bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the Utility and Challenges of Machine Learning in Spinal Deformity Management
Authors: Khan Jibran A. , Houdane Abdelrafour , Hajja Amro , Nassar Joseph E. , Alsoof Daniel , Diebo Bassel G. , Sardar Zeeshan M. , Abd-El-Barr Muhammad M. , Bourghli Anouar , Konbaz Faisal 
Published: February 2025

Study design.
Systematic review

Objective.
To review the application of machine learning (ML) in scoliosis management, while addressing the limitations and challenges in implementing ML in scoliosis practice.

Summary of Background Data.
ML has revolutionized medical research, particularly in scoliosis management, enabling automated assessment of diagnosis, disease progression, and treatment response.

Methods.
A systematic review of the literature was conducted following the PRISMA guidelines and was registered in the PROSPERO database. The literature search included the PubMed, Embase, and Google Scholar databases. Studies since 2019 were included if they used ML models in scoliosis management. Studies that did not meet the inclusion criteria were excluded. Data extraction focused on the scoliosis type, sample size, model utility, ML model architecture, model development, training data, cross-validation, single- or multi-center study design, and study/model limitations.

Results.
The study included 63 articles that underwent full-text review. The most commonly studied disorders were adolescent idiopathic scoliosis (n=48) and adult spinal deformity (n=15), with five studies including other disorders and one not specifying. The uses of ML were diagnosis/classification (n=38), operative outcomes (n=11), prognosis (n=7), and risk assessment (n=7). The most used models included convolutional neural networks (n=38), random forest (n=11), and support vector machines (n=9). Only 16 studies reported external validation, while none implemented their model in practice. Common limitations reported were small sample size, artifacts obscuring images, potential selection bias, limited variety in disease severity, exclusion of parameters, lack of patient diversity, varying accuracy with curve site and severity, retrospective study, and lack of external validation.

Conclusion.
The current state of machine learning in scoliosis management is promising, showing potential for improving diagnosis and optimizing treatments. However, significant challenges remain. To fully understand the benefits of ML, larger, multi-center studies with more validation and effective implementation strategies are needed.
Characterization of Spine Implant Device Recalls
Authors: Goheer Haseeb E. , Botros Mina , Ghattas Yasmine S. , Yang Phillip T. , Irwin Rebecca M. , Puvanesarajah Varun 
Published: February 2025

Study Design.
Observational epidemiological study.

Objective.
To identify and comprehensively assess reasons for recalls of spinal implant devices used in patients over the past 21 years.

Summary of Background Data.
The number of spine implant devices on the market continues to rise. Although the Food and Drug Administration (FDA) regulates the safety of these devices, there is a paucity of literature on the reasons spine implant devices are recalled.

Methods.
The FDA device recall database was queried using the search term “spine” for recalls between 2003 and 2024. Data were collected regarding recall class, recall reason, FDA 510(k)/premarket approval decision date, product manufacturer, and device indication. The data was then reviewed to identify recalls for spine implant devices.

Results.
A total of 386 spine implant devices were identified between January 2003 and December 2024. Among all recalls classified, 3.4% (n=13) were class I, 88.1% (n=340) were class II, and 8.5% (n=33) were class III. The most common reasons for recall were “Device/Component design” (52.8%) and “Packing/Processing Control” (24.1%). The median number of devices recalled by manufacturers included in the study was two with the highest being 41 devices.

Conclusions.
Overall, 76.9% of spine implant recalls reviewed were primarily due to issues with device design and processing control. 88.1% of recalls were classified with a class II FDA designation. This is the first study to present a retrospective regulatory analysis of FDA spine implant recalls and highlights the importance of premarket analysis and postmarketing surveillance to improve device safety.

Level of Evidence.
4.
Dual Sustained-Release BMP7-Nanoparticle Hydrogel Scaffolds for Enhanced BMSC Neuronal Differentiation and Spinal Cord Injury Repair
Authors: Sun Xudong , Zhang Heng , Huang Shiyuan , Li Kuanxin , Wang Xuyi 
Published: February 2025

Study Design:
Preclinical experimental study

Objective:
To explore the use of hydrogels as bioactive scaffolds for encapsulating bone marrow mesenchymal stem cells (BMSCs) to enhance their therapeutic potential in spinal cord injury (SCI). This study further aims to evaluate the added value of a BMP7 nanoparticle delivery system in overcoming the limitations of BMSCs alone for SCI repair.

Summary of Background Data:
SCI leads to significant neuron loss and functional impairment. While BMSC-based stem cell therapies show promise, their efficacy is limited by challenges such as the instability of bone morphogenetic protein (BMP)-7 in inducing neuronal differentiation. High concentrations of BMP7, though effective in promoting neuronal differentiation, may cause inflammation, necessitating the development of a delivery system for sustained and localized release.

Methods:
BMSCs were isolated from Sprague-Dawley rats, and BMP-7’s effects on neuronal differentiation were assessed via western blotting. BMP7-loaded nanoparticles (NPs) and BMSCs were co-loaded into a gelatin methacrylate (Gel-MA) hydrogel scaffold, with a cell loading density of 1 × 10⁵ cells/μl. BMP7 was encapsulated at a 0.04% (w/V) concentration, corresponding to approximately 0.4 ng BMP7 per μl of hydrogel. Optimization was performed using mechanical, cytotoxicity, and neuronal marker analyses. Scaffold properties, including water absorption, BMP7 release, and BMSC morphology, were characterized. Therapeutic efficacy was evaluated in a rat SCI model using motor function recovery, histological analysis, and molecular assessments.

Results:
BMP-7 effectively promoted BMSC differentiation into neurons while suppressing glial cell development. The BMP7-NPs/Gel-MA scaffold ensured sustained BMP7 release, achieving optimal differentiation at a 0.04% (w/V) BMP7 concentration. In vivo, the scaffold combined with BMSCs enhanced neuronal proliferation and differentiation, stimulated myelin regeneration, reduced lesion volume, and significantly improved motor function recovery.

Conclusion:
The BMP7-NPs/Gel-MA scaffold provides sustained delivery of BMP-7, effectively directing BMSC differentiation into neuron-like cells while avoiding glial commitment. Combined with BMSCs, it offers a promising therapeutic strategy for SCI repair.
Nondrainage Scleral Buckling in the Modern Vitrectomy Era
Authors: Barile Gaetano R , Gupta Rohun , Engelbert Michael , Kaden Talia R , Schiff William M 
Published: February 2025

Purpose:
To evaluate outcomes of rhegmatogenous retinal detachment (RRD) treated with a scleral buckle (SB) without external drainage of subretinal fluid during the modern vitrectomy era.

Methods:
The records of 107 eyes of 107 patients that underwent treatment with nondrainage SB surgery for primary RRD with at least 3 months of follow-up were reviewed.

Results:
SB surgery included segmental elements (radial, 44.9%; circumferential, 23.4%) and encircling procedures (31.8%). Most (68.2%) patients were under age 60 years, and most eyes (89.7%) were phakic. Single breaks were present in 53.3% of the eyes. The macula was attached preoperatively in 66 (61.7%) eyes. Myopia > 5.5 diopters (35.5%) and lattice degeneration (48.6%) were notable risk factors. Posterior vitreous detachment (PVD) was present in 37.4% of the eyes. Single surgery retinal reattachment was achieved in 104 eyes; three of these eyes also received pneumatic gas injections postoperatively. Four eyes underwent anatomically successful repeat surgery, including one eye that developed a recurrent RRD after release of an encircling element. One eye underwent removal of an exposed SB without sequalae, and one eye developed persistent diplopia treated with prism.

Conclusions:
With proper case selection, nondrainage SB remains an excellent surgical procedure for repair of RRD in the modern vitrectomy era.
Intraoperative Three-Dimensional Fluorescein Angiography-Guided Pars Plana Vitrectomy for the Treatment of Multiple Retinal Diseases
Authors: Wang Xi , Ling Ruolan , Cheng Hongzhuang , Shen Yadan , Chen Li , Ning Xinru , Guo Chuyun , Li Jie , Jie Zhong , Wang You 
Published: February 2025

Purpose:
To explore the effectiveness and practicality of intraoperative fluorescein angiography (IOFA) in both common and rare retinal diseases.

Methods:
We conducted a case series study involving three patients with vascular abnormality from various causes. A custom-designed, single-photon ultra-wideband spectral light source and integrated filters were utilized to perform IOFA. The cases included one patient with diabetic retinopathy, one with Coat’s disease, and one with familial exudative vitreoretinopathy (FEVR). IOFA was performed, and individualized treatment was conducted based on the angiographic findings.

Results:
All three patients had successful IOFA, and two of them also underwent pars plana vitrectomy (PPV) guided by the IOFA results. Postoperative outcomes were favorable, with controlled disease progression and improved or stable vision. The diabetic retinopathy patient’s vision improved significantly post-surgery, the Coats disease patient’s retinal detachment resolved without recurrence, and the FEVR patient showed no further bleeding on follow-up.

Conclusion:
The integration of an enhanced light source and filters reduced the transition time from standard surgical mode to angiography mode to just 10 seconds. Moreover, this study demonstrates that IOFA can effectively guide PPV surgeries and treatment for both common and rare retinal vascular diseases, offering a promising direction for personalized retinal disease management. In addition, further research and clinical trials are warranted to confirm the efficacy of IOFA-guided targeted retinal photocoagulation, particularly in diabetic retinopathy-induced vitreous hemorrhage.
Isolated vitritis as the presenting feature of disseminated Mycobacterium chelonae subspecies gwanakae, a novel subspecies
Authors: Massenzio Samantha S , Kuriyan Ajay E. , Milman Tatyana , Pecora Nicole D. , Pettengill Matthew A. , Zurlo John J , Deaner Jordan D 
Published: February 2025

Purpose:
To report a case of isolated vitritis as the presenting feature of a disseminated infection with Mycobacterium chelonae subspecies gwanakae, a novel subspecies.

Methods:
Case report.

Results:
A 66-year-old male who presented with progressive floaters and blurred vision was found to have isolated vitritis of the left eye. Diagnostic vitrectomy revealed acid-fast bacilli in the vitreous. Whole genome sequencing identified the organism as Mycobacterium chelonae subspecies gwanakae, a recently identified novel subspecies. The patient was admitted for further evaluation and treatment. Punch biopsies of the numerous ulcerative skin lesions revealed acid-fast bacilli. Magnetic resonance imaging revealed osteomyelitis underlying the soft tissue infections, requiring incision and drainage. Biopsy of the bone also revealed acid-fast bacilli. He was treated with weekly intravitreal amikacin and empiric intravenous azithromycin, imipenem, and tobramycin. His ocular infection responded well to treatment with resolution of the vitritis and improvement in visual acuity. Unfortunately, his systemic condition deteriorated, and he declined further intervention, ultimately succumbing to his systemic infection 12 weeks after presentation.

Conclusion:
Isolated vitritis can be the presenting feature of a severe disseminated Mycobacterium chelonae subspecies gwanakae infection.
Active Osseointegrated Steady-State Implant System: Surgical and Clinical Performance
Authors: Ordoñez-Ordoñez Leornardo , Caraballo José Agustin , Ortiz Jorge Guillermo Cabrera , Eslait Francisco Gonzalez , Saffon Rafael Jaramillo , Lora José Gabriel , Hernandez Santiago , Guzman Jose , Rincon Luz Adriana , Buzo Byanka Cagnacci 
Published: February 2025

Purpose
We aimed to investigate the surgical outcomes and clinical performance of an active osseointegration implant system that uses piezoelectric technology.

Methods
This national, multicenter, prospective, repeated measures study was approved by the Ethics Committee (opinion no. CEISH 0559-2019). The sample included patients with conductive hearing loss (CHL), mixed hearing loss (MHL), or single-sided deafness (SSD) who were eligible for osseointegrated implant surgery. Surgical parameters were assessed, along with functional and effective gain (FG and EG) and self-perception of benefits, which were evaluated between 3 and 6 months after activation. Participants also completed the Client Oriented Scale of Improvement (COSI) questionnaire to subjectively report expected and perceived benefits.

Results
A total of 580 participants aged 5 to 73 years were included in the study between June 2020 and April 2023. Most participants were diagnosed with CHL (58.8%), followed by MHL (28.8%) and SSD. 11.4% of the surgeries involved conversion of other devices to the piezoelectric system. The mean surgery duration was 54 min, and the mean skin thickness was 5.6 mm. Soft tissue reduction was required for 4% of the participants, while 21.2% required bone polishing. The mean PTA (pure tone average) FG was 38.6 dB for participants with CHL, 44.4 dB for those with MHL, and 66.1 dB for those with SSD.

Conclusion
These results confirmed the clinical safety, performance, and benefits of an innovative active transcutaneous bone conduction implant with a piezoelectric transducer design for patients with CHL, MHL, or SSD.
Surgical Transcanal Procedure for Injection of Cells and Substances into the Human Cochlear Modiolus
Authors: Cayé-Thomasen Per , Erfurt Peter , Baumhoff Peter , Kral Andrej , Navntoft Charlotte Amalie 
Published: February 2025

Introduction
Cochlear implants (CIs) enhance hearing by stimulating spiral ganglion neurons (SGNs) but are less effective in individuals with compromised SGN functionality. Advances in regenerative medicine suggest that local delivery of medical drugs or cell therapy could regenerate the auditory nerve. This study evaluates a minimally invasive technique for precise delivery of cell-sized beads, simulating cell therapy, into the cochlear modiolus of human temporal bones.

Methods
Ten fresh-frozen human temporal bone specimens were used. Five bones served to establish the injection trajectory using a tungsten rod probe, and the remaining five for injecting microbeads into the modiolus. The surgical procedure involved accessing the middle ear via the external ear canal, performing a cochleostomy at the first cochlear turn, and drilling into the modiolus. Beads were injected into the modiolus using a Hamilton syringe connected to an injection pump, followed by micro-computed tomography imaging and histological assessment.

Results
Accurate placement of the tungsten rod probe within the modiolus was achieved in four out of five bones. Microbead injections indicated 89 to 97% retention within the modiolus, with minimal leakage. The technique showed consistent trajectory with low variability.

Conclusion
The study demonstrates the feasibility of a minimally invasive, precise injection method for delivering and retaining cell-sized beads into the cochlear modiolus. This technique enables future local delivery of medical drugs or cell therapy drugs aimed at hearing restoration, benefiting both current CI users and CI candidates. Further research is necessary to evaluate precision, reproducibility, and long-term outcomes of the procedure.
Update in paediatric asthma
Authors: Bush Andrew 
Published: February 2025

Purpose of review
The field of paediatric asthma is rapidly moving, with the advent of new biologicals for severe asthma and increased understanding of preschool wheeze amongst other developments and insights.

Recent findings
There is increasing evidence of efficacy in children for biologics directed against Type 2 inflammation (especially mepolizumab and dupilumab) as well encouraging evidence that Tezepelumab may be effective against Type 2 low phenotypes. The importance of airway remodelling and infection in the pathophysiology of preschool wheeze is increasingly appreciated. The treatment of preschool wheeze is moving from symptom-based to biomarker driven therapies. Other important areas are prediction of risk of asthma attacks, the SMART regime, the importance of climate change and reducing greenhouse gas emissions from inhalers while ensuring adequate therapy for young children, the association of early adverse environmental factors including childhood poverty and deprivation and the switch to race-neutral lung function equations.

Summary
We are increasingly moving towards personalized medicine and the use of biomarkers to guide treatment of wheeze at all ages, but we need to move from counting cells to determining their functional status. Airway wall structural changes rather than inflammation may drive the progression of preschool wheeze to school age asthma
Sodium benzoate for the treatment of hepatic encephalopathy in humans and animals: a systematic review and meta-analysis
Authors: van Zoest Danny , Gal Bram , Agha Ayaz H. , den Hoed Caroline M. , Langendonk Janneke G. , Wagenmakers Margreet A.E.M. , Peltenburg Chantal 
Published: February 2025

Background and aim
Hepatic encephalopathy (HE) is a life-threatening condition where brain function is impaired mainly due to high systemic ammonia levels. HE is associated with a high 1-year mortality. No universally accepted guidelines for the treatment of HE exist. Nitrogen scavengers, such as sodium benzoate (SB), have been proven very effective to treat hyperammonemia in patients with urea cycle defects, in acute and chronic settings. We hypothesized that SB can also be an effective treatment of HE caused by end-stage liver disease or portosystemic shunting, as long as liver function is partially intact. The aim of this meta-analysis is to study the effect of SB in humans and animals with HE due to end-stage liver disease or portosystemic shunting.

Methods
Embase, Medline (Ovid and PubMed), Web-of-Science, Cochrane, and Google Scholar were searched on 19 July 2021, both human and animal studies were eligible.

Results
Sixteen studies were included, consisting of four clinical trials, five animal studies, and seven case reports, including 314 subjects. Meta-analysis included 284 subjects. The standardized mean difference (SMD) of SB’s ammonia-lowering effect was 0.89 SMD [95% confidence interval (CI): 0.27–1.51] in clinical trials and 1.63 SMD (95% CI: −0.12 to 3.39) in animal studies. Considerable heterogeneity was present in the included studies.

Conclusion
SB seems to be an effective treatment for HE or hyperammonemia caused by end-stage liver disease or portosystemic shunting. However, additional high-quality studies are necessary for more robust conclusions.
Efficacy and safety of tofacitinib for the treatment of moderate-to-severe ulcerative colitis in biologic-naive patients
Authors: Liatsos Christos , Tzouvala Maria , Michalopoulos Georgios , Giouleme Olga , Karmiris Konstantinos , Kozompoli Dimitra , Mousourakis Konstantinos , Kyriakos Nikolaos , Giakoumis Marios , Striki Athanasia , Karoubalis Ioannis , Bellou Georgia , Zacharopoulou Eirini , Katsoula Anastasia , Kalogirou Maria , Viazis Nikos 
Published: February 2025

Background and aims
Tofacitinib has been approved for the treatment of patients with moderate-to-severe ulcerative colitis independently of prior therapies. We aimed to assess the efficacy and safety of tofacitinib in biologic-naive patients.

Methods
This was a retrospective analysis of prospectively collected data extracted from the notes of patients with moderate-to-severe ulcerative colitis naive to advanced therapies, who were treated with tofacitinib [10 mg twice daily (b.i.d.) for 8 or 16 weeks followed by a 5 mg b.i.d. maintenance dose] in six Greek Hospitals, who had a follow-up of at least 26 weeks after treatment initiation.

Results
Overall, 48 patients were included. Clinical response was seen in 30 (62.5%) and 32 (66.6%) patients at week 8 and 16, respectively. Clinical remission, corticosteroid-free clinical remission, biochemical response, and endoscopic remission at week 26 was observed in 26 (54.2%), 26 (54.2%), 28 (60.8%), and 29 (60.4%) patients, respectively. No major adverse events or infections were recorded.

Conclusion
In this retrospective ongoing cohort study, tofacitinib demonstrated clinical response at weeks 8 and 16 in more than 60% and steroid-free clinical remission at week 26 in more than 50% of biologic-naive patients with moderate-to-severe ulcerative colitis with a good safety profile, indicating that tofacitinib is an effective first-line treatment for this group of patients.
Leveraging drug-target Mendelian randomization for tailored lipoprotein-lipid lowering
Authors: Gagnon Eloi , Arsenault Benoit J. 
Published: February 2025

Purpose of review
The study of naturally occurring genetic variation in human populations has laid the foundation for proprotein converts subtilisin/kexin type 9 inhibitors, and more recently new classes of lipid-lowering drugs such as lipoprotein(a) inhibitors and lipoprotein lipase pathway activators. These emerging therapies lower plasma lipoprotein-lipid levels that are not adequately managed by traditional low-density lipoprotein (LDL) cholesterol-lowering medications. By targeting different risk factors, these therapies could help manage the important residual cardiovascular risk of LDL cholesterol medications.

Recent findings
We review the latest insights into the pharmacological and genetic modulation of these new therapeutic targets. We highlight that the drugs remarkably recapitulate the lipid effects observed in genetic studies. In addition to lowering lipoprotein-lipid levels, robust genetic evidence support that these drugs may prevent cardiometabolic outcomes.

Summary
Emerging lipid-lowering therapies could launch a new era for preventive medicine in which treatments are optimally tailored to patient's lipoprotein-lipid profiles.
Characterisation of the virome of Culicoides brevitarsis Kieffer (Diptera: Ceratopogonidae), a vector of bluetongue virus in Australia
Authors: Sharpe Stephen R. , Madhav Mukund , Klein Melissa J. , Blasdell Kim R. , Paradkar Prasad N. , Lynch Stacey E. , Eagles Debbie , López-Denman Adam J. , Ahmed Khandaker Asif 
Published: February 2025

Graphical abstract
A metatranscriptomics study of a dominant bluetongue virus vector, Culicoides brevitarsis from Australia, identified 10 complete/near-complete viral genomes including 7 novel species.