bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research priorities to support the development of integrated national strategies to control skin-neglected tropical diseases
Authors: Simpson Hope , Mengiste Asrat , Mbonigaba Jean Bosco , Kollie Karsor , Nganda Motto , Dean Laura , Argaw Daniel , Davey Gail , Semrau Maya 
Published: September 2022

Abstract

Background
Skin-presenting neglected tropical diseases (skin-NTDs) impose large burdens on affected people, families and communities. The NTD Roadmap 2021–2030 presents a strategic plan to guide collaborative, multisectoral action to overcome these burdens, defining targets to control, eliminate and/or eradicate skin-NTDs by 2030. One of its targets is for 40 countries to adopt integrated skin-NTD strategies. Despite this high-level support for integration, only four countries were implementing integrated skin-NTD strategies in 2020.

Methods
We hosted workshops at the 2021 annual meeting of the Coalition for Operational Research on NTDs, to discuss the operationalisation of Roadmap goals into national strategies and interventions for skin-NTD control. Speakers included NTD Programme Managers from NTD-endemic countries, technical experts and researchers of different aspects of skin-NTDs.

Results
Challenges include community perceptions of interventions, demonstrating the cost-effectiveness of integrated care, availability and accessibility of community-based and primary healthcare services, the quality of data on skin-NTD morbidity and changes to operational structures required for integration. Research priorities included the identification of optimal case detection platforms, evaluation of integrated care, understanding the impacts of integration on community members and community health staff and development of point-of-care diagnostics.

Conclusions
The operational research priorities are intended to support the scale-up of integrated skin-NTDs programmes.
New Directions for Measurement in the Field of Work, Aging and Retirement
Authors: Fasbender Ulrike , Baltes Boris , Rudolph Cort W 
Published: September 2022

AbstractResearch on work, aging and retirement has reached a level of maturity as indicated by an established base of empirical findings and an increasing number of empirical studies on these and related phenomena. Given the development of the field, it is a good time to critically reflect on the measurement of core theoretical constructs that inform our understanding of work and aging and of retirement-related processes. Moreover, given the increasing popularity of studying aging at work and retirement, refocusing attention on the measurement of core constructs will help further advance these areas of research. The purpose of this special issue is to challenge the use of existing measures and measurement techniques and provide new advancements and directions for measurement, broadly defined, in the field of work, aging and retirement. This special issue features 8 scholarly articles that focus on: (1) innovative measurement instruments, (2) applying new techniques to address old problems, and (3) improving existing measures. In this special issue editorial, we derive key lessons learned from each of the 8 articles. We also offer practical recommendations for ways that these lessons may be incorporated into the design and execution of future research.
Incidence of and predictors for serious opioid-related adverse drug events
Authors: Denke Linda , Atem Folefac D. , Khazzam Michael 
Published: September 2022

Abstract

Purpose:
To determine the incidence of and predictors for serious opioid-related adverse drug events (ORADEs) in postoperative inpatients.

Methods:
A retrospective cohort study design of serious ORADEs in surgical inpatients between 2015 and 2017, who were abstracted from the electronic health record, in an 800-bed academic medical health center.

Results:
A total of 27,942 surgery patients met the inclusion criteria. Of those, 25,208 patients (90%) were exposed to opioids after surgery. A total of 25,133 (99.7%) patients exposed to opioids did not experience a serious ORADE while 75 (0.3%) patients did experience a serious ORADE and required naloxone. The predictors for ORADEs include age (OR = 1.040, P-value < .0001); gender (OR = 0.394, P-value = .0006); psychiatric disorder (OR = 4.440, CI: 2.435, 8.095); morphine level with respect to hydrocodone-acetaminophen (OR = 5.841, P-value = .0384); and were almost six times more likely to experience a serious ORADE when morphine is prescribed and 4.44 times more likely in patients with a psychiatric disorder (P-value < .0001).

Conclusion:
Once a baseline incidence is known, predictors for serious ORADEs in surgical inpatients are useful in guiding medical-surgical nurses' opioid safety practices, with more frequent focused respiratory assessments before opioid dosing and closer monitoring when opioids are prescribed postoperatively, especially in higher-risk surgical inpatients.
Validation of a Deep Learning–based Automatic Detection Algorithm for Measurement of Endotracheal Tube–to–Carina Distance on Chest Radiographs
Authors: Huang Min‑Hsin , Chen Chi-Yeh , Horng Ming-Huwi , Li Chung-I , Hsu I-Lin , Su Che-Min , Sun Yung-Nien , Lai Chao-Han 
Published: September 2022

Background
Improper endotracheal tube (ETT) positioning is frequently observed and potentially hazardous in the intensive care unit. The authors developed a deep learning–based automatic detection algorithm detecting the ETT tip and carina on portable supine chest radiographs to measure the ETT–carina distance. This study investigated the hypothesis that the algorithm might be more accurate than frontline critical care clinicians in ETT tip detection, carina detection, and ETT–carina distance measurement.

Methods
A deep learning–based automatic detection algorithm was developed using 1,842 portable supine chest radiographs of 1,842 adult intubated patients, where two board-certified intensivists worked together to annotate the distal ETT end and tracheal bifurcation. The performance of the deep learning–based algorithm was assessed in 4-fold cross-validation (1,842 radiographs), external validation (216 radiographs), and an observer performance test (462 radiographs) involving 11 critical care clinicians. The performance metrics included the errors from the ground truth in ETT tip detection, carina detection, and ETT–carina distance measurement.

Results
During 4-fold cross-validation and external validation, the median errors (interquartile range) of the algorithm in ETT–carina distance measurement were 3.9 (1.8 to 7.1) mm and 4.2 (1.7 to 7.8) mm, respectively. During the observer performance test, the median errors (interquartile range) of the algorithm were 2.6 (1.6 to 4.8) mm, 3.6 (2.1 to 5.9) mm, and 4.0 (1.7 to 7.2) mm in ETT tip detection, carina detection, and ETT–carina distance measurement, significantly superior to that of 6, 10, and 7 clinicians (all P < 0.05), respectively. The algorithm outperformed 7, 3, and 0, 9, 6, and 4, and 5, 5, and 3 clinicians (all P < 0.005) regarding the proportions of chest radiographs within 5 mm, 10 mm, and 15 mm error in ETT tip detection, carina detection, and ETT–carina distance measurement, respectively. No clinician was significantly more accurate than the algorithm in any comparison.

Conclusions
A deep learning–based algorithm can match or even outperform frontline critical care clinicians in ETT tip detection, carina detection, and ETT–carina distance measurement.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
The Incidence of Posterolateral Tibial Plateau and Central Lateral Femoral Condylar Impaction Fractures in a Pediatric and Young Adult Population
Authors: Bernholt David L. , Buchman Jessica M. , Baessler Aaron M. , Eason Robert R. , Witte Dexter A. , Spence David D. , Throckmorton Thomas W. , Brolin Tyler J. , Azar Frederick M. 
Published: September 2022

Background:Posterolateral tibial plateau and central lateral femoral condylar impaction fractures are known to occur in the setting of anterior cruciate ligament (ACL) tears. There have been no prior investigations into the incidence and morphology of posterolateral tibial plateau impaction fractures in the setting of ACL injury in a pediatric population.Methods:Patients between 9 and 22 years of age with knee magnetic resonance imagings (MRIs) performed demonstrating complete or partial ACL tear were included in this study. MRI reports were reviewed to denote the presence of posterior cruciate ligament, medial collateral ligament, or lateral collateral ligament injury, meniscus tears, cartilage lesions. MRIs were reviewed by 2 fellowship-trained orthopaedic surgeons to denote the presence of posterolateral tibial plateau and central lateral femoral condylar impaction fractures and physeal status of femoral and tibial physes. Statistical analysis performed included χ2analysis and the Studentttesting.Results:A total of 328 patients with a primary ACL tear were identified. The mean age of patients included was 16.5 years (range: 9.0-21.5). The incidence of posterolateral tibial plateau impaction fractures was 83/328 (25.3%) while the incidence of lateral femoral condylar impaction fractures was 119/328 (36.3%). Bipolar impaction fractures occurred in 37/328 (11.3%). Of the 83 tibial impaction fractures identified, 82 were low-grade morphologic subtypes. Patients with lateral tibial plateau impaction fractures were older than those with no fracture (17.2±2.2 vs. 16.3±2.1,P=0.001). Only 3/38 (7.9%) patients with an open tibial physis sustained a tibial plateau impaction fracture compared with 80/290 (27.6%) with a closed tibial physis (χ2value: 6.9,P=0.009). There was no difference in proportion of patients with lateral femoral condylar impaction fractures based on femoral physeal status (P=0.484).Conclusion:The incidence of posterolateral tibial plateau impaction fractures in the setting of ACL tear in a pediatric and young adult patient population appears to be lower while lateral femoral condylar impaction fractures occur more frequently when comparing to previously reported incidences found in adult populations in the literature. Furthermore, posterolateral tibial plateau impaction fractures occur less frequently in those with an open proximal tibial physis and high-grade posterolateral tibial plateau bone loss is exceedingly rare in pediatric and young adult patients. Lateral femoral condylar impaction fractures are associated with lateral meniscal tears and medial meniscal ramp lesions.Level of Evidence:Level IV—cross-sectional study.
The Impact of Upper Instrumented Vertebra Orientation on Proximal Junctional Kyphosis: A Novel and Fixed Parameter, Fused Spinopelvic Angle
Authors: Im Sang-Kyu , Lee Ki Young , Lee Jung-Hee 
Published: September 2022

Study Design.
A retrospective study.

Objectives.
To evaluate the impact of upper instrumented vertebra (UIV) orientation including the fused spinopelvic angle (FSPA) on proximal junctional kyphosis (PJK).

Summary of Background Data.
PJK is a challenging complication after adult spinal deformity (ASD) surgery. Some studies proposed UIV orientation act as a risk factor of PJK, but there remain debates because UIV orientation is changed by position. Therefore, we investigated the relationship between the FSPA, a novel parameter for the relationship between UIV and pelvis which did not change by position, and PJK.

Materials and Methods.
ASD patients who underwent long-segment fusion to the pelvis and followed up for more than two years were included. Comparative analysis was performed on spinopelvic parameters including UIV orientation parameters (UIV slope angle and FSPA) between PJK and non-PJK group. Binary regression analysis was conducted to find out the risk factors for PJK. And correlation analysis was conducted to find out the parameters that affect the FSPA.

Results.
A total of 190 patients were included. PJK incidence was 13.2% (25/190). PJK group showed a significantly greater postoperative UIV slope (21.3° vs. 18.8°, P=0.041) and significantly lesser postoperative FSPA (−0.9° vs. 4.5°, P<0.001). In binary regression analysis, only FSPA acted as a risk factor of PJK (odds ratio=0.920, P=0.004). The FSPA has strong positive correlation with pelvic incidence (PI)-lumbar lordosis (LL) (r=0.666, P<0.001) and negative correlation with lordosis distribution index (LDI) (r=−0.228, P=0.004).

Conclusion.
The FSPA is a fixed parameter which is not dependent on position. A reduction of the FSPA increases the risk for PJK. The FSPA can be adjusted through PI-LL and LDI. Thus, surgeons should increase the FSPA by adjusting the PI-LL and LDI during ASD surgery to prevent PJK.
miR-4478 Accelerates Nucleus Pulposus Cells Apoptosis Induced by Oxidative Stress by Targeting MTH1
Authors: Zhang Jiafang , Liu Ruiduan , Mo Ling , Liu Caijun , Jiang Jianming 
Published: September 2022

Objectives.
Low back pain is the leading cause of disability in the elderly population and is strongly associated with intervertebral disk degeneration (IVDD). However, the precise molecular mechanisms regulating IVDD remain elusive. This study aimed to investigate the role of differentially expressed miRNAs in the pathogenesis of IVDD.

Materials and Methods.
We analyzed miRNA microarray datasets to identify differentially expressed miRNAs in IVDD progression and conducted quantitative real-time polymerase chain reaction and fluorescence in situ hybridization analysis to further confirm the differential expression of miR-4478 in nucleus pulposus (NP) tissues of patients diagnosed with IVDD. Using public databases of miRNA-mRNA interactions, we predicted the target genes of miR-4478, and subsequent flow cytometry and western blot analyses demonstrated the effect of MTH1 in H2O2-induced nucleus pulposus cells (NPCs) apoptosis. Finally, miR-4478 inhibitor was injected into NP tissues of the IVDD mouse model to explore the effect of miR-4478 in vivo.

Results.
miR-4478 was upregulated in NP tissues from IVDD patients. Silencing of miR-4478 inhibits H2O2-induced NPCs apoptosis. MTH1 was identified as a target gene for miR-4478, and miR-4478 regulates H2O2-induced NPCs apoptosis by modulating MTH1. In addition, downregulation of miR-4478 alleviated IVDD in a mouse model.

Conclusions.
In summary, our study provides evidence that miR-4478 may aggravate IVDD through its target gene MTH1 by accelerating oxidative stress in NPCs and demonstrates that miR-4478 has therapeutic potential in IVDD treatment.
MRSA Prophylaxis in Spine Surgery Decreases Postoperative Infections
Authors: Conaway William , Lambrechts Mark J. , D’Antonio Nicholas D. , Karamian Brian A. , DiMaria Stephen , Mao Jennifer , Canseco Jose A. , Rihn Jeffrey , Kurd Mark F. , Woods Barrett I. , Kaye I. David , Hilibrand Alan S. , Kepler Christopher K. , Vaccaro Alexander R. , Schroeder Gregory D. 
Published: September 2022

Study Design:
Retrospective cohort study.

Objective:
To compare infection rates before and after the implementation of a quality improvement protocol focused on methicillin-resistant Staphylococcus aureus (MRSA) screening and decolonization in patients undergoing lumbar fusion and/or decompression.

Summary of Background Data:
Prior studies have demonstrated MRSA infections comprise a sizable portion of SSIs. Additional studies are required to improve our understanding of the risks and benefits of MRSA decolonization with vancomycin prophylaxis.

Methods:
A retrospective cohort analysis was conducted on patients who underwent spinal fusion or laminectomy before (2008–2011) and after (2013–2016) the implementation of an MRSA screening and treatment protocol. Odds ratios for MRSA, methicillin-sensitive Staphylococcus aureus (MSSA), and Vancomycin-resistant Enterococcus (VRE) infection before and after screening was calculated. Multivariate analysis assessed demographic characteristics as potential independent predictors of infection.

Results:
A total of 8425 lumbar fusion and 2558 lumbar decompression cases met inclusion criteria resulting in a total cohort of 10,983 patients. There was a significant decrease in the overall rate of infections (P <0.001), MRSA infections (P<0.001), and MSSA infections (P<0.001) after protocol implementation. Although VRE infections after protocol implementation were not significantly different (P=0.066), VRE rates as a percentage of all postoperative infections were substantially increased (0 vs. 3.36%, P=0.007). On multivariate analysis, significant predictors of the infection included younger age (OR=0.94[0.92–0.95]), shorter length of procedure (OR=1.00[0.99–1.00]), spinal fusion (OR=18.56[8.22–53.28]), higher ASA class (OR=5.49[4.08–7.44]), male sex (OR=1.61[1.18–2.20]), and history of diabetes (OR=1.58[1.08–2.29]).

Conclusion:
The implemented quality improvement protocol demonstrated that preoperative prophylactically treating MRSA colonized patients decreased the rate of overall infections, MSSA infections, and MRSA infections. In addition, younger age, male sex, diabetic status, greater ASA scores, and spinal fusions were risk factors for postoperative infection.
Non-invasive continuous cardiac output monitoring in thoracic cancer surgery
Authors: Fellahi Jean-Luc , Abraham Paul , Tiberghien Nicolas , Coelembier Clément , Maury Jean-Michel , Bendjelid Karim 
Published: September 2022

BACKGROUND
Patients scheduled for thoracic cancer surgery are eligible for goal-directed fluid therapy, but cardiac output monitoring remains challenging in that specific setting.

OBJECTIVE
We aimed to compare cardiac output as measured with chest bioreactance with that measured by calibrated pulse contour analysis; the hypothesis being that both methods would be interchangeable.

DESIGN
A prospective monocentre observational study.

SETTING
A tertiary university hospital.

PATIENTS
Fifty adult patients undergoing thoracic cancer surgery over a one year period.

MAIN OUTCOME MEASURES
Simultaneous measurements of cardiac index (CI) with bioreactance (CI-NICOM) and arterial pulse contour analysis calibrated by transthoracic echocardiography (CI-PCA) were performed at eight pre-specified intra-operative time points and following fluid challenge and/or vasoactive agents. Relationships between absolute values and changes in CI were assessed by linear regression. Interchangeability was tested with Bland–Altman analysis and percentage error calculation. A four quadrant plot was used to evaluate trending ability.

RESULTS
There was a significant difference between CI-PCA and CI-NICOM: 2.4 ± 0.8 (range: 0.9 to 5.8) l min−1 m−2 vs. 2.9 ± 0.9 (range: 0.9 to 7.2) l min−1 m−2, respectively (P < 0.001). A positive relationship was found between both techniques: y = 0.29x + 2.19; r
2 = 0.08 (P < 0.001). Taking CI-PCA as the reference method, there was a systematic overestimation of CI-NICOM by 21% (0.5 l min−1 m−2) and limits of agreement were large: -2.49 to 1.47 l min−1 m−2. The percentage error was 77% and concordance rates were 75 and 70% with and without an exclusion zone of 0.5 l min−1 m−2.

CONCLUSION
Chest bioreactance is feasible and well tolerated in patients undergoing thoracic surgery for cancer. When compared with calibrated PCA over a wide range of CI values, the technique is moderately correlated, not interchangeable, and provides moderate trending ability.

TRIAL REGISTRATION
NCT04251637.
Volumetric Absorptive Microsampling for the Therapeutic Drug Monitoring of Everolimus in Patients Who Have Undergone Liver Transplant
Authors: Yoo Seungji , Kim Giseob , Kim Soyeon , Ha Jungeun , Cho Beom Sik , Joo Dong Jin , Lee Jangik I. 
Published: September 2022

Background:
Therapeutic drug monitoring (TDM) of everolimus is required to prevent organ rejection in patients who have undergone transplant. Volumetric absorptive microsampling (VAMS) is a minimally invasive method for accurately collecting a small amount of blood from a patient's fingers. This study aimed to assess the applicability of VAMS for TDM of everolimus.

Methods:
VAMS and venous blood samples were collected from 45 liver transplant recipients who had been receiving stable everolimus doses for at least 7 days. Whole blood everolimus concentrations were measured using ultrahigh performance liquid chromatography with tandem mass spectrometry. Deming regression and Bland–Altman analysis were performed to compare everolimus concentrations measured using VAMS (CVAMS) and venous blood samples (CIV). The regression coefficient (r2) between CVAMS and CIV was calculated using a linear regression. The effects of the hematocrit and blood sampling time on the difference between CVAMS and CIV were investigated.

Results:
Thirty-two participants were included in the final analysis. The Deming regression line was CIV = 1.04 × CVAMS + 0.55 [95% confidence interval (CI) of slope, 0.91–1.18; 95% CI of intercept, −0.05 to 1.16]. CVAMS and CIV were strongly correlated (r2 = 0.92), with no proportional or constant bias. The mean difference between CVAMS and CIV was −0.79 ng/mL, with the 95% limit of agreement ranging from −2.55 to 0.97 ng/mL in a Bland–Altman plot. No effect of the hematocrit or blood sampling time was observed.

Conclusions:
VAMS and venous blood sampling showed good agreement for the measurement of whole blood everolimus concentrations. Less invasive VAMS can substitute for more invasive venous blood sampling in the TDM of everolimus in liver transplant patients.
Two Adjacent Capillary Perforator Flaps? A Reconstruction of a Full-thickness Alar Defect
Authors: Gunnarsson Gudjon Leifur 
Published: September 2022

Summary:
Any aspect of nasal reconstruction poses a worthy challenge for every plastic surgeon. Most skin tumors affect older patients who also happen to have surplus skin. This is certainly a blessing in disguise for the reconstructive surgeon, enabling the use of local flaps to reconstruct the lost skin, like with like. We present a simple case of full thickness alar and partial lateral nasal defect for malignant melanoma, and how we were fortunate to reconstruct the defect successfully in a single operation using two adjacent local capillary perforator flaps: one for inner lining and the other for outer lining. A touch-up was performed after 3 months for improved cosmesis. A successful reconstruction is displayed with a video showing key steps of the procedure and results before and after a simple touch-up correction for improved appearance. This is a case of successful reconstruction of a full-thickness alar defect using a combination of two adjacent capillary perforator flaps. It is the first case to our knowledge where this combination is applied and displayed in a video demonstration.