bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptom experiences in hypertension: a mixed methods systematic review
Authors: Horne Carolyn E. , Stayt Louise C. , Schutz Susan , Smith Christopher M. , Haberstroh Amanda , Bolin Linda P. , Taylor Catherine L. , Moosavi Shakeeb H. , Bibbey Adam 
Published: October 2022

Aim:
Understanding patients’ hypertension (HTN) symptoms can assist healthcare professionals’ awareness of individual, cultural, and behavioral responses and improve diagnostic accuracy to optimize treatment. The purpose of this review was to evaluate and synthesize current literature exploring HTN symptoms.

Methods:
Databases searched included MEDLINE (PubMed), CINAHL (EBSCO), Scopus, and Web of Science from January 2010 to January 2022. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The McMaster critical review forms were used to determine the quality of both qualitative and quantitative articles. Synthesis of the data was guided by the Joanna Briggs Institute Convergent Integrated Approach to Mixed Study Systematic Reviews.

Results:
In total, 41 articles were included, nine qualitative studies and 32 quantitative. The quality of the articles varied. Symptoms included commonly reported symptoms and some less prevalent, including some reporting absence of symptoms. Factors that affected symptoms included culture, beliefs, psychosocial factors, and knowledge. We also found that there may be a bidirectional relationship between symptoms and behaviors that may lead to self-management.

Conclusion:
HTN is common and symptoms are frequently reported. HTN management is related to multiple factors. Symptoms continue in a number of individuals after initial diagnosis. Evaluating symptoms after initial diagnosis may help to optimally manage and meet blood pressure guidelines.
Persistent hyperparathyroidism in long-term kidney transplantation: time to consider a less aggressive approach
Authors: Disthabanchong Sinee 
Published: October 2022

Purpose of review
Persistent hyperparathyroidism affects 50% of long-term kidney transplants with preserved allograft function. Timing, options and the optimal target for treatment remain unclear. Clinical practice guidelines recommend the same therapeutic approach as patients with chronic kidney disease.

Recent findings
Mild to moderate elevation of parathyroid hormone (PTH) levels in long-term kidney transplants may not be associated with bone loss and fracture. Recent findings on bone biopsy revealed the lack of association between hypercalcaemic hyperparathyroidism with pathology of high bone turnover. Elevated PTH levels may be required to maintain normal bone volume. Nevertheless, several large observational studies have revealed the association between hypercalcemia and the elevation of PTH levels with unfavourable allograft and patient outcomes. Both calcimimetics and parathyroidectomy are effective in lowering serum calcium and PTH. A recent meta-analysis suggested parathyroidectomy may be performed safely after kidney transplantation without deterioration of allograft function.

Summary
Treatment of persistent hyperparathyroidism is warranted in kidney transplants with hypercalcemia and markedly elevated PTH levels. A less aggressive approach should be applied to those with mild to moderate elevation. Whether treatments improve outcomes remain to be elucidated.
The changing trajectory of diabetic kidney disease
Authors: Mistry Nupur , Bakris George L. 
Published: October 2022

Purpose of review
Progression of diabetic kidney disease has slowed over the past 40 years by as much as 70–75%, thanks to a diversity of drug classes that have less effect on glucose and more on reducing cardiorenal risk.

Recent findings
With the advent of sodium-glucose co-transporter 2 (SGLT2) inhibitors and the novel nonsteroidal mineralocorticoid antagonist, finerenone, we now have three ‘pillars of therapy’ considering the renin–angiotensin system (RAS) inhibitors as already established treatment to slow diabetic kidney disease. Both renal and cardiovascular outcomes trials have provided solid evidence of the benefit by these agents to slow kidney disease progression and reduce heart failure hospitalizations. Using these agents together reduces the risk of hyperkalemia by finerenone and further reduces albuminuria in animal models. Trials are underway to also see if the glucagon-like peptide 1 receptor agonist, semaglutide, will also protect against diabetic kidney disease progression as seen in post hoc analyses of positive cardiovascular outcome trials. If positive, this would be the fourth pillar to support cardiorenal protection without fear of hypoglycemia.

Summary
Nephrologists now have three different agents neither of which has a major effect on blood pressure but both add to further reduce progression of diabetic nephropathy and hospitalization from heart failure.
Negative pressure wound therapy with instillation and dwell time (NPWTi-d) with antiseptic solution leads to a greater reduction in the number of pathogen species detected compared to conventional NPWT despite the recontamination of the wound by eluates with high bacterial load.
Authors: Stichling Marcus , Wiessner Alexandra , Kikhney Judith , Gatzer Renate , Müller Martin , Scheuermann-Poley Catharina , Moter Annette , Willy Christian 
Published: October 2022

The aim of the study was to investigate bacterial colonisation of the foam eluate after negative pressure wound therapy with instillation and dwell time (NPWTi-d) to obtain an indication of possible recontamination of the wound during NPWTi-d. To detect bacterial colonisation and the extent of planktonic and non-planktonic bioburden as comprehensively as possible, routine culture and molecular biology methods were used.

Methods:
Before (TP1) and after (median 3.0 days, TP2) of NPWT (n=15) and NPWTi-d with antiseptic installation (n=15), wound bed (WB) (n=22 acute, n=8 chronic wounds, median age 51 (24-91) years; 26 male), foam and eluate were examined by routine culture methods and fluorescence in situ hybridisation (FISH), polymerase chain reaction (PCR) and sequencing (FISHseq).

Results:
At TP2, 94.9% (37/39) of the pathogens identifiable in the eluate were also detected in WB. Foam and eluate were always bacterially contaminated. NPWTi-d resulted in a significant reduction in the number of pathogen species compared to NPWT (NPWTi-d: TP1 vs. TP2: p=0.026; NPWT: TP1 vs. TP2: ns). Routine culture of WB samples at TP2 identified only 28/52 (53.8%) of the pathogens, while examination of WB, foam and eluate and additional FISHseq use detected 50/52 (96.2%) of the bacterial species. FISHseq identified biofilm in n=1 and microcolonies in n=10 wounds (TP2).

Conclusion:
The bacterial load of the foam is flushed back into the wound during NPWTi-d. FISHseq should be used in addition to the routine culture method when pathogen identification and detection of non-planktonic bacterial growth is particularly important for the patient's therapy.
Reconstruction of dentomaxillofacial deformity secondary to a long-term mandibular defect using concomitant orthognathic surgery and fibula free flap: a preliminary study
Authors: Cao Jian , Shen Shunyao , Liu Zhixu , Wu Jinyang , Shi Jun , Zhang Lei , Zhu Min , Wang Xudong 
Published: October 2022

Summary:
The reconstruction of mandibular defect may be delayed or compromised due to many reasons, especially in pediatric patients. With the growth of the remaining mandible and the maxilla in the malocclusion status, the secondary dentomaxillofacial deformity is plausible. To treat the concomitant mandibular defect and secondary dentomaxillofacial deformity, a hierarchical algorithm using orthodontics, orthognathic surgery, and fibula free flap was developed. This retrospective case series included six patients with long-term mandibular defects caused by tumor resection without repair or with compromised costochondral reconstruction. All patients were treated using the same staged protocol, but with minor changes: 1) pre-surgical orthodontics, 2) virtual surgical planning, 3) fabrication of the guides and splints, 4) sequenced operations and 5) postoperative care. The sequence of surgery included the Le Fort I osteotomy, mandibular sagittal split ramus osteotomy (MSSO) of the remaining ramus, final occlusion registration, repositioning of the distal segment of the mandible, segmented fibula reconstruction, and finally the fixation of MSSO. The operations and wound healing were uneventful in all patients, and no flap failure or severe complications were detected. Also, the patients exhibited no signs of temporomandibular joint ankylosis during the follow-up. The subspinale-nasion-supramental angle (ANB) reduced significantly after the surgery. A significant improvement was detected in the facial contour symmetry measurements postoperatively. This proposed workflow of concomitant orthognathic surgery and the fibula free flap is effective and reliable for the reconstruction of dentomaxillofacial deformity secondary to the long-term mandibular defect.
“Migraine Surgery and Determination of Success Over Time by Trigger Site: A Systematic Review of the Literature”
Authors: Huayllani Maria T. , Janis Jeffrey E. 
Published: October 2022

Background:
Migraine surgery is a debilitating disorder that produces high costs and compromises the quality of life. This study aimed to evaluate surgery success and the longevity of the surgical benefit by trigger site.

Methods:
A systematic literature review was performed by querying PubMed, EMBASE, Scopus, and Web of Science databases. The keywords “surgery”, “migraine”, “outcomes”, “headache index” and synonyms in titles and abstracts were used to perform the search.

Results:
A total of 17 articles published between 2009 and 2019 met the inclusion criteria. Six studies were prospective and eleven were retrospective. Most of the studies (77.8%, 77.8%, and 80%) reported success of migraine surgery at 12 months follow-up for trigger sites I, II, and III, respectively. For trigger site IV, the greatest MHI reduction (93.4%) was observed at 12 months follow-up, and the earliest MHI reductions (80.3% and 74.6%) were observed at 6 months follow-up. All studies that evaluated trigger sites V and VI identified surgery success at 12 months follow-up. Migraine surgery was found to remain beneficial at 22 months for trigger sites I, II, III, and IV.

Conclusions:
The symptomatic improvement may initially be evident at 6 months for trigger site IV and at 12 months for trigger sites I, II, III, V, and VI. Surgical benefit in trigger sites I, II, III, IV can persist after 22 months. Further studies are required to evaluate results at longer follow-up.
Machine learning-based Automatic Evaluation of Tissue Handling Skills in Laparoscopic Colorectal Surgery: A Retrospective Experimental Study
Authors: Sasaki Shoma , Kitaguchi Daichi , Takenaka Shin , Nakajima Kei , Sasaki Kimimasa , Ogane Tateo , Takeshita Nobuyoshi , Gotohda Naoto , Ito Masaaki 
Published: October 2022

Objective:
To develop a machine learning model that automatically quantifies the spread of blood in the surgical field using intraoperative videos of laparoscopic colorectal surgery and evaluate whether the index measured with the developed model can be used to assess tissue handling skill.

Background:
Although skill evaluation is crucial in laparoscopic surgery, existing evaluation systems suffer from evaluator subjectivity and are labor-intensive. Therefore, automatic evaluation using machine learning is potentially useful.

Materials and Methods:
In this retrospective experimental study, we used training data with annotated labels of blood or non-blood pixels on intraoperative images to develop a machine learning model to classify pixel RGB values into blood and non-blood. The blood pixel count per frame (the total number of blood pixels throughout a surgery divided by the number of frames) was compared among groups of surgeons with different tissue handling skills.

Results:
The overall accuracy of the machine learning model for the blood classification task was 85.7%. The high tissue handling skill group had the lowest blood pixel count per frame, and the novice surgeon group had the highest count (mean [SD]: high tissue handling skill group 20972.23 [19287.05] vs. low tissue handling skill group 34473.42 [28144.29] vs. novice surgeon group 50630.04 [42427.76], P<0.01). The difference between any 2 groups was significant.

Conclusions:
We developed a machine learning model to measure blood pixels in laparoscopic colorectal surgery images using RGB information. The blood pixel count per frame measured with this model significantly correlated with surgeons’ tissue handling skills.
A systematic review and meta-analysis comparing postoperative outcomes of laparoscopic versus open omental patch repair of perforated peptic ulcer
Authors: Chan Kai Siang , Ng Shi Tong Carissa , Tan Chin Hong Ben , Gerard Gheslynn , Oo Aung Myint 
Published: October 2022

BACKGROUND
The mainstay of surgical management of perforated peptic ulcer is omental patch repair. Advances in minimally invasive techniques have shown feasibility of laparoscopic omental patch repair (LOPR). Laparoscopic omental patch repair is limited by learning curve (LC), but there is a lack of reporting of LC in LOPR. This study aims to compare outcomes following LOPR versus open omental patch repair (OOPR) with reporting of LC.

METHODS
PubMed, Embase, The Cochrane Library, and Scopus were systematically searched from inception till January 2022 for randomized controlled trials (RCTs) and non-RCTs comparing LOPR and OOPR in perforated peptic ulcer. Exclusion criteria were primary repair without use of omental patch repair. Primary outcomes were 30-day mortality, postoperative leak, and LC analysis.

RESULTS
There were a total of 29 studies including 5,311 patients (LOPR, n = 1,687; OOPR, n = 3,624), with 4 RCTs with 238 patients (LOPR, n = 118; OOPR, n = 120). Majority of ulcers were located in the duodenum (57.0%) followed by stomach (30.7%). Mean ulcer size ranged from 5 to 16.2 mm in LOPR and 4.7 to 15.8 mm in OOPR. Laparoscopic omental patch repair was associated with lower 30-day mortality (odds ratio [OR], 0.57; 95% confidence interval [CI], 0.35–0.92; p = 0.02), overall morbidity (OR, 0.31; 95% CI, 0.18–0.53; p < 0.0001), surgical site infection (OR, 0.27; 95% CI, 0.18–0.42; p < 0.00001), and length of stay (mean difference, −2.84 days; 95% CI, −3.63 to −2.06; p < 0.00001). Postoperative leakage (OR, 1.06; 95% CI, 0.43–2.61; p = 0.90) was comparable between LOPR and OOPR. Only three studies analyzed the proportion of consultants to trainees; LOPR was performed mainly by consultants (range, 82.4–91.4%), while OOPR was mainly performed by trainees (range, 52.8–96.8%). One study showed that consultants who performed open conversion had shorter operating time compared with chief residents (85 vs. 186.6 minutes, p < 0.003).

CONCLUSION
Laparoscopic omental patch repair has lower mortality, overall morbidity, length of stay, intraoperative blood loss, and postoperative pain compared with OOPR. More prospective studies should be conducted to evaluate LC in LOPR.

LEVEL OF EVIDENCE
Systematic Review and Meta-Analysis; Level IV.
Reconceptualizing high-quality emergency general surgery care: Non–mortality-based quality metrics enable meaningful and consistent assessment
Authors: Zogg Cheryl K. , Staudenmayer Kristan L. , Kodadek Lisa M. , Davis Kimberly A. 
Published: October 2022

BACKGROUND
Ongoing efforts to promote quality-improvement in emergency general surgery (EGS) have made substantial strides but lack clear definitions of what constitutes “high-quality” EGS care. To address this concern, we developed a novel set of five non–mortality-based quality metrics broadly applicable to the care of all EGS patients and sought to discern whether (1) they can be used to identify groups of best-performing EGS hospitals, (2) results are similar for simple versus complex EGS severity in both adult (18–64 years) and older adult (≥65 years) populations, and (3) best performance is associated with differences in hospital-level factors.

METHODS
Patients hospitalized with 1-of-16 American Association for the Surgery of Trauma–defined EGS conditions were identified in the 2019 Nationwide Readmissions Database. They were stratified by age/severity into four cohorts: simple adults, complex adults, simple older adults, complex older adults. Within each cohort, risk-adjusted hierarchical models were used to calculate condition-specific risk-standardized quality metrics. K-means cluster analysis identified hospitals with similar performance, and multinomial regression identified predictors of resultant “best/average/worst” EGS care.

RESULTS
A total of 1,130,496 admissions from 984 hospitals were included (40.6% simple adults, 13.5% complex adults, 39.5% simple older adults, and 6.4% complex older adults). Within each cohort, K-means cluster analysis identified three groups (“best/average/worst”). Cluster assignment was highly conserved with 95.3% of hospitals assigned to the same cluster in each cohort. It was associated with consistently best/average/worst performance across differences in outcomes (5×) and EGS conditions (16×). When examined for associations with hospital-level factors, best-performing hospitals were those with the largest EGS volume, greatest extent of patient frailty, and most complicated underlying patient case-mix.

CONCLUSION
Use of non–mortality-based quality metrics appears to offer a needed promising means of evaluating high-quality EGS care. The results underscore the importance of accounting for outcomes applicable to all EGS patients when designing quality-improvement initiatives and suggest that, given the consistency of best-performing hospitals, natural EGS centers-of-excellence could exist.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
The development of the amnion in mice and other amniotes
Authors: Chuva de Sousa Lopes Susana M. , Roelen Bernard A. J. , Lawson Kirstie A. , Zwijsen An 
Published: October 2022

The amnion is an extraembryonic tissue that evolutionarily allowed embryos of all amniotes to develop in a transient and local aquatic environment. Despite the importance of this tissue, very little is known about its formation and its molecular characteristics. In this review, we have compared the basic organization of the extraembryonic membranes in amniotes and describe the two types of amniogenesis, folding and cavitation. We then zoom in on the atypical development of the amnion in mice that occurs via the formation of a single posterior amniochorionic fold. Moreover, we consolidate lineage tracing data to better understand the spatial and temporal origin of the progenitors of amniotic ectoderm, and visualize the behaviour of their descendants in the extraembryonic–embryonic junctional region. This analysis provides new insight on amnion development and expansion. Finally, using an online-available dataset of single-cell transcriptomics during the gastrulation period in mice, we provide bioinformatic analysis of the molecular signature of amniotic ectoderm and amniotic mesoderm. The amnion is a tissue with unique biomechanical properties that deserves to be better understood.
This article is part of the theme issue ‘Extraembryonic tissues: exploring concepts, definitions and functions across the animal kingdom’.
Origin, form and function of extraembryonic structures in teleost fishes
Authors: Concha Miguel L. , Reig Germán 
Published: October 2022

Teleost eggs have evolved a highly derived early developmental pattern within vertebrates as a result of the meroblastic cleavage pattern, giving rise to a polar stratified architecture containing a large acellular yolk and a small cellular blastoderm on top. Besides the acellular yolk, the teleost-specific yolk syncytial layer (YSL) and the superficial epithelial enveloping layer are recognized as extraembryonic structures that play critical roles throughout embryonic development. They provide enriched microenvironments in which molecular feedback loops, cellular interactions and mechanical signals emerge to sculpt, among other things, embryonic patterning along the dorsoventral and left–right axes, mesendodermal specification and the execution of morphogenetic movements in the early embryo and during organogenesis. An emerging concept points to a critical role of extraembryonic structures in reinforcing early genetic and morphogenetic programmes in reciprocal coordination with the embryonic blastoderm, providing the necessary boundary conditions for development to proceed. In addition, the role of the enveloping cell layer in providing mechanical, osmotic and immunological protection during early stages of development, and the autonomous nutritional support provided by the yolk and YSL, have probably been key aspects that have enabled the massive radiation of teleosts to colonize every ecological niche on the Earth.
This article is part of the theme issue ‘Extraembryonic tissues: exploring concepts, definitions and functions across the animal kingdom’.
Review of extra-embryonic tissues in the closest arthropod relatives, onychophorans and tardigrades
Authors: Treffkorn Sandra , Mayer Georg , Janssen Ralf 
Published: October 2022

The so-called extra-embryonic tissues are important for embryonic development in many animals, although they are not considered to be part of the germ band or the embryo proper. They can serve a variety of functions, such as nutrient uptake and waste removal, protection of the embryo against mechanical stress, immune response and morphogenesis. In insects, a subgroup of arthropods, extra-embryonic tissues have been studied extensively and there is increasing evidence that they might contribute more to embryonic development than previously thought. In this review, we provide an assessment of the occurrence and possible functions of extra-embryonic tissues in the closest arthropod relatives, onychophorans (velvet worms) and tardigrades (water bears). While there is no evidence for their existence in tardigrades, these tissues show a remarkable diversity across the onychophoran subgroups. A comparison of extra-embryonic tissues of onychophorans to those of arthropods suggests shared functions in embryonic nutrition and morphogenesis. Apparent contribution to the final form of the embryo in onychophorans and at least some arthropods supports the hypothesis that extra-embryonic tissues are involved in organogenesis. In order to account for this role, the commonly used definition of these tissues as ‘extra-embryonic’ should be reconsidered.This article is part of the theme issue ‘Extraembryonic tissues: exploring concepts, definitions and functions across the animal kingdom’.