bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal Surgical Approach for the Dumbbell-Shaped Trigeminal Schwannoma
Authors: Liu Yong , Meng Qiang , Li Huanfa , Wu Hao , Dong Shan , Zhang Hua 
Published: May 2021

Abstract
Dumbbell-shaped trigeminal schwannoma afflicts the middle and posterior cranial fossa. Surgical approach for gross total resection remains highly challenging. The authors present a case of dumbbell-shaped trigeminal schwannoma treated successfully by using frontotemporal intradural approach with the removal of temporal pole. Subtotal resection was achieved as the schwannoma was closely adhered to trigeminal nerve. As a postoperative complication, abducens paralysis recovered significantly within the 3-month follow-up. No severe complication was observed. The authors suggest that frontotemporal intradural approach is optimal surgical approach as it is particularly convenient and safe.
Facilitating Success of the Early Stage Surgeon Scientist Trainee
Authors: Barker Jenny C. , Jalilvand Anahita , Onuma Amblessed , Shelby Rita , Shah Kejal , Daulton Robert , Bumgardner Ginny L. 
Published: May 2021

Objective:
Surgeon scientists bring to bear highly specialized talent and innovative and impactful solutions for complicated clinical problems. Our objective is to inform and provide framework for early stage surgeon scientist training and support.

Summary of Background Data:
Undergraduate, medical student, and residency experiences impact the career trajectory of surgeon scientists. To combat the attrition of the surgeon scientist pipeline, interventions are needed to engage trainees and to increase the likelihood of success of future surgeon scientists.

Methods:
A surgery resident writing group at an academic medical center, with guidance from faculty, prepared this guidance document for early stage surgeon scientist trainees with integration of the published literature to provide context. The publicly available National Institutes of Health RePORTER tool was queried to provide data salient to early stage surgeon scientist training.

Results:
The educational path of surgeons and the potential research career entry points are outlined. Challenges and critical supportive elements needed to inspire and sustain progress along the surgeon scientist training path are detailed. Funding mechanisms available to support formal scientific training of early stage surgeon scientists are identified and obstacles specific to surgical careers are discussed.

Conclusions:
This guidance enhances awareness of essential education, communication, infrastructure, resources, and advocacy by surgery leaders and other stakeholders to promote quality research training in residency and to re-invigorate the surgeon scientist pipeline.
Prospective Study of Pain Outcomes Associated With Breast Surgery in Women With Nonhereditary Breast Cancer
Authors: Smith-Graziani Demetria J. , Parker Patricia A. , Peterson Susan K. , Bedrosian Isabelle , Shen Y , Black Dalliah M. , DeSnyder Sarah M. , Hunt Kelly K. , Dong Wenli , Brewster Abenaa M. 
Published: May 2021

Objective:
To assess pain severity and interference with life in women after different types of breast cancer surgery and the demographic, treatment-related, and psychosocial variables associated with these pain outcomes.

Summary of Background Data:
Data are conflicting regarding pain outcomes and quality of life (QOL) among women who undergo different types of breast surgery.

Methods:
Women with nonhereditary breast cancer completed the brief pain inventory before surgery and at 1, 6, 12, and 18 months postsurgery. We assessed associations between pain outcomes and CPM status and mastectomy status using multivariable repeated measures models. We assessed associations between pain outcome and QOL and decision satisfaction.

Results:
Of 288 women (mean age 56 years, 58% non-Hispanic White), 50 had CPM, 75 had unilateral mastectomy, and 163 had BCS. Mean pain severity scores were higher at one (2.78 vs 1.9, P = 0.016) and 6 months (2.79 vs 1.96, P = 0.031) postsurgery in women who had CPM versus those who did not, but there was no difference at 12 and 18 months. Comparing mastectomy versus BCS, pain severity was higher at 1 and 12 months. There was a significant interaction between pain severity and time point for CPM (P = 0.006), but not mastectomy status (P = 0.069). Regardless of surgery type, Black women had higher pain severity (P = 0.004) than White women. Higher pain interference was associated with lower QOL (P < 0.001) and lower decision satisfaction (P = 0.034).

Conclusions:
Providers should counsel women considering mastectomy about the potential for greater acute pain and its impact on overall well-being. Racial/ethnic disparities in pain exist and influence pain management in breast surgical patients.
Challenging the Contraindications of Minimally Invasive Inguinal Lymph Node Dissection: Report of 2 Cases
Authors: Abdel Mageed Hisham Hassan , Saad Ihab , Lasithiotakis Konstantinos 
Published: May 2021

Background:
Endoscopic inguinal dissection is an emerging procedure utilizing minimally invasive technology to perform inguinal dissections aiming to avoid skin complications. Despite numerous reports there seems to be no consensus on inclusion and exclusion criteria, raising the question of when and when not to choose the minimally invasive technique. We compare the inclusion and exclusion criteria in published literature, and present our experience with 2 challenging cases; 1 with skin infiltration and the other with a previous lymphadenectomy scar.

Materials and Methods:
We present 2 cases where this procedure was performed, despite limited nodal skin infiltration in the first case, and presence of a fresh scar of a previous biopsy and recent history of chemotherapy treatment in the second case.

Results:
Despite skin infiltration by inguinal nodes, endoscopic inguinal dissection was performed and the attached skin was excised and delivered with the lymph nodes through the incision in the first case. Presence of a fresh scar and history of chemotherapy did not affect the outcomes in the second case, albeit fibrosis and adhesions.

Conclusions:
Skin infiltration, previous lymphadenectomy, and previous groin therapy might not represent absolute contraindications in selected cases and in the hands of experienced surgeons.
Deaths from cardiovascular disease involving anticoagulants: a systematic synthesis of coroners’ case reports
Authors: Anis Ali , Heneghan Carl , Aronson Jeffrey K. , DeVito Nicholas J. , Richards Georgia C. 
Published: May 2021

AbstractBackgroundThe global burden of cardiovascular disease (CVD) is forecast to increase, and anticoagulants will remain important medicines for its management. Coroners’ Prevention of Future Death reports (PFDs) provide valuable insights that may enable safer and more effective use of these agents.AimTo identify CVD-related PFDs involving anticoagulants.Design and SettingRetrospective observational study of coronial case reports in England and Wales between 2013 and 2019.MethodWe screened 3037 PFDs for eligibility and included PFDs where CVD and an anticoagulant caused or contributed to the death. We descriptively analysed included cases and used content analysis to assess concerns raised by coroners and who responded to them.ResultsWe identified 113 cardiovascular disease-related PFDs involving anticoagulants. Warfarin (36%), enoxaparin (11%), and rivaroxaban (11%) were the most common anticoagulants reported. Concerns most frequently raised by coroners included poor systems (31%), poor communication (25%), and failures to keep accurate medical records (25%). These concerns were most often directed to NHS trusts (29%), hospitals (10%), and general practices (8%). Nearly two-thirds (60%) of PFDs had not received responses from such organisations, which are mandatory under regulation 28 of the Coroners’ (Investigations) Regulations 2013. We created a publicly available tool,https://preventabledeathstracker.net/, which displays coroners’ reports in England and Wales to streamline access and identify important lessons to prevent future deaths.ConclusionNational organisations, healthcare professionals, and prescribers should take actions to address the concerns of coroners’ in PFDs to improve the safe use of anticoagulants in patients with cardiovascular disease.How this fits inA previous assessment of 500 PFDs identified anticoagulants as the class of drugs most often involved in fatal medication errors. This study uses innovative methods to automatically collect all available PFDs between 2013 and 2019 to identify deaths from cardiovascular disease when the use of or lack of anticoagulants caused or contributed to the death. Coroners’ raised hundreds of coroners in their reports, including issues with communication, following protocols, education and training, access to resources, and safety. Despite repeat concerns with national relevance being identified, most CVD-anticoagulant PFDs were sent locally to NHS Trusts, hospitals, and general practices, limiting their ability to reduce harms and prevent premature deaths.
COVID-19 Vaccine Acceptance Among Healthcare Workers in a United States Medical Center
Authors: Moniz Michelle H. , Townsel Courtney , Wagner Abram L. , Zikmund-Fisher Brian J. , Hawley Sarah , Jiang Charley , Stout Molly J. 
Published: May 2021

ABSTRACTBackgroundThe Centers for Disease Control and Prevention prioritized healthcare personnel for the first phase of COVID-19 vaccination in the United States to keep critical healthcare infrastructure open and functioning, but vaccine hesitancy may limit vaccine uptake.ObjectiveTo evaluate vaccine intentions among healthcare workers eligible for COVID-19 vaccination and explore differences by sociodemographic and occupational characteristics.DesignFrom February 1-15, 2021, we conducted a cross-sectional, opt-in online survey at a Midwest U.S. academic healthcare center that began vaccinating employees in December 2020.ParticipantsThe entire employee workforce of the study site was eligible.Main MeasuresCOVID-19 vaccination intention, categorized as Received/Scheduled/ASAP, Not Now, and Not Ever. Logistic regression models to assess the relationship between demographic and occupational characteristics and intention to receive COVID-19 vaccination.Key ResultsMost participants (n=11,387, of 39,259 individual and group email accounts invited) had received or were scheduled to receive the COVID-19 vaccine (n=9081, 79.8%) or planned to receive it as soon as possible (n=546, 4.8%), while fewer were hesitant (Not Now, n=954, 8.4%; Not Ever, n=369, 3.2%). In multivariable logistic regression models predicting vaccine intention, physicians (aOR 22.2, 9.1-54.3), trainees (aOR 5.9, 3.0-11.4), and nurse practitioners/nurse midwives/physician assistants (aOR 1.9, 1.2-3.0) were significantly more likely to demonstrate vaccine acceptance, compared to nurses, whereas other clinical staff were significantly less likely (aOR 0.8, 0.6-0.9). Prior infection with COVID-19, gender, race/ethnicity, and age were all significantly associated with vaccine intention. Overall, 29.6% reported at least one concern about COVID-19 vaccination.ConclusionsIn a large, diverse sample of healthcare workers, over 11% delayed COVID-19 vaccination when it was available to them, with notable variation in vaccine hesitancy across professional roles and demographic groups. Our findings suggest immediate opportunities to empathetically engage those with COVID-19 vaccine concerns and optimize vaccine coverage across our healthcare system.
Hypercoagulation detected by Rotational Thromboelastometry predicts mortality in COVID-19: A risk model based on a prospective observational study
Authors: Almskog Lou M. , Wikman Agneta , Svensson Jonas , Bottai Matteo , Kotormán Mariann , Wahlgren Carl-Magnus , Wanecek Michael , van der Linden Jan , Ågren Anna 
Published: May 2021

ABSTRACTBackgroundSevere disease due to COVID-19 has been shown to be associated with hypercoagulation. Early identification of prothrombotic patients may help guiding anticoagulant treatment and improve survival. The aim of this study was to assess Rotational Thromboelastmetry (ROTEM®) as a marker of coagulopathy in hospitalized COVID-19 patients.MethodsThis was a prospective, observational study. Patients hospitalized due to a COVID-19 infection were eligible for inclusion. Conventional coagulation tests and ROTEM were taken after hospital admission, and patients were followed for 30 days. Patient characteristics and outcome variables were collected, and a prediction model including variables age, respiratory frequency and ROTEM EXTEM-MCF, was developed using logistic regression to evaluate the probability of death.ResultsOut of the 141 patients included, 18 (13%) died within 30 days. D-dimer (p=0.01) and Activated Partial Thromboplastin Time (APTT) (p=0.002) were increased, and ROTEM EXTEM-/INTEM-CT (p<0.001) were prolonged in non-survivors. In the final prediction model, the risk of death within 30 days for a patient hospitalized due to COVID-19 was increased with increased age, respiratory frequency and EXTEM-MCF. Longitudinal ROTEM data in the severely ill subpopulation showed enhanced hypercoagulation. In our in vitro analysis, no heparin effect on EXTEM-CT was observed, supporting a SARS-CoV-2 effect on initiation of coagulation.ConclusionsHere we show that hypercoagulation measured with ROTEM predicts 30-day mortality in COVID-19. Longitudinal ROTEM data strengthen the hypothesis of hypercoagulation as a driver of severe disease in COVID-19. Thus, ROTEM may be a useful tool to assess disease severity in COVID-19, and could potentially guide anticoagulation therapy.
Metabologenomic approach reveals intestinal environmental features associated with barley-induced glucose tolerance improvements in Japanese cohort: a randomized controlled trial
Authors: Goto Yuka , Nishimoto Yuichiro , Murakami Shinnosuke , Nomaguchi Tatsuhiro , Mori Yuka , Ito Masaki , Nakaguro Ryohei , Kudo Toru , Matsuoka Tsubasa , Yamada Takuji , Kobayashi Toshiki , Fukuda Shinji 
Published: May 2021

AbstractConsumption of barley has been known to exert beneficial effects on metabolic disorders; however, it has also been reported that there are inter-individual differences in these responses. Recent evidence has suggested that these individual differences are mediated by the gut microbiota. Therefore, in the present study, we aimed to understand the relationship between the intestinal environment, including gut microbiota, and metabolic disorders. A randomized controlled trial in Japanese subjects with 4-week consumption of barley or control food was conducted. In this study, we analyzed the intestinal environment, including microbiota and their metabolites, and blood parameters were assessed collectively. We found that microbial genera Blautia and Agathobacter belonging to Lachnospiraceae, and fecal metabolites such as azelate were increased 1.31-fold, 1.84-fold, and 1.48-fold after barley consumption, respectively. Furthermore, the subjects whose glucose tolerance were slightly impaired showed improvement in their glucose tolerance index following the barley consumption. Additionally, the analysis showed that the increase in the abundance of the Anaerostipes was correlated with the improvement in the glucose tolerance index. Our findings indicate that the effects of barley consumption for glucose tolerance are partly defined by the intestinal environment of consumers, providing a quantitative measurement of the dietary effect based on the intestinal environment.
Preterm birth is associated with immune dysregulation which persists in infants exposed to histologic chorioamnionitis: a descriptive study
Authors: Sullivan Gemma , Galdi Paola , Borbye-Lorenzen Nis , Stoye David Q. , Lamb Gillian J. , Evans Margaret J. , Skogstrand Kristin , Chandran Siddharthan , Boardman James P. 
Published: May 2021

AbstractObjectiveTo characterise the umbilical cord blood immune profile in preterm infants compared to term-born controls and the postnatal immune response following exposure to histologic chorioamnionitis (HCA) in preterm infants.DesignDescriptive, observational cohort study.SettingEdinburgh, UK.Population118 preterm infants (mean gestational age 29+0 weeks, range 23+2 to 32+0) and 59 term-born controls.MethodsPlacental histopathology was used to identify reaction patterns indicative of HCA, and a customised immunoassay of 24 inflammatory markers and trophic proteins selected to reflect the perinatal immune response was performed on umbilical cord blood in term and preterm participants and postnatal day 5 blood in the preterm group.ResultsThe umbilical cord blood immune profile classified gestational age category with 86% accuracy (95% CI 0.78-0.92), p-value=1.242×10−14. Pro-inflammatory proteins IL-6, MCP-1 and CRP were elevated in the cord blood of preterm infants whilst BDNF, C3, C9, IL-18, MMP-9 and RANTES were decreased, compared to infants born at term. In preterm infants, exposure to HCA was associated with elevations in 5 immune proteins on postnatal day 5 (BDNF, C3, IL-8, MIP-1β and MMP-9) when compared to preterm infants who were not exposed.ConclusionPreterm birth is associated with a distinct immune profile in umbilical cord blood and infants exposed to HCA experience specific alterations in immune function that persist to day 5 of postnatal life.
Transcriptional Pathology Evolves Over Time in Rat Hippocampus Following Lateral Fluid Percussion Traumatic Brain Injury
Authors: Catta-Preta Rinaldo , Zdillar Iva , Jenner Bradley , Doisy Emily T. , Tercovich Kayleen , Nord Alex S. , Gurkoff Gene G. 
Published: May 2021

ABSTRACTTraumatic brain injury (TBI) causes acute and lasting impacts on the brain, driving pathology along anatomical, cellular, and behavioral dimensions. Rodent models offer the opportunity to study TBI in a controlled setting, and enable analysis of the temporal progression that occurs from injury to recovery. We applied transcriptomic and epigenomic analysis, characterize gene expression and in ipsilateral hippocampus at 1 and 14 days following moderate lateral fluid percussion (LFP) injury. This approach enabled us to identify differential gene expression (DEG) modules with distinct expression trajectories across the two time points. The major DEG modules represented genes that were up- or downregulated acutely, but largely recovered by 14 days. As expected, DEG modules with acute upregulation were associated with cell death and astrocytosis. Interestingly, acutely downregulated DEGs related to neurotransmission mostly recovered by two weeks. Upregulated DEG modules related to inflammation were not necessarily elevated acutely, but were strongly upregulated after two weeks. We identified a smaller DEG module with delayed downregulation at 14 days including genes related to cholesterol metabolism and amyloid beta clearance. Finally, differential expression was paralleled by changes in H3K4me3 at the promoters of differentially expressed genes at one day following TBI. Following TBI, changes in cell viability, function and ultimately behavior are dynamic processes. Our results show how transcriptomics in the preclinical setting has the potential to identify biomarkers for injury severity and/or recovery, to identify potential therapeutic targets, and, in the future, to evaluate efficacy of an intervention beyond measures of cell death or spatial learning.
An automated approach to improve the speed and accuracy of pericyte and microglia quantification in whole mouse brain sections
Authors: Courtney Jo-Maree , Morris Gary P , Cleary Elise M , Howells David W , Sutherland Brad A 
Published: May 2021

AbstractWhole slide scanning technology has enabled the generation of high-resolution images of complete tissue sections. However, commonly used analysis software is often unable to handle the large data files produced. Here we present a method using the open-source software QuPath to detect, classify and quantify fluorescently-labelled cells (microglia and pericytes) in whole coronal brain tissue sections. Whole brain sections from both male and female NG2DsRed x CX3CR1+/GFP mice were analysed. Small regions of interest were selected and manual counts were compared to counts generated from an automated approach, across a range of detection parameters. The optimal parameters for detecting cells and classifying them as microglia or pericytes in each brain region were determined and applied to annotations corresponding to the entire cortex, hippocampus, thalamus and hypothalamus in each section. 3.71% of all detected cells were classified as pericytes, however this proportion was significantly higher in the thalamus (6.39%) than in other regions. In contrast, microglia (4.45% of total cells) were more abundant in the cortex (5.54%). No differences were detected between male and female mice. In conclusion, QuPath offers a user-friendly, rapid and accurate solution to whole-slide image analysis which could lead to important new discoveries in both health and disease.Significance StatementRapid and accurate quantification of cell numbers and distributions from whole tissue sections represents a difficult challenge in biomedical research. Slide scanning microscopes generate high-resolution images of complete tissue sections but most common image analysis software packages struggle to cope with the large data files they produce. We provide a method for rapidly and accurately quantifying pericyte and microglia cell numbers in whole brain tissue sections using QuPath, a new open-source software designed specifically to overcome this challenging roadblock.
Allosteric Cross-Talk Among SARS-CoV-2 Spike’s Receptor-Binding Domain Mutations Triggers an Effective Hijacking of Human Cell Receptor
Authors: Spinello Angelo , Saltalamacchia Andrea , Borišek Jure , Magistrato Alessandra 
Published: May 2021

ABSTRACTThe rapid and relentless emergence of novel highly transmissible SARS-CoV-2 variants, possibly decreasing vaccine efficacy, currently represents a formidable medical and societal challenge. These variants frequently hold mutations on the Spike protein’s Receptor-Binding Domain (RBD), which, binding to the Angiotensin-Converting Enzyme 2 (ACE2) receptor, mediates viral entry into the host cells.Here, all-atom Molecular Dynamics simulations and Dynamical Network Theory of the wild-type and mutant RBD/ACE2 adducts disclose that while the N501Y mutation (UK variant) enhances the Spike’s binding affinity towards ACE2, the N501Y, E484K and K417N mutations (South African variant) aptly adapt to increase SARS-CoV-2 propagation via a two-pronged strategy: (i) effectively grasping ACE2 through an allosteric signaling between pivotal RBD structural elements; and (ii) impairing the binding of antibodies elicited by infected/vaccinated patients. This information, unlocking the molecular terms and evolutionary strategies underlying the increased virulence of emerging SARS-CoV-2 variants, set the basis for developing the next-generation anti-COVID-19 therapeutics.TOC GRAPHICS