bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality and Readability of Online Educational Mohs Micrographic Surgery Resources
Authors: Nigro Alexandra R. , Osman Alim , Nanda Sonali , Collins Lindsey K. 
Published: June 2024

BACKGROUNDAs internet access continues to expand, online health care information is increasingly influencing patient decisions. Mohs micrographic surgery (MMS) is commonly used in the field of dermatology but may be unfamiliar to many patients.OBJECTIVEThe purpose of this study was to identify and analyze online educational resources regarding MMS and learn how to optimize the understanding and informational content of MMS for patients and their families.MATERIALS AND METHODSThirty-two websites were evaluated for authorship, quality, and readability using DISCERN, JAMA Benchmark Criteria, and Flesch–Kincaid tests.RESULTSPhysician-authored content showed a trend toward higher quality (p= .058). Google scored higher in specific DISCERN questions when overlapping websites were excluded. Bing scored higher in JAMA criteria (p= .03) in criteria such as authorship and currency. Higher DISCERN scores correlated with lower readability.CONCLUSIONPhysician involvement improves content quality, raising questions about physicians' responsibility in online resource creation. Correlations between content quality and readability highlight potential challenges for certain demographics. Balancing medical accuracy with comprehensibility is crucial for equitable patient education. This study underscores the need to refine online resources, ensuring accurate, transparent, and accessible health care information.
Blood pressure variability at rest and during pressor challenges in patients with acute ischemic stroke
Authors: Roy Sankanika , Lam Man Y. , Panerai Ronney B. , Robinson Thompson G. , Minhas Jatinder S. 
Published: June 2024

Introduction
Patients with acute ischemic stroke (AIS) have elevated blood pressure (BP) variability (BPV) and reduced baroreflex sensitivity (BRS) at rest for several days after initial stroke symptoms. We aimed to assess BPV and BRS in AIS patients during pressor challenge maneuvers in the acute and subacute phases of stroke. Pressor challenge maneuvers simulate day-to-day activities and can predict the quality of life.

Methods
Continuous beat-to-beat BP and ECG in 15 AIS patients (mean age 69 ± 7.5 years) and 15 healthy controls (57 ± 16 years) were recorded at rest and during a 5-min rapid head positioning (RHP) paradigm. Patients were assessed within 24 h (acute phase) and 7 days (subacute phase) of stroke onset. Low frequency (LF) SBP power (measure of BPV), LF-α, and combined α-index (measure of BRS) were calculated from the recordings.

Results
In the acute phase, at rest, LF-SBP power was higher (P = 0.024) and α-index was lower (P = 0.006) in AIS patients than in healthy controls. There was no change in LF-SBP during RHP in the patients but in healthy controls, it increased significantly (P = 0.018). In the subacute phase, at rest, the alpha-index increased (P = 0.037) and LF-SBP decreased (P = 0.029) significantly in the AIS patients, however, there was still no rise in the LF-SBP power during RHP (P = 0.240).

Conclusion
AIS patients have a high resting BPV. High resting BPV may be responsible for blunted BPV responses during pressor challenge maneuvers such as RHP, suggesting ongoing autonomic dysfunction and compromised quality of life.
Future for cardiogenic shock research
Authors: Møller Jacob Eifer , Thiele Holger , Hassager Christian 
Published: June 2024

Purpose of review
To discuss future research themes and study design in cardiogenic shock.

Recent findings
Cardiogenic shock research faces multiple challenges, hindering progress in understanding and treating this life-threatening condition. Cardiogenic shock's heterogeneous nature poses challenges in patient selection for clinical trials, potentially leading to variability in treatment responses and outcomes. Ethical considerations arise due to the acuity and severity of the condition, posing challenges in obtaining informed consent and conducting randomized controlled trials where time to treatment is pivotal.

Summary
This review discusses research in this area focusing on the importance of phenotyping patients with cardiogenic shock, based on artificial intelligence, machine learning, and unravel new molecular mechanisms using proteomics and metabolomics. Further, the future research focus in mechanical circulatory support and targeting inflammation is reviewed. Finally, newer trial designs including adaptive platform trials are discussed.
How preclinical models help to improve outcome in cardiogenic shock
Authors: Moiroux-Sahraoui Alexander , Manicone Francesca , Herpain Antoine 
Published: June 2024

Purpose of review
Preclinical experimentation of cardiogenic shock resuscitation on large animal models represents a powerful tool to decipher its complexity and improve its poor outcome, when small animal models are lacking external validation, and clinical investigation are limited due to technical and ethical constraints. This review illustrates the currently available preclinical models addressing reliably the physiopathology and hemodynamic phenotype of cardiogenic shock, highlighting on the opposite questionable translation based on low severity acute myocardial infarction (AMI) models.

Recent findings
Three types of preclinical models replicate reliably AMI-related cardiogenic shock, either with coronary microembolization, coronary deoxygenated blood perfusion or double critical coronary sub-occlusion. These models overcame the pitfall of frequent periprocedural cardiac arrest and offer, to different extents, robust opportunities to investigate pharmacological and/or mechanical circulatory support therapeutic strategies, cardioprotective approaches improving heart recovery and mitigation of the systemic inflammatory reaction. They all came with their respective strengths and weaknesses, allowing the researcher to select the right preclinical model for the right clinical question.

Summary
AMI-related cardiogenic shock preclinical models are now well established and should replace low severity AMI models. Technical and ethical constraints are not trivial, but this translational research is a key asset to build up meaningful future clinical investigations.
What is cardiogenic shock? New clinical criteria urgently needed
Authors: Ostadal Petr , Belohlavek Jan 
Published: June 2024

Purpose of review
Cardiogenic shock is a clinical syndrome with different causes and a complex pathophysiology. Recent evidence from clinical trials evokes the urgent need for redefining clinical diagnostic criteria to be compliant with the definition of cardiogenic shock and current diagnostic methods.

Recent findings
Conflicting results from randomized clinical trials investigating mechanical circulatory support in patients with cardiogenic shock have elicited several extremely important questions. At minimum, it is questionable whether survivors of cardiac arrest should be included in trials focused on cardiogenic shock. Moreover, considering the wide availability of ultrasound and hemodynamic monitors capable of arterial pressure analysis, the current clinical diagnostic criteria based on the presence of hypotension and hypoperfusion have become insufficient. As such, new clinical criteria for the diagnosis of cardiogenic shock should include evidence of low cardiac output and appropriate ventricular filling pressure.

Summary
Clinical diagnostic criteria for cardiogenic shock should be revised to better define cardiac pump failure as a primary cause of hemodynamic compromise.
Exercise training in solid organ transplant candidates and recipients
Authors: Bourgeois Nicholas , Tansey Catherine M. , Janaudis-Ferreira Tania 
Published: June 2024

Purpose of reviewExercise training programs are an integral part of the management of solid organ transplantation (SOT) candidates and recipients. Despite this, they are not widely available and specific guidelines on exercise parameters for each type of organ are not currently provided. A review of this topic could help clinicians to prescribe appropriate exercise regimens for their patients.Recent findingsIn this narrative review, we discuss the physical impairments of SOT candidates and recipients and how these affect their physical function and transplant outcomes. We examine recent systematic reviews, statements, and randomized controlled trials on exercise training in SOT candidates and recipients and present the current available evidence while providing some practical recommendations for clinicians based on the frequency, intensity, time, and type principle.SummaryWhile randomized controlled trials of better methodology quality are needed to strengthen the evidence for the effects of exercise training and for the optimal training characteristics, the available evidence points to beneficial effects of many different types of exercise. The current evidence can provide some guidance for clinicians on the prescription of exercise training for transplant candidates and recipients.
In vivo study of the effect of anlotinib on the stemness of the lenvatinib-resistant hepatocellular carcinoma cells and the underlying mechanisms
Authors: Zhan Jing , Huang Shu , Wei Bai , Huang Zao-Zao , Yang Sheng-Li 
Published: June 2024

AbstractBackgroundIn vivo experiments were conducted to examine the effects of the targeted drug anlotinib on the stemness of hepatocellular carcinoma (HCC) cells and lenvatinib-resistant liver cancer cells and to explore the underlying molecular mechanisms.MethodsA subcutaneous xenograft model of Hep3B-derived HCC was established in nude mice, which were randomly divided into 2 groups (n = 5 males per group): (1) intragastric administration of anlotinib (0.4 mg/kg) and (2) intragastric administration of normal saline. We constructed lenvatinib-resistant cell lines and randomly divided the mice into 3 groups (n = 5 males per group): (1) intragastric administration of anlotinib, (2) intragastric administration of lenvatinib, and (3) intragastric administration of normal saline. After 2 weeks of treatment, tumor tissues were harvested, and mRNA and proteins were isolated from the tissues. Changes in the expression of cancer stemness markers (epithelial cell adhesion molecule [EpCAM], CD13, CD90, aldehyde dehydrogenase 1 [ALDH1], CD44, and CD45), totipotency factors (sex-determining region Y-box 2 [Sox2], Nanog, octamer-binding transcription factor 4 [Oct4]), and genes related to the Notch signaling pathway were examined.ResultsCompared with that in the control group, tumor size and weight were reduced in nude mice treated with anlotinib. These differences were statistically significant in both the types of nude mice. Anlotinib affected stemness markers and totipotency factors by downregulating the expression of CD133, CD90, and G-protein–coupled receptor 5 (LGR5) and upregulating the expression of intercellular adhesion molecule 1 (ICAM-1) and Sox2. In addition, lenvatinib-resistant cell lines increased Notch signaling pathway, whereas anlotinib inhibited Notch signaling pathway.ConclusionsThe antitumor effect of anlotinib on HCC and lenvatinib-resistant HCC cells may occur through inhibition of the Notch signaling pathway. Anlotinib may be the drug of choice for sequential therapy in lenvatinib-resistant liver cancer.
Downregulation of the circadian clock gene period 2 aggravates prognosis in breast cancer patients with obesity
Authors: Wu Ru-Xing , Hu Dan , Zhang Han-Wang , Huang Xiao-Yuan , Zhuang Liang 
Published: June 2024

Abstract

Background
Obese individuals diagnosed with breast cancer often experience a less favorable prognosis; however, the underlying mechanisms linking obesity to breast cancer outcomes remain elusive. This study aimed to identify and validate novel prognostic markers associated with breast cancer in patients with obesity.

Methods
We conducted a reanalysis of gene expression profiles from normal-weight, overweight, and obese breast cancer patients to identify candidate genes. Subsequently, we validated the protein levels of these candidates using immunohistochemistry. Finally, we investigated the association between candidate genes and breast cancer prognosis at Tongji Hospital, utilizing data from an 8-year follow-up through the Kaplan-Meier method and univariate and multivariate Cox regression models.

Results
The fold change of the circadian clock gene period 2 (PER2), which exhibited a declining trend with increasing body mass index, was 0.76 in obese patients compared with normal-weight patients. The expression rates of PER2 protein were 44.7%, 51.5%, and 61.3% in normal-weight, overweight, and obese patients, respectively. The 8-year recurrence-free survival rates were 75.9%, 69.6%, and 64.1%, whereas the 8-year overall survival rates were 86.8%, 83.0%, and 76.1% in normal-weight, overweight, and obese patients, respectively (P < 0.05). Furthermore, the 8-year recurrence-free survival rates were 66.2% and 76.4%, and the 8-year overall survival rates were 79.9% and 86.3% in the low and high PER2 expression groups, respectively (P < 0.05). The unadjusted hazard ratio for PER2 was 1.550 (95% confidence interval, 1.029–2.335), and the adjusted hazard ratio was 3.003 (95% confidence interval, 1.838–4.907).

Conclusions
Our findings indicate that low PER2 expression serves as an independent risk factor for breast cancer prognosis and may contribute to the unfavorable outcomes observed in obese patients.
Massive bleeding in small intestinal mucosa-associated lymphoid tissue lymphoma associated with COVID-19 infection: a case report
Authors: Huang Meiling , Wu Xiaowei , Wang Ji 
Published: June 2024

Abstract
The increased risk of mucosa-associated lymphoid tissue (MALT) lymphoma is closely associated with chronic antigenic stimulation, with infection being the most common cause of recurrence. Lesions are usually associated with the gastrointestinal tract, and the involvement of small intestinal is rare. Recent studies have established a close relationship between novel coronavirus 2019 (COVID-19) and the occurrence and progression of various diseases. This article presents a rare case of a small intestinal MALT lymphoma. The patient was initially admitted with COVID-19 pneumonia and subsequently developed gastrointestinal bleeding during hospitalization. Medical and endoscopic treatments were ineffective, and an emergency exploratory laparotomy was performed. The affected segment of the small intestine was excised, and a pathological biopsy confirmed the diagnosis of MALT lymphoma. This case underscores the significance of raising clinical awareness of this condition among health care professionals.
Columbia-Suicide Severity Rating Scale (C-SSRS) Reveals High Rates of Suicidality in 602 Patients With Cleft and Craniofacial Conditions
Authors: Romeo Dominic J. , Le Thalia , Massenburg Benjamin B. , Wu Meagan , Ng Jinggang J. , Salinero Lauren K. , Akarapimand Patrick , Liao Eric C. , Rudofker Adam , Taylor Jesse A. , Magee Leanne 
Published: June 2024

Introduction:
Little is known about rates of suicidal ideation and behavior among youth with cleft lip and/or palate (CLP) and other craniofacial conditions.

Methods:
Records of patients ages 6 and older who were administered the Columbia-Suicide Severity Rating Scale (C-SSRS) Lifetime Version during routine multidisciplinary cleft or craniofacial team visits between 2019 and 2023 were examined. Demographics information, C-SSRS data, and diagnoses were assessed with statistics including t tests, the Fisher exact test, and odds ratios.

Results:
A total of 1140 C-SSRS questionnaires across 602 (433 CLP and 169 craniofacial) patients with an average age of 11.2±3.7 years were included. Eighty-four (13.6%) patients endorsed lifetime suicidal ideation, 9 (1.5%) had at least one instance of suicidal behavior, 30 (5.0%) endorsed nonsuicidal self-injury, and 2 (0.3%) engaged in self-injurious behavior. Compared with CLP, those with other craniofacial conditions had similar odds of endorsing suicidal ideation and behavior (P≥0.05). Compared with those with isolated cleft palates, CLP had greater odds of endorsing suicidal ideation and behavior, though those differences were not significant (P≥0.05). Incidence of suicidality was unchanged before, during, and after the COVID-19 pandemic (P≥0.05). Dividing patients by sex or insurance type revealed no difference in suicidality (P≥0.05).

Conclusion
Patients with CLP and craniofacial conditions have a high incidence of suicidal ideation and behavior, though levels are similar between these groups. Suicidality in these patients was not negatively impacted by the COVID-19 pandemic. Early identification of safety risks and psychosocial challenges through regular screening can facilitate connection with appropriate clinical interventions.
Consequences of a Surveillance Strategy for Side-branch Intraductal Pancreatic Mucinous Neoplasms
Authors: Wehrle Chase J. , Hossain Mir Shanaz , Perlmutter Breanna , Chang Jenny H. , Joyce Daniel , Simon Robert , Augustin Toms , Walsh R. Matthew 
Published: June 2024

Objective:
To quantify the rate of progression in surveilled cysts and assess what factors should indicate delayed resection.

Background:
Side-branch intraductal papillary mucinous neoplasms (SB-IPMNs) are increasingly discovered, making it challenging to identify which patients require resection, thus avoiding inappropriate treatment. Most incidental lesions are surveyed, yet the consequences of that decision remain uncertain.

Methods:
A prospectively maintained database of pancreatic cystic neoplasms was queried for patients with SB-IPMN. Patients with ≥2 imaging studies >6 months apart were included. Clinically relevant progression (CR-progression) was defined by symptoms, worrisome/high-risk stigmata, or invasive cancer (IC). Growth ≥5 mm in 2 years is considered CR-progression; size ≥3 cm alone is not.

Results:
Between 1997 and 2023, 1337 patients were diagnosed with SB-IPMN. Thirty-seven (2.7%) underwent up-front surgery; 1000 (75.0%) had >6 months of surveillance.
The rate of CR-progression was 15.3% (n = 153) based on size increase (n = 63, 6.3%), main-duct involvement (n = 48, 4.8%), symptoms (n = 8, 5.0%), or other criteria (n = 34, 3.4%). At a median follow-up of 6.6 years (interquartile range: 3.0–10.26), 17 patients (1.7%) developed IC. Those with CR-progression developed IC in 11.1% (n = 17) and high-grade dysplasia (HGD) in 6.5% (n = 10). Nearly half of the cancers were not contiguous with the surveyed SB-IPMN.
Size ≥3 cm was not associated with HGD/IC (P = 0.232). HGD/IC was least common in CR-progression determined by size growth (6.3%) versus main-duct involvement (24%) or other (43%, P < 0.001)
Patients with CR-progression demonstrated improved survival (overall survival) with resection on time-to-event (P < 0.001) and multivariate Cox regression (hazard ratio = 0.205, 0.096–0.439, P < 0.001) analyses. Overall survival was not improved with resection in all patients (P = 0.244).

Conclusions:
CR-progression for SB-IPMNs is uncommon, with the development of cancer anywhere in the pancreas being rare. Initial size should not drive resection. Long-term and consistent nonoperative surveillance is warranted, with surgery currently reserved for CR-progression, knowing that the majority of these still harbor low-grade pathology.
Collider imprints of a right handed neutrino magnetic moment operator
Authors: Chun Eung Jin , Mandal Sanjoy , Padhan Rojalin 
Published: June 2024

We consider the most general effective Lagrangian up to dimension five, built with Standard Model fields and right-handed neutrinos (RHNs) Ni. Assuming that the RHNs are present near the electroweak scale, we study the phenomenology of the RHNs and highlight the differences that arise due to the inclusion of dimension five operators. We specifically focus on the production process e+e−/pp→NiNj, which comes from the dimension five magnetic moment operator. We find that this production process followed by the decay chains such as Ni→Njγ, Ni→νjγ, and Ni→ℓ±jj leads to striking collider signatures, which might help to probe the Majorana nature of neutrinos. We discuss the current collider constraints on this operator, as well as projected limit at future colliders. In addition, we discuss the stellar-cooling bounds applicable to the RHN mass below 0.1 GeV.

Published by the American Physical Society
2024
Lindblad dynamics from spatio-temporal correlation functions in nonintegrable spin-
1/2
chains with different boundary conditions
Authors: Kraft Markus , Richter Jonas , Jin Fengping , Nandy Sourav , Herbrych Jacek , Michielsen Kristel , De Raedt Hans , Gemmer Jochen , Steinigeweg Robin 
Published: June 2024

We investigate the Lindblad equation in the context of boundary-driven magnetization transport in spin-1/2 chains. Our central question is whether the nonequilibrium steady state of the open system, including its buildup in time, can be described on the basis of the dynamics in the closed system. To this end, we rely on a previous study [Heitmann , ], in which a description in terms of spatio-temporal correlation functions was suggested in the case of weak driving and small system-bath coupling. Because this work focused on integrable systems and periodic boundary conditions, we here extend the analysis in three directions: (1) We consider nonintegrable systems, (2) we take into account open boundary conditions and other bath-coupling geometries, and (3) we provide a comparison to time-evolving block decimation. While we find that nonintegrability plays a minor role, the choice of the specific boundary conditions can be crucial due to potentially nondecaying edge modes. Our large-scale numerical simulations suggest that a description based on closed-system correlation functions is a useful alternative to already existing state-of-the-art approaches.

Published by the American Physical Society
2024