bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility, clinical outcomes, and learning curves of robotic-assisted colorectal cancer surgery in a high-volume district general hospital: a cohort study
Authors: Massias Samuel , Vadhwana Bhamini , Arjomandi Rad Arian , Hollingshead James , Patel Vanash 
Published: September 2024

Introduction:
Robotic-assisted surgery (RAS) is one of the most influential surgical advances with widespread clinical and health-economic benefits. West Hertfordshire Teaching Hospital NHS Trust was the first in the UK to simultaneously integrate two CMR Surgical Versius robots. This study aims to investigate clinical outcomes of RAS, explore surgeon learning curves and assess the feasibility of implementation within a district general hospital (DGH).

Methods:
A prospective cohort study of 100 consecutive patient data were collected between July 2022 and August 2023, including demographics, operative and clinical variables, and compared with laparoscopic surgery (LS) data from the National Bowel Cancer Audit. Surgeon learning curves were analysed using sequential surgical and console times.

Results:
In the RAS cohort, the median age was 70 (IQR 57–78 years) and 60% were male. Retrieval of a minimum of 12 lymph nodes significantly increased in RAS compared to LS (95% vs. 88%, P=0.05). The negative mesorectal margin rate was similar between RAS and LS (97% vs. 91%, P=0.10), as well as length of stay greater than 5 days (42% vs. 39%, P=0.27). For anterior resections performed by the highest volume surgeon (n=16), surgical time was reduced over 1 year by 35% (304.9–196.9 min), whilst console time increased by 111% (63.0–132.8 min).

Conclusions:
Key quality performance indicators were either unchanged or improved with RAS. There is potential for improved theatre utilisation and cost-savings with increased RAS. This study demonstrates the feasibility and easy integration of robotic platforms into DGHs, offering wider training opportunities for the next generation of surgeons.
Cerebellopontine angle metastasis from pancreatic cancer: a case report
Authors: Wang Tianhong , Pu Kuairong , Lin Xiwen , Li Zhe , Wu Jun , Shao Dongchuan , Zhao Nan 
Published: September 2024

Introduction:
Pancreatic cancer metastasis to the cerebellopontine angle (CPA) is extremely rare and often misdiagnosed preoperatively. The clinical characteristics and prognosis of this uncommon condition remain largely unknown.

Case presentation:
We report the case of a 68-year-old male who presented with recurrent headaches, dizziness, and gait disturbances. The patient had undergone pancreaticoduodenectomy for pancreatic head adenocarcinoma two years prior. Preoperative imaging suggested a right CPA meningioma. The patient underwent resection of the CPA tumor under general anesthesia. Postoperative pathology revealed a metastatic pancreatic adenocarcinoma. Despite treatment with adjuvant chemotherapy, the patient developed widespread metastatic disease and succumbed 2 months after the CPA tumor resection.

Discussion:
The rarity of pancreatic cancer metastasizing to the CPA presents diagnostic challenges, as evidenced by the initial misdiagnosis of meningioma in this case. The clinical presentation can mimic benign conditions, leading to delays in appropriate management. This case underscores the importance of considering metastatic disease in patients with a history of cancer, even when presenting with symptoms typical of more common CPA lesions.

Conclusion:
Vigilant monitoring is crucial in pancreatic cancer patients, as neurological symptoms may herald metastatic spread to uncommon sites like the CPA. Despite surgical intervention, widespread metastasis can lead to poor outcomes. Early diagnosis and a high index of suspicion are essential for optimal management of these rare cases.
Twelve-month results for a randomized sham-controlled effectiveness trial of an in-home skills-based virtual reality program for chronic low back pain
Authors: Maddox Todd , Oldstone Liesl , Sackman Josh , Maddox Roselani , Adair Takisha , Ffrench Kelsey , Sparks Charisse , Darnall Beth D. 
Published: September 2024

Introduction:
Low-risk, accessible, and long-term effective nonpharmacologic behavioral interventions for chronic low back pain (cLBP) are needed. Pain education and cognitive behavioral therapy (CBT) are recommended first-line treatments, but access is poor, treatment effectiveness is variable, and long-term effectiveness is inconsistent. In-home virtual reality (VR)-delivered therapies might address these shortcomings because therapeutic content can be delivered in a consistent and quality-controlled manner.

Objective:
To determine whether a 56-session, self-administered in-home, Skills-Based VR program for cLBP (RelieVRx) yields long-term reductions in pain intensity and pain interference 12 months posttreatment in a large demographically diverse and clinically severe real-world sample.

Methods:
Participants were 1,093 demographically diverse individuals with self-reported nonmalignant cLBP >3 months duration and average pain intensity and interference scores >4/10. Participants were randomized to Skills-Based VR or active Sham, and data were collected from January 31, 2022 to October 31, 2023. Pretreatment to 12-month posttreatment analyses were conducted.

Results:
From baseline to 12 months posttreatment, Skills-Based VR reductions for average pain intensity (1.7 ± 2.1) and pain interference (1.9 ± 2.3) were robust and significantly greater than those found for Sham. More than half of Skills-Based VR participants reported at least a 2-point reduction in pain intensity, pain interference, or both at 12 months posttreatment.

Conclusions:
A standardized, in-home Skills-Based VR therapy is effective for reducing pain intensity and pain interference, and these effects are maintained to 12 months posttreatment.
Advanced Practice Providers in Pediatric Surgery: A 10-Year Analysis of Clinical Productivity
Authors: Layon Sarah A. , Marsack Kristina , Parham Matthew J. , Burns Heather R. , Hollier Larry H. 
Published: September 2024

Introduction:
Advanced practice providers (APPs) are integral to nonsurgical and surgical fields. In surgical settings, APPs work autonomously alongside surgeons to enhance continuity of care. While small-scale studies across various surgical specialties have explored APP utilization, literature specific to the pediatric population is limited. This study assesses the impact of increased APP utilization on productivity within one of the largest pediatric surgery departments in the United States.

Methods:
Data was sourced from the Surgery Department Executive Committee (SDEC) annual reports. Descriptive analyses were performed to delineate trends in clinical volumes, OR cases, gross charges, work relative value units (wRVUs), and provider full-time equivalents (FTEs) between October 2011 and September 2023. Secondary analyses were performed from 2016 to 2023, after APP roles were refined in each division.

Results:
Since 2012, an upward trend is observed in total clinic visits, total OR cases, and OR cases per MD. In 2016, APPs saw 1 clinic patient for every 2.2 seen by MDs, decreasing to a 1:1 ratio by 2023. The MD surgical conversion rate has increased by 20.5% since 2016, while the conversion rate per total clinic volume has decreased by 7.3% over the same period. Total wRVUs and gross charges increased across the department and per provider, despite fewer overall providers since 2021.

Conclusion:
Increased utilization of APPs within the department of surgery may enhance procedural productivity for surgeons while ensuring continued patient access to care. This study highlights the importance of developing care models that optimize the full skillset of APPs.
Effectiveness of Core Excision Technique for Keloids: A Systematic Review
Authors: Ran Xiaoye , Guo Xiaoshuang , Liu Yuanbo , Zhu Shan , Li Shanshan , Chen Zixiang , Han Tinglu , Jin Shengyang , Zhou Mengqi , Zang Mengqing 
Published: September 2024

Background:
The keloid core excision technique mitigates the risk of wound tension and promotes favorable morphological outcomes. However, whether residual keloid tissue or other factors increase the risk of recurrence remains unclear. This systematic review aimed to evaluate the therapeutic outcomes of core excision techniques for keloids.

Methods:
A systematic literature review was conducted by searching PubMed, Embase, Web of Science Core Collection, and Cochrane Library databases on July 30, 2023. The search terms employed were “keloid,” “core excision,” “intralesional excision,” “intramarginal excision,” “rind flap,” and “fillet flap.” The inclusion criteria for the studies were established in advance and evaluated by multiple investigators.

Results:
Overall, 20 studies involving 926 keloid cases managed through core excision were included. Adjuvant therapies were used in 19 studies, with radiotherapies and steroid injections emerging as the predominant methods. The recurrence rates ranged from 0% to 28.6%. Residual scar tissue after core excision and complications, such as flap necrosis and hematoma, are the major factors contributing to recurrence.

Conclusion:
The core excision technique is a surgical treatment of keloids with a low recurrence rate when combined with adjuvant therapies. However, randomized controlled trials and conclusive quantitative studies are necessary to further investigate the effects of the core excision technique on keloids.
Innovative Endovascular Management of Giant Superficial Temporal Artery Pseudoaneurysm Presented With Periorbital Ulcerative Mass
Authors: Shao Miriam M. , Huda Shayan , Narayan Vinayak , Serulle Yafell , Ben-Shalom Netanel 
Published: September 2024

Objective:
Superficial temporal artery (STA) pseudoaneurysms, characterized by arterial wall defects leading to blood leakage into perivascular tissues, present as pulsatile edematous masses, often originating from trauma or iatrogenic causes. Although rare (<1% of vascular lesions), anticoagulation agent use may contribute to their increasing incidence.

Methods:
Traditional surgical ligation and resection have been standard, but the advent of endovascular techniques offers minimally invasive alternatives that mitigate surgical risks, especially in patients with multiple medical comorbidities. This case report details the successful endovascular management of an STA pseudoaneurysm using n-butyl cyanoacrylate (n-BCA) glue embolization.

Results:
A 93-year-old female with renal failure, cardiac history, and anticoagulant therapy presented with large periorbital ecchymosis and edema after a fall. Computed tomography revealed a periorbital mass corresponding to her symptoms, and a repeat computed tomography conducted 2 months later indicated mass growth. Doppler ultrasonography suggested a partially thrombosed pseudoaneurysm from the right STA. Considering the patient’s age and medical conditions, endovascular embolization using n-BCA glue was chosen over surgical ligation. The patient was discharged uneventfully, and follow-up confirmed spontaneous resolution.

Conclusion:
This case demonstrates the evolving role of endovascular techniques, particularly in cases unsuitable for surgery. Liquid embolic agents like n-BCA offer precise occlusion capabilities, solidifying their potential as a standalone treatment option for STA pseudoaneurysms.
Analysis of Indeterminate QuantiFERON Assay Results in Solid Organ Transplant Candidates and Proposed Management Algorithm
Authors: Chiu Chia-Yu , Mahmood Maryam , Brumble Lisa M. , Vikram Holenarasipur R. , Theel Elitza S. , Beam Elena 
Published: September 2024

Background.
Identification and treatment of latent tuberculosis infection (LTBI) mitigate the risk of tuberculosis (TB) reactivation after transplantation. TB reactivation is higher in those with indeterminate QuantiFERON (QFT) than those with negative results. Management of indeterminate QFT results in the pretransplant period remains unclear.

Methods.
We conducted a retrospective study of solid organ transplant (SOT) recipients, 18 y and older, who were screened with QFT assay pretransplantation at Mayo Clinic between January 2010 and June 2023. We examined the frequency of indeterminate QFT results, results of repeat LTBI screening, treatment decisions, and rate of posttransplant TB infection.

Results.
Of 13 008 patients screened for LTBI before SOT, 736 (6%) patients had indeterminate QFT results. Among these, 247 (34%) underwent a second LTBI screening test, and 39 (5%) received LTBI treatment. Among 247 patients with a repeat LTBI screening test, 185 (75%), 48 (19%), and 14 (6%) were tested by QFT, T-SPOT.TB, or TST, respectively. The repeat QFT remained indeterminate in 160 (86%) patients, whereas all T-SPOT.TB results were negative. Posttransplant TB infection occurred in 2 (0.3%) patients; neither had a second TB screening test pretransplant nor received LTBI treatment.

Conclusions.
In SOT recipients with indeterminate QFT results at pretransplant evaluation, opting for T-SPOT.TB as a second test may be preferable over repeat QFT. TB infection after transplantation in patients with a pretransplant indeterminate QFT result was rare. Patient management and LTBI treatment in those with indeterminate QFT pretransplant should account for epidemiological risk factors, and shared decision-making is recommended.
The past, present and future of multi-scale modelling applied to wave–structure interaction in ocean engineering
Authors: Sriram V. , Saincher Shaswat , Yan S. , Ma Q. W. 
Published: September 2024

Concepts and evolution of multi-scale modelling from the perspective of wave–structure interaction have been discussed. In this regard, both domain and functional decomposition approaches have come into being. In domain decomposition, the computational domain is spatially segregated to handle the far-field using potential flow models and the near field using Navier–Stokes equations. In functional decomposition, the velocity field is separated into irrotational and rotational parts to facilitate identification of the free surface. These two approaches have been implemented alongside partitioned or monolithic schemes for modelling the structure. The applicability of multi-scale modelling approaches has been established using both mesh-based and meshless schemes. Owing to said diversity in numerical techniques, massively collaborative research has emerged, wherein comparative numerical studies are being carried out to identify shortcomings of developed codes and establish best-practices in numerical modelling. Machine learning is also being applied to handle large-scale ocean engineering problems. This paper reports on the past, present and future research consolidating the contributions made over the past 20 years. Some of these past as well as future research contributions have and shall be actualized through funding from the Newton International Fellowship as the next generation of researchers inherits the present-day expertise in multi-scale modelling.
This article is part of the theme issue ‘Celebrating the 15th anniversary of the Royal Society Newton International Fellowship’.
Potential of coupled array harvester in enhanced energy harvesting
Authors: De Srimanta Lal , Ali Shaikh Faruque 
Published: September 2024

Harvesting energy from nonlinear systems has been at the centre of research in the energy harvesting community. Many such proposed systems are single nonlinear harvester. While these systems show an increase in bandwidth of harvesting frequency, overall, they are not effective enough in power generation. This article studies power harvesting and frequency bandwidth characteristics of an array of harvesters. Multiple harvesters are considered with linear and nonlinear coupling between the harvesters. The phenomena of internal resonance (IR) and stochastic resonance (SR) are reported. The IR in multiple coupled nonlinear harvesters is explored using multiple-scale analysis. A parametric study is conducted to demonstrate the effect of coupling strength, frequency mistuning, innate nonlinearity and other parameters. The parametric study helped establish effective ways to increase bandwidth. Moreover, a stochastically loaded linearly coupled bistable harvester array is numerically analysed to find the effect of coupling strength and array size on the phenomenon of SR and on the system’s harvesting performance. Through these studies, the potential of multiple coupled nonlinear harvesters in enhanced energy harvesting is demonstrated under both harmonic and stochastic excitation.
This article is part of the theme issue ‘Celebrating the 15th anniversary of the Royal Society Newton International Fellowship’.
Time spent in conversation over meals predicts default network function: Evidence from a passive mobile-sensing and fMRI study
Authors: Bhatt Dhaval , Huckins Jeremy F. , Nepal Subigya , Campbell Andrew T. , Meyer Meghan L. 
Published: September 2024

AbstractSharing meals with others, often referred to as ‘commensality,’ fosters social connection and may have been essential to human brain evolution. Here, we investigate whether shared meals impact social brain processes through the conversations they afford. If so, then time spent in conversation over meals should affect the default network– a set of interconnected cortical regions reliably associated with the social exchange of ideas. To test this possibility, we combined passive-mobile sensing with neuroimaging. Undergraduate participants had an application on their smartphone for two months that unobtrusively captured their time spent in conversation, as well as their location on and around campus. In between these two months, participants completed a resting state scan. Time spent in conversations around meals (e.g., at cafeterias and restaurants) during the prior month predicted greater functional connectivity in the dorsomedial default network subsystem, specifically between the left inferior frontal gyrus (LIFG) portion and the rest of the subsystem regions. This relationship was preferential to: (1) time spent in conversation over the past (vs. future) month, (2) connectivity with the LIFG (vs. other dorsomedial subsystem nodes), (3) the dorsomedial subsystem (vs. other default network subsystems), (4) eateries (vs. other locations), and (5) time spentaround conversationat eateries, rather than time at eateries more generally. Follow-up analyses further revealed results were driven by a ventral portion of the LIFG, with peaks in voxel-connectivity associated with language, social, memory, and affective processes, as determined by the meta-analytic platform, NeuroSynth. Time spent in conversation over meals may exercise social cognitive processes supported by the dorsomedial subsystem, a network key to social communication, understanding, and connection.
Putting computational models of immunity to the test - an invited challenge to predictB. pertussisvaccination outcomes
Authors: Shinde Pramod , Willemsen Lisa , Anderson Michael , Aoki Minori , Basu Saonli , Burel Julie G , Cheng Peng , Dastidar Souradipto Ghosh , Dunleavy Aidan , Einav Tal , Forschmiedt Jamie , Fourati Slim , Garcia Javier , Gibson William , Greenbaum Jason A , Guan Leying , Guan Weikang , Gygi Jeremy P , Ha Brendan , Hou Joe , Hsiao Jason , Huang Yunda , Jansen Rick , Kakoty Bhargob , Kang Zhiyu , Kobie James J , Kojima Mari , Konstorum Anna , Lee Jiyeun , Lewis Sloan A , Li Aixin , Lock Eric F , Mahita Jarjapu , Mendes Marcus , Meng Hailong , Neher Aidan , Nili Somayeh , Olsen Lars Rønn , Orfield Shelby , Overton James A. , Pai Nidhi , Parker Cokie , Qian Brian , Rasmussen Mikkel , Reyna Joaquin , Richardson Eve , Safo Sandra , Sorenson Josey , Srinivasan Aparna , Thrupp Nicky , Tippalagama Rashmi , Trevizani Raphael , Ventz Steffen , Wang Jiuzhou , Wu Cheng-Chang , Ay Ferhat , Grant Barry , Kleinstein Steven H , Peters Bjoern 
Published: September 2024

AbstractSystems vaccinology studies have been used to build computational models that predict individual vaccine responses and identify the factors contributing to differences in outcome. Comparing such models is challenging due to variability in study designs. To address this, we established a community resource to compare models predictingB. pertussisbooster responses and generate experimental data for the explicit purpose of model evaluation. We here describe our second computational prediction challenge using this resource, where we benchmarked 49 algorithms from 53 scientists. We found that the most successful models stood out in their handling of nonlinearities, reducing large feature sets to representative subsets, and advanced data preprocessing. In contrast, we found that models adopted from literature that were developed to predict vaccine antibody responses in other settings performed poorly, reinforcing the need for purpose-built models. Overall, this demonstrates the value of purpose-generated datasets for rigorous and open model evaluations to identify features that improve the reliability and applicability of computational models in vaccine response prediction.
Enhancing Vaxign-DL for Vaccine Candidate Prediction with added ESM-Generated Features
Authors: Chen Yichao , Zhang Yuhan , He Yongqun 
Published: September 2024

AbstractMany vaccine design programs have been developed, including our own machine learning approaches Vaxign-ML and Vaxign-DL. Using deep learning techniques, Vaxign-DL predicts bacterial protective antigens by calculating 509 biological and biomedical features from protein sequences. In this study, we first used the protein folding ESM program to calculate a set of 1,280 features from individual protein sequences, and then utilized the new set of features separately or in combination with the traditional set of 509 features to predict protective antigens. Our result showed that the usage of ESM-derived features alone was able to accurately predict vaccine antigens with a performance similar to the orginal Vaxign-DL prediction method, and the usage of the combined ESM-derived and orginal Vaxign-DL features significantly improved the prediction performance according to a set of seven scores including specificity, sensitivity, and AUROC. To further evaluate the updated methods, we conducted a Leave-One-Pathogen-Out Validation (LOPOV) study, and found that the usage of ESM-derived features significantly improved the the prediction of vaccine antigens from 10 bacterial pathogens. This research is the first reported study demonstrating the added value of protein folding features for vaccine antigen prediction.