bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laparoscopic Totally Extraperitoneal Inguinal Hernia Repair Under Combined Spinal Epidural Anesthesia Versus General Anesthesia
Authors: Donmez Turgut , Tulubas Evrim Kucur , Bostanci Ipek 
Published: October 2024

Background:
Inguinal hernia repair is one of the most frequently used elective surgical operations in the world. General anesthesia (GA) has risks and routine postoperative complications, such as nausea, vomiting, throat irritation, and postoperative pain. Regional anesthesia (RA) has many advantages over GA, such as faster recovery, less postoperative pain, nausea, and vomiting, and less hemodynamic compromise. We aimed to investigate the efficacy and safety of combined spinal and epidural anesthesia (CSEA) in preventing shoulder pain in patients undergoing totally extraperitoneal herniorrhaphy (TEP).

Materials and Methods:
The files of patients who had undergone the TEP method under GA and CSEA due to inguinal hernia between April 2020 and November 2021 at the Bakirköy Dr. Sadi Konuk Training and Research Hospital were reviewed retrospectively.

Results:
A total of 81 patients were included in the study. The number of patients operated on GA (group 1) was 40, and the number of patients operated under CSEA (group 2) was 41. There was no significant difference in the demographic characteristics of the patients. The surgical time was 42.9 and 42.5 minutes in groups 1 and 2, respectively (P=0.970). The mean operative time was recorded as 60.1 and 80.2 minutes in groups 1 and 2, respectively, and it was statistically significantly shorter in group 1 (P<0.001). A peritoneal tear was seen in 18 patients (43.90%) in the GA group and 16 patients (40%) in the CSEA group, but no significant difference was found between the groups (P=0.823). Mild shoulder pain that did not require intervention was observed in 1 patient (2.5%) in the CSEA group. In group 2, the VAS scores at all times and the need for postoperative analgesia were statistically significantly lower (P<0.001). In terms of anesthesia complications, headache was not observed in group 1, while it was seen in 6 (15%) patients in group 2 (P=0.012)

Conclusions:
In laparoscopic TEP surgeries, CSEA may be an alternative anesthesia method to GA anesthesia due to the low VAS score, less need for analgesia, and fewer postoperative pulmonary complications.
Damage control thoracic surgery: What you need to know
Authors: Ghneim Mira H. , O'Connor James V. , Scalea Thomas M. 
Published: October 2024

ABSTRACT
Damage control surgery in trauma prioritizes patient stabilization through an initial temporizing surgical approach to rapidly control hemorrhage and contamination, minimizing intraoperative time to allow for resuscitation and the correction of hypothermia, coagulopathy, and acidosis in the intensive care unit. This is followed by definitive repair of injuries once physiological parameters have improved. While damage control techniques for traumatic intra-abdominal and extremity injuries are well established and frequently utilized, the same cannot be said for damage control thoracic surgery. The complexity of thoracic injuries, the intricate decision making process, the level of surgical expertise required, and potential complications make damage control thoracic surgery particularly challenging. However, advances in surgical techniques, improvements in perioperative care, and the emergence of adjuncts such as extracorporeal membrane oxygenation have significantly enhanced decision making and underscored the importance of timely and decisive intervention in damage control thoracic surgery to optimize patient outcomes. This review aims to provide a comprehensive overview of damage control thoracic surgery, detailing the principles, indications, operative techniques, perioperative management, and the integration of advanced therapies to improve outcomes in patients with severe thoracic injuries.
Clinical Significance of Grade A Small-for-size Syndrome After Living Donor Liver Transplantation Utilizing the New Definition of Diagnostic Criteria: An International Multicenter Study
Authors: Jo Hye-Sung , Kim Dong-Sik , Gunasekaran Vasanthakumar , Krishnamurthy Jagadeesh , Toshima Takeo , Takahashi Ryugen , Kim Jae-Yoon , Krishnan Sathish Kumar , Okumura Shinya , Hara Takanobu , Shimata Keita , Haruki Koichiro , Minnee Robert C. , Rammohan Ashwin , Gupta Subash , Yoshizumi Tomoharu , Ikegami Toru , Lee Kwang-Woong , Rela Mohamed 
Published: October 2024

Background.
New diagnostic criteria have recently been established to classify small-for-size syndrome (SFSS) after living donor liver transplantation into 3 groups based on severity. This study aimed to evaluate the clinical impact of grade A SFSS and identify the mortality risk.

Methods.
We collected data from 406 patients diagnosed with grade A SFSS after living donor liver transplantation. Grade A SFSS is characterized by total bilirubin >5 mg/dL on postoperative day (POD) 7 or total bilirubin >5 mg/dL or ascites >1 L/d on POD 14. After propensity score matching, 193 patients were categorized into the up-trend group, down-trend group, and ascites group, with 43 patients (22.3%) in the up-trend group (total bilirubin on POD 7 < POD 14), 107 patients (55.4%) in the down-trend group (total bilirubin on POD 7 > POD 14), and 43 patients (22.3%) in the ascites group (only satisfying ascites criteria).

Results.
There was no significant difference in survival between patients with grade A SFSS and those without SFSS (P = 0.152). The up-trend group showed a higher 90-d mortality rate than the down-trend and ascites groups (P = 0.025). The 1-y survival rate differed significantly between the groups (87.6%, 91.9%, and 97.7%, respectively; P = 0.044). The independent risk factors for survival were up-trend of total bilirubin, recipient age (65 y and older), model for end-stage liver disease score (≥30), and ABO incompatibility. Patients with ≥2 risk factors had worse survival rates than those with none and only 1 risk factor (P < 0.001).

Conclusions.
Although the survival rate was comparable between the grade A SFSS and non-SFSS cohorts, the up-trend group showed worse survival. Aggressive interventions should be considered for up-trend patients with risk factors.
Urbanization and substance use in left-behind children and adolescents: a systematic review and meta-analysis
Authors: Lin Kelly , Buys Nicholas , Jiang Yannan , Sun Jing 
Published: October 2024

Purpose of review
Inequalities in job opportunities between urban and rural regions have driven many parents to move from rural to urban regions with aims to improve household income. Financial and political barriers prevent children from moving with their parents, meaning that their children become left-behind in rural regions. This study aims to meta-analyse the risk of drinking, smoking, illicit drug use and drunk experiences in left behind children (LBC) and non-LBC.

Recent findings
Previous studies have indicated the negative effects of prolonged parental separation on children and adolescent mental health. Parental separation and poor mental health have both been identified as proximal risk factors for substance use in adolescence.

Summary
The results indicated that LBC were at significantly greater risk of drinking, smoking, using illicit drugs, and having drunk experiences. Positive psychology interventions are required to help provide LBC with positive coping strategies against psychological distress. Policy changes to reduce inequalities in job opportunities between urban and rural regions are required to reduce the prevalence of LBC.
Cell-based high-content approach for SARS-CoV-2 neutralization identifies unique monoclonal antibodies and PI3K pathway inhibitors
Authors: Cabel Carly R. , Guzman Briana A. , Alizadeh Elaheh , Li Shuaizhi , Holberg Cameron , Wichaidit Chonlarat , Cusanovich Darren A. , Paek Andrew L. , Thatcher Gregory R. J. , Doorslaer Koenraad Van , Nargi Rachel S. , Sutton Rachel E. , Suryadevara Naveenchandra , Crowe James E. , Carnahan Robert H. , Campos Samuel K. , Thorne Curtis A. 
Published: October 2024

ABSTRACTThe sudden rise of the SARS-CoV-2 virus and the delay in the development of effective therapeutics to mitigate it made evident a need for ways to screen for compounds that can block infection and prevent further pathogenesis and spread. Yet, identifying effective drugs efficacious against viral infection and replication with minimal toxicity for the patient can be difficult. Monoclonal antibodies were shown to be effective, yet as the SARS-CoV-2 mutated, these antibodies became ineffective. Small molecule antivirals were identified using pseudovirus constructs to recapitulate infection in non-human cells, such as Vero E6 cells. However, the impact was limited due to poor translation of these compounds in the clinical setting. This is partly due to the lack of similarity of screening platforms to the in vivo physiology of the patient and partly because drugs effective in vitro showed dose-limiting toxicities. In this study, we performed two high-throughput screens in human lung adenocarcinoma cells with authentic SARS-CoV-2 virus to identify both monoclonal antibodies that neutralize the virus and clinically useful kinase inhibitors to block the virus and prioritize minimal host toxicity. Using high-content imaging combined with single-cell and multidimensional analysis, we identified antibodies and kinase inhibitors that reduce virus infection without affecting the host. Our screening technique uncovered novel antibodies and overlooked kinase inhibitors (i.e. PIK3i, mTORi, multiple RTKi) that could be effective against SARS-CoV-2 virus. Further characterization of these molecules will streamline the repurposing of compounds for the treatment of future pandemics and uncover novel mechanisms viruses use to hijack and infect host cells.
Compression andk-mer based Approach For Anticancer Peptide Analysis
Authors: Ali Sarwan , Ali Tamkanat E , Chourasia Prakash , Patterson Murray 
Published: October 2024

AbstractOur research delves into the imperative realm of anti-cancer peptide sequence analysis, an essential domain for biological researchers. Presently, neural network-based methodologies, while exhibiting precision, encounter challenges with a substantial parameter count and extensive data requirements. The recently proposed method to compute the pairwise distance between the sequences using the compression-based approach [26] focuses on compressing entire sequences, potentially overlooking intricate neighboring information for individual characters (i.e., amino acids in the case of protein and nucleotide in the case of nucleotide) within a sequence. The importance of neighboring information lies in its ability to provide context and enhance understanding at a finer level within the sequences being analyzed. Our study advocates an innovative paradigm, where we integrate classical compression algorithms, such as Gzip, with a pioneeringk-mersbased strategy in an incremental fashion. Diverging from conventional techniques, our method entails compressing individualk-mers and incrementally constructing the compression for subsequences, ensuring more careful consideration of neighboring information for each character. Our proposed method improves classification performance without necessitating custom features or pre-trained models. Our approach unifies compression, Normalized Compression Distance, andk-mers-based techniques to generate embeddings, which are then used for classification. This synergy facilitates a nuanced understanding of cancer sequences, surpassing state-of-the-art methods in predictive accuracy on the Anti-Cancer Peptides dataset. Moreover, our methodology provides a practical and efficient alternative to computationally demanding Deep Neural Networks (DNNs), proving effective even in low-resource environments.
Modeling Thoracic Aortic Dissection Using Patient-Specific iPSCs Reveals VSMC Dysfunction and Extracellular Matrix Dysregulation
Authors: Jin Peifeng , Xu Yubin , Wang Sixian , Ding Lu , Chen Yuhao , Zhou Miqi , Chen Xiufang , Fang Xiaofang , Gong Yongsheng , Li Ming , Wang Yongyu 
Published: October 2024

AbstractThoracic aortic dissection (TAD) is a life-threatening condition characterized by medial degeneration and vascular smooth muscle cell (VSMC) dysfunction, with no effective medical therapy currently available. The underlying pathological mechanisms of TAD remain incompletely understood. In this study, we used a non-integrated episomal vector-based reprogramming system to generate induced pluripotent stem cells (iPSCs) from TAD patients and healthy controls. Both TAD and normal iPSCs expressed key pluripotency markers and were capable of differentiating into the three germ layers in vitro. These iPSCs were differentiated into VSMCs through a mesodermal intermediate for disease modeling. VSMCs derived from both TAD and normal iPSCs expressed smooth muscle α-actin (α-SMA), calponin, and SM22α. However, TAD-iPSC-derived VSMCs exhibited significantly reduced contraction in response to carbachol stimulation compared to their normal counterparts. Whole-exome sequencing identified a mutation in the COL4A2 gene (c.392G>T, p. R131M) in TAD-iPSCs. This mutation was associated with reduced collagen IV expression and increased expression of collagen I and III in TAD-VSMCs, both with and without TGF-β stimulation. Furthermore, noncanonical TGF-β signaling was hyperactivated in TAD-VSMCs, accompanied by elevated MMP9 expression. This patient-specific iPSC model reveals key dysfunctions in VSMC contractility, extracellular matrix protein expression, and dysregulated TGF-β signaling, which may contribute to TAD pathogenesis. Our findings provide new insights into the molecular mechanisms driving TAD and offer a platform for future therapeutic development.
Primosomal protein PriC rescues replication initiation stress by bypassing the DnaA-DnaB interaction step for DnaB helicase loading atoriC
Authors: Yoshida Ryusei , Korogi Kazuma , Wu Qinfei , Ozaki Shogo , Katayama Tsutomu 
Published: October 2024

AbstractInEscherichia coli, replisome and replication fork assembly are initiated by DnaB helicase loading at the chromosomal originoriCvia its interactions with the DnaA initiator and the DnaC helicase loader. Upon replication fork arrest, the replisome including DnaB dissociates from the stalled fork. Replication fork progression is rescued by primosomal protein PriA- or PriC-dependent pathway in which PriA and PriC promote reloading of DnaB in different mechanisms. However, the mechanism responsible for rescue of blocked replication initiation atoriCremains unclear. Here, we found that PriC rescued blocked replication initiation in cells expressing an initiation-specific DnaC mutant, in mutant cells defective in DnaA-DnaB interactions, and in cells containing truncatedoriCsequence variants. PriC rescued DnaB loading atoriCeven in the absence of Rep helicase, a stimulator of the PriC-dependent replication fork restart pathway. These and results ofin vitroreconstituted assays concordantly suggest that this initiation-specific rescue mechanism provides a bypass of the DnaA-DnaB interaction for DnaB loading by PriC-promoted loading of DnaB to the unwoundoriCregion. These findings expand understanding of mechanisms sustaining the robustness of replication initiation and specific roles for PriC in the genome maintenance.
A quantitative multi-parameter mapping protocol standardized for clinical research in autoimmune neuroinflammatory diseases with white matter abnormalities
Authors: Trang Henri , Hartung Tim J. , Chen Qianlan , Hetzer Stefan , Chien Claudia , Sperber Pia S. , Schmitz-Hübsch Tanja , Asseyer Susanna , Rust Rebekka , Mewes Darius , Anderhalten Lina , Sy Michael , Brandt Alexander U. , Finke Carsten , Paul Friedemann 
Published: October 2024

AbstractQuantitative magnetic resonance imaging (qMRI) involves mapping microstructure in standardized units sensitive to histological properties and supplements conventional MRI, which relies on contrast weighted images where intensities have no biophysical meaning. While measuring tissue properties such as myelin, iron or water content is desired in a disease context, qMRI changes may typically reflect mixed influences from aging or pre-clinical degeneration. We used a fast multi-parameter mapping (MPM) protocol for clinical routine at 3T to reconstruct whole-brain quantitative maps of magnetization transfer saturation (MT), proton density (PD), longitudinal (R1), and transverse relaxation rate (R2*) with 1.6 mm isotropic resolution. We report reference MPM values from a healthy population with age and gender distributions typical of neuroimmunology studies in whole brain white matter (WM), T2-weighted WM hyperintensities, cortical grey matter and deep grey matter regions and present post-processing optimizations including integration of lesions and normalization of PD maps against cerebrospinal fluid (CSF) for standardized research in multiple sclerosis (MS) and related disorders. PD maps were affected by WM abnormalities in MS using WM calibration. The results acknowledge the impact of non-linear age effects on MPM and suggest using CSF calibration for future clinical application in autoimmune neuroinflammatory diseases with WM abnormalities.
Characterization and Racial Stratification of Social Determinants of Health for Individuals with Type 2 Diabetes as Recorded in Electronic Health Records: Implications for Artificial Intelligence Development
Authors: Kukhareva Polina V. , O’Brien Matthew J. , Malone Daniel C , Kawamoto Kensaku , Gouripeddi Ramkiran , Reddy Deepika , Zhang Mingyuan , Deshmuch Vikrant G. , Facelli Julio C. 
Published: October 2024

AbstractBackgroundAccurate documentation of social determinants of health (SDoH) in electronic health records (EHRs) is critical for developing equitable AI models for diabetes management. This study investigates SDoH data in a cross-institutional EHR database.MethodsWe analyzed neighborhood-level (i.e., social vulnerability index [SVI], Rural-Urban Community Area [RUCA]) and individual-level SDoH (e.g., preferred language, marital status, tobacco, alcohol, and substance use) within the Epic Cosmos database, focusing on adults diagnosed with T2D (E11.*) who had encounters between 2021 and 2023. We measured data completeness (i.e., the proportion of individuals who have a non-missing value) and the prevalence of non-canonical values (e.g., preference for language other than English) for each available SDoH variable.FindingsThe study included 12,696,680 individuals with T2D. SVI, RUCA and preferred language were available for all individuals, while marital status, and smoking data were available for over 90%. However, financial needs, interpersonal violence, social activity, and physical activity were present in EHRs for 7.6%-24.6% of the population depending on race/ethnicity. Minority groups experienced lower data completeness and higher burden of non-canonical values compared to White individuals.InterpretationNeighborhood-level and some individual-level SDoH have potential for use in AI development and evaluation. Other SDoH data cannot be used without additional analysis to address high amounts of missing data. Significant disparities in completeness exist across racial/ethnic groups. Addressing these data gaps may require government and payer mandates, standardized SDoH screening tools, and personnel training.HighlightsThis study examined social determinants of health (SDoH) data for adults with type 2 diabetes in a cross-institutional electronic health record (EHR) database to support equitable AI model development.Neighborhood-level SDoH data and some individual-level SDoH data (individual-level SDoH (i.e., race/ethnicity, preferred language, marital status) were highly complete.Disparities in SDoH data completeness by race/ethnicity underscore the need for standardized SDoH documentation.
Association of RDoC dimensions with post-mortem brain transcriptional profiles in Alzheimer’s Disease
Authors: Jiang Weiqian , Vogelgsang Jonathan , Dan Shu , Durning Peter , McCoy Thomas H. , Berretta Sabina , Klengel Torsten 
Published: October 2024

AbstractINTRODUCTIONNeuropsychiatric symptoms are common in people with Alzheimer’s disease (AD) across all severity stages. Their heterogeneous presentation and variable temporal association with cognitive decline suggest shared and distinct biological mechanisms. We hypothesized that specific patterns of gene expression associate with distinct NIMH Research Domain Criteria (RDoC) domains in AD.METHODSPost-mortem bulk RNAseq on the insula and anterior cingulate cortex from 60 brain donors representing the spectrum of canonical AD neuropathology combined with natural language processing approaches based on the RDoC Clinical Domains.RESULTSDistinct sets of >100 genes (pFDR<0.05) were specifically associated with at least one clinical domain (Cognitive, Social, Negative, Positive, Arousal). In addition, dysregulation of immune response pathways was shared across domains and brain regions.DISCUSSIONOur findings provide evidence for distinct transcriptional profiles associated with RDoC domains suggesting that each dimension is characterized by specific sets of genes providing insight into the underlying mechanisms.
Predictors and outcomes of pulmonary hypertension after mitral valve replacement in severe mitral regurgitation
Authors: Rocío García-Orta , Mercedes González Molina , Inés Uribe Morales , Lucía Torres Quintero , Diego J. Rodríguez Torres , Diego Segura Rodríguez , Eduardo Moreno Escobar 
Published: October 2024

ABSTRACTBackgroundThe objective of the study was to determine perioperative clinical and echocardiographic factors associated with pulmonary hypertension (PH) during long-term follow-up of patients with severe primary mitral regurgitation (MR) after mitral valve replacement surgery and its prognostic repercussions.MethodsProspective cohort of consecutive patients undergoing mitral valve replacement between January 2005 and January 2015 and followed for ≥3 years. Main exclusion criteria were receipt of mitral repair surgery and the presence of mitral stenosis. The main outcome was a systolic pulmonary pressure (SPAP) by echocardiography >50 mmHg at least 12 months’ post-surgery.Results106 patients, 46% male, mean age of 61.7±11 yrs. and median follow-up of 8.8 [6- 16] yrs. SPAP was >50 mmHg in 33% of patients. Predictors identified by multivariate analysis were diabetes (OR 8.3, 95%CI 1.1-73.9), persistent atrial fibrillation (OR 4.2, 95%CI 1.1-20.6), non-rheumatic MR (OR 7.3, 95%CI 1.1-45.5), prosthesis gradient, (OR 2.8, 95%CI 1.3-5.7), patient-prosthesis mismatch (OR 16.9, 95%CI 1.2-234), and preoperative SPAP ≥50 mmHg (OR 19.3, 95%CI 3.4-107). Patients with PH had higher hospitalization (78.8 % vs. 37%, p<0.001) and mortality (72,4% vs. 19,7%, p<0.001) rates. The 10-year survival rate was 83% in patients without PHversus30% in those with PH (p<0.001).ConclusionsPersistent PH is a frequent and serious long-term complication of valve replacement for severe mitral regurgitation. It is associated with a poor prognosis and is related to preoperative pulmonary pressure. Surgery could be considered in candidates for mitral valve replacement with moderate PH, especially in the presence of atrial fibrillation.Clinical perspectiveWhat is already known on this topicPulmonary hypertension is not reversed in an important subset of patients with severe mitral regurgitation after mitral valve replacement surgery and it is associated with a poor prognosis.No prospective study has been published on preoperative factors associated with this condition. The prevalence and prognosis of postoperative PH has not been precisely described.What this study addsPersistent PH after valve replacement for severe mitral regurgitation is common and its prognosis is ominous.Preoperative SPAP ≥50 mmHg and persistent atrial fibrillation are the main predictive factors. The results of this study might affect clinical practice suggesting considering surgery in this population (not only in mitral valve repair) when SPAP ≥50 mmHg, especially if persistent atrial fibrillation.Graphical abstract