bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Predictive Model to Identify Treatment-related Risk Factors for Odontoid Fracture Nonunion Using Machine Learning
Authors: Leister Iris , Haider Thomas , Vogel Matthias , Vastmans Jan , Langthaler Patrick , Mattiassich Georg , Christ Alexandra , Etschmaier Martin , Eijkenboom Alexander , Burghuber Julia , Kindermann Harald , Mach Orpheus , Maier Doris , Högel Florian 
Published: January 2023

Study Design.
Multicenter retrospective analysis of routinely collected data.

Objective.
The underlying aim of this study was to identify potential treatment-related risk factors for odontoid fracture nonunion while accounting for known patient- and injury-related risk factors.

Summary of Background Data.
Type II and III odontoid fractures represent the most common cervical spine fracture in elderly patients and are associated with a relatively high nonunion rate. The management of odontoid fractures is controversial and treatment strategies range from conservative treatment to extensive surgical stabilization and fusion.

Methods.
A total of 415 individuals who sustained odontoid fracture and were treated in either of four tertiary referral centers in Austria and Germany were included in the study. We included the following potential contributing factors for fracture nonunion in cross-validated extreme gradient boosted (XGBoost) and binary logistic regression models: age, gender, fracture displacement, mechanism of injury (high vs. low energy), fracture classification (Anderson II vs. III), presence of comorbidities (Charlson comorbidity index), and treatment (conservative, anterior screw fixation with one or two screws, posterior C1/C2 spondylodesis, cervico-occipital C0–C4 fusion).

Results.
In our cohort, 187 (45%) had radiologically confirmed odontoid nonunion six months postinjury. The odds for nonunion increase significantly with age, and are lower in type III compared to type II fractures. Also, odds for nonunion are significantly lower in posterior C1/C2 spondylodesis, and C0–C4 fusion compared to conservative treatment. Importantly, odds are not statistically significantly lower in the group treated with anterior screw fixation compared to conservative treatment. The factors gender, fracture displacement, mechanism of injury, and the presence of comorbidities did not produce significant odds.

Conclusion.
Higher age, type II fractures, and conservative treatment are the main risk factors for odontoid nonunion. Anterior screw fixation did not differ significantly from conservative treatment in terms of fracture union.

Level of Evidence.
3.
Immunocompromised Children With Acute Respiratory Distress Syndrome Possess a Distinct Circulating Inflammatory Profile
Authors: Nguyen John , Thompson Jill M. , Balcarcel Daniel R. , Alder Matthew N. , McKeone Daniel J. , Halstead E. Scott , Rowan Courtney M. , Lindell Robert B. , Yehya Nadir 
Published: January 2023

IMPORTANCE:
Immunocompromised status, with and without stem cell transplant, confers a worse prognosis in pediatric acute respiratory distress syndrome. An improved understanding of the biochemical profile of immunocompromised children with acute respiratory distress syndrome would inform whether specific pathways are targetable, or merely bystanders, in order to improve outcomes in this high-risk subgroup.

OBJECTIVES:
We aimed to identify a biomarker profile of immunocompromised children, with and without stem cell transplant, independent of illness severity.

DESIGN, SETTINGS, AND PARTICIPANTS:
This was a secondary analysis of a prospective cohort study of intubated children with Berlin-defined acute respiratory distress syndrome with existing biomarker measurements conducted in a large academic PICU between 2014 and 2019.

MAIN OUTCOMES AND MEASURES:
Biomarker levels were compared between immunocompetent and immunocompromised children, with and without stem cell transplant, both prior to and after adjusting for severity of illness.

RESULTS:
In 333 children with acute respiratory distress syndrome, 84 were immunocompromised, of whom 39 had a stem cell transplant. Circulating neutrophil levels were strongly correlated with biomarkers, with 14 of 18 measured proteins differentially expressed in patients with versus without neutropenia. In order to identify biomarker levels independent of severity of illness, acute respiratory distress syndrome etiology, and neutrophil levels, we computed predicted (log-transformed) biomarker levels after adjusting for confounders using linear regression and then compared these severity-adjusted levels between immunocompetent and immunocompromised (with and without stem cell transplant) subjects using analyses of variance and post hoc Bonferroni. After multivariable adjustment, 11 biomarkers were higher in immunocompromised subjects without stem cell transplant, relative to immunocompetent, implicating endotheliopathy (angiopoietin-2), tissue damage (procollagen type III N-terminal peptide), and innate immunity. A single biomarker, C-C motif chemokine ligand 22, was lower in immunocompromised subjects with and without stem cell transplant.

CONCLUSIONS AND RELEVANCE:
Immunocompromised children with acute respiratory distress syndrome were characterized by elevations in pro-inflammatory and endothelial damage biomarkers. Our study provides insight into mechanisms underlying the molecular heterogeneity of this population and potentially identifies targetable pathways to mitigate their increased mortality risk.
Applications of Speech Analysis in Psychiatry
Authors: Dikaios Katerina , Rempel Sheri , Dumpala Sri Harsha , Oore Sageev , Kiefte Michael , Uher Rudolf 
Published: January 2023

Abstract
The need for objective measurement in psychiatry has stimulated interest in alternative indicators of the presence and severity of illness. Speech may offer a source of information that bridges the subjective and objective in the assessment of mental disorders. We systematically reviewed the literature for articles exploring speech analysis for psychiatric applications. The utility of speech analysis depends on how accurately speech features represent clinical symptoms within and across disorders. We identified four domains of the application of speech analysis in the literature: diagnostic classification, assessment of illness severity, prediction of onset of illness, and prognosis and treatment outcomes. We discuss the findings in each of these domains, with a focus on how types of speech features characterize different aspects of psychopathology. Models that bring together multiple speech features can distinguish speakers with psychiatric disorders from healthy controls with high accuracy. Differentiating between types of mental disorders and symptom dimensions are more complex problems that expose the transdiagnostic nature of speech features. Convergent progress in speech research and computer sciences opens avenues for implementing speech analysis to enhance objectivity of assessment in clinical practice. Application of speech analysis will need to address issues of ethics and equity, including the potential to perpetuate discriminatory bias through models that learn from clinical assessment data. Methods that mitigate bias are available and should play a key role in the implementation of speech analysis.
A double-blind phase II randomized controlled trial of an online cognitive bias modification for interpretation program with and without psychoeducation for people with chronic pain
Authors: Sharpe Louise , Jones Emma Blaisdale , Pradhan Poorva , Todd Jemma , Colagiuri Ben 
Published: January 2023

Abstract
Cognitive bias modification for interpretation (CBM-I) is an effective intervention for anxiety, but there is only a single trial in people with chronic pain. The aim of this randomized controlled trial was to test CBM-I with and without psychoeducation for people with chronic pain. We randomized 288 participants to 4 groups comprising treatment (CBM-I vs placebo) with or without psychoeducation. One hundred and eighty-three participants (64%) completed 4, 15-minute training sessions over 2 weeks. The coprimary outcomes were pain interference and pain intensity. We also measured interpretation bias, fear of movement, catastrophizing, depression, anxiety, and stress. Participants with more psychopathology at baseline were more likely to dropout, as were those allocated to psychoeducation. Intention-to-treat analyses using linear mixed models regression were conducted. Training effects of CBM-I were found on interpretation bias, but not a near-transfer task. Cognitive bias modification of interpretation improved both primary outcomes compared with placebo. For pain interference, there was also a main effect favoring psychoeducation. The CBM-I group improved significantly more than placebo for fear of movement, but not catastrophizing, depression, or anxiety. Cognitive bias modification of interpretation reduced stress but only for those who also received psychoeducation. This trial shows that CBM-I has promise in the management of pain, but there was limited evidence that psychoeducation improved the efficacy of CBM-I. Cognitive bias modification of interpretation was administered entirely remotely and is highly scalable, but future research should focus on paradigms that lead to better engagement of people with chronic pain with CBM-I.
The association of ambient temperature variability with blood pressure in southern China
Authors: Li Muyun , Luo Jiali , Hu Jianxiong , Meng Ruilin , Xu Xiaojun , He Guanhao , Li Xing , Liu Tao , Xiao Jianpeng , Zeng Weilin , Wang Yuqin , Ma Wenjun 
Published: January 2023

Objectives
Numerous studies have shown a positive relationship between temperature variability and mortality, but few studies have investigated the effect of temperature variability on blood pressure (BP). We aimed to estimate the effect of temperature variability on BP in Guangdong Province, southern China.

Methods
Data on meteorological factors were obtained from the Guangdong Meteorological Center, and BP was collected from a series of cross-sectional surveys conducted in Guangdong Province, China, from 2004 to 2015. There were 38 088 participants aged 18 years and over. A generalized additive model was used to estimate the association between temperature variability and BP after adjusting for confounding variables.

Results
Our study found a significant positive association between temperature variability and SBP, and this effect increased with the increment of exposure days in total population. The highest estimate was for temperature variability at 7 days lag (TV0–7) with a 0.497 (95% confidence interval, 0.335–0.660) mmHg rise of SBP for each 1°C increase of TV0–7. The effects of TV0–1 and TV0–2 on SBP were higher for hypertensives than that for normotensives, and in warm season higher than that in cold season. However, we did not observe statistical significance between temperature variability and DBP.

Conclusions
There was a positive association between temperature variability and SBP in Guangdong Province, which should be considered in clinical management and epidemiological survey of hypertension.
Conventional office blood pressure measurements and unattended automated office blood pressure compared with home self-measurement and 24-h ambulatory blood pressure monitoring
Authors: Fonseca-Reyes Salvador , Fonseca-Cortés Karla , Coca Antonio , Romero-Velarde Enrique , Pérez-Molina Jesús 
Published: January 2023

Objective
To assess whether automated office blood pressure (BP) (AOBP) measurement is a better method for measuring BP in the office than conventional techniques and an alternative to out-of-office BP measurements: home-self BP (HSBP) or ambulatory BP monitoring (ABPM).

Methods
We conducted a cross-sectional study of 74 patients and compared AOBP with the conventional technique using a mercury sphygmomanometer and with both out-to-office BP measurements: HSBP of 7 days (three measurements in the morning, afternoon, and night) and daytime ABPM. In addition, we compared BP values obtained using HSBP and ABPM to determine their level of agreement. We used ANOVA to compare means, Bland–Altman, and intraclass correlation coefficients (ICC) for concordance.

Results
BP values obtained by the two office methods were similar: conventional 147.2/85.0 mmHg and AOBP 146.0/85.5 mmHg (P > 0.05) with good agreement (ICC 0.85). The mean SBP differences between AOBP and HSBP (P < 0.001) and between AOBP and ABPM (P < 0.001) were 8.6/13.0 mmHg with limits of agreement of −21.2 to 38.5 and −18.4 to 44.3 mmHg, respectively. The average SBP values obtained by HSBP were 4.3 mmHg higher than those obtained by ABPM (P < 0.01).

Conclusion
Our study showed good agreement and concordance between the two office methods as well between the two out-to-office methods, although there was a significant difference in the mean SBP between the HSBP and ABPM. Moreover, AOBP was not comparable to either HSBP or ABPM; therefore, the estimation of out-to-office BP using AOBP is not supported.
Trimethoprim-sulfamethoxazole induced aseptic meningitis case report
Authors: Pata Giulia , Montagna Marco , Bosi Emanuele , Davalli Alberto , Rovere Querini Patrizia 
Published: January 2023

Rationale:
Drug-induced aseptic meningitis (DIAM) is an uncommon meningitis and trimethoprim with or without sulfamethoxazole is the most involved antibiotic. Although DIAM is easily treated with the discontinuation of the causative drug, the diagnosis is a big challenge for physicians, as it remains a diagnosis of exclusion. Here, we present a case report of trimethoprim-sulfamethoxazole induced aseptic meningitis in a woman with acute osteomyelitis.

Patient concerns:
A 52-year-old woman was admitted to the hospital for septic shock and acute osteomyelitis of the right homerus. She was started on antibiotic therapy with oxacillin and daptomycin, then oxacillin was replaced with cotrimoxazole, due to its excellent tissue penetration, including bone tissue. During cotrimoxazole therapy, the patient developed a fluent aphasia with ideomotor apraxia and muscle hypertonus.

Diagnosis and interventions:
Having excluded infectious, epileptic and vascular causes of the acute neurologic syndrome of our patient, given the improvement and full recovery after discontinuation of cotrimoxazole, we hypothesized a DIAM.

Outcomes:
After discontinuation of cotrimoxazole, in 48 hours the patient had a full recovery.

Lessons:
Although DIAM can be easily managed with the withdrawal of the causative drug, it can be difficult to recognize if it is not included in the differential diagnosis. An antimicrobial stewardship program with a strict monitoring of patients by infectious disease specialists is essential, not only to optimize the appropriate use of antimicrobials, but also to improve patient outcomes and reduce the likelihood of adverse events.
Combined acupuncture-medicine anesthesia used in thyroid surgery: A systematic review and meta-analysis
Authors: Zhang Wei , Zhang Meng , Han Yanxun , Liu Yuchen , Liu Yehai , Sun Chunping 
Published: January 2023

Background:
Combined acupuncture-medicine anesthesia (CAMA) is extensively used in thyroid surgery in China. We conducted a systematic review and meta-analysis to assess the efficacy and safety of CAMA.

Methods:
We searched the China National Knowledge Infrastructure (CNKI), VIP database, WanFang database, PubMed, EMBASE, and the Cochrane Library for relevant literature. The term of literature was published before April 18, 2020, and there were no restrictions on publication language, region, or publication year. The inclusion criteria included a randomized controlled trial (RCT) of acupuncture combined with cervical plexus anesthesia. We used RevMan5.3 software for data analysis. If the chi-square test showed no significant heterogeneity (P > .10, I
2 < 50%), we used the fixed-effect model to calculate risk ratio (RR) and mean difference. Otherwise, the random-effects model was used.

Results:
Overall, 18 RCTs involving 1211 patients were included in the study. The anesthesia significant rate (ASR) in the transcutaneous electrical acupoint stimulation (TEAS) plus cervical plexus block anesthesia (CPBA) and electroacupuncture (EA) plus CPBA groups was significantly higher compared with the CPBA group (TEAS + CPBA: P < .001; EA + CPBA: P < .001). The pooled effect values of the intraoperative heart rate (HR) and mean arterial pressure (MAP) were significantly lower in both the TEAS + CPBA and EA + CPBA groups relative to the control group (HR: P = .05, P < .001; the MAP: P = .002, P < .001; respectively). Moreover, the postoperative adverse reaction was markedly lower in the experimental group than in the control group (RR = 0.30, P < .001), and there was no heterogeneity between the two groups (P = .71, I
2 = 0%).

Conclusion:
Combined acupuncture-medicine anesthesia significantly increases the anesthesia significance rate, reduces the intraoperative heart rate, and blood pressure, and reduces the incidence of postoperative adverse reactions. However, more high-quality future studies should be conducted to validate the efficacy and safety of acupuncture combined anesthesia further.
Safety and efficacy of etomidate in combination with oxycodone in painless gastroscopic procedures in the elderly: A prospective randomized controlled trial study
Authors: Zhou Ying , Li Yan-Ping 
Published: January 2023

Objective:
Etomidate is often combined in rapid succession during induction of anesthesia. However, the effect of pretreatment with oxycodone on recovery of cognitive function and adverse effects has rarely been studied. We conducted a prospective randomized controlled trial to compare etomidate alone with etomidate combined with oxycodone in elderly patients undergoing painless gastroscopy.

Methods:
Hundred elderly patients undergoing painless gastroscopy were divided into a control and an observation group, with 50 cases in each group. The age, gender, height, weight, body mass index and American Society of Anesthesiologists physical status (I/II) of patients in both groups were recorded. The recovery of cognitive function was compared in both groups using the Neurobehavioral Cognitive Status Examination. Adverse events, including somatic motor reactions, hypotension, bradycardia, myocardial tremor, nausea and vomiting, and injection pain, were also recorded in both groups. Moreover, heart rate, peripheral capillary oxygen saturation, systolic blood pressure, and diastolic blood pressure were evaluated in the 2 groups at different time points.

Results:
A total of 100 patients were enrolled in this study. The demographic characteristics in the 2 groups were not significantly different (P > .05). Regarding the recovery of cognitive functions, more subjects in the observation group passed the memory, arithmetic and orientation test than in the control group (P < .05). Fewer adverse events such as dynamic body reactions, cardiac tremor, nausea and vomiting, and injection pain occurred in the observation group than in the control group (P < .05). During anesthesia and after awakening, the results of peripheral capillary oxygen saturation, systolic blood pressure and diastolic blood pressure were better in the observation group than in the control group (P < .05).

Conclusion:
Etomidate in combination with oxycodone for painless gastroscopic operation in the elderly is a safe and effective anesthetic strategy.
Change in left ventricular diastolic function after pioglitazone treatment in patients with type 2 diabetes mellitus: A protocol for systematic review and meta-analysis
Authors: Song Han , Li Yunye , Yu Ruiming , Meng Xiangbin , Bi Yanwen 
Published: January 2023

Background:
Pioglitazone is currently used as an anti-diabetic agent and can reduce cardiovascular events in in patients with type 2 diabetes mellitus (T2DM). Left ventricular diastolic dysfunction has been recognized as an early manifestation of myocardial dysfunction in T2DM patients. This systematic review and meta-analysis aimed to investigate changes in the left ventricular diastolic function after the treatment of pioglitazone.

Methods:
A systematic literature search of PubMed, Embase, and the Cochrane Library until May 2021 with keywords pioglitazone and left ventricular diastolic function was performed in accordance with the meta-analysis of observational studies in epidemiology guidelines and preferred reporting items for systematic reviews and meta-analyses statement. Three reviewers independently selected the studies and extracted data. Quality assessment of the included studies was undergone. A fixed effects model was used to calculate overall effect sizes. Subgroup analyses were subsequently performed. A fixed effects model was used to calculate the overall effect size. Subgroup analyses were then performed.

Results:
Seven studies with 233 patients were investigated. We found pioglitazone significantly improved hemoglobin A1c (%) in patients with T2DM and left ventricular diastolic function had an improvement tendency (weighted mean difference [WMD], 0.03; 95% confidence interval [CI], 0.01–0.05, P < .01) despite moderate heterogeneity (I
2 = 66%). Subsequent subgroup analysis indicated that left ventricular diastolic function were significantly improved (WMD, 0.20; 95% CI, 0.12–0.29, P < .001) in T2DM patients whose average age < 55 after receiving pioglitazone treatment. However, in T2DM patients with mean age ≥ 55 years, there was no significant improvement of left ventricular diastolic function (WMD, 0.02; 95% CI, 0–0.04, P = .04).

Conclusion:
Pioglitazone treatment significantly improved left ventricular diastolic function in type 2 diabetic patients with a mean age of < 55 years, but did not improve left ventricular diastolic function in patients with a mean age of ≥ 55 years.
Glioblastoma in the contralateral cerebral hemisphere with previous surgery for meningioma: A case report
Authors: Wang Zhe , Sun Shushu , Xie Kunming , Miao Junjie 
Published: January 2023

Rationale:
Meningioma and glioblastoma (GBM) are 2 common intracranial tumors with different pathophysiologies and prognoses. It is rare for these 2 kinds of tumors to occur in the same patient. Most of the similar cases reported in the literature have been treated with radiotherapy, while cases without radiotherapy are rare. In particular, GBM in the contralateral cerebral hemisphere after resection of meningioma has not been reported.

Patient concerns:
We present a case of a 66-years-old man with GBM in the right temporal lobe after previous resection of a benign meningioma of the left frontal lobe without radiotherapy.

Diagnoses:
The patient was admitted to our hospital for the first time because of right upper limb weakness. Brain magnetic resonance imaging indicated a space-occupying lesion in the left frontal area. Surgical treatment was performed, and postoperative pathology confirmed a meningioma. The patient was readmitted to the hospital 3 years after surgery of the meningioma due to a new lesion of the right temporal lobe and underwent reoperation. The postoperative pathological results showed GBM.

Interventions:
The patient underwent 2 operations, and the postoperative pathologies were meningioma and GBM. In addition, the patient received concurrent chemoradiotherapy and 2 cycles of temozolomide adjuvant chemotherapy.

Outcomes:
During the last 4 months of follow-up, the patient was in good condition with no recurrence of the tumor.

Lessons:
The development of GBM without radiotherapy after meningioma surgery is very rare, especially at different sites, and it is necessary to accumulate relevant cases to reveal the causes of the disease and provide more evidence for the treatment of similar patients in the future.