bluuebunny/crossref_metadata_2025 huggingface dataset:
A Hitchhiker’s Guide Toward CSF Biomarkers for Neuro-Oncology
Authors: Riviere-Cazaux Cecile , Keough Michael B , Zuccato Jeffrey A , Kumar Rahul , Schulz Sebastian , Warrington Arthur E , Ruff Michael W , Ellingson Benjamin M , Sanai Nader , Campian Jian L , Kizilbash Sani H , Parney Ian F , Zadeh Gelareh , Khasraw Mustafa , Kessler Tobias , Sener Ugur , Cahill Daniel P , Mansouri Alireza , Burns Terry C
Published: December 2024

Cerebrospinal fluid (CSF) has emerged as a valuable liquid biopsy source for glioma biomarker discovery and validation. CSF produced within the ventricles circulates through the subarachnoid space, where the composition of glioma-derived analytes is influenced by the proximity and anatomical location of sampling relative to tumor, in addition to underlying tumor biology. The substantial gradients observed between lumbar and intracranial CSF compartments for tumor-derived analytes underscore the importance of sampling site selection. Moreover, radiographic features, such as tumor-CSF contact and blood-brain barrier (BBB) disruption, are critical covariates that may affect biomarker detectability and the abundance of plasma-derived analytes in CSF, respectively. Longitudinal intracranial CSF sampling, enabled by access devices like Ommaya reservoirs, may offer a window into treatment response and disease progression, though variability in analyte yield, sample volumes, and the dynamic effects of surgical resection pose challenges. This review critically evaluates the anatomic, radiographic, and longitudinal factors that impact glioma CSF biomarker abundance. Practical considerations for longitudinal CSF biobanking, including access device placement and collection, are also reviewed. Key takeaways and recommendations for CSF glioma biomarker discovery and validation are provided based on our collective experience, along with resources for investigators aiming to develop CSF biobanking at their institutions.
METTL3 promotes osteogenesis by regulating N6-methyladenosine-dependent primary processing of hsa-miR-4526
Authors: Song Yidan , Gao Hongyu , Pan Yihua , Gu Yuxi , Sun Wentian , Liu Jun
Published: December 2024

The function and mechanism of pri-miRNA N6-methyladenosine (m6A) modification in promoting miRNA maturation and regulating osteoblastic differentiation are not fully understood. The aim of this study was to investigate the role and regulatory mechanism of miRNA shear maturation regulated by methyltransferase like 3 (METTL3) in human adipose-derived stem cell (hASC) osteogenesis. Firstly, we found METTL3 promoted osteogenesis both in vivo and in vitro. Subsequently, three pri-miRNAs with the most significant methylated peaks were identified through methylated RNA immunoprecipitation sequencing (MeRIP-seq). Through quantitative real-time polymerase chain reaction (qRT-PCR), MeRIP-qPCR and co-immunoprecipitation (CO-IP), it was determined that METTL3 promoted the processing of hsa-miR-4526 by mediating pri-miR4526/5190 m6A modification. Subsequent in vivo and in vitro experiments demonstrated that hsa-miR-4526 promoted osteogenesis. Dual luciferase reporter assay was performed to verify that hsa-miR-4526 regulated osteogenic differentiation through TUBB3. It was found that TUBB3 can inhibit hASC osteogenesis. Further rescue experiments confirmed that METTL3 inhibited TUBB3 expression through hsa-miR-4526, thereby regulating osteogenic differentiation. RNA-seq revealed that TUBB3 may be involved in cell metabolism, calcium enrichment, osteoclast differentiation, and other pathways. Our study is the first to investigate the mechanism of pri-miRNA m6A modification in regulating hASC osteogenesis, presenting a novel idea and method for repairing bone defects.
Therapeutic potential of Achillea millefolium L. extract on 7,12-dimethylbenz(a)anthracene (DMBA) -induced ovary cancer in Wistar rats: a biochemical, molecular and histopathological approach
Authors: Zhang Linsen , Yuan Xiu , Peng Qingmei
Published: December 2024

Ovarian cancer (OC) is a significant cause of cancer-related mortality among women. This study explores the efficacy of Achillea millefolium L. (A. millefolium) extract, known for its phytoestrogenic properties, in treating OC through hormonal and metabolic modulation. Using a Wistar rat model, OC was induced with 7,12-dimethylbenz(a)anthracene (DMBA), and the effects of A. millefolium, both alone and in combination with paclitaxel (PTX), were evaluated. The study involved five groups of ten rats each: normal, OC, and those receiving 100 mg/kg of A. millefolium with or without PTX. Key hormonal levels, oxidative stress markers, and inflammatory cytokines were measured. Additionally, ovarian tissues were analyzed for malondialdehyde and ferric reducing ability of plasma, while gene and protein expressions related to apoptosis were assessed. Results showed that A. millefolium, particularly when combined with PTX, reduced the luteinizing hormone/follicle-stimulating hormone ratio, increased antioxidant enzyme activity, and upregulated apoptosis-related pathways, leading to higher p53 expression and fewer Ki-67 positive cells. These findings suggest A. millefolium’s potential as a complementary therapy for women with OC, particularly those with ovulation disorders.
Within-host genetic diversity of SARS-CoV-2 across animal species
Authors: Naderi Sana , Sagan Selena M , Shapiro B. Jesse
Published: December 2024

Infectious disease transmission to different host species makes eradication very challenging and expands the diversity of evolutionary trajectories taken by the pathogen. Since the beginning of the ongoing COVID-19 pandemic, SARS-CoV-2 has been transmitted from humans to many different animal species, in which viral variants of concern could potentially evolve. Previously, using available whole genome consensus sequences of SARS-CoV-2 from four commonly sampled animals (mink, deer, cat, and dog), we inferred similar numbers of transmission events from humans to each animal species. Using a genome-wide association study, we identified 26 single nucleotide variants (SNVs) that tend to occur in deer—more than any other animal—suggesting a high rate of viral adaptation to deer. The reasons for this rapid adaptive evolution remain unclear, but within-host evolution—the ultimate source of the viral diversity that transmits globally—could provide clues. Here, we quantify intra-host SARS-CoV-2 genetic diversity across animal species and show that deer harbor more intra-host SNVs (iSNVs) than other animals, providing a larger pool of genetic diversity for natural selection to act upon. Mixed infections involving more than one viral lineage are unlikely to explain the higher diversity within deer. Rather, a combination of higher mutation rates, longer infections, and species-specific selective pressures are likely explanations. Combined with extensive deer-to-deer transmission, the high levels of within-deer viral diversity help explain the apparent rapid adaptation of SARS-CoV-2 to deer.
Cementum attachment protein‐derived peptide induces cementum formation
Authors: Rodríguez Lía Hoz , Vázquez Maricela Santana , Ramírez González Luis Fernando , Ayala Gonzalo Montoya , Letayf Sonia López , Narayanan A. Sampath , Arzate Higinio
Published: December 2024

A pentapeptide AVIFM (CAP‐p5) derived from the carboxy‐terminus end of cementum attachment protein was examined for its role on proliferation, differentiation, and mineralization of human periodontal ligament cells (HPLC), and for its potential to induce cementum deposition in vivo. CAP‐p5 capability to induce hydroxyapatite crystal formation on demineralized dentin blocks was characterized by scanning electron microscopy, μRAMAN, and high‐resolution transmission electron microscopy. The results revealed that CAP‐p5 promoted cell proliferation and cell differentiation and increases alkaline phosphatase activity of HPLC and mineralization at an optimal concentration of 10 μg/mL. It induced the expression of cementum molecular markers BSP, CAP, CEMP1, and ALP at the protein level. In a cell‐free system, human demineralized dentin blocks coated with CAP‐p5 induced the deposition of a homogeneous and continuous mineralized layer, intimately integrated with the underlying dentin indicating new cementum formation. Physicochemical characterization of this mineral layer showed that it is composed of hydroxyapatite crystals. Demineralized dentin blocks coated with CAP‐p5 implanted subcutaneously in BALB/cAnNCrl were analyzed histologically; the results disclosed that CAP‐p5 could induce the deposition of a cementum layer intimately integrated with the subjacent dentin with cementocytes embedded into the cementum matrix. Immunostaining showed the expression of cementum molecular markers; v.gr. BSP, CAP, CEMP1 and ALP, validating the molecular identity of the newly deposited cementum. We conclude that CAP‐p5 is a new biomolecule with the potential of therapeutic application to contribute to the regeneration of cementum and periodontal structures lost in periodontal disease.
Ginsenoside Ro improves Salmonella Typhimurium‐induced colitis through inhibition of the virulence factors SopB and SopE2 via the RAC1/CDC42/ARP2/3 pathway
Authors: Cui Xinhua , Wang Yang , Liu Ziyan , Zhao Meng , Zhu Mingmei , Yu Wanlu , Lu Baochun , Xu Hongyue , Liu Jiajia , Liao Ning , Shi Jinyang , Peng Danping , Niu Sijia , Shen Jiayi , Qiu Jiazhang , Yu Lu
Published: December 2024

Salmonella enterica serovar Typhimurium (S. Typhimurium) poses a serious threat to human and animal health, and there is an urgent need to develop new therapeutic agents. In our in vivo study, ginsenoside Ro (Ro) reduced the mortality rate of S. Typhimurium‐infected mice by effectively improving three key disease activity index (DAI) indicators. In particular, ginsenoside Ro inhibited S. Typhimurium‐induced colitis by reversing colon length shortening; alleviating pathological damage to the colon; decreasing the levels of IL‐1β, TNF‐α, IFN‐γ, and IL‐6; and decreasing the activities of MPO and EPO, while increasing the levels of IL‐10 as well as the colon epithelial barrier and tight junction‐related genes (Mucin 1, Mucin 2, Occludin, Claudin‐3, and ZO‐1). Furthermore, ginsenoside Ro reduced CFUs in the liver, spleen, colon, and feces. In a mechanistic in vitro study, ginsenoside Ro reduced CFUs in HeLa and Raw264.7 cells, which was associated with ginsenoside Ro inhibition of the recruited S. Typhimurium‐containing vacuole (SCV) biomarkers LC3, Rab7, GAL8, and NDP52. Molecular docking results revealed that the binding energies of ginsenoside Ro and SopB and ginsenoside Ro and SopE2 were as high as −11.3 and −9.7 kcal/mol, respectively, as verified by CETSA and DARTS assays. Moreover, ginsenoside Ro at 100 and 200 μM significantly decreased the enzyme activities and expression of SopB and SopE2. Finally, ginsenoside Ro inhibited the membrane ruffling caused by SopB‐regulated Arf6/Cyth2/Arf1‐, RAC1‐, and CDC42‐driven Arp2/3‐dependent actin polymerization and the SopE2‐regulated CDC42/Arp2/3 signaling pathway. In summary, our findings suggest that ginsenoside Ro is a potential lead compound for therapeutic use against S. Typhimurium infection, and these findings lay a foundation for its further development.
The Attempted Assassination of William H. Seward: Analysis of His Nonfatal Head and Neck Injuries
Authors: Pappas Theodore N. , Llewellyn Megan , Barr Justin
Published: December 2024

On April 14, 1865, Abraham Lincoln was assassinated by John Wilkes Booth at Ford’s Theatre in Washington DC. Booth’s actions were part of a conspiracy by Confederate sympathizers to disrupt the US Government. The conspiracy also targeted Secretary of State William H. Seward, who was attacked in his home on the same evening by Lewis Powell. Seward, who was recuperating from a violent carriage accident, was brutally stabbed several times in the face and neck but survived his wounds. This article will review the assassination attempt before focusing on the details of Seward’s wounds and his subsequent medical care. We will also analyze how Powell managed not to kill Seward despite having the opportunity to stab the defenseless, recumbent Secretary 5 times.
Deloyers Technique for Restoration of Bowel Continuity Following Extended Left Hemicolectomy: A Comprehensive Analysis of 97 Cases and Literature Review
Authors: Sobrado Lucas F. , Schabl Lukas , Foley Niamh M. , Prien Christopher , Nahas Sergio C. , Liska David , Kessler Hermann , Valente Michael A. , Steele Scott R , Hull Tracy L
Published: December 2024

BACKGROUND:

Deloyers technique addresses challenges in restoring bowel continuity following extended left hemicolectomies. Despite being first described in 1958, the technique remains underutilized, with limited data on long-term outcomes.

OBJECTIVE:

To evaluate the indications, surgical and functional outcomes of Deloyers technique and review existing literature.

DESIGN:

Using a prospectively maintained database, patient demographics and perioperative data were collected. A telephone interview was conducted to assess bowel function and statistical analysis identified factors affecting bowel function.

SETTINGS:

Single tertiary care center.

PATIENTS:

Patients that underwent Deloyers technique from January 1995 to February 2023.

RESULTS:

A total of 97 patients were included. Most common indications were colorectal cancer (50.5%) and diverticular disease (21.6%). In 53.6% of cases DT was performed at re-operations and in 70.1% a diverting loop ileostomy was created. Early surgical complications occurred in 7.2% of patients, including five anastomotic leaks, one colonic conduit ischemia and one small bowel obstruction. Late complications occurred in 8.2%, including 6 anastomotic strictures and 2 chronic leaks. There was no perioperative mortality. A total of 40 patients were interviewed and reported an average of 3.5 bowel movements per day and 0.5 at night, 17.5% used bowel stoppers and 52.5% of patients reported that their bowel function did not impact their quality of life. Previous radiotherapy and anastomosis less than eight cm from the anal verge were associated with having four or more bowel movements per day (p < 0.01).

MAIN OUTCOMES MEASURES:

Postoperative morbidity and bowel function.

LIMITATIONS:

Retrospective analysis of a heterogeneous group of patients with different pathologies and indications for surgery.

CONCLUSION:

Deloyers technique is a safe and effective alternative for restoring bowel continuity after extended left hemicolectomy. Postoperative functional results are generally satisfactory, with more favorable outcomes noted in patients with higher anastomoses and those who have not undergone prior pelvic radiotherapy.
Ambient temperature and dengue hospitalization in Brazil: A 10-year period case time series analysis
Authors: Lopes Rafael , Basagaña Xavier , Bastos Leonardo S. L. , Bozza Fernando A. , Ranzani Otavio T.
Published: December 2024

Background:

Dengue has an increased worldwide epidemic potential with the global rising temperature due to climate change. Heat and rainfall are known to influence seasonal patterns of dengue transmission over the course of weeks to months. However, there is a gap in knowledge about the short-term effect of heat on dengue severity. We aimed to quantify the effect of ambient temperature on dengue hospitalization risk in Brazil.

Methods:

Daily dengue hospitalization counts and average daily ambient temperature from 2010 to 2019 were analyzed from Brazil. We applied the case time series design combined with a distributed lag nonlinear model framework to estimate relative risk (RR) estimates for dose–response and lag–response structures for the association of temperature and dengue hospitalization. We estimate the overall dengue hospitalization RR for the whole country as well as for each of the five macroregions.

Results:

A total of 579,703 hospital admissions due to dengue occurred between 2010 and 2019. We observed a positive association between high temperatures and a high risk of hospitalization across the country. Under extreme heat (95th percentile of temperature), the RR was 3.47 (95% confidence interval: 2.88, 4.19) compared with minimum hospitalization risk. This association was mainly driven by an immediate effect of heat (lag 0) and was similar for the Northeast, Center-West, Southeast, and South regions, but unclear for the North. The risk was of greater magnitude among females and those aged ≥65 years.

Conclusion:

Short-term high temperatures are associated with an increase in the risk of hospitalization by dengue.
Self-Diagnosed Cases of Dissociative Identity Disorder on Social Media: Conceptualization, Assessment, and Treatment
Authors: Salter Michael , Brand Bethany L. , Robinson Matt , Loewenstein Rich , Silberg Joyanna , Korzekwa Marilyn
Published: December 2024

Recent global popularity of social media content about dissociative identity disorder (DID) has coincided with increased self-diagnosis among children and young people who have formed large online communities and presented in clinical settings seeking to affirm their self-diagnoses. We situate this phenomenon within a broader trend toward self-diagnosis due to the widespread visibility and accessibility of mental health content on social media. Social media propelled self-diagnosis raises particular questions for the study and treatment of DID due to long-standing debates over whether the condition is traumagenic, sociogenic, or iatrogenic. This paper draws from the current state of knowledge about psychiatric self-diagnosis, the influence of social media on youth mental health, and the authors’ clinical experience to present preliminary conceptualizations of DID self-diagnosis and its significance for clinical practice. Established etiological models for DID acknowledge the role of sociocultural and contextual factors in shaping and reinforcing the elaboration of DID self-states. We hypothesize that multiple forms of online sociality and interaction encourage such elaborations. Social media content regarding DID, however, is routinely unreliable and low quality, often mischaracterizing the condition’s symptoms and minimizing associated suffering and disability. This paper considers the likelihood that the self-diagnosing DID cohort includes genuine, genuine but exaggerated, imitative, and malingering cases, and underscores the importance of careful and personalized assessment and diagnosis.
A positive spin: large language models can help directors evaluate programs through their patients' own words
Authors: Flaherty Leah Russell , Oliver Kendra H.
Published: December 2024

Introduction:

Interpretation and utilization of qualitative feedback from participants has immense value for program evaluation. Reliance on only quantitative data runs the risk of losing the lived patient experience, forcing their outcomes to fit into our predefined objectives.

Objectives:

Using large language models (LLMs), program directors may begin to employ rich, qualitative feedback expediently.

Methods:

This study provides an example of the feasibility of evaluating patient responses (n = 82) to Empowered Relief, a skill-based pain education class using LLMs. We utilized a dual-method analytical approach, with both LLM-assisted and supported manual thematic review.

Results:

The thematic analysis of qualitative data using ChatGPT yielded 7 major themes: (1) Use of Specific Audiofile; (2) Mindset; (3) Technique; (4) Community and Space; (5) Knowledge; (6) Tools and Approaches; and (7) Self-awareness.

Conclusion:

Findings from the LLM-derived analysis provided rich and unexpected information, valuable to the program and the field of pain psychology by employing the set of patients' own words to guide program evaluation. Program directors may benefit from evaluating treatment outcomes on a broader scale such as this rather than focusing solely on improvements in disability. These insights would only be uncovered with open-ended data, and although potentially more insights could emerge with the help of a qualitative research team, ChatGPT offered an ergonomic solution.
Evaluating the Accuracy of Relative Value Unit and Operative Time Changes in Breast Reconstruction
Authors: Rochlin Danielle H. , Rubenstein Robyn N. , Levy Jacob , Boe Lily , Mehrara Babak J. , Nelson Jonas A. , Matros Evan
Published: December 2024

Background:

As part of the 2021 changes to breast reconstruction CPT codes, the Relative Value Scale Update Committee (RUC) recommended adjustments to work RVUs (wRVUs) based on newly surveyed intraoperative times. Our objective was to gauge the accuracy of operative time and wRVU adjustments using national data as a benchmark.

Methods:

We queried the National Surgical Quality Improvement Program (NSQIP) database for operative times from 2005-2021 for reevaluated CPT codes. For each code, we compared NSQIP median operative times with CMS historical operative times and the RUC’s 2021 recommendations. CPT 19364 (breast reconstruction with free flap) was not reevaluated but was included for comparison. Linear regression modeled the change in NSQIP median intraoperative time by year.

Results:

For 9 reevaluated CPT codes, NSQIP operative times were derived from 59,941 cases from 2005-2021. RUC-recommended operative times were shorter than NSQIP benchmarks for 3 CPT codes (CPT 19316, 19325,19340) by 2-7 minutes and longer for 6 codes (CPT 19318, 19328, 19330, 19342, 19357, 19380) by 1-44 minutes. Compared to operative times prior to reevaluation, 2021 RUC times better approximated median NSQIP times by 4.5% overall. Operative times significantly decreased over time for most CPT codes.

Conclusion:

The 2021 RUC recommendations for intraoperative times were collectively more accurate compared to prior CMS times when measured against NSQIP benchmarks. Despite these improvements, CMS chose not to adopt many of the RUC’s recommendations and lowered wRVU values more than recommended. These findings question the necessity and favorability of future efforts to reevaluate CPT 19364.
Nomogram-based Approach for Predicting Complication Risks Following Prepectoral Direct-to-Implant Breast Reconstruction
Authors: Bae Juyoung , Mun Goo-Hyun , Lee Kyeong-Tae , Pyon Jai Kyong
Published: December 2024

Background:

Despite the recent steep rise in the use of prepectoral direct-to-implant (DTI) breast reconstruction, concerns remain regarding the potentially risk of complications, resulting in the selective application of the technique; however, the selection process was empirically based on the operator's decision. Using patient and operation-related factors, this study aimed to develop a nomogram for predicting postoperative complications following prepectoral DTI reconstruction.

Methods:

Between August 2019 and March 2023, immediate prepectoral DTI was performed for all patients deemed suitable for one-stage implant-based reconstruction. A retrospective analysis of the complications was conducted for this cohort. The cohort was randomly divided into the training and validation datasets. A nomogram was developed using least absolute shrinkage and selection operator logistic regression and Firth’s bias-reduced logistic regression.

Results:

We analyzed 433 breasts (362 patients). Complications developed in 131 patients (33.5%), including early complications within 90 days postoperatively (26.1%), infection (1.8%), wound revision (9.7%), and reconstructive failure (3.5%). Increased age and body mass index (BMI), therapeutic mastectomy, reduction pattern mastectomy, implant size, and projection, and radiotherapy history were associated with early complications. For infection and reconstructive failure, increased age and BMI, heavier mastectomy specimen weight, implant projection, previous and adjuvant radiotherapy showed association. The internal validation of each model demonstrated areas under the receiver operating characteristic curve of 68.9%, 68.0%, 84.9%, and 79.0% for early complications, delayed wound healing, infection, and reconstructive failure, respectively.

Conclusion:

A nomogram-based approach for predicting complications in prepectoral DTI reconstruction may enhance clinical decision-making, leading to optimized outcomes.
18F-FDG PET/CT of Intrapulmonary Schwannoma Mimicking Lung Cancer in the Right Lower Lobe
Authors: Liang Zhiying , Li Wei
Published: December 2024

A 53-year-old woman was found to have a soft tissue mass in the right lower lung lobe on chest CT, raising suspicion of lung cancer. For staging, 18F-FDG PET/CT was performed, which demonstrated intense tracer uptake in the mass (SUVmax, 14.6). Subsequently, surgical excision was undertaken, and histopathological examination of the resected specimen confirmed the diagnosis of a schwannoma.
Syphilitic Lymphadenitis and Clavicle Pathological Fracture Mimicking Malignant Tumor on 18F-FDG PET/CT
Authors: Zhang Hongzheng , Dong Youwen , Dai Sheng
Published: December 2024

A 66-year-old woman presented with 9 days of left clavicle pain, with no history of recent trauma. CT images showed a left clavicle fracture with a surrounding soft tissue mass. An 18F-FDG PET/CT scan revealed increased FDG uptake in the tonsils, multiple lymph nodes, and the pathologically fractured clavicle, initially suggesting malignancy. However, serologic tests and pathology confirmed syphilitic lymphadenitis and osteomyelitis. Given the inguinal and cervical lymphadenopathy with FDG uptake, potential bone destruction, or pathological fractures mimicking malignancy, syphilis should be considered in the differential diagnosis. Serologic testing and Treponema pallidum screening are essential.
Hepatic Arterial Infusion Pump Complication With Multimodal Radiologic and Anatomic Review
Authors: Chavda Rihin , Aldine Amro Saad , Pillai Akhilesh , Soni Jayesh , Sibley Robert Carson
Published: December 2024

Hepatic arterial infusion therapy involves surgically implanting a subcutaneous hepatic arterial infusion pump with the catheter tip at the hepatic artery. This pump directly delivers chemotherapy to the liver, which may reduce systemic toxicity, improve resectability, and treat unresectable hepatic lesions. This therapy is used in primary or metastatic hepatic malignancies. We present a case that reviews a multimodal radiologic approach to a less common complication of hepatic arterial infusion pump. Using nuclear medicine, interventional radiology, and pictographic presentation, we provide an anatomic review, demonstrate radiologic intervention capability, and show posttreatment resolution of the complication.
Usability of a Cloud-Based Home Healthcare Client Monitoring Platform: A Simulation-Based Approach
Authors: Alimohammadbeik Kourosh , Chung Joohyun , Noh Yeonsik , Jacelon Cynthia S.
Published: December 2024

Purpose

The aim of this study was to assess the usability of a cloud-based home healthcare monitoring platform (CHHM).

Design

A proof of concept using a simulated client scenario was used in this study.

Methods

Using a mixed-methods approach, a convenience sample of 14 nursing students was used to assess the usability of CHHM during a simulation. Students engaged in evaluation using two questionnaires: the Post-Study System Usability Questionnaire (Usability Questionnaire) and a researcher-developed questionnaire incorporating qualitative responses.

Results

The overall mean score of the Usability Questionnaire was 2.91, with the range of 7, indicating the usability of the platform. The Usability Questionnaire was negatively scored, with 1 being the best. The means of the two subscales, System Usefulness (2.77) and Information Quality (3.26), illustrated the platform’s solid performance. The Interface Quality subscale mean was 2.94, indicating a lower level of satisfaction. Qualitative data from the researcher-developed questionnaire indicated that participants found the platform straightforward, clear, and user-friendly, with the potential to enhance practice.

Clinical Relevance

This platform may enhance rehabilitation nurses’ ability to monitor clients at home.

Conclusion

The CHHM can support and enhance the delivery of home health care by enabling continuous remote monitoring. By incorporating user-centered design principles, cloud-native architecture, and wearable sensors, we demonstrated a proof of concept and laid the foundation for further platform development.
Application of Reverse Sural Flaps in Pediatric Patients
Authors: Wang Amy , Durand Jean Pierre F. , Dadzie Aaron I. , Lopez Annalisa , Konofaos Petros
Published: December 2024

Introduction

The reverse sural flap (RSF) is a random-type, pedicled flap based on sural artery perforators indicated for traumatic lower-extremity wounds. The RSF has demonstrated comparable results to free flap placement in the adult population for reconstruction of distal third defects, but few reports describe its application and outcomes in the pediatric population.

Methods

We investigated RSF application in pediatric patients (<18 years of age) through systematic review and meta-analysis. PubMed, Scopus, CINAHL, and ProQuest databases were utilized. Inclusion criteria included case series and chart studies reporting on pediatric RSF patients. Primary outcomes included overall flap survival rate, venous congestion, and necrosis. Screening of 244 initial articles yielded 16 studies for further review and statistical analysis.

Results

There were 207 patients treated with a mean age of 9.51 ± 2.27 years and follow-up of 20.07 months. The majority of studies focus on the distal third as the primary site for RSF reconstruction, with fasciocutaneous being the most commonly used flap type. Trauma was the predominant etiology of soft-tissue defect (91.0%). Analysis of outcomes shows a 91.0% survival rate for reverse sural flaps. Approximately 13.0% of patients experienced venous congestion. Flap necrosis rate was 15.0%, although most cases were subtotal (93.1%) and successfully managed through additional skin grafting.

Conclusions

With comparable efficacy to free flaps for distal third defects in the pediatric population as well as similar success rates to adult RSF patients, the RSF should be considered a first-line therapy for lower-extremity soft-tissue reconstruction in pediatric patients.
3D-Printed “Jigsaw Puzzle” in Craniomaxillofacial Comminuted Fracture Reduction
Authors: Wang Tien-Hsiang , Yu Wen-Chan , Shih Yu-Chung , Chen Ching-En , Wang Shyh-Jen , Ma Hsu , Chen Wei-Ming
Published: December 2024

Background

Surgical treatment of comminuted and multiple facial fractures is challenging, as identifying the bone anatomy and restoring the alignment are complicated. To overcome the difficulties, 3D-printed “jigsaw puzzle” has been innovated to improve the surgical outcome. This study aimed to demonstrate the feasibility of 3D-printed model in facial fracture restoration procedures.

Materials and Methods

Patients with traumatic craniomaxillofacial fractures treated at a single institution were enrolled in this study. The exclusion criteria included the presence of mandibular fractures, greenstick fractures, isolated fractures, and revision cases. Fine-cut (1-mm thick) computed tomography images of each patient were assembled into a 3D model for preoperative planning. Major fragments were segmented in virtual surgical planning, printed out with a 3D printer as “jigsaw puzzle” pieces, and assembled with plates and screws as in surgical rehearsals. We further matched our study group with a control group of patients who underwent the corresponding procedures to compare operative time.

Results

Nine patients with craniomaxillofacial fractures were included in the study, including 2 patients with zygomaticomaxillary complex fractures and 7 patients with multiple fractures. No remarkable postoperative complications, such as enophthalmus or optic nerve injury, that require additional or revision surgery were noted. The mean operative time was 391 and 435 minutes in the study and control groups, respectively. The t test results were not statistically significant.

Conclusions

Surgeons can perform comprehensive preoperative planning, simulation, and obtain a real-time reference for facial bone reduction by using the 3D-printed “jigsaw puzzle” in multiple complicated craniomaxillofacial fractures.
Focused Investigation of Facial Nerve Dysfunction After Mandibular Distraction Osteogenesis for Robin Sequence
Authors: Mantilla-Rivas Esperanza , Finestone Sofia , Crowder Hannah R. , Escandon Joseph M. , Rana Md Sohel , Oh Nathanael S. , Duarte-Bateman Daniela , Manrique Monica , Rogers Gary F. , Oh Albert K.
Published: December 2024

Facial nerve dysfunction (FND) is a well-recognized but poorly documented complication of mandibular distraction osteogenesis (MDO) for Robin sequence (RS). This study aims to document the authors' experiences with FND and identify risk factors associated with this adverse event. A retrospective review of a prospectively gathered database was performed to identify patients with RS who underwent MDO at the authors' institution from March 2016 to June 2023. The authors included all infants with at least 3 months of follow-up after device removal. Data collected included patient demographics, incidence, laterality and onset of FND, and time to resolution. Thirty-six patients met the inclusion criteria. The median age at MDO was 2.7 (interquartile range: 0.7, 129) months. The median latency, distraction, and consolidation phases were 3.0 days, 17.5 days, and 77.5 days, respectively. The median length of distraction was 19.8 (interquartile range: 11, 30) mm. Thirteen infants (36.1%) demonstrated FND. While the majority (n = 10, 27.8%) experienced temporary palsy with a mean time to resolution of 98.6 (± 124.3) days, 3 infants (8.3%) had persistent FND at a mean of 29.3 (±35.6) months after hardware removal. The majority of FND occurred during the distraction phase and involved the marginal mandibular nerve. The current study demonstrated that over 1/3 of patients with RS experience FND after MDO. Most cases of FND were transient and occurred during the active distraction phase.
Simultaneous Lefort 2 Distraction and Fronto-Orbito-Malar Advancement: Correcting Severe Upper and Midface Retrusion in a Patient With Crouzon Syndrome
Authors: De Stefano Sofia , Nadal López Emmanuela , Sabas Mariana
Published: December 2024

Craniofacial syndromes present with exorbitism and airway obstruction as a result of upper and middle facial hypoplasia. Classical subcranial Lefort III (LF III) or monobloc distraction osteogenesis (DO) using an external craniofacial device is used to treat these deformities. These procedures are done during mixed dentition, in most cases, advancing an abnormal face, to a more normal position. In patients with a severe midface retrusion, to achieve differential facial changes, Hopper and colleagues have proposed a combination of LF II distraction with simultaneous zigomatic repositioning. The aim of this presentation is to show a 3-year follow-up of a patient with Crouzon syndrome with severe upper and midface retrusion, who underwent an LF II DO combined with a fronto-malar advancement to achieve cranial and midface expansion and facial ratio normalization. The authors present a variation of technique by Hopper and colleagues;​ a combined intra and extracranial procedure, performing simultaneously a fronto-orbital-malar advancement and LF II DO. The authors performed photographs and craniofacial computed tomography scans to evaluate the patient’s appearance and shape of the cranial base. Authors found an important expansion of the middle third of the face with improved facial rations due to differential movement of the bony segments. Lefort II distraction in combination with fronto-orbito-malar advancement is an excellent option for the treatment of patients with severe upper and middle face retrusion. It provides eye globe protection enabling maximal midfacial expansion, resulting in a better functional and esthetic outcome. Results have remained stable after 3 years.
New Productive Force: The Preliminary Report of First Craniofacial Surgical Robot IST Multicenter Clinical Trial in China
Authors: Li Li , Lin Li , Xu HaiSong , Zhang Yan , Chai Gang
Published: December 2024

Background:

This paper presents the authors' team’s research on a craniofacial surgical robot developed in China. Initiated in 2011 with government funding, the craniofacial surgical robot project was officially launched in Shanghai, developed jointly by the Ninth People’s Hospital affiliated with Shanghai Jiao Tong University School of Medicine and the Shanghai Jiao Tong University medical-engineering team. Currently, based on multiple rounds of model surgeries, animal experiments, and clinical trials, our team is applying for approval as a Class III medical device from the National Medical Products Administration (NMPA). As an innovative tool in the field of craniofacial surgery, it fills a technological gap within the country.

Methods:

This study is a multicenter cohort study based on patient data from Shanghai Ninth People’s Hospital from 2019 to 2024. Inclusion criteria included patients who underwent craniofacial surgery with complete follow-up data, with the primary variable being the use of robotic assistance in craniofacial surgery. Data analysis involved descriptive statistics, t tests, and multivariable regression, with a significance level set at P<0.05.

Results:

The craniofacial surgical robot has been widely explored in the fields of congenital deformities, tumor reconstruction, and esthetic surgery. In the clinical trials discussed in this article, which included experiments on both craniofacial deformity correction surgeries and esthetic surgeries, a total of 39 patients were enrolled. In mandibular osteotomy surgery, robotic-assisted procedures can reduce osteotomy length error by an average of 2.2 mm and mandibular angle error by 9.09 degrees, while also decreasing the average surgery time by 10.43 minutes. In hemifacial microsomia distraction osteogenesis surgery, robotic-assisted surgery can reduce osteotomy length error by an average of 4.6 mm and shorten the average surgery time by 60 minutes. The robotic-assisted group also showed better perioperative outcomes for patients. The surgical precision was improved and there was a significant reduction in postoperative complications.

Conclusion:

The authors' research team has completed the first multicenter study on craniofacial surgical robots in China, demonstrating that this robot significantly enhances surgical precision, reduces operation time, and improves perioperative patient indicators. These findings indicate that the robot is highly effective in assisting surgeons with complex procedures. The study suggests that, in the future, this robot is likely to be widely adopted in craniofacial surgery, significantly advancing surgical efficiency and precision, and bringing transformative progress to clinical practice.
Factors affecting the direct red cell effect on thrombosis: Hematocrit dilution and injury patterns
Authors: Price Adam D. , Becker Ellen R. , Chae Ryan C. , Baucom Matthew R. , Wallen Taylor E. , Schuster Rebecca , England Lisa , Pritts Timothy A. , Goodman Michael D.
Published: December 2024

BACKGROUND

Red blood cell (RBC) aggregation can be initiated by calcium and tissue factor, which may independently contribute to microvascular and macrovascular thrombosis after injury and transfusion. Previous studies have demonstrated that increased blood storage duration may contribute to thrombotic events. The aims of this study were to first determine the effect of blood product components, age, and hematocrit (HCT) on the aggregability of RBCs, followed by measurement of RBC aggregability in two specific injury models including traumatic brain injury (TBI) and hemorrhagic shock.

METHODS

Human whole blood (WB) units were obtained following the standard 21-day storage period. Whole blood was separated into components including RBCs, platelet-rich plasma (PRP), and platelet-poor plasma (PPP) via serial centrifugation and diluted to a standardized HCT on Days 2 and 23 following isolation. Finally, WB was collected from murine models of TBI and hemorrhagic shock at sequential, postinjury timepoints. Whole blood and component groups were analyzed for RBC aggregability with calcium and tissue factor initiated electrical impedance aggregometry.

RESULTS

At both timepoints, nondiluted HCT RBCs demonstrated similar aggregability to standardized-HCT RBCs when diluted with phosphate buffered saline (PBS). Red blood cells diluted with PRP and PPP demonstrated significantly higher aggregation than RBCs diluted with PBS at both timepoints. Reconstitution with PRP and PPP demonstrated similar aggregability. Murine RBCs demonstrated increased aggregation at the 4-hour postinjury timepoint following TBI and decreased aggregation at the 1-hour postinjury following hemorrhagic shock.

CONCLUSION

Neither hemoconcentration or age of donated blood products affect the calcium and tissue-factor dependent aggregability of RBCs. Further, RBC aggregation is increased in the presence of plasma, not platelets—indicating a potential role for plasma in regulating RBC aggregation. Finally, injury patterns including TBI and hemorrhagic shock may influence hypercoagulability or coagulopathy via change in RBC aggregability.
Human gut microbiome gene co-expression network reveals a loss in taxonomic and functional diversity in Parkinson′s disease
Authors: Villette Remy , Novikova Polina V , Laczny Cedric Christian , Mollenhauer Brit , May Patrick , Wilmes Paul
Published: December 2024

Alterations of gut microbiome structure have been observed in a panoply of human diseases including neurodegeneration. However, the ecological and functional deficits of microbiome dysbiosis have yet to be understood. Here, using integrated multi-omics (metagenomics and metatranscriptomics), we resolve microbiome gene co-expression networks in individuals with Parkinson′s disease (PD) and healthy individuals. We uncover network modules with high closeness and degree centrality that represent core ecological functions, and identify key features lost in PD. More specifically, we observe a significant depletion in specific functions including secondary bile acid biosynthesis and flagellar assembly (FA) in PD. Strikingly, most hub genes, particularly those involved in bacterial microcompartments (BMCs) and FA, are predominantly found in healthy individuals. Blautia and Anaerobutyricum genera are the main contributors to these functions, showing significantly lower expression of BMC genes in PD. Additionally, we identify a strong correlation between the expression of BMC and FA genes, but also an apparent dysregulation in cross feeding between commensals in PD. Importantly, gene expression in PD was tied to reduced diversity in expressed genes, whereas in healthy individuals, higher expression levels were linked to higher diversity. Our findings reveal disruptions in key gut metabolic functions at both functional and taxonomic levels, potentially driving disease progression. Notably, we identify crucial microbiome-wide ecological features that should be restored in future gut microbiome rewilding efforts.
Haemodynamic impact of implant materials and anastomotic angle in peripheral vascular grafts
Authors: Schoenborn Sabrina , Lloyd Thomas , Sivakumaran Yogeesan , Woodruff Maria A. , Fletcher David F. , Pirola Selene , Allenby Mark C.
Published: December 2024

End-to-side anastomoses are commonly utilised in peripheral arterial bypass surgery and are plagued by high rates of re-stenosis as a result of non-physiological blood flow impacting arterial and graft structures. Computational simulations can examine how patient-specific surgical decisions in bypass graft placement and material selection affect blood flow and future risk of graft restenosis. Despite graft geometry and compliance being key predictors of restenosis, current simulations do not consider the interaction of flowing blood with compliant vessel, graft, and suture structures. Utilising fluid-structure interaction simulations, this study examines the impact of surgical technique, such as anastomosis angle, graft material, and suture material, on blood flow and fluid-structure forces in patient-specific asymptomatic arterial tree versus side-to-end peripheral grafts for symptomatic atherosclerotic disease. To render these complex simulations numerically feasible, our pipeline uses regional suture mechanics and a pre-stress pipeline previously validated in small-scale idealised models. Our simulations found that higher anastomosis angles generate larger regions of slow and recirculating blood, characterised by non-physiologically low shear stress and high oscillatory shear index. The use of compliant graft materials reduces regions of non-physiologically high shear stress only when used in combination with compliant suture materials. Altogether, our fluid-structure interaction simulation provides patient-specific platforms for vascular surgery decisions concerning graft geometry and material.

Highlights

Simulating bypass graft haemodynamics with realistic fluid-structure interactions.

Bypass grafts generate large regions of slow blood flow and blood recirculation.

Greater graft anastomosis angles correlate with larger blood recirculation regions.

Nonphysiologically stiff graft and suture materials increase vessel shear stress.
PhosF3C: A Feature Fusion Architecture with Fine-Tuned Protein Language Model and Conformer for prediction of general phosphorylation site
Authors: Liu Yuhuan , Zhong Haitian , Zhai Jixiu , Wang Xueying , Lu Tianchi
Published: December 2024

Protein phosphorylation, a key post-translational modification (PTM), provides essential insight into protein properties, making its prediction highly significant. Using the emerging capabilities of large language models (LLMs), we apply LoRA fine-tuning to ESM2, a powerful protein large language model, to efficiently extract features with minimal computational resources, optimizing task-specific text alignment. Additionally, we integrate the conformer architecture with the Feature Coupling Unit (FCU) to enhance local and global feature exchange, further improving prediction accuracy. Our model achieves state-of-the-art (SOTA) performance, obtaining AUC scores of 79.5%, 76.3%, and 71.4% at the S, T, and Y sites of the general data sets. Based on the powerful feature extraction capabilities of LLMs, we conduct a series of analyses on protein representations, including studies on their structure, sequence, and various chemical properties (such as Hydrophobicity (GRAVY), Surface Charge, and Isoelectric Point). We propose a test method called Linear Regression Tomography (LRT) which is a top-down method using representation to explore the model’s feature extraction capabilities, offering a pathway to improved interpretability.