bluuebunny/crossref_metadata_2025_split huggingface dataset:
The EUropean PErioperative MEdical Networking (EUPEMEN) project and recommendations for perioperative care in colorectal surgery: a quality improvement study
Authors: Pesce Antonio , Ramírez Jose Manuel , Fabbri Nicolò , Martínez Ubieto Javier , Pascual Bellosta Ana , Arroyo Antonio , Sánchez-Guillén Luis , Whitley Adam , Kocián Petr , Rosetzka Kristyna , Bona Enguita Alejandro , Ioannidis Orestis , Bitsianis Stefanos , Symeonidis Savvas , Anestiadou Elissavet , Teresa-Fernandéz Marta , Carlo Vittorio Feo 
Published: May 2024

Background:
Despite consensus supporting enhanced recovery programs, their full implementation in such a context is difficult due to conventional practices within various groups of professionals. The goal of the EUropean PErioperative MEdical Networking (EUPEMEN) project was to bring together the expertise and experience of national clinical professionals who have previously helped deliver major change programs in their countries and to use them to spread enhanced recovery after surgery protocols (ERAS) in Europe. The specific aim of this study is to present and discuss the key points of the proposed recommendations for colorectal surgery.

Materials and methods:
Five partners from university hospitals in four European countries developed the project as partners. Following a non-systematic review of the literature, the European consensus panel generated a list of recommendations for perioperative care in colorectal surgery. A list of recommendations was formulated and distributed to collaborators at each center to allow modifications or additional statements. These recommendations were then discussed in three consecutive meetings to share uniform ERAS protocols to be disseminated.

Result:
The working group developed (1) the EUPEMEN online platform to offer, free of charge, evidence-based standardized perioperative care protocols, learning activities, and assistance to health professionals interested in enhancing the recovery of their patients; (2) the preparation of the EUPEMEN Multimodal Rehabilitation manuals; (3) the training of the trainers to teach future teachers; and (4) the dissemination of the results in five multiplier events, one for each partner, to promote and disseminate the protocols.

Conclusion:
The EUPEMEN project allowed the sharing of the expertise of many professionals from four different European countries with the objective of training the new generations in the dissemination of ERAS protocols in daily clinical practice through a new learning system. This project was proposed as an additional training tool for all the enhanced recovery program teams.
Antiseptic management of critical wounds: differential bacterial response upon exposure to antiseptics and first insights into antiseptic/phage interactions
Authors: Tagliaferri Thaysa Leite , Rhode Sophie , Muñoz Priscila , Simon Kevin , Krüttgen Alex , Stoppe Christian , Ruhl Tim , Beier Justus P. , Horz Hans-Peter , Kim Bong-Sung 
Published: May 2024

Background:
With the antibiotic crisis, the topical antibacterial control including chronic wounds gains increasing importance. However, little is known regarding tolerance development when bacteria face repetitive exposure to the identical antiseptics as commonly found in clinical practice.

Materials and Methods:
Clinical isolates foremost of chronic wounds were exposed in vitro to dilutions of two antiseptics used for wound therapy: polyhexanide or octenidine. Adaptive response was determined by growth/kill curves, minimal inhibitory concentration (MIC), and whole genome sequencing. Antiseptic/bacteriophage combinations were studied by liquid-infection assays and bacterial plating.

Results:
Polyhexanide acted stronger against Escherichia coli and Proteus mirabilis while octenidine was more potent against Staphylococcus aureus. Otherwise, the antiseptic efficacy varied across isolates of Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. Upon repetitive exposure with constant antiseptic concentrations P. aeruginosa and P. mirabilis adaptation was evident by a reduced lag-phase and a twofold increased MIC. Under increasing octenidine concentrations, P. aeruginosa adapted to an eightfold higher dosage with mutations in smvA, opgH, and kinB affecting an efflux pump, alginate and biofilm formation, respectively. S. aureus adapted to a fourfold increase of polyhexanide with a mutation in the multiple peptide resistance factor MprF, also conferring cross-resistance to daptomycin. Antiseptic/bacteriophage combinations enhanced bacterial inhibition and delayed adaptation.

Conclusion:
Different bacterial species/strains respond unequally to low-level antiseptic concentrations. Bacterial adaptation potential at phenotypic and genotypic levels may indicate the necessity for a more nuanced selection of antiseptics. Bacteriophages represent a promising yet underexplored strategy for supporting antiseptic treatment, which may be particularly beneficial for the management of critical wounds.
Prevalence and location of coronary artery disease in anomalous aortic origin of coronary arteries
Authors: Zendjebil Sandra , Koutsoukis Athanasios , Rodier Thomas , Hyafil Fabien , Halna du Fretay Xavier , Dupouy Patrick , Juliard Jean-Michel , Farnoud Reza , Ou Phalla , Laissy Jean-Pierre , Couffignal Camille , Aubry Pierre ,   on behalf of the ANOCOR investigators
Published: May 2024

Background
The prevalence and location of coronary artery disease (CAD) in anomalous aortic origin of a coronary artery (AAOCA) remain poorly documented in adults. We sought to assess the presence of CAD in proximal (or ectopic) and distal (or nonectopic) segments of AAOCA. We hypothesized that the representation of CAD may differ among the different courses of AAOCA.

Methods
The presence of CAD was analyzed on coronary angiography and/or coronary computed tomography angiography in 390 patients (median age 64 years; 73% male) with AAOCA included in the anomalous coronary arteries multicentric registry.

Results
AAOCA mainly involved circumflex artery (54.4%) and right coronary artery (RCA) (31.3%). All circumflex arteries had a retroaortic course; RCA mostly an interarterial course (98.4%). No CAD was found in the proximal segment of interarterial AAOCA, whereas 43.8% of retroaortic AAOCA, 28% of prepulmonic AAOCA and 20.8% subpulmonic AAOCA had CAD in their proximal segments (P < 0.001). CAD was more prevalent in proximal than in distal segments of retroaortic AAOCA (OR: 3.1, 95% CI: 1.8–5.4, P < 0.001). On multivariate analysis, a retroaortic course was associated with an increased prevalence of CAD in the proximal segment (adjusted OR 3.4, 95% CI: 1.3–10.7, P = 0.022).

Conclusion
Increased prevalence of CAD was found in the proximal segment of retroaortic AAOCA compared to the proximal segments of other AAOCA, whereas no CAD was observed in the proximal segment of interarterial AAOCA. The mechanisms underlying these differences are not yet clearly identified.
Metachromatic leukodystrophy in infant presenting as acute febrile illness: a case report
Authors: Acharya Santosh , Upadhaya Regmi Binit , Adhikari Yuvraj , Thapa Prabin , Basnet Deep , Paudel Bikram 
Published: May 2024

Introduction and Importance:
Metachromatic leukodystrophy (MLD) is a rare genetic disorder affecting the central and peripheral nervous systems. It results from ARSA enzyme deficiency, causing sulfatide accumulation and myelin damage. Early diagnosis is crucial, and this case highlights the diagnostic challenges and rapid health deterioration associated with MLD.

Case Presentation:
A 14-month-old male, initially presenting with fever and crying during micturition, experienced a devastating health decline. Previously, he had achieved developmental milestones but rapidly lost motor and cognitive skills. Extensive investigations led to an MLD diagnosis, complicated by severe malnutrition. Despite medical interventions, his condition worsened, leading to cardiopulmonary arrest and a tragic end.

Clinical Discussion:
MLD is an exceedingly rare genetic disease with systemic effects, as illustrated by severe metabolic acidosis in this case. Early diagnosis, through comprehensive investigations like MRI, is critical, but MLD’s rapid progression poses challenges in management. Therapeutic options remain limited, emphasizing the importance of a multidisciplinary approach.

Conclusion:
This case emphasizes the insidious nature of MLD, highlighting the need for considering rare genetic conditions in unexplained neurological regression. It underscores the urgency of improved awareness, early diagnosis, and comprehensive care for individuals affected by such devastating disorders. Despite the challenges, the medical community’s dedication to providing care and support remains unwavering.
Unusual spread of cervical adenocarcinoma to the endometrium and left fallopian tube: a case report and literature review
Authors: Zeer Zahraa M. M. , Jawaada Duha , Bannoura Sami , Jaber Saadah 
Published: May 2024

Introduction:
The incidence of cervical adenocarcinoma and adenocarcinoma in situ are gradually increasing especially in younger women. However, unusual spread of cervical adenocarcinoma has rarely been reported.

Case presentation:
The authors report a case of a 60-year-old woman who presented with postmenopausal bleeding. She was misdiagnosed to have endometrial adenocarcinoma on the lower uterine segment depending on curettage specimen. After hysterectomy, it was revealed depending on morphological features in histology accompanied with immunohistochemistry that the patient had cervical adenocarcinoma with endometrial and left fallopian tube extension.

Discussion:
Distinguishing endocervical adenocarcinoma from endometroid adenocarcinoma poses many challenges especially when evaluating endometrial curettage specimens. Histological diagnosis based on morphological features combined with a panel of immunohistochemistry stains is crucial for accurate diagnosis and identifying the primary origin of the tumor.

Conclusion:
Accurate distinction between cervical adenocarcinoma versus endometrial adenocarcinoma is important because of its significant effects on choosing the appropriate treatment option.
A challenging diagnosis of Langerhans’ cell histiocytosis with hypothalamic-pituitary and mandibular involvement: case report and literature review
Authors: Ahmad Heya , Ahmad Yara , Ktyman Hanaa , Alali Mousa , Saifo Maher 
Published: May 2024

Background:
Langerhans cell histiocytosis (LCH) is a rare bone marrow derived neoplasm that mainly affects children. It is a multiorgan disorder and hypothalamic-pituitary involvement is uncommon. LCH reveals a wide spectrum of indications; thus, the diagnosis and treatment are usually challenging.

Case Report:
A 22-year-old male presented with polydipsia, polyuria with nonspecific radiological findings, later on, developed a mandibular lesion and a biopsy was conducted which led to LCH diagnosis. After many improper treatments due to unclear diagnosis, the patient was finally placed on chemotherapy and is now under surveillance.

Discussion:
LCH is a rare disease with diverse clinical manifestations affecting various organs. Associated mutations, such as BRAF V600E, contribute to its complexity. In adults, initial symptoms include pain, weight loss, and fever, with potential pituitary involvement leading to Arginine vasopressin (AVP) deficiency. Commonly affected organs include bone, skin, and the pituitary gland. The disease can be categorized into single-system and multisystem. Pathological diagnosis involves electron microscopy or immunohistochemical staining. Treatment options vary; the presented case utilized Desmopressin acetate and prednisolone before transitioning to cyclophosphamide for multisystemic LCH.

Conclusion:
AVP deficiency can suggest hypothalamic-pituitary LCH, and a biopsy, if possible, is recommended to confirm the diagnosis.
Overcome intraoperative difficulties of ALPPS procedure: a single-center outcomes and technical experience
Authors: Pham Anh The , Truong Cuong Manh , Trinh Phuong Huy 
Published: May 2024

Backgrounds/aims:
Recently, the ALPPS (Associating liver partition and portal vein ligation for staged hepatectomy) has become widely known to achieve hepatic resection by rapid future liver remnant hypertrophy, but it comes with intraoperative difficulties, followed by increased complications. This study aimed to report the outcomes of an oncology center in a low-income and middle-income country with ALPPS in patients with liver tumors and its technical variants, which were invented to overcome intraoperative difficulties of the ALPPS procedure.

Patients and methods:
A retrospective analysis of patients undergoing ALPPS from September 2022 to December 2023 was performed.

Results:
A total of 25 patients underwent the ALPPS procedure: 21 procedures for hepatocellular carcinoma (HCC), 3 combined hepatocellular-cholangiocarcinoma (cHCC-CCA), and 1 for small cell neuroendocrine carcinoma (SNEC). The mean postoperative stay was 29.6 ± 9.3 days (range 16–58 days). After stage 1, we counted 8 complications, all of grade II; after stage 2, the number of complications was decreased to 3:2 were of grade I and 1 were of grade IIIB. 3 (12%) patients failed to proceed to ALPPS stage 2. After a median follow-up of 9 months (range 2–25), disease recurrence has been recorded in 3 patients (12%), while 1 patient (4%) died, affected by HCC. The entire group’s 2-year overall survival (OS) and disease-free survival (DFS) were 83.3% and 82.5%, respectively.

Conclusion:
The ALPPS procedure is an approach for large liver tumors with small future liver remnant with acceptable OS and DFS in a low-income and middle-income country.
Management of multiple giant bladder diverticula: a comprehensive approach – a case report
Authors: Gazzah Wael , Ben Taher Souheil , Masmoudi Sedki , Hamza Mahmoud , Naouar Sahbi , Salem Braiek 
Published: May 2024

Introduction and importance:
Bladder diverticula are commonly due to obstruction of the bladder outlet and are typically treated conservatively. However, the rarity and complexity of multiple giant diverticula require a tailor-made surgical approach.

Case presentation:
We report on a 72-year-old male who presented with severe urinary symptoms and lumbar pain, diagnosed with multiple giant bladder diverticula, including one compressing the ureter. The complex presentation of the patient, including his age and comorbidities, added layers of complexity to the clinical decision-making process.

Interventions and outcomes:
The patient underwent a two-stage surgery consisting of transurethral prostate resection followed by resection of three diverticula. Postoperatively, the patient showed a remarkable improvement in urinary symptoms, resolution of hydronephrosis, and, more importantly, no complications, demonstrating the efficacy and safety of the surgical strategy chosen.

Relevance and impact:
This case underscores the challenges in managing complex bladder diverticula, highlighting the importance of personalized treatment strategies and further research in atypical urological conditions. Furthermore, this case highlights the need to increase awareness and research on rare urological conditions. By sharing detailed insights from this case, we aim to enrich the clinical knowledge base, ultimately improving patient outcomes in similar challenging scenarios.
Trauma-informed palliative care for humanitarian crises
Authors: de Groot Janet M. , Miller Danielle S. , Willis Kelcie D. , Green Tamara , Calman Lynn , Feldstain Andrea , Rao Seema R. , Bahcivan Ozan , Fehon Dwain C. 
Published: May 2024

Abstract
Healthcare triage during humanitarian crises requires attention to saving lives and prevention of suffering at end of life. The prevalence of life-threatening experiences during humanitarian crises needs a trauma-informed palliative care approach, attending to the trauma-related psychosocial needs of patients, caregivers, and health care providers to support healing. This commentary includes research and practice literature that builds on and complements themes from an International Psychosocial Oncology Society Palliative Care Special Interest Group initiative. During humanitarian crises, palliative care experts contribute to mobilizing and training host country health care providers and volunteers who reciprocally promote cultural sensitivity for patients and their caregivers in all aspects of death and dying. Future directions require assessing how best to integrate trauma-informed principles into early and later responses to humanitarian crises. Culturally sensitive research partnerships with patients and caregivers must account for hierarchy and flexibility in research design and knowledge construction.
Investigating the Role of Local Board of Health Governance on Local Health Department Policymaking Behavior
Authors: Johnson Karl , Jensen Todd , Cilenti Dorothy , Wiesman John , Lich Kristen Hassmiller 
Published: May 2024

Objectives:
This study sought to identify groupings of policymaking behavior among local governmental health departments (LHDs) across the country and assess whether such groupings were associated with the governance activity of their board of health (BOH).

Design:
We conducted latent class analysis (LCA) to identify possible classes of policymaking behavior among LHDs. Once classes were identified, we used multinomial logistic regression (MLN) to estimate the association between an LHD’s policymaking behavior and the governance activity of their BOH.

Setting:
2019 wave of the National Association of City and County Health Officials (NACCHO) Profile Survey.

Participants:
All LHDs with BOHs in the 2019 NACCHO Profile Survey (n = 1003).

Outcome Measures:
Within our MLN, our primary outcome of interest was the association between an LHD’s policymaking class (the main dependent variable) and the governance activity of its BOH (the main independent variable).

Results:
Based on our LCA, we determined our sample to be composed of what we characterized as “Limited Policy-Involvement,” “Average Policy Involvement,” and “Expanded Policy Involvement” LHDs. Those in the Expanded Class were more likely to be involved across all policy areas compared to the Limited and Average class, especially among social determinants of health (SDOH)-related areas. Our MLN estimated that having a BOH active in legal authority was associated with an 86% increased chance that an LHD would be in the “Average Class” compared to the “Limited Class” and having a BOH active in partnership engagement was associated with an 86% more likely chance that an LHD is in the “Expanded Class” compared to the “Average Class.”

Conclusion:
Using nationally representative data on LHD activity, we found distinct groups of policymaking behavior, including a quarter of LHDs that are highly active in traditional and SDOH-related policy areas. We also found that groupings of policymaking behavior, as indicated by class designation, are strongly associated with the BOH’s governance activity.
Use it or Lose it: Predictors of Compliance and Satisfaction With Postoperative Nasal Stent Therapy After Primary Cleft Lip Repair
Authors: Obinero Chioma G. , Wei Shuyan , Tran Joseph T. , Govande Janhavi V. , Nguyen Phuong D. , Greives Matthew R. 
Published: May 2024

Objective:
Postoperative nasal stents (NSs) are used to improve esthetic outcomes after primary or secondary cleft lip repair (CLR). Prior studies have utilized anthropometric measurements or physician assessment to determine the efficacy of NS, but data on caregiver-reported outcomes is limited. This study aims to assess caregiver compliance and satisfaction with postoperative NS.

Methods:
The authors designed a survey to collect parent-reported postoperative NS usage outcomes. Parents of infants with cleft lip (CL) who used postoperative NS after primary CLR were approached through social media to complete the survey. Data were analyzed to determine factors impacting compliance, satisfaction, and parent-reported outcomes.

Results:
Eighty-five parents completed the questionnaire, and 60% reported noncompliance with NS. Parents with male children (odds ratio: 5.08, P = 0.019) and patients with incomplete CL (odds ratio: 5.72, P = 0.006) were more likely to be non-compliant with NS for over a week. Complete CL and use of presurgical molding therapy were each associated with better overall experience with postoperative NS (P = 0.002 and P = 0.037), higher appearance ratings (P = 0.005 and P = 0.0008), and greater satisfaction with nostril shape after surgery (P = 0.016 and P = 0.001).

Conclusions:
Despite limited literature related to caregiver-reported outcomes after postoperative NS for primary CLR, the authors’ results align with what has been published regarding this topic. These results can help guide surgeons in counseling patients preoperatively. Larger, multi-institutional studies are needed to better delineate and address factors associated with compliance and satisfaction after NS therapy.
WITHDRAWN: Ovarian Autotransplantation and experimental life span improvement
Authors: Ruhliada Nikolai 
Published: May 2024

Withdrawal StatementThe authors have withdrawn this manuscript due to a duplicate posting of manuscript number BIORXIV/2024/592661Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author. The correct preprint can be found at doi: 10.1101/2024.05.06.592661
Evolutionary and functional analyses reveal a role for the RHIM in tuning RIPK3 activity across vertebrates
Authors: Fay Elizabeth J. , Isterabadi Kolya , Rezanka Charles M. , Le Jessica , Daugherty Matthew D. 
Published: May 2024

AbstractReceptor interacting protein kinases (RIPK) RIPK1 and RIPK3 play important roles in diverse innate immune pathways. Despite this, some RIPK1/3-associated proteins are absent in specific vertebrate lineages, suggesting that some RIPK1/3 functions are conserved while others are more evolutionarily labile. Here, we perform comparative evolutionary analyses of RIPK1-5 and associated proteins in vertebrates to identify lineage-specific rapid evolution of RIPK3 and RIPK1 and recurrent loss of RIPK3-associated proteins. Despite this, diverse vertebrate RIPK3 proteins are able to activate NF-κB and cell death in human cells. Additional analyses revealed a striking conservation of the RIP homotypic interaction motif (RHIM) in RIPK3, as well as other human RHIM-containing proteins. Interestingly, diversity in the RIPK3 RHIM can tune activation of NF-κB while retaining the ability to activate cell death. Altogether, these data suggest that NF-κB activation is a core, conserved function of RIPK3, and the RHIM can tailor RIPK3 function to specific needs within and between species.