bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of the phosphate binder sucroferric oxyhydroxide in dialysis patients on endogenous calciprotein particles, inflammation, and vascular cells
Authors: Thiem Ursula , Hewitson Tim D , Toussaint Nigel D , Holt Stephen G , Haller Maria C , Pasch Andreas , Cejka Daniel , Smith Edward R 
Published: September 2022

ABSTRACT

Background
Calciprotein particles (CPPs), colloidal mineral-protein nanoparticles, have emerged as potential mediators of phosphate toxicity in dialysis patients, with putative links to vascular calcification, endothelial dysfunction and inflammation. We hypothesized that phosphate binder therapy with sucroferric oxyhydroxide (SO) would reduce endogenous CPP levels and attenuate pro-calcific and pro-inflammatory effects of patient serum towards human vascular cells in vitro.

Methods
This secondary analysis of a randomised controlled crossover study compared the effect of 2-week phosphate binder washout with high-dose (2000 mg/day) and low-dose (250 mg/day) SO therapy in 28 haemodialysis patients on serum CPP levels, inflammatory cytokine/chemokine arrays and human aortic smooth muscle cell (HASMC) and coronary artery endothelial cell (HCAEC) bioassays.

Results
In our cohort (75% male, 62 ± 12 years) high-dose SO reduced primary (amorphous) and secondary (crystalline) CPP levels {−62% [95% confidence interval (CI) −76 to −44], P &lt; .0001 and −38% [−62 to −0.14], P &lt; .001, respectively} compared with washout. Nine of 14 plasma cytokines/chemokines significantly decreased with high-dose SO, with consistent reductions in interleukin-6 (IL-6) and IL-8. Exposure of HASMC and HCAEC cultures to serum of SO-treated patients reduced calcification and markers of activation (IL-6, IL-8 and vascular cell adhesion protein 1) compared with washout. Serum-induced HASMC calcification and HCAEC activation was ameliorated by removal of the CPP-containing fraction from patient sera. Effects of CPP removal were confirmed in an independent cohort of chronic kidney disease patients.

Conclusions
High-dose SO reduced endogenous CPP formation in dialysis patients and yielded serum with attenuated pro-calcific and inflammatory effects in vitro.
Artificial neural networks predict the need for permanent cerebrospinal fluid diversion following posterior fossa tumor resection
Authors: Bray David P , Saad Hassan , Douglas James Miller , Grogan Dayton , Dawoud Reem A , Chow Jocelyn , Deibert Christopher , Pradilla Gustavo , Nduom Edjah K , Olson Jeffrey J , Alawieh Ali M , Hoang Kimberly B 
Published: September 2022

Abstract

Background
Resection of posterior fossa tumors (PFTs) can result in hydrocephalus that requires permanent cerebrospinal fluid (CSF) diversion. Our goal was to prospectively validate a machine-learning model to predict postoperative hydrocephalus after PFT surgery requiring permanent CSF diversion.

Methods
We collected preoperative and postoperative variables on 518 patients that underwent PFT surgery at our center in a retrospective fashion to train several statistical classifiers to predict the need for permanent CSF diversion as a binary class. A total of 62 classifiers relevant to our data structure were surveyed, including regression models, decision trees, Bayesian models, and multilayer perceptron artificial neural networks (ANN). Models were trained using the (N = 518) retrospective data using 10-fold cross-validation to obtain accuracy metrics. Given the low incidence of our positive outcome (12%), we used the positive predictive value along with the area under the receiver operating characteristic curve (AUC) to compare models. The best performing model was then prospectively validated on a set of 90 patients.

Results
Twelve percent of patients required permanent CSF diversion after PFT surgery. Of the trained models, 8 classifiers had an AUC greater than 0.5 on prospective testing. ANNs demonstrated the highest AUC of 0.902 with a positive predictive value of 83.3%. Despite comparable AUC, the remaining classifiers had a true positive rate below 35% (compared to ANN, P &lt; .0001). The negative predictive value of the ANN model was 98.8%.

Conclusions
ANN-based models can reliably predict the need for ventriculoperitoneal shunt after PFT surgery.
Breaking the Tie: Benacerraf’s Identification Argument Revisited
Authors: Avron Arnon , Grabmayr Balthasar 
Published: September 2022

ABSTRACTMost philosophers take Benacerraf’s argument in ‘What numbers could not be’ to rebut successfully the reductionist view that numbers are sets. This philosophical consensus jars with mathematical practice, in which reductionism continues to thrive. In this note, we develop a new challenge to Benacerraf’s argument by contesting a central premise which is almost unanimously accepted in the literature. Namely, we argue that — contra orthodoxy — there are metaphysically relevant reasons to prefer von Neumann ordinals over other set-theoretic reductions of arithmetic. In doing so, we provide set-theoretical facts which, we believe, are crucial for informed assessment of reductionism.
Treating spondyloarthritis early: does it matter? Results from a systematic literature review
Authors: Capelusnik Dafne , Benavent Diego , van der Heijde Désirée , Landewé Robert , Poddubnyy Denis , van Tubergen Astrid , Falzon Louise , Navarro-Compán Victoria , Ramiro Sofia 
Published: September 2022

AbstractObjectiveTo summarize evidence on the relationship between early treatment (definition based on symptom/disease duration or radiographic damage) and treatment clinical response in patients with SpA.MethodsA systematic literature review was conducted in studies on SpA patients treated with NSAIDs or biological/targeted synthetic DMARDs addressing the impact of symptom/disease duration or presence of radiographic damage on treatment response assessed by any disease activity outcome. For categorical outcomes, relative risk, relative risk ratio and number needed to treat were calculated, and for continuous outcomes, differences in differences, to compare groups stratified based on symptom/disease duration or the presence of radiographic damage.ResultsFrom the 8769 articles retrieved, 25 were included and 2 added by hand-search, all in axial SpA (axSpA), most of them with low risk of bias. Twenty-one studies compared groups based on symptom duration (n = 6) or disease duration (n = 15) and seven studies based on absence/presence of radiographic damage (two studies used two comparisons). When early axSpA was defined by symptom duration (&lt;5 years) in randomized controlled trials, early treatment was associated with better outcomes in patients with non-radiographic axSpA [n = 2, ASAS40 relative risk ratio 5.24 (95% CI 1.12, 24.41) and 1.52 (0.60, 3.87)] but not in radiographic axSpA (n = 1) [ASAS20 0.96 (0.53–1.73)]. When early axSpA was defined based on disease duration or radiographic damage, no differences were found between groups.ConclusionEvidence towards better outcomes in early axSpA is very limited and restricted to non-radiographic axSpA and &lt;5 years symptom duration. When early axSpA is defined based on disease duration or radiographic damage, no differences in response to treatment are found.
Effects of feeding variable levels of mycotoxins with or without a mitigation strategy on growth performance, gut permeability, and oxidative biomarkers in nursery pigs
Authors: Wilson Victoria C , Ramirez Shelby M , Murugesan Ganapathi Raj , Hofstetter Ursula , Kerr Brian J 
Published: September 2022

Abstract
The objectives were to determine how high levels (&gt; 2.5 mg/kg diet) of deoxynivalenol (DON), in conjunction with other naturally occurring mycotoxins (MTX) would impact growth, intestinal integrity, and oxidative status, with or without a mitigation strategy, in nursery pigs. One-hundred and five pigs (5.5 ± 0.52 kg) were randomly allotted to 35 pens and fed dietary treatments for 45 d. Treatments were factorially arranged with the inclusion of MTX being low (L-MTX; &lt; 1 mg/kg diet) or high (H-MTX; &gt; 2.5 mg/kg diet) in combination with no mitigation strategy or the inclusion of a mitigation strategy (Biofix® Plus, BPL; 1.5 mg/kg diet). There was no interaction between MTX level and BPL inclusion on average daily gain (ADG) or gain to feed ratio (GF), (P &gt; 0.10). Compared to pigs fed diets containing L-MTX, feeding pigs diets containing H-MTX decreased ADG and GF (P &lt; 0.05). The addition of BPL had no effect on ADG (P &gt; 0.10), but improved GF (P = 0.09). There was an interaction between MTX and BPL on average daily feed intake (ADFI), where the addition of BPL had no effect on ADFI of pigs fed L-MTX diets but improved ADFI of pigs fed H-MTX diets (P = 0.09). An interaction was detected between MTX and BPL on protein oxidation as measured by plasma protein carbonyls (PC, P = 0.01), where the inclusion of BPL decreased plasma PC in pigs fed H-MTX diets to a greater extent than pigs fed the L-MTX diets. There was no interaction between MTX and BPL, or an effect of MTX or BPL on DNA damage as measured by 8-hydroxy-2ʹdexoxyguanosine (P &gt; 0.10). There was no interaction between MTX and BPL, or a BPL effect on lipid damage as measured by thiobarbituic acid reactive substances (TBARS, P &gt; 0.10), but pigs fed diets containing H-MTX exhibited lower concentrations of plasma TBARS (P = 0.07) compared to pigs fed L-MTX diets. There was no interaction between MTX and BPL, or an effect of MTX or BPL on plasma lactulose and mannitol ratio as a measure of intestinal permeability (P &gt; 0.10). In conclusion, feeding H-MTX decreased ADG and GF, decreased plasma TBARS, but did not affect plasma 8-hydroxy-2ʹdexoxyguanosine or plasma LM ratio. The inclusion of a mitigation strategy improved ADFI when pigs were fed H-MTX diets and improved GF regardless of MTX level. Addition of a mitigation strategy also reduced plasma protein damage but did not affect indicators of DNA or lipid damage or affect gastrointestinal integrity.
Respiration-timing-dependent changes in activation of neural substrates during cognitive processes
Authors: Nakamura Nozomu H , Fukunaga Masaki , Yamamoto Tetsuya , Sadato Norihiro , Oku Yoshitaka 
Published: September 2022

Abstract
We previously showed that cognitive performance declines when the retrieval process spans an expiratory-to-inspiratory (EI) phase transition (an onset of inspiration). To identify the neural underpinning of this phenomenon, we conducted functional magnetic resonance imaging (fMRI) while participants performed a delayed matching-to-sample (DMTS) recognition memory task with a short delay. Respiration during the task was monitored using a nasal cannula. Behavioral data replicated the decline in memory performance specific to the EI transition during the retrieval process, while an extensive array of frontoparietal regions were activated during the encoding, delay, and retrieval processes of the task. Within these regions, when the retrieval process spanned the EI transition, activation was reduced in the anterior cluster of the right temporoparietal junction (TPJa, compared to cases when the retrieval process spanned the inspiratory-to-expiratory phase transition) and the left and right middle frontal gyrus, dorsomedial prefrontal cortex, and somatosensory areas (compared to cases when the retrieval process did not span any phase transition). These results in task-related activity may represent respiratory interference specifically in information manipulation rather than memory storage. Our findings demonstrate a cortical-level effect of respiratory phases on cognitive processes and highlight the importance of the timing of breathing for successful performance.
Limited Hip Flexion and Internal Rotation Resulting From Early Hip Impingement Conflict on Anterior Metaphysis of Patients With Untreated Severe SCFE Using 3D Modelling
Authors: Lerch Till D. , Kim Young-Jo , Kiapour Ata M. , Zwingelstein Sébastien , Steppacher Simon D. , Tannast Moritz , Siebenrock Klaus A. , Novais Eduardo N. 
Published: September 2022

Introduction:
Slipped capital femoral epiphysis (SCFE) is the most common hip disorder in adolescent patients that can result in complex 3 dimensional (3D)-deformity and hip preservation surgery (eg, in situ pinning or proximal femoral osteotomy) is often performed. But there is little information about location of impingement.
Purpose/Questions: The purpose of this study was to evaluate (1) impingement-free hip flexion and internal rotation (IR), (2) frequency of impingement in early flexion (30 to 60 degrees), and (3) location of acetabular and femoral impingement in IR in 90 degrees of flexion (IRF-90 degrees) and in maximal flexion for patients with untreated severe SCFE using preoperative 3D-computed tomography (CT) for impingement simulation.

Methods:
A retrospective study involving 3D-CT scans of 18 patients (21 hips) with untreated severe SCFE (slip angle>60 degrees) was performed. Preoperative CT scans were used for bone segmentation of preoperative patient-specific 3D models. Three patients (15%) had bilateral SCFE. Mean age was 13±2 (10 to 16) years and 67% were male patients (86% unstable slip, 81% chronic slip). The contralateral hips of 15 patients with unilateral SCFE were evaluated (control group). Validated software was used for 3D impingement simulation (equidistant method).

Results:
(1) Impingement-free flexion (46±32 degrees) and IRF-90 degrees (−17±18 degrees) were significantly (P<0.001) decreased in untreated severe SCFE patients compared with contralateral side (122±9 and 36±11 degrees).
(2) Frequency of impingement was significantly (P<0.001) higher in 30 and 60 degrees flexion (48% and 71%) of patients with severe SCFE compared with control group (0%).
(3) Acetabular impingement conflict was located anterior-superior (SCFE patients), mostly 12 o’clock (50%) in IRF-90 degrees (70% on 2 o’clock for maximal flexion). Femoral impingement was located on anterior-superior to anterior-inferior femoral metaphysis (between 2 and 6 o’clock, 40% on 3 o’clock and 40% on 5 o’clock) in IRF-90 degrees and on anterior metaphysis (40% on 3 o’clock) in maximal flexion and frequency was significantly (P<0.001) different compared with control group.

Conclusion:
Severe SCFE patients have limited hip flexion and IR due to early hip impingement using patient-specific preoperative 3D models. Because of the large variety of hip motion, individual evaluation is recommended to plan the osseous correction for severe SCFE patients.

Level of Evidence:
Level III.
Surgical Site Infection After Posterior Stabilization of the Spine – When do we Have to Remove the Implants?
Authors: Prost Max , Röckner Melanie Elisabeth , Flüh Greta , Windolf Joachim , Konieczny Markus Rafael 
Published: September 2022

Study Design:
Retrospective data analysis.

Objection:
The primary objective of this investigation was to analyze if treatment of Postoperative surgical site infections (PSSI) after posterior stabilization of the spine (PS) without radiological signs of screw loosening (RSL) shows a sufficient success rate without implant removal and if there was any difference between early and late PSSI.

Summary of Background Data:
PSSI after PS are usually treated by implant removal and reinstrumentation if loosening of one of more screws is detected. There is presently no conclusive data that shows the success rate of the treatment of PSSI after PS without implant removal if no RSL are perceived.

Materials and Methods:
All patients who were treated for a PSSI after PS without RSL in a single spine center from 12/2009 to 03/2020 were enrolled in a retrospective analysis. Patients were treated by revision surgery with debridement and irrigation and subsequent antibiotic therapy. Implant removal was performed if the initial treatment did not lead to an improvement in wound healing and normalization of laboratory values. Statistical analysis was performed by Statistical Package for the Social Sciences 25. Descriptive data are given as mean and standard error of mean, a χ2 test was performed.

Results:
Of the 32 enrolled patients, 17 had an early PSSI, 15 a late PSSI. In 71.9% (23/32), the PSSI was treated without implant removal: 12/17 in early PSSI, 11/15 in late PSSI. The difference was not significant (P>0.05). One patient died, all other patients were discharged from the hospital with no remaining laboratory signs of the infection and with closed soft tissues.

Conclusions:
In our group of patients, the success rate of irrigation and debridement without implant removal was 71.9%. In the light of this data, performing at least two irrigations and debridement before implant removal seems to be a valid treatment option in PSSI after PS if there are no RSL in early and late PSSI.
Correction and Maintenance of Cervical Alignment
Authors: Campion Chad , Crawford Charles H. , Glassman Steven D. , Berkay Fehmi , Mkorombindo Tino , Carreon Leah Y. 
Published: September 2022

Study Design:
Longitudinal observational comparative cohorts.

Objective:
The objective of this study is to compare 3 and 12-month radiographic sagittal parameters and patient-reported outcomes (PROs) in patients who underwent 3-level ACDF or a hybrid procedure.

Summary of Background Data:
Anterior Cervical Discectomy and Fusion (ACDF), Anterior Cervical Corpectomy and Fusion (ACCF), and hybrids (combination ACCF-ACDF) are common procedures used to treat symptomatic cervical spondylosis. Although there is a relative abundance of literature comparing 1-level ACCF versus 2-level ACDF and 2-level ACCF versus 3-level ACDF, detailed comparisons of 3-level ACDF versus hybrid procedures have not been extensively addressed.

Methods:
Patients who underwent a 3-Level ACDF (3L-ACDF, N=47) or 1-Level Corpectomy/1-Level ACDF (Hybrid, N=52) with at least a 12-month post-op data available were identified. Standard demographic, surgical and PROs were collected in addition to preoperative and postoperative radiographic data, including C2 plumb line (C2PL), C2–C7 lordosis (CL), segmental lordosis (SL), and T1 slope (T1S).

Results:
The 2 cohorts were similar in terms of demographics. At 3 months post-op, CL (9.04° vs. −2.12°, P=0.00) and SL (6.06° vs. −2.26°, P=0.003) were significantly greater in the 3L-ACDF group versus the HYBRID group. This significant difference was maintained at 12 months postoperative for CL [(6.62° vs. −0.60°, P=0.015) but not for SL (2.36° vs. −1.09°, P=0.199)]. There were no differences in PROs between the 2 groups before surgery, at 3 months postoperative or 12 months postoperative. Seven patients required revision surgery in the 1-year study period (1 in the 3L-ACDF, and 6 in the Hybrid P<0.001).

Conclusions:
Three level ACDF resulted in greater C2–C7 lordosis and segmental lordosis postoperatively, which was maintained at 1 year for cervical lordosis. While PROs were similar between the groups, patients with hybrid instrumentation required significantly more revision surgeries than those treated with 3-level ACDF.
Risk Factors and Clinical Outcomes of Candidemia Associated With Severe COVID-19
Authors: Dixit Deepali , Jen Polly , Maxwell Tyler D. , Smoke Steven , McCracken James Andrew , Cardinale-King Maria , Haribhakti Aditi , Patel Purvi , Cani Eris , Choi Seohyun (Claudia) , Jagpal Sugeet , Varughese Tilly , Tatem Luis L. , Bhowmick Tanaya 
Published: September 2022

IMPORTANCE:
COVID-19 can cause serious illness requiring multimodal treatment and is associated with secondary infections. Studies have suggested an increased risk of fungal infections, including candidemia following severe COVID-19 though understanding of risk factors and clinical outcomes remains unclear.

OBJECTIVES:
To describe clinical characteristics, outcomes and risk factors of candidemia among patients hospitalized with severe COVID-19.

DESIGN, SETTING, AND PARTICIPANTS:
A multicenter, case-control study of patients with severe COVID-19 was conducted to evaluate risk factors and clinical outcomes in patients who developed candidemia between August 2020 and August 2021.

MAIN OUTCOMES AND MEASURES:
Chart review evaluating institutional and patient demographics, clinical and mycological characteristics, concomitant interventions (antibiotics, immunosuppressive agents, parenteral nutrition, degree of oxygen support, mechanical ventilation, surgery), treatment regimens, and outcomes (length of stay and discharge disposition)

RESULTS:
A total of 275 patients were enrolled in the study, including 91 patients with severe COVID-19 and subsequent candidemia and 184 with severe COVID-19 without candidemia. Most patients received antibiotics prior to candidemia episode (93%), while approximately one-quarter of patients received biologic for COVID-19. In-hospital mortality was significantly higher in the cases compared with the controls (68% vs 40%; p < 0.01). Candida albicans was the most common (53%), followed by C. glabrata (19%). Use of central lines, biologic, and paralytics were independent risk factors for candidemia.

CONCLUSIONS AND RELEVANCE:
Candidemia following COVID-19 infection is a concern that requires clinical consideration and patient monitoring. Risk factors for the development of candidemia in the setting of COVID-19 infection are largely consistent with traditional risk factors for candidemia in hospitalized patients.
Fingerprick Microsampling Methods Can Replace Venepuncture for Simultaneous Therapeutic Drug Monitoring of Tacrolimus, Mycophenolic Acid, and Prednisolone Concentrations in Adult Kidney Transplant Patients
Authors: Scuderi Carla , Parker Suzanne , Jacks Margaret , John George T. , McWhinney Brett , Ungerer Jacobus , Mallett Andrew , Healy Helen , Roberts Jason , Staatz Christine 
Published: September 2022

Background:
Kidney transplant patients undergo repeated and frequent venepunctures during allograft management. Microsampling methods that use a fingerprick draw of capillary blood, such as dried blood spots (DBS) and volumetric absorptive microsamplers (VAMS), have the potential to reduce the burden and volume of blood loss with venepuncture.

Methods:
This study aimed to examine microsampling approaches for the simultaneous measurement of tacrolimus, mycophenolic acid, mycophenolic acid glucuronide (MPAG), and prednisolone drug concentrations compared with standard venepuncture in adult kidney transplant patients. DBS and VAMS were simultaneously collected with venepuncture samples from 40 adult kidney transplant patients immediately before and 2 hours after immunosuppressant dosing. Method comparison was performed using Passing–Bablok regression, and bias was assessed using Bland–Altman analysis. Drug concentrations measured through microsampling and venepuncture were also compared by estimating the median prediction error (MPE) and median absolute percentage prediction error (MAPE).

Results:
Passing–Bablok regression showed a systematic difference between tacrolimus DBS and venepuncture [slope of 1.06 (1.01–1.13)] and between tacrolimus VAMS and venepuncture [slope of 1.08 (1.03–1.13)]. Tacrolimus values were adjusted for this difference, and the corrected values showed no systematic differences. Moreover, no systematic differences were observed when comparing DBS or VAMS with venepuncture for mycophenolic acid and prednisolone. Tacrolimus (corrected), mycophenolic acid, and prednisolone microsampling values met the MPE and MAPE predefined acceptability limits of <15% when compared with the corresponding venepuncture values. DBS and VAMS, collected in a controlled environment, simultaneously measured multiple immunosuppressants.

Conclusions:
This study demonstrates that accurate results of multiple immunosuppressant concentrations can be generated through the microsampling approach, with a preference for VAMS over DBS.