bluuebunny/crossref_metadata_2025_split huggingface dataset:
Managing Complicated Nontuberculous Mycobacteria Infections in Plastic Surgery
Authors: García-Ruza Miriam , Blanco Juan , Campusano Katherine , Silva Douglas , Claro Franklin , de Waard Jacobus H. 
Published: October 2024

Summary:
Nontuberculous mycobacteria (NTM) infections after cosmetic surgery have become an increasing concern. These infections are often initially misdiagnosed and treated with standard antibiotic regimens, which fail to resolve the underlying infection, leading to prolonged patient suffering. In this case study, we describe a chronic wound infection caused by Mycobacterium abscessus subsp. bolletii after a muscle-repair abdominoplasty. This case illustrates the diagnostic and therapeutic challenges plastic surgeons face in successfully treating such infections. Initial obstacles included the isolation of co-contaminating bacteria that masked the NTM infection, the use of antibiotics ineffective against the specific NTM species, and the failure to identify the infection source. In this instance, contaminated skin marker ink used to mark the rectus muscle, combined with a nonabsorbable (permanent) suture for muscle repair, led to the development of a biofilm that acted as a persistent reservoir for the infection, resistant to antibiotic treatments. Complete resolution was achieved only after evaluation by a plastic surgeon experienced in treating NTM infections and the subsequent removal of the permanent suture. The delayed suture removal contributed to a 15-month recovery period. This case underscores the importance of early recognition of NTM infections after cosmetic procedures. By sharing this case, we aim to raise awareness of NTM infections and help prevent future cases of misdiagnosis and prolonged antibiotic treatments. Key points regarding the diagnosis, sources of infection, and treatment options for NTM infections are highlighted in this article using "text boxes" to emphasize the most important information and provide concise summaries of critical insights.
Quick action required: revealing pheochromocytoma as the hidden trigger behind postoperative hypertensive crisis
Authors: Calçada Alexandre , Costa Vasco , Lêdo Lia , Freire Pedro 
Published: October 2024

Managing patients who present with elevated blood pressure (BP) requires careful but expeditious assessment and triage to differentiate between those at immediate risk of complications and those for whom BP elevation does not pose an immediate threat to health. We present a case of a 54-year-old healthy male patient who experienced refractory hypertension during the immediate postoperative period following nasal surgery. Additional gastrointestinal symptoms and imaging findings made it possible to consider a catecholamine-producing tumour as the primary cause. Despite efforts, managing hypertension continued to be a challenge, and major neurologic complications arose within the following hours.
This case illustrates the potential for rapid changes in the clinical scene during hypertensive emergency management. If not addressed promptly, a routine postoperative complication (at first glance) can turn into serious complications, particularly when there are uncommon underlying causes involved.
Is pancreaticoduodenectomy justified for metastatic melanoma to the ampulla of Vater?
Authors: Hsi Chieh-Ning , Wang Shin-E , Shyr Bor-Shiuan , Chen Shih-Chin , Shyr Yi-Ming , Shyr Bor-Uei 
Published: October 2024

Background:
Metastatic melanoma of the ampulla of Vater is rare. The purpose of this study was to summarize the characteristics and outcomes of metastatic melanoma in the ampulla of Vater and highlight the impact of surgery on the prognosis of patients with metastatic melanoma.

Methods:
Pooled data from a case encountered at our institution and from all sporadic cases published on PubMed and MEDLINE between 1996 and 2023 were analyzed.

Results:
Fourteen patients with metastatic melanoma in the ampulla of Vater were enrolled. Seventy-three percent of primary melanomas were cutaneous and 27% were mucosal. Jaundice was the most common symptom (86%). The size of metastatic melanoma to the ampulla ranged from 1.5 cm to 8 cm, with a median of 2.75 cm. Concomitant metastasis to other organs occurred in 82% of the patients at the time of diagnosis, most commonly in the brain, lungs, and liver (36% each). Among the reported cases, pancreaticoduodenectomy was performed in five patients. The overall 1-year survival rate was 27.3%, with a median survival of four months. Wide excision of the primary lesion and chemotherapy significantly improved survival rates (p= 0.048). There is a trend toward improved survival in patients undergoing pancreaticoduodenectomy followed by chemotherapy.

Conclusion:
Given the availability of effective systemic therapies, metastatic melanoma of the ampulla of Vater does not necessarily preclude major surgeries.
Examining the Effect of Peppermint Oil on Postoperative Nausea After Cervical Surgery
Authors: Cetin Nurdan , Kose Gulsah , Gokbel Aykut 
Published: October 2024

ABSTRACT

PURPOSE: The aim of this study was to investigate the effect of peppermint oil aromatherapy on postoperative nausea and vomiting (PONV) and hemodynamic parameters in patients undergoing single-level cervical surgery. METHODS: This prospective randomized controlled study consisted of 76 single-level cervical surgery patients admitted to the neurosurgery department between March 2021 and November 2022. The patients were randomized into 2 groups: the intervention group received peppermint oil aromatherapy through inhalation, whereas the control group received routine clinical treatment. Both groups were observed for the presence and severity of PONV, the use of antiemetics, and hemodynamic parameters at minute 5, 35, 65, and 95, and at hour 2, 6, 12, and 24 after surgery. RESULTS: In the control group, 18 (47.8%) patients experienced nausea, 11 (28.9%) experienced vomiting, and 7 (18.4%) used antiemetics. In contrast, the intervention group included only 2 (5.3%) patients who experienced nausea, and none of those patients experienced vomiting or used antiemetics. It was determined that peppermint oil had a 40% effect on reducing PONV, 34% effect on reducing postoperative antiemetic use, and 75% effect on reducing severity of nausea. Hemodynamic parameters did not differ significantly between the 2 groups. The systolic blood pressure of the control group was significantly greater than that of the intervention group only at minute 95 and at hour 24 after surgery. CONCLUSIONS: The results suggest that the use of peppermint oil aromatherapy can have a positive effect on reducing the presence and severity of PONV and the need for antiemetic medication in patients undergoing single-level cervical surgery.
Efficacy of physical activity in polycystic ovary syndrome treatment
Authors: Parmar Sehej-Leen Kaur , Whooten Rachel 
Published: October 2024

Purpose of review
Physical activity (PA) is acknowledged as an important component of lifestyle therapy in the management of polycystic ovary syndrome (PCOS). The purpose of this current systematic review is to analyze recent literature assessing the role of PA and exercise interventions as potential treatment for PCOS.

Recent findings
The recent literature published since 2022 has focused on understanding the specific benefits of different PA modalities on PCOS pathophysiology, suggesting that high intensity exercise may relay greater metabolic improvements, although results are still inconclusive; expanding our understanding of the impact PA has on a wider range of outcomes, including sleep, quality of life, inflammation, and DNA methylation; and recognizing barriers and limitations of implementing efficacious PA interventions for individuals with PCOS.

Summary
Current literature supports a role for PA in improving PCOS-related cardiometabolic and reproductive outcomes; however, there is still a significant evidence gap of high-quality studies assessing optimal exercise regimens as well as strategies for implementing PA interventions in real-world settings for individuals with PCOS.
The analgesic effect of acupuncture in neuropathic pain: regulatory mechanisms of DNA methylation in the brain
Authors: Jang Jae-Hwan , Lee Yoon Jae , Ha In-Hyuk , Park Hi-Joon 
Published: October 2024

Abstract
Recent research has demonstrated that chronic pain, resulting from peripheral nerve injury, leads to various symptoms, including not only allodynia and hyperalgesia but also anxiety, depression, and cognitive impairment. These symptoms are believed to arise due to alterations in gene expression and neural function, mediated by epigenetic changes in chromatin structure. Emerging evidence suggests that acupuncture can modulate DNA methylation within the central nervous system, contributing to pain relief and the mitigation of comorbidities. Specifically, acupuncture has been shown to adjust the DNA methylation of genes related to mitochondrial dysfunction, oxidative phosphorylation, and inflammation pathways within cortical regions, such as the prefrontal cortex, anterior cingulate cortex, and primary somatosensory cortex. In addition, it influences the DNA methylation of genes associated with neurogenesis in hippocampal neurons. This evidence indicates that acupuncture, a treatment with fewer side effects compared with conventional medications, could offer an effective strategy for pain management.
Impact of Photon-counting Detector Computed Tomography on a Quantitative Interstitial Lung Disease Machine Learning Model
Authors: Koo Chi Wan , Huls Sean J. , Baffour Francis , McCollough Cynthia H. , Yu Lifeng , Bartholmai Brian J. , Zhou Zhongxing 
Published: October 2024

Purpose:
Compare the impact of photon-counting detector computed tomography (PCD-CT) to conventional CT on an interstitial lung disease (ILD) quantitative machine learning (QML) model.

Materials and Methods:
A QML model analyzed 52 CT exams from patients who underwent same-day conventional and PCD-CT for suspected ILD. Lin’s concordance correlation coefficient (CCC) assessed agreement between conventional and PCD-CT QML results. A CCC >0.90 was regarded as excellent, 0.9 to 0.8 as good, and <0.80 as a poor concordance. Spearman rank correlation evaluated the association between pulmonary function test results (PFT) and QML features (reticulation [R], honeycombing [HC], ground glass [GG], interstitial lung disease [ILD], and vessel-related structures [VRS]). Correlations were statistically significant if the 95% CI did not include 0.00 and P value <0.05.

Results:
Conventional and PCD-CT QML results had good to excellent concordance (CCC ≥0.8) except for total HC (CCC <0.8), likely related to better PCD-CT honeycombing delineation. Overall, compared with conventional CT, PCD-CT had consistently more statistically significant correlation with PFT for HC (9 PCD vs. 2 conventional of 28 total and regional associations), similar correlation for R (20 PCD vs. 18 conventional of 28 associations) and VRS (19 PCD vs. 23 conventional of 28 associations), and less correlation for GG extent (12 PCD vs. 20 conventional associations).

Conclusions:
There is strong agreement between conventional and PCD-CT QML ILD features except for HC. PCD-CT improved HC but decreased GG extent correlation with PFT. Therefore, even though most quantitative features were not impacted by the newer PCD-CT technology, model adjustment is necessary.
Risk Factors for Postoperative Complications Following Mandibular Fracture Repair
Authors: Resnick Eric , Hassan Bashar A. , Er Seray , Pope Pharibe , Lamaris Gregory A. , Grant Michael P. , Pan Judy 
Published: October 2024

Complications following mandibular fracture repair (MFR) may carry significant morbidity to patients. The purpose of our study is to determine the risk factors for postoperative complications following MFR. The authors conducted a retrospective cohort study of trauma patients who underwent MFR in 2018 and 2019. Excluded were patients below 18 years old and those with postoperative follow-up <2 weeks. The primary outcome was the incidence of major and minor postoperative complications following MFR. Of n=275 patients included, mean (SD) age was 35 (14) years and median (IQR) follow up was 49 (26–117) days. Most patients [n=208 (76%)] underwent both maxillomandibular/intermaxillary fixation (MMF/IMF) and open reduction and internal fixation (ORIF). The incidence of major postoperative complications was 19% (n=51) including malunion [n=8 (2.9%)], malocclusion [n=21 (7.6%)], and unplanned reoperation [n=26 (9.5%)]. The incidence of minor postoperative complications was 61% (n=167). Alcohol use at the time of surgery and greater MISS score were associated with greater odds of major complications [adjusted odds ratio (aOR) 95% CI: 3.4 (1.2–9.0), 1.09 (1.02–1.160), respectively]. Smoking at the time of surgery and moderately (>2 mm) and severely displaced fractures (>4 mm) were associated with greater odds of minor complications [aOR (95% CI): 2.1 (1.04–4.2), 2.7 (1.2–6.4), 2.7 (1.1–6.6), respectively]. Alcohol use, smoking, greater MISS score, and displaced fractures >2 mm were significant risk factors for postoperative complications following MFR. Our findings can help guide informed decision making and surgical planning in patients with mandibular fractures.
No benefit from the addition of low-dose ketamine infusion to standard evidence-based care of patients with multiple rib fractures
Authors: Macheel Chad , Farhat Joseph , Gipson Jonathan , Lindbloom Peter , West Michaela A. 
Published: October 2024

BACKGROUND
Multiple rib fractures from blunt thoracic trauma cause significant morbidity. Optimal current management includes multimodal analgesia, pulmonary hygiene, and early mobilization. Low-dose ketamine infusion (LDKI) has been proposed as an adjunctive analgesic in this setting. A prior study reported decreased pain scores with LDKI in patients with multiple rib fractures. We hypothesized that LDKI would decrease morphine milligram equivalents (MMEs) in patients with multiple rib fractures.

METHODS
A prospective randomized placebo-controlled trial was performed in adult (18 years or older) patients with three or more rib fractures. A prestudy power analysis calculated an 80% chance of identifying a 15% decrease in MMEs with 50 subjects. The study was approved by the institutional review board and informed consent obtained in all subjects. Demographic (age, sex) and injury specific information (Injury Severity Score, number of rib fractures) were obtained. Subjects were randomized 1:1 to receive continuous LDKI (0.1 mg/kg/h) or placebo infusion (0.9% NaCl) for ≤48 hours. All patients received a standard evidence-based multidisciplinary protocol for rib fractures management. Primary outcome measure was MME use or pulmonary complications. Statistical comparison of LDKI versus placebo was performed using the Mann-Whitney U test.

RESULTS
All 50 enrolled subjects (placebo, 25; LDKI, 25) received study drug infusion. The two groups were well matched for age, Injury Severity Score, and number of rib fractures. We observed no differences in the Day 1 (p = 0.961), Day 2 (p = 0.373), or total MMEs (p = 0.946) between groups. Similar total MME use was observed when subjects who received ≥40 hours of study drug and were compared (p = 0.924). Use of LDKI did not alter subsequent need for opiate analgesics postinfusion, hospital length of stay, pulmonary complications, or need for readmission.

CONCLUSION
The addition of LDKI to an established multimodal, evidence-based protocol for management of multiple rib fractures did not decrease opiate usage or impact pulmonary complications.

LEVEL OF EVIDENCE
Therapeutic/Care Managaement; Level I.
Histopathology of extracutaneous tissues in a uremic calciphylaxis patient treated with human amnion-derived mesenchymal stem cells: a comparison with ESKD patients
Authors: Li Cui , Lu Shijiu , Yang Guang , Cao Yue , Zeng Ming , Liu Kang , Yuan Yanggang , Ding Yan , Su Zhonglan , Xu Fangyan , Ren Wenkai , Liu Wei , Xu Yi , Zhang Jing , Ye Xiaoxue , Jiang Chunyan , Cui Yugui , Ma Xiang , Ning Song , Xiao Yujie , Luan Changxing , Ji Qiang , Zhang Zhiwei , Gu Mufeng , Xing Changying , Wang Xiuqin , Liang Ningxia , Chen Feng , Liu Jiayin , Qin Lianju , Yu Youjia , Wang Ningning 
Published: October 2024

AbstractBackgroundCalciphylaxis, which mostly affects individuals with end-stage kidney disease (ESKD), is also known as calcific uremic arteriolopathy (CUA). It is a rare and fatal disease that manifests with calcification and thrombosis of microvessels, ischemia, and necrosis in skin tissues(ORPHA:280062). Histopathological features of extracutaneous tissues of CUA patients undergoing human amnion–derived mesenchymal stem cell (hAMSC) treatment remain unknown.MethodsA female CUA patient, treated with hAMSCs for 20 months, passed away due to stroke. Histopathological features of her extracutaneous tissues were compared with those of ESKD patients (n = 7). Raman spectroscopy was applied to identify the composition of calcifications. The distribution of hAMSCs, derived from the amnion of a male fetus, in tissues of the CUA patient was determined by detecting the Y chromosome using reverse-transcription–polymerase chain reaction.ResultsMicrovessel lesions were more prevalent in the extracutaneous tissues of the CUA patient than in those of ESKD patients, although the regenerated skin showed normal histological characteristics. The CUA patient exhibited calcifications of microvessel media, including the microvessels in the lungs, kidneys, spleen, pancreas, and uterus. Her mitral valve and kidney displayed severe calcification, identified as calcium phosphate with some calcium carbonate. hAMSCs were not detected in the tissues of the CUA patient.ConclusionUnder the treatment strategy with hAMSCs, based on the effects of skin regeneration, microvascular lesions in the extracutaneous tissues of the CUA patient were more severe than those in ESKD patients. CUA should be considered a systemic disease when identifying treatment targets.
Clinical and Genetic Spectrum of Fanconi Anaemia in Australia and New Zealand
Authors: Fluhler Hannah , Granger Elissah , Sharp Michael , Harris Caitlin , Mckinley Mark , Riyat Sarbjit , Krieg Christine , Deans Andrew , Fraser Chris , Cross Siobhan , Carter Tina , Worgan Lisa , Nelson Adam , Fox Lucy C. , Nicholl Jillian , Attwood Alison , McLeman Lorna , Hughes David , Conyers Rachel , Kujan Omar , Velleuer-Carlberg Eunike , Nandini Adayapalam , Crismani Wayne 
Published: October 2024

AbstractFanconi anaemia (FA) is a rare genetic condition which predisposes to progressive bone marrow failure, a specific spectrum of malignancies including head and neck squamous cell carcinoma (HNSCC), and an array of other clinical manifestations. The clinical and genetic spectrum of FA in Australia and New Zealand remains relatively undescribed in the literature and is limited to case reports. In this study, we conducted the first comprehensive investigation of FA within this region combining cohort data and case reports, aiming to elucidate its diagnostic patterns, clinical manifestations, and genetic characteristics. Our findings reveal a positive correlation between national testing rates and case detection, across states and territories of Australia, suggesting that targeted testing strategies may enhance the identification of FA cases. Further, our analysis demonstrates that the physical and genetic profiles of FA patients in Australia and New Zealand resemble those observed in other international cohort studies. This study emphasises the continued significance of cytogenetic testing for FA while stressing the need for heightened awareness among medical professionals. FA, once perceived primarily as a paediatric condition, now demands vigilance across all age groups due to advances in medical care and complementary detection methods such as high-throughput sequencing. This study also underscores the heightened susceptibility of individuals with FA in Australia and New Zealand to HNSCC, consistent with observations in other regions worldwide.
Disentangling heritability and plasticity effects onPopulus fremontiileaf reflectance across a temperature gradient
Authors: Seeley M. M. , Thomson E. , Allan G. J , Wiebe B. C. , Whitham T. G. , Hultine K. R. , Cooper H. F. , Asner G. P. , Doughty C.E. 
Published: October 2024

AbstractGlobally, vegetation biodiversity is expected to decline as the rate of plant adaptation struggles to keep pace with rising temperatures. To support conservation efforts through remote sensing, we disentangled the nested effects of genetic and environmental influences on reflectance spectra, leveraging spectroscopy to assess plant adaptations to temperature. Specifically, we quantified the relative effect of plasticity and heritability onPopulus fremontii(Fremont cottonwood) leaf reflectance using clonal replicates propagated from 16 populations and grown across three common gardens spanning a mean annual temperature gradient representing the thermal range ofP. fremontii. We used variance partitioning to decompose phenotypic variation expressed in the leaf spectra into genotypic and environmental components to estimate broad-sense heritability. Heritability was strongly expressed in the spectral red edge (∼680-750nm) and shortwave infrared (∼1400-3000nm), though the heritability peak in the red edge was sensitive to extreme temperatures. By comparing distances of group centroids in principal component space, we determined thatP. fremontiiintraspecific spectral variation was shaped by the interaction between common garden site conditions and source population. Support vector machine models indicated pronounced environmental influence on spectral variation, asP. fremontiisource population and garden location were classified at 71.8% and 92.6% accuracy, respectively. These findings emphasize the utility of reflectance data in separating genetic and environmental influences on plant phenotypes, offering a pathway to scale these insights across broader landscapes and aid in the conservation and management of vulnerable ecosystems in a warming climate.