bluuebunny/crossref_metadata_2025_split huggingface dataset:
The learning curve for robot-assisted distal pancreatectomy: a single-center experience of 301 cases
Authors: Xu Qiang , Liu Tiantong , Zou Xi , Li Pengyu , Gao Ruichen , Dai Menghua , Guo Junchao , Zhang Taiping , Liao Quan , Liu Ziwen , Wang Weibin , Cong Lin , Wu Wenming , Zhao Yupei 
Published: August 2022

Objective:
Robotic distal pancreatectomy (RDP) has become a routine procedure in many pancreatic centers. This study aimed to describe a single-center experience with RDP since the first case, identify the learning curves of operation time and complication rate, and discuss the safety and feasibility of RDP.

Methods:
We collected and retrospectively analyzed the single-center surgical experience of 301 patients undergoing RDP at Peking Union Medical College Hospital (PUMCH) between 2012 and 2022 and described the change in operation proficiency and occurrence of perioperative complications in this observational study. The learning curve was assessed using the cumulative sum method.

Results:
We observed a three-phase pattern of RDP learning with operation time, complications, and postoperative pancreatic fistula as indicators and a two-phase pattern for spleening-preserving success. The mean operation time was 3.9 hours. The incidence rate of clinically significant postoperative pancreatic fistula (CRPOPF) was 17.9% and overall Clavien-Dindo complication rate (≥3) was 16.6%. The change of postoperative complicate rate was correlated with percentage of malignant cases.

Conclusion:
In the last decade, an evident decrease was seen in operation time, complication rate, and an increase in the spleen-preserving rate of distal pancreatectomy. With proper training, RDP is a safe and feasible procedure.
Machine Learning to Predict Hearing Preservation After Middle Cranial Fossa Approach for Sporadic Vestibular Schwannomas
Authors: Dixon Peter R. , Wojdyla Luke , Lee Joshua , Moshtaghi Omid , Claussen Alexander D. , Khan Usman A. , Mcdonald Marin A. , Schwartz Marc S. , Friedman Rick A. 
Published: August 2022

Objective
Predict hearing preservation after middle cranial fossa approach for vestibular schwannomas.

Study Design
Application of machine learning algorithms, including classification and regression trees and random forest models to observational data.

Setting
Single-tertiary referral center.

Participants
Patients (n = 144) with a previously untreated sporadic vestibular schwannoma who underwent microsurgical resection by middle cranial fossa approach between November 2017 and November 2021.

Interventions
Middle cranial fossa approach.

Main Outcome and Measure(s)
Hearing preservation, defined by postoperative word recognition score of 50% or greater and pure tone average below 50 dB HL or less than 10% reduction in word recognition score. Model performance was evaluated with classification accuracy in an independent validation sample. Variable importance for the random forest model is reported according to entropy, a measure of mean decrease in model accuracy incurred by excluding each variable from the model.

Results
Hearing preservation was achieved in 60% of patients (86 of 144) overall. The classification and regression tree model identified preoperative pure tone average with a cut point of 30 dB HL, and more posterior tumor position to be the most important prognostic features for hearing preservation. Model accuracy was 0.68. The random forest model demonstrated perfect accuracy (1). Baseline pure tone average, word recognition score, and anteroposterior tumor position were among the most influential features for hearing preservation prediction.

Conclusion
Machine learning algorithms have the potential for accurate prediction of hearing preservation rates after middle fossa approach for vestibular schwannomas at a single institution. These models have the capacity for continued refinement with ongoing addition of data.
Hearing Loss Is Associated With Worse Socialization in the U.S. Hispanic Adult Population
Authors: Grewal Maeher R. , Golub Justin S. 
Published: August 2022

Objective
The association between hearing loss and socialization has been characterized in limited detail and primarily among non-Hispanic Caucasians. We aimed to study this relationship using more detailed socialization measures than previously used and focusing on Hispanics.

Study Design
Cross-sectional epidemiologic study (Hispanic Community Health Study).

Setting
Multicentered, four U.S. communities.

Participants
U.S. Hispanics ages 18 to 76 years.

Main Measures
Multivariable linear regression controlling for confounders (age, sex, education) was conducted to analyze the association between hearing loss (four-frequency pure tone average) and socialization. Socialization was assessed with three independent surveys: a modified Cohen Interpersonal Support Evaluation List (ISEL), the Cohen Social Network Index (SNI), and a modified Moos Family Environment Scale.

Results
Average age was 46.7 years (standard deviation [SD], 13.6 yr; range, 18–75 yr). Average ISEL composite score was 25.9 (SD, 6.66; n = 4,330). Controlling for confounders, for every 10 dB worsening in hearing, the ISEL score decreased by 0.31 (95% confidence interval [CI], 0.08–0.52; p < 0.01). Average SNI network diversity score was 6.89 (SD, 1.81; n = 3,117) and average SNI network size was 15.4 individuals (SD, 8.11). Controlling for confounders, for every 10 dB worsening in hearing, the SNI network diversity decreased by 0.22 (95% CI, 0.15–0.29; p < 0.001), and SNI size decreased by 0.25 (95% CI, 0.07–0.62; p < 0.05). Average family cohesion score on the Moos Family Environment Scale was 12.9 (SD, 2.77; n = 4,234). Controlling for age, sex, and education, for every 10 dB worsening in hearing, family cohesion decreased by 0.14 (95% CI, 0.04–0.23; p < 0.01).

Conclusion
Hearing loss is associated with less social support, smaller/less diverse social networks, and less family cohesion in U.S. Hispanics.
Bacterial infection in coronavirus disease 2019 patients: co-infection, super-infection and how it impacts on antimicrobial use
Authors: Nedel Wagner , da Silveira Fernando , da Silva Cristofer Farias , Lisboa Thiago 
Published: August 2022

Purpose of review
Since the beginning of the severe acute respiratory syndrome coronavirus 2 pandemic, there has been a large increase in the consumption of antimicrobials, both as a form of treatment for viral pneumonia, which has been shown to be ineffective, and in the treatment of secondary infections that arise over the course of the severe presentation of coronavirus disease 2019 (COVID-19). This increase in consumption, often empirical, ends up causing an increase in the incidence of colonization and secondary infections by multi and pan-resistant germs.

Recent findings
The presence of a hyperinflammatory condition induced by the primary infection, associated with the structural damage caused by viral pneumonia and by the greater colonization by bacteria, generally multiresistant, are important risk factors for the acquisition of secondary infections in COVID-19. Consequently, there is an increased prevalence of secondary infections, associated with a higher consumption of antimicrobials and a significant increase in the incidence of infections by multi and pan-resistant bacteria.

Summary
Antimicrobial stewardship and improvement in diagnostic techniques, improving the accuracy of bacterial infection diagnosis, may impact the antibiotic consumption and the incidence of infections by resistant pathogens.
Cosmetic Outcomes of Simple Pediatric Facial Lacerations Repaired With Skin Adhesive Compared With Skin Adhesive With Underlying Adhesive Strips
Authors: Munns Erin , Kienstra Andrew J. , Combs Patrick D. , Gabriele Giovanni , Wilkinson Matthew 
Published: August 2022

Objectives
A randomized controlled trial was designed to compare 2 methods of repairing simple pediatric facial lacerations. We hypothesized that wounds repaired with skin adhesive and underlying adhesive strips compared with skin adhesive alone would be superior in regard to cosmetic outcome.

Methods
Patients aged younger than 18 years presenting to the emergency department with simple facial lacerations requiring repair were eligible for enrollment. Patients were randomly assigned to repair with either skin adhesive alone or skin adhesive with underlying adhesive strips. Families were contacted by phone 1 week after enrollment to discuss short-term complications. The cosmetic appearance of photographs of the scars at 2 months was analyzed using a visual analog scale by a blinded pediatric emergency physician and pediatric plastic surgeon.

Results
One hundred twenty patients were enrolled, with 92 returning for the 2-month follow-up. The visual analog scale scores for the skin adhesive with adhesive strips group were similar to the skin adhesive alone group (60 mm vs 58 mm, P = 0.540). Spearman ρ correlation coefficient between the raters was 0.669, indicating strong agreement. There was no significant difference in rates of return visits, wound dehiscence, or infection. The skin adhesive with adhesive strips group had a longer time to perform the repair (195 seconds vs 107 seconds, P < 0.001).

Conclusions
Using adhesive strips to first approximate a wound before applying skin adhesive leads to a similar cosmetic outcome compared with simple facial lacerations repaired with skin adhesive alone. Although the study showed longer time to complete the repair, this approach may still be useful in settings where approximation is difficult to obtain manually.
Biomechanical comparison of a 3D-printed prosthetic foot with conventional feet in people with transtibial amputation: A prospective cohort study
Authors: Trinler Ursula , Heitzmann Daniel W W , Hitzeroth Sebastian , Alimusaj Merkur , Rehg Mathias , Hogan Aidan 
Published: August 2022

Introduction:
The method of 3D printing is increasingly gaining utilization in clinical applications and may support prosthetic fitting. The aim was to compare biomechanical outcomes of people with a transtibial amputation using a novel, individualizable, 3D-printed prosthetic foot (ComfyStep, Mecuris) with two conventional, widely used prosthetic feet during level ground walking using a 3D motion analysis system.

Methods:
Ten individuals with an unilateral transtibial amputation were fitted with 3 prosthetic feet (ComfyStep, Assure/Össur, DynamicMotion/Ottobock) using their current, well-fitting socket. They had at least 1 week of familiarization for each foot before gait analyses were conducted. Kinematics and kinetics as well as roll over shape (ROS) length and radius were calculated and compared between feet.

Results:
The sound side gait parameters of the participants were comparable when using different feet. However, there were differences on the affected side. The statistical analysis revealed that the 3D-printed foot differed significantly compared with the conventional feet in the following aspects: reduced range of motion, increased plantar flexion moment, reduced plantar flexion power, larger ROS radius, less favorable energy ratio, and higher overall stiffness.

Conclusion:
In principle, 3D-printed feet have advantages over conventional “off the shelf” feet, as their biomechanical characteristics could be adjusted more in detail according to the patient needs. Although, differences between conventional feet and the ComfyStep were shown. Whether these differences have a negative clinically relevant effect remains unclear. However, results suggest that commercially available 3D-printed feet should incorporate systematically better adjustments, for example, for stiffness, to enhance prosthetic performance.
Intense 68Ga-Pentixafor Activity in Idiopathic Retroperitoneal Fibrosis
Authors: Shu Qiaoqiao , Hu Mei , Deng Maoxue , Chen Yue , Cai Liang 
Published: August 2022

Abstract
A 52-year-old man was admitted to our hospital with lower abdominal and low back pain, and abdomen CT at an outside hospital presented a retroperitoneal mass with left urinary tract obstruction and hydronephrosis. In 68Ga-pentixafor PET/CT, the retroperitoneal mass showed intense radioactivity. Subsequently, the patient underwent biopsy of the retroperitoneal mass. The pathological examination showed only fibrous tissue without tumor cells. The patient was finally diagnosed with idiopathic retroperitoneal fibrosis. Our case demonstrated that idiopathic retroperitoneal fibrosis had intense uptake of 68Ga-pentixafor.
HOSPITAL CHARACTERISTICS ARE ASSOCIATED WITH CLINICAL OUTCOMES IN PATIENTS WITH CARDIOGENIC SHOCK
Authors: Bloom Jason E. , Nehme Ziad , Andrew Emily , Dawson Luke P. , Fernando Himawan , Noaman Samer , Stephenson Michael , Anderson David , Pellegrino Vincent , Cox Shelley , Lefkovits Jeffrey , Chan William , Kaye David M. , Smith Karen , Stub Dion 
Published: August 2022

ABSTRACT

Background: Regionalized systems of care for the management of cardiogenic shock (CS) are increasingly being utilized. This study aims to assess whether receiving hospital characteristics such as the availability of 24-hour coronary angiography, on-site cardiac surgery, and annual treated CS volume influence outcomes in patients transferred by emergency medical services (EMS) to hospital with CS. Methods: This population-based cohort study included consecutive adult patients with CS who were transferred to hospital by EMS between January 1, 2015 and June 30, 2019 in Victoria, Australia. Data were obtained from individually linked ambulance, hospital, and state death index data sets. The primary outcome assessed was 30-day mortality stratified by the availability of 24-hour coronary angiography (cardiac center) at the receiving hospital. Results: A total of 3,217 patients were transferred to hospital with CS. The population had an average age of 67.9 +/− 16.1 years, and 1,289 (40.1%) were female. EMS transfer to a cardiac center was associated with significantly reduced rates of 30-day mortality (adjusted odds ratio [aOR], 0.78; 95% confidence interval [CI], 0.64–0.95), compared with noncardiac centers. Compared with the lowest annual CS volume quartile (<18 cases per year), hospitals in the highest volume quartile (>55 cases per year) had reduced risk of 30-day mortality (aOR, 0.71; 95% CI, 0.56–0.91). A stepwise reduction in the adjusted probability of 30-day mortality was observed in patients transferred by EMS to trauma level 1 centers (34.6%), compared with cardiothoracic surgical centers (39.0%), noncardiac surgical metropolitan (44.9%), and rural (51.3%) cardiac centers, all P < 0.05. Conclusion: Receiving hospital characteristics are associated with survival outcomes in patients with CS. These finding have important implications for establishing regionalized systems of care for patients with CS who are transferred to hospital by EMS.
EARLY INITIATION OF VASOPRESSIN REDUCES ORGAN FAILURE AND MORTALITY IN SEPTIC SHOCK
Authors: Rydz Alexandria C. , Elefritz Jessica L. , Conroy Megan , Disney Kathryn A. , Miller Christopher J. , Porter Kyle , Doepker Bruce A. 
Published: August 2022

ABSTRACT

Purpose: The aim of the study is to determine whether initiating vasopressin earlier in septic shock reduces organ dysfunction and in-hospital all-cause mortality. Methods: This multicenter, retrospective, cohort study evaluated patients admitted to the medical intensive care unit between October 2011 and August 2018 with septic shock who received vasopressin within 48 hours of shock onset. The primary composite outcome was the proportion of patients with a change in the Sequential Organ Failure Assessment score greater than 3 from baseline to 72 hours after initiation of vasopressin and/or in-hospital all-cause mortality. Secondary outcomes included time to hemodynamic stability, acute kidney injury, and intensive care unit length of stay. Results: A total of 385 patients included in the final evaluation with a mean Acute Physiology and Chronic Health Evaluation II score of 31 and a mean baseline Sequential Organ Failure Assessment score of 13. Median time to initiation of vasopressin after norepinephrine was 7.3 hours. The primary composite outcome was significantly reduced in patients who had vasopressin initiated earlier in septic shock (odds ratio = 1.08, 95% confidence interval = 1.03–1.13, P < 0.001). After controlling for baseline data in a multivariable regression model the primary outcome remained statistically significant (odds ratio = 1.04, 95% confidence interval = 1.02–1.07, P = 0.001). Conclusions: Early initiation of vasopressin in septic shock may reduce the risk of in-hospital all-cause mortality and/or organ dysfunction.
Unmet Social Health Needs as a Driver of Inequitable Outcomes After Surgery
Authors: Taylor Kathryn K. , Neiman Pooja U. , Bonner Sidra , Ranganathan Kavitha , Tipirneni Renuka , Scott John W. 
Published: August 2022

Objective:
This study aims to identify opportunities to improve surgical equity by evaluating unmet social health needs by race, ethnicity, and insurance type.

Background:
Although inequities in surgical care and outcomes based on race, ethnicity, and insurance have been well documented for decades, underlying drivers remain poorly understood.

Methods:
We used the 2008–2018 National Health Interview Survey to identify adults age 18 years and older who reported surgery in the past year. Outcomes included poor health status (self-reported), socioeconomic status (income, education, employment), and unmet social health needs (food, housing, transportation). We used logistic regression models to progressively adjust for the impact of patient demographics, socioeconomic status, and unmet social health needs on health status.

Results:
Among a weighted sample of 14,471,501 surgical patients, 30% reported at least 1 unmet social health need. Compared with non-Hispanic White patients, non-Hispanic Black, and Hispanic patients reported higher rates of unmet social health needs. Compared with private insurance, those with Medicaid or no insurance reported higher rates of unmet social health needs. In fully adjusted models, poor health status was independently associated with unmet social health needs: food insecurity [adjusted odds ratio (aOR)=2.14; 95% confidence interval (CI): 1.89–2.41], housing instability (aOR=1.69; 95% CI: 1.51–1.89), delayed care due to lack of transportation (aOR=2.58; 95% CI: 2.02–3.31).

Conclusions:
Unmet social health needs vary significantly by race, ethnicity, and insurance, and are independently associated with poor health among surgical populations. As providers and policymakers prioritize improving surgical equity, unmet social health needs are potential modifiable targets.
Capillimicrobium parvum gen. nov., sp. nov., a novel representative of Capillimicrobiaceae fam. nov. within the order Solirubrobacterales, isolated from a grassland soil
Authors: Vieira Selma , Huber Katharina J. , Geppert Alicia , Wolf Jacqueline , Neumann-Schaal Meina , Luckner Manja , Wanner Gerhard , Müsken Mathias , Overmann Jörg 
Published: August 2022

The order

Solirubrobacterales

is a deep-branching lineage within the phylum

Actinomycetota

. Most representatives have been isolated from terrestrial environments. A strain isolated from a grassland soil was found to be affiliated with this order and therefore characterized by a polyphasic approach. Cells of strain 0166_1T are Gram-positive, short rods, non-motile, non-spore-forming and divide by binary fission. A surface layer with protrusions covers the majority of the cells. Strain 0166_1T grows optimally around neutral to slightly alkaline pH (pH 7.1–7.9) and at temperatures between 24–36 °C in SSE/HD 1 : 10 medium. It grows optimally with 0–0.5% NaCl (w/v) but can withstand concentrations up to 5 %. The major fatty acids are C18 : 1 ω9c, C16 : 1
ω7c, C17 : 0 cyclo ω7c, C18 : 1
ω7c methyl and C19 : 0 cyclo ω9c. The major polar lipids are diphosphatidylglycerol, two unidentified phospholipids and one unidentified glycolipid. MK-7(H4) and MK-7(H2) are the predominant respiratory quinones. meso-2,6-Diaminopimelic acid is the diagnostic diamino acid in the cell-wall peptidoglycan. The G+C content for strain 0166_1T is 72.8 mol%. 16S rRNA gene sequence analysis indicated that this bacterium was related to

Conexibacter arvalis

KV-962T and

Conexibacter stalactiti

YC2-25T with 95.5 and 95.2 % sequence similarity, respectively. Based on the phenotypic, genomic and phylogenetic data, we propose the novel species Capillimicrobium parvum sp. nov. (type strain 0166_1T=DSM 104329T=LMG 29999T=CECT 9240T) of the novel genus Capillimicrobium gen. nov. within the novel family Capillimicrobiaceae fam. nov.
Screening Immunotherapy Targets to Counter Radiation-Induced Neuroinflammation
Authors: Sharma Sadhana , Fallgreen Christina , Weil Michael M. , Chatterjee Anushree , Nagpal Prashant 
Published: August 2022

ABSTRACTGalactic cosmic rays (GCR) in space induce increase in cerebral amyloid-β levels and elevated levels of microgliosis and astrocytosis, causing accelerated neurodegeneration from this increased neuroinflammation. Even exposure to low-levels of high-Z high-energy (HZE) radiation (50 cGy) has been shown to induce biochemical and immunohistochemical changes in short-term leading to degradation in cognition, motor skills, and development of space-induced neuropathy. There is lack of effective neuroinflammation countermeasures, and current experimental therapies require invasive intracerebral and intrathecal delivery due to difficulty associated with therapeutic crossover between blood-brain barrier. Here, we present a new countermeasure development approach for neurotherapeutics using high-throughput drug-discovery, target validation, and lead molecule identification with nucleic acid-based molecules. These Nanoligomer™ molecules are rationally designed using a bioinformatics and AI-based ranking method and synthesized as a single-modality combining 6-different design elements to up- or down-regulate gene expression of target gene at will, resulting in elevated or diminished protein expression of intended target. This platform approach was used to perturb and identify most effective upstream regulators and canonical pathways for therapeutic intervention to reverse radiation-induced neuroinflammation. The lead Nanoligomer™ and corresponding target granulocyte-macrophage colony-stimulating factor (GM-CSF) were identified usingin vitrocell-based screening in human astrocytes and donor derived peripheral blood mononuclear cells (PBMCs) and further validatedin vivousing a mouse model of radiation-induced neuroinflammation. GM-CSF transcriptional downregulator Nanoligomer 30D.443_CSF2 downregulated proinflammatory cytokine GM-CSF (or CSF2) using simple intraperitoneal injection of low-dose (3mg/kg) and completely reversed expression of CSF2 in cortex tissue, as well as other neuroinflammation markers. These results point to the broader applicability of this approach towards space countermeasure development, and potential for further investigation of lead neurotherapeutic molecule as a reversible gene therapy.