bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic Versus Microscopic Transcanal Resection of Glomus Tympanicum: A Retrospective Comparative Study
Authors: Kunnath Ansley J. , Freeman Michael H. , Witcher Ryan , Patro Ankita , Lindquist Nathan R. , Tawfik Kareem O. 
Published: March 2024

Objective
Comparison of outcomes of microscopic and endoscopic resection of glomus tympanicum (GT) tumors

Study Design
Retrospective case review.

Setting
Single tertiary referral center.

Patients
All adult patients undergoing transcanal GT resection without mastoidectomy from 2007 to 2021

Interventions
Surgical resection—endoscopic versus microscopic approach.

Main Outcome Measures
Primary outcomes were tumor recurrence at 1 year and presence of residual tumor at conclusion of surgery. Secondary outcome measures included operative time, postoperative air-bone gap, postoperative symptom resolution, and surgical complications.

Results
Thirty-eight patients underwent resection of GT (74% female; mean age, 59 years). Twenty-nine cases were performed microscopically, and nine cases were performed endoscopically. Both endoscopic and microscopic approaches yielded high rates of complete tumor resection (27/29 microscopic cases, 7/9 endoscopic cases). There was no significant difference in mean operative time (2.3 hours for microscopic; 2.6 hours for endoscopic). On average, air-bone gaps (ABGs) decreased by 6.3 dB after endoscopic resection compared with 1.0 dB after microscopic resection (p = 0.064). No patients were found to have tumor recurrence during an average follow-up interval of 21 months.

Conclusions
These results suggest comparable outcomes with both endoscopic and microscopic approaches for GT resection, and decisions regarding preferred approach should be dictated by surgeon preference.
Enteral nutrition in septic shock: a call for a paradigm shift
Authors: Patel Jayshil J. , Lopez-Delgado Juan Carlos , Stoppe Christian , McClave Stephen A. 
Published: March 2024

Purpose of review
The purpose of this review is to identify contemporary evidence evaluating enteral nutrition in patients with septic shock, outline risk factors for enteral feeding intolerance (EFI), describe the conundrum of initiating enteral nutrition in patients with septic shock, appraise current EFI definitions, and identify bedside monitors for guiding enteral nutrition therapy.

Recent findings
The NUTRIREA-2 and NUTRIREA-3 trial results have better informed the dose of enteral nutrition in critically ill patients with circulatory shock. In both trials, patients with predominant septic shock randomized to receive early standard-dose nutrition had more gastrointestinal complications. Compared to other contemporary RCTs that included patients with circulatory shock, patients in the NUTRIREA-2 and NUTRIREA-3 trials had higher bowel ischemia rates, were sicker, and received full-dose enteral nutrition while receiving high baseline dose of vasopressor. These findings suggest severity of illness, vasopressor dose, and enteral nutrition dose impact outcomes.

Summary
The provision of early enteral nutrition preserves gut barrier functions; however, these benefits are counterbalanced by potential complications of introducing luminal nutrients into a hypo-perfused gut, including bowel ischemia. Findings from the NUTRIREA2 and NUTRIREA-3 trials substantiate a ‘less is more’ enteral nutrition dose strategy during the early acute phase of critical illness. In the absence of bedside tools to guide the initiation and advancement of enteral nutrition in patients with septic shock, the benefit of introducing enteral nutrition on preserving gut barrier function must be weighed against the risk of harm by considering dose of vasopressor, dose of enteral nutrition, and severity of illness.
Effective approaches to address noncompressible torso hemorrhage
Authors: Maegele Marc 
Published: March 2024

Purpose of review
Noncompressible torso hemorrhage (NCTH) is now considered as the major cause of preventable death after both severe military and civilian trauma. Around 20% of all trauma patients still die from uncontrolled exsanguination along with rapidly evolving hemostatic failure. This review highlights the most recent advances in the field and provides an outline for future research directions.

Recent findings
The updated definition of NCTH includes a combination of high-grade anatomical torso injury, hemodynamic instability, urgent need for hemorrhage control and aggressive hemostatic resuscitation. Therapeutic concepts consider the following three aspects: control the bleeding source (close the tap), resuscitate to maintain organ perfusion and restore hemostasis (fill the tank), and increase the body's resistance against ischemia (upgrade the armor).

Summary
The concepts for the early management of NCTH have substantially evolved over the last decade. The development of new devices and techniques combined with early intervention of hemostatic failure have contributed to more successful resuscitations. Future research needs to refine and validate their potential clinical application.
Current fistula management
Authors: Vanzant Erin , Thompson Ashley , Mendoza April , Yeh Dante 
Published: March 2024

Purpose of review
Enterocutaneous fistulas (ECFs) pose a significant impact in the healthcare system, both financially and in resource utilization. Delivery of optimal care is complex and involves intensive wound care, complex nutritional delivery and multidisciplinary care teams for optimization. Recently, there have been pushes to modernize the traditional approach to ECF care to a new paradigm of protocol-based individualized delivery of care.

Recent findings
There is an increased trend towards pushing enteral nutrition for the management of ECF patients. Adjuncts, including improved fistuloclysis devices, supplements and absorptive aides have challenged the conventional dogma of ECF treatment. There has also been increased focus on surgical prehabilitation and the ability to improve patient outcomes.

Summary
ECF care is complex and requires a multidisciplinary approach focused on source control, nutritional optimization with focus on enteral nutrition, wound care and prehabilitation.
Obesity-related asthma: new insights leading to a different approach
Authors: Witte Adjan , Türk Yasemin , Braunstahl Gert-Jan 
Published: March 2024

Purpose of review
Obesity is a growing global health threat that significantly contributes to the burden of asthma by increasing the risk of developing asthma and exerting a distinct effect on lung function and inflammation. The treatment of obesity-related asthma is hindered by a poor response to standard asthma treatments, leading to worse asthma control. Weight loss strategies have a significant effect on asthma symptoms but are not feasible for a large proportion of patients, underscoring the need for a better understanding of the pathophysiology and the development of additional treatment options.

Recent findings
Recent literature focusing on pathophysiology particularly delved into nontype 2 inflammatory mechanisms, associations with the metabolic syndrome and small airway impairment. Additionally, several new treatment options are currently investigated, including biologics, weight reduction interventions, and novel antiobesity drugs.

Summary
Obesity-related asthma is a highly prevalent asthma phenotype for which weight loss strategies currently stand as the most specific treatment. Furthermore, novel pharmacological interventions aiming at metabolic processes are on the way.
Preoperative geriatric assessment of urological patients: a narrative review
Authors: Köller Marcus 
Published: March 2024

Purpose of review
The proportion of older people is increasing disproportionately. The age between 60 and 65 years is seen as the transition to ‘old age’. Frailty is a risk factor for morbidity, mortality, and complications in the context of medical interventions or adverse effects of drug therapies. One of the core components of frailty, the age-related loss of muscle mass, is sarcopenia. Is there an influence of frailty, as well as sarcopenia and some other aspects, i.e. malnutrition, on the outcome in elderly urologic patients?

Recent findings
These phenomena of aging correlate with the incidence postoperative complication, infections, readmission rates or mortality. There are numerous studies on the value and informative value of the 5-item frailty index or the G8 questionnaire in older urological patients.

Summary
Geriatric assessment is becoming increasingly important in urological surgery. Simple instruments that are practicable in clinical routine are required in this clinical setting. Which method of preoperative assessment is chosen is secondary. It is important that the risk of geriatric syndromes is assessed prior to surgical interventions in order to determine the most suitable therapeutic approach for each patient.
Guillain-barre syndrome following COVID-19 vaccination: A study of 70 case reports
Authors: Sah Biki Kumar , Fatima Zahra , Sah Rajan Kumar , Syed Bushra , Garg Tulika , Chowdhury Selia , Ghosh Bikona , Kunwar Binita , Shree Anagha , Sah Vivek Kumar , Raut Anisha 
Published: March 2024

Background and objective:
Guillain-Barre Syndrome (GBS) has been found to have some interesting association with vaccinations. This paper mainly focuses on exploring different associations between COVID-19 vaccination and GBS.

Methods:
Electronic databases such as PubMed, Google Scholar, Cochrane, and Embase were searched using MESH terms for case reports published till 1st August 2023 from which 70 case reports were documented involving 103 individuals from 23 different countries.

Result and discussion:
The case reports were from a wide range of individuals aged from 13 to 87 years with an average age of 53±20 IQR years along with male predominance. The average time between receiving the vaccine and the onset of symptoms was 13.08±2.14 days. Prominent clinical features included back pain, facial diplegia, weakness, and paresthesia whereas the main diagnostic studies were cerebrospinal fluid (CSF) analysis and electromagnetic studies. The principal diagnostic clue was albumin-cytological dissociation in CSF while being negative for anti-ganglioside antibodies or SARS-CoV-2. Available treatment options consisted of IVIG and Plasmapheresis. Patients with comorbidities such as diabetes mellitus, hypertension, dyslipidemia, permanent atrial fibrillation, hypothyroidism, Hashimoto’s thyroiditis, COPD, asthma, osteoporosis, migraine, rheumatoid arthritis, osteoarthritis, ulcerative colitis, celiac disease, seizures, bipolar disorder, endometriosis, multiple sclerosis, bell’s palsy, squamous cell carcinoma, prostate cancer were included in our study.

Conclusion:
Overall, this review evaluated innovative and clinically relevant associations between COVID-19 vaccination and GBS. Understanding of this uncommon potential side effect of COVID-19 vaccination is crucial for prompt diagnosis and appropriate treatment. Importantly, GBS should not be considered a contraindication to vaccination. This underscores the importance of ongoing research to enhance the safety and efficacy of COVID-19 vaccination efforts.
Renal vein thrombosis in a patient secondary to high grade Rhabdoid renal cell carcinoma: a case report and review of literature
Authors: KC Manish , Bhattarai Himal Bikram , Subedi Pratik , Kashyap Ashutosh , Wadhwa Manish , Kaur Dania , Koirala Sabina , Gautam Swotantra 
Published: March 2024

Introduction:
Renal cell carcinoma, a common kidney tumor which is often incidentally discovered on imaging, can manifest with atypical symptoms. Renal cell carcinoma with rhabdoid features is a rare occurrence and even rarer in case of adults. Renal cell carcinoma has the tendency to form thrombus that can migrate to renal vein, inferior venacava and even right atrium.

Case Presentation:
The authors report a case of an 81-year-old male with rhabdoid renal cell carcinoma presenting with persistent cough for six to seven months. with tumor thrombus extending into the renal vein and hepatic inferior vena cava. The patient was found feeble for the surgery and hence was treated on anticancer drugs pembrolizumab and axitinib.

Conclusion:
Renal cell carcinoma has the tendency to form tumor thrombus in renal vein and inferior vena cava. Prognosis without surgical intervention in these conditions is very poor.
Percutaneous posterior to anterior screw fixation through achilles tendon for posterior malleolus fractures: technique description and case series
Authors: Dimitroulias Apostolos , Putur Danielle , Bogdan Yelena , Sen Milan K. 
Published: March 2024

Abstract
Posterior malleolus fractures (PMFs) (OTA 43B1.1) are frequently seen in combination with fractures of the fibula, medial malleolus, and distal tibia; they can rarely be seen in isolation. PMFs affect the alignment of the ankle mortise and the stability of syndesmosis. Techniques described for fixation of PMFs include open reduction internal fixation through a posterolateral or posteromedial approach or anterior-to-posterior screw fixation. For selected minimally displaced or nondisplaced fractures of the posterior malleolus, we developed a percutaneous technique through the Achilles tendon for the insertion of a posterior-to-anterior cannulated screw. The technique is described, and a clinical series is reviewed.
The Role of Fingernails in Death Investigation
Authors: Wankhede Ashesh Gunwantrao 
Published: March 2024

Abstract
In forensic pathology, forensic onychology studies fingernails and toenails for medicolegal purposes. It mainly deals with DNA profiling from nails, toxicological analysis for detecting poisons, and the collection of trace evidence present under the nails. Injuries to fingernails and their interpretation for medicolegal purposes are the neglected areas of this study. We have discussed the most common types of fingernail injuries and their significance. We found that their notification has significant value in drowning cases, defense wounds on the palm, self-inflicted cuts, burns, electrocution, blunt trauma, physical assault, sexual offenses, and other issues like torture. We emphasize the examination of fingernails in the autopsy and medicolegal clinical examination for better administration of law and justice.
Recovery after moderate to severe TBI and factors influencing functional outcome: What you need to know
Authors: Golden Katherine , Borsi Lydia , Sterling Ally , Giacino Joseph T. 
Published: March 2024

ABSTRACT
Traumatic brain injury (TBI) represents a major cause of death and disability, significantly impacting the lives of 2.5 million people annually in the United States. Long-term natural history studies have clarified that functional recovery continues for up to a decade, even among those who sustain severe TBI. Despite these findings, nihilistic attitudes regarding prognosis persist among clinicians, highlighting the need for improved understanding of the natural history of recovery from TBI and the factors that influence outcome. Recent advances in neuroimaging technologies and blood-based biomarkers are shedding new light on injury detection, severity classification and the physiologic mechanisms underlying recovery and decline postinjury. Rehabilitation is an essential component of clinical management after moderate to severe TBI and can favorably influence mortality and functional outcome. However, systemic barriers, including healthcare policy, insurance coverage and social determinants of health often limit access to inpatient rehabilitation services. Posttraumatic amnesia and confusion contribute to morbidity after TBI; however, early initiation and sustained provision of rehabilitation interventions optimize long-term outcome. Evidence-based reviews have clearly shown that cognitive rehabilitation strategies can effectively restore or compensate for the cognitive sequelae of TBI when used according to existing practice guidelines. Neurostimulant agents are commonly employed off-label to enhance functional recovery, however, only amantadine hydrochloride has convincingly demonstrated effectiveness when used under tested parameters. Noninvasive brain stimulation procedures, including transcranial direct current stimulation and transcranial magnetic stimulation, have emerged as promising treatments in view of their ability to modulate aberrant neuronal activity and augment adaptive neuroplasticity, but assessment of safety and effectiveness during the acute period has been limited. Understanding the natural history of recovery from TBI and the effectiveness of available therapeutic interventions is essential to ensuring appropriate clinical management of this complex population.
Social Vulnerability Index and Survivorship after Colorectal Cancer Resection
Authors: Masoud Sabran J , Seo Jein E , Singh Eden , Woody Regina L , Muhammed Makala , Webster Wendy , Mantyh Christopher R 
Published: March 2024

BACKGROUND:
Race and socioeconomic status incompletely identify patients with colorectal cancer (CRC) at the highest risk for screening, treatment, and mortality disparities. Social vulnerability index (SVI) was designed to delineate neighborhoods requiring greater support after external health stressors, summarizing socioeconomic, household, and transportation barriers by census tract. SVI is implicated in lower cancer center use and increased complications after colectomy, but its influence on long-term prognosis is unknown. Herein, we characterized relationships between SVI and CRC survival.

STUDY DESIGN:
Patients undergoing resection of stage I to IV CRC from January 2010 to May 2023 within an academic health system were identified. Clinicopathologic characteristics were abstracted using institutional National Cancer Database and NSQIP. Addresses from electronic health records were geocoded to SVI. Overall survival and cancer-specific survival were compared using Kaplan–Meier and Cox proportional hazards methods.

RESULTS:
A total of 872 patients were identified, comprising 573 (66%) patients with colon tumor and 299 (34%) with rectal tumor. Patients in the top SVI quartile (32%) were more likely to be Black (41% vs 13%, p < 0.001), carry less private insurance (39% vs 48%, p = 0.02), and experience greater comorbidity (American Society of Anesthesiologists physical status III: 86% vs 71%, p < 0.001), without significant differences by acuity, stage, or CRC therapy. In multivariable analysis, high SVI remained associated with higher all-cause (hazard ratio 1.48, 95% CI 1.12 to 1.96, p < 0.01) and cancer-specific survival mortality (hazard ratio 1.71, 95% CI 1.10 to 2.67, p = 0.02).

CONCLUSIONS:
High SVI was independently associated with poorer prognosis after CRC resection beyond the perioperative period. Acknowledging needs for multi-institutional evaluation and elaborating causal mechanisms, neighborhood-level vulnerability may inform targeted outreach in CRC care.
Mechanism of electroconvulsive therapy in schizophrenia: a bioinformatics analysis study of RNA-seq data
Authors: Wang Tingting , Yu Minglan , Gu Xiaochu , Liang Xuemei , Wang Ping , Peng Wanhong , Liu Dongmei , Chen Dechao , Huang Chaohua , Tan Youguo , Liu Kezhi , Xiang Bo 
Published: March 2024

Objective
The molecular mechanism of electroconvulsive therapy (ECT) for schizophrenia remains unclear. The aim of this study was to uncover the underlying biological mechanisms of ECT in the treatment of schizophrenia using a transcriptional dataset.

Methods
The peripheral blood mRNA sequencing data of eight patients (before and after ECT) and eight healthy controls were analyzed by integrated co-expression network analysis and the differentially expressed genes were analyzed by cluster analysis. Gene set overlap analysis was performed using the hypergeometric distribution of phypfunction in R. Associations of these gene sets with psychiatric disorders were explored. Tissue-specific enrichment analysis, gene ontology enrichment analysis, and protein–protein interaction enrichment analysis were used for gene set organization localization and pathway analysis.

Results
We found the genes of the green-yellow module were significantly associated with the effect of ECT treatment and the common gene variants of schizophrenia (P = 0.0061; family-wise error correction). The genes of the green-yellow module are mainly enriched in brain tissue and mainly involved in the pathways of neurotrophin, mitogen-activated protein kinase and long-term potentiation.

Conclusion
Genes associated with the efficacy of ECT were predominantly enriched in neurotrophin, mitogen-activated protein kinase and long-term potentiation signaling pathways.
Development of an MRI-compatible robotic perturbation system for studying the task-dependent contribution of the brainstem to long-latency responses
Authors: Nikonowicz Rebecca C. , Sergi Fabrizio 
Published: March 2024

AbstractMethodological constraints have hindered directin vivomeasurement of reticulospinal tract (RST) function. The RST is thought to contribute to the increase in the amplitude of a long latency response (LLR), a stereotypical response evoked in stretched muscles, that arises when participants are asked to “resist” a perturbation. Thus, functional magnetic resonance imaging (fMRI) during robot-evoked LLRs under different task goals may be a method to measure motor-related RST function. We have developed the Dual Motor StretchWrist (DMSW), a new MR-compatible robotic perturbation system, and validated its functionality via experiments that used surface electromyography (sEMG) and fMRI. A first study was conducted outside the MRI scanner on six participants using sEMG to measure wrist flexor muscle activity associated with LLRs under different task instructions. Participants were given a Yield or Resist instruction before each trial and performance feedback based on the measured resistive torque was provided after every “Resist” trial to standardize LLR amplitude (LLRa). In a second study, ten participants completed two sessions of blocked perturbations under 1) Yield, 2) Resist, and 3) Yield Slow task conditions (control) during whole-brain fMRI.Statistical analysis of sEMG data shows significantly greater LLRa in Resist relative to Yield. Analysis of functional images shows increased activation primarily in the bilateral medulla and midbrain, and contralateral pons and primary motor cortex in the Resist condition. The results validate the capability of the DMSW to elicit LLRs of wrist muscles with different amplitudes as a function of task instruction, and its capability of simultaneous operation during fMRI.
Alanine and glutamate catabolism ensure proper sporulation by preventing premature germination and providing energy respectively
Authors: Lyu Fengzhi , Zhang Tianyu , Yang Dong , Rao Lei , Liao Xiaojun 
Published: March 2024

AbstractSporulation as a typical bacterial differentiation process has been studied for decades. However, two crucial aspects of sporulation, (i) the energy sources supporting the process, and (ii) the maintenance of spore dormancy throughout sporulation, are scarcely explored. Here, we reported the crucial role of RocG-mediated glutamate catabolism in regulating mother cell lysis, a critical step for successful sporulation, likely by providing energy metabolite ATP. Notably,rocGoverexpression resulted in an excessive ATP accumulation in sporulating cells, leading to adverse effects on future spore properties, e.g. increased germination efficiency, reduced DPA content, and lowered heat resistance. Additionally, we revealed that Ald-mediated alanine metabolism decreased the typical germinant L-alanine concentration in sporulating environment, thereby preventing premature germination and maintaining spore dormancy. Our data inferred that sporulation was a highly orchestrated biological process requiring a delicate balance in diverse metabolic pathways, hence ensuring both the completion of sporulation and production of high-quality spores.