bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interim analysis of short-term outcomes after laparoscopic spleen-preserving distal pancreatectomy with or without preservation of splenic vessels: a randomised controlled trial
Authors: Chen Qiangxing , Fu Yangzhi , Li Yongbin , Cai He , Wang Xin , Wu Zhong , Meng Lingwei , Zhang Man , Chen Zixin , Jiang Jingwen , Cheng Ke , Li Jun , Zhang Dian , Cai Yu , You Jiaying , Cai Yunqiang , Peng Bing 
Published: July 2024

Background:
Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) is a widely adopted surgical approach for benign and low-grade malignant neoplasms of the distal pancreas. The Kimura and Warshaw techniques represent two principal strategies, yet it still needs to be determined which one is superior. Our investigation aimed to evaluate the clinical outcomes associated with each technique.

Materials and methods:
This single-center, parallel-group, patient-blinded randomized controlled trial was conducted at the West China Hospital of Sichuan University. Stratified block randomization was utilized to enroll 114 patients starting in March 2022, with an interim analysis of short-term outcomes scheduled after 45–50% of participant enrollment. Patients were randomized to receive LSPDP via either the Kimura or Warshaw technique. The primary endpoint was intraoperative blood loss, while secondary endpoints included a range of outcomes from composite outcome to quality of life, as quantified by the EQ-5D-5L.

Results:
From March 2022 to November 2023, 53 patients were randomly allocated to the Kimura (n=25) or Warshaw (n=28) groups for LSPDP. Baseline characteristics and postoperative outcomes were similar between the groups, such as pancreatic fistula incidence, EQ-5D-5L index scores, and delayed gastric emptying rates. Per-protocol (PP) analysis revealed that the Kimura group experienced significantly less blood loss (52.5±51.6 ml vs. 91.7±113.5 ml, P=0.007) and a reduced rate of composite outcome (23.8 vs. 56.7%, P=0.019), but incurred higher costs in the Warshaw group (¥56 227.4±¥7027.0 vs. ¥63 513.8±¥12 944.5, P=0.013). Splenic infarction rates were higher in the Warshaw group, though not statistically significant (ITT: 39.3 vs. 12.5%, P=0.058; PP: 36.7 vs. 14.3%, P=0.113), without necessitating intervention. Neither group experienced postpancreatectomy hemorrhage, 90-day mortality, or ICU admissions, and all postoperative complications were mild (Clavien–Dindo Grade <III).

Conclusions:
The 90-day interim analysis postoperatively indicates that both Kimura and Warshaw techniques for LSPDP are safe and viable. The Kimura technique, however, confers superior in terms of reduced intraoperative blood loss and fewer complications, alongside lower costs.
The Diagnostic Utility of Cervical Spine Proprioception for Adolescent Concussion
Authors: Smulligan Katherine L. , Magliato Samantha N. , Keeter Carson L. , Wingerson Mathew J. , Smith Andrew C. , Wilson Julie C. , Howell David R. 
Published: July 2024

Objective:
Cervical spine proprioception may be impaired after concussion. Our objective was to determine the diagnostic utility of cervical spine proprioception for adolescent concussion.

Design:
Cross-sectional.

Setting:
Research laboratory.

Participants:
Adolescents ≤18 days of concussion and uninjured controls.

Interventions:
N/A.

Main Outcomes:
Head repositioning accuracy (HRA) testing, a measure of cervical spine proprioception. The HRA test involved patients relocating their head back to a neutral starting position with eyes closed after maximal cervical spine flexion, extension, and right and left rotations. The overall HRA error score was the mean error (distance from the starting point to self-reported return to neutral) across 12 trials: 3 trials in each direction. We used t-tests to compare group means and logistic regression (outcome = group, predictor = HRA, covariates) to calculate odds ratios. We used a receiver operator characteristic curve to evaluate area under the curve (AUC) and calculate the optimal HRA cutpoint to distinguish concussion from controls.

Results:
We enrolled and tested 46 participants with concussion (age = 15.8 ± 1.3 years, 59% female, mean = 11.3 ± 3.3 days postconcussion) and 83 uninjured controls (age = 16.1 ± 1.4 years, 88% female). The concussion group had significantly worse HRA than controls (4.3 ± 1.6 vs 2.9 ± 0.7 degrees, P < 0.001, Cohen d = 1.19). The univariable HRA model AUC was 0.81 (95% CI = 0.73, 0.90). After adjusting for age, sex, and concussion history, the multivariable model AUC improved to 0.85 (95% CI = 0.77, 0.92). The model correctly classified 80% of participants as concussion/control at a 3.5-degree cutpoint.

Conclusions:
Adolescents with concussion demonstrated worse cervical spine proprioception than uninjured controls. Head repositioning accuracy may offer diagnostic utility for subacute concussion.
Just the tip of the iceberg: Extensive flexor tenosynovitis due to Candida parapsilosis, a case report
Authors: Schade Meredith , Payatakes Alexander , Fanburg-Smith Julie , Petscavage-Thomas Jonelle 
Published: July 2024

Rationale:
We present a case of a healthy 51-year-old female who developed extensive flexor tenosynovitis due to Candida parapsilosis following treatment for trigger thumb.

Patient concerns:
Initial care had included corticosteroid injections and operative trigger finger release. She presented to us with reduced range of motion of her right thumb and a nodular swelling of the thenar eminence. No purulence was found with incision and drainage of the nodule and an empiric course of trimethoprim-sulfamethoxazole was given.

Diagnosis:
Weeks later, an increase in thenar swelling and inability to extend her fingers lead to operative debridement. Multiple intraoperative samples grew C. parapsilosis, and a diagnosis of extensive flexor tenosynovitis was made.

Interventions:
We suspect that corticosteroid injections to treat trigger finger and exposure to a broad-spectrum antibacterial selected for the growth of Candida species. The unique anatomy of the hand, indolent nature of Candida in a normal host and underestimation of the infectious burden contributed to a delay in diagnosis.

Outcomes and Lessons:
The purpose of our report is to alert others to consider all commensal organisms of the skin in recalcitrant infections of the hand.
Kinked Again! From Congenital Brachial Plexus Palsy to Adult Neurogenic Thoracic Outlet Syndrome: A Case Report
Authors: Hearn Sandra L. , Medley Kyle , Liao Eric A. 
Published: July 2024

Abstract
Neurogenic thoracic outlet syndrome is a chronic, focal lesion of the lower trunk of the brachial plexus or of the T1 and C8 anterior primary rami, often arising due to distortion of neural structures by a fibrous congenital band extending from a C7 transverse process or cervical rib. Accordingly, patients present with chronic weakness or atrophy of the hand, most prominently of the thenar eminence, which receives most innervation from the T1 root. We present clinical, electrophysiologic, and imaging findings in a case of neurogenic thoracic outlet syndrome presenting in an adult with a history most suggestive of congenital brachial plexus palsy, another pathology sharing the mechanism of nerve compression or injury within the supracostoclavicular space. The patient had new right thenar eminence atrophy and a lifelong history of medial forearm sensory deficit and she improved after first rib resection. The convergence of two disorders in the same patient arising in different phases of life illustrates how anatomic or structural variation in this space can predispose to lower brachial plexus injury.
Where Will I Go? Relative Location of Physical Medicine and Rehabilitation Residencies Compared With Medical Schools Among Recent Residents
Authors: Wen Jimmy , Alam Meraj , Ansari Ubaid , Shehabat Mouhamad , Syed Burhaan , Akhtar Muzammil , Razick Daniel , Puglisi Jose , Wang Austin 
Published: July 2024

Abstract
Physical medicine and rehabilitation has rapidly been garnering interest as health care increases the emphasis on rehabilitation and management for acute and chronic diseases. This study analyzes recent geographical trends of physical medicine and rehabilitation residents via physical medicine and rehabilitation residents from 2019 to 2023, which were identified from publicly available data. The relative distribution from medical school to residency, medical school to preliminary program, and preliminary program to residency were analyzed. These locations were categorized as within 100 miles, same state, same region, or different region. Odds ratio were calculated for the aforementioned relative locations with respect to the presence of a home residency program. A total of 1836 residents were included. The majority of residents (51%) stayed within the same region as their medical school. Residents from medical schools with a home program were more likely to stay within 100 miles (odds ratio: 3.64), the same state (odds ratio: 3.19), and same region (odds ratio: 2.56). Overall, physical medicine and rehabilitation residents are likely to stay within the same region as their medical school and preliminary year. In addition, the presence of a home program significantly increases the odds of matching within 100 miles, same state, and same region.
Full Robotic Whole Graft Liver Transplantation
Authors: Pinto-Marques Hugo , Sobral Mafalda , Magistri Paolo , Gomes da Silva Sílvia , Guerrini Gian Piero , Mega Raquel , Guidetti Cristiano , Coelho João Santos , Di Sandro Stefano , Di Benedetto Fabrizio 
Published: July 2024

Objective:
To report the first European series of full robotic whole liver transplantation (RLT) with technical details and future perspectives.

Background:
Few cases of liver transplantation with a minimally invasive approach using partial grafts have been reported so far, and no cases of robotic whole liver transplantation have been reported in the scientific literature.

Methods:
The adopted technique was full robotic liver hepatectomy, followed by robotic implantation after graft introduction through a small midline incision. Patients presenting with hepatocellular carcinoma in liver cirrhosis with a small caudate lobe, low degree of portal hypertension, no porto-mesenteric thrombosis, as well as low Model for End-Stage Liver Disease patients have been considered ideal candidates.

Results:
Six patients underwent RLT between February and March 2024 at Lisbon and Modena University Liver Transplant Centers. Warm ischemia time during RLT ranged between 55 and 90 minutes, with a total surgery duration between 440 and 710 minutes. The median total operative time was 595 (±111.3) minutes. Only 1 recipient had prolonged hyperbilirubinemia, which was safely treated. The median in-hospital stay was 7.5 days (±4.8 d).

Conclusions:
RLT is a promising technique to further reduce the impact of liver transplantation thanks to smaller incision, gentle tissue manipulation, high magnification and precision for vascular and biliary anastomosis, and reduced postoperative pain. This is the first step toward the demonstration of the feasibility of minimally invasive surgery in liver transplantation, although further selection and technical refinements are needed to improve reproducibility.
Symptomatic Autonomic Dysfunction in Interstitial Cystitis/Bladder Pain Syndrome
Authors: Ritts Rory , Wolff Dylan , Namugosa Mary , Hsu Fang-Chi , Ferrara Kaylee , Evans Robert , Walker Stephen J. 
Published: July 2024

Importance
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a highly prevalent condition with incompletely understood pathophysiology, especially in relation to the systemic symptoms experienced. The role of autonomic nervous system dysfunction in IC/BPS remains poorly understood.

Objective
The purpose of this study was to assess the relationship between autonomic symptom severity and clinical characteristics of patients with IC/BPS.

Study Design
This is a retrospective cohort study of 122 IC/BPS patients who completed the Composite Autonomic Symptoms Score (COMPASS-31) questionnaire. Data were collected on anesthetic bladder capacity (BC), Hunner lesion (HL) status, results for validated IC/BPS symptom questionnaires (O’Leary Sant Interstitial Cystitis Symptom Index and Interstitial Cystitis Problem Index (ICSI/ICPI) and the Pelvic Pain and Urgency/Frequency (PUF) scale), and comorbid nonurologic associated syndromes. Using the first quartile of COMPASS-31 scores as the cutoff, we compared patients within the first quartile (low symptom load; n = 30), to the remainder of the patients (high symptom load; n = 92).

Results
Patients scoring ≥20.36 were significantly less likely to be HL positive (10.9% vs 26.7%; P = 0.043) and had a significantly higher BC (823.10 ± 396.07 vs 635.00 ± 335.06; P = 0.027), higher scores on the PUF questionnaire (23.80 ± 4.98 vs; 19.61 ± 5.22 P < 0.001), and a higher number of nonurologic associated syndromes (5.65 ± 2.90 vs 2.60 ± 1.89; P < 0.001).

Conclusions
Patients with IC/BPS experience widespread symptoms associated with autonomic nervous system dysfunction. A higher symptom load strongly correlates with a nonbladder-centric phenotype. These findings provide further evidence that total body nervous system dysfunction is present in patients with nonbladder centric IC/BPS.
Nocardioides bizhenqiangii sp. nov. and Nocardioides renjunii sp. nov., isolated from soil and faeces of Tibetan antelope (Pantholops hodgsonii) on the Qinghai-Tibet Plateau
Authors: Zhou Huimin , Cao Linglin , Yang Caixin , Zhang Sihui , Pu Ji , Yang Jing , Ning Shuo , Liu Xiaorui , Liu Chunmei , Liu Liyun , Xu Jianguo 
Published: July 2024

Two novel strain pairs (HM61T/HM23 and S-34T/S-58) were isolated from soil and the faeces of Tibetan antelope (Pantholops hodgsonii) collected at the Qinghai-Tibet Plateau of PR China. All four new isolates were aerobic, non-motile, Gram-stain-positive, catalase-positive, oxidase-negative, and short rod-shaped bacteria. The results of phylogenetic analysis based on the full-length 16S rRNA genes and 283 core genomic genes indicated that the four strains were separated into two independent branches belonging to the genus Nocardioides. Strains HM61T and HM23 were most closely related to Nocardioides pelophilus THG T63T (98.58 and 98.65 % 16S rRNA gene sequence similarity). Strains S-34T and S-58 were most closely related to Nocardioides okcheonensis MMS20-HV4-12T (98.89 and 98.89 % 16S rRNA gene sequence similarity). The G+C contents of the genomic DNA of strains HM61T and S-34T were 70.6 and 72.5 mol%, respectively. Strains HM61T, S-34T and the type strains of closely related species in the analysis had average nucleotide identity values of 75.4–90.5 % as well as digital DNA–DNA hybridization values between 20.1 and 40.8 %, which clearly indicated that the four isolates represent two novel species within the genus Nocardioides. The chemotaxonomic characteristics of strains HM61T and S-34T were consistent with the genus Nocardioides. The major fatty acids of all four strains were iso-C16 : 0, C17 : 1
ω8c or C18 : 1
ω9c. For strains HM61T and S-34T, MK-8(H4) was the predominant respiratory quinone, ll-2,6-diaminopimelic acid was the diagnostic diamino acid in the cell-wall peptidoglycan, and the polar lipids profiles were composed of diphosphatidylglycerol and phosphatidylglycerol. Based on phylogenetic, phenotypic, and chemotaxonomic data, we propose that strains HM61T and S-34T represent two novel species of the genus Nocardioides, respectively, with the names Nocardioides bizhenqiangii sp. nov. and Nocardioides renjunii sp. nov. The type strains are HM61T (=GDMCC 4.343T=JCM 36399T) and S-34T (=CGMCC 4.7664T=JCM 33792T).
Encoding of T=1 virus capsid structures through the interfaces of oligomer subcomponents
Authors: Jeppesen Mads , André Ingemar 
Published: July 2024

AbstractVirus capsid formation is one the most complex self-assembly processes in nature, involving the association of a large number of protein subunits into well-defined structural states. The ability of protein subunits to efficiently self-assembly is encoded in the protein sequence, and ultimately in the protein-protein interfaces within the growing capsid. The relative strengths of interfaces can be important in directing the self-assembly process, and determine which intermediates are formed early in the self-assembly process. In this study we characterize the interfaces in homomeric T=1 virus capsids to investigate to what extent interfaces within the assemblies are different from other protein-protein interfaces, and which interfaces are most critical for self-assembly. Interfaces were divided into dimers, trimers, and pentamers and compared to interfaces of non-viral homomeric dimers, trimers, and pentamers. The analysis suggests that viral interfaces are larger than non-viral counterparts, and differ in amino acid content, but are energetically similar in terms of the quality of intermolecular interactions. Trimers are predicted to be the most stable oligomers, which may imply that they form early in the self-assembly process. However, dimeric and pentameric interfaces are typically similar in terms of predicted stability suggesting that assembly formation in T=1 capsids may progress through many different routes, rather than progressing through a single dominant intermediate species. With symmetric docking calculations, the energy landscape of the assembled capsid was characterized, and the results highlight that the assemblies exhibit deeply funneled energy landscapes encoded by protein-protein interfaces that have a high degree of specificity.
Uncovering differential tolerance to deletions versus substitutions with a protein language model
Authors: Goldman Grant , Chati Prathamesh , Ntranos Vasilis 
Published: July 2024

AbstractDeep mutational scanning (DMS) experiments have been successfully leveraged to understand genotype to phenotype mapping, with broad implications for protein engineering, human genetics, drug development, and beyond. To date, however, the overwhelming majority of DMS have focused on amino acid substitutions, excluding other classes of variation such as deletions or insertions. As a consequence, it remains unclear how indels differentially shape the fitness landscape relative to substitutions. In order to further our understanding of the relationship between substitutions and deletions, we leveraged a protein language model to analyze every single amino acid deletion in the human proteome. We discovered hundreds of thousands of sites that display opposing behavior for deletions versus substitutions, i.e. sites that can tolerate being substituted but not deleted, and vice versa. We identified secondary structural elements and sequence context to be important mediators of differential tolerability at these sites. Our results underscore the value of deletion-substitution comparisons at the genome-wide scale, provide novel insights into how substitutions could systematically differ from deletions, and showcase the power of protein language models to generate biological hypothesesin-silico. All deletion-substitution comparisons can be explored and downloaded athttps://huggingface.co/spaces/ntranoslab/diff-tol.
A central steering circuit inDrosophila
Authors: Feng Kai , Khan Mariam , Minegishi Ryo , Müller Annika , Van De Poll Matthew N. , Swinderen Bruno van , Dickson Barry J. 
Published: July 2024

AbstractLocomotion steering control enables animals to pursue targets, evade threats, avoid obstacles, and explore their environment. Steering commands are generated in the brain and communicated via descending neurons to leg or wing motor circuits. The diversity of ways in which turns are triggered and executed has led to the view that steering might rely on distributed neural processing across multiple control circuits. Here, however, we present evidence for a central steering circuit inDrosophilathat is used for both goal-directed and exploratory turns and is capable of eliciting turns ranging from subtle course corrections to rapid saccades. The circuit is organized in a hierarchy, the top layer of which comprises the reciprocally connected DNa03 and LAL013 neurons. Our data suggest that turns are initiated by DNa03 neurons and reinforced and stabilized through a winner-take-all mechanism involving LAL013. The descending DNa11 neurons form an intermediate layer. They receive input from both DNa03 and LAL013 and target leg motor circuits directly as well as indirectly through subordinate descending neurons. DNa11 activation coordinately changes the stepping directions of all six legs to generate rapid saccadic turns. Together, these data define a central steering control circuit inDrosophilathat is flexibly used to generate turns as the fly exploits or explores its environment.
Quantitative T1 and Effective Proton Density (PD*) mapping in children and adults at 7T from an MP2RAGE sequence optimised for uniform T1-weighted (UNI) and FLuid And White matter Suppression (FLAWS) contrasts
Authors: Sıla Dokumacı Ayşe , Vecchiato Katy , Tomi-Tricot Raphael , Eyre Michael , Bridgen Philippa , Di Cio Pierluigi , Casella Chiara , Wood Tobias C. , Sedlacik Jan , Wilkinson Tom , Giles Sharon L. , Hajnal Joseph V. , O’Muircheartaigh Jonathan , Malik Shaihan J. , Carmichael David W. 
Published: July 2024

AbstractIntroductionQuantitative MRI is important for non-invasive tissue characterisation. In previous work we developed a clinically feasible multi-contrast protocol for T1-weighted imaging based on the MP2RAGE sequence that was optimised for both children and adults. It was demonstrated that a range of Fluid And White Matter Suppression (FLAWS) related contrasts could be produced while maintaining T1-weighted uniform image (UNI) quality, a challenge at higher field strengths. Here we introduce an approach to use these images to calculate effective proton density (PD*) and quantitative T1relaxation maps especially for shorter repetition times (TRMP2RAGE) than those typically used previously.MethodsT1and PD* were estimated from the analytical equations of the MP2RAGE signal derived for partial Fourier acquisitions. The sensitivity of the fitting results was evaluated with respect to the TRMP2RAGEand B1+effects on both excitation flip angles and inversion efficiency and compared to vendor T1maps which do not use B1+information. Data acquired for a range of individuals (aged 10-54 years) at the shortest TRMP2RAGE(4000ms) were compared across white matter (WM), cortical grey matter, and deep grey matter regions.ResultsThe T1values were insensitive to the choice of different TRMP2RAGE. The results were similar to the vendor T1maps if the B1+effects on the excitation flip angle and inversion efficiency were not included in the fits. T1values varied over development into adulthood, especially for the deep grey matter regions whereas only a very small difference was observed for WM T1. Effective PD maps were produced which did not show a significant difference between children and adults for the age range included.ConclusionWe produced PD* maps and improved the accuracy of T1maps from an MP2RAGE protocol that is optimised for UNI and FLAWS-related contrasts in a single scan at 7T by incorporating the excitation flip angle and inversion efficiency related effects of B1+in the fitting. This multi-parametric protocol made it possible to acquire high resolution images (0.65mm iso) in children and adults within a clinically feasible duration (7:18 min:s). The combination of analytical equations utilizing B1+maps led to T1fits that were consistent at different TRMP2RAGEvalues. Average WM T1values of adults and children were very similar (1092ms vs 1117ms) while expected reductions in T1with age were found for GM especially for deep GM.