bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virchow's Second Protocol; a 21st-Century Review
Authors: Hansma Patrick 
Published: July 2024

Abstract
Rudolf Virchow published several autopsy protocols in his 1876 book on postmortem examinations. The protocols demonstrate the application of the 1875 Regulations to medicolegal practice. The book went through several editions and translations throughout the remainder of the 19th century, but the second autopsy protocol was subject to scathing criticism in 1915. This article summarizes the protocol and reviews the criticism, historic context, and conclusions. Application of 21st-century practice principles is also attempted in order to test the durability of Virchow's methods and protocol across centuries.
Predictors of the Difficulty of Laparoscopic Cholecystectomy After Percutaneous Transhepatic Gallbladder Drainage for Grade II Acute Cholecystitis
Authors: Lyu Yunxiao , Wang Bin 
Published: July 2024

Background:
The predictors of difficulty performing laparoscopic cholecystectomy (LC) following percutaneous transhepatic gallbladder drainage (PTGBD) for grade II acute cholecystitis have not been clearly understood.

Methods:
This retrospective study was performed between January 2019 and February 2023 and involved 102 eligible patients with grade II acute cholecystitis. Patients were categorized into 2 groups: difficult LC group (n=14) and nondifficult LC group (n=88). Preoperative characteristics and postoperative outcomes were analyzed, and a logistic regression model was used for multivariate analyses of the significant factors identified in the univariate analyses.

Results:
Logistic multivariable regression analysis revealed that C-reactive protein (CRP) levels (odds ratio [OR]: 1.028, 95% confidence interval [CI]: 1.013-1.044; P<0.05), and time intervals between PTGBD and LC (OR: 1.047, 95% CI: 1.003-1.092; P=0.034) were independent predictors of difficult LC. When preoperative CRP was >154 mg/L, LC difficulty, blood loss, and operative time increased (P<0.05, P=0.01, P=0.01, respectively) compared with CRP <154 mg/L. Difficult LC, increased blood loss, and longer operative time occurred more frequently when the interval between PTGBD and LC was >35 days compared with <35 days (P<0.05, P=0.003, P=0.002, respectively).

Conclusions:
CRP levels >154 mg/L and intervals between PTGBD and LC exceeding 35 days are associated with greater LC difficulty.
Laparoscopic Pancreaticoduodenectomy With Open Reconstruction: The Buddha’s Middle Path
Authors: Kumar Ameet , Kaistha Sumesh , Gangavatiker Rajesh 
Published: July 2024

Background:
Laparoscopic pancreaticoduodenectomy (LPD) is not universally adopted because of its steep learning curve. Its technical complexity discourages many surgeons. We believe that laparoscopic pancreaticoduodenectomy with open reconstruction (LPOR) has all the benefits of LPD without its drawbacks and combines the ease of open surgery with the benefits of minimal access surgery. We assessed the feasibility and safety of LPOR and compared it with open pancreaticoduodenectomy (OPD), with the objectives being perioperative and short-term clinical/oncologic outcomes.

Methods:
Retrospective review of prospectively maintained database; study period from January 2013 to December 2019. Till 2015, we did only OPD. In 2016, we started with LPD but soon switched to LPOR. The resection part was done laparoscopically and the reconstruction part was done through a 8-cm mini-laparotomy.

Results:
We did 19 OPDs and 15 LPORs. Demographic data of the 2 groups were comparable. The duration of surgery was significantly longer in the LPOR group (360 vs. 410 min; P=0.01), whereas the blood loss and hospital stay were longer in the OPD group (520 vs. 360 mL; P=0.03 and 13 vs. 11 d; P=0.08, respectively). Clinically significant complication rates, including delayed gastric emptying and postoperative pancreatic fistulas, were not different in either group. No patients in the LPOR group had wound-related/pulmonary complications. Lymph node yield was similar in both groups (20 vs. 22) and we had 100% R0 resections.

Conclusions:
LPOR was better than OPD in terms of short-term outcomes and was not inferior to OPD in terms of complications/oncologic outcomes.
Enhanced perioperative care for the prevention of anastomotic leakage – DOUBLE CHECK: study protocol for an international, multicenter open-label trial with historical controls
Authors: Bootsma Boukje T. , Huisman Daitlin E. , Reudink Muriël , de Wit Anne , Feo Carlo , Hering Jens-Peter , Hompes Roel , Komen Niels , Lagae Emmanuel A.G.L. , Lubbers Tim , Müller Connie S. , van der Pas Stéphanie L. , Stassen Laurents P.S. , Stens Jurre , Sonneveld Dirk J.A. , Verdaasdonk Emiel G.G. , van Velzen Colin , Wegdam Johannes A. , van Wely Bob , Slooter Gerrit D. , Daams Freek 
Published: July 2024

Background:
Colorectal anastomotic leakage (CAL) remains a severe complication after bowel surgery. Recent research has identified several modifiable perioperative CAL risk factors. The aim of this study is to implement an enhanced perioperative care protocol, to optimize the intraoperative condition of the patient and minimalize exposure to modifiable CAL risk factors. Secondly, this study will investigate whether implementation of this new protocol results in a decreased CAL rate.

Methods:
The DOUBLE CHECK study will be performed using an open-label, international, multicenter design in 11 participating hospitals. The aim is to include an intervention group of 943 adult patients that underwent a colorectal resection with creation of a primary anastomosis. The patients in the intervention group will be treated according to an enhanced perioperative care protocol focusing on optimizing the intraoperative condition of the patient by minimalizing exposure to the following perioperative factors: anemia, hyperglycemia, hypothermia, epidural anesthesia, vasopressor drug administration, and incorrect or lack of antibiotic prophylaxis. The control group will consist of 1562 historical patients that were treated with standard perioperative practice (LekCheck study cohort). The patient’s intraoperative condition defined by exposure to the six perioperative risk factors, compliance to the DOUBLE CHECK study protocol, 30-day and 90-day CAL and other postoperative complications, length of hospital-stay, and ICU stay, hospital readmission and 30-day mortality will be measured.

Discussion:
The strength of this study is that it is an implementation study of an enhanced perioperative practice protocol for patients that are scheduled for colorectal resection in combination with a comparative study. This protocol could be a tool for other hospitals that want to improve their perioperative care pathway.
Research protocol to identify the effect of concentrated growth factors on healing of apicomarginal defects
Authors: Zheng Kaiyue , Yang Chao , Sun Honglan , Huang Yuqi , Li Zhixin , Kuang Huifang , Zheng Xu , Hao Chunbo , Luo Wen 
Published: July 2024

Periapical periodontitis can cause damage to both the tooth and the periodontium, thereby affecting the life quality of patients. Traditional periapical surgery takes a long time to heal, and postoperative pain and swelling are obvious. Seeking a good treatment strategy for faster and better healing of periapical periodontitis is an urgent issue that needs to be addressed. Concentrated growth factor (CGF) is considered an ideal biomaterial for retaining abundant and denser growth factors in accelerating bone formation. To investigate the effect of CGF on healing of apicomarginal defects, this prospective study aims to enroll 72 patients with periapical periodontitis in their anterior teeth or premolars who have undergone comprehensive root canal treatment. The patients will be randomly allocated into the following four groups: control group, which will receive apical surgery alone (including apicoectomy, inflammation debridement, and retrofilling of the root apex); bone group, which will undergo apical surgery in conjunction with the use of bone substitute; CGF group, which will undergo apical surgery in conjunction with the use of CGF; and CGF+bone group, which will undergo apical surgery in conjunction with the use of bone substitute and CGF gel. Each group will comprise 18 patients, and all surgeries will be conducted by the same proficient surgeon. The participants will undergo a 1-year follow-up with the assistance of a physician, including questionnaire data and daily records of pain and swelling at 2, 6, and 12 h and 7 days after the surgery. Cone-beam computed tomography images will be taken before the surgery, immediately after the surgery, and at 3, 6, and 12 months after the surgery. This study aims to explore the therapeutic effect of CGF on apicomarginal defects, in order to help clinical doctors find better treatment methods.
A Prediction Model for Pelvic Floor Recovery After Vaginal Birth With Risk Factors
Authors: Fairchild Pamela S. , Low Lisa Kane , Thibault Mary Duarte , Kowalk Katherine M. , Kolenic Giselle E. , Fenner Dee E. 
Published: July 2024

ImportanceAlthough parturients report few postpartum symptoms, birth is clearly associated with future symptom development. The ability to identify asymptomatic at-risk women would facilitate prevention.ObjectiveThe aim of the study was to develop a model predicting abnormal recovery in women at risk for childbirth-associated pelvic floor injury.Study DesignWomen undergoing first vaginal birth at high risk of pelvic floor injury underwent examinations and ultrasound imaging and completed 6-week and 6-month postpartum questionnaires. We defined “abnormal” recovery as having ≥1 of the following 3 findings: (1) levator ani injury, (2) decreased objective pelvic floor strength, and (3) Pelvic Organ Prolapse Quantification point Bp ≥0. Descriptive statistics and bivariate analyses compared “normal” and “abnormal” recovery. Birth characteristics, 6-week examinations, and questionnaires potentially predicted abnormal recovery at 6 months. Significant variables were included as candidates in the multivariable logistic regression predicting “abnormal” recovery after birth.ResultsFifty-four women (63.5%) had normal and 31 (36.5%) had abnormal recovery at 6 months. At 6 weeks, women with abnormal recovery had decreased pelvic floor strength by Oxford scores (3 [2–5], 6 [2–8];P= 0.002), lower point Bp (−1 [−3 to 0], −2 [−3 to −1];P= 0.02), larger genital hiatus (4 [3 to 4], 3 [3 to 3.5];P= 0.02), and higher levator ani injury rate (76.7%, 22.4%;P< 0.001). Between-group questionnaire differences were not clinically significant. Our final model included postpartum examination findings or birth characteristics: Oxford Scale, 6-week Pelvic Organ Prolapse Quantification GH strain, infant head circumference, and second stage ≥120 minutes. The area under the curve for predicting abnormal recovery at 6 months was 0.84, indicating a good sensitivity and specificity balance.ConclusionThe model identifies women at risk for an abnormal recovery trajectory.
Current advance on distal myopathy genetics
Authors: Ranta-aho Johanna , Johari Mridul , Udd Bjarne 
Published: July 2024

Purpose of review
Distal myopathies are a clinically heterogenous group of rare, genetic muscle diseases, that present with weakness in hands and/or feet at onset. Some of these diseases remain accentuated in the distal muscles whereas others may later progress to the proximal muscles. In this review, the latest findings related to genetic and clinical features of distal myopathies are summarized.

Recent findings
Variants in SMPX, DNAJB2, and HSPB6 have been identified as a novel cause of late-onset distal myopathy and neuromyopathy. In oculopharyngodistal myopathies, repeat expansions were identified in two novel disease-causing genes, RILPL1 and ABCD3. In multisystem proteinopathies, variants in HNRNPA1 and TARDBP, genes previously associated with amyotrophic lateral sclerosis, have been shown to cause late-onset distal myopathy without ALS. In ACTN2-related distal myopathy, the first recessive forms of the disease have been described, adding it to the growing list of genes were both dominant and recessive forms of myopathy are present.

Summary
The identification of novel distal myopathy genes and pathogenic variants contribute to our ability to provide a final molecular diagnosis to a larger number of patients and increase our overall understanding of distal myopathy genetics and pathology.
Improving the quality of medication administration practices in a tertiary Australian hospital: a best practice implementation project
Authors: Brown Travis , Roberts Elizabeth , Lizarondo Lucylynn , McArthur Alexa , Basnet Pravala , Basukoski Monica , Cheng Stephanie , Findlay Bernadette , Gao Jessica , Joshua Ranjit Kanagaraj , Jun Rosa , Kennedy Rosemary , Laing Michelle , Lawler Margaret , Ling Rachel , Lo Yin , Lockwood Craig , Mandla Andrea , Milnes Cate , Rule Michele Louise , Taylor Joanna , Thornton Anna 
Published: July 2024

ABSTRACT

Introduction:
Medication safety is an important health priority that focuses on preventing harm from medication-related events. Unsafe medication administration practices can lead to errors, which can cause avoidable injury (or harm) to patients.

Objectives:
This paper reports on an evidence implementation project conducted in a large tertiary hospital in Australia to improve nursing compliance with best practice recommendations for medication administration.

Methods:
The project was guided by JBI's seven-phase approach to evidence implementation, using audit and feedback and a structured framework to identify barriers, enablers, and implementation strategies.

Results:
The project resulted in improved compliance with best practice recommendations. This was achieved through multimodal strategies, including education, improved access to resources, and targeted feedback and discussion sessions to encourage culture and behavior change.

Conclusions:
The project improved nurses’ medication administration practices, specifically in performing independent second checks. Collaborative efforts of the project leads facilitated the review of medication administration policy and the development of staff education resources. Patient engagement remains an area for improvement, along with the potential need for further ongoing medication education.

Spanish abstract:

http://links.lww.com/IJEBH/A237
GBMPurity: A Machine Learning Tool for Estimating Glioblastoma Tumour Purity from Bulk RNA-seq Data
Authors: Thomas Morgan P. H. , Ajaib Shoaib , Tanner Georgette , Bulpitt Andrew J. , Stead Lucy F. 
Published: July 2024

AbstractBackgroundGlioblastoma (GBM) presents a significant clinical challenge due to its aggressive nature and extensive heterogeneity. Tumour purity, the proportion of malignant cells within a tumour, is an important covariate for understanding the disease, having direct clinical relevance or obscuring signal of the malignant portion in molecular analyses of bulk samples. However, current methods for estimating tumour purity are non-specific, unreliable or technically demanding. Therefore, we aimed to build a reliable and accessible purity estimator for GBM.MethodsWe developed GBMPurity, a deep learning model specifically designed to estimate the purity of IDH-wildtype primary GBM from bulk RNA-seq data. The model was trained using simulated pseudobulk tumours of known purity from labelled single-cell data acquired from the GBmap resource. The performance of GBMPurity was evaluated and compared to several existing tools using independent datasets.ResultsGBMPurity outperformed existing tools, achieving a mean absolute error of 0.15 and a concordance correlation coefficient of 0.88 on validation datasets. We demonstrate the utility of GBMPurity through inference on bulk RNA-seq samples and reveal reduced purity of the Proneural molecular subtype attributed to increased presence of healthy brain cells.ConclusionsGBMPurity provides a reliable and accessible tool for estimating tumour purity from bulk RNA-seq data, enhancing the interpretation of bulk RNA-seq data and offering valuable insights into GBM biology. To facilitate the use of this tool by the wider research community, GBMPurity is available as a web-based tool at:https://gbmdeconvoluter.leeds.ac.uk/.Key PointsGBMPurity is a glioblastoma-specific purity estimation tool.The model accurately estimates the purity of bulk RNA-seq data, outperforming existing tools.The model is available online at:https://gbmdeconvoluter.leeds.ac.uk/.Importance of the StudyGlioblastoma (GBM) is a deadly brain tumour with a dismal prognosis. Research on this disease has lagged compared to other cancers, underscoring the need to streamline investigations. The cellular composition of the GBM tumour microenvironment significantly influences therapy resistance, prognosis, and the molecular state of neoplastic cells. Consequently, tumour purity (the proportion of malignant cells within a tumour) is a critical variable for understanding and contextualizing molecular and clinical analyses. We present GBMPurity (https://gbmdeconvoluter.leeds.ac.uk/), an accessible, GBM-specific tool that accurately predicts sample purity from bulk RNA-seq data. This tool can be used by the wider research community to support the interpretation of bulk omics data and accelerate the identification of more effective therapeutic strategies for treating GBM.
On the Geometry of Somatosensory Representations in the Cortex
Authors: Saadon-Grosman Noam , Asher Tsahi , Loewenstein Yonatan 
Published: July 2024

AbstractIt is well-known that cortical areas specializing in the processing of somatosensory information from different parts of the body are arranged in an orderly manner along the cortex. It is also generally accepted that in the cortex, somatosensory information is initially processed in the primary somatosensory cortex and from there, it is hierarchically processed in other cortical regions. Previous studies have focused on the organization of representation at a level of a single or few cortical regions, identifying multiple body maps. However, the question of the large-scale organization of these different maps, and their relation to the hierarchical organization has received little attention. This is primarily because the highly convoluted shape of the cortical surface makes it difficult to characterize the relationship between cortical areas that are centimeters apart. Here, we used functional MRI to characterize cortical responses to full-body light touch stimulation. Our results indicate that the organization of both body representation and hierarchy is radial, with a small number of extrema that reign over a large number of cortical regions. Quantitatively computing the local relationship between the gradients of body and hierarchy maps, we show that the interaction between these two radial geometries, body representation and hierarchy in S1 are approximately orthogonal. However, this orthogonality is restricted to S1. Similar organizational patterns in the visual and auditory systems suggest that radial topography may be a common feature across sensory systems.Significance statementThe sensation of touch on our skin is represented in the brain as a map, where body parts are organized sequentially from head to toe. In the cerebral cortex, multiple body maps are distributed across numerous regions, processing signals at different hierarchical levels. Is there a large-scale organization of these body maps in the cerebral cortex? We show that all previously known body maps and their hierarchies are organized with a radial geometry. Similar radial geometry may also characterize the visual and auditory systems, indicating that radial geometry is a common organizational principle of sensory processing in the cortex.
OsHMA3overexpression works more efficiently in generating low-Cd rice grain thanOsNramp5knockout mutation
Authors: Gui Yuejing , Teo Joanne , Tian Dongsheng , Mohan Raji , Yin Zhongchao 
Published: July 2024

ABSTRACTCadmium (Cd) is highly toxic and a carcinogen to humans. Rice is prone to absorbing Cd and accumulating it in the grain, which raises health concerns for rice consumers. OsNramp5 is a major transporter for Cd and manganese (Mn) uptake in rice, whereas OsHMA3 is a tonoplast-localized transporter for Cd detoxification. In this study, we compared the efficiency ofOsNramp5knockout mutation andOsHAM3overexpression in reducing Cd content in the rice grain. The grain Cd content of theOsNramp5knockout mutants was significantly lower than that of the wild-type rice T5105. However, theOsNramp5knockout mutants still had much higher grain Cd content than the similarOsNramp5mutants reported previously or theOsHAM3overexpression line developed in our previous study. Pyramiding theOsNramp5mutant allele and theOsHAM3transgene in a double homozygous line could not further reduce grain Cd content. TheOsNramp5gene in T5105 has a haplotype II promoter, and its knockout mutation partially impairs Mn uptake in rice. Our results demonstrate thatOsHMA3overexpression works more efficiently in generating low-Cd rice grain thanOsNramp5knockout mutation without affecting Mn uptake in rice.
Generation of human appetite-regulating neurons and tanycytes from stem cells
Authors: Abay-Nørgaard Zehra , Müller Anika K , Hänninen Erno , Rausch Dylan , Piilgaard Louise , Christensen Jens Bager , Peeters Sofie , Schörling Alrik L. , Salvador Alison , Nikulina Viktoriia , Li Yuan , Kajtez Janko , Pers Tune H , Kirkeby Agnete 
Published: July 2024

SummaryThe balance between energy intake and expenditure is controlled by the hypothalamus, a small brain region characterised by high neuronal diversity. Specifically, the arcuate nucleus (ARC) and ventromedial hypothalamus (VMH) are key hypothalamic nuclei controlling appetite through behavioural response to circulating humoral signals. Yet, despite their physiological importance, the cellular and functional characteristics of this highly specialised neural region has been studied mainly in animals due to a lack of human models. Here, we fine-tuned the differentiation of human pluripotent stem cells toward the ARC and VMH hypothalamic nuclei and identified key subtype-specific progenitor markers of these subregions. We demonstrate that the timing for initiation and termination of bone morphogenetic protein (BMP) signalling is essential for controlling subregional specification of tuberal hypothalamic progenitors along the anterior-posterior axis, balancing VMH versus ARC fates. A particular population of SHH-/NKX2.1+/FGF10high/RAXhigh/TBX3highposterior tuberal progenitors was identified as the source for generation of ARC-associated agouti-related peptide (AGRP) neurons and tanycytes whilst anterior tuberal SHH+/NKX2.1+/FGF10low/RAXlow/TBX3lowprogenitors generated VMH phenotypes including NR5A1 neurons. Upon maturationin vitroand in xenografts, ARC-patterned progenitors gave rise to key appetite-regulating cell types including those producing AGRP, prepronociceptin (PNOC), growth hormone-releasing hormone (GHRH), thyrotropin-releasing hormone (TRH) and pro-opiomelanocortin (POMC), as well as tanycyte glial cells. Differentiated ARC cultures showed high transcriptomic similarity to the human ARC and displayed evidence of functionality by AGRP secretion and responsiveness to leptin and fibroblast growth factor 1 (FGF1). In summary, our work provides insights into the developmental lineages underlying hypothalamic subregional specification and enables access to highly characterised human ARC and VMH cultures, which will provide novel opportunities for investigating the cellular and molecular pathways triggered by obesity-associated genetic variants and weight-regulating stimuli.