bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcranial Motor-evoked Potentials for Intraoperative Nerve Root Monitoring During Adult Spinal Deformity Surgery: A Prospective Multicenter Study
Authors: Yoshida Go , Ushirozako Hiroki , Machino Masaaki , Shigematsu Hideki , Kawabata Shigenori , Yamada Kei , Kanchiku Tsukasa , Fujiwara Yasushi , Iwasaki Hiroshi , Ando Muneharu , Taniguchi Shinichirou , Takatani Tsunenori , Tadokoro Nobuaki , Takahashi Masahito , Wada Kanichiro , Yamamoto Naoya , Funaba Masahiro , Yasuda Akimasa , Hashimoto Jun , Morito Shinji , Kurosu Kenta , Kobayashi Kazuyoshi , Ando Kei , Takeshita Katsushi , Matsuyama Yukihiro , Imagama Shiro 
Published: July 2022

Study Design.
A prospective, multicenter study.

Objective.
This study clarified the uses and limitations of transcranial motor-evoked potentials (Tc-MEPs) for nerve root monitoring during adult spinal deformity (ASD) surgeries.

Summary of Background Data.
Whether Tc-MEPs can detect nerve root injuries (NRIs) in ASD surgeries remains controversial.

Materials and Methods.
We prospectively analyzed neuromonitoring data from 14 institutions between 2017 and 2020. The subjects were ASD patients surgically treated with posterior corrective fusion using multichannel Tc-MEPs. An alert was defined as a decrease of ≥70% in the Tc-MEP’s waveform amplitude from baseline, and NRI was considered as meeting the focal Tc-MEP alerts shortly following surgical procedures with postoperative nerve root symptoms in the selected muscles.

Results.
A total of 311 patients with ASD (262 women and 49 men) and a mean age of 65.5 years were analyzed. Tc-MEP results revealed 47 cases (15.1%) of alerts, including 25 alerts after 10 deformity corrections, six three-column osteotomies, four interbody fusions, three pedicle screw placements or two decompressions, and 22 alerts regardless of surgical maneuvers. Postoperatively, 14 patients (4.5%) had neurological deterioration considered to be all NRI, 11 true positives, and three false negatives (FN). Two FN did not reach a 70% loss of baseline (46% and 65% loss of baseline) and one was not monitored at target muscles. Multivariate logistic regression analysis revealed that risk factors of NRI were preexisting motor weakness (P<0.001, odds ratio=10.41) and three-column osteotomies (P=0.008, odds ratio=7.397).

Conclusions.
Nerve root injuries in our ASD cohort were partially predictable using multichannel Tc-MEPs with a 70% decrease in amplitude as an alarm threshold. We propose that future research should evaluate the efficacy of an idealized warning threshold (e.g., 50%) and a more detailed evoked muscle selection, in reducing false negatives.
Sex-specific effects of neuropathic pain on long-term pain behavior and mortality in mice
Authors: Millecamps Magali , Sotocinal Susana G. , Austin Jean-Sebastien , Stone Laura S. , Mogil Jeffrey S. 
Published: August 2022

Abstract
Human epidemiological studies suggest that chronic pain can increase mortality risk. We investigated whether this was true in mice so that underlying mechanisms might be identified. At 10 weeks of age, C57BL/6 mice of both sexes received sham or spared nerve injury (SNI) surgery producing neuropathic pain. Mice were weighed monthly, tested behaviorally for mechanical and cold sensitivity and guarding behavior every 3 months postsurgery, and otherwise left undisturbed in their cages until death by natural causes. Evidence of pain over the lifespan displayed a strikingly sex-specific pattern. Male mice displayed largely stable mechanical and cold hypersensitivity and guarding at 6 to 30 months post-SNI. By contrast, female mice displayed a biphasic temporal pattern of mechanical hypersensitivity and guarding behavior, with a complete resolution of SNI-induced pain behavior at 6 to 9 months post-SNI followed by the return of pain thereafter. Mouse lifespan was not significantly altered by SNI in either sex nor was frailty as assessed by cage inspection in the last 6 months of life. However, in male mice with SNI, we observe a significant correlation between average lifetime mechanical hypersensitivity and lifespan, such that death occurred sooner in male mice exhibiting more evidence of chronic pain. This relationship was not observed in female SNI mice nor in sham-operated mice of either sex. This experiment is the first to investigate pain behavior over an entire adult lifetime and suggests that biology of relevance to human chronic pain is being ignored by the very short timespans of most extant preclinical pain research.
The Relationship Between Pedagogy and Changes in Students’ Learning Styles in Physician Assistant Education
Authors: Wardley C. Sonia , Applegate E. Brooks , Wang Qian , Van Rhee James 
Published: August 2022

Introduction
The purpose of this study was to examine the relationship between instructional pedagogy and changes in physician assistant (PA) students’ learning styles during a 2-year master’s program.

Methods
Two parallel curricular tracks were established in the didactic year, one using problem-based learning (PBL) and the other lecture-based learning (LBL) for 6 years. Kolb’s Learning Style Inventory (LSI) was administered to both groups at matriculation and at the end of the first and second years. Multivariate analyses, including logarithmic transformations of LSI data because of its ipsative nature, were conducted to evaluate differences and changes in students’ learning style.

Results
A majority of students changed learning styles during the program. Despite considerable movement within and between learning styles, the percentage distribution of LBL students’ learning styles changed little during the program, whereas there was a significant increase in PBL students having a Convergent learning style after 2 years. PBL students preferred more transformation than prehension in information processing than LBL students. About a third of LBL students, compared to a fifth of PBL students, had reverted to close to their matriculation learning style by the end of the clinical year.

Discussion
Primary care physicians and PAs tend to have a convergent learning style. Little movement towards this learning style was seen with LBL students, whereas a significant increase in the number of PBL students had adopted this learning style by the end of the program.
Emerging functional microfluidic assays for the study of thromboinflammation in sickle cell disease
Authors: An Ran , Gurkan Umut A. 
Published: August 2022

Purpose of review
This review briefly summarizes the significant impact of thromboinflammation in sickle cell disease in relation to recent advances in biomarkers that are used in functional microfluidic assays.

Recent findings
Sickle cell disease (SCD) is an inherited hemoglobinopathy that affects 100 000 Americans and millions worldwide. Patients with SCD exhibit chronic haemolysis, chronic inflammation and thrombosis, and vaso-occlusion, triggering various clinical complications, including organ damage and increased mortality and morbidity. Recent advances in functional microfluidic assays provide direct biomarkers of disease, including abnormal white blood cell and red blood cell adhesion, cell aggregation, endothelial degradation and contraction, and thrombus formation.

Summary
Novel and emerging functional microfluidic assays are a promising and feasible strategy to comprehensively characterize thromboinflammatory reactions in SCD, which can be used for personalized risk assessment and tailored therapeutic decisions.
The effect of perichondrium on cartilage graft properties
Authors: Akkina Sarah R. , Most Sam P. 
Published: July 2022

Purpose of review
The role of perichondrium in cartilage graft survival has been long debated. Although the innate function of perichondrium in providing mechanical and regenerative support to cartilage in its native position is relatively undisputed, studies continue to vacillate over how the perichondrium effects cartilage grafts once transplanted. This review evaluates historical and recent experiments showing how perichondrium may or may not impact graft survival.

Recent findings
Experimental studies in animal models have more recently evaluated macroscopic and microscopic properties of diced cartilage grafts with and without perichondrium, finding that in general grafted cartilage with perichondrial components retains greater weight and mechanical strength compared with cartilage without perichondrial components. However, these findings have not been replicated in humans. Solid pieces of rib cartilage have most recently been used without perichondrium to prevent warping, though no studies have evaluated whether retaining perichondrium with oblique and concentric cutting techniques may effect overall resorption.

Summary
Although historical opinions and more recent animal studies suggest a role of perichondrium in cartilage graft survival, randomized controlled human studies are still lacking on whether retaining perichondrium truly effects graft survival and ultimate surgical outcomes.
Clinical considerations for open versus endoscopic approaches in skull base surgery
Authors: Jawad Basit , Vankoevering Kyle , Carrau Ricardo , Patil Yash 
Published: July 2022

Purpose of review
We aim to distill the current body of evidence to consider when selecting an endoscopic versus open approach to address cranial base disease. We evaluate the evolution of modern surgical techniques and their respective limitations.

Recent findings
Greater understanding of the role of tumor biology in relation to patient outcomes has led to increasingly sophisticated treatment algorithms. This combined with further development of advanced instrumentation and technique has led to the adoption of new surgical corridors previously unapproachable via traditional surgery.

Summary
Endoscopic and open craniofacial approaches both remain important surgical techniques in the management of cranial base tumors. The modern skull base surgeon may employ a combination of approaches to optimize tumor extirpation while preserving functional outcomes. Patient history, anatomic tumor extent, histology, and functional goals should be considered thoroughly when planning any surgical intervention.
Outcomes of COVID-19 and Factors Associated With Its Severity Among Hospitalized Patients With and Without Systemic Rheumatic Disease During the First Wave of the Pandemic in New York City
Authors: Siegel Caroline H. , Choi Jacky M. , D'Angelo Debra , Christos Paul , Lally Lindsay , Navarro-Millan Iris , Cooke Joseph , Goyal Parag , Mandl Lisa A. , Barbhaiya Medha 
Published: July 2022

Background/Objective
Conflicting data exist regarding whether patients with systemic rheumatic disease (SRD) experience more severe outcomes related to COVID-19. Using data from adult patients hospitalized with COVID-19 in New York City during the first wave of the pandemic, we evaluated whether patients with SRD were at an increased risk for severe outcomes.

Methods
We conducted a medical records review study including patients aged ≥18 years with confirmed SARS-CoV-2 infection hospitalized at 3 NewYork-Presbyterian sites, March 3–May 15, 2020. Inverse probability of treatment weighting was applied to a multivariable logistic regression model to assess the association between SRD status and the composite of mechanical ventilation, intensive care unit admission, or death.

Results
Of 3710 patients hospitalized with COVID-19 (mean [SD] age, 63.7 [17.0] years; 41% female, 29% White, and 34% Hispanic/Latinx), 92 (2.5%) had SRD. Patients with SRD had similar age and body mass index but were more likely to be female, ever smokers, and White or Black, compared with those without SRD. A higher proportion of patients with versus without SRD had hypertension and pulmonary disease, and used hydroxychloroquine, corticosteroids, and immunomodulatory/immunosuppressive medications before admission. In the weighted multivariable analysis, patients with SRD had an odds ratio of 1.24 (95% confidence interval, 1.10–1.41; p < 0.01) for the composite of mechanical ventilation, intensive care unit admission, or death, compared with patients without SRD.

Conclusions
During the initial peak of the pandemic in New York City, patients with versus without SRD hospitalized with COVID-19 had a 24% increased likelihood of having severe COVID-19 after multivariable adjustment.
Developing a National Trauma Research Action Plan (NTRAP): Results from the Post-Admission Critical Care Research Gap Delphi Survey
Authors: Brasel Karen , Braverman Maxwell A. , Phuong Jimmy , Price Michelle A. , Kaplan Lewis J. , Kozar Rosemary , Michetti Christopher P. , Callcut Rachael , Bulger Eileen M. ,   the Post-Admission Critical Care Research Panel Group
Published: August 2022

Abstract

Introduction
The 2016 NASEM report included a proposal to establish a National Trauma Research Action Plan (NTRAP). In response, the Department of Defense funded the Coalition for National Trauma Research to generate a comprehensive research agenda spanning the continuum of trauma and burn care from prehospital care to rehabilitation as part of an overall strategy to achieve zero preventable deaths and disability after injury. The Post-Admission Critical Care Research panel was one of 11 panels constituted to develop this research agenda.

Methods
We recruited interdisciplinary experts in surgical critical care and recruited them to identify current gaps in clinical critical care research, generate research questions and establish the priority of these questions using a consensus-driven Delphi survey approach. The first of four survey rounds asked participants to generate key research questions. On subsequent rounds, we asked survey participants to rank the priority of each research question on a 9-point Likert scale, categorized to represent low-, medium-, and high-priority items. Consensus was defined as ≥ 60% of panelists agreeing on the priority category.

Results
Twenty-five subject matter experts generated 595 questions. By Round 3, 249 questions reached ≥60% consensus. Of these, 22 questions were high, 185 were medium and 42 were low priority. The clinical states of hypovolemic shock and delirium were most represented in the high-priority questions. Traumatic brain injury was the only specific injury pattern with a high-priority question.

Conclusions
The NTRAP critical care research panel identified 22 high-priority research questions, that, if answered, would reduce preventable death and disability after injury.

Level of Evidence
IV

Type of Study
Delphi panel gap analysis
Lung ultrasound to assess pulmonary congestion in patients with acute exacerbation of COPD - a feasibility study
Authors: Johannessen Øyvind , Reite Fride Uthaug , Bhatnagar Rahul , Øvrebotten Tarjei , Einvik Gunnar , Myhre Peder L. 
Published: July 2022

AbstractBackgroundChronic heart failure (HF) coexist with chronic obstructive pulmonary disease (COPD) in approximately 25% of patients and is associated with worse outcomes. Lung ultrasound (LUS) is a validated technique to diagnose pulmonary congestion by detecting vertical lung artifacts, B-lines. Pulmonary inflammation is also associated with B-lines, but little is known about LUS in patients with acute exacerbation of COPD (AECOPD).AimsTo assess the feasibility of LUS to detect concurrent acute HF in AECOPD and examine the associations between B-lines, clinical parameters during hospitalization and re-hospitalizations and mortality.Methods & resultsIn a prospective cohort study 123 patients with AECOPD (age 75±9 years, 57 [46%] men) underwent 8-zone bedside LUS within 24h after admission. A positive LUS was defined by ≥3 B-lines in ≥2 zones bilaterally. A cardiologist committee blinded for LUS adjudicated whether concurrent HF was present (n=48, 39%). The median number of B-lines was 8 (IQR 5-13) and 16 (13%) patients had positive LUS. Positive LUS was associated with infiltrates on chest X-ray. The prevalence of positive LUS was similar with and without concurrent HF 8 (17%) vs 8 (11%), p=0.34, while the number of B-lines was higher in concurrent HF: median 10 (IQR 6–16) vs 7 (IQR 5-12) (p=0.03). The sensitivity and specificity for positive LUS to detect concurrent HF was 16.7% and 89.3%, respectively. Positive LUS was not associated with re-hospitalization and mortality: Adjusted HR 0.93 (0.49-1.75), p=0.81.ConclusionsLUS did not detect concurrent HF or predict risk in patients hospitalized with AECOPD.
Priority age targets for COVID-19 vaccination in Ethiopia under limited vaccine supply
Authors: Galli Margherita , Zardini Agnese , Gamshie Worku Nigussa , Santini Stefano , Tsegaye Ademe , Trentini Filippo , Marziano Valentina , Guzzetta Giorgio , Manica Mattia , d’Andrea Valeria , Putoto Giovanni , Manenti Fabio , Ajelli Marco , Poletti Piero , Merler Stefano 
Published: July 2022

AbstractBackgroundThe worldwide inequitable access to vaccination claims for a re-assessment of policies that could minimize the COVID-19 burden in low-income countries. An illustrative example is what occurred in Ethiopia, where nine months after the launch of the national vaccination program in March 2021, only 3% of the population received two doses of COVID-19 vaccine. In the meantime, a new wave of cases caused by the emergence of Delta variant of SARS-CoV-2 was observed between July and November 2021.MethodsWe used a SARS-CoV-2 transmission model to estimate the level of immunity accrued before the launch of vaccination in the Southwest Shewa Zone (SWSZ) and to evaluate the impact of alternative age priority vaccination targets in a context of limited vaccine supply. The model was informed with available epidemiological evidence and detailed contact data collected across different socio-demographic settings.ResultsWe found that, during the first year of the pandemic, 46.1-58.7% of SARS-CoV-2 infections and 24.9-48% of critical cases occurred in SWSZ were likely associated with infectors under 30 years of age. During the Delta wave, the contribution of this age group in causing critical cases was estimated to increase to 66.7-70.6%. However, our findings suggest that, when considering the vaccine product available at the time (ChAdOx1 nCoV-19; 65% efficacy against infection after 2 doses), prioritizing the elderly for vaccination remained the best strategy to minimize the disease burden caused by Delta, irrespectively to the number of available doses. Vaccination of all individuals aged 50□years or older would have averted 40 (95%CI: 18-60), 90 (95%CI: 61-111), and 62 (95%CI: 21-108) critical cases per 100,000 residents in urban, rural, and remote areas, respectively. Vaccination of all individuals aged 30□years or more would have averted an average of 86-152 critical cases per 100,000 individuals, depending on the setting considered.ConclusionsDespite infections among children and young adults likely caused 70% of critical cases during the Delta wave in SWSZ, most vulnerable ages should remain a key priority target for vaccination against COVID-19.
Graph lesion-deficit mapping of fluid intelligence
Authors: Cipolotti Lisa , Ruffle James K , Mole Joe , Xu Tianbo , Hyare Harpreet , Shallice Tim , Chan Edgar , Nachev Parashkev 
Published: August 2022

AbstractFluid intelligence is arguably the defining feature of human cognition. Yet the nature of its relationship with the brain remains a contentious topic. Influential proposals drawing primarily on functional imaging data have implicated “multiple demand” frontoparietal and more widely distributed cortical networks, but extant lesion-deficit studies with greater causal power are almost all small, methodologically constrained, and inconclusive. The task demands large samples of patients, comprehensive investigation of performance, fine-grained anatomical mapping, and robust lesion-deficit inference, yet to be brought to bear on it.We assessed 165 healthy controls and 227 frontal or non-frontal patients with unilateral brain lesions on the best-established test of fluid intelligence, Raven’s Advanced Progressive Matrices, employing an array of lesion-deficit inferential models responsive to the potentially distributed nature of fluid intelligence. Non-parametric Bayesian stochastic block models were used to reveal the community structure of lesion deficit networks, disentangling functional from confounding pathological distributed effects.Impaired performance was confined to patients with frontal lesions (F(2,387) = 18.491; p < .001; frontal worse than non-frontal and healthy participants p < .01; p <.001), more marked on the right than left (F(4,385) = 12.237; p < .001; right worse than left and healthy participants p<.01; p<.001). Patients with non-frontal lesions were indistinguishable from controls and showed no modulation by laterality. Neither the presence nor the extent of multiple demand network involvement affected performance. Both conventional network-based statistics and non-parametric Bayesian stochastic block modelling heavily implicated the right frontal lobe. Crucially, this localisation was confirmed on explicitly disentangling functional from pathology-driven effects within a layered stochastic block model, prominently highlighting a right frontal network involving middle and inferior frontal gyrus, pre- and post-central gyri, with a weak contribution from right superior parietal lobule. Similar results were obtained with standard lesion-deficit analyses.Our study represents the first large-scale investigation of the distributed neural substrates of fluid intelligence in the focally injured brain. Combining novel graph-based lesion-deficit mapping with detailed investigation of cognitive performance in a large sample of patients provides crucial information about the neural basis of intelligence. Our findings indicate that a set of predominantly right frontal regions, rather than a more widely distributed network, is critical to the high-level functions involved in fluid intelligence. Further they suggest that Raven’s Advanced Progressive Matrices is a useful clinical index of fluid intelligence and a sensitive marker of right frontal lobe dysfunction.
Unmet Expectations About Material Properties Delay Perceptual Decisions
Authors: Malik Amna , Doerschner Katja , Boyaci Huseyin 
Published: August 2022

AbstractBased on our expectations about material properties we can implicitly predict an object’s future states, e.g. a wine glass falling down will break when it hits the ground. How these expectations affect relatively low level perceptual decisions, however, has not been systematically studied previously. To seek an answer to this question we conducted a behavioral experiment using animations of various familiar objects (e.g. key, wine glass etc.) freely falling and hitting the ground. During a training session participants first built expectations about the dynamic properties of those objects. Half of the participants (N=28) built expectations consistent with our daily lives (e.g. a key bounces rigidly), whereas the other half learned an anomalous behavior (e.g. a key wobbles). This was followed by experimental sessions, in which expectations were unmet in 20% of the trials. In both training and experimental sessions, participants’ task was to report whether the objects broke or not upon hitting the ground. Critically a specific object always remained intact or broke, only the manner with which it did so differed. For example, a key could wobble or remain rigid, but it never broke. We found that participants’ reaction times were longer when expectations were unmet even when those expectations were anomalous and learned during the training session. Furthermore, we found an interplay between long-term and newly learned expectations, which could be predicted by a Bayesian updating approach. Overall, our results show that expectations about material properties can have an impact on relatively low-level perceptual decision making processes.