bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microsurgical Thoracic Duct Lymphovenous Bypass in the Adult Population
Authors: Othman Sammy , Azoury Saïd C. , Klifto Kevin , Toyoda Yoshiko , Itkin Maxim , Kovach Stephen J. 
Published: October 2021

Summary:
Thoracic duct occlusion can lead to devastating complications, resulting in recalcitrant chylothoraces, ascites, generalized lymphedema, metabolic derangement, and death. Lymphatic extravasation has traditionally been managed conservatively and, in recent years, using minimally invasive techniques, such as thoracic duct ligation and embolization. However, these measures are often limited in application and therapeutic success, resulting in chronically difficult conditions with few modalities available for definitive management. Advances in microsurgery have allowed for surgical treatment and resolution of peripherally-based lymphatic pathology, though microsurgical intervention to address central lymphatic abnormalities is scarcely described. This report is the first series detailing experiences utilizing microsurgical thoracic duct lymphovenous bypass in a refractory adult population with thoracic duct occlusion. Four patients successfully underwent the procedure, with three achieving complete resolution of symptoms. The fourth patient enjoyed partial resolution, though ubiquitous lymphatic deformities have conferred recurrent residual lower-extremity peripheral edema requiring future intervention. Postoperatively, patent anastomoses were confirmed under magnetic resonance lymphangiography. This series demonstrates the feasibility of microsurgical thoracic duct lymphovenous bypass as a promising technique in treating patients suffering from thoracic duct occlusion. This intervention is effective for recalcitrant chylothorax, chylous ascites, and generalized lymphedema, particularly when traditional and interventional radiological techniques are unsuccessful.
Thin-Flap Laser In Situ Keratomileusis-Associated Dry Eye: A Comparative Study Between Femtosecond Laser and Mechanical Microkeratome–Assisted Laser In Situ Keratomileusis
Authors: Abdel-Radi Mahmoud , Abdelmotaal Hazem , Anwar Mohamed 
Published: October 2021

Objective:
To assess and compare postlaser in situ keratomileusis (LASIK) dry eye after LASIK with planned thin flaps created by a femtosecond laser (FS) and mechanical microkeratome (MK).

Methods:
Patients were stratified according to the flap creation technique into FS and MK groups with planned 100 μm flap thickness in all eyes. Dry eye parameters including tear film break-up time (TBUT), Schirmer I test, ocular surface disease index (OSDI), and lower tear meniscus height and area (tear meniscus height [TMH] and tear meniscus area [TMA]) were assessed before surgery and at 3 and 6 months after surgery.

Results:
The study included 102 eyes of 55 patients (52 eyes underwent FS-LASIK/50 eyes underwent MK-LASIK). The preoperative characteristics including age, gender, and spherical equivalents were similar in both groups (P>0.05). The difference in postoperative flap thickness was statistically significant (P<0.05). In each group, dry eye parameters showed a statistically significant worsening (P value<0.001) at 3 months with later significant improvement at 6 months but did not return to baseline. The mean TBUT, Schirmer I, and lower TMH and TMA were statistically higher, and the mean OSDI was statistically lower in FS-LASIK than the MK-LASIK group at both 3 and 6 months (P value<0.001). The depth of ablation had a statistically significant correlation with Schirmer I at 6 months and OSDI at both 3 and 6 months post-LASIK (P<0.05).

Conclusion:
The use of femtosecond laser technology in performing thin-Flap LASIK eye surgeries has improved the outcome of post-LASIK dry eye when compared with the mechanical microkeratome.
Delayed onset neurologic deterioration following traumatic brain injury
Authors: Bova Michael , Tu Justin , Chang Albert , Weppner Justin 
Published: October 2021

Abstract

Introduction:
Patients with traumatic brain injury (TBI) are at risk of developing idiopathic intracranial hypertension (IIH). IIH is a diagnosis of exclusion but is similar to many other diagnoses. Therefore, a high index of suspicion following TBI is required for appropriate management.

Patient concerns:
A 59-year-old-female presented with moderate TBI due to motor vehicle collision. Her initial symptoms included headache and dizziness, which resolved quickly. Over the following two months she developed worsened headaches with vomiting, progressive vision impairment, worsening balance, and gait ataxia. The patient had no medical history.

Diagnosis:
Delayed-onset IIH following moderate TBI, diagnosed with a constellation of findings including brain magnetic resonance imaging showing moderate-to-severe flattening of the adenohypophysis, symmetric fluid signal along the optic nerves, ophthalmologic examination revealing early papilledema, and lumbar puncture revealed elevated opening pressures.

Intervention:
A six-month course of acetazolamide resulted in resolution of the patient's IIH.

Outcomes:
A six-month course of acetazolamide resulted in improvements in the patient's symptoms, including headaches, vision impairment, balance, and ataxia. Repeat lumbar puncture showed normal opening pressure.

Conclusion:
This case demonstrates the acute management and subsequent improvement of delayed onset IIH following moderate TBI. As IIH is a diagnosis of exclusion, physicians caring for patients with brain injuries should be aware of the presenting signs, symptoms, and diagnostic criteria of IIH.
Comparing Published Gut Microbiome Taxonomic Data Across Multinational Studies
Authors: Meeks Brianna K. , Maki Katherine A. , Ames Nancy J. , Barb Jennifer J. 
Published: October 2021

Abstract

Background
Nurse researchers are well poised to study the connection of the microbiome to health and disease. Evaluating published microbiome results can assist with study design and hypothesis generation.

Objectives
This article aims to present and define important analysis considerations in microbiome study planning and to identify genera shared across studies despite methodological differences. This methods article will highlight a workflow that the nurse scientist can use to combine and evaluate taxonomy tables for microbiome study or research proposal planning.

Methods
We compiled taxonomy tables from 13 published gut microbiome studies that had used Ion Torrent sequencing technology. We searched for studies that had amplified multiple hypervariable (V) regions of the 16S rRNA gene when sequencing the bacteria from healthy gut samples.

Results
We obtained 15 taxonomy tables from the 13 studies, comprised of samples from four continents and eight V regions. Methodology among studies was highly variable, including differences in V regions amplified, geographic location, and population demographics. Nevertheless, of the 354 total genera identified from the 15 data sets, 25 were shared in all V regions and the four continents. When relative abundance differences across the V regions were compared, Dorea and Roseburia were statistically different. Taxonomy tables from Asian subjects had increased average abundances of Prevotella and lowered abundances of Bacteroides compared with the European, North American, and South American study subjects.

Discussion
Evaluating taxonomy tables from previously published literature is essential for study planning. The genera found from different V regions and continents highlight geography and V region as important variables to consider in microbiome study design. The 25 shared genera across the various studies may represent genera commonly found in healthy gut microbiomes. Understanding the factors that may affect the results from a variety of microbiome studies will allow nurse scientists to plan research proposals in an informed manner. This work presents a valuable framework for future cross-study comparisons conducted across the globe.
Adapting Research to a Global Pandemic
Authors: Vigoureux Taylor F. D. , Mu Christina X. , Mason Tina M. , Gonzalez Brian D. , Lee Soomi 
Published: October 2021

Background
Mandated social distancing practices and quarantines in response to COVID-19 have resulted in challenges for research on healthcare workers, such as hospital nurses. It remains unknown whether nursing studies utilizing complex methodology like sleep actigraphy and ecological momentary assessment (EMA) can be conducted remotely without compromising data quality.

Objectives
We aimed to (a) disseminate our remote study protocol for sleep actigraphy and EMA data from hospital nurses during COVID-19, (b) assess feasibility and acceptability of this approach for studies on hospital nurses, and (c) examine the reliability and ecological validity of sleep characteristics measured across 14 days.

Methods
Using an online platform, we provided 86 outpatient nurses from a cancer hospital with detailed video/text instructions regarding the study and facilitated virtual study onboarding meetings. Feasibility was assessed by comparing adherence rates to a similar in-person study of nurses from the same hospital; acceptability was evaluated through content analysis of qualitative study feedback. Multilevel modeling was conducted to assess changes in sleep characteristics as a function of study day and daily stressful experiences.

Results
Adherence to EMA (91.8%) and actigraphy (97.9%) was high. EMA adherence was higher than the in-person study of inpatient day-shift nurses from the same hospital. Content analyses revealed primarily positive feedback, with 51.2% reporting “easy, clear, simple onboarding” and 16.3% reporting the website was “helpful.” Six participants provided only negative feedback. Sleep characteristics did not change as a function of study day except for self-reported quality, which increased slightly during Week 1 and regressed toward baseline after that. A higher incidence of stressor days or higher stressor severity followed nights with shorter-than-usual time in bed or poorer-than-usual sleep quality, supporting the ecological validity for these methods of assessing sleep in nurses.

Discussion
Findings suggest that a fully remote study protocol for EMA and actigraphy studies in nursing yields robust feasibility, acceptability, reliability, and validity. Given the busy schedules of nurses, the convenience of this approach may be preferable to traditional in-person data collection. Lessons learned from COVID-19 may apply to improving nursing research postpandemic.
Conducting Neonatal Intensive Care Unit Research During a Pandemic
Authors: Nist Marliese Dion , Casavant Sharon G. , Dail Robin B. , Everhart Kayla C. , Sealschott Stephanie , Cong Xiaomei S. 
Published: October 2021

Background
The coronavirus pandemic disrupted normal clinical operations and research. Nurse scientists conducting research studies in the neonatal intensive care unit experienced significant challenges to continuing their research studies amid national lockdowns and hospital visitation restrictions.

Objectives
The purpose of this article is to describe the challenges encountered by nurse scientists conducting research studies in the neonatal intensive care unit during the pandemic, the creative solutions devised to overcome these barriers, and the lessons learned during this unprecedented time.

Methods
Using our pandemic area studies as exemplars, we highlight the barriers encountered in continuing our research in the intense environment of the neonatal intensive care unit.

Results
Visitor restrictions limited the presence of parents and researchers in the neonatal intensive care unit during the pandemic, causing disruptions to participant recruitment and data collection. Laboratory closures further limited research activities during the pandemic. Strategies to overcome these barriers include building formal collaborations among researchers and clinicians, creating the infrastructure to support virtual recruitment and electronic consent, and developing contingency plans for studies involving the analysis of biological samples.

Discussion
The neonatal intensive care unit is a unique environment because of vulnerable patient population and need for researchers to interact with parents to recruit study participants. Implementing the strategies developed during the coronavirus pandemic may allow for the continuation of research activities during future public health crises.
Improving reproducibility of proton MRS brain thermometry: theoretical and empirical approaches
Authors: Dong Zhengchao , Kantrowitz Joshua T. , Mann J. John 
Published: October 2021

AbstractPurposeIn 1H MRS-based thermometry of brain, averaging temperatures measured from more than one reference peak offers several advantages including improving the reproducibility, i.e., precision, of the measurement. This paper proposes theoretically and empirically optimal weighting factors to improve the weighted average of temperatures measured from three references.MethodsWe first proposed concepts of equivalent noise and equivalent signal-to-noise ratio in terms of frequency measurement and a concept of relative frequency that allows the combination of different peaks in a spectrum for improving the precision of frequency measurement. Based on these, we then derived a theoretically optimal weighting factor and proposed an empirical weighting factor, both involving equivalent noise levels, for a weighted average of temperatures measured from three references, i.e., the singlets of NAA, Cr, and Ch, in 1H MR spectrum. We assessed these two weighting factors by comparing their errors in measurement of temperatures with the errors of temperatures measured from individual references; we also compared these two new weighting factors with two previously proposed weighting factors. These errors were defined as the standard deviations (SDs) in repeated measurements or in Monte Carlo studies.ResultsBoth the proposed theoretical and empirical weighting factors outperformed the two previously proposed weighting factors as well as the three individual references in all phantom and in vivo experiments. In phantom experiments with 4 Hz or 10 Hz line broadening, the theoretical weighting factor outperformed the empirical one, but the latter was superior in all other repeated and Monte Carlo tests performed on phantom and in vivo data.ConclusionThe proposed weighting factors are superior to the two previously proposed weighting factors and can improve the reproducibility of temperature measurement using the 1H MRS-based thermometry.
Clinical indicants and electrophysiological patterns of sciatic nerve in patients after total hip replacement
Authors: Ostrovskij V.V. , Tolkachev V.S. , Bazhanov S.P. , Korshunova G.A. , Chekhonatsky A.A. 
Published: October 2021

AbstractBackgroundThe incidence of sciatic nerve (SN) damage after a total hip replacement (THR) is 10 percent. The underdiagnosis of paucisymptomatic sciatic neuropathy may lead to the unsatisfactory outcome of the treatment in these patients featured by frequent chronic pain syndrome. This research was aimed at the evaluation of the dynamics of clinical and electrophysiological patterns in SN after THR.Material and methodsThe research involved 16 individuals 45 to 68 years old with primary idiopathic coxarthrosis who underwent THR in the Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, Federal State Budgetary Educational Institution of Higher Education ‘V.I. Razumovsky Saratov State Medical University’, the Russian Federation Ministry of Healthcare. We compared the findings of clinical and neurologic examinations (VAS, muscle strength, and sensitivity evaluation) as well as ENMG before surgeries and 14 days after them.ResultsIn the evaluation of the clinical score in 9 patients, we observed some negative changes featured by paresthesia around the area of the SN innervation. The analysis of changes in ENMG findings revealed the decrease in M-response amplitudes of both peroneal and tibial nerves by more than 10 percent of the age-appropriate normal value; this was more prominent in patients who had undergone the lengthening of extremities in more than 3 cm.ConclusionTHR is associated with a higher risk of traction and entrapment changes in SN that lead to the progress of their neuropathies in the post-operative period.ReviewersAssoc. Prof. Ulyanov V.Yu., MD, DSc;Assoc. Prof. Gulyaev D.A., MD, DSc
Nutritional deficiency recapitulates intestinal injury associated with environmental enteric dysfunction in patient-derived Organ Chips
Authors: Bein Amir , Fadel Cicely W. , Swenor Ben , Cao Wuji , Powers Rani K. , Camacho Diogo M. , Naziripour Arash , Parsons Andrew , LoGrande Nina , Sharma Sanjay , Kim Seongmin , Jalili-Firoozinezhad Sasan , Grant Jennifer , Breault David T. , Iqbal Junaid , Ali Asad , Denson Lee A , Moore Sean R. , Prantil-Baun Rachelle , Goyal Girija , Ingber Donald E. 
Published: October 2021

ABSTRACTEnvironmental Enteric Dysfunction (EED) is a chronic inflammatory condition of the intestine characterized by villus blunting, compromised intestinal barrier function, and reduced nutrient absorption. Here, we show that key genotypic and phenotypic features of EED-associated intestinal injury can be reconstituted in a human intestine-on-a-chip (Intestine Chip) microfluidic culture device lined by organoid-derived intestinal epithelial cells from EED patients and cultured in niacinamide- and tryptophan-deficient (-N/-T) medium. Exposure of EED Intestine Chips to -N/-T deficiencies resulted in transcriptional changes similar to those seen in clinical EED patient samples including congruent changes in six of the top ten upregulated genes. Exposure of EED Intestine Chips or chips lined by healthy intestinal epithelium (healthy Intestine Chips) to -N/-T medium resulted in severe villus blunting and barrier dysfunction, as well as impairment of fatty acid uptake and amino acid transport. EED Intestine Chips exhibited reduced secretion of cytokines at baseline, but their production was significantly upregulated compared to healthy Intestine Chips when exposed to -N/-T deficiencies. The human Intestine Chip model of EED-associated intestinal injury may be useful for analyzing the molecular, genetic, and nutritional basis of this disease and can serve as a preclinical model for testing potential EED therapeutics.
Colorectal cancer is associated with the presence of cancer driver mutations in normal colon
Authors: Matas Julia , Kohrn Brendan , Fredrickson Jeanne , Carter Kelly , Yu Ming , Wang Ting , Gui Xianyong , Soussi Thierry , Moreno Victor , Grady William M. , Peinado Miguel A. , Risques Rosa Ana 
Published: October 2021

ABSTRACTWhile somatic mutations in colorectal cancer (CRC) are well characterized, little is known about the accumulation of cancer mutations in the normal colon prior to cancer. Here we have developed and applied an ultra-sensitive, single-molecule mutational test based on CRISPR-DS technology, which enables mutation detection at extremely low frequency (<0.001) in normal colon from patients with and without CRC. We found oncogenic KRAS mutations in the normal colon of about one third of patients with CRC but in none of the patients without CRC. Patients with CRC also carried more TP53 mutations than patients without cancer, and these mutations were more pathogenic and formed larger clones, especially in patients with early onset CRC. Most mutations in normal colon were different from the driver mutations in tumors suggesting that the occurrence of independent clones with pathogenic KRAS and TP53 mutations is a common event in the colon of individuals that develop CRC.SIGNIFICANCEOur results suggest a prevalent process of somatic mutation and evolution in the normal colon of patients with CRC, which can be detected by ultra-sensitive sequencing of driver genes and potentially employed clinically for CRC risk prediction.
Impact Of Adaptive Natural Killer Cells, KLRC2 Genotype and Cytomegalovirus Reactivation On Late Mortality In Patients With Severe Covid-19 Lung Disease
Authors: Jaiswal Sarita Rani , Arunachalam Jaganath , Bhardwaj Ashutosh , Saifullah Ashraf , Lakhchaura Rohit , Soni Mayank , Bhagawati Gitali , Chakrabarti Suparno 
Published: October 2021

AbstractObjectiveCOVID-19 infection results in severe lung disease in a small but significant number of infected patients. The etiopathogenesis in a subset of such patients, who continue to have progressive pulmonary disease following virus clearance remains unexplored.MethodsWe investigated the role of NKG2C+/NKG2A-adaptive natural killer (ANK) cells, KLRC2 genotype and cytomegalovirus reactivation in 22 such patients.ResultsThe median duration of virus positivity was 23 days and the median duration of hospitalisation was 48 days. The overall survival at 60 days in this group was 50%. Older age and comorbidities impacted survival negatively. CMV viremia was documented in 11 patients, with a survival of 25% vs 80% in those without viremia with viral load correlating with mortality. ANK cells were markedly depressed in all patients at day 15. However, persistently low ANK cells at 30 days along with an inversely high NKG2C-/NKG2A+inhibitory NK cells significantly correlated with high CMV viremia as well as mortality, irrespective of KLRC2 genotype. Day 30 ANK cells were significantly lower in KLRC2 deletion group. IFN-gamma and Perforin release were severely compromised in all patients at day +15, with significant improvement in the survivors at day +30, but not in those with adverse outcome.ConclusionPatients with severe lung disease even after negative SARS-CoV-2 status, with persistently reduced and functionally compromised ANK cells, are more likely to have CMV reactivation and an adverse outcome, independent of KLRC2 genotype.