bluuebunny/crossref_metadata_2025_split huggingface dataset:
Basilar Invagination Diagnosis, Classification, and Radiology
Authors: Yaman Onur , Zileli Mehmet , Avcı İdris , Chen Zan , Lee June Ho , Sá-Carneiro Geraldo , Costa Francesco , Ben Ali Said , Dantas Fernando , Oertel Joachim , Visocchi Massimiliano , Parthiban Jutty , Goel Atul , Botelho Ricardo , Alves Oscar L. 
Published: February 2025

Study Design.
A systematic literature review and consensus using Delphi method.

Objective.
This review aimed to analyze recent literature on diagnosis, classification, and radiologic characteristics of Basilar Invagination (BI) to generate recommendations on these topics.

Summary of background.
Basilar invagination diagnosis, classifications, and radiologic characteristics evolved during the last decade; however, many debatable criteria disturb a common language fundamental to compare clinical research.

Material and Methods.
The WFNS Spine Committee organized two separate consensus meetings to discuss and create statements that were voted on to reach a consensus.

Results.
Basilar invagination mainly results from a CVJ developmental abnormality and is often associated with congenital anomalies. There is also an acquired type that occurs by bone softening, such as rheumatoid arthritis. It can be classified as Type I (atlantoaxial dislocation) and Type II (without atlantoaxial dislocation) basilar invagination. Clinical signs may either be due to brainstem compression or cervical spinal cord compression and instability. Although many radiological measurements are proposed, the most reliable ones are the McRae’s line, Chamberlain’s line, and Boogard angle.

Conclusions.
Diagnosis of basilar invagination should be made by midsagittal craniocervical X-Rays, CTs or MRI. There are two types of basilar invagination: Type I basilar invagination is associated with instability, and treatment can focus on stabilization. However, Type II basilar invagination may need decompressive surgeries.
Wearable Sensors for Pre- and Post-Operative Assessment of Cervical Myelopathy
Authors: Glassman Steven D , Gum Jeffrey L , Mathew Justin , Crawford Charles H , Djurasovic Mladen , Carreon Leah Yacat 
Published: February 2025

Study design.
Prospective observational cohort.

Objectives.
To report on the role of a single wearable sensor in the evaluation of patients with Cervical Spondylotic Myelopathy (CSM).

Summary of Background Data.
Clinical evaluation of CSM is limited, as Hoffmann’s sign, Romberg testing and Tandem Gait are largely subjective and binary, making deterioration or improvement difficult to document accurately.

Methods.
Patients scheduled for surgical treatment of CSM underwent in-office and 24-hour continuous at-home data collection using a single wearable sensor. In-office testing consisted of Standing, Romberg testing, Tandem Gait and Timed Up & Go (TUG). Testing was repeated 6-months post-operatively.

Results.
Statistically significant improvements were seen following surgical treatment in the Romberg test eyes-open maximum antero-posterior sway (P=0.010), eyes-open total path traveled (P=0.048); in Tandem Gait speed (P=0.021), duration (P=0.002), antero-posterior sway (P=0.046) and initial peak acceleration (P=0.001). There was no statistically significant difference in TUG testing. At-home gait pattern revealed a trend toward decreased lateral sway post-operatively (P=0.062) and fewer sleep turns (P=0.078)

Conclusion.
Wearable sensor data effectively quantifies standard exam findings and identifies new metrics with the potential to assess more accurately pre-operative and post-operative function in patients with CSM. Previously unreported pre-operative to 6-month post-operative changes were seen in speed of gait and ground impact force during Tandem Gait. These metrics were more sensitive as compared to the normal antero-posterior and lateral sway assessment. 24-hour sensor data showed decreased number of turns during sleep post-operatively. This study suggests that wearable sensor data will be a viable source for quantifiable data with the potential to guide treatment for patients with CSM. This capability is based partly on better quantification of existing binary measures, but also on identification of unanticipated patterns within the data.
The Impact of Chronic Obstructive Pulmonary Disease on Immune Checkpoint Inhibitor Effectiveness in Non-small Cell Lung Cancer: A Population Health Study
Authors: Chan Sze Wah Samuel , Pond Gregory R. , Goffin John R. 
Published: February 2025

Summary:
Chronic obstructive pulmonary disease (COPD) and lung cancer are associated diseases. COPD confers a negative prognosis in NSCLC, but the clinical benefit of immune checkpoint inhibitors (ICI) in this population is unclear. A population-level analysis of patients in Ontario, Canada was performed through the ICES (formerly known as the Institute for Clinical Evaluative Sciences) administrative database. Patients with NSCLC and treated with PD-1/PD-L1 immune checkpoint inhibitors between Jan 2010 and Dec 2020 were included. Overall survival (OS) was estimated using the Kaplan-Meier method and compared using Cox proportional hazards regression. Hospitalizations and duration of treatment were compared secondarily using logistic and linear regression. A total of 4306 patients received ICI and 54% of patients had a diagnosis of COPD. Median (95% CI) OS was 9.2 (8.5–9.9) months for patients with COPD and 8.2 (7.3–8.8) for patients without COPD, which was not significantly different (adjusted hazard ratio (aHR) = 0.94, 95% CI, 0.87–1.01, P = 0.092). Similarly, the median time on treatment was not different (85 vs. 99 days, multivariable P = 0.10). However, the 90-day hospitalization rate was decreased in the COPD population (multivariable odds ratio 0.76, 95% CI 0.62–0.94, P = 0.011). Among patients with NSCLC receiving ICI, our data suggest that a diagnosis of COPD does not result in shortened treatment, poorer survival, or higher rates of hospitalization. COPD itself should not be considered a contraindication to ICI.
Breaking the ice: How awareness training affects the treatment of domestic violence patients by health care professionals
Authors: Beck Thomas , Förster Charlotte , König Stefanie , Pavlic Marion 
Published: February 2025

Background
Domestic violence (DV) is a neglected topic in health care, resulting in delays in the identification of DV victims and suboptimal care.

Purpose
The attitudes of health care professionals (HCPs) toward stigmas associated with victims of DV can affect the care offered to the latter. The HCPs' attitude toward victims of DV is therefore an important but neglected topic in health care research. Therefore, the purpose of this study was to determine whether awareness training changes HCPs' attitudes toward victims of DV, especially with regard to their stigmatization.

Methodology
Problem-centered interviews were conducted with 12 health professionals (six women and six men, six with and six without previous awareness training) concerning their attitudes and approaches to DV and those affected by it.

Results
Our data analysis indicates a significant difference in HPC attitudes toward potential DV victims depending on whether or not HCPs have undergone awareness training.

Conclusion
Awareness training does not only improve theoretical knowledge about DV; it also changes staff attitudes toward DV victims, especially with regard to their stigmatization.

Practice Implications
Our study shows that awareness training changes the HCPs' attitudes toward victims of DV. This change in attitude might reduce pressure on both the HCP and the victim, which in turn might help the victim to accept the care offered. Therefore, awareness training can help to reduce barriers to helping victims of DV.
Chorioretinal Findings in Intraocular IgG4-Related Disease: A Case Report and Review of the Literature
Authors: Magazin Maja , Jones Skyler G. , Fazio Alexis , Thomas Dilip A. , Espinosa-Heidmann Diego 
Published: February 2025

Purpose:
This manuscript reports intraocular IgG4-related disease (IgG4-RD) presenting as panuveitis with a large subretinal mass and contralateral orbital mass. It includes a literature review highlighting IgG4-RD's diagnostic challenges, emphasizing clinical, histopathologic, and multimodal-imaging findings.

Methods:
PubMed was searched for “all fields” with keywords "IgG4" AND "retina" AND "choroid" from 1974 to March 2024, revealing 16 cases of 23 eyes detailing IgG4-related chorioretinal manifestations.

Results:
The most common presenting symptom was painful vision loss (31%). Chorioretinal findings included: large subretinal or choroidal masses (35%), multifocal subretinal lesions (26%), and retinal detachment (22%). Associated ophthalmic findings included: scleritis or sclerouveitis (52%), vitritis (48%), orbital disease (13%), and papillitis (9%). IgG4+/IgG ratios in ocular tissue varied 20-54.5%. IgG4+ plasma cells per high power field ranged 50-133. Ophthalmic modalities used to aid in diagnosis included B-scan ultrasonography (US-B, 56%), optical coherence tomography (OCT, 31%), fluorescein angiography (FA, 25%), fundus-autofluorescence (FAF, 13%), and indocyanine-green angiography (ICGa, 13%). Masses on B-scan were heterogenous or homogenous with medium-to-high reflectivity. Magnetic resonance imaging (MRI) evaluation was hypointense on T2-weighted imaging (75%) and hyperintense on T1-weighted imaging (38%) with progressive contrast enhancement (50%). Management required a multidisciplinary approach with steroid and steroid-sparing agents.

Conclusion:
IgG4-RD has diverse and variable ocular presentations and diagnostic manifestations. Definitive diagnosis is made via biopsy. Further studies are necessary for non-invasive diagnosis.
Postoperative bile leaks did not affect the survival of hepatoblastoma but were associated with long-term complications: retrospective case-control study
Authors: Maniwa Junnosuke , Kawakubo Naonori , Tamaki Akihiko , Kondo Takuya , Takahashi Yoshiaki , Fukuta Atsuhisa , Yoshimaru Koichiro , Nagata Kouji , Miyata Junko , Matsuura Toshiharu , Tajiri Tatsuro 
Published: February 2025

Purpose:
This study assessed the long-term impact of bile leak complications on the pediatric hepatoblastoma (HB) patients post-surgery. With HB predominantly affecting children under five, the increased survival rates necessitate a focus on the post-surgical complications, particularly concerning the effects of bile leaks.

Methods:
A retrospective analysis was conducted on patients treated for HB at our institution from 1980 to 2022. The diagnosis, operative procedure, complications, mortality, and prognosis were retrospectively analyzed to examine the incidence and long-term effects of surgical complications, especially bile leaks. The study involved detailed statistical analyses, including assessments of the Kaplan–Meier survival rates and comparisons of complication incidences using log-rank tests.

Results:
Of the 53 reviewed cases, 43 were analyzed. Bile leaks occurred in 20% of liver resection patients, markedly impacting their long-term QOL through severe complications like gastric obstructions, portal vein occlusion, and bile duct stricture. Nonetheless, the overall 5-year survival rate was high at 87.8%. The prognosis did not differ significantly between patients with and without short-term complications.

Conclusion:
In patients with HB, postoperative bile leaks occasionally lead to long-term complications. Even if the complications do not influence their prognosis, surgeons must be alert for the possibility of long-term complications after surgery for HB.
First Responder Perceptions on Occupational Health and Safety Following the 2010 Deepwater Horizon Oil Spill Cleanup Operations: A Qualitative Study
Authors: Testoff Addison C. , Louzado-Feliciano Paola , Moore Kevin J. , Caban-Martinez Alberto J. 
Published: February 2025

ABSTRACT

Objective
Identify and describe factors that impacted first responder’s health and safety during the 2010 Deepwater Horizon oil spill cleanup.

Methods
Pre-discussion survey and six focus group sessions conducted in May 2017 among Louisiana first responders.

Results
Among the 50 first responders 98.0% were male, 98% Caucasian, 95.3% non-Hispanic, 70.0% married and group mean age, 40.6 years (SD = 9.8). Oil exposure was reported by 56.2% of first responders, with 59.3% reporting skin contact, 77.8% inhalation, 11.1% ingestion, and 36.7% visited a doctor after the oil spill event. Four focus group themes emerged: 1) Collaboration between fire personnel and incident command staff; 2) Ensuring access to personal protective equipment; 3) Establishing contamination control protocols; and 4) Providing training.

Conclusion
Louisiana first responders at the oil spill cleanup reported post-event health effects and factors to improve response activities.
Cochlear Implantation in Vestibular Schwannoma Surgery: Diagnostic Accuracy Analysis of Intraoperative Monitoring with Intracochlear Electrode
Authors: Zanoletti Elisabetta , Concheri Stefano , Tealdo Giulia , Cazzador Diego , Di Pasquale Fiasca Valerio M. , Franchella Sebastiano , Impala’ Giuseppe , Brotto Davide 
Published: February 2025

Objective
To investigate the role of intraoperative cochlear nerve (CN) electric monitoring with MED-EL intracochlear test electrode (ITE) in assessing the CN functional integrity.

Setting
Tertiary referral center.

Patients
Patients with intrameatal or 2 to 13 mm in the cerebello-pontine angle vestibular schwannoma (VS), not suitable for hearing preservation surgery but eligible for tumor resection via translabyrinthine approach and simultaneous cochlear implant (CI) rehabilitation.

Intervention
ITE was used to register electrically evoked auditory brainstem response (eABR) before and after VS resection. All patients with anatomical preservation of CN underwent CI, regardless of eABR results, which served as the index test and was compared with postoperative sound perception by CI stimuli (gold standard test).

Results
Twelve of seventeen cases allowed anatomical preservation of CN and were considered for the study. Seven of twelve cases demonstrated sound detection with CI, and six of twelve showed some degree of speech discrimination. eABR test with ITE achieved an accuracy of 66.7%, a sensitivity of 42.9%, and a specificity of 100%. Positive and negative predictive values were 100% and 55.6%, respectively.

Conclusion
When eABR can be evoked with ITE, the attempt of CI was likely to be successful, whereas in cases of eABR absence, other factors should be considered to reduce unsuccessful CI and not preclude rehabilitation in patients who would benefit from CI. Further studies and longer follow-up are needed to analyze the role of ITE in VS surgery with CI.
Time-in-therapeutic range falls as the target international normalized ratio range increases in patients on warfarin
Authors: Malik Imran , Priest Paul , Jennings Ian , Gomez Keith 
Published: February 2025

The main objective was to assess whether the time-in-therapeutic range (TTR) in patients on warfarin is affected by the international normalized ratio (INR) range. We also evaluated whether the performance of the INR is negatively impacted as its absolute value increases.
First, we extracted key performance indicators of the INR from 22 surveys of the UK National External Quality Assurance Scheme (NEQAS). We then analysed TTR in 6584 warfarin monitoring episodes that were categorized by range and indication.
NEQAS surveys in which the sample INR was above 3.0 had more participants outwith consensus with higher coefficient of variation and standard error mean. The outwith consensus percentage was correlated with the mean reported INR value.
In warfarinised patients, we found that the TTR was lower at INR ranges above the standard 2.0 to 3.0.
We concluded that the performance of the INR assay decreases at higher values. Furthermore, increasing the INR range above the standard 2.0 to 3.0 in warfarinised patients has an adverse effect on TTR. This is important because the INR range may be increased to try and improve efficacy, whereas these data suggest that it may have the opposite effect.
Characteristics, risk factors, and disease course of musculoskeletal manifestations in patients with inflammatory bowel disease: a prospective longitudinal cohort study
Authors: Jansen Fenna M. , den Broeder Nathan , van Hal Tamara W. , Mahler Elien A.M. , van Dop Willemijn A. , Hoentjen Frank 
Published: February 2025

Background
Musculoskeletal manifestations occur in half of the patients with inflammatory bowel disease (IBD) and contribute to a reduced quality of life (QoL) and increased work disability. We aimed to evaluate the natural disease course, characteristics, and risk factors of musculoskeletal manifestations in patients with IBD.

Methods
We performed a prospective longitudinal cohort study in patients with IBD with and without musculoskeletal manifestations with a 1-year follow-up. Primary outcome was the proportion of patients with resolution of musculoskeletal manifestations. Secondary outcomes included the proportion of patients with IBD that developed new musculoskeletal manifestations during follow-up; the correlation among IBD activity, baseline characteristics, and musculoskeletal disease course; and the difference in QoL between patients with and without musculoskeletal manifestations.

Results
In total, 243 patients with IBD were included (124 with and 119 without musculoskeletal manifestations). In the majority of patients (62.2%), musculoskeletal manifestations were of noninflammatory nature. Overall, peripheral and axial manifestations were persistent in 85.7 and 44.6% at 1 year, respectively. The QoL at baseline and at 1 year was lower in the group with musculoskeletal manifestations compared with patients without these manifestations. Female sex and age above 40 were associated with the presence of musculoskeletal manifestations.

Conclusion
Musculoskeletal manifestations in patients with IBD are mostly noninflammatory disorders, persist at 1 year of follow-up, and occur more frequently in patients of age above 40 and female sex. Overall, patients with musculoskeletal manifestations have lower QoL compared with patients without musculoskeletal manifestations.
Comparison of clinical characteristics and outcomes in patients with hepatocellular carcinoma based on serum alpha-fetoprotein status
Authors: Li Jing , Cheng Xi , Meng Yan , Wang Miaomiao 
Published: February 2025

Background:
Alpha-fetoprotein (AFP) is the most commonly used and crucial tumor marker in clinical diagnosis and prognosis guidance for hepatocellular carcinoma (HCC). However, approximately 30% of HCC patients do not exhibit abnormal serum AFP levels at the time of diagnosis. This study aims to investigate the clinical characteristics and prognosis differences between AFP-negative and AFP-positive patients with HCC.

Methods
Clinical data on patients diagnosed between 2010 and 2015 from the Surveillance, Epidemiology, and End Results Program were collected and analyzed. All patients with HCC were reported as AFP-negative or AFP-positive based on AFP test results. Overall survival (OS) and cancer-specific survival (CSS) were compared between the AFP-negative and AFP-positive patients. Logistic regression analysis and multivariable Cox regression analysis were performed to identify the association of AFP with tumor size, lymph node metastasis, distant metastasis, and CSS.

Results
Of 7090 patients, 2074 (29.3%) and 5016 (70.7%) were AFP-negative and AFP-positive patients, respectively. The 5-year OS and CSS rates in AFP-negative patients were significantly better than AFP-positive patients (36.4 vs. 20.7% and 46.7 vs. 27.2%, both P < 0.001). Logistic regression analysis revealed that the AFP level was an independent risk factor of tumor size [odds ratio (OR), 1.821; 95% confidence interval (CI), 1.625–2.040; P < 0.001], N stage (OR, 1.922; 95% CI, 1.528–2.417; P
< 0.001) and M stage (OR, 2.435; 95% CI, 1.980–2.995; P < 0.001). On multivariable Cox-regression analyses, AFP-positive was associated with decreased CSS (hazard ratio, 1.452; 95% CI, 1.355–1.557; P < 0.001).

Conclusion
Abnormal serum AFP was significantly associated with worse prognosis, larger tumor size, more lymph node metastasis, and distant metastasis. Patients with AFP-positive may need more individualized treatment decision and further optimization of HCC management strategies.
The causes, and impact, of colonoscopic perforation for endoscopists: lessons from a qualitative interview study
Authors: Derbyshire Edmund , Brown Sally , Hungin Sir Pali , Dobson Christina , Rutter Matthew D. 
Published: February 2025

Introduction
Safety and the avoidance of adverse events are crucial in patient care. A number of explanatory variables for the serious adverse event of colonoscopic perforation have been identified; however, the context in which perforation occurs has largely been overlooked, as too has the subsequent impact on the colonoscopist. This study examined the human and environmental factors associated with colonoscopic perforations, along with colonoscopists’ reactions to these, with a view to informing strategies for safer practice and clinician support.

Methods
This qualitative study explored the experiences of colonoscopists who reported a previous colonoscopic perforation. Semi-structured interviews were undertaken with 11 colonoscopists, recruited through professional networks. Interviews were recorded and transcribed and analysed using a framework approach.

Results
Human and environmental factors contributing to perforation included colonoscopist fatigue, time pressure and equipment failure. Four distinct stages were identified in colonoscopists’ reactions to perforation: ‘The Perforation Realisation’ comprising a range of strong and powerful emotions; ‘The Consequences’ involving feelings of personal responsibility, self-blame, fear of repercussion and vulnerability; ‘Acceptance and Refocus’ comprising a period of coming to terms with the perforation; and finally ‘Reflection and Learning’ where the colonoscopist reflected on the case and applied learning to their future practice.

Conclusion
This study examines colonoscopists’ personal experiences of perforations. It identifies the stages that colonoscopists experience after causing a perforation, and some of the broader contextual factors that can lead to these potentially preventable adverse events. The data suggest the need for greater emotional and pastoral support for endoscopists when such events occur.