bluuebunny/crossref_metadata_2025_split huggingface dataset:
Within-host genetic diversity of SARS-CoV-2 across animal species
Authors: Naderi Sana , Sagan Selena M , Shapiro B. Jesse 
Published: December 2024

Abstract
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

AbstractA 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

AbstractSalmonella 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.
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

Abstract
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

Abstract

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

Abstract
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

Abstract
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

Abstract
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

Abstract

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.