bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term complications of extracranial pericranial flaps in skull base reconstruction
Authors: Daniels Kelly E. , Mocharnuk Joseph , Balogun Zainab , Zenonos Georgios A. , Gardner Paul A. , Snyderman Carl H. , Wang Eric W. 
Published: November 2024

Purpose of review
Nasoseptal flaps are a frequently used and well characterized means of reconstruction following endoscopic endonasal approach surgery (EEA). However, there are alternative means of reconstruction, including the extracranial pericranial flap (ePCF), that while used infrequently fulfill a specialized need in larger or salvage reconstructions. This review aims to better characterize long-term outcomes using ePCF where there is currently a paucity of objective data on use and outcomes.

Recent findings
A traditional pericranial flap involves elevating and rotating the flap through a craniotomy defect to reconstruct defects of the ventral skull base. The ePCF is implemented without performing a craniotomy, and instead tunnels the flap through a bony opening created at the level of the nasion. This review presents outcomes in a large single-center cohort of patients with ePCFs to better characterize the short- and long-term success, risks, and complications of this reconstructive method.

Summary
Long-term follow-up demonstrates that obstruction of the frontal sinus outflow may occur but rarely requires surgical intervention. ePCF are a reasonable alternative to consider in cases where local tissue would be insufficient, is not available, or has already failed. There is a low risk of flap complications.
FDG PET/CT Image of Extragastrointestinal Stromal Tumor in the Posterior Mediastinum
Authors: Xiao Liu , Li Lin , Zhang Wenjie 
Published: November 2024

Abstract
Extragastrointestinal stromal tumor (EGIST) in the posterior mediastinum is very rare. Herein, we report FDG PET/CT findings of posterior mediastinum EGIST in a 77-year-old man. On FDG PET/CT, it manifested as a solitary posterior mediastinum mass with heterogeneous necrosis and intense FDG uptake. The final pathology supported a diagnosis of EGIST. This case hints us when we encounter a soft tissue mass with intense FDG uptake in the posterior mediastinum; EGIST should be regarded as a differential diagnosis.
Rare Findings of Multiple Bone Metastases From Duodenal Gangliocytic Paraganglioma on 68Ga-DOTATATE PET/CT Imaging
Authors: Xin Tong , Chen Xiaoliang , Li Yanxia 
Published: November 2024

Abstract
We present the imaging findings of a 48-year-old woman that metastasized to multiple bones with a history of duodenal gangliocytic paraganglioma. 68Ga-DOTATATE PET/CT showed multiple osteolytic bone destruction with intense uptake. Multiple bone metastases originating from duodenal gangliocytic paraganglioma confirmed histopathological results of a biopsy on the chest-back bone.
Return to Play Guidelines in Pediatric Concussion: A Systematic Review of Current Literature
Authors: Isch Emily L. , Schillinger Kristen , Monzy Judith N. , Galantini Gianfranco , Self Dwight Mitchell , Habarth-Morales Theodore E. , Caterson Edward J. 
Published: November 2024

Introduction:
Pediatric concussions, particularly in youth sports, are a significant public health concern, with up to 18% of children experiencing one by age 17. Return-to-play (RTP) guidelines aim to protect athletes from the adverse effects of repeated injuries, but these protocols vary widely based on factors such as age, sport, and geography. This review synthesizes current literature on RTP guidelines for pediatric concussions to provide evidence-based recommendations.

Methods:
A systematic search of PubMed was conducted using Medical Subject Headings (MeSH) terms “return to play,” “pediatric concussion,” and “mild traumatic brain injury.” Studies published between January 2000 and December 2023 were included if they focused on RTP protocols for children aged 5 to 17. After screening 60 articles, 45 were selected for review. Study quality was assessed using the Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool.

Results:
RTP protocols showed significant variability influenced by age, gender, and sport type. Common themes included initial rest followed by a gradual return to activity. Female athletes generally required longer recovery periods. Multidisciplinary care and early therapeutic interventions, such as vestibular therapy, were associated with better outcomes and faster recovery.

Conclusions:
There is a need for standardized, evidence-based RTP guidelines to address inconsistencies in concussion management. Future research should focus on creating universally applicable protocols, with attention to gender, sport-specific factors, and early intervention to improve recovery outcomes for young athletes.
A high protein meal does not change autophagy in human blood
Authors: Singh S , Fourrier C , Hattersley K , Hein LK , Gore J , Heilbronn LK , Bensalem J , Sargeant TJ 
Published: November 2024

AbstractAutophagy is a catabolic quality control pathway that has been linked to neurodegenerative disease, atherosclerosis and ageing, and can be modified by nutrient availability in preclinical models. Consequently, there is immense public interest in stimulating autophagy in people. However, progress has been hampered by the lack of techniques to measure human autophagy. As a result, several key concepts in the field, including nutritional modulation of autophagy, have yet to be validated in humans. We conducted a single arm pre-post study in 42 healthy individuals, to assess whether an acute nutritional intervention could modify autophagy in humans. Two blood samples were collected per participant: after a 12 h overnight fast and 1 h post-consumption of a high protein meal. Autophagy turnover was assessed using a physiologically relevant measure of autophagic flux in peripheral blood mononuclear cells. A lysosomal inhibitor was added directly to whole blood, with the resulting build-up of autophagy marker LC3B-II designated as flux, and measured quantitatively via ELISA. Notably, consumption of a high protein meal had no impact on autophagy, with no differences between overnight fasting and postprandial autophagic flux. We observed sexual dimorphism in autophagy, with females having higher autophagic flux compared to males (p = 0.0031). Exploratory analyses revealed sex-specific correlations between autophagy, insulin and glucose signalling. Importantly, our findings show that an acute nutritional intervention (overnight fasting followed by consumption of a protein-rich meal) does not change autophagic flux in humans, highlighting the need to conduct further autophagy studies in humans.
Organ damage proteomic signature identifies patients with MASLD at-risk of systemic complications
Authors: Pirola Carlos José , Diambra Luis , Fernández Gianotti Tomas , Castaño Gustavo Osvaldo , San Martino Julio , Garaycoechea Martin , Sookoian Silvia 
Published: November 2024

AbstractBackground & objectivesMetabolic steatotic liver disease (MASLD), which affects more than 30% of the world’s population, is associated with multisystemic comorbidities. We combined multidimensional OMICs approaches to explore the feasibility of using high-throughput targeted circulating proteomics to track systemic organ damage and to infer its underlying mechanisms at the molecular level.DesingWe tested a 92-plex panel of prioritised proteins with pathophysiological relevance to organ damage in serum samples of patients with in-depth phenotyping. We included proteomics data from 60,042 people in the discovery and validation stages. The identified protein was validated across diverse study designs and cross-proteomic platforms. Deconvolution strategies were used to investigate whether the affected liver is involved in expressing biomarkers of organ damage. To assess the cell type-specific transcriptional changes of the selected target we used liver organoid data.ResultsThe implicated proteins, including ADGRG1 (GPR56), are deregulated in patients with MASLD at-risk of progressive disease and significant fibrosis. ADGRG1 liver expression profile mirrors the circulation pattern. ADGRG1 levels were associated with increased risk of end-stage liver disease and a modest but clinically significant risk of death, chronic obstructive pulmonary disease, and ischaemic heart disease over 16 years of follow-up. Mechanistic insight shows that ADGRG1 shifts its transcriptional profile from low expression to upregulation in liver cells of the fibrotic niche in response to injury.ConclusionsOur study provides a framework of potential mechanisms associated with systemic organ injury that facilitates holistic management by stratifying patients with MASLD into subclasses at-risk of extrahepatic manifestations.
Parallel transmit improves 7T MRI adult epilepsy pre-surgical evaluation
Authors: Klodowski Krzysztof , Zhang Minghao , Jen Jian P. , Scoffings Daniel J , Morris Robert , Lupson Victoria , Mauconduit Franck , Massire Aurélien , Gras Vincent , Boulant Nicolas , Rodgers Christopher T. , Cope Thomas E. 
Published: November 2024

AbstractObjectiveTo implement parallel transmit (pTx) 7T MRI in the pre-surgical evaluation of patients with drug resistant focal epilepsy, and to compare quality and diagnostic yield to conventional single transmit (specifically, circularly polarised, CP) 7T MRI.MethodsWe implemented a comparative protocol comprising both pTx and CP 7T MRI in consecutive adult candidates for epilepsy surgery who had negative or equivocal 3T MRI imaging. Here we report the outcomes from the first 31 patients.We acquired pTx and CP T1, T2, FLAIR and EDGE images, all in the same 3D 0.8mm isotropic space. 2D high-resolution T2and T2*-weighted sequences were acquired only in CP mode due to current technological limitations.Two neuroradiologists, a neurologist and a neurosurgeon made independent, blinded quality and preference ratings of pTx vs CP images. Quantitative methods were used to assess signal dropout.ResultsBlinded comparison confirmed significantly better overall quality of pTx FLAIR images (F(2,184)=13.7, p=2.88×10-6), while pTx MP2RAGE images were subjectively non-inferior and had improved temporal lobe coverage with quantitatively less signal drop-out.7T-pTx revealed previously-unseen structural lesions in 9 patients (29%), confirmed 3T-equivocal lesions in 4 patients (13%), and disproved 3T-equivocal lesions in 4 patients (13%).Lesions were better visualised on pTx than CP in 57% of cases, and never better visualised on CP.Clinical management was altered by pTx-7T in 18 cases (58%). 9 cases were offered surgical resection and 1 LITT. 3 cases were removed from the surgical pathway because of bilateral or extensive lesions. 5 cases were offered sEEG with better targeting (in 3 because the 7T lesion was deemed equivocal by the MDT, and in 2 because the lesion was extensive).SignificanceParallel transmit 7T MRI is implementable in a clinical pathway, is superior to single transmit 7T MRI, and changed management in 58% of patients scanned.Key pointsWe scanned 31 patients with parallel transmit and conventional 7T MRI, finding previously-unreported structural lesions in 9 patients (29% of cases).In 13% of cases pTx 7T MRI showed that an equivocal lesion at 3T MRI was likely significant.In 13% of cases pTx 7T MRI showed that an equivocal lesion at 3T MRI could be disregarded.Both qualitative and quantitative quality assessments indicate superiority of pTx images over CP.Future clinical implementations of 7T MRI for epilepsy should utilise parallel transmit where possible.
GraftIQ: A Hybrid Multi-Class Neural Network Integrating Clinical Insight for Multi-Outcome Prediction in Liver Transplant Recipients
Authors: Sharma Divya , Gotlieb Neta , Chahal Daljeet , Naimimohasses Sara , Ray Ankit , Han Yoojin , Gehlaut Sara , Shojaee Maryam , Sivanendran Surabie , Naghibzadeh Maryam , Azhie Amirhossein , Keshavarzi Sareh , Duan Kai , Lilly Leslie , Selzner Nazia , Tsien Cynthia , Jaeckel Elmar , Xu Wei , Bhat Mamatha 
Published: November 2024

ABSTRACTBackground and AimsLiver transplant recipients (LTRs) are at risk of developing graft injury, leading to cirrhosis and reduced survival. Liver biopsy remains the gold standard method for the diagnosis of graft pathology but is invasive and risky. Our study aimed to develop a novel hybrid multi-class neural network (NN) model ‘GraftIQ’ integrating clinician expertise for non-invasive diagnosis of graft pathology.MethodsGraft injury diagnosis was based on liver biopsies from LTRs (1992-2020). Demographic, clinical, and laboratory data from the 30 days before biopsy were used to train a multi-class NN model to classify biopsies into six categories. The dataset was split into 70% training and 30% test sets, with external validation on additional biopsies from 2020-2024. To enhance predictive capabilities, clinician expertise was integrated with neural network predictions using Bayesian fusion to combine clinician-provided probabilities with data-driven outcomes.ResultsOur dataset comprises 5,217 biopsies categorized into six graft etiology groups. In response to findings from expert versus machine implementation analysis, Bayesian fusion of clinical expertise and NN predictions enhanced predictive performance. GraftIQ (MulticlassNN + clinical insight) achieved an overall AUC of 0.902 (95% CI: 0.884, 0.919), improving from an AUC of 0.885 using the NN alone. Robustness validated through 10-fold internal cross-validation and external validation, showed AUC improvements of 10-16% compared to conventional machine learning approaches.ConclusionOur multi-class neural network model demonstrates high accuracy in predicting common causes of graft pathology. Through the integration of clinician expertise, we observed an improvement in its performance, affirming the effectiveness of GraftIQ as a valuable clinical decision support tool.Availability of codehttps://github.com/divya031090/multiclassNN
Ayahuasca-Inspired DMT/HAR Formulation Reduces Brain Differentiation Between Self and Other Faces
Authors: Suay Dila , Aicher Helena D. , Kometer Micheal , Mueller Michael J. , Caflisch Luzia , Hempe Alexandra , Steinhart Camilla P. , Elsner Claudius , Wicki Ilhui A. , Müller Jovin , Meling Daniel , Dornbierer Dario A. , Scheidegger Milan , Bottari Davide 
Published: November 2024

AbstractBackgroundPsychedelics are known to profoundly alter perception and self-referential processing, yet their specific effects on face recognition—a key aspect of social cognition—remain underexplored.ObjectiveThis study investigates the effects of an ayahuasca-inspired novel DMT/HAR (N,N-dimethyltryptamine/Harmine) formulation and Harmine alone on face recognition and self-referential processing, as measured by event-related potentials (ERPs).MethodsIn a within-subject, double-blind, placebo-controlled design, 31 healthy male participants underwent EEG recording during a visual oddball task involving Self, Familiar, and Unknown Faces. The study compared the effects of a DMT/HAR formulation, harmine alone, and placebo on key visual ERP components: P1, N170, and P300.ResultsDMT/HAR increased P1 amplitude and decreased N170 amplitude across all face categories, indicating enhanced early visual processing and disrupted face structural encoding. DMT/HAR also reduced P300 amplitude specifically for self-faces, diminishing neural differentiation between self and other faces.ConclusionThe DMT/HAR formulation significantly blurs the neural distinction between self and other faces, suggesting a potential mechanism by which psychedelics diminish attentional focus on self-referential information, thereby enhancing empathy and unity. These insights into serotonergic modulation of face recognition could inform therapeutic strategies for disorders characterized by altered self-processing.
Primary Care Providers’ Perspectives on Receiving Tier 1 Genomic Results from a National Study – the Million Veteran Program Return Of Actionable Results (MVP-ROAR) Study
Authors: Johannsen Anna L. , Danowski Morgan E. , Sitter Kailyn E. , Preys Charlene L. , Gerety Haley C. , Brunette Charles A. , Christensen Kurt D. , Gaziano J. Michael , Knowles Joshua W. , Muralidhar Sumitra , Sturm Amy C. , Sun Yan V. , Whitbourne Stacey B. , Yi Thomas ,   the VA Million Veteran Program, Vassy Jason L. 
Published: November 2024

ABSTRACTBackgroundPatients are increasingly obtaining genetic health information and integrating it into their care with the help of their primary care provider (PCP). However, PCPs may not be adequately prepared to effectively utilize genetic results . Across the VA health system, the Million Veteran Program-Return of Actionable Results-Familial Hypercholesterolemia (MVP-ROAR) study clinically confirms and returns genetic results associated with familial hypercholesterolemia (FH), identified in a national biobank program.MethodsPCPs who received their patient’s genetic results through the MVP-ROAR Study were invited to participate in semi-structured interviews, which explored PCPs’ familiarity with FH, how the results impacted medical management, and suggestions for process improvement. Interviews were transcribed and analyzed using directed content analysis and constant comparison methods to identify key themes.ResultsInterviews with nine PCPs revealed varied levels of familiarity with genetic testing and FH. Most PCPs did not distinguish FH from common high cholesterol issues and already used similar treatment approaches. Many PCPs did not recall receiving results from the MVP-ROAR Study. Alerts in medical records were deemed effective for communicating results. PCPs valued genetics in informing patient care and identifying at-risk family members but noted several implementation barriers, such as additional workload and unclear medical management benefits. Recommendations for improving results disclosure included simplifying the genetic testing report and associated support documents.ConclusionThe study represents the first investigation into PCPs’ experiences with receiving genetic test results from a biobank linked to a national healthcare system. Results suggest that PCPs generally view genetic testing as beneficial, though they may not significantly alter medical management. PCPs expressed that integrating genetics into routine care may be burdensome and require additional training, which may not be practical. The study underscores the need for accessible genetic information, which could be aided by specialized support roles or different clinical specialties assisting with incorporating genetic results into patient care.
Aridity and coexistence with vascular plants determine the dynamics of coastal dune bryophyte communities
Authors: Varela Z. , Chozas S. , Dias S. Lobo , Giráldez P. , Monteiro J. , Branquinho C. , Hortal J. 
Published: November 2024

AbstractThe bryophyte communities of Atlantic coastal dunes help stabilising these habitats by promoting nutrient fixation, contributing to soil consolidation and enhancing water retention. Because of climate change and sea level rise, negative impacts on this dune vegetation have already been recorded, including habitat loss, shifts in species distribution and the spread of invasive bryophyte species. Moreover, in this stressful environment, biotic interactions may play a key in shaping plant diversity at these scales. We characterised coastal dune vegetation in 32 sampling sites along a latitudinal aridity gradient across the western Iberian Atlantic. We aimed to assess the potential interactions among moss species and between mosses and vascular plants, and analyse their relationship with abiotic factors to explain the community dynamics of dune bryophytes, and forecast how these communities may respond to climate change. Our results showed that the moss community is mainly influenced by aridity and temperature, with biotic interactions playing a minor, yet significant, role. As aridity increases, moss cover in these dune environments will decrease, and interactions with other plants are unlikely to compensate for this decline, thus in a climate change scenario we expect a decrease in coastal bryophyte community as well as the ecosystem services they provide; simultaneously the spread of the alien moss speciesCampylopus introflexus, linked to lower aridity, may also slow down. Consequently, the changing climate will shift optimal conditions for moss species to higher latitudes, pushing competition further north
Somatic mutation and selection at epidemiological scale
Authors: Lawson Andrew R. J. , Abascal Federico , Nicola Pantelis A. , Lensing Stefanie V. , Roberts Amy L. , Kalantzis Georgios , Baez-Ortega Adrian , Brzozowska Natalia , El-Sayed Moustafa Julia S. , Vaitkute Dovile , Jakupovic Belma , Nessa Ayrun , Wadge Samuel , Paterson Anna L. , Rassl Doris M. , Alcantara Raul E. , O’Neill Laura , Widaa Sara , Austin-Guest Siobhan , Neville Matthew D. C. , Przybilla Moritz J. , Cheng Wei , Morra Maria , Sykes Lucy , Mayho Matthew , Müller-Sienerth Nicole , Williams Nick , Alexander Diana , Harvey Luke M. R. , Clarke Thomas , Byrne Alex , Blundell Jamie R. , Young Matthew D. , Mahbubani Krishnaa T. A. , Saeb-Parsy Kourosh , Martin Hilary C. , Stratton Michael R. , Campbell Peter J. , Rahbari Raheleh , Small Kerrin S. , Martincorena Iñigo 
Published: November 2024

AbstractAs we age, many tissues become colonised by microscopic clones carrying somatic driver mutations (1–10. Some of these clones represent a first step towards cancer whereas others may contribute to ageing and other diseases. However, our understanding of the clonal landscapes of human tissues, and their impact on cancer risk, ageing and disease, remains limited due to the challenge of detecting somatic mutations present in small numbers of cells. Here, we introduce a new version of nanorate sequencing (NanoSeq)11, a duplex sequencing method with error rates <5 errors per billion base pairs, which is compatible with whole-exome and targeted gene sequencing. Deep sequencing of polyclonal samples with single-molecule sensitivity enables the simultaneous detection of mutations in large numbers of clones, yielding accurate somatic mutation rates, mutational signatures and driver mutation frequencies in any tissue. Applying targeted NanoSeq to 1,042 non-invasive samples of oral epithelium and 371 samples of blood from a twin cohort, we found an unprecedentedly rich landscape of selection, with 49 genes under positive selection driving clonal expansions in the oral epithelium, over 62,000 driver mutations, and evidence of negative selection in some genes. The high number of positively selected mutations in multiple genes provides high-resolution maps of selection across coding and non-coding sites, a form of in vivo saturation mutagenesis. Multivariate regression models enable mutational epidemiology studies on how carcinogenic exposures and cancer risk factors, such as age, tobacco or alcohol, alter the acquisition and selection of somatic mutations. Accurate single-molecule sequencing has the potential to unveil the polyclonal landscape of any tissue, providing a powerful tool to study early carcinogenesis, cancer prevention and the role of somatic mutations in ageing and disease.