bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of high or modified low tie of the inferior mesenteric artery in laparoscopic rectal cancer surgery: A meta-analysis
Authors: Zhong Wu , Liu Chuanyuan , Zhang Lei , Zhong Junqiao , He Xianping , Fang Chuanfa , Liu Hongquan , Xia Laiyang , Zuo Zhengyun , Zhang Leichang 
Published: November 2022

Objective:
The purpose of this study was to perform a meta-analysis comparing the oncological, intraoperative and safety outcomes in laparoscopic rectal cancer surgery with and without preservation of the left colic artery (LCA).

Method:
We searched several databases including PubMed, Web of Science, Cochrane Library, and Embase databases. This meta-analysis included randomized clinical trials, prospective, and retrospective comparative studies regarding high- or modified low-tie ligation of the inferior mesenteric artery in laparoscopic rectal cancer surgery.

Results:
Of 641 potentially eligible articles, 16 studies with 3050 participants met the eligibility criteria and were included in the meta-analysis. There was no significant difference in estimated blood loss (WMD −2.63, 95% CI −5.69 to 0.43; P = .09), the number of harvested lymph nodes (WMD −0.35, 95% CI −1.60 to 0.20; P = .50), the number of apical lymph node yield (WMD −0.19, 95% CI −0.52 to 0.13; P = .24), the number of apical lymph node metastasis (OR 0.76, 95% CI 0.40 to 1.45; P = .40), rate of conversion to open surgery (OR 0.74, 95% CI 0.50 to 1.09; P = .513), rate of urinary dysfunction (OR 1.39, 95% CI 0.71 to 2.74; P = .34), rate of recurrence and metastasis (OR 1.10, 95% CI 0.75 to 1.61; P = .64), 5-year survival rate (OR 0.89, 95% CI 0.67 to 1.18; P = .42). However, this meta-analysis demonstrated a statistically significant difference in operating time (WMD −9.92, 95% CI −15.49 to −5.84; P = .0005), rate of diverting stom (OR 1.42, 95% CI 1.06 to 1.92; P = .02), rate of anastomotic leakage (OR 2.673, 95% CI 1.91 to 3.62; P < .00001), time to first flatus (WMD 0.29, 95% CI 0.11 to 0.48; P = .002), time of hospitalization (WMD 0.64, 95% CI 0.14 to 1.15; P = .01) between the 2 surgical techniques.

Coclusion:
The available evidence suggests that preserving the left colic artery is a safe, effective technique for patients with laparoscopic rectal cancer. nique for patients with laparoscopic rectal cancer.
Trends of fecal calprotectin levels and associations with early life experience in preterm infants
Authors: Xu Wanli , Zhang Yiming , Zhao Wenxiao , Chen Jie , Maas Kendra , Hussain Naveed , Henderson Wendy A. , Cong Xiaomei 
Published: November 2022

Abstract

Background:
Preterm infants are at risk for severe infections due to their immature immune systems. Factors such as early life pain/stress experiences and feeding may influence immune activation and maturation of immune systems. However, the underlying mechanism remains unclear. Fecal calprotectin (FCP) is a noninvasive surrogate biomarker of mucosal inflammation in the gastrointestinal tract and has been used in detecting intestinal inflammation in specific pediatric gastrointestinal disorders.

Objective:
To describe the longitudinal trajectory of FCP levels in preterm infants and investigate the contributing factors that are associated with FCP levels.

Design:
A longitudinal study design was used.

Settings:
Preterm infants were recruited from 2 neonatal intensive care units (NICU) of a children’s medical center in the North-eastern US.

Methods:
Preterm infants were followed during their first 4 weeks of NICU hospitalization. Stool samples were collected twice per week to quantify the FCP levels. Cumulative pain/stress experiences and feeding types were measured daily. A linear mixed-effect model was used to examine the associations between FCP levels and demographic and clinical characteristics, cumulative pain/stress, and feeding over time.

Results:
Forty-nine preterm infants were included in the study. Infants’ FCP levels varied largely with a mean of 268.7±261.3 µg/g and increased over time. Preterm infants experienced an average of 7.5±5.0 acute painful procedures and 15.3±20.8 hours of chronic painful procedures per day during their NICU stay. The mean percentage of mother’s own milk increased from the first week (57.1±36.5%) to the fourth week (60.7±38.9%) after birth. Elevated FCP concentration was associated with acute and cumulative (chronic) pain/stress levels, mother’s own milk, non-White race, and higher severity of illness score.

Conclusions:
FCP levels were elevated in preterm infants with wide interindividual and intraindividual variations. Cumulative pain/stress during the NICU hospitalization, feeding, race, and health status may influence FCP concentrations in early life that may be associated with inflammatory gut processes.
Transfemoral interface considerations: A clinical consensus practice guideline
Authors: O'Brien Erin , Stevens Phillip M. , Miro Rebecca , Highsmith M. Jason 
Published: November 2022

Background:
Although there have been a number of studies exploring the impact and efficacy of transfemoral prosthetic components such as knee and foot mechanisms, the empirical evidence surrounding transfemoral prosthetic interface considerations is limited. This constitutes a substantial void for practicing clinicians seeking to apply best practices for patients who use transfemoral prostheses. Recent years have seen increased production and availability of clinical practice guidelines germane to prosthetic rehabilitation. In those areas where empirical evidence is lacking, consensus clinical opinions may constitute the highest level of evidence.

Objective:
A consensus exercise was performed to generate clinical practice recommendations in the areas of transfemoral interface considerations including socket variations and critical design features, suspension and interface considerations, alignment, heat retention and dermatologic considerations, female considerations, surgical considerations, and both regulatory and ethical considerations related to osseointegration.

Methods:
This began with the generation of postulate items through systematic and narrative literature reviews. A Delphi consensus exercise was performed among clinical experts in government hospital and private clinical practice settings, culminating in a series of clinical practice recommendations associated with the prosthesis–limb interface for individuals with transfemoral amputation.

Results:
The completed recommendations include guidance statements relative to socket variations and critical design features, female considerations, suspension and interface considerations, surgical variations and prescription considerations, rehabilitation team considerations and both regulatory and ethical considerations related to osseointegration.

Conclusions:
The Delphi process facilitated the development of practice guidelines for transfemoral prosthetic interface considerations based on aggregated subject matter expertise.
Cognitive Interview Validation of a Novel Household Hazard Vulnerability Assessment Instrument
Authors: Amberson Taryn , Ndayishimiye Olive , Cloud Quanah Yellow , Castner Jessica 
Published: November 2022

AbstractBackgroundWeather and climate disasters are responsible for over 13,000 USA deaths, worsened morbidity, and $1.7 trillion additional costs over the last 40 years with profound racial disparities. This project empirically generated items for a novel survey instrument of household hazard vulnerability with initial construct validation while addressing racial data bias.MethodsCognitive interviewing methodology was completed with transdisciplinary disaster expert panelists (n=20) from diverse USA regions on 60 unique hazard, disaster, or event items. Interview video recordings were qualitatively analyzed using thematic and pattern coding.ResultsA cognitive process mapped to themes of disaster characteristics, resources, individual life facet, and felt effect was revealed. 379 unique instances of linked terms as synonyms, co-occurring, compounding, or cascading events were identified. Potential for racial data bias was elucidated. Analysis of radiation exposure, trauma, criminal acts of intent items revealed participants may not interpret survey items with these terms as intended.DiscussionThe findings indicate the potential for racial data bias relative to water dam failure, evacuation, external flood, suspicious package/substance, and transportation failure. Hazard terms that were not interpreted as intended require further revision in the validation process of individual or household disaster vulnerability assessments.ConclusionSeveral commonalities in the cognitive process and mapping of disaster terms may be utilized in disaster and climate change research aimed at the individual and household unit of analysis.Highlights⍰Older adults and those with Black/African American racial identities are particularly susceptible to post-disaster health sequelae.⍰Prior to this study, no household-level Hazard Vulnerability Analysis existed. Quantifying risk for at-risk individuals/groups is a necessary initial step for working to eliminate disparities in large-scale disaster health outcomes.⍰Our findings indicate the potential for racial data bias relative to water dam failure, evacuation, external flood, suspicious package/substance, and transportation failure. Overall, several hazard, disaster, and event terms were not interpreted by survey-takers as intended, which may require elimination, replacement, or further revision in the validation process of individual or household assessments.
Segment and Slice: A Two-Step Deep Learning Pipeline for Opportunistic Vertebral Fracture Detection in Computed Tomography
Authors: Glessgen Carl G. , Cyriac Joshy , Yang Shan , Manneck Sebastian , Wichtmann Hildegard , Wasserthal Jakob , Kovacs Balazs K. , Harder Dorothee 
Published: November 2022

AbstractObjectivesAn end-to-end method is introduced to build a combined segmentation-classification pipeline using deep learning for opportunistic fracture detection in CT spine images of varying field-of-views.Materials and MethodsThis retrospective study builds on 452 CTs of the lumbar/thoracolumbar spine. Patients were included based on the evidence of ≥ 1 vertebral body fracture and excluded in case of history of spinal surgery or pathologic fractures. The collective was split into training/validation (405) and test (47) sets. An open-source pre-segmented spine dataset was used to train a preliminary segmentation model, which was applied on the training set. The resulting segmentation was post-processed to remove posterior vertebral structures and if needed manually refined by a radiologist. Using the refined version as new training data, a final segmentation nnU-net was trained. Sagittal slices from each vertebra were labelled individually with regard to fracture evidence. Slices without signs of fracture were used as negative class. 27,019 slices (20,396 negative, 6,623 positive) trained a classification algorithm using resnet18. Two senior readers independently assessed fractures in the test set to obtain a consensual ground truth. The segmentation-classification pipeline was applied to the test set and compared to the ground truth.ResultsThe segmentation model correctly segmented 330/339 (97%) vertebrae. Considering every segmented vertebra, the classifier detected fractures with 88% sensitivity, 95% specificity and 93% accuracy.ConclusionOur two-step method can help to detect spine fractures on images of varying field-of-views, with an accuracy comparable to that of a radiologist in-training. The final models as well as our code material are available athttps://github.com/usb-radiology/VertebraeFx.
A scoping review of virtual morning report and outcomes in Canada and the United States
Authors: Sarma Shohinee , Kanagalingam Tharsan , Lai James , Ahmad Tehmina 
Published: November 2022

AbstractPurposeTo describe the current landscape of virtual morning report (VMR) in medical residency education including its varying formats, methods, and associated effectiveness on learning and clinical outcomes.MethodsThe authors conducted a scoping review using the Arksey and O’Malley methodology. They searched Embase, OvidMEDLINE, Google Scholar, and PubMed between January 1, 1991 to April 15, 2022. Articles written in English on virtual morning report and virtual case-based teaching in medical residency programs were captured. Two authors independently screened articles using the inclusion criteria. Using a snowball approach, further citations were identified from included references. Two authors performed data extraction including outcomes using the Kirkpatrick model. We conducted thematic analysis using an iterative process.ResultsA total of 401 citations were screened for eligibility and we included 40 articles. The number of published studies per year on VMR increased since the COVID-19 pandemic. Most studies used online case-based modules (n=20; 50.0%) or videoconferencing (n=12; 30.0%). The majority of studies described improved confidence with clinical reasoning, easy access, and preference for chatboxes/polls for engagement (Kirpatrick level 1). Nineteen studies demonstrated improved knowledge acquisition with pre-and post-test scores (Kirkpatrick level 2). Behaviour changes (Kirkpatrick level 3) included improved screening tests and medication prescribing. There were no studies on clinical outcomes (Kirkpatrick level 4). Thematic analyses revealed that VMR increased clinical reasoning, efficiently used technology, provided an inclusive environment for diverse learners, but reduced peer engagement and bedside teaching.ConclusionVirtual morning report has a positive impact on learner confidence, knowledge, inclusivity, accessibility, and behaviour change. Future research is needed to explore the impact on patient outcomes as well as identify strategies for peer engagement and social interaction.
Determinants of catastrophic health expenditure attributable to non-communicable diseases and impoverishment in Pakistan
Authors: Naz Lubna , Sriram Shyamkumar , Sardar Filzah 
Published: November 2022

AbstractBackgroundPakistan has a disproportionately high burden of non-communicable diseases (NCDs), leading to an increase in healthcare utilization and associated out-of-pocket health expenditure, adversely affecting the well-being of the household. This study aims to identify the determinants of catastrophic health expenditure (CHE) on NCDs and quantify the impoverishment effects of OOP expenditure attributable to NCDs.MethodsThe study used Household Integrated Economic Survey - 2018/2019 and the National Health Accounts Data 2017. The welfare impact of out-of-pocket health spending associated with NCDs was assessed using specific measures: a) incidence and intensity of catastrophic health expenditure and b) the impoverishing effect. A generalized linear model with a logit link function was used to study the determinants of CHE at different thresholds.ResultsThe poverty headcount was 20.5% without accounting for OOP expenditure for NCDs; with adjustment, it increased to 27%, causing 13 million (from 42.4 million to 55.6) more people to fall into poverty. Households experiencing CHE fell from 60% to 3.5% as the threshold increased from 10% to 40%, implying fewer households encounter CHE at higher thresholds. Larger families, male-headed, families with children and older members, having more members with NCDs, and using private healthcare were more likely to incur CHE.ConclusionsCHE has a high propensity to push households into poverty. Pakistan’s National Health Vision 2016-2025 recognizing the provision of Universal Health Coverage and poverty alleviation as the top health and social priorities needs to be implemented to achieve Sustainable Development Goal targets of UHC and financial risk protection.Key messagesHousehold’s out-of-pocket spending associated with non-communicable disease was USD19 per month.Female headed families had a lower likelihood of incurring catastrophic health expenditure on NCDs than the male.Only a fewer households encountered catastrophic health expenditure at higher thresholds.Rural households had a higher impoverishing effect of out-of-pocket expenditure associated with NCDs compared to the urban.
Paediatric snakebite in Kilifi County, Kenya: A 19-year observational study
Authors: Abouyannis Michael , Boga Mwanamvua , Amadi David , Ouma Nelson , Nyaguara Amek , Mturi Neema , Berkley James A. , Adetifa Ifedayo , Casewell Nicholas R , Lalloo David G , Hamaluba Mainga 
Published: November 2022

AbstractIntroductionEstimates suggest that one-third of snakebite cases in sub-Saharan Africa affect children. Despite children being at a greater risk of disability and death, there are limited published data describing the burden of paediatric snakebite. This study describes the clinical features, hospital management, population-incidence, and mortality of consecutive paediatric snakebite cases over a 19-year period.MethodsUsing the Kilifi Health and Demographic Surveillance System (KHDSS), all children with snakebite presenting to Kilifi County Hospital were identified. All cases were prospectively registered, admitted for at least 24-hours, and managed on a paediatric high dependency unit (HDU). Households within the KHDSS study area have been included in 4-monthly surveillance and verbal autopsy, enabling calculation of population-incidence and mortality. Predictors of severe local tissue damage were identified using a multivariate logistic regression analysis.ResultsBetween 2003 and 2021, there were 19,798 admissions to the paediatric HDU, of which 619 were due to snakebite. Amongst infants (≤5-years age) the population-incidence of hospital-attended snakebite was 9.8/100,000 person-years; for children aged 6-13-years this was 26.4/100,000 person-years. The number of children attending hospital with snakebite has increased over time. Children aged 8-11 years had the highest incidence. There were six snakebite associated deaths. At admission, low haemoglobin, raised white blood cell count, and an upper limb bite-site were associated with the development of severe local tissue damage.ConclusionThere is a substantial burden of disease due to paediatric snakebite and this has increased in-line with population growth. Most cases present with local rather than systemic envenoming, and many of these receive antivenom. The mortality rate was low, which may reflect the quality of care delivered on the paediatric HDU. There is an urgent need to better define the burden of paediatric snakebite across Africa, to initiate community engagement to prevent snakebites, and to improve treatments for local tissue damage.
Myeloid-specific KDM6B inhibition sensitizes Glioblastoma to PD1 blockade
Authors: Goswami Sangeeta , Raychaudhuri Deblina , Singh Pratishtha , Natarajan Seanu Meena , Chen Yulong , Poon Candice , Hennessey Mercedes , Zhang Jan , Anandhan Swetha , Kerrigan Brittany Parker , Macaluso Marc D. , He Zhong , Jindal Sonali , Lang Frederick F. , Basu Sreyashi , Sharma Padmanee 
Published: November 2022

AbstractGlioblastoma (GBM) tumors are enriched in immune-suppressive myeloid cells and are refractory to immune checkpoint therapy (ICT). Targeting epigenetic pathways to reprogram the functional phenotype of immune-suppressive myeloid cells to overcome resistance to ICT remains unexplored. Single-cell and spatial transcriptomic analyses of human GBM tumors demonstrated high expression of an epigenetic enzyme - histone 3 lysine 27 demethylase (KDM6B) in intra- tumoral immune-suppressive myeloid cell subsets. Importantly, myeloid-cell specificKdm6bdeletion enhanced pro-inflammatory pathways and improved survival in GBM tumor-bearing mice. Mechanistic studies elucidated that the absence ofKdm6benhances antigen-presentation, interferon response and phagocytosis in myeloid cells by inhibiting mediators of immune suppression includingMafb, Socs3andSirpa. Further, pharmacological inhibition of KDM6B mirrored the functional phenotype ofKdm6bdeleted myeloid cells and enhanced anti-PD1 efficacy. Thus, this study identified KDM6B as an epigenetic regulator of the functional phenotype of myeloid cell subsets and a potential therapeutic target to improve response to ICT.
A simple within-host, between-host model for a vector-transmitted disease
Authors: Núñez-López Mayra , Castro-Echeverría Jocelyn A. , Velasco-Hernández Jorge X. 
Published: November 2022

AbstractWe present a model that explicitly links the epidemiological Ross-Macdonald model with a simple immunological model through a virus inoculation term that depends on the abundance of infected mosquitoes. We explore the relationship between the reproductive numbers at the population (between-host) and individual level (within-host), in particular the role that viral load and viral clearance rate play in the coupled dynamics. Our model shows that under certain conditions on the strength of the coupling and the immunological response of the host, there can be sustained low viral load infections, with a within-host reproduction number below one that still can trigger epidemic outbreaks provided the between host reproduction number is greater than one. We also describe a particular kind of transmission-clearance trade off for vector-host systems with a simple structure.
Multimodal MALDI imaging mass spectrometry for improved diagnosis of melanoma
Authors: Zhang Wanqiu , Patterson Nathan Heath , Verbeeck Nico , Moore Jessica L. , Ly Alice , Caprioli Richard M. , De Moor Bart , Norris Jeremy L. , Claesen Marc 
Published: November 2022

AbstractImaging mass spectrometry (IMS) provides promising avenues to augment histopathological investigation with rich spatio-molecular information. We have previously developed a classification model to differentiate melanoma from nevi lesions based on IMS protein data, a task that is challenging solely by histopathologic evaluation.Most IMS-focused studies collect microscopy in tandem with IMS data, but this microscopy data is generally omitted in downstream data analysis. Microscopy, nevertheless, forms the basis for traditional histopathology and thus contains invaluable morphological information. In this work, we developed a multimodal classification pipeline that uses deep learning, in the form of a pre-trained artificial neural network, to extract the meaningful morphological features from histopathological images, and combine it with the IMS data.To test whether this deep learning-based classification strategy can improve on our previous results in classification of melanocytic neoplasia, we utilized MALDI IMS data with collected serial H&E stained sections for 331 patients, and compared this multimodal classification pipeline to classifiers using either exclusively microscopy or IMS data. The multimodal pipeline achieved the best performance, with ROC-AUCs of 0.968 vs. 0.938 vs. 0.931 for the multimodal, unimodal microscopy and unimodal IMS pipelines respectively. Due to the use of a pre-trained network to perform the morphological feature extraction, this pipeline does not require any training on large amounts of microscopy data. As such, this framework can be readily applied to improve classification performance in other experimental settings where microscopy data is acquired in tandem with IMS experiments.