bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maxillary Reconstruction with Free Vascularized Fibula: 15-Year Experience
Authors: Cho Min-Jeong , Padilla Pablo L. , Skoracki Roman J. , Hanasono Matthew M. 
Published: August 2024

Background:
Reconstruction of the midface after maxillectomy is extremely challenging because of the need to reestablish the contour of the midface, maintain oronasal separation, support the orbit, and to restore the dentition. In this study, the authors present their specific technique, surgical and functional outcomes, and pitfalls to avoid for reconstruction of the midface with the fibula osteocutaneous free flap.

Methods:
A retrospective review of patients who underwent maxillary reconstruction with a fibula osteocutaneous free flap was performed.

Results:
Eighty-five flaps were performed in 73 patients (61 patients received a fibula flap only; 12 patients received an additional soft-tissue free flap). Reconstructions were performed for Cordeiro type 2 (82.2%) and Cordeiro type 3a (18.8%) defects. Osseointegrated dental implants were placed in 95.9% of patients, 13.7% of whom underwent immediate implant placement. Concurrent orbital floor reconstruction was performed in 16.2% of patients. The rate of operative take-back was 18.9%, and total flap loss occurred in 2.7%. Hardware exposure occurred in 11.0% at a mean of 4.4 years postoperatively and palatal fistulas occurred in 5.5%, usually within the first 3 weeks following reconstruction. Functionally, 79.5% demonstrated excellent speech and 80.9% had unrestricted diet postoperatively. The mean follow-up period was 3.4 years.

Conclusions:
The present study shows that maxillary reconstruction with free fibula flap provides reliable reconstruction that restores dental, orbital, and midfacial support. Modifications and nuances to the reconstructive technique learned over time to avoid complications and improve outcomes are described herein.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Cultural Influences on the Receipt of Breast Reconstruction: A Scoping Review
Authors: Liang Joey , Flusche Ann Marie , Kaplan Samantha , Rezak Kristen , Sisk Geoffroy C. , Patel Ash 
Published: August 2024

Background:
Postmastectomy breast reconstruction can provide breast cancer patients with lasting psychosocial, functional, and body image benefits. Although sociodemographic factors affecting the receipt of breast reconstruction have been well studied, the cultural factors influencing patients’ decisions to undergo breast reconstruction remain unclear. There are currently no reviews on cultural factors influencing breast reconstruction decision-making. This scoping review aimed to broadly evaluate the current literature on cultural factors that influence the receipt of breast reconstruction in breast cancer patients who have undergone mastectomies.

Methods:
A combination of keywords and subject headings was used to search for articles related to breast reconstruction and decision-making. Databases were searched from inception to November 20, 2023. Screening was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines, and quantitative studies examining the receipt of breast reconstruction in breast cancer patients following mastectomy were evaluated for inclusion.

Results:
Of the 4520 studies that were screened, 61 were included in the final review. The majority of studies included in the review were retrospective and performed in the United States. Included studies were evaluated for cultural influences on the receipt of breast reconstruction. Six themes emerged across the included studies: race and ethnicity, language and communication barriers, education and literacy, cultural competency, patient perceptions, and family and relationships.

Conclusion:
In addition to well-established influences on breast reconstruction such as race and ethnicity, this review broadly identified additional cultural factors that influence patients’ decisions to undergo breast reconstruction.
Evaluation of Prognostic Factors in Adult Chemical Corneal Injury
Authors: Eröz Pinar , Özer Ömer , Güçlü Emin Serbülent , Baysal Zeki , Doğan Levent 
Published: August 2024

Objective:
The aim of this study was to evaluate prognostic factors that may be useful in predicting final visual acuity in patients admitted to the clinic with chemical corneal injuries.

Methods:
Data on age, sex, time to admission, irrigation solutions (balanced salt solution or phosphate buffered saline) and type of substance causing chemical injury were recorded. On admission, all patients were evaluated according to Roper Hall and Dua classifications. At the twelfth month after treatment, all measurements were repeated.

Results:
A total of 131 patients with chemical corneal injuries [group 1 (acid, n = 73) and group 2 (alkaline, n = 58)] were included. The initial best corrected visual acuity (BCVA) level was “20/40 and above” in 32 patients (43.8%) in group 1 and 14 patients (24.1%) in group 2. According to Roper Hall classification, the mean grade was 1.92 ± 0.9 in group 1 and 2.27 ± 1.1 in group 2. According to Dua classification, the mean grade of the patients in group 1 was 2.16 ± 0.9 and 2.58 ± 1.2 in group 2. Posttreatment BCVA level improved to “1/200 to 19/200” in 8 (66.7%) of the patients with an initial BCVA level of “perception of light or hand movements.” In univariate analysis, initial visual acuity and posttreatment visual acuity were statistically significant (P < 0.001). It was also statistically significant in multivariate analysis adjusted for sex and age (P < 0.001).

Conclusion:
In conclusion, the treatment of chemical corneal injuries is a long and exhausting process. The use of initial visual acuity and Dua classification in prognosis prediction may provide high success.
Small versus large-bore thoracostomy for traumatic hemothorax: A systematic review and meta-analysis
Authors: Lyons Nicole B. , Abdelhamid Mohamed O. , Collie Brianna L. , Ramsey Walter A. , O’Neil Christopher F. , Delamater Jessica M. , Cobler-Lichter Michael D. , Shagabayeva Larisa , Proctor Kenneth G. , Namias Nicholas , Meizoso Jonathan P. 
Published: August 2024

BACKGROUND
Traumatic hemothorax (HTX) is common, and while it is recommended to drain it with a tube thoracostomy, there is no consensus on the optimal catheter size. We performed a systematic review to test the hypothesis that small bore tube thoracostomy (SBTT) (≤14 F) is as effective as large-bore tube thoracostomy (LBTT) (≥20F) for the treatment of HTX.

METHODS
Pubmed, EMBASE, Scopus, and Cochrane review were searched from inception to November 2022 for randomized controlled trials or cohort studies that included adult trauma patients with HTX who received a tube thoracostomy. Data was extracted and Critical Appraisal Skills Program checklists were used for study appraisal. The primary outcome was failure rate, defined as incompletely drained or retained HTX requiring a second intervention. Cumulative analysis was performed with χ2 test for dichotomous variables and an unpaired t-test for continuous variables. Meta-analysis was performed using a random effects model.

RESULTS
There were 2,008 articles screened, of which nine were included in the analysis. The studies included 1,847 patients (714 SBTT and 1,233 LBTT). The mean age of patients was 46 years, 75% were male, average ISS was 20, and 81% had blunt trauma. Failure rate was not significantly different between SBTT (17.8%) and LBTT (21.5%) (p = 0.166). Additionally, there were no significant differences between SBTT vs. LBTT in mortality (2.9% vs. 6.1%, p = 0.062) or complication rate (12.3% vs. 12.5%, p = 0.941), however SBTT had significantly higher initial drainage volumes (753 vs. 398 mL, p < 0.001) and fewer tube days (4.3 vs. 6.2, p < 0.001). There are several limitations. Some studies did not report all the outcomes of interest, and many of the studies are subject to selection bias.

CONCLUSION
SBTT may be as effective as LBTT for the treatment of traumatic HTX.

LEVEL OF EVIDENCE
Systematic Review/Meta-Analysis; Level IV.
The effect of whole blood resuscitation on in-hospital mortality: A propensity score weighted analysis of patients treated at a Level I trauma center
Authors: Acharya Pawan , Garwe Tabitha , Vesely Sara K. , Janitz Amanda , Peck Jennifer D. , Celii Amanda 
Published: August 2024

BACKGROUND
Whole blood (WB) transfusion, compared with blood component therapy (CT), has been shown to have superior outcomes in the military population. However, whether this translates to the civilian population remains understudied. This study sought to determine the effect of WB on short-term in-hospital outcomes.

METHODS
This retrospective cohort study included trauma patients at a Level I trauma center who received either WB or CT upon massive transfusion protocol activation between January 2021 and June 2023. The primary outcome was in-hospital mortality, and secondary outcomes included 24-hour mortality, 7-day mortality, 30-day mortality, trauma-induced coagulopathy, and the number of transfusion events required. The effect of transfusion type on patient outcomes was evaluated using a propensity-weighted modified Poisson regression.

RESULTS
Of 1,027 massive transfusion protocol–activated patients, 480 (46.8%) received any WB. The propensity score weighting balanced the covariate distribution between the transfusion groups. Significant effect modification (p < 0.05) by injury type (blunt vs. penetrating) on mortality outcomes was observed. Compared with CT recipients, penetrating trauma patients who received WB had a significantly lower adjusted risk of in-hospital (risk ratio [RR], 0.36; 95% confidence interval [CI], 0.15–0.89), 7-day (RR, 0.37; 95% CI, 0.15–0.94), and 30-day (RR, 0.36; 95% CI, 0.15–0.89) mortality but not significantly different 24-hour mortality (RR, 0.39; 95% CI, 0.15–1.00; p = 0.05). An elevated risk of trauma-induced coagulopathy was observed among WB recipients than CT recipients with blunt trauma (RR, 1.59; 95% CI, 1.07–2.36) but not among patients with penetrating injury (RR, 0.65; 95% CI, 0.30–1.40). Compared with CT recipients, WB recipients had reduced transfusion rates for both penetrating (RR, 0.59; 95% CI, 0.36–0.95) and blunt-related injuries (RR, 0.73; 95% CI, 0.58–0.91).

CONCLUSION
The effect of WB on in-hospital mortality is modified by injury type, suggesting the need to consider penetrating injury as an important indication for WB resuscitation. In addition, WB reduces transfusion requirements across both injury types, decreasing patient exposure to transfusion events.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
Stronger together: harnessing natural algal communities as potential probiotics for inhibition of aquaculture pathogens
Authors: Smahajcsik Dóra , Roager Line , Strube Mikael Lenz , Zhang Sheng-Da , Gram Lone 
Published: August 2024

ABSTRACTIntensive fish rearing in aquaculture is challenged by infectious diseases, and although vaccines have been successfully developed for mature fish, alternative disease control measures are needed for fish larvae and juveniles. Probiotics offer a promising alternative to antibiotics, with the potential to reduce the risk of antibiotic resistance. Probiotics are typically isolated and used as pure cultures, however, in natural environments it is the concerted effort of the complex microbiome that keeps pathogens at bay. Here, we developed anin vitroassay to evaluate the anti-pathogen efficacy of mixed algal microbiomes from the live-feed microalgaeTetraselmis suecicaandIsochrysis galbana.The inhibition of a GFP-taggedVibrio anguillarum, a key fish pathogen, by microbial communities, was measured and quantified as reduction in fluorescence. TheIsochrysis galbanamicrobiome was more inhibitory toV. anguillarumthan theTetraselmis suecicamicrobiome. During co-culture with the pathogen, the bacterial density of theIsochrysismicrobiomes increased whilst the diversity was reduced as determined by metataxonomic analyses. Bacteria isolated from the fully inhibitory microbiomes were members ofAlteromonadaceae, Halomonadaceae, Rhodobacteraceae, Vibrionaceae, Flavobacteriaceae,andErythrobacteraceae. Although some strains individually inhibited the pathogen, these were not the key members of the microbiome and enhanced inhibition was observed whenSulfitobacter pontiacusD3 andHalomonas campaniensisD2 were co-cultured, even though neither were inhibitory as monocultures. Thus, this study demonstrates that microbial communities derived from natural algal microbiomes can have anti-pathogen effects, and that bacterial co-cultures may offer synergistic advantages over monocultures as probiotics, highlighting their promise for aquaculture health strategies.IMPORTANCEAquaculture is the fastest growing food protein producing sector and sustainable disease control measures are required. Probiotics have gained interest as a promising solution for combating fish pathogens and using mixtures of microorganisms rather than pure cultures may represent a more stable pathogen control. We developed an assay using GFP-tagging of a fish pathogen, enabling the quantitative assessment of the anti-pathogen effects of complex microbiomes. We show that the efficiency of pathogen suppression can be increased with co-cultures compared to monocultures, thus emphasising the potential in using mixtures of bacteria as probiotics.
Mutant p53 Exploits Enhancers to Elevate Immunosuppressive Chemokine Expression and Impair Immune Checkpoint Inhibitors in Pancreatic Cancer
Authors: Mahat Dig B. , Kumra Heena , Castro Sarah A. , Metcalf Emily , Nguyen Kim , Morisue Ryo , Ho William W. , Chen Ivy , Sullivan Brandon , Yim Leon K. , Singh Arundeep , Fu Jiayu , Waterton Sean K. , Cheng Yu-Chi , Roberge Sylvie , Moiso Enrico , Chauhan Vikash P. , Silva Hernandez Moura , Spranger Stefani , Jain Rakesh K. , Sharp Phillip A. 
Published: August 2024

SummaryPancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer without effective treatments. It is characterized by activating KRAS mutations and p53 alterations. However, how these mutations dysregulate cancer-cell-intrinsic gene programs to influence the immune landscape of the tumor microenvironment (TME) remains poorly understood. Here, we show that p53R172Hestablishes an immunosuppressive TME, diminishes the efficacy of immune checkpoint inhibitors (ICIs), and enhances tumor growth. Our findings reveal that the upregulation of the immunosuppressive chemokine Cxcl1 mediates these pro-tumorigenic functions of p53R172H. Mechanistically, we show that p53R172Hassociates with the distal enhancers of the Cxcl1 gene, increasing enhancer activity and Cxcl1 expression. p53R172Hoccupies these enhancers in an NF-κB-pathway-dependent manner, suggesting NF-κB’s role in recruiting p53R172Hto the Cxcl1 enhancers. Our work uncovers how a common mutation in a tumor-suppressor transcription factor appropriates enhancers, stimulating chemokine expression and establishing an immunosuppressive TME that diminishes ICI efficacy in PDAC.Graphical Abstract
Control of Physical and Biochemical Parameters Influencing Exogeneous Cargo Protein association to Extracellular Vesicle using Lipid Anchors Enables High Loading and Effective Intracellular Delivery
Authors: Marquant Antonin , Berthelot Jade , Bich Claudia , Elfekih Zeineb Ibn , Simon Laurianne , Robin Baptiste , Chopineau Joël , Wang David Tianpei , Emerson Samuel Jay , Wang Aijun , Benedetti Clément , Langlois Simon , Guglielmi Laurence , Martineau Pierre , Aubert-Pouëssel Anne , Morille Marie 
Published: August 2024

AbstractDespite biomolecule delivery is a natural function of Extracellular Vesicles (EVs), loading of exogenous macromolecules such as proteins into EVs remains a major challenge limiting their interest as convincing protein delivery systems for health applications. In this context, lipid-anchorage of exogenous cargo into EV membrane recently emerged as a promising option to enable their vectorization into cells. Nevertheless, this option was not explored for protein intracellular delivery, and further characterization of the critical parameters governing the association of a lipid-anchored cargo protein to EVs is still needed to confirm the relevance of this anchorage strategy. Therefore, in this work, we have sought to identify these parameters in a precise and quantitative manner, working with bulk and single nanoparticle analysis methods to identify protein loading capacity and subsequent intracellular delivery. Incubation temperature, cargo concentration and Lipid Anchor (LA) structure (lipid nature and PEG size) appeared as critical factors influencing maximal EV loading capacity. Precise control of these parameters enabled to load cargo protein close to EV saturation without hindering cellular delivery. Interestingly, we evidenced that EV isolation process influenced this association. Structural properties of LA influenced not only cargo protein/EV association, but also its intracellular delivery into different carcinoma cell lines. By thoroughly characterizing Lipid-PEG-protein anchorage, this study evidences the interest of this tunable and controllable approach for efficient EV protein delivery.Graphical abstract
TGF-β signaling promotes the expression of proviral circular RNA ciTRAN in HIV-1 infection
Authors: Choudhary Aditi , Mallick Katyayani , Dalavi Rishikesh , Chande Ajit 
Published: August 2024

AbstractCircular RNA (circRNA) expression is widespread in immune cells infected by HIV-1, but the crosstalk between circRNA expression and various cellular signaling pathways remains unclear. We report that HIV-1 Vpr triggers TGF-β signaling, which we linked to the increased expression of ciTRAN, a proviral circRNA encoded bySMARCA5. Consistent with this finding, we observed that the essential intracellular TGF-β receptor signaling component SMAD2/3 was recruited to theSMARCA5promoter in a Vpr-dependent manner.SMARCA5promoter analysis and functional assays further revealed that the SAMD2/3 binding motif is crucial for ciTRAN upregulation. In response to treatment with DNA-damaging agents or the exogenous addition of recombinant TGF-β, the TGF-β-SMAD axis upregulated the expression of ciTRAN as well as the parentalSMARCA5mRNA. Finally, pharmacological targeting of TGF-β signaling or genetic ablation ofTGFBR1can reduce the ability of HIV-1 Vpr to induce the expression of ciTRAN and viral genes. These results offer crucial mechanistic insights into the regulation of ciTRAN expression by TGF-β signaling and suggest a strategy to inhibit circRNA expression during infection by small molecules.
Auditory feedback effect of self-pacing treadmill walking in comparison to overground walking
Authors: Evans Trevor V. , Reissman Megan E. , Reissman Timothy , Shelhamer Mark , Chaudhari Ajit M. W. 
Published: August 2024

AbstractSelf-pacing treadmills provide advantages for assessing locomotion, but there are differences between gait patterns in overground and treadmill paradigms. A potential explanation could be that the variable auditory sound from the treadmill belt motors when changing speed provides artificial sensory feedback to walkers that may influence their motor output while on the self-pacing treadmill. We hypothesized that there would be significantly different temporal measures between the sound and no-sound conditions, and these same measures from the no-sound condition would be similar to overground walking. Participants (n=29) walked under three different conditions for five-minute periods each: on the self-pacing treadmill with sound inclusion, on the self-pacing treadmill with sound exclusion, and overground walking. Significant differences were found in the variability of all temporal walking measurements between the overground and both treadmill conditions (p < 0.05). Effects of sound on temporal walking measurements were not observed. The lack of difference between the two treadmill conditions suggests that self-pacing treadmill walkers may not utilize the variable belt motor sounds available to them. Additionally, overground walking still has different gait patterns compared to self-pacing treadmill walking, so other potential sources of differences should be explored in future work. Given that both treadmill conditions had different temporal gait patterns from overground, considerations for using the self-pacing treadmill as an alternative for overground walking should be taken when studying human locomotion.
Using in vivo calcium imaging to examine joint neuron spontaneous activity and home cage analysis to monitor activity changes in mouse models of arthritis
Authors: Goodwin George L , Marin Alina-Cristina , Walker Julia Vlachaki , Hobbs Carl , Denk Franziska 
Published: August 2024

AbstractBackgroundStudying pain in rodent models of arthritis is challenging. For example, assessing functional changes in joints neurons is challenging due to their relative scarcity amongst all sensory neurons. Additionally, studying pain behaviors in rodent models of arthritis poses its own set of difficulties. Commonly used tests, such as static weight-bearing, often require restraint, which can induce stress and consequently alter nociception. The aim of this study was to evaluate two emerging techniques for investigating joint pain in mouse models of rheumatoid and osteoarthritis:In vivocalcium imaging to monitor joint afferent activity and group-housed home cage monitoring to assess pain-like behaviors. Specifically, we examined whether there was increased spontaneous activity in joint afferents and reduced locomotor activity following induction of arthritis.MethodsAntigen induced arthritis (AIA) was used to model rheumatoid arthritis and partial medial meniscectomy (PMX) was used to model osteoarthritis. Group-housed home cage monitoring was used to assess locomotor behavior in all mice, and weight bearing was assessed in PMX mice.In vivocalcium imaging with GCaMP6s was used to monitor spontaneous activity in L4 ganglion joint neurons retrogradely labelled with fast blue 2 days following AIA and 13-15 weeks following PMX model induction. Cartilage degradation was assessed in knee joint sections stained with Safranin O and fast green in PMX mice.ResultsAntigen induced arthritis produced knee joint swelling and PMX caused degeneration of articular cartilage in the knee. In the first 46 hours following AIA, mice travelled less distance and were less mobile compared to their control cage mates. In contrast, no such differences were found between PMX and sham mice when measured between 4-12 weeks post-surgery. A larger fraction of joint neurons showed spontaneous activity in AIA but not PMX mice. Spontaneous activity was mostly displayed by medium-sized neurons in AIA mice and was not correlated with any of the home cage behaviors.ConclusionGroup-housed home cage monitoring revealed locomotor changes in AIA mice, but not PMX mice (with n=10/group).In vivocalcium imaging can be used to assess activity in multiple retrogradely labelled joint afferents and revealed increased spontaneous activity in AIA but not PMX mice.