bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognosis and ablation success in thyroid cancer: overcoming the challenges of incomplete clinical profiles
Authors: Ora Manish , Nazar Aftab Hasan , Mishra Prabhakar , Barai Sukanta , Arya Amitabh , Pradhan Prasanta Kumar , Gambhir Sanjay 
Published: November 2024

Background
Differentiated thyroid carcinoma (DTC) is managed by surgery followed by radioiodine (RAI) therapy in most intermediate and high-risk patients. Most nonmetastatic patients have excellent treatment responses and have long-term disease-free status. A lack of comprehensive medical services in resource-limited nation leads to attrition of critical clinical prognostication information. This study aimed to identify readily available clinical, biochemical, and histopathological parameters to predict remnant ablation success and long-term outcomes.

Methods
The study included DTC patients who underwent RAI after surgery. Ablation success was determined by thyroglobulin (Tg) and whole-body radioiodine scan. Patients were followed for at least 5 years to assess biochemical incomplete response (BIR) and structural recurrence.

Results
The study included 383 patients (a mean age of 37.8 ± 12.9 years). Successful ablation was noted in 251 (65.5%). High preablative stimulated serum Tg (presTg), papillary variants, and central and lateral compartment lymph nodal metastases were associated with ablation failure. PresTg (P < 0.001) was the most significant predictor. After a 102.9 ± 34.5 months follow-up, 280 (73.1%) patients were disease-free. BIR and structural recurrence were noted in 103 and 32 patients. PresTg (8.1 ± 27.7 vs. 92.3 ± 99.9 ng/ml), ATg (112.9 ± 389.8 vs. 43.2 ± 89.8 IU/ml), papillary variant, central [109 (66.1%) vs. 56 (33.9%)], and lateral compartment [65 (63.7%) vs. 37 (36.3%) lymph nodal metastases were associated (P < 0.05) with BIR. PresTg >10.5 has a sensitivity and specificity of 86.6 and 86.0% for predicting BIR. Patients with successful remnant ablation and a presTg level <10.5 ng/ml had a low risk of long-term disease recurrence (less than 5%).

Conclusion
This ambispective study found that successful ablation and long-term disease-free survival were achievable in a significant proportion of DTC patients. BIR (26.9%) and structural recurrence (8.4%) were not uncommon. PresTg levels emerged as a crucial predictor of ablation success and subsequent outcomes. In resource-limited regions, presTg levels and ablation failure can aid in optimizing treatment strategies and improving patient care.
Exploring the potential role of financial interventions to improve the health of families impacted by incarceration
Authors: Tolliver Destiny G. , Howell Benjamin , Blanton Sarah , Wang Emily A. 
Published: November 2024

Purpose of review
To summarize the impact of financial hardship on children whose parents have been incarcerated, describe both existing cash transfer and guaranteed income programs, and highlight their impact on child and family well being.

Recent findings
Emerging data on guaranteed income programs for formerly incarcerated adults indicates that the funds improve recipient health and legal system outcomes and allow participants to spend funds on stabilizing themselves and their families. Guaranteed income programs in the broader population similarly highlight the use of funds to support families’ basic needs and improved parent-child relationships, but more data are needed to understand the impact on child health and well being among families impacted by the criminal legal system.

Summary
Over 5 million children experience parental incarceration, which directly contributes to financial hardship and subsequent negative health outcomes. Cash transfers may assist these families, but policies and administrative burdens limit the ability of existing programs to fully address financial hardship. Guaranteed income programs may therefore serve a unique role in supporting the financial needs of families impacted by incarceration. More longitudinal data focusing on child health outcomes are necessary to fully understand the impact of guaranteed income of children and families impacted by parental incarceration.
Timing and risk factors of complications following total knee arthroplasty
Authors: Aljuhani Wazzan S. , Aljaian Amer R. , Alyahya Yahya K. , Alanazi Abdulmalik M. , Aljaafri Ziad A. , Alanazi Abdullah M. 
Published: November 2024

Introduction:
Total knee arthroplasty (TKA) is a common surgical procedure for end-stage arthritis; however, the precise timing of postoperative complications remains uncertain. This study aimed to estimate complication rates, timing, and risk factors associated with TKA.

Methods:
Data from 846 patients with TKA treated at a single tertiary center, were scrutinized. Complications were categorized based on timing, whereas risk factors were assessed through logistic regression.

Results:
Most patients were aged >60 years (76.2%) and obese (78.4%). Urinary tract infection (UTI) was the most common complication (2.7%). Fever and hypernatremia each affected 1.8% of patients, whereas acute kidney injury (AKI) occurred in 1.4% of cases. Major complications typically arose within the first 4 days after surgery, with delirium, fever, and hyponatremia appearing earliest (median 2.0 days). Late complications included deep vein thrombosis (median 13.5 days) and surgical site infections (median 11.5 days). Risk factors included age ≥60 for UTI (odds ratio [OR]=9.09) and longer surgery duration for AKI (OR=1.01).

Conclusions:
This study offers crucial insights into the risk factors and timing of complications after TKA. By identifying the risk factors and timing of post-TKA complications, clinicians can better tailor interventions, and improve patient care. Further research is needed to refine risk prediction models and optimize therapeutic strategies.
Distal femur osteosarcoma in a seven-year-old: a case report on acute symptom presentation
Authors: Shalalfa Neveen , Wajeeh Saleh , Sheeb Zaina , Nawaja Omama , Abuarqoub Fatima , Abufara Jameel , Shalalfa Shatha 
Published: November 2024

Introduction and importance:
Osteosarcoma is an exceptionally serious, uncommon disease in children with morbidity, mortality, and psychological burdens.

Case presentation:
In this report, the authors present the case of a previously healthy 7-year-old girl who exhibited continuous, painful limping. Plain imaging and a MRI scan revealed the presence of a lytic lesion in the femur on the left side. The diagnosis of osteosarcoma was confirmed. There was no significant familial history of cancer. The girl and her family underwent the operation and chemotherapy, received follow-up and support for a year, and both the patient and the medical team expressed a lot of satisfaction.

Clinical discussion:
The survival and prognosis from osteosarcoma in the literature was 59% for all patients at a median follow-up up 54 months, current treatment of osteosarcoma involves chemotherapy and limb surgery, with (60–80)% of patients in remission after 5 years.

Conclusion:
This case emphasizes the importance of promptly considering osteosarcoma in a child when the clinical presentation and medical imaging align with the diagnosis.
Enoxaparin Failure in Patient With Cerebral Venous Sinus Thrombosis and Prothrombin G20210A Mutation
Authors: Polavarapu Adithya , Bhushan Anita , Duarte-Celada Walter , Windisch Thomas , Bhushan Bharat 
Published: November 2024

Introduction:
Cerebral venous sinus thrombosis (CVST) is a rare, serious, and complex cerebrovascular disease. The prothrombin G20210A mutation is the second most common inherited thrombophilia and is considered to be one of the etiologies of CVST. The optimal heparinoid medication for treatment remains a topic of debate.

Case Report:
This case report describes a young woman with CVST who did not respond to low–molecular-weight heparin (LMWH). The patient was initially treated with LMWH; however, her symptoms and clot burden in the sagittal sinus worsened, and coagulation studies showed no evidence of therapeutic anticoagulation despite good compliance. Unfractionated heparin was then initiated, and the patient’s symptoms improved dramatically within 24 hours, along with the recanalization of the cerebral venous sinuses. Genetic testing revealed a heterozygous mutation in the prothrombin gene (G20210A). This mutation is a known risk factor for CVST. However, it is unclear why the patient did not respond to LMWH but responded appropriately to unfractionated heparin.

Conclusion:
This case report highlights the potential for LMWH resistance in patients with CVST and prothrombin gene mutations. These findings also emphasize the importance of close monitoring of coagulation parameters and clinical response in patients with CVST receiving LMWH.
Comparison of Pediatric and Adult Mandibular Fractures: Identifying Differences in Presentation and Management Using a National Trauma Database
Authors: Oxford Madison , Tucker Jacqueline , Goldenberg Dana , King Tonya S. , Ziai Kasra , Henry Cathy , Lighthall Jessyka G. 
Published: November 2024

Background:
Facial fractures in children are less common than in adults but can lead to significant long-term complications, including growth abnormalities and functional issues. Mandibular fractures are the most common facial fractures in both age groups, yet there is no consensus on optimal management strategies. This study investigates the epidemiology, presentation, treatment, and outcomes of mandibular fractures in pediatric versus adult populations.

Methods:
The authors conducted a retrospective, population-based study using 2016 to 2019 data from the National Trauma Data Bank. Patients with mandibular fractures were categorized into pediatric (below 18 y) and adult (18 y or above) groups. The authors analyzed demographics, fracture mechanism, treatment modality, hospital outcome, and complication data.

Results:
Of the 42,866 patients with operative mandibular fractures, 3968 were pediatric (mean age: 13.3 y), and 38,898 were adult (mean age: 36.2 y). The primary fracture etiology for both groups was being struck, followed by motor vehicle incidents and falls. Pediatric patients were more frequently treated at level I trauma centers, had shorter times for surgical intervention, and were more frequently transferred to other facilities compared to adults. Antibiotic use was similar between groups, and hospital complications were infrequent, with low rates of infection and unplanned return to the operating room.

Conclusions:
Mandibular fractures in children, though less common than in adults, exhibit unique epidemiological and management characteristics. Children were more frequently transferred for care and received surgical intervention sooner than adults. Antibiotic use and complication rates were low and similar across both groups. Further research is needed to establish specific treatment guidelines for pediatric mandibular fractures.
Craniofacial Growth in Children With Unilateral Cleft Lip and Palate: Adopted From China Versus Born in Sweden
Authors: Sahlsten Schölin Johnna , Mark Hans , Rizell Sara 
Published: November 2024

Objective:
In 2005, the number of internationally adopted children (IAC) with cleft lip and palate (CLP) from China increased globally, followed by an increase in the number of surgical complications. The aim was therefore to evaluate the craniofacial growth of children with unilateral CLP adopted from China and compare with non-adopted peers (NA).

Methods:
Cephalograms taken at 10 and 13 were analysed for the SNA, SNB, ANB, NAPg and NSBa angles. Surgical data were extracted from the medical records.

Results:
The rate of secondary cleft-related surgery including secondary alveolar bone grafting (SABG) was higher in the IAC group than in the native groups. At age 10, the IAC exhibited higher SNB and NAPg and lower ANB values than the NA-Mod group and a similar pattern was observed at age 13. The IAC group demonstrated significantly lower SNA and ANB and higher NAPg values than the NA-Orig group at age 10. At age 13, lower SNA and ANB and higher SNB, NAPg, and NSBa values were observed in the IAC group compared with the NA-Orig group.

Limitations:
Craniofacial growth is not finalized at age 13 years, why additional studies are needed to determine long-term outcomes.

Conclusions:
Results from this novel study present unfavorable craniofacial growth at age 10 and 13 years of age among IAC with UCLP and indicate an increased need for future orthognathic surgery compared with NA peers.
The always evolving diagnosis and management of Clostridioides difficile colitis: What you need to know
Authors: L'Huillier Joseph C. , Guo Weidun Alan 
Published: November 2024

ABSTRACT
The diagnosis, pharmacologic management, and surgical options for Clostridioides difficile infection (CDI) are rapidly evolving, which presents a challenge for the busy surgeon to remain up to date on the latest clinical guidelines. This review provides an evidence-based practical guide for CDI management tailored to the needs of surgeons and surgical intensivists. Historically, the diagnosis of CDI relied on slow cell culture cytotoxicity neutralization assays, but now, the rapidly resulting nucleic acid amplification tests and enzyme immunoassays have become mainstream. In terms of antibiotic therapy, metronidazole and oral vancomycin were the main “workhorse” antibiotics in the early 2000s, but large randomized controlled trials have now demonstrated that fidaxomicin produces superior results. Regarding surgical intervention, total abdominal colectomy was once the only procedure of choice; however, diverting loop ileostomy with colonic lavage is emerging as a viable alternative. Finally, novel adjuncts such as fecal microbiota transplantation and targeted therapy against toxin B (bezlotoxumab) are playing an increasingly important role in the management of CDI.
Acute stroke care in low and middle-income countries
Authors: Martins Sheila Cristina Ouriques , Matuja Sarah Shali 
Published: November 2024

Purpose of review
The purpose of this article is to discuss the global impact of stroke, the disparities and barriers to implement stroke care, and the global efforts to improve access to acute treatments in low and middle-income countries (LMICs).

Recent findings
Disparities in access to stroke care are influenced by socioeconomic inequalities, geographic disparities, and limited healthcare infrastructure, particularly in LMICs. Effective stroke care requires a coordinated approach involving emergency services, rapid diagnosis, timely treatment, and early rehabilitation. However, there are significant delays in implementing evidence-based practices, particularly in areas where stroke care resources are scarce.
Key barriers include geographic disparities, economic constraints, insufficient healthcare infrastructure, low public awareness, and weak policy frameworks. Addressing these challenges requires strengthening health systems, promoting universal health coverage, enhancing public and healthcare provider education, leveraging technology like telemedicine, and fostering international collaboration. Global efforts, including initiatives by the World Stroke Organization, focus on improving stroke care through infrastructure development, workforce training, and policy advocacy.

Summary
These recommended strategies aim to make stroke care accessible and effective for everyone, regardless of location or socioeconomic status, ultimately helping to reduce the global burden of stroke.
A comprehensive foundation model for cryo-EM image processing
Authors: Yan Yang , Fan Shiqi , Yuan Fajie , Shen Huaizong 
Published: November 2024

AbstractCryogenic electron microscopy (cryo-EM) has become a premier technique for high-resolution structural determination of biological macromolecules1–4. However, its widespread adoption is hampered by the need for specialized expertise. We introduce the Cryo-EM Image Evaluation Foundation (Cryo-IEF) model, pre-trained on an extensive dataset of approximately 65 million cryo-EM particle images using unsupervised learning. Cryo-IEF excels in various cryo-EM data processing tasks, such as classifying particles from different structures, clustering particles by pose, and assessing the quality of particle images. Upon fine-tuning, the model effectively ranks particle images by quality at high efficiency, enabling the creation of CryoWizard—a fully automated single-particle cryo-EM data processing pipeline. This pipeline has successfully resolved high-resolution structures of diverse properties and proven adept at mitigating the prevalent preferred orientation challenge in many cryo-EM samples. The Cryo-IEF model and CryoWizard pipeline collectively represent a significant advancement in rendering cryo-EM technology more accessible, efficient, and robust, with substantial implications for life sciences research.
TOP-DOWN CLIMATIC PROCESSES MODULATE BIODIVERSITY-FUNCTIONING RELATIONSHIPS ACROSS NORTH AMERICAN FORESTS
Authors: Maluquer Xavier Serra , Godoy Oscar , Ruiz-Benito Paloma , Astigarraga Julen , Rodríguez-Sánchez Francisco , Tijerín-Triviño Julián , Rueda Marta 
Published: November 2024

AbstractExperimental evidence indicates that more diverse communities sustain higher levels of ecosystem functioning. Generally, bottom-up processes accounting for community selection and complementarity effects on biodiversity are used to explain biodiversity effects on ecosystem functioning. However, top-down macroecological processes can also influence the distribution of ecosystem functions across large environmental gradients and, importantly, biodiversity patterns. Here, we tested whether past climate instability, current climate, and climate-driven species abundance explain tree richness gradients, and therefore, determine the relationship between species richness and ecosystem functioning using 137,808 forest inventory plots across continental extents including forests of Canada, the US, and Mexico. Consistent with previous research, we found a positive monotonic relationship between species richness and biomass (measured as level stand basal area) across North American forests. However, structural equation models revealed that the indirect effect of past climate instability, current climate conditions, and climate-driven individuals’ abundance underlie species richness patterns and the positive covariation between species richness and biomass. The importance of top-down climatic processes varied from boreal to tropical regions, yet their significant effects were pervasive across all forest types, indicating that climate strongly modulates the strength of the relationships between species richness and basal area. Our results help to understand the assembly processes driving the ubiquitous positive monotonic relationship between species richness and basal area across continental extents. This knowledge, obtained from adopting a macroecological perspective, helps understanding biodiversity-functioning relationships, which are usually explained by mechanisms at the community level.Significance statementMore biodiverse communities sustain higher levels of ecosystem functions (BEF hypothesis). The role of biotic interactions among trees within ecological communities determining BEF has been widely studied, but it is not well known how past climatic variability, current climate, and species abundance determine BEF. Using 137,808 forest inventory plots across North American forests located in Canada, the US, and Mexico, we document a positive relationship between tree species richness and stand basal area. Detailed analysis revealed that the positive BEF relationship is underlined by a strong and indirect effect of past and current climate. Our results highlight the importance of top-down climate processes operating at macroecological scales to understand biodiversity-functioning relationships.
Blocking SHP2 benefits FGFR2 inhibitor and overcomes its resistance in FGFR2-amplified gastric cancer
Authors: Zhang Yue , Wang Hanbing , Wei Yutao , Pan Yunfeng , Song Xueru , Shi Tao , Shao Jie , Yu Lixia , Liu Baorui , Wang Yue , Wei Jia 
Published: November 2024

AbstractFibroblast growth factor receptor 2 (FGFR2) is an important member of receptor tyrosine kinase (RTK) family. FGFR2 amplification occurs at a high frequency in gastric cancer (GC) and has been proven to be closely associated with poor prognosis and insensitivity to chemotherapy or immunotherapy. Current FGFR2-targeted therapies have limited efficacy. Hence, how to enhance efficacy and reverse resistance are urgent problems clinically. Src homology region 2-containing protein tyrosine phosphatase 2 (SHP2) serves as the shared downstream mediator of all RTKs and a prominence immunosuppressive molecule. In this study, we identified FGFR2 amplification in 6.2% (10/161) of GC samples in our center. Then we showed that dual blocking SHP2 and FGFR2 enhanced the effects of FGFR2 inhibitor (FGFR2i) in FGFR2-amplified GC bothin vitroandin vivovia suppressing RAS/ERK and PI3K/AKT pathways. We further showed that it overcame FGFR2i resistance by reversing the feedback activation mediated by other RTKs and continuously suppressing FGFR2-initiated downstream pathways. Notably, SHP2 blockade could suppress PD-1 expression and promoted IFN-γ secretion of CD8+T cells, enhancing the cytotoxic functions of T cells in tumor immune microenvironment. Overall, our findings suggest that dual blocking SHP2 and FGFR2 is a compelling rationale with both targeted treatment and immune regulation for FGFR2-amplified GC.Impact statementDual blocking SHP2 and FGFR2 can not only promote the targeted tumor-killing effects and overcome FGFR2 inhibitor resistance caused by feedback activation, but also activate T cell-mediated anti-tumor immunity by inhibiting PD-1 pathway in FGFR2-amplified GC.
Magnetotactic Bacteria Optimally Navigate Natural Pore Networks
Authors: Petroff Alexander P. , Kelin Vladislav , Radchenko-Hannafin Nina 
Published: November 2024

AbstractMagnetotactic bacteria swim along geomagnetic field lines to navigate the pore spaces of water-saturated sediment. To understand the physical basis for efficient navigation in confined geometries, we observe the motion of Multicellular Magnetotactic Bacteria through an artificial pore space under an applied magnetic field. Magnetotaxis is fastest when bacteria swim a distance that is of order the pore size in the time required to align with the applied field. A model—in which bacteria deterministically align with the magnetic field and randomly scatter off boundaries—predicts the observed non-monotonic relationship between the drift velocity and applied magnetic field and the value of the maximum drift velocity. A comparison of diverse magnetotactic bacteria shows that the magnetic moments, swimming speeds, and hydrodynamic mobilities of different species covary such that the average speed of magnetotaxis for each species is close to optimal for its natural environment.