bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Epidemiology, Management, and Outcomes of Civilian Gunshot Wounds to the Upper Extremity at an Urban Trauma Center
Authors: Muss Tessa E. , Hu Sophia , Bauder Andrew R. , Lin Ines C. 
Published: April 2024

Background:
Gunshot wounds (GSWs) create significant morbidity in the United States. Upper extremity (UE) GSWs are at high risk of combined injuries involving multiple organ systems and may require variable treatment strategies. This study details the epidemiology, management, and outcomes of civilian UE GSWs at an urban level 1 trauma center.

Methods:
Using the University of Pennsylvania Trauma Registry, all adult patients with UE GSWs from 2015 to 2020 who were at least 6-months postinjury were studied for demographics, injury pattern, operative details, and postoperative outcomes. Fisher exact and Wilcoxon rank sum tests were used to determine differences in treatment modalities and outcomes.

Results:
In 360 patients, the most common victim was young (x̄ = 29.5 y old), African American (89.4%), male (94.2%), and had multiple GSWs (70.3%). Soft tissue-only trauma (47.8%) and fractures (44.7%) predominated. Presence of fracture was independently predictive of neurologic, vascular, and tendinous injuries (P < 0.001). Most soft tissue-only injuries were managed nonoperatively (162/173), whereas fractures frequently required operative intervention (115 of 161, P < 0.001). Despite a prevalence of comminuted (84.6%) and open (43.6%) fractures, hardware complications (7.5%) and wound infection (1.1%) occurred infrequently.

Conclusions:
Civilian GSWs to the UE with only soft tissue involvement can often be managed conservatively with antibiotic administration, bedside washout, and local wound care. Even with combined injuries and open fractures, single-stage operative debridement and fracture care with primary or secondary closure often prevail. As civilian ballistic trauma becomes more frequent in the United States, these data help inform patient expectations and guide management.
A Novel Technique for scleral fixation of Carlevale Intraocular Lens without conjunctival opening utilizing Hoffman Pockets
Authors: Manousakis Evangelos , Gartaganis Panos S. , Manousakis Emmanouil , Karmiris Efthymios 
Published: April 2024

Purpose:
To report a novel surgical technique for scleral fixation of Carlevale intraocular lens (IOL) without conjunctival dissection using Hoffman pockets.

Methods:
An 80-years-old female with IOL dislocation in her right eye required IOL exchange. After removing the dislocated IOL, a Carlevale IOL was implanted, securing the self-blocking harpoons within scleral pockets which were constructed using Hoffman technique.

Results:
Surgical procedure was uneventful. During the next 3 months follow up, Carlevale IOL remained stable within the scleral pockets, and no signs of IOL dislocation or decentration were observed. Visual acuity significantly improved from 20/200 preoperatively up to 20/32 postoperatively due to corneal scaring from previous herpetic keratitis. No postoperative complications were recorded.

Conclusion:
Creating scleral pockets without conjunctival dissection using Hoffman pockets technique, represent a reliable and effective method for achieving both secure fixation and effective scleral covering of Carlevale IOL haptics. Absence of conjunctival opening, apart from patient postoperative comfort, reduces risk of postoperative complications, including conjunctival erosion and infection. The presented technique offers a promising alternative for Carlevale IOL scleral fixation.
Venovenous extracorporeal membrane oxygenation for severe acute respiratory distress syndrome in metastatic choriocarcinoma during systemic chemotherapy: Case report
Authors: Cappelli Jared , Edwards Amber , Emling Jonathan 
Published: April 2024

Rationale:
Gestational trophoblastic neoplasms are rare and include multiple different types of tumors such as hydatidiform moles, placental site trophoblastic tumors, and choriocarcinoma. Metastatic choriocarcinoma is well described with an excellent prognosis when treated appropriately with chemotherapy. The most common location for metastatic disease is the lungs which can unfortunately lead to severe acute respiratory distress syndrome (ARDS) in the most severe cases.

Patient concerns:
Metastatic cancer has historically been a contraindication for the use of extracorporeal life support (including extracorporeal membrane oxygenation or extracorporeal membrane oxygenation [ECMO]). With advancing technology and medicine, this contraindication has been called into question. Prior case reports describe the use of ECMO in complicated cases of metastatic cancer and even choriocarcinoma with lung metastasis and refractory ARDS.

Diagnoses:
We describe a case in which a patient with choriocarcinoma in viable pregnancy developed lung metastasis and ARDS.

Interventions:
The patient was managed with venovenous ECMO successfully.

Outcomes:
The patient was cannulated for VV-ECMO for 14 days with subsequent full pulmonary recovery.

Lessons:
The purpose of this work is to help providers understand the broad utility of ECMO and the need to assess candidacy for this therapy on a case by case basis, even in the setting of metastatic cancer.
Preclinical models for bladder cancer therapy research
Authors: Ertl Iris , Shariat Shahrokh F. , Berger Walter , Englinger Bernard 
Published: April 2024

Purpose of review
Bladder cancer (BC) is a highly heterogenous disease comprising tumours of various molecular subtypes and histologic variants. This heterogeneity represents a major challenge for the development of novel therapeutics. Preclinical models that closely mimic in vivo tumours and reflect their diverse biology are indispensable for the identification of therapies with specific activity in various BC subtypes. In this review, we summarize efforts and progress made in this context during the last 24 months.

Recent findings
In recent years, one main focus was laid on the development of patient-derived BC models. Patient-derived organoids (PDOs) and patient-derived xenografts (PDXs) were demonstrated to widely recapitulate the molecular and histopathological characteristics, as well as the drug response profiles of the corresponding tumours of origin. These models, thus, represent promising tools for drug development and personalized medicine. Besides PDXs, syngenic in vivo models are of growing importance. Since these models are generated using immunocompetent hosts, they can, amongst others, be used to develop novel immunotherapeutics and to evaluate the impact of the immune system on drug response and resistance.

Summary
In the past two years, various in vivo and in vitro models closely recapitulating the biology and heterogeneity of human bladder tumours were developed.
The Effect of an Educational Intervention on Nurses' Knowledge, Beliefs, and Actions to be Taken, Regarding Suicide
Authors: Kramer Margaret , Miniard Samantha , Hayden Maria , Hovermale Rachael , Jones Aileen , Davies Claire C. , Monroe Martha , Ponder Judy , Miller Brook 
Published: April 2024

OBJECTIVE
The aim of this study was to examine the effect of an educational intervention on nurses' knowledge defined as understanding, beliefs, and actions to be taken, regarding nurse suicide.

BACKGROUND
Between 2007 and 2018, nurses were 18% more likely to die by suicide than the general public. As a result, an assessment of nurses' knowledge regarding suicide has become an important issue for nursing administration.

METHODS
A quasi-experiment (N = 225) was conducted. Variables of interest were assessed pre and post an educational intervention on 3 domains related to suicide.

RESULTS
Significant and meaningful differences were found regarding 2 domains of interest in nurses' understanding related to nurse suicide, and actions to be taken, pre and post intervention. A significant change occurred regarding beliefs; however, the difference was small and therefore not meaningful.

CONCLUSIONS
Finding demonstrate that educational interventions focused on issues related to suicide can enhance nurses' knowledge of the challenges implicit when one considers taking one's own life.
Upper Limb Casting Application Post-Botulinum Toxin Injection for Elbow Spasticity: A Guided Casting Protocol
Authors: WORTLEY Kate , CARDA Stefano , GANZERT Carl , FARAG Jordan , REEBYE Rajiv 
Published: April 2024

Abstract
Casting is an effective adjunctive treatment which increases the effects of botulinum toxin on patients with spasticity. The evidence for casting as an adjunctive therapy post-botulinum toxin has been well documented in the literature. However, standardized casting protocols are lacking, with no published descriptions of upper limb casting application post-botulinum toxin injection for spasticity. In this paper we will describe our experience regarding the application of upper limb casting as an adjunctive therapy for elbow spasticity, detailing indications, contraindications and description of our protocol (materials required and technique).
Effects of Russian and Aussie Currents Combined With Isokinetic Training on Symptoms, Pain, Functional Mobility, and Quality of Life in Individuals With Patellofemoral Pain Syndrome
Authors: Çankaya Musa , Karakaya İlkim Çitak , Yargiç Pelin Melda , Karakaya Mehmet Gürhan 
Published: April 2024

Objective
To find out if burst-modulated medium frequency alternating currents (Russian and Aussie types) contribute to the effects of isokinetic-training in patients with patellofemoral pain, and to compare their effectiveness on symptoms, pain, functional mobility, and quality of life.

Design
Forty-five patients with patellofemoral pain were randomized into Russian current, Aussie current or placebo electrical stimulation groups. Patellofemoral Pain Severity Scale, Stair Climbing Test, Anterior Knee Pain Scale, Knee Outcome Survey Activities of Daily Living Scale, and Short Form-36 data were obtained before and after 15 sessions of interventions and at the end of a 3-wk follow-up period.

Results
Severity of symptoms and pain decreased; functional mobility, activity limitations and quality of life improved significantly after interventions (P < 0.05), and these effects were maintained at the follow-up period (P < 0.05). The amount of improvements in symptom and pain severity, and quality of life was higher in the Russian and Aussie current groups than in the placebo group (P < 0.05).

Conclusions
In patients with patellofemoral pain, burst-modulated medium frequency alternating currents may provide extra benefit in improving symptoms, pain, functional mobility and quality of life, and the Aussie currents provide greater improvement in symptom and pain severity.
Glial Activity Load on PET Reveals Persistent “Smoldering” Inflammation in MS Despite Disease-Modifying Treatment
Authors: Singhal Tarun , Cicero Steven , Rissanen Eero , Ficke John , Kukreja Preksha , Vaquerano Steven , Glanz Bonnie , Dubey Shipra , Sticka William , Seaver Kyle , Kijewski Marie , Callen Alexis M. , Chu Renxin , Carter Kelsey , Silbersweig David , Chitnis Tanuja , Bakshi Rohit , Weiner Howard L. 
Published: April 2024

Purpose of the Report18F-PBR06-PET targeting 18-kDa translocator protein can detect abnormal microglial activation (MA) in multiple sclerosis (MS). The objectives of this study are to develop individualized mapping of MA using18F-PBR06, to determine the effect of disease-modifying treatment (DMT) efficacy on reducing MA, and to determine its clinical, radiological, and serological correlates in MS patients.Patients and MethodsThirty18F-PBR06-PET scans were performed in 22 MS patients (mean age, 46 ± 13 years; 16 females) and 8 healthy controls (HCs). Logarithmically transformed “glial activity load on PET” scores (calculated as the sum of voxel-by-voxelz-scores ≥4), “lnGALP,” were compared between MS and HC and between MS subjects on high-efficacy DMTs (H-DMT, n = 13) and those on no or lower-efficacy treatment, and correlated with clinical measures, serum biomarkers, and cortical thickness.ResultsCortical gray matter (CoGM) and white matter (WM) lnGALP scores were higher in MS versus HC (+33% and +48%,P< 0.001). In H-DMT group, CoGM and WM lnGALP scores were significantly lower than lower-efficacy treatment (P< 0.01) but remained abnormally higher than in HC group (P= 0.006). Within H-DMT patients, CoGM lnGALP scores correlated positively with physical disability, fatigue and serum glial fibrillary acid protein levels (r= 0.65–0.79, allP's < 0.05), and inversely with cortical thickness (r= −0.66,P< 0.05).ConclusionsHigh-efficacy DMTs decrease, but do not normalize, CoGM and WM MA in MS patients. Such “residual” MA in CoGM is associated with clinical disability, serum biomarkers, and cortical degeneration. Individualized mapping of translocator protein PET using18F-PBR06 is clinically feasible and can potentially serve as an imaging biomarker for evaluating “smoldering” inflammation in MS patients.
Visual and Pharmacotherapy Outcomes After Transverse Sinus Stenting for Idiopathic Intracranial Hypertension
Authors: Handzic Armin , Xie Jim Shenchu , Hendriks Eef , Mosimann Pascal , Nicholson Patrick , Micieli Jonathan , Margolin Edward 
Published: April 2024

Background:
Transverse sinus stenting (TSS) is an increasingly common treatment for patients with idiopathic intracranial hypertension (IIH). However, detailed neuro-ophthalmic evidence on visual and pharmacotherapy outcomes after TSS is scarce and heterogeneous. This study aimed to describe the visual outcomes of patients undergoing TSS for IIH and to ascertain the proportion of patients who could be weaned off intracranial pressure (ICP)-lowering medication postoperatively.

Methods:
A retrospective chart review of all patients with IIH from 2 tertiary academic neuro-ophthalmology practices who underwent TSS between 2016 and 2022 was performed. Indications for stenting included failure of pharmacotherapy, intolerance of pharmacotherapy, and acute vision loss from severe papilledema. Data on demographics, symptoms, visual function, pharmacotherapy, and TSS were collected. The paired Wilcoxon rank sum test was used to compare changes in visual acuity (VA) and visual field mean deviation (VFMD) between the baseline and most recent visits.

Results:
Of the 435 patients with IIH, 15 (13 women) met inclusion criteria. After TSS, ICP-lowering pharmacotherapy was discontinued in 10 patients and decreased in 4; 1 patient was not on ICP-lowering medication before TSS. All patients experienced resolution or improvement of symptoms (10 resolution, 4 improved, 1 asymptomatic before TSS) and papilledema (11 resolution, 4 improved) after stenting. Papilledema resolution was confirmed with optical coherence tomography–measured peripapillary nerve fiber layer thickness (median decrease 147 µm, interquartile range 41.8–242.8 µm, P < 0.001). Change in VA between the baseline and most recent visit was not significant, but VFMD improved significantly after stenting (median increase 3.0, IQR 2.0–4.2, P < 0.001). No patient developed transverse sinus restenosis nor in-stent thrombosis postoperatively across a median venogram follow-up of 20.8 (11.3–49.8) weeks. In addition, no patient required subsequent surgical intervention for IIH.

Conclusions:
In this cohort of patients with IIH and fulminant presentation, medication resistance, or medication intolerance, TSS was an effective and safe treatment modality. Most patients were able to stop ICP-lowering medications while demonstrating striking improvement in symptomatology and visual function.
Instruction Alters the Influence of Allocentric Landmarks in a Reach Task
Authors: Musa Lina , Yan Xiaogang , Crawford J. Douglas 
Published: April 2024

AbstractAllocentric landmarks have an implicit influence on aiming movements, but it is not clear how an explicit instruction (to aim relative to a landmark) influences reach accuracy and precision. Here, 12 participants performed a task with two instruction conditions (egocentricvs.allocentric), but with similar sensory and motor conditions. Participants fixated gaze near the centre of a display aligned with their right shoulder while a target stimulus briefly appeared alongside a visual landmark in one visual field. After a brief mask/memory delay the landmark then re-appeared at a different location (same or opposite visual field), creating an ego/allocentric conflict. In theegocentriccondition, participants were instructed to ignore the landmark and point towards the remembered location of the target. In theallocentriccondition, participants were instructed to remember the initial target location relative to the landmark and then reach relative to the shifted landmark (same/opposite visual field). To equalize motor execution between tasks, participants were instructed to anti-point (point to the visual field opposite to the remembered target) on 50 % of the egocentric trials. Participants were more accurate, precise, and quicker to react in the allocentric condition, especially when pointing to the opposite field. We also observed a visual field effect, where performance was worse overall in the right visual field. These results suggest that when egocentric and allocentric cues conflict, explicit use of the visual landmark provides better reach performance than reliance on noisy egocentric signals. Such instructions might aid rehabilitation when the egocentric system is compromised by disease or injury.Highlights12 participants reached to remembered targets in the presence of a visual landmarkParticipants were instructed to ignore, or point relative to, the landmarkThe landmark instruction improved reaction time, precision, and accuracyThese effects were stronger when pointing was cued toward the opposite visual fieldKnowledge of these rules might be used to enhance performance or in rehabilitation
Using GPT-4 to write a scientific review article: a pilot evaluation study
Authors: Wang Zhiping Paul , Bhandary Priyanka , Wang Yizhou , Moore Jason H. 
Published: April 2024

AbstractGPT-4, as the most advanced version of OpenAI’s large language models, has attracted widespread attention, rapidly becoming an indispensable AI tool across various areas. This includes its exploration by scientists for diverse applications. Our study focused on assessing GPT-4’s capabilities in generating text, tables, and diagrams for biomedical review papers. We also assessed the consistency in text generation by GPT-4, along with potential plagiarism issues when employing this model for the composition of scientific review papers. Based on the results, we suggest the development of enhanced functionalities in ChatGPT, aiming to meet the needs of the scientific community more effectively. This includes enhancements in uploaded document processing for reference materials, a deeper grasp of intricate biomedical concepts, more precise and efficient information distillation for table generation, and a further refined model specifically tailored for scientific diagram creation.
A graphSAGE discovers synergistic combinations of Gefitinib, paclitaxel, and Icotinib for Lung adenocarcinoma management by targeting human genes and proteins: the RAIN protocol
Authors: Sadeghi Sogand , Kiaei Ali A. , Boush Mahnaz , Salari Nader , Mohammadi Masoud , Safaei Danial , Mahboubi Mitra , Tajfam Arian , Moghadam Sabra 
Published: April 2024

AbstractBackgroundAdenocarcinoma of the lung is the most common type of lung cancer, and it is characterized by distinct cellular and molecular features. It occurs when abnormal lung cells multiply out of control and form a tumor in the outer region of the lungs. Adenocarcinoma of the lung is a serious and life-threatening condition that requires effective and timely management to improve the survival and quality of life of the patients. One of the challenges in this cancer treatment is finding the optimal combination of drugs that can target the genes or proteins that are involved in the disease process.MethodIn this article, we propose a novel method to recommend combinations of trending drugs to target its associated proteins/genes, using a Graph Neural Network (GNN) under the RAIN protocol. The RAIN protocol is a three-step framework that consists of: 1) Applying graph neural networks to recommend drug combinations by passing messages between trending drugs for managing disease and genes that act as potential targets for disease; 2) Retrieving relevant articles with clinical trials that include those proposed drugs in previous step using Natural Language Processing (NLP). The search queries include “Adenocarcinoma of the lung”, “Gefitinib”, “Paclitaxel”, “Icotinib” that searched context based in databases using NLP; 3) Analyzing the network meta-analysis to measure the comparative efficacy of the drug combinations.ResultWe applied our method to a dataset of nodes and edges that represent the network, where each node is a drug or a gene, and each edge is a p-value between them. We found that the graph neural network recommends combining Gefitinib, Paclitaxel, and Icotinib as the most effective drug combination to target this cancer associated proteins/genes. We reviewed the clinical trials and expert opinions on these medications and found that they support our claim. The network meta-analysis also confirmed the effectiveness of these drugs on associated genes.ConclusionOur method is a novel and promising approach to recommend trending drugs combination to target cancer associated proteins/genes, using graph neural networks under the RAIN protocol. It can help clinicians and researchers to find the best treatment options for patients, and also provide insights into the underlying mechanisms of the disease.HighlightsProposing the combination of medicinal compounds together for the treatment of lung adenocarcinomaachieved a p-value of 0.002858 between lung adenocarcinoma and targeted proteins/genes3-Leveraging GraphSAGE for Suggesting an Optimal Drug Combinations.Abstract Figure