bluuebunny/crossref_metadata_2025_split huggingface dataset:
Designed for Satisfaction
Authors: Fay Lindsey , Daneshvar Zahra , Julien-Bell Sarah , Haynes Shannon , Santiago Joshua E. 
Published: September 2024

Purpose:
This study aimed to assess the extent to which single-family room (SFR) designs enhance family presence and satisfaction and to examine the impact of built environment factors such as proximity, access, privacy, technology, lighting, and acoustics on these outcomes.

Background:
The SFR neonatal intensive care unit (NICU) presents a highly intricate setting with distinctive design attributes. This study investigated a NICU environment moving from an open-bay model to a single-family unit.

Methods:
A comprehensive research study was conducted by a NICU patient care manager and researchers specializing in design and health communication. Quantitative data were collected from NICU family participants by electronic surveys and 30 hours of observation focused on occupancy. Qualitative data were gathered through 7 focus groups and 1 interview.

Results:
The findings reveal that single-family designs can facilitate enhanced feelings of safety, privacy, and satisfaction among families but support the desire for enhanced social opportunities among parents. The patient room was predominantly occupied by the patient, nursing staff, and family.

Conclusions:
This study further validates that SFR NICUs are beneficial for families when compared to open-bay designs.

Implications for Practice and Research:
As NICUs continue to increase in size, research should understand the impact this has on parental access to staff and concerns about isolation. This study highlights the importance of privacy, acoustics, and the implementation of technology in enhancing parental satisfaction. Optimizing NICU design positively influences parents’ experiences, reinforcing the ongoing commitment to improving the environment for infant care.
Primary Central Nervous System Burkitt’s Lymphoma in a Pediatric Patient: A Case Report and Literature Review
Authors: Zhao Jian , Hassani Mohammad Arian , Song Jincheng , Sun Xiuhua 
Published: September 2024

Objective:
The objective of this research is to examine the therapy and outlook of pediatric primary central nervous system Burkitt lymphomas.

Methods:
This study involves a retrospective analysis of the clinical data of a child with primary central nervous system Burkitt lymphoma who underwent treatment in our department. In addition, pertinent literature was reviewed to provide a comprehensive understanding of the topic.

Results:
The patient was admitted to the neurosurgery department with symptoms of headache and vomiting. Brain magnetic resonance imaging (MRI) revealed multiple lesions in the right frontal and temporal lobes, dorsal thalamus, and posterior medulla oblongata. Most of the tumor mass was surgically removed from the right ventricle and diagnosed as Burkitt lymphoma. Abnormal lymph nodes were not found outside of the central nervous system. The patient achieved complete remission (CR) after receiving 6 cycles of treatment (R-AA-BB-CC-AA-BB-CC) based on the regimen of the Southern Pediatric Non-Hodgkin Lymphoma Treatment Collaboration Group 2017. As of November 23, 2023, the patient remained alive with no evidence of recurrence.

Conclusions:
Primary central nervous system Burkitt lymphoma is rare in children, and there is no universally accepted treatment protocol. However, the regimen outlined by the South China Children’s Cancer Group-Non-Hodgkin Lymphoma in 2017 (SCCCG-NHL-2017) can serve as a useful reference for treating pediatric non-Hodgkin lymphoma.
Impostor Phenomenon and Advanced Practice Registered Nurse Faculty
Authors: Williams Ty 
Published: September 2024

Background:
Impostor phenomenon (IP), or syndrome, is a behavioral health phenomenon where individuals discount personal accomplishments, success, and aptitude. It negatively affects high-functioning individuals in nursing and other health care professions.

Purpose:
This study aimed to investigate IP in advanced practice registered nurse (APRN) faculty.

Methods:
This descriptive correlational study included the Clance Impostor Phenomenon Scale (CIPS).

Results:
The sample included 478 APRN faculty members representing 50 states and Washington DC. The majority (n = 324) of CIPS scores were moderate (n = 198) or frequent (n = 133), indicating that scores may be clinically relevant. Moderate levels were associated with an increased likelihood of experiencing negative sequelae, including decreased job satisfaction and increased burnout. Comparing CIPS scores yielded no statistically significant differences between APRN roles. Significant predictors included age, years of teaching, and rank of associate professor.

Conclusions:
Findings can inform strategies to improve retention, recruitment, and job satisfaction.
Jaundice as a Rare Presentation of Neuroblastoma in a Pediatric Patient
Authors: Xie Peng , Yang Lan , Wei Lingge , Ma Huan , Yang Jigang 
Published: September 2024

Abstract
Neuroblastoma presenting as obstructive jaundice due to compression of the extrahepatic bile duct is very rare. An 11-month-old girl had sudden onset of jaundice. Initial imaging suggested a dilated biliary system caused by hepatic hilum mass. 18F-FDG PET/CT showed a lesion with increased 18F-FDG accumulation associated with surrounding enlarged lymph nodes. Surgical pathology confirmed the diagnosis of a poorly differentiated neuroblastoma associated with multiple lymph node metastases.
18F-FDG PET/CT for Detection of Immunotherapy-Induced Hypophysitis—A Case-Control Study
Authors: Fischer Alessa , Martínez-Gómez Julia M. , Mangana Joanna , Dummer Reinhard , Erlic Zoran , Nölting Svenja , Beuschlein Felix , Maurer Alexander , Messerli Michael , Huellner Martin W. , Skawran Stephan 
Published: September 2024

Purpose
Hypophysitis occurs in up to 10% of patients treated with immune-checkpoint inhibitors (ICIs). MRI shows no abnormalities of the pituitary gland in one third of patients. A delayed diagnosis increases the risk for life-threatening adrenal crisis, underscoring the need for early detection. This study evaluates the diagnostic accuracy FDG PET/CT in detecting ICI-induced hypophysitis in a cohort of melanoma patients.

Materials and Methods
Patients with metastatic melanoma and ICI-induced hypophysitis, who underwent FDG PET/CT 90 days before to 10 days after diagnosis, were compared with an age- and sex-matched control group of patients undergoing ICI treatment without signs of hypophysitis. The ratio of SUVmax of the pituitary gland to the SUVmean of the blood pool (target-to-background ratio [TBR]) was calculated. Diagnostic accuracy of the TBR was assessed using area under the receiver operating characteristics curve analysis.

Results
A total of 28 patients was included. The majority of patients with hypophysitis received ipilimumab/nivolumab (64.3%, 9/14). Visual assessment of the TBR distribution demonstrated a positive correlation with decreasing time to diagnosis. To evaluate diagnostic performance, only patients with FDG PET/CT 50 days before to 8 days after diagnosis (11/14) were included. TBR was significantly higher in these compared with the control group (median [interquartile range], 2.78 [2.41] vs 1.59 [0.70], respectively; P = 0.034). A sensitivity of 72.7% and a specificity of 90.9% were achieved at a TBR threshold of 2.41 (area under the receiver operating characteristics curve = 0.769).

Conclusions
Our findings suggest that, in patients undergoing ICI treatment for metastatic melanoma, a pituitary TBR of approximately 2.4 may indicate impending ICI-induced hypophysitis.
Catheter-Related Thrombosis With Extremely High FDG Uptake on 18F-FDG PET
Authors: Ishikawa Sho , Nakamoto Ryusuke , Yamamoto Takeshi , Miyake Kanae Kawai , Nakamoto Yuji 
Published: September 2024

Abstract
A 38-year-old woman with exertional dyspnea and decreased ejection fraction underwent 18F-FDG PET/CT, which showed extraordinarily high FDG uptake in a catheter-related thrombus formed along a central venous catheter. The thrombus’s uptake (SUVmax, 127.3) was comparable to or greater than uptake seen in the bladder’s urine. This abnormal uptake was unusual for thrombi, suggesting additional factors like undiluted FDG solution stasis due to a fibrin sheath formation around the catheter and first-pass effect. A new peripheral venous route should be secured to administer FDG in case of suspected catheter-related thrombus to avoid potential complications including a pulmonary embolism.
18F-FAPI PET/CT Imaging in a Case of Synovial Sarcoma
Authors: Ni Haopeng , Dong Yanzhao , Abdalbary Sahar Ahmed , Liu Zhenfeng , Lu Hui 
Published: September 2024

Abstract
Synovial sarcoma is a rare malignancy of mesenchymal origin, known for its propensity for metastasis and challenging early diagnosis, primarily affecting adolescents and young adults. This case report illustrates the utility of 18F-fibroblast activation protein inhibitor PET/CT in an 18-year-old woman with synovial sarcoma primarily located in the left calf and metastases in the left thoracic cavity.
Distraction Osteotomy Combined With Orthodontics: An Effective Way to Decrease Short-term Recurrence in Treating Child Craniofacial Microsomia
Authors: Ding Bo , Zang Tianying , Tang Xiaojun , Zhang Zhiyong , Zhao Shanbaga , Liu Bingyang , Ma Lunkun , Liu Wei 
Published: September 2024

Background:
This study aims to investigate strategies for reducing early relapse following mandibular distraction osteotomy (MDO) in craniofacial microsomia (CFM) patients.

Methods:
Forty CFM patients were divided into 2 groups: 20 underwent MDO alone, while 20 received MDO combined with orthodontic treatment (MDO-O). Preoperative, prefixation, and postfixation CT data in DICOM format were collected and reconstructed using Proplan software. Spatial geometric analysis was conducted to assess the inclination angle of the occlusal plane (OP), and OP deviation was directly measured using the software.

Results:
Patients in the MDO-O group demonstrated a statistically significant improvement in OP inclination at the end of the fixation period compared with those who underwent MDO alone (P=0.003).

Conclusions:
Combining MDO with a bite plate and bite glue sticks in CFM patients during the mixed dentition period enhances OP outcomes, effectively reducing short-term recurrence.
Intraoperative factors associated with unplanned return to the operating room after emergent hemorrhage control surgery
Authors: Wilson Kayla M. , Mery Marissa W. , Bengtson Erika , McWilliam Sarah E. , Bradford James M. , Teixeira Pedro G. R. , Dubose Joseph J. , Cardenas Tatiana C. , Ali Sadia , Brown Carlos V. R. 
Published: September 2024

BACKGROUND
Unplanned return to the operating room (uROR) is associated with worse outcomes and increased mortality. Little is known regarding intraoperative factors associated with uROR after emergent surgery in trauma patients. The objective of this study was to identify intraoperative factors associated with uROR after emergent hemorrhage control procedures in bleeding trauma patients.

METHODS
We used anesthetic record of intraoperative management to perform a retrospective study (2017–2022) of bleeding trauma patients who were taken for an emergent hemorrhage control operation.

RESULTS
A total of 225 patients met the inclusion criteria, 46 (20%) had uROR, and 181 (80%) did not. While there was no difference in demographics, mechanism, admission physiology, or time from emergency department to operating room, the uROR patients had a higher Injury Severity Score (30 vs. 25, p = 0.007). While there was no difference in volume of crystalloid infused (3,552 ± 2,279 mL vs. 2,977 ± 2,817 mL, p = 0.20), whole blood (2.2 ± 0.9 vs. 2.0 ± 0.5, p = 0.20), or platelets (11.6 ± 8.6 vs. 9.2 ± 9.0, p = 0.14), the uROR group received more packed red blood cells (11.5 ± 10.6 vs. 7.8 ± 7.5, p = 0.006) and plasma (9.6 ± 8.3 vs. 6.5 ± 6.6, p = 0.01), and more uROR patients received ≥10 U of packed red blood cells (48% vs. 27%, p = 0.006). Damage-control surgery (DCS) was more common in uROR patients (78% vs. 45%, p < 0.0001). After logistic regression, ≥10 U of packed cells in the operating room (4.3 [1.5–12.8], p = 0.009), crystalloid (1.0 [1.0–1.001], p = 0.009), International Normalized Ratio (INR) (7.6 [1.3–45.7], p = 0.03), and DCS (5.7 [1.7–19.1], p = 0.005) were independently associated with uROR.

CONCLUSION
Massive transfusion, crystalloid resuscitation, persistent coagulopathy, and DCS are the most significant risk factors for uROR. During hemorrhage control surgery in bleeding trauma patients who receive ≥10 U of blood, providers must maintain a keen focus on minimizing crystalloid and ongoing balanced resuscitation, particularly during damage-control procedures.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level IV.
3D spatial distribution ofSostmRNA and Sclerostin expression in response toin vivomechanical loading
Authors: Meslier Quentin A. , Hoffmann Jacy , Oehrlein Robert , Kurczy Daniel , Monaghan James R. , Shefelbine Sandra J. 
Published: September 2024

AbstractBones adapt to external mechanical loads through a process known as mechanoadaptation. Osteocytes are the bone cells that sense the mechanical environment and initiate a biological response. Investigating the changes in osteocyte molecular expression following mechanical loading has been instrumental in characterizing the regulatory pathways involved in bone adaptation. However, current methods for examining osteocyte molecular expression do not preserve the three-dimensional structure of the bone, which plays a critical role in the mechanical stimuli sensed by the osteocytes and their spatially controlled biological responses.In this study, we used WISH-BONE to investigate the spatial distribution ofSost-mRNA transcripts and its encoded protein, sclerostin, in 3D mouse tibia midshaft followingin vivotibia loading. Our findings showed a decrease in the percentage ofSost-positive osteocytes predominantly at 25% and 37% of the bone length, and in the posterior-lateral side of the tibia after loading. Sclerostin-positive osteocytes in the loaded legs were found to be similar to the contralateral legs after 2 weeks of loading.This work is the first to provide a 3D analysis ofSostand sclerostin distribution in loaded versus contralateral mouse tibia midshafts. It also highlights the importance of the bone region analyzed and the method utilized when interpreting mechanoadaptation results. WISH-BONE represents a powerful tool for further characterization of mechanosensitive genes regulation in bone and holds potential for advancing the development of new treatments targeting mechanosensitivity-related bone disorders.
The mean and variance of infection load reveal unseen host evolution
Authors: Walsman Jason Cosens , Streipert Sabrina H , Briggs Cheryl J , Wilber Mark Q 
Published: September 2024

AbstractSome hosts are more heavily infected than others, but this fact has been relatively neglected in the microparasite literature compared to the macroparasite literature. We develop a model that allows a host population’s mean and variance of microparasite load to fluctuate dynamically over time, dependent on underlying processes. Our model uses empirically reasonable, non-linear functional forms, e.g., for the probability of infected hosts surviving as a function of load. Despite non-linearities, we derive an approximation that assumes a lognormal distribution of load, improving computational and analytical tractability. We show negative feedbacks between load mean and variance at equilibrium. These feedbacks determine how a change in the host-microparasite system shifts mean and variance in load, directly as well as indirectly. We parameterize this model with empirically supported parameter values for a focal frog-fungal pathogen system. We illustrate system changes through evolution of host defenses against microparasites that may drive evolutionary recovery from disease-induced declines. We find that different forms of host defenses have different implications for load, e.g., constitutive resistance has little impact on the standard deviation while inducible resistance decreases it, with different outcomes for host fitness, pathogen fitness, and our ability to infer underlying dynamics from population-level data.
Muscle synergies to reduce the number of electromyography channels in neuromusculoskeletal modelling: a pilot study
Authors: Romanato M. , Spolaor F. , Sawacha Z. 
Published: September 2024

GRAPHICAL ABSTRACTGraphical abstract.In the black squares, we present recorded experimental data. The black box on the left contains information about the experimental data used for calibration purposes, including kinematics, kinetics, and surface electromyography (sEMG) data. The black box on the right contains information about the experimental data used for testing the algorithm, which includes kinematics and a reduced set of sEMG data. In the red boxes, we depict two parallel calibration processes. The bottom red box outlines the muscle synergies calibration algorithm, which takes as input the sEMG recordings from the calibration set (black box on the left) and provides subject-specific parameters for reconstructing missing muscle excitations from a new set of collected sEMGs. The top red box illustrates the sEMG-driven musculoskeletal model calibration, which takes input from kinematics, kinetics, and sEMG data, yielding a calibrated model with subject-specific neuromuscular parameters. The blue box describes how subject-specific muscle forces are estimated from a new dataset with limited sEMG recordings. A complete set of muscle excitations is estimated based on these few recordings and the subject-specific parameters obtained in the muscle synergies calibration algorithm box. These excitations, along with the kinematics data, drive the calibrated musculoskeletal model obtained in the sEMG-driven musculoskeletal model calibration box. Dotted arrows represent inputs, and solid lined arrows represent outputs.
Mechanisms of AAV2 neutralization by human alpha-defensins
Authors: Porter Jessica M. , Oswald Mackenzi S. , Busuttil Kevin , Emmanuel Shanan N. , Bennett Antonette , McKenna Robert , Smith Jason G. 
Published: September 2024

AbstractAntiviral immunity compromises the efficacy of adeno-associated virus (AAV) vectors used for gene therapy. This is well understood for the adaptive immune response. However, innate immune effectors like alpha-defensin antimicrobial peptides also block AAV infection, although their mechanisms of action are unknown. To address this gap in knowledge, we investigated AAV2 neutralization by human neutrophil peptide 1 (HNP1), a myeloid alpha-defensin, and human defensin 5 (HD5), an enteric alpha-defensin. We found that both defensins bind to AAV2 and inhibit infection at low micromolar concentrations. While HD5 prevents AAV2 from binding to cells, HNP1 does not. However, AAV2 exposed to HD5 after binding to cells is still neutralized, indicating an additional block to infection. Accordingly, both HD5 and HNP1 inhibit externalization of the VP1 unique domain, which contains a phospholipase A2enzyme required for endosome escape and nuclear localization signals required for nuclear entry. Consequently, both defensins prevent AAV2 from reaching the nucleus. Disruption of intracellular trafficking of the viral genome to the nucleus is reminiscent of how alpha-defensins neutralize other non-enveloped viruses, suggesting a common mechanism of inhibition. These results will inform the development of vectors capable of overcoming these hurdles to improve the efficiency of gene therapy.Author SummaryAAVs are commonly used as gene therapy vectors due to their broad tropism and lack of disease association; however, host innate immune factors, such as human alpha-defensin antimicrobial peptides, can hinder gene delivery. Although it is becoming increasingly evident that human alpha-defensins can block infection by a wide range of nonenveloped viruses, including AAVs, their mechanism of action remains poorly understood. In this study, we describe for the first time how two types of abundant human alpha-defensins neutralize a specific AAV serotype, AAV2. We found that one defensin prevents AAV2 from binding to cells, the first step in infection, while both defensins block a critical later step in AAV2 entry. Our findings support the emerging idea that defensins use a common strategy to block infection by DNA viruses that replicate in the nucleus. Through understanding how innate immune effectors interact with and impede AAV infection, vectors can be developed to bypass these interventions and allow more efficient gene delivery.
Structure of the complete extracellular bacterial flagellum reveals mechanism for flagellin incorporation
Authors: Einenkel Rosa , Qin Kailin , Schmidt Julia , Al-Otaibi Natalie S. , Mann Daniel , Drobnič Tina , Cohen Eli J. , Gonzalez-Rodriguez Nayim , Harrowell Jane , Shmakova Elena , Beeby Morgan , Erhardt Marc , Bergeron Julien R. C. 
Published: September 2024

SummaryThe bacterial flagellum is essential for motility, adhesion, and colonization in pathogens likeSalmonella entericaandCampylobacter jejuni. Its extracellular structure comprises the hook, hook-filament junction, filament, and filament cap. The native structures of the hook-filament junction and the cap remain elusive, leaving the molecular details of cap-mediated filament assembly largely uncharacterized. Here, we report the structure of the complete extracellular flagellum, encompassing the hook, hook-filament junction, filament, and cap. This structure reveals intermediates of filament assembly, providing a molecular blueprint for flagellin folding and insertion at the filament tip. Mutagenesis and functional assays demonstrate the crucial roles of the cap’s terminal regions in flagellin incorporation, and of the structural integrity of the hook-filament junction. Finally, the structure of the cap and hook-filament junction prior to filament assembly reveals the structural basis for the initiation of filament assembly. Collectively, this study provides comprehensive insights into flagellum assembly and how flagellin incorporation is coupled with its secretion.