bluuebunny/crossref_metadata_2025_split huggingface dataset:
Headaches in Traumatic Brain Injury: Improvement Over Time, Associations With Quality of Life, and Impact of Migraine-Type Headaches
Authors: Flynn Spencer , Moore Brian , van der Merwe Andre J. , Moses Anita , Lo Jessica , Shahim Pashtun , Chan Leighton 
Published: June 2022

Objective:
To describe headache characteristics over time in patients with traumatic brain injury (TBI).

Setting:
Patients enrolled and followed at the National Institutes of Health Clinical Center between 2011 and 2020.

Participants:
There were 147 patients with TBI, with 74 mild TBI (mTBI), 49 moderate (modTBI), 24 severe (sTBI), and 20 individuals without brain injury (IWBIs).

Design:
Regular surveys of headache characteristics in patients with TBI were conducted. Patients were enrolled as early as 30 days post-injury and followed up to 5 years, for 419 total visits and 80 patients with multiple return visits.

Main Measures:
Surveys of headache characteristics, including headache severity, were measured on a 0- to 10-point Likert scale and headache frequency quantified as headaches per month. Patients with migraine-type headaches (n = 39) were identified by a clinician-administered tool. Functional outcomes were measured using the Glasgow Outcome Scale-Extended (GOS-E) and quality of life by the Satisfaction with Life Scale (SWLS) and the 36-item Short Form Survey (SF-36).

Results:
At their initial visit, patients with TBI had more severe and frequent headaches than IWBIs (median 5 vs 2.5, P < .001; median 2 vs 0.2, P < .001), as did patients with mTBI compared with modTBI/sTBI (all P ≤ .01). Migraines were associated with lower SWLS and SF-36 scores. Migraines and young age were associated with higher headache severity and frequency across time points. Longitudinally, time post-injury correlated with improvement in headache severity and frequency without differences by injury severity. However, time post-injury did not correlate with improvement in headache characteristics in a patient subgroup with moderate/severe headaches.

Conclusion:
Our findings suggest that patients with mild, moderate, or severe TBI see improvement in headaches over time. However, patients should be counseled that improvement is modest and seen more in patients with milder headache symptoms. Patients with migraine headaches in particular are at risk for worse headache characteristics with greater impact on quality of life.
IMPACT OF PENETRATION AND IMAGE ANALYSIS IN OPTICAL COHERENCE TOMOGRAPHY ON THE MEASUREMENT OF CHOROIDAL VASCULARITY PARAMETERS
Authors: Chen Sisi , Zheng Gu , Yu Xiangle , Jiang Yanfeng , Lin Zhiyang , Lin Guangqing , Chen Wen , Shen Meixiao , Lu Fan 
Published: June 2022

Purpose:
To investigate the impact of penetration and image analysis in different optical coherence tomography (OCT) instruments on the measurement of choroidal vascularity parameters.

Methods:
Twenty-three healthy volunteers were imaged using two swept-source OCTs and one spectral-domain OCT. A fully automatic segmentation method based on ResNet-UNet and Niblack local threshold binarization was performed to quantify the relevant choroidal vascular parameters, including choroidal vascularity index, total choroidal volume, and luminal volume. The intraclass correlation coefficient (ICC) and coefficient of repeatability (COR) were used to analyze the repeatability and consistency of automatic and manual segmentation, respectively.

Results:
Both swept-source OCT devices showed good consistency of luminal volume and total choroidal volume measurements (all ICC value >0.98 with COR% < 8.53%) based on manual segmentation, whereas the consistency of the spectral-domain OCT was lower (ICC value <0.60 with COR% > 40%), which was greatly improved after using the automatic algorithm (ICC value >0.99 with COR% < 4%). The repeatability of choroidal vascularity index obtained from different OCT images using manual or automatic segmentation showed good agreement (all ICC values >0.85), whereas the choroidal vascularity index measurement from the spectral-domain OCT was larger than the other two swept-source OCT devices (ICC value <0.65).

Conclusion:
For healthy youngsters, the penetration of OCT plays a role in the measurement precision for choroidal vascularity parameters, and automatic segmentation can improve the ability of choroidal boundary identification with deficient penetration, suggesting these factors need to be considered in clinical work.
DETECTION AND LOCALIZATION OF RETINAL BREAKS IN ULTRAWIDEFIELD FUNDUS PHOTOGRAPHY USING a YOLO v3 ARCHITECTURE-BASED DEEP LEARNING MODEL
Authors: Oh Richul , Oh Baek-Lok , Lee Eun Kyoung , Park Un Chul , Yu Hyeong Gon , Yoon Chang Ki 
Published: June 2022

Purpose:
We aimed to develop a deep learning model for detecting and localizing retinal breaks in ultrawidefield fundus (UWF) images.

Methods:
We retrospectively enrolled treatment-naive patients diagnosed with retinal break or rhegmatogenous retinal detachment and who had UWF images. The YOLO v3 architecture backbone was used to develop the model, using transfer learning. The performance of the model was evaluated using per-image classification and per-object detection.

Results:
Overall, 4,505 UWF images from 940 patients were used in the current study. Among them, 306 UWF images from 84 patients were included in the test set. In per-object detection, the average precision for the object detection model considering every retinal break was 0.840. With the best threshold, the overall precision, recall, and F1 score were 0.6800, 0.9189, and 0.7816, respectively. In the per-image classification, the model showed an area under the receiver operating characteristic curve of 0.957 within the test set. The overall accuracy, sensitivity, and specificity in the test data set were 0.9085, 0.8966, and 0.9158, respectively.

Conclusion:
The UWF image-based deep learning model evaluated in the current study performed well in diagnosing and locating retinal breaks.
Development and validation of a nomogram for predicting the likelihood of metastasis in prostate cancer patients undergoing Ga-68 PSMA PET/CT due to biochemical recurrence
Authors: Coskun Nazim , Kartal M. Oguz , Erdogan A. Sinem , Ozdemir Elif 
Published: June 2022

Objective
To develop a nomogram based on commonly used clinical data for predicting the likelihood of metastasis in gallium-68 prostate-specific membrane antigen PET/computed tomography (Ga-68 PSMA PET/CT) scans of prostate cancer patients with confirmed biochemical recurrence (BCR).

Methods
One-hundred thirty-five (n = 135) patients who underwent Ga-68 PSMA PET/CT due to BCR were included in the study. Predictors of metastasis in Ga-68 PSMA PET/CT were determined with multivariable logistic regression analysis. Coefficients derived from the regression model were used to develop a prediction nomogram. The performance of the prediction model was evaluated with receiver operating characteristic analysis. Internal validation was performed with 50 bootstrap resamples, and the nomogram’s clinical benefit was assessed with decision curve analysis.

Results
Multivariable logistic regression analysis revealed that ISUP group, prostate-specific antigen (PSA) before PET and PSA doubling time were independent predictors of metastasis in Ga-68 PSMA PET/CT. A prediction nomogram was developed according to this model [the area under curve: 0.866; 95% confidence interval (CI), 0.788–0.944]. The best cutoff value of the nomogram-derived likelihood for predicting metastasis was 60%, with a bootstrap-corrected accuracy of 78.8%. An online version of the nomogram was implemented on pro-gram.nzm.co (https://pro-gram.nzm.co).

Conclusion
The proposed nomogram provides a practical approach for predicting the likelihood of imaging-based metastasis according to Ga-68 PSMA PET/CT in patients with BCR, with results ≥60% being the most accurate cutoff for referring patients to Ga-68 PSMA PET/CT. If validated in a larger cohort, this tool can serve as a guide for the appropriate use of Ga-68 PSMA PET/CT.
Mycophenolate Mofetil Use Is Associated With Reduced Incidence of Food Allergy in Liver Transplanted Children
Authors: Haflidadottir Svanhildur , Østensen Anniken Bjørnstad , Matthews Iren Lindbak , Line Pål-Dag , Almaas Runar 
Published: June 2022

Objectives:
The incidence of food allergy in children following liver transplantation is high, and the pathogenesis is still not known. We aimed to identify risk factors for development of food allergies in liver transplant children.

Methods:
One hundred seven children and adolescents who underwent liver transplantation from 1999 to 2019 were included. Data were retrospectively collected from medical records and included total and specific immunoglobulin E (IgE), eosinophil cationic protein, and eosinophil count 12 months after transplantation and at yearly follow-up (median follow-up).

Results:
Twenty-four/107 (22%) patients reported clinical food reactions. Median time from transplantation to debut of food allergy was 1.6 [interquartile range (IQR): 0.6–3.3] years. Mycophenolate mofetil (MMF) was discontinued in 24 out of 78 patients (31%) due to side effects. Children treated with MMF in addition to tacrolimus 1 year after transplantation reported less food allergy (12.5% vs 37.8%, P = 0.003) and sensitization to food allergens one year after transplantation (8.9% vs 17.8%, P = 0.02) than those not receiving MMF. Tacrolimus trough levels did not differ between the patients treated with MMF and those who were not. Treatment with MMF 2 years after transplantation was associated with less food allergy (P = 0.001) and food sensitization (P = 0.002), also when adjusted for age at transplantation (P = 0.006 and P = 0.03, respectively) or for use of basilixmab (P = 0.015 and P = 0.018, respectively). Basiliximab was also associated with less food allergies.

Conclusions:
Use of MMF 1 and 2 years after transplantation was associated with less food allergy and sensitization against food allergens. The effect of MMF was not due to reduced trough levels of tacrolimus.
Volumetric Effect and Patient Satisfaction after Facial Fat Grafting
Authors: Tuin A. Jorien , Schepers Rutger H. , Spijkervet Frederik K. L. , Vissink Arjan , Jansma Johan 
Published: June 2022

Background:
Facial fat grafts decrease in volume after transplantation. This observation is based on overall facial three-dimensional analyses, because there is sparse information on volume changes in well-defined aesthetic areas. The authors aimed to assess the overall and, more specifically, the local volumetric effects of facial fat grafting and relate these effects to patient satisfaction up to 1 year after treatment.

Methods:
All consecutive adult female patients who were scheduled for facial fat grafting without additional surgical procedures were asked to participate. All patients underwent the same fat grafting method. An algorithm-based personalized aesthetic template was applied to define specific aesthetic areas on the preoperative three-dimensional image. Objective outcome parameters [i.e., three-dimensional volume differences, patient satisfaction (FACE-Q questionnaire)] were measured at baseline and at 6 weeks, 6 months, and 12 months after fat grafting.

Results:
Of 33 female patients who underwent a facial fat graft procedure, 23 patients had complete three-dimensional data and were eligible for analysis. The highest volume gain was observed 6 weeks after grafting and was followed by a gradual loss thereafter. Overall and in the zygomatic area, a substantial gain in volume was still present 1 year after grafting, whereas this effect was lost in the lip area. FACE-Q scales Satisfaction with Facial Appearance Overall and Satisfaction with Cheeks improved too, whereas scores for Lines: Lips returned to baseline levels. The improvement in FACE-Q scales was in agreement with the objective change in volume.

Conclusion:
Gain in overall and local volumetric effects is accompanied by comparable changes in patient satisfaction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Evolution of the Coleman Technique
Authors: Egro Francesco M. , Roy Eva , Rubin J. Peter , Coleman Sydney R. 
Published: June 2022

Summary:
Fat grafting is one of the most revolutionary surgical techniques of our century, and it has changed the field of plastic surgery and regenerative medicine. Early reports of fat grafting date back to the late nineteenth century, but the results were unsatisfactory because of minimal graft retention. It was not until Sydney R. Coleman challenged the dogma and introduced a standardized approach to fat grafting after years of research and learning from experts across the world. The Coleman technique represents an evolutionary approach to fat grafting, with three main components: harvesting, refinement, and placement. The Coleman technique has been adopted and modified by surgeons around the world because it has allowed a reliable increase in fat graft survival through a standardized process. This article discusses the influencing factors and milestones that led to this world-known technique, in addition to Dr. Coleman’s current practices, pearls, pitfalls, and lessons learned over the years. The knowledge of the true potential and usefulness of fat is in its infancy, with its regenerative potential becoming increasingly recognized. Current and future research will likely prove that autologous fat has many clinical applications beyond its well-known aesthetic and reconstructive benefits and extending beyond the regenerative realm.
Variation in Heart Failure Risk by HIV Severity and Sex in People With HIV Infection
Authors: Lam Jennifer O. , Leyden Wendy A. , Leong Thomas K. , Horberg Michael A. , Reynolds Kristi , Ambrosy Andrew P. , Avula Harshith R. , Hechter Rulin C. , Towner William J. , Vupputuri Suma , Go Alan S. , Silverberg Michael J. 
Published: June 2022

Background:
HIV is an independent risk factor for heart failure (HF). However, the association of HIV severity with incident HF and the potential interaction with sex are incompletely understood.

Setting:
Integrated health care system.

Methods:
We conducted a cohort study of people with HIV (PWH) and matched people without HIV (PWoH), all aged ≥ 21 years and with no previous HF. Poisson regression was used to compare incident HF by HIV status, with PWH stratified by severity of HIV infection [defined by recent (<6 months) CD4 count, nadir CD4 count, or recent HIV RNA level]. Models were adjusted for sociodemographic characteristics, substance use, and HF risk factors. Analyses were conducted for men and women combined, then by sex.

Results:
The study included 38,868 PWH and 386,569 PWoH (mean baseline age = 41.0 ± 10.8 years; 88% men). Compared with PWoH, incident HF risk was higher among PWH with lower recent CD4 [200–499 cells/µL, adjusted rate ratio (aRR) = 1.82, 95% confidence interval (CI) = 1.50 to 2.21 and <200 cells/µL, aRR = 3.26 (2.47 to 4.30)] and a low nadir CD4 [<200 cells/µL, aRR = 1.56 (1.37 to 1.79)] but not among PWH with normal CD4 [≥500 cells/µL, aRR = 1.14 (0.90 to 1.44)]. Higher incident HF risk was observed among PWH at all HIV RNA levels, with greater HF risk at higher HIV RNA levels. The excess HF risk associated with low CD4 (recent or nadir) and high HIV RNA was stronger among women than men (P interactions=0.05, 0.08, and 0.01, respectively).

Conclusions:
Given the association of HIV severity with HF, optimizing HIV treatment and management may be important for HF prevention among PWH.
The microbiota in respiratory tract infections: from association to intervention
Authors: Koenen Mischa H. , de Steenhuijsen Piters Wouter A.A. , Bogaert Debby , Verhagen Lilly M. 
Published: June 2022

Purpose of review
The respiratory microbiota has a role in respiratory tract infection (RTI) pathogenesis. On the mucosa, the respiratory microbiota interacts with potential pathogenic viruses, bacteria and the host immune system, including secretory IgA (sIgA). This review discusses the role of the respiratory microbiota and its interaction with the (mucosal) immune system in RTI susceptibility, as well as the potential to exploit the microbiota to promote health and prevent RTIs.

Recent findings
Recent studies confirm that specific microbiota profiles are associated with RTI susceptibility and during susceptibility and found accompanying RTIs, although clear associations have not yet been found for SARS-CoV-2 infection. sIgA plays a central role in RTI pathogenesis: it stands under control of the local microbiota, while at the same time influencing bacterial gene expression, metabolism and defense mechanisms. Respiratory microbiota interventions are still newly emerging but promising candidates for probiotics to prevent RTIs, such as Corynebacterium and Dolosigranulum species, have been identified.

Summary
Improved understanding of the respiratory microbiota in RTIs and its interplay with the immune system is of importance for early identification and follow-up of individuals at risk of infection. It also opens doors for future microbiota interventions by altering the microbiota towards a healthier state to prevent and/or adjunctively treat RTIs.
Updates in central nervous system malaria: literature review and considerations
Authors: Marino Andrea , Bivona Dalida Angela , Bonacci Paolo 
Published: June 2022

Purpose of review
Cerebral malaria (CM) represents one of the most common and severe complications of Plasmodium falciparum infection, leading to high morbidity and mortality along with challenging sequelae, especially in children.

Recent findings
Although CM pathogenesis remains unclear due to the few studies made and the difficulty to analyze affected patients, there are valid theories involving P. falciparum endothelium interactions, and clinical manifestations have been better investigated and differentiated between adults and children.

Summary
At the time of writing, diagnostic management is based on fast severe malaria identification by blood smear (thin and thick). However, newer techniques involving molecular testing (such as PCR or LAMP) and biomarkers identification are now available. It is also important to check patients’ cerebral functions. As regards therapeutic management, although we could rely on several options, artesunate represents the gold standard treatment. Cerebral complications such as seizures and coma need to be managed as well.
Neurocysticercosis: an update on diagnosis, treatment, and prevention
Authors: Pineda-Reyes Roberto , White A. Clinton 
Published: June 2022

Neurocysticercosis (NCC) is an important cause of neurological disease worldwide, including imported cases in nonendemic countries.

Purpose of review
The purpose of this review is to update information on diagnosis, management, and prevention of neurocysticercosis

Recent findings
WHO and Infectious Diseases Society of America/American Society of Tropical Medicine and Hygiene guidelines emphasize the importance of corticosteroids and antiparasitic drugs for viable parenchymal disease and single enhancing lesions. Subarachnoid NCC is associated with a high fatality rate unless optimally treated. Advances in subarachnoid NCC include use of prolonged antiparasitic and anti-inflammatory courses and the increasing use of antigen-detection and quantitative PCR assays in diagnosis and follow-up. Emerging data support the safety and efficacy of minimally invasive surgery in ventricular cases. Calcified neurocysticercosis continues to be associated with a high burden of disease. Field studies are demonstrating the feasibility of eradication using a combination of mass chemotherapy for human tapeworms and vaccination/treatment of porcine cysticercosis.

Summary
NCC remains an important and challenging cause of neurological disease with significant morbidity despite advances in treatment and prevention.
Diagnostic approach and update on encephalitis
Authors: Bhimraj Adarsh , Hasbun Rodrigo 
Published: June 2022

Purpose of review
The present article gives an update and outlines the fundamental principles of clinical reasoning and a diagnostic approach to a patient suspected to have acute encephalitis.

Recent findings
Encephalitis remains to be associated with significant mortality and neurological morbidity. Unfortunately, the etiologic diagnosis remains elusive for the majority of the patients with encephalitis preventing targeted therapies. Clinicians could utilize clues such as duration of symptoms, exposure history, cerebrospinal fluid profile, neuroimaging findings and locations, and entertain certain opportunistic infections in immunosuppressed individuals. A comprehensive diagnostic for the most common viral and autoimmune etiologies should be systematically done and prompt empiric antiviral therapy should be started. Evaluation and therapy for autoimmune etiologies should be done for patients with a negative viral work up. Brain biopsy and metagenomic sequencing should be considered for patients with unknown etiologies that are clinically worsening.

Summary
Encephalitis remains with unacceptable mortality and morbidity with the most common etiologies being idiopathic. A comprehensive diagnostic work up and prompt antiviral and autoimmune therapies are of paramount importance to improve the outcomes of this devastating disease.
Escherichia coli 0157:H7 virulence factors and the ruminant reservoir
Authors: Kolodziejek Anna M. , Minnich Scott A. , Hovde Carolyn J. 
Published: June 2022

Purpose of review
This review updates recent findings about Escherichia coli O157:H7 virulence factors and its bovine reservoir. This Shiga toxin (Stx)-producing E. coli belongs to the
E
nterohemorrhagic
E
.
c

oli (EHEC) pathotype causing hemorrhagic colitis. Its low infectious dose makes it an efficient, severe, foodborne pathogen. Although EHEC remains in the intestine, Stx can translocate systemically and is cytotoxic to microvascular endothelial cells, especially in the kidney and brain. Disease can progress to life-threatening hemolytic uremic syndrome (HUS) with hemolytic anemia, acute kidney failure, and thrombocytopenia. Young children, the immunocompromised, and the elderly are at the highest risk for HUS. Healthy ruminants are the major reservoir of EHEC and cattle are the primary source of human exposure.

Recent findings
Advances in understanding E. coli O157:H7 pathogenesis include molecular mechanisms of virulence, bacterial adherence, type three secretion effectors, intestinal microbiome, inflammation, and reservoir maintenance

Summary
Many aspects of E. coli O157:H7 disease remain unclear and include the role of the human and bovine intestinal microbiomes in infection. Therapeutic strategies involve controlling inflammatory responses and/or intestinal barrier function. Finally, elimination/reduction of E. coli O157:H7 in cattle using CRISPR-engineered conjugative bacterial plasmids and/or on-farm management likely hold solutions to reduce infections and increase food safety/security.