bluuebunny/crossref_metadata_2025_split huggingface dataset:
NODULAR EPIRETINAL MÜLLER CELL GLIOSIS IN THE FOVEA
Authors: Jung Jesse J. , Zeng Anne , Komati Rahul , Mackin Anna G. , Skondra Dimitra , Yonekawa Yoshihiro , Fineman Mitchell S. , Ezon Isaac , Rofagha Soraya , Hoang Quan V. 
Published: July 2022

Purpose:
The purpose of this study was to report the findings of a hyperreflective nodular epiretinal gliosis observed with optical coherence tomography presumed to be due to subclinical hyaloidal traction causing Mϋller cell cone gliosis.

Methods:
Retrospective, observational case series.

Results:
Six eyes of six patients (mean age: 57 years, range 35–81 years) presented with a nodular epiretinal gliosis and had an average follow-up interval of 26 months (range 1–82 months). The mean baseline best-corrected visual acuity was 0.25 ± 0.17 (Snellen equivalent 20/38.3 ± 16.9). Fundus photography demonstrated a yellowish lesion overlying the fovea. Optical coherence tomography imaging revealed a hyperreflective preretinal lesion with a mean vertical length of 267 μm (range 185–497) and a mean greatest linear diameter of 312 µm (range 124–640). There was no vitreoretinal abnormality including vitreomacular traction or epiretinal membrane noted in any eye, and two of six eyes displayed a definitive posterior vitreous detachment. These nodules may have occurred before and persisted even after a posterior vitreous detachment or may have been acquired after the posterior vitreous detachment. The nodules typically remained stable with minimal change although in one eye, a posterior vitreous detachment occurred 6 months after initial presentation and lifted the gliosis off of the retinal surface where it remained attached to the posterior hyaloid.

Conclusion:
Foveal nodular epiretinal gliosis may occur due to subclinical hyaloidal traction on the Müller cell cone even without obvious vitreoretinal interface abnormality on optical coherence tomography.
Delphi study to define core clinical outcomes for inclusion in a complex regional pain syndrome international research registry and data bank
Authors: Llewellyn Alison , Buckle Lisa , Grieve Sharon , Birklein Frank , Brunner Florian , Goebel Andreas , Harden R. Norman , Bruehl Stephen , Vaughan-Spickers Nicole , Connett Robyn , McCabe Candida 
Published: July 2022

Abstract
Complex regional pain syndrome (CRPS) clinical trials have historically captured a diverse range of outcomes. A minimum set of CRPS patient-reported outcomes has been agreed for inclusion in a future CRPS international clinical research registry and data bank. This study aimed to identify a complementary set of core clinical outcomes. Clinicians and researchers from the international CRPS community informed the content of a 2-round electronic Delphi study. Participation was invited from members of the International Association for the Study of Pain CRPS Special Interest Group and the International Research Consortium for CRPS. In round 1, participants rated the relevance of 59 clinical outcomes in relation to the question “What is the clinical presentation and course of CRPS, and what factors influence it?” (1 = not relevant and 9 = highly relevant). In round 2, participants rerated each outcome in the light of the round 1 median scores. The criterion for consensus was median score ≥7, agreed by 75% of respondents. The core study team considered the feasibility of data collection of each identified outcome in agreeing final selections. Sixty respondents completed both survey rounds, with responses broadly consistent across professions. Nine outcomes met the consensus criterion. Final outcomes recommended for inclusion in the core clinical set were record of medications, presence of posttraumatic stress disorder, extent of allodynia, and skin temperature difference between limbs. Study findings provide robust recommendations for core clinical outcome data fields in the future CPRS international clinical research registry. Alongside patient-reported outcomes, these data will enable a better understanding of CRPS.
Update on vitamin C administration in critical illness
Authors: Fujii Tomoko , Lankadeva Yugeesh R. , Bellomo Rinaldo 
Published: July 2022

Purpose of review
Several studies have recently explored the effects of intravenous vitamin C in sepsis. We aimed to summarize their findings to provide perspectives for future research.

Recent findings
Sepsis trials examined 6 g/day of intravenous vitamin C with or without the thiamine and/or hydrocortisone compared with placebo or hydrocortisone. Network meta-analysis reported that intravenous vitamin C, thiamine, hydrocortisone, or combinations of these drugs was not proven to reduce long-term mortality. However, the component network meta-analysis suggested an association of high-dose (>6 g/day) and very-high dose vitamin C (>12 g/day) and decreased mortality but with low certainty. The preclinical investigations have, however, advanced to much higher doses of intravenous vitamin C therapy since a scoping review on harm reported that mega-doses of intravenous vitamin C (50–100 g/day) had been administered without any conclusive adverse effects. In a Gram-negative sheep model, renal tissue hypoperfusion was reversed, followed by improvements in kidney function when a mega-dose of vitamin C (150 g/day equivalent) was administered.

Summary
The effect of intravenous vitamin C in critically ill patients has yet to be determined and might be dose-dependent. Clinical studies of very high or mega doses of vitamin C are justified by preclinical data.
Challenges and advances in nutrition for the critically ill child
Authors: Albert Ben D. , Martinez Enid E. 
Published: July 2022

Purpose of review
Malnutrition remains prevalent in critically ill children and is associated with worse clinical outcomes. Conversely, nutrition provision has been associated with improved survival. Nutritional challenges must be addressed to guide best nutrition practices for the critically ill child. In this narrative review, we summarize findings from research published between July 2020 and January 2022 on nutrition in critically ill children. Findings from these articles build on previous work to guide next steps in both research and clinical practice in this cohort.

Recent findings
A comprehensive literature review was performed. We identified the following common themes for research published between July 2020 and January 2022-metabolism, enteral nutrition, including timing, dosing, protein prescription and delivery in special populations, gastrointestinal function, and enteral nutrition adjunctive therapies.

Summary
Research continues to support early initiation and advancement of enteral nutrition. Achieving nutritional adequacy is challenging, but research associated with the timing and dosing of enteral nutrition, alternative methods of enteral nutrition delivery and the use of adjuncts are expanding our understanding of best practices for this cohort. Areas for further research continue to be the use of measured energy requirements, protein dosing and inclusion of functional outcomes to assess the benefit of nutritional interventions.
Protein metabolism in critical illness
Authors: Chapple Lee-anne S. , van Gassel Rob J.J. , Rooyackers Olav 
Published: July 2022

Purpose of review
Critically ill patients experience skeletal muscle wasting that may contribute to the profound functional deficits in those that survive the initial injury. Augmented protein delivery has the potential to attenuate muscle loss, yet the ability for dietary protein to improve patient outcomes is reliant on effective protein metabolism. This review will discuss the recent literature on protein delivery and digestion, amino acid absorption, and muscle protein synthesis (MPS) in critically ill adults.

Recent findings
Critically ill patients are prescribed protein doses similar to international recommendations, yet actual delivery remains inadequate. The majority of trials that have achieved higher protein doses have observed no effect on muscle mass, strength or function. Critically ill patients have been observed to have minimal deficits in protein digestion and amino acid absorption when delivery bypasses the stomach, yet postprandial MPS is impaired. However, the literature is limited due to the complexities in the direct measurement of protein handling.

Summary
Postprandial MPS is impaired in critically ill patients and may exacerbate muscle wasting experienced by these patients. Studies in critically ill patients require assessment not only of protein delivery, but also utilization prior to implementation of augmented protein doses.
Insulin resistance in children
Authors: Mainieri Francesca , Tagi Veronica Maria , Chiarelli Francesco 
Published: July 2022

Purpose of review
Insulin resistance (IR) is a clinical condition due to the decline in the efficiency of insulin promoting glucose uptake and utilization. The aim of this review is to provide an overview of the current knowledge on IR in children, focusing on its physiopathology, the most appropriate methods of measurement of IR, the assessment of risk factors, the effects of IR in children, and finally giving indications on screening and treatment.

Recent findings
IR has evolved more and more to be a global public health problem associated with several chronic metabolic diseases.

Summary
Detecting a correct measurement method and specific risk predictors, in order to reduce the incidence of IR, represents a challenging goal.
A Systematic Review and Meta-Analysis of the Association Between Periodontal Disease and Severe Mental Illness
Authors: Cai Vickie , Peng Ng Chee , Zhao Jenny , Siskind Dan , Kisely Steve 
Published: July 2022

ABSTRACT

Background
Periodontal disease represents a global public health concern, with a disproportionate burden being borne by vulnerable populations. One such group is people with severe mental illness (SMI), and this study examined whether periodontal health is poorer in people with SMI than the general population.

Methods
We conducted a systematic search for studies published before March 2021 on the periodontal health of people with SMI using the following databases: PubMed, PsycINFO, EMBASE, China National Knowledge Infrastructure, and Chongqing VIP. Outcomes were periodontitis, periodontal disease, and shallow and deep periodontal pockets. Results were compared with the general population.

Results
Seventeen studies had sufficient data for a random-effects meta-analysis, consisting of 4404 psychiatric patients and 95,411 controls. SMI was associated with an increased prevalence of periodontitis (odds ratio = 1.97, 95% confidence interval [CI] = 1.15–3.35) compared with the general population. People with SMI had 4.28 the odds of having periodontal disease compared with controls (95% CI = 2.54–7.21). They also had 3.65 the odds of shallow pockets (95% CI = 1.80–7.42) and 2.76 the odds of deep pockets (95% CI = 1.10–6.93).

Conclusions
Our findings highlight the increased prevalence and severity of periodontal disease in people with SMI. Oral health is often considered the gateway to overall health and should be a public health priority for this population.
The Relationship Between Family Socioeconomic Status and Adolescent Sleep and Diurnal Cortisol
Authors: Rocha Sarah , Almeida David M. , Chiang Jessica J. , Cole Steve W. , Irwin Michael R. , Seeman Teresa , Fuligni Andrew J. 
Published: July 2022

ABSTRACT

Objective
This study aimed to investigate the associations between indices of family socioeconomic status and sleep during adolescence and to examine whether measures of hypothalamic-pituitary-adrenal (HPA) axis functioning mediate the observed associations.

Methods
A total of 350 ethnically diverse adolescents (57% female; mean [standard deviation] agewave 1 = 16.4 [0.7] years) completed a three-wave longitudinal study in which sleep and cortisol data were collected at 2-year time intervals. Sleep duration, latency, and variability were assessed via actigraphy during a period of 8 days per study wave. Salivary cortisol was collected across 3 days per study wave to assess cortisol diurnal slope, area under the curve, and the cortisol awakening response. Adolescents’ caregivers reported their education levels, family income, and economic hardship.

Results
A greater family income-to-needs ratio was associated with longer adolescent sleep duration (b = 2.90, p = .023), whereas greater parental education was associated with shorter sleep duration (b = −3.70, p = .030), less sleep latency (b = −0.74, p = .016), and less variability across days (b = −2.06, p = .010). Diurnal cortisol slope statistically mediated the association of parental education with sleep duration (b = −0.48, 95% confidence interval = −1.099 to −0.042), but not the association of income-to-needs ratio with sleep duration.

Conclusions
Findings suggest that parental education and family resources may have unique impacts upon sleep and HPA axis functioning during the period of adolescence. Future research is needed to examine family and behavioral factors that may underlie socioeconomic status associations with adolescent sleep and HPA axis functioning.
Harms and Contributors of Leaving Against Medical Advice in Patients With Infective Endocarditis
Authors: Mishra Ajay Kumar , Abraham Benson M. , Sahu Kamal K. , George Anu A. , Sargent Jennifer , Kranis Mark J. , George Susan V. , Abraham George M. 
Published: July 2022

Introduction
Patients leaving against medical advice (AMA) are commonly encountered in hospital medicine. The problem is prevalent worldwide and across all fields of medicine. A retrospective study of 47,583 patients reported a 3.3% AMA rate in 2015.

Objectives
In this retrospective study, we aimed (1) to study the demographic, clinical, and laboratory parameters of infective endocarditis (IE) patients leaving AMA. We also compared (2) the various risk factors and outcomes of these patients with IE patients who completed treatment.

Results
A total of 111 patients diagnosed with IE were recruited for 36 months. Of the 74 patients with available details, 32 patients (29%) left AMA during their treatment. The mean age of patients leaving AMA was 39, and among those who left AMA, 66% were females. As compared with patients completing therapy, patients leaving AMA tend to have higher comorbidities, including injection drug use (68.1% versus 31.9%), prior IE (83.3% versus 16.7%), and chronic hepatitis C (72.4% versus 27.8%). Rates of consumption of substances of abuse were higher among those who left AMA. Patients leaving AMA also had higher psychiatric comorbidities (63% versus 37.5%), history of leaving AMA (70.5% versus 29.5%), and consumption of more than 2 substances of abuse. Morbidity was higher in patients leaving AMA. There was a statistically significant association between the development of distal embolus (P < 0.001), the need for recurrent admissions (P = 0.002), recurrent bacteremia (P < 0.001), developing new embolus (P < 0.001), and overall morbidity (P = 0.002) among IE patients leaving AMA.

Conclusions
Infective endocarditis patients leaving AMA tend to be younger females. These patients have prior comorbidities of injection drug use, prior IE, multiple psychiatric comorbidities, drug use, and multiple socioeconomic issues. Patients leaving AMA tend to develop further non–Central nervous system embolic events, recurrent bacteremia, and require frequent admissions. Morbidity in these patients was higher.
Long-term Clinical and Patient-Reported Outcomes After Transversus Abdominis Release With Permanent Synthetic Mesh: A Single Center Analysis of 1203 Patients
Authors: Zolin Samuel J. , Krpata David M. , Petro Clayton C. , Prabhu Ajita S. , Rosenblatt Steven , Rosen Samantha , Thompson Reid , Fafaj Aldo , Thomas Jonah D. , Huang Li-Ching , Rosen Michael J. 
Published: July 2022

Objective:
We aimed to report long-term clinical and patient-reported outcomes of transversus abdominis release (TAR) with permanent synthetic mesh performed in a high-volume abdominal wall reconstruction practice.

Summary Background Data:
Despite increasing utilization of TAR in abdominal wall reconstruction, long-term clinical and patient-reported outcomes remain uncertain.

Methods:
Prospectively collected registry data from the Cleveland Clinic Center for Abdominal Core Health were analyzed retrospectively. Patients undergoing elective, open VHR with TAR and permanent synthetic mesh implantation between August 2014 and March 2020 with 30-day clinical and ≥1 year clinical or patient-reported outcome follow-up were included. Outcomes included composite hernia recurrence, characterized by patient-reported bulges and recurrent hernias noted on physical exam or imaging, as well as hernia-specific quality of life and pain.

Results:
A total of 1203 patients were included. Median age was 60 years [interquartile range (IQR): 52–67], median body mass index was 32 kg/m2 (IQR: 28–36), median hernia width was 15 cm (IQR: 12–19), and 57% of hernias were recurrent. Fascial reapproximation was achieved in 92%. At a median follow-up of 2 years (IQR: 1–4), the overall composite hernia recurrence rate was 26%, with sensitivity analysis yielding best-case and worst-case estimates of 5% and 28%, respectively. Patients experienced improved hernia-specific quality of life and pain regardless of recurrence outcome; however, those who did not recur experienced more substantial improvement.

Conclusions:
TAR with permanent synthetic mesh remains a valuable, versatile technique; however, surgeon and patient expectations should be tempered regarding long-term durability. Despite a high rate of recurrence, patients experience measurable improvements in quality of life.
Lymph Node Ratio Improves Prediction of Overall Survival in Esophageal Cancer Patients Receiving Neoadjuvant Chemoradiotherapy: A National Cancer Database Analysis
Authors: Zhang Yajie , Cao Yuqin , Zhang Jiahao , Huang Maosheng , Roy Pascal , Huang Binhao , Yang Hong , Rong Yi , Chen Yuping , Zhu Chengchu , Fang Wentao , Yu Zhentao , Mao Weimin , Xiang Jiaqing , Han Yongtao , Lin Jules , Zhang Jie , Fu Jianhua , He Jie , Li Hecheng 
Published: July 2022

Objective:
This study aimed to propose a revised ypN (r-ypN) classification based on lymph node ratio (LNR) and to examine its prognostic value in postneoadjuvant esophageal cancer.

Background:
A new postneoadjuvant pathologic (ypTNM) staging classification has been introduced for esophageal cancer. However, the ypN classification currently defined by the number of positive lymph nodes is influenced by the extent of lymphadenectomy.

Methods:
Data on 7195 esophageal cancer patients receiving neoadjuvant chemoradiation were extracted from the National Cancer Database (NCDB). Four r-ypN stages were defined by 3 LNR thresholds (0%, 10%, and 20% using X-tile software). A revised ypTNM (r-ypTNM) classification was developed by solely changing N categories. Kaplan-Meier method and Cox proportional hazards models were used for survival analyses. Akaike information criterion (AIC) and Harrell’s concordance index (C-index) were used to compare the predictive performance of the current and the revised classification. External validation was performed using an independent cohort from the NEOCRTEC5010 clinical trial.

Results:
Both ypN (P<0.001) and r-ypN (P<0.001) were independent prognostic factors of overall survival (OS) for esophageal cancer patients. Kaplan-Meier curves demonstrated a better discrimination with r-ypN than ypN categories. Within each ypN category (except ypN3), OS was significantly different comparing r-ypN strata; however, there were no differences between ypN strata within each r-ypN category (except r-ypN3). r-ypN (AIC: 60752 vs 60782; C-index: 0.591 vs 0.587) and r-ypTNM (AIC: 60623 vs 60628; C-index: 0.613 vs 0.610) showed better predictive performance than the current staging system, with a lower AIC (better calibration) and higher C-index (improved discrimination). This advantage was also confirmed by external validation using the NEOCRTEC5010 cohort.

Conclusions:
LNR showed better performance than ypN in predicting OS of esophageal cancer patients after neoadjuvant chemoradiation and may be an improvement on the current staging system.
Operative Team Familiarity and Specialization at an Academic Medical Center
Authors: Witmer Hunter D.D. , Keçeli Çağla , Morris-Levenson Joshua A. , Dhiman Ankit , Kratochvil Amber , Matthews Jeffrey B. , Adelman Dan , Turaga Kiran K. 
Published: July 2022

Objective:
To propose a framework for quantification of surgical team familiarity.

Background:
Operating room (OR) teamwork quality is associated with familiarity among team members and their individual specialization. We describe novel measures of OR team familiarity and specialty experience.

Methods:
Surgeon-scrub (SS) and surgeon-circulator (SC) teaming scores, defined as the pair’s proportion of interactions relative to the surgeon’s total cases in the preceding 6 months were calculated between 2017 and 2021 at an academic medical center. Nurse service-line (SL) experience scores were defined as the proportion of a nurse’s cases performed within the given specialty. SS, SC, and nurse-SL scores were analyzed by specialty, case urgency, robotic approach, and surgeon academic rank. Two-sample Kolmogorov-Smirnov tests were used to determine heterogeneity between distributions.

Results:
A total of 37,364 operations involving 150 attending surgeons and 222 nurses were analyzed. Median SS and SC scores were 0.08 (interquartile range: 0.03–0.19) and 0.06 (interquartile range: 0.03–0.13), respectively. Higher margin SLs, senior faculty rank, elective, and robotic cases were associated with greater SS, SC, and nurse-SL scores (P<0.001).

Conclusions:
These novel measures of teaming and specialization illustrate the low levels of OR team familiarity and objectively highlight differences that necessitate a deliberate evaluation of current OR scheduling practices.
Descending neuron population dynamics during odor-evoked and spontaneous limb-dependent behaviors
Authors: Aymanns Florian , Chen Chin-Lin , Ramdya Pavan 
Published: July 2022

AbstractDeciphering how the brain regulates motor circuits to control complex behaviors is an important, long-standing challenge in neuroscience. In the fly, Drosophila melanogaster, this is accomplished by a population of ∼ 1100 descending neurons (DNs). Activating only a few DNs is known to be sufficient to drive complex behaviors like walking and grooming. However, what additional role the larger population of DNs plays during natural behaviors remains largely unknown. For example, they may modulate core behavioral commands, or comprise parallel pathways that are engaged depending on sensory context. We evaluated these possibilities by recording populations of nearly 100 DNs in individual tethered flies while they generated limb-dependent behaviors. We found that the largest fraction of recorded DNs encode walking while fewer are active during head grooming and resting. A large fraction of walk-encoding DNs encode turning and far fewer weakly encode speed. Although odor context does not determine which behavior-encoding DNs are recruited, a few DNs encode odors rather than behaviors. Lastly, we illustrate how one can identify individual neurons from DN population recordings by analyzing their spatial, functional, and morphological properties. These results set the stage for a comprehensive, population-level understanding of how the brain’s descending signals regulate complex motor behaviors.