bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design, Implementation, and Evolution of the Medicaid Outcomes Distributed Research Network (MODRN)
Authors: Zivin Kara , Allen Lindsay , Barnes Andrew J. , Junker Stefanie , Kim Joo Yeon , Tang Lu , Kennedy Susan , Ahrens Katherine A. , Burns Marguerite , Clark Sarah , Cole Evan , Crane Dushka , Idala David , Lanier Paul , Mohamoud Shamis , Jarlenski Marian , McDuffie Mary Joan , Talbert Jeffery , Gordon Adam J. , Donohue Julie M. 
Published: July 2022

Background:
In the US, Medicaid covers over 80 million Americans. Comparing access, quality, and costs across Medicaid programs can provide policymakers with much-needed information. As each Medicaid agency collects its member data, multiple barriers prevent sharing Medicaid data between states. To address this gap, the Medicaid Outcomes Distributed Research Network (MODRN) developed a research network of states to conduct rapid multi-state analyses without sharing individual-level data across states.

Objective:
To describe goals, design, implementation, and evolution of MODRN to inform other research networks.

Methods:
MODRN implemented a distributed research network using a common data model, with each state analyzing its own data; developed standardized measure specifications and statistical software code to conduct analyses; and disseminated findings to state and federal Medicaid policymakers. Based on feedback on Medicaid agency priorities, MODRN first sought to inform Medicaid policy to improve opioid use disorder treatment, particularly medication treatment.

Results:
Since its 2017 inception, MODRN created 21 opioid use disorder quality measures in 13 states. MODRN modified its common data model over time to include additional elements. Initial barriers included harmonizing utilization data from Medicaid billing codes across states and adapting statistical methods to combine state-level results. The network demonstrated its utility and addressed barriers to conducting multi-state analyses of Medicaid administrative data.

Conclusions:
MODRN created a new, scalable, successful model for conducting policy research while complying with federal and state regulations to protect beneficiary health information. Platforms like MODRN may prove useful for emerging health challenges to facilitate evidence-based policymaking in Medicaid programs.
Photodermatoses: what's new
Authors: Scollan Margaret E. , Lauren Christine T. 
Published: July 2022

Purpose of reviewThe purpose of this review is to summarize and highlight the recent literature in photodermatoses. In the past year, there have been many developments in this heterogeneous group of conditions.Recent findingsThis review is divided by photodermatoses type, which include idiopathic photodermatoses, photodermatoses secondary to exogenous agents, photodermatoses secondary to endogenous agents (the porphyrias), and genodermatoses. The idiopathic photodermatoses section focuses on case series and reports highlighting new disease presentations or further disease characterization and new treatment strategies for these disorders. The second section discusses a unique case and has a brief update on photoallergens. Clinical, diagnostic, and treatment updates for porphyrias are discussed in Section 3. For genodermatoses, we discuss complications and neoplastic risk of xeroderma pigmentosum and a few highlights from other rare disorders. Finally, we conclude with a brief overview of photoprotection updates, from assessing sun-damaged skin to the most effective photoprotective agents.SummaryUp-to-date information will help providers identify and manage this rare group of disorders.
Genetics of neuroendocrine prostate cancer: recent progress in genetic understanding is translating into therapeutic opportunities
Authors: Rinott Mizrahi Gal , Williams Isabella , Azad Arun , Lawrentschuk Nathan 
Published: July 2022

Purpose of review
Neuroendocrine prostate cancer (NEPC) is a rare histologic subtype of prostate cancer with extremely aggressive clinical behaviour and very limited data regarding treatment options. This review is intended to relay new research advances in the understanding of the genetic and epigenetic aberrations underlying NEPC development and to review new targeted therapeutic options developed based on NEPC genetics.

Recent findings
Multiple genomic alterations and epigenetic regulators have been identified in NEPC development. Among these are amplifications of oncogenic transcriptional factors, changes in expression of cell surface markers and epigenetic alterations. This in turn has facilitated a number of new targeted therapies for NEPC that act via different mechanisms including catalytic inhibitors, immune-modulators and epigenetic modifiers. These targeted therapies are now being studied in different phases of clinical trials with some preliminary results showing efficacy.

Summary
NEPC is a highly aggressive malignancy with currently lack of effective treatments. Considerable challenges still remains to improve clinical outcomes in NEPC; however, ongoing trials exploiting novel genetic and epigenetic alterations hold promise for patients suffering from this aggressive disease.
Brief update of the new WHO classification for urothelial carcinoma
Authors: Compérat Eva , Wasinger Gabriel , Oszwald André , Shariat Shahrokh 
Published: July 2022

Purpose of review
Six years after the release of the 4th edition of the WHO classification on male and genitourinary tumors in 2016, the upcoming 5th edition will be released in 2022. This review will discuss significant changes in the new WHO classification for urothelial carcinoma.

Recent findings
Substantial progress has been made during the last 6 years, especially in the molecular definition of bladder cancer, but also in treatment approaches. The authors have incorporated these and other changes relating to surgical pathology and made relevant changes to provide a more logical and consistent structure in separating chapters.

Summary
As the WHO bluebook is intended to be used worldwide, the authors believe that the impact of these changes will be considerable.
Early Peritoneal Dialysis and Postoperative Outcomes in Infants After Pediatric Cardiac Surgery: A Systematic Review and Meta-Analysis*
Authors: Namachivayam Siva P. , Law Suvikrom , Millar Johnny , d’Udekem Yves 
Published: July 2022

Objective:
Peritoneal dialysis (PD) is used in several cardiac surgical units after cardiac surgery, and early initiation of PD after surgery may have the potential to influence postoperative outcomes. This systematic review and meta-analysis aims to summarize the evidence for the association between early PD after cardiac surgery and postoperative outcomes.

Data Sources:
MEDLINE, Embase, and PubMed from 1981 to November 1, 2021.

Study Selection:
Observational studies and randomized trials reporting on early PD after pediatric cardiac surgery.

Data Extraction:
Random-effects meta-analysis was used to estimate the pooled odds ratios (ORs) and their 95% CIs for postoperative mortality and pooled mean difference (MD) (95% CI) for duration of mechanical ventilation and ICU length of stay.

Data Synthesis:
We identified nine studies from the systematic review, and five were considered suitable for meta-analysis. Early initiation of PD after cardiac surgery was associated with a reduction in postoperative mortality (OR, 0.43 (95% CI, 0.23–0.80); number of estimates = 4). Early commencement of PD shortened duration of mechanical ventilation (MD [95% CI], –1.09 d [–1.86 to −0.33 d]; I
2 = 56.1%; p = 0.06) and intensive care length of stay (MD [95% CI], –2.46 d [–3.57 to –1.35 d]; I
2 = 18.7%; p = 0.30], respectively. All three estimates had broad 95% prediction intervals (crossing null) denoting major heterogeneity between studies and wide range of possible study estimates in similar future studies. Overall, studies reporting on the effects of early PD included only a subset of infants undergoing cardiac surgery (typically high-risk infants), so selection bias may be a major issue in published studies.

Conclusions:
This review suggests that early initiation of PD may be associated with beneficial postoperative outcomes in infants after cardiac surgery. However, these results were based on studies of varying qualities and risk of bias. Early identification of high-risk infants after cardiac surgery is important so that prevention or early mitigation strategies can be applied to this cohort. Future prospective studies in high-risk populations are needed to study the role of early PD in influencing postoperative outcomes.
The Utility of Ultrasound in Evaluation of Traumatic Hallux Valgus: a Case Report
Authors: Fultz Connor , Luetmer Marianne T. , Onishi Kentaro 
Published: July 2022

ABSTRACT
Isolated disruption of the medial collateral ligament (MCL) of the great toe is rare and often misdiagnosed as turf toe. It may progress to acquired traumatic hallux valgus (THV), often requiring operative intervention, and a longer return to play. This case of a grade II MCL injury highlights the importance of a thorough physical examination and consideration of the mechanism of injury. It demonstrates the utility of diagnostic musculoskeletal ultrasound in establishing a specific diagnosis upon initial patient presentation with great toe pain. It is an example of the use of ultrasound in guiding treatment and monitoring interval healing. In this case, differentiation of the injury from the classic ‘turf toe’ led to proper stabilization with a toe spacer and activity modification, thus preventing progression of THV and leading to successful nonoperative treatment with full return to sport.

LEVEL OF EVIDENCE
Level V
Lung and Plasma Metabolome in HIV-Associated Obstructive Lung Disease
Authors: Wendt Chris H. , Samorodnitsky Sarah , Lock Eric F. , Kruk Monica , Morris Alison , Leung Janice M. , Kunisaki Ken M. , Griffin Timothy J. 
Published: July 2022

Background:HIV is a risk factor for obstructive lung disease (OLD), independent of smoking. We used mass spectrometry (MS) approaches to identify metabolomic biomarkers that inform mechanistic pathogenesis of OLD in persons with HIV (PWH).Methods:We obtained bronchoalveolar lavage fluid (BALF) samples from 52 PWH, in case:control (+OLD/−OLD) pairs matched on age, smoking status, and antiretroviral treatment. Four hundred nine metabolites from 8 families were measured on BALF and plasma samples using a MS-based Biocrates platform. After filtering metabolites with a high proportion of missing values and values below the level of detection, we performed univariate testing using pairedttests followed by false discovery rate corrections. We used distance-weighted discrimination (DWD) to test for an overall difference in the metabolite profile between cases and controls.Results:After filtering, there were 252 BALF metabolites for analysis from 8 metabolite families. DWD testing found that collectively, BALF metabolites differentiated cases from controls, whereas plasma metabolites did not. In BALF samples, we identified 3 metabolites that correlated with OLD at the false discovery rate of 10%; all were in the phosphatidylcholine family. We identified additional BALF metabolites when analyzing lung function as a continuous variable, and these included acylcarnitines, triglycerides, and a cholesterol ester.Conclusions:Collectively, BALF metabolites differentiate PWH with and without OLD. These included several BALF lipid metabolites. These findings were limited to BALF and were not found in plasma from the same individuals. Phosphatidylcholine, the most common lipid component of surfactant, was the predominant lipid metabolite differentially expressed.
Left Forearm Langerhans Cell Sarcoma Demonstrated by 18F-FDG PET/CT
Authors: He Limeng , Deng Yujiao , Huang Jing , Xie Hongjun , Zhang Wei 
Published: July 2022

Abstract
Langerhans cell sarcoma is a rare neoplastic proliferation of Langerhans cells with a poor prognosis. We report FDG PET/CT findings of Langerhans cell sarcoma in the left forearm of a 77-year-old woman who presented with progressive enlargement of the left forearm mass for over 2 months. 18F-FDG PET/CT demonstrated a high FDG uptake by the mass along with several FDG-avid enlarged lymph nodes in the left arm and axilla. Pathology examination of the biopsied specimen from the left forearm mass led to a diagnosis of Langerhans cell sarcoma.
Fistula Risk Score for Auditing Pancreatoduodenectomy
Authors: van Dongen Jelle C. , van Dam Jacob L. , Besselink Marc G. , Bonsing Bert A. , Bosscha Koop , Busch Olivier R. , van Dam Ronald M. , Festen Sebastiaan , van der Harst Erwin , de Hingh Ignace H. , Kazemier Geert , Liem Mike S.L. , de Meijer Vincent E. , Mieog Jan S.D. , Molenaar Izaak.Q. , Patijn Gijs A. , van Santvoort Hjalmar C. , Wijsman Jan H. , Stommel Martijn W.J. , Wit Fennie , De Wilde Roeland F. , van Eijck Casper H.J. , Groot Koerkamp Bas ,   on behalf of the Dutch Pancreatic Cancer Group
Published: July 2022

Objective:To develop a fistula risk score for auditing, to be able to compare postoperative pancreatic fistula (POPF) after pancreatoduodenectomy among hospitals.Background:For proper comparisons of outcomes in surgical audits, case-mix variation should be accounted for.Methods:This study included consecutive patients after pancreatoduodenectomy from the mandatory nationwide Dutch Pancreatic Cancer Audit. Derivation of the score was performed with the data from 2014 to 2018 and validation with 2019 to 2020 data. The primary endpoint of the study was POPF (grade B or C). Multivariable logistic regression analysis was performed for case-mix adjustment of known risk factors.Results:In the derivation cohort, 3271 patients were included, of whom 479 (14.6%) developed POPF. Male sex [odds ratio (OR)=1.34; 95% confidence interval (CI): 1.09–1.66], higher body mass index (OR=1.07; 95% CI: 1.05–1.10), a final diagnosis other than pancreatic ductal adenocarcinoma/pancreatitis (OR=2.41; 95% CI: 1.90–3.06), and a smaller duct diameter (OR=1.43/mm decrease; 95% CI: 1.32–1.55) were independently associated with POPF. Diabetes mellitus (OR=0.73; 95% CI: 0.55–0.98) was independently associated with a decreased risk of POPF. Model discrimination was good with aC-statistic of 0.73 in the derivation cohort and 0.75 in the validation cohort (n=913). Hospitals differed in particular in the proportion of pancreatic ductal adenocarcinoma/pancreatitis patients, ranging from 36.0% to 58.1%. The observed POPF risk per center ranged from 2.9% to 25.4%. The expected POPF rate based on the 5 risk factors ranged from 11.6% to 18.0% among hospitals.Conclusions:The auditing fistula risk score was successful in case-mix adjustment and enables fair comparisons of POPF rates among hospitals.
Intraoperative Blood Loss Estimation in Hepato-pancreato-biliary Surgery—Relevant, Not Reported, Not Standardized
Authors: Perri Giampaolo , Marchegiani Giovanni , Reich Federico , Casetti Luca , Fontana Martina , Esposito Alessandro , Ruzzenente Andrea , Salvia Roberto , Bassi Claudio 
Published: July 2022

Objective:
To provide an overview of the current practice of intraoperative blood loss (BL) estimation in hepato-pancreato-biliary (HPB) surgery.

Background:
Intraoperative BL is a major quality marker in HPB surgery and a predictor of perioperative outcomes. However, the method for BL estimation is not standardized.

Methods:
A systematic review was performed of original studies published between 2006 and 2021 reporting the intraoperative BL of patients undergoing pancreatic or hepatic resections. A web-based snapshot survey was distributed globally to all members of the International Hepato-Pancreato-Biliary Association (IHPBA).

Results:
A total of 806 studies were included; 480 (60%) had BL as their primary outcome, and 105 (13%) had BL as their secondary outcome. However, 669 (83%) did not specify how BL estimation was performed, and 9 different methods were found among the remaining 136 (17%) studies.
The survey was completed by 252 surgeons. Most of the responders (94%) declared that they systematically performed BL estimation and considered BL predictive of postoperative complications after pancreatic (73%) and liver (74%) resection. All methods previously identified in the literature were used by responders with different frequencies. A calculation based on suction fluid amounts, operative gauze weight, and irrigation was the most used method in the literature (7%) and among responders (51%). Most responders (83%) felt that BL estimation in HPB surgery needs improved standardization.

Conclusions:
Standardization of intraoperative BL estimation is urgently needed in HPB surgery to ensure the consistency of reporting and reproducibility.
Early Outcomes Following Implementation of a Multispecialty Geriatric Surgery Pathway
Authors: Ehrlich April L. , Owodunni Oluwafemi P. , Mostales Joshua C. , Qin Caroline Xu , Hadvani Priyanka J. , Sirisegaram Luxey , Bettick Dianne , Gearhart Susan L. 
Published: July 2022

Objective:
To examine geriatric-specific outcomes following implementation of a multispecialty geriatric surgical pathway (GSP).

Background:
In 2018, we implemented a GSP in accordance with the proposed 32 standards of American College of Surgeons’ Geriatric Surgery Verification Program.

Methods:
This observational study combined data from the electronic health record system (EHR) and ACS-National Surgery Quality Improvement Program (NSQIP) to identify patients ≥65 years undergoing inpatient procedures from 2016 to 2020. GSP patients (2018–2020) were identified by preoperative high-risk screening. Frailty was measured with the modified frailty index. Surgical procedures were ranked according to the operative stress score (1–5). Loss of independence (LOI), length of stay, major complications (CD II–IV), and 30-day all-cause unplanned readmissions were measured in the pre/postpatient populations and by propensity score matching of patients by operative procedure and frailty.

Results:
A total of 533 (300 pre-GSP, 233 GSP) patients similar by demographics (age and race) and clinical profile (frailty) were included. On multivariable analysis, GSP patients showed decreased risk for LOI [odds ratio (OR) 0.26 (0.23, 0.29) P<0.001] and major complications [OR: 0.63 (0.50, 0.78) P<0.001]. Propensity matching demonstrated similar findings. Examining frail patients alone, GSP showed decreased risk for LOI [OR: 0.30 (0.25, 0.37) P<0.001], major complications [OR: 0.31 (0.24, 0.40) P<0.001], and was independently associated with a reduction in length of stay [incidence rate ratios: 0.97 (0.96, 0.98), P<0.001].

Conclusions:
In our diverse patient population, implementation of a GSP led to improved geriatric-specific surgical outcomes. Future studies to examine pathway compliance would promote the identification of further interventions.
Diabetes Mellitus is an Independent Predictor of Spinal Cord Injury After Descending Thoracic and Thoracoabdominal Aneurysm Repair
Authors: Gambardella Ivancarmine , Worku Berhane , Lau Christopher , Tranbaugh Robert F. , Tabaie Sheida , Ivascu Natalia , Girardi Leonard N. 
Published: July 2022

Objective:To discern the impact of diabetes mellitus (DM) on spinal cord injury (SCI) after open descending thoracic and thoracoabdominal aneurysm repair (DTAAAR).Background:Compared with euglycemia, hyperglycemia, and ketosis make neurons respectively more vulnerable and more resilient to ischemia.Methods:During the study period (1997–2021), patient who underwent DTAAAR were dichotomized according to the presence/absence of DM. The latter was investigated as predictor of our primary (SCI) and secondary [operative mortality (OM), myocardial infarction, stroke, need for tracheostomy, de novo dialysis, and survival] endpoints. Two-level risk-adjustment employed maximum likelihood conditional regression after 1:2 propensity-score matching.Results:DTAAAR was performed in 934 patients. Ninety-two diabetics were matched to 184 nondiabetics. All preoperative variables had a standardized mean difference <0.1 between the matched groups. Patients with DM had higher SCI (6.5% vs. 1.6%,P0.03) and OM (14.1% vs. 6.0%,P=0.01), while the other secondary endpoints were similar between groups in the matched sample. DM was an independent predictor for SCI in the matched sample (odds ratio: 5.05, 95% confidence interval: 1.17–21.71). Matched patients with DM presented decreased survival at 1 (70.2% vs. 86.2%), 5 (50.4% vas 67.5%), 10 years (31.7% vs. 36.7%) (P=0.03). The results are summarized in the graphical abstract.Conclusion:DM is associated to increased OM and decreased survival, and it is an independent predictor of SCI after open DTAAAR. Strict perioperative glycemic control should be implemented, and exogenous ketones should be investigated as neuroprotective agents to reduce such adverse events.
The Effect of Hyperosmolar Water-Soluble Contrast for the Management of Adhesive Small Bowel Obstruction
Authors: Klingbeil Kyle D. , Wu James X. , Osuna-Garcia Antonia , Livingston Edward H. 
Published: July 2022

Objective:
To better understand the efficacy of water-soluble contrast (WSC) in the treatment of adhesive small bowel obstruction (SBO).

Background:
Guidelines recommend using WSC to treat adhesive SBO nonoperatively by acting as a cathartic agent. The evidence supporting this practice is mixed.

Methods:
A systematic review and meta-analysis of published articles describing the effect of WSC compared with control treatments was performed for the period of January 1, 1990 to November 1, 2021. Study quality was assessed using the Cochrane risk-of-bias and the Newcastle-Ottawa tools. The therapeutic effect of WSC was assessed by operative rates and hospital length of stay (HLOS) in nonsurgical patients.

Results:
The initial search yielded 4879 articles, of which, 28 were selected for full text review. We identified 11 eligible randomized controlled trials (RCTs) which included 817 patients and 9 observational studies of 3944 patients. HLOS in nonsurgical patients decreased by 1.95 days (95% confidence interval: 0.56–3.3) in the RCTs and could not be assessed in the observational studies. WSC did not significantly affect operative rates in the RCTs (19.8% vs. 21.4%) but did reduce rates in the observational studies (11% vs. 16%, risk ratio: 0.56, 95% confidence interval: 0.39–0.82).

Conclusion:
WSC studies may reduce HLOS for patients who have SBO and do not require surgery. However, the current literature is heterogenous with considerable design limitations. High-quality RCTs are needed using standardized protocols to determine the full benefit of WSC for the management of SBO.
Endoscopic Retrograde Appendicitis Therapy
Authors: Khan Suliman , Ali Faisal S. , Ullah Saif 
Published: July 2022

Abstract:
Endoscopic retrograde appendicitis therapy (ERAT) has emerged as a promising, non-invasive treatment for acute uncomplicated appendicitis (AUA). ERAT involves cannulation, appendicography, appendiceal stone extraction, appendiceal lumen irrigation, and stent deployment. Recent randomized trials comparing ERAT to laparoscopic appendectomy (LA) have provided promising results in terms of safety and efficacy of ERAT. If the current trajectory of research and development is maintained, ERAT will likely become a strong contender for the standard of care for AUA. Standardized training and credentialing for ERAT, akin to procedures established for endoscopic retrograde cholangiopancreatography, will be pivotal to global adoption of this modality.