRACTBackgroundThere is a paucity of longitudinal studies in the literature which have investigated age-related differences in the relationship between lifestyle factors and cognitive decline. Thus, the purpose of this study was to investigate which lifestyle factors at baseline would slow the longitudinal rate of cognitive decline in young-old (55-64 years), middle-old (65-74 years), and old-old (75+ years) individuals.MethodsWe conducted an 11-year follow-up of 6189 older adults from the Korean Longitudinal Study of Aging, which is a cohort of community-dwelling older Koreans. Lifestyle factors including physical activity (PA), social activity (SA), smoking, and alcohol consumption were assessed at baseline. Cognitive function was measured at 2-year intervals over a duration of 11 years. Latent growth curve modeling (LGM) and multigroup analyses (MGA) were performed.ResultsThe influence of lifestyle factors on the rate of cognitive decline differed by age. Smoking at baseline (−0.05, 95% CI −0.11 to −0.001, per study wave) accelerated the cognitive decline in young-old individuals while frequent SA participation at baseline (0.02, 95% CI 0.01 to 0.03, per study wave) decelerated the cognitive decline in middle-old individuals. None of the lifestyle factors in this study decelerated the cognitive decline in old-old individuals.ConclusionCognitive strategies through modifiable lifestyle factors such as smoking cessation in the young-old and frequent SA participation in the middle-old age groups may have great potential in preventing cognitive decline. Since the influence of lifestyle factors varies by age group, age-specific approaches are recommended for promoting cognitive health.What is already known on this topicPrevious studies have shown that lifestyle factors are associated with cognitive decline in older adults. However, longitudinal population-based studies are scarce, and few studies have considered age differences based on the heterogeneity of the elderly population.What this study addsThe results of the present study show a difference in the influence of lifestyle factors on the rate of cognitive decline with age. Smoking at baseline accelerated cognitive decline in the young-old (55-64 years) group, while frequent social activity participation at baseline decelerated in the middle-old (65-74 years) group. In the old-old group (75+ years), there were no lifestyle factors that could decelerate cognitive decline.How this study might affect research, practice or policyThese results emphasize the importance of an age-specific modifiable lifestyle approach for promoting cognitive health in the elderly.