bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of short-term outcomes of robotic versus open pancreaticoduodenectomy: a meta-analysis of randomized controlled trials and propensity-score-matched studies
Authors: Tang Gang , Zhang Linyu , Xia Lingying , Zhang Jie , Chen Rui , Zhou Rongxing 
Published: June 2024

Background:
Robotic pancreaticoduodenectomy (RPD) is used more commonly, but this surge is mostly based on observational data. This meta-analysis aimed to compare the short-term outcomes between RPD and open pancreaticoduodenectomy (OPD) using data collected from randomized controlled trials (RCTs) and propensity-score-matched (PSM) studies.

Methods:
We searched PubMed, Cochrane Library, Embase, and Web of Science databases for RCTs and PSM studies comparing RPD and OPD. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated.

Results:
Twenty-four studies, encompassing two RCTs and 22 PSM studies, were included, with a total of 9393 patients (RPD group: 3919 patients; OPD group: 5474 patients). Although RPD was associated with a longer operative time (MD, 61.61 min), patients may benefit from reduced blood loss (MD, −154.05 ml), shorter length of stay (MD, −1.60 days), lower blood transfusion rate (RR, 0.85), and wound infection rate (RR, 0.61). There were no significant differences observed in 30-day readmission (RR, 0.99), 90-day mortality (RR, 0.97), overall morbidity (RR, 0.88), major complications (RR, 1.01), reoperation (RR, 1.08), bile leak (RR, 1.01), chylous leak (RR, 0.98), postoperative pancreatic fistula (RR, 0.97), post-pancreatectomy hemorrhage (RR, 1.15), delayed gastric emptying (RR, 0.88), number of harvested lymph nodes (MD, −0.12), and R0 resection (RR, 1.01) between the groups.

Conclusions:
Although some short-term outcomes were similar between RPD and OPD, RPD exhibited reduced intraoperative blood loss, shorter hospital stays, lower wound infection, and blood transfusion rates. In the future, RPD may become a safe and effective alternative to OPD.
Semaglutide outperforms insulin in restoring neutrophil function against implant-related infection in diabetic and obese mice: experimental research
Authors: Liu Tiexin , Zhou Lenian , Chen Yiwei , Lin Junqing , Zhu Hongyi 
Published: June 2024

Background:
Bone and joint infections (BJI) are a significant complication after arthroplasty and fracture fixation, particularly challenging in patients with type 2 diabetes mellitus (T2DM) and obesity. Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), has shown efficacy in managing T2DM and obesity. However, its impact on BJI risk and neutrophil function remains unclear. To investigate whether preoperative semaglutide treatment (1) reduces the risk of BJI in diabetic and obese mice undergoing intra-articular implants, and (2) outperforms insulin in restoring neutrophil function to mitigate implant-related infection.

Methods:
A C57BL/6 mouse model of T2DM/obesity was induced using a high-fat diet (HFD) for 12 weeks. Mice received preoperative insulin or semaglutide therapy for 1–28 days. BJI risk was assessed using an intra-articular-implant model challenged with Staphylococcus aureus or Escherichia coli. The neutrophil function was evaluated through bactericidal activity, superoxide production, and migration ability.

Results:
Semaglutide treatment led to a significant and sustained reduction in body weight and improved glucose tolerance in HFD mice. Both insulin and semaglutide therapies significantly reduced BJI risk, with semaglutide showing a more pronounced effect over time. Semaglutide therapy also enhanced neutrophil bactericidal activity, superoxide production, and migration ability compared to insulin therapy.

Conclusions:
Preoperative semaglutide treatment effectively reduces BJI risk and improves neutrophil function in diabetic and obese mouse models. These findings suggest that semaglutide may be a promising pharmacological intervention to mitigate infection risk in orthopedic patients with T2DM or obesity.
Nutritional aspects in patients with gastroparesis
Authors: Wierzbicka Adrianna , Ukleja Andrew 
Published: June 2024

Purpose of review
The purpose of this review was to highlight most recent updates on nutritional aspects in gastroparesis (GP) focusing on dietary recommendations, utilization of enteral and parenteral nutrition, endoscopic and surgical interventions.

Recent findings
Recent data addressed eating patterns, nutritional interventions, and clarifications on the role of endoscopic and surgical interventions underlying an impact on nutritional management of GP patients. They support the importance of gastroparesis-specific diet in addition to drug therapy, and confirm the benefits of a modified low-fat, low-fiber diet. Current guidelines suggest a new approach to GP management based on predominant symptoms. Gastric peroral endoscopic pyloromyotomy (G-POEM) and surgical gastric electrical stimulator (GES) placement may be considered in individuals with nausea and vomiting before the need for jejunostomy tube placement for enteral feeding or parenteral nutrition.

Summary
Current literature supports the importance of dietary interventions, focusing on low-fat and low-fiber diets, in addition to drug therapies. Severely fiber-restrictive diets may not be necessary. There is enhanced understanding when jejunal feeding should be incorporated for refractory cases with consideration of G-POEM or/and GES even before jejunal tube placement. This approach will require patient evaluation in specialized motility centers.
Risk and factors determining diabetes after mild, nonnecrotizing acute pancreatitis
Authors: Pichardo-Lowden Ariana , Goodarzi Mark O. , Trikudanathan Guru , Serrano Jose , Dungan Kathleen M. 
Published: June 2024

Purpose of review
Diabetes mellitus (DM) is relatively common following acute pancreatitis (AP), even after mild acute pancreatitis (MAP), the most frequent AP presentation, in which there is no overt beta cell injury. Post-AP related diabetes is widely misdiagnosed, resulting in potentially inappropriate treatment and worse outcomes than type 2 diabetes (T2D). Thus, it is important to understand risk across the spectrum of AP severity.

Recent findings
Biological mechanisms are unclear and may include local and systemic inflammation leading to beta cell dysfunction and insulin resistance, altered gut barrier and/or gut peptides and possibly islet autoimmunity, though no studies have specifically focused on MAP. While studies examining clinical risk factors on MAP exclusively are lacking, there are studies which include MAP. These studies vary in scientific rigor, approaches to rule out preexisting diabetes, variable AP severity, diagnostic testing methods, and duration of follow-up. Overall, disease related factors, including AP severity, as well as established T2D risk factors are reported to contribute to the risk for DM following AP.

Summary
Though numerous studies have explored risk factors for DM after AP, few studies specifically focused on MAP, highlighting a key knowledge gap that is relevant to the majority of patients with AP.
Labor Support during the Early Months of the COVID-19 Pandemic in the United States
Authors: Tucker Janet Adams , Waller Melody , Fouquier Kate , Fant Melanie , Rhoads Sarah 
Published: June 2024

Abstract

Purpose:
To describe the experiences of registered nurses and certified nurse midwives who provided labor support and care in the early months of the COVID-19 pandemic.

Study Design and Methods:
A descriptive, qualitative approach was used to explore nurses' and midwives' perceptions via in-depth interviews. Data were analyzed via thematic analysis.

Results:
Thirteen nurses, four of whom were also midwives, participated in semi-structured interviews. All provided care during the first 9 months of the pandemic and represented seven states across the United States. The analysis revealed an overarching theme, A New World but still a Celebration. This overarching theme encompasses participants' accounts of trying to provide the same support, presence, and celebration while dealing with constant policy changes, the impact of limited family presence in labor, and their own fears and risks. Four sub-themes were identified: The Impact of Nursing during COVID-19; Challenges, Changes, and Consequences; Unexpected Benefits; and The Cost.

Clinical Implications:
The first year of the COVID-19 pandemic saw unprecedented challenges for nurses. Practice changes due to these changing policies had negative and positive effects. Negative practices affected family support, decreased interprofessional collaboration, and caused shorter hospital stays for new mothers. Some positive aspects of practice changes included additional time for mother–newborn bonding due to restrictive visitation policies, increased initiation of breastfeeding, and focused patient education. Nurses across the United States are still coping with practice changes from the pandemic. Our study highlights the need to support nurses in adapting care in the midst of practice changes.
Pre-Pandemic Versus Early COVID-19 Perinatal Outcomes at a Military Hospital
Authors: Gibson Brandi L. , Urbieta Dehussa , Sweeney Sheila , Ferguson Jane A. , Glaser Dale , Marter Abigail Yablonsky 
Published: June 2024

Abstract

Purpose:
The purpose of this study was to examine the impact of the first year of COVID-19 pandemic on maternal and neonatal outcomes at a large military treatment facility in Southern California.

Study Design and Methods:
A retrospective review of maternal and neonatal medical records was conducted between January 1, 2019, and December 31, 2020. Outcomes measured included stillbirth rate, neonatal intensive care unit admission, neonatal death, cesarean birth, and postpartum hemorrhage.

Results:
A total of 4,425 records were analyzed. Rates of stillbirth between the years did not vary. The neonatal death rate decreased more than 50% in 2020 (p = .149). Cesarean births rose by 2.7% in 2020 (p = .046). Rates of postpartum hemorrhage did not vary between years.

Clinical Implications:
The impact of COVID-19 on maternal and neonatal outcomes at a military treatment facility in the first year of the COVID-19 pandemic provides guidance for optimizing perinatal health care. Vertical transmission of COVID-19 is low and routine testing of asymptomatic neonates of positive mothers may not be necessary. COVID-19 infections should not be an indication for cesarean birth and are not associated with neonatal deaths or NICU admission.
Fatigue Is Associated With Perceived Effort and 2-Dimensional Reach Performance After Stroke
Authors: Goh Hui-Ting , Stewart Jill , Becker Kevin 
Published: June 2024

Background and Purpose:
Poststroke fatigue (PSF) is prevalent and often manifests as high perceived effort during activities. Little is known about how PSF influences goal-directed reaching after stroke. The purpose of this study was 2-fold (1) to evaluate how perceived effort changed when individuals with stroke performed a reaching task with various demands and (2) to determine whether PSF was associated with perceived effort during reaching and reach performance.

Methods:
Thirty-six individuals with chronic stroke performed 2-dimensional reach actions under varied conditions with the more and less affected arms. Perceived effort during reaching was assessed using rating of perceived exertion (RPE) and Paas Mental Effort Rating Scale (MERS). Derived reach kinematics were used to quantify reach performance. The Fatigue Severity Scale (FSS) was administered to assess fatigue severity.

Results:
Perceived effort was higher when participants reached with the more affected arm, reached toward far and small targets, and performed memory-guided reaching. Both RPE and MERS significantly correlated with the FSS score (r = 0.50 and 0.35, respectively, P < 0.05). Further, FSS correlated with movement time during the more affected arm reaching (ρ = 0.40, p < 0.05) and reach performance discrepancy between the fast and self-selected speed conditions when participants performed with the less affected arm (ρ = 0.36, P < 0.05). Exploratory analysis revealed that the relationship between fatigue and reach control appeared to be modulated by task demand.

Discussion and Conclusions:
PSF is associated with perceived effort during reaching and reach performance after stroke. These relationships might offer insights into arm performance in the real world after stroke.

Video Abstract:
for more insights from the authors Supplemental Digital Content available at http://links.lww.com/JNPT/A476
Robotic exoskeleton-assisted gait training in patients with motor incomplete myelopathy
Authors: Gupta Anupam , Prakash Navin B. , Honavar Preethi , S Jotheeswaran , Khanna Meeka , Ramakrishnan Subasree 
Published: June 2024

Objectives:
To assess the effect of gait training with robotic exoskeleton-assisted rehabilitation systems on gait parameters, balance, and overall disability in motor incomplete myelopathy.

Design:
Prospective pre-post study.

Setting:
Neurological rehabilitation unit in a tertiary university teaching hospital.

Participants:
Thirty-four motor incomplete myelopathy patients [22 males, mean age 36.7 y (12.7)] were included in this prospective, pre-post study. Twenty-two had nontraumatic etiology, and 17 had tetraplegia. American Spinal Injury Association impairment scale suggested 23 as C and 11 as American Spinal Injury Association impairment scale-D. The mean duration of the lesion was 333 days.

Intervention:
Twenty-four sessions of robotic gait training (1-h session, 5–6 sessions/wk) for 4–6 weeks.

Outcome measures:
Gait speed was assessed using a 10-meter walk test (10MWT), endurance with a 2-minute walk test (2MWT) and 6-minute walk test (6MWT), walking ability by Walking Index in Spinal Cord Injury-walking index for spinal cord injury II, functionality using Spinal cord Independence Measure-SCIM III, and balance by Timed-up-and-go (TUG) test.

Results:
At baseline, 20 patients were nonwalkers-NWB, and 14 were walkers-WB. The walking index for spinal cord injury II and SCIM III suggested significant improvement in both groups by the end of the study (P<0.05). Among the WB group, 10MWT, 2MWT, and TUG showed significant improvement (P=0.004, 0.02, and 0.01, respectively) with training. Patients in NWB group were able to perform 10MWT, 2MWT, 6MWT, and TUG by the end of the study.

Conclusions:
Gait training with robotic exoskeleton-assisted rehabilitation systems can lead to a significant improvement in gait endurance, speed, balance, and functional outcomes in individuals with incomplete myelopathy. The effect is more pronounced among already ambulatory patients.
Breaking Down Silos in the Workplace: A Framework to Foster Collaboration
Authors: Jones Anita A. , Uhd Justin , Kabore Charlotte D. , Cornett Kelly A. 
Published: June 2024

Introduction:
Employees are often placed within an organization based on their respective roles or duties, which can lead to vertical and horizontal organizational silos. Organizational silos may restrict information, resources, and stymie progress and innovation. This analysis presents a framework to mitigate silos and overcome communication barriers within an organization by increasing collaboration.

Methods:
The project team examined results from the Centers for Disease Control and Prevention (CDC), the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) 2020 Employee Viewpoint Survey Results and conducted 19 key informant discussions with NCCDPHP employees. Participants were asked to provide feedback on (1) understanding silos in the workplace and (2) best practices for reducing silos and fostering collaboration. A thematic analysis was conducted to understand organizational silos, the motivation to reduce silos, and identify best practices and strategies.

Results:
Respondents felt that siloing exists at the division and branch levels; however, 95% of respondents were motivated to reduce silos. Fifty-eight percent of respondents identified that institutional factors such as the organizational structure (n = 8) and red tape/bureaucracy (n = 3) contribute to siloing. Additional behaviors and actions that perpetuate silos were identified, and efforts to reduce silos were categorized to propose a model: Framework to Foster Collaboration for improving organizational collaborative efforts.

Discussion and Conclusion:
Key themes included inclusion, shared goals and vision, bi-directional communication, and relationship building and developing trust as critical elements for improving collaboration and creating synergy across teams in efforts to reduce silos in the workplace.
Stereoelectroencephalography of the Deep Brain: Basal Ganglia and Thalami
Authors: Pati Sandipan , Agashe Shruti , Kheder Ammar , Riley Kristen , Gavvala Jay , McGovern Robert , Suresh Surya , Chaitanya Ganne , Thompson Stephen 
Published: June 2024

Summary:
Stereoelectroencephalography (SEEG) has emerged as a transformative tool in epilepsy surgery, shedding light on the complex network dynamics involved in focal epilepsy. This review explores the role of SEEG in elucidating the role of deep brain structures, namely the basal ganglia and thalamus, in epilepsy. SEEG advances understanding of their contribution to seizure generation, propagation, and control by permitting precise and minimally invasive sampling of these brain regions. The basal ganglia, comprising the subthalamic nucleus, globus pallidus, substantia nigra, and striatum, have gained recognition for their involvement in both focal and generalized epilepsy. Electrophysiological recordings reveal hyperexcitability and increased synchrony within these structures, reinforcing their role as critical nodes within the epileptic network. Furthermore, low-frequency and high-frequency stimulation of the basal ganglia have demonstrated potential in modulating epileptogenic networks. Concurrently, the thalamus, a key relay center, has garnered prominence in epilepsy research. Disrupted thalamocortical connectivity in focal epilepsy underscores its significance in seizure maintenance. The thalamic subnuclei, including the anterior nucleus, centromedian, and medial pulvinar, present promising neuromodulatory targets, suggesting pathways for personalized epilepsy therapies. The prospect of multithalamic SEEG and thalamic SEEG stimulation trials has the potential to revolutionize epilepsy management, offering tailored solutions for challenging cases. SEEG's ability to unveil the dynamics of deep brain structures in epilepsy promises enhanced and personalized epilepsy care in our new era of precision medicine. Until deep brain SEEG is accepted as a standard of care, a rigorous informed consent process remains paramount for patients for whom such an exploration is proposed.
Towards routine proteome profiling of FFPE tissue: Insights from a 1,200 case pan-cancer study
Authors: Tüshaus Johanna , Eckert Stephan , Fraefel Marius , Zhou Yuxiang , Pfeiffer Pauline , Halves Christiane , Fusco Federico , Weigl Johannes , Hönikl Lisa , Butenschön Vicki , Todorova Rumyana , Rauert-Wunderlich Hilka , The Matthew , Rosenwald Andreas , Heinemann Volker , Holch Julian , Meyer Bernhard , Weichert Wilko , Mogler Carolin , Hendrik-Kuhn Peer , Kuster Bernhard 
Published: June 2024

AbstractProteome profiling of formalin-fixed paraffin-embedded (FFPE) specimens has gained traction for the analysis of cancer tissue for the discovery of molecular biomarkers. However, reports so far focused on single cancer entities, comprised relatively few cases and did not assess the long-term performance of experimental workflows. Here, we did so by analyzing 1,220 tumors from six cancer entities processed over the course of three years. Key findings include the need for a new normalization method ensuring equal and reproducible sample loading for LC-MS/MS analysis across cohorts, showing that tumors can, on average, be profiled to a depth of >4,000 proteins and discovering that current software fails to process such large data sets. We report the first comprehensive pan-cancer proteome expression resource for FFPE material comprising 11,000 proteins which is of immediate utility to the scientific community by way of a web resource. It enables a range of analysis including quantitative comparisons of proteins between patients or cohorts or the discovery of protein fingerprints representing the tissue of origin, or proteins enriched in certain cancer entities.
Phylogenetics and genomic variation of two genetically distinctHepatocystisclades isolated from shotgun sequencing of wild primate hosts
Authors: Haffener Paige E. , Hopson Helena D. , Leffler Ellen M. 
Published: June 2024

AbstractHepatocystisare apicomplexan parasites nested within thePlasmodiumgenus that infect primates and other vertebrates, yet few isolates have been genetically characterized. Using taxonomic classification and mapping characteristics, we searched forHepatocystisinfections within publicly available, blood-derived low coverage whole genome sequence (lcWGS) data from 326 wild non-human primates (NHPs) in 17 genera. We identified 30Hepatocystisinfections inChlorocebusandPapiosamples collected from locations in west, east, and south Africa.Hepatocystis cytbsequences fromPapiohosts phylogenetically clustered with previously reported isolates from multiple NHP taxa whereas sequences fromChlorocebushosts form a separate cluster, suggesting they represent a new host-specific clade ofHepatocystis.Additionally, there was no geographic clustering ofHepatocystisisolates suggesting both clades ofHepatocystiscould be found in NHPs throughout sub-Saharan Africa. Across the genome, windows of high SNP density revealed candidate hypervariable loci includingHepatocystis-specific gene families possibly involved in immune evasion and genes that may be involved in adaptation to their insect vector and hepatocyte invasion. Overall, this work demonstrates how lcWGS data from wild NHPs can be leveraged to study the evolution of apicomplexan parasites and potentially test for association between host genetic variation and parasite infection.Author SummaryNon-human primates are hosts to many species ofPlasmodium, the parasites that cause malaria, and a closely related group of parasites calledHepatocystis. However, due to restrictions and challenges of sampling from wild populations, we lack a complete understanding of the breadth of diversity and distribution of these parasites. Here, we provide a framework for testing already-sampled populations for parasite infections using whole genome sequences derived from whole blood samples from the host. Following taxonomic classification of these sequences using a database of reference genomes, we mapped reads to candidate parasite genomes and used an unsupervised clustering algorithm including coverage metrics to further validate infection inferences. Through this approach, we identified 30Hepatocystisinfections from two genetically distinct clades ofHepatocystisin African non-human primates and described genes that may be under immune selection in each. Most importantly, the framework here can be applied to additional sequencing datasets from non-human primates and other vertebrate hosts as well as datasets from invertebrate vectors. Therefore, this approach could greatly improve our understanding of where these parasites are found, their host-specificity, and their evolutionary history. This framework may also be adapted to study evolution in other host-pathogen groups.