bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breaking through the eggshell: embryonic development of the premaxillary dentition in Lacerta agilis (Squamata: Unidentata) with special emphasis on the egg tooth
Authors: Kaczmarek Paweł , Metscher Brian , Kowalska Magdalena , Rupik Weronika 
Published: August 2024

Abstract
The egg tooth of squamates is a true tooth that allows them to break, tear, or cut the eggshell during hatching. In this clade there are some uncertainties concerning the egg tooth implantation geometry, the number of germs, and their fates during embryonic development. Here, we used X-ray microtomography and light microscopy, focusing on the egg tooth and remaining premaxillary teeth of the sand lizard (Lacerta agilis, Squamata: Unidentata). The developing egg tooth of this species passes through all the classic stages of tooth development. We did not find any evidence that the large size of the egg tooth is related to the merging of two egg tooth germs, which has recently been suggested to occur in snakes. Instead, this feature can be attributed to the delayed formation of the neighbouring regular premaxillary teeth. This might provide more resources to the developing egg tooth. At the last developmental stage, the egg tooth is a large, midline structure, bent forward as in most oviparous Unidentata. It is characterized by pleurodont implantation, and its base is attached to the pleura and a peculiar ridge of the alveolar bone. The attachment tissue contains periodontal ligament-like tissue, acellular cementum-like tissue, and alveolar bone.
Indocyanine Green Lymphography–guided Lymphatic Vessel Suture Ligation for Superficial Abdominal Flap Donor Site for Breast Reconstruction
Authors: Nakatsuka Kengo , Fuse Yuma , Karakawa Ryo , Yoshimatsu Hidehiko , Yano Tomoyuki 
Published: August 2024

Summary:
Autologous breast reconstruction using the abdominal flap based on the superficial system has the potential to minimize donor-site morbidity. Although efforts to improve its transfer have been focused, there have been scarce attempts to further reduce donor-site complications in the abdomen. Seroma formation is a significant complication after the superficial based abdominal flap harvest. The authors report our novel technique to address this issue. Using indocyanine green (ICG) lymphography, we identified lymphatic leakage sites in the abdominal donor site and repaired them by selective suture: ICG-guided lymphatic vessel suture ligation (ICG-LVSL). We performed ICG-LVSL for 10 patients who underwent breast reconstruction using the superficial abdominal flap and compared the incidence of seroma development between ICG-LVSL and non-LVSL groups. After propensity score matching, nine patients remained in each group. The ICG-LVSL group experienced lower incidence of seroma formation (0 versus 55%, P <0.01). The ICG-LVSL technique may be useful for reducing donor-site morbidity of the superficial abdominal flap.
Prompt, Objective, and Accurate Measurement of Rat Abdominal Flap Blood Flow Using Laser Speckle Flowgraphy
Authors: Tsunekawa Kazuhiro , Takashimizu Ikkei , Yuzuriha Shunsuke 
Published: August 2024

Background:
The indications for free flap procedures have expanded, with recent technical advances enhancing procedural safety. However, few objective indicators exist to monitor flap status during and after the operation. This experimental study assessed laser speckle flowgraphy (LSFG) as a prompt and accurate indicator of free flap blood flow.

Methods:
After elevating bilateral lower abdomen flaps with superficial inferior epigastric artery (SIEA) and superficial inferior epigastric vein vasculature in Wistar rats, the right flap with the SIEA was cut (ischemic group) or the superficial inferior epigastric vein was cut (congestive group), and the unaltered left flaps were monitored using LSFG every 5 minutes for a 30-minute period. Flap survival or necrosis was assessed after 7 days.

Results:
In the ischemic group, LSFG measurements were significantly lower after cutting the SIEA than beforehand (74% at 5 minutes and 72% at 30 minutes). Similar findings were seen in the congestive group (63% at 5 minutes and 55% at 30 minutes). LSFG measurements were significantly lower in the congestive group than in the ischemic group. Seven days afterward, whereas all right-side flaps with cut vessels were necrotic, all unaltered left-side flaps had survived.

Conclusions:
Our preliminary results demonstrated that LSFG could objectively identify abnormal blood flow in skin flaps as early as 5 minutes into surgery and predict graft survival. LSFG may potentially enable quick and objective assessment of flap blood flow and reduce the risk of complications and flap loss.
Analysis of the Characteristics of Patients Visiting the Tokyo 2020 Olympics Polyclinic
Authors: Tsukahara Yuka , Mountjoy Margo , Takazawa Yuji , Yagishita Kazuyoshi , Ohuchi Hiroshi , Akagi Ryuichiro , Katayose Masaki , Fujiwara Sayaka , Engebretsen Lars 
Published: August 2024

Objective:
To evaluate the characteristics of patients who visited the Polyclinic during the Tokyo 2020 Olympics and analyze geographical and economic correlations with the number of clinic visits.

Design:
Cross-sectional study.

Setting:
Polyclinic during the Tokyo 2020 Olympics.

Participants:
Patients who visited the Polyclinic.

Intervention:
Data from the electronic medical record system of the Polyclinic were extracted.

Main Outcome Measures:
The number of visits for each athlete or team official was calculated by country. Relationship between number of visits per patient and total number of team members, total health expenditure per capita, density of medical doctors, life expectancy at birth, and education expenditure per gross domestic product (GDP) were investigated. Independent variables related to medal tables were also investigated.

Results:
The average number of visits per athlete was 0.67, and it was higher in athletes from non–high-income countries compared with high-income countries for both male and female athletes. Number of visits per athlete was higher in countries with low life expectancy at birth (95% CI, −0.16 to −0.02, P = 0.012) and education expenditure per GDP (95% CI, −0.17 to −0.04, P = 0.003).

Conclusions:
During the Tokyo 2020 Olympics, the number of visits to the Polyclinic per athlete was higher in countries with low life expectancy at birth and education expenditure per GDP.
Effect of a semirigid ankle brace on the in vivo kinematics and muscle activity of patients with functional ankle instability during simulated ankle sprain
Authors: Zhang Gonghao , Zha Chaochao , Cao Shengxuan , Xiong Li , Huang Ping , Zhang Guoning , Ji Yunhan 
Published: August 2024

Introduction:Ankle braces can effectively decrease the incidence of recurrent ankle sprain; however, whether the brace can decrease the severity of sprain and its related mechanism during sprain remain unknown.Methods:Twenty-two patients with functional ankle instability (FAI) (12 males and 10 females) and 16 healthy subjects (8 males and 8 females) were enrolled in this study. All of the subjects walked on a custom-built tilting platform that offered a 30° inversion (IV) to mimic the IV of ankle sprain. We collected the kinematic and surface electromyography data of patients with FAI with or without ankle brace and normal controls 6 times.Results:The FAI without brace group showed significantly higher maximum IV angles and average IV velocities than the control group (P < .001). The FAI with brace group revealed significantly lower maximum IV angles and average IV velocities than the FAI without brace group (P < .001); this group also showed significantly higher maximum external rotation (ER) angle and average ER velocities than the FAI with brace (P < .001) and control (P < .001) groups. The FAI with brace group indicated significantly lower average EMGPrep(P = .047), EMGTilt(P = .037), and EMGafterTilt(P = .004) of the peroneus longus than the FAI without brace group.Conclusions:The ankle brace could effectively decrease IV angles and their velocities and increase ER angles and their corresponding velocities during ankle sprain in patients with FAI. It could also decrease the activity of the peroneus longus muscle during ankle sprain.
Primary intraspinal neuroendocrine tumor: A case report and literature review
Authors: Dai Li , Zou Ming-Ju , Liao Ren-Li , Zhang Bing-Ran , Ma Zhi-Qiang , Liu Ming-Wei 
Published: August 2024

Rationale:
Neuroendocrine tumors (NET) refer to a group of uncommon tumors arising in the neuroendocrine system. Most NETs occur in the digestive tract and bronchi but are rare in the central nervous system, especially in the spinal canal. NET in the central nervous system mainly metastasize from other systems, with non-specific clinical symptoms. In this study, we report the diagnosis and treatment of intraspinal NET to provide clinical guidance as well as to avoid misdiagnosis and missed diagnosis.

Patient concerns:
A 59-year-old male patient, presented with recurrent right lower limb pain for half a year, accompanied by numbness and weakness for 4 months and aggravation for 2 months. Lumbar spine magnetic resonance imaging (MRI) revealed a space-occupying lesion in the spinal canal. The diagnosis of primary intraspinal NET was confirmed by topathological examination.

Diagnosis:
Primary intraspinal NET tumor.

Interventions:
Surgical resection.

Outcomes:
Significant improvements in right lower limb pain, numbness, and weakness were observed, and lumbar spine MRI was performed again to dynamically observe the changes in intraspinal NET.

Conclusions:
Surgical resection may be an effective treatment for intraspinal NETs.

Lessons:
Intraspinal NETs are relatively rare and mostly manifest as limb numbness, weakness, and pain. Due to its nonspecific clinical symptoms, intraspinal NETs are easily misdiagnosed as lumbar disc herniation with radiculopathy and lumbar spondylolisthesis. Therefore, in patients with long-term symptoms, in addition to common lumbar neuromuscular diseases, lumbar MRI should be performed promptly to exclude the possibility of lumbar NETs.
A visualized and bibliometric analysis of nursing research during the COVID-19 pandemic
Authors: Yang Lu , Wang Yao , Mu Xin , Liao Yanbiao 
Published: August 2024

Background:
The global spread of Coronavirus disease 2019 (COVID-19) has been increasing since December 2019. A total of 8460 publications were obtained from the Web of Science Core Collection from 2019 to 2023, providing insights into the progress of nursing research throughout the COVID-19 pandemic.

Methods:
Bibliometric analysis was conducted on these articles using CiteSpace. The analysis focused on examining the distribution of these publications in terms of space and time, distribution of authors, subject categories, distribution of topics, and cited references.

Results:
These results may be explained from 3 perspectives. Initially, the number of yearly publications on nursing research consistently increased during the COVID-19 pandemic. Furthermore, a co-occurrence analysis of the countries and the authors revealed that certain countries, including the United States, China, and England, have successfully implemented organized and standardized nursing models. These countries also have well-developed and established nursing research systems. Notably, academic communities in specific regions, such as the team led by MD Stefan Gravenstein, Mor Vincent, and White Elizabeth at Brown University in the United States, have emerged as leaders in this field. Furthermore, examining the papers’ subject categories and topic distribution indicate that nursing during the COVID-19 pandemic has been predominantly interdisciplinary, encompassing various disciplines such as clinical medicine, essential medicine, psychology, public health management, and even telematics science.

Conclusion subsectiongs:
Our study provided valuable insights into acquiring knowledge on nursing research during the COVID-19 pandemic, pinpointed possible partners for researchers interested in nursing, and uncovered prevalent research patterns and popular subjects.
Bilateral pontine brachium lesions in one autoantibodies directed against MOG positive patient: A case report
Authors: Sun Fan-Ya , Shen Jia , Ding Le , Zhu Bo , Gu Naibing , Liu Zhiqin , Di Zhengli , Jia Xiao-Tao 
Published: August 2024

Rationale:
Myelin oligodendrocyte glycoprotein (MOG) antibody-related disease is a relatively recent entity in inflammatory demyelinating disease. Its clinical presentation varies in severity and the lack of specific imaging features makes it easy to misdiagnose. We now report the case of a MOG antibody-positive patient who presented with diplopia and dizziness, and whose brain magnetic resonance imaging (MRI) showed abnormal signals in the bilateral pontine brachium.

Patient concerns:
A previously healthy 52-year-old woman presented with diplopia and dizziness, and was hospitalized 4 days after onset.

Diagnoses:
Brain MRI demonstrated abnormal hyperintense signals in the bilateral pontine brachium on T2-weighted fluid attenuated inversion recovery imaging. MRI enhancement showed abnormal enhancement foci in bilateral pontine brachium and pons. Cerebrospinal fluid examination showed Oligoclonal IgG bands were negative. The IgG index was normal, and serum aquaporin-4 antibody was negative, while serum MOG-Ab was positive (1:100). In conjunction with a positive serum MOG antibody and exclusion of other diseases, diagnosis of MOG antibody-related disease was made.

Interventions:
Intravenous methylprednisolone followed by oral corticosteroids.

Outcomes:
Symptoms resolved completely. At 4-month follow-up. Follow-up after 4 months showed disappearance of the abnormal signal in the left pontine brachium and diminution of abnormal high signal in the right compared to the previous one, and there was no recurrence 1 year after the onset of the disease.

Lessons:
If brain MRI indicating bilateral, multiple, and diffuse abnormal signals in the pontine brachium, and a discrepancy between the clinical symptoms and the imaging severity, a diagnosis of demyelinating disease should be considered highly probable. In such cases, anti-MOG antibody testing is essential for further defining the etiology. The clinical phenotype and imaging manifestations of MOG antibody-positive brainstem encephalitis may lack sufficient specificity to be readily identifiable. Timely diagnosis and early glucocorticoid therapy are beneficial in improving prognosis and preventing recurrence.
Decreasing Pain in Hospitalized Patients by Increasing Topical Anesthetic Use for Peripheral IVs
Authors: Lewis Emilee C. , Komkov Stephanie , Rickles Jenny , Saccoccio Mary , Thomesen Margaret , Turcotte Lauren , Zempsky William T. , Waynik Ilana 
Published: August 2024

Introduction:
Venous access is a common source of pain for hospitalized patients. Topical anesthetics are effective at decreasing needle pain, can improve success rate, and decrease procedure time; however, use before peripheral intravenous line (PIV) placement is inconsistent. The aim was to reduce pain experienced by hospitalized pediatric patients by increasing topical anesthetic use for PIV placement from a mean of 11% to 40% within 6 months.

Methods:
The Model for Improvement was utilized. An institutional clinical pathway and PIV order panel were developed. Pre-checked orders for topical anesthetics were added to order sets. Visual aids were placed on IV carts, including reminders for anesthetics, pathway use and scripting examples. Nurses received individual feedback. Statistical process control charts were posted weekly on daily management system boards on medical-surgical floors, and data were shared at daily nursing huddles to increase awareness of performance and discuss opportunities for improvement.

Results:
Topical anesthetic use for PIV placement increased from a mean of 11% to 46%. Documentation of comfort measures during PIV placement increased from a mean of 6% to 13%. The percentage of PIV placements with an order for a topical anesthetic in the electronic health record increased from a mean of 14% to 54%. PIV procedures with documentation of placement attempts increased from a mean of 47% to 70%.

Conclusions:
Through systems and culture change, awareness of the importance of pain prevention for venous access procedures increased, and patient-centered care improved with greater collaboration between nurses, providers, and families for venous access planning.
Development of machine learning-based algorithms for classifying physical activity intensity using wrist and thigh worn wearables
Authors: Koemel Nicholas A. , Biswas Raaj K. , Ahmadi Matthew N. , Stamatakis Emmanuel 
Published: August 2024

ABSTRACTThe use of semi-supervised learning approaches can be used to extend a base-level classifier and offers a significant advantage by reducing the need for extensive labeled datasets. We utilized a two-stage semi-supervised learning model to classify physical activity intensity for wrist and thigh worn monitors, by retraining a base classifier with free-living wearable sensor data. Data was collected in two-phases comprising a laboratory and free-living session. Total classified time spent in light intensity, moderate intensity, and vigorous intensity were not significantly different from ground-truth minutes for either placement. The machine learning classifiers re-trained on free-living data accurately predicted light, moderate and vigorous intensity between both device placements. These findings demonstrate that similar estimates of physical activity intensity can be correctly classified for wrist and thigh placements when using semi-supervised techniques.
Analysis of oogenesis defects inDyromutant ofDrosophila melanogaster
Authors: Shima Takamoto , Kawabata Yuuki , Yagi Yoshimasa 
Published: August 2024

AbstractDyromutant is female sterile, and oogenesis is aborted during stage8-9 of oogenesis. We investigated detail of the oogenesis defect ofDyromutant. At first, we confirmed loss of Dyro caused female sterility by genetic rescue experiment. Then, we performed genetic mosaic analysis and found Dyro expression in germ cell is important for oogenesis. InDyromutant, inhibition of programmed cell death suppressed cell death of germ cells during oogenesis but failed to rescue fertility. It indicates that abortion of oogenesis is not because of mis-regulation of cell death signal but there is oogenesis defect which activates Caspase signaling pathway. Then, we observedDyromutant and looking for defects which may trigger cell death of germ cells inDyromutant. We found oogenesis abortion timing is similar to yolk protein mutant but different from amino acid starvation. It suggests that nutrient signal defect does not triggers cell death inDyromutant. We carefully observed the defect ofDyromutant ovaries and found abnormal morphology of nucleolus and chromosome in nurse cells. It seems chromosome inDyromutant is thick and nucleolus is limited in small space between thick chromosomes inDyromutant nurse cells. Other defect we found is aggregated protein accumulation in germ cells. These data suggest thatDyrohas important role in mid-oogenesis stage germ cell and loss of Dyro causes defect in nuclear of nurse cells which may leads to abortion of oogenesis.
Beyond the Prescription Pad: “Unveiling Outpatient Antimicrobial Patterns”
Authors: kumar D. Suresh , Ratheesh R. , Poojadharshini M. 
Published: August 2024

ABSTRACTBackgroundAntimicrobial resistance (AMS) is recognized as one of the major threats of human health all around the world especially in low-and-middle income countries. Misuse or overuse of antimicrobials are considered as the major cause for developing AMS.MethodsThis prospective observational study was conducted in outpatient’s department in a tertiary care hospital after obtaining prior ethics committee approval. The study was conducted during the month of April 2023.RESULTSThe study analysed 301 outpatient prescriptions over a period of 1 month. Of these prescriptions, Gender distribution was balanced, with 153 males (50.8%) and 148 females (49.2%). On average, the prescribed duration of antimicrobial therapy for all patients was found to be 6 days.CONCLUSIONThis study underscores the urgency of addressing the issue of antibiotic overuse and misuse in outpatient care. By implementing evidence-based strategies and targeted educational initiatives, we can take significant strides towards preserving the effectiveness of antibiotics for future generations and ultimately improving patient outcomes. It is imperative that healthcare providers, administrators, and policymakers collaborate in promoting responsible antimicrobial prescribing practices to safeguard public health and combat the global threat of antibiotic resistance.
Circulating pancreatic enzyme levels are a causal biomarker of type 1 diabetes
Authors: Elgamal Ruth M , Melton Rebecca L. , Chiou Joshua , McGrail Carolyn W , Gaulton Kyle J 
Published: August 2024

AbstractNovel biomarkers of type 1 diabetes (T1D) are needed for earlier detection of disease and identifying therapeutic targets. We identified biomarkers of T1D by combining plasmacisandtransprotein QTLs (pQTLs) for 2,922 proteins in the UK Biobank with a T1D genome-wide association study (GWAS) in 157k samples. T1D risk variants at over 20% of known loci colocalized withcisortranspQTLs, and distinct sets of T1D loci colocalized with immune, pancreatic secretion, or gut-related proteins. We identified 23 proteins with evidence for a causal role in using pQTLs as genetic instruments in Mendelian Randomization which included multiple sensitivity analyses. Proteins increasing T1D risk were involved in immune processes (e.g.HLA-DRA) and, more surprisingly, T1D protective proteins were enriched in pancreatic secretions (e.g.CPA1), cholesterol metabolism (e.g.APOA1), and gut homeostasis. Genetic variants associated with plasma levels of T1D-protective pancreatic enzymes such as CPA1 were enriched incis-regulatory elements in pancreatic exocrine and gut enteroendocrine cells, and the protective effects of CPA1 and other enzymes on T1D were consistent when using instruments specific to acinar cells. Finally, pancreatic enzymes had decreased acinar expression in T1D, including CPA1 which was altered prior to onset. Together, these results reveal causal biomarkers and highlight processes in the exocrine pancreas, immune system, and gut that modulate T1D risk.
Tunable Cytosolic Chloride Indicators for Real-Time Chloride Imaging in Live Cells
Authors: Morse Jared , Nadiveedhi Maheshwara Reddy , Schmidt Matthias , Tang Fung-Kit , Hladun Colby , Ganesh Prasanna , Qiu Zhaozhu , Leung Kaho 
Published: August 2024

AbstractChloride plays a crucial role in various cellular functions, and its level is regulated by a variety of chloride transporters and channels. However, to date, we still lack the capability to image instantaneous ion flux through chloride channels at single-cell level. Here, we developed a series of cell-permeable, pH-independent, chloride-sensitive fluorophores for real-time cytosolic chloride imaging, which we call CytoCl dyes. We demonstrated the ability of CytoCl dyes to monitor cytosolic chloride and used it to uncover the rapid changes and transient events of halide flux, which cannot be captured by steady-state imaging. Finally, we successfully imaged the proton-activated chloride channel-mediated ion flux at single-cell level, which is, to our knowledge, the first real-time imaging of ion flux through a chloride channel in unmodified cells. By enabling the imaging of single-cell level ion influx through chloride channels and transporters, CytoCl dyes can expand our understanding of ion flux dynamics, which is critical for characterization and modulator screening of these membrane proteins. A conjugable version of CytoCl dyes was also developed for its customization across different applications.