bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and Economic Implications of Interventions in Pancreatic Fluid Collections
Authors: Varadarajulu Shyam , Cangelosi Michael J. , Cramer Geri R. , Kuipers Kevin , Reimer Stacey , Roy Ann K. 
Published: April 2024

Objective
To compare clinical and economic implications of percutaneous and endoscopic treatment approaches in patients with pancreatic fluid collections (PFCs).

Materials and Methods
This is a retrospective claims analysis of Medicare beneficiaries who underwent inpatient endoscopic or percutaneous PFC drainage procedures (2016–2020). We performed longitudinal analysis of claims for all-cause mortality and rehospitalization during 180-day follow-up. Main outcome was mortality. Other outcomes were rehospitalization and direct costs.

Results
A total of 1311 patients underwent endoscopic (n = 727) or percutaneous (n = 584) drainage. Percutaneous as compared with endoscopic approach was associated with higher mortality (23.08% vs 16.7%, P = 0.004), rehospitalization (58.9% vs 53.3%, P = 0.04), and mean direct hospital costs ($37,107 [SD = $67,833] vs $27,800 [SD = $43,854], P = 0.004). On multivariable analysis, percutaneous drainage (adjusted hazard ratio [HR], 1.38; 95% confidence interval [CI], 1.02–1.86; P = 0.039), older age (hazard ratio [HR], 1.04; 95% CI, 1.01–1.04; P < 0.001), intensive care unit stay (HR, 1.02; 95% CI, 1.01–1.03; P < 0.001), and multiple comorbidities (HR, 1.07; 95% CI, 1.05–1.09; P < 0.001) were significantly associated with mortality. Percutaneous drainage (adjusted odds ratio [OR], 1.30; 95% CI, 1.04–1.63; P = 0.027) and older age (OR, 0.98; 95% CI, 0.97–0.99; P < 0.001) were significantly associated with rehospitalizations.

Conclusions
As percutaneous drainage may be associated with higher mortality, rehospitalization, and costs, when requisite expertise is available, endoscopy should be preferred for treatment of PFC amenable to such an approach. Randomized trials are required to validate these findings.
Oncology’s Silent Caregivers
Authors: Hendricks Bailey A. , Kupzyk Kevin , Poppert Cordts Katrina M. , Lally Robin M. 
Published: April 2024

Background
Cancer affects the whole family system causing reorganization of functioning and responsibilities where children may take on a caregiving role. In the United States, an estimated 204 000 to 475 000 caregiving youth provide multifaceted, extended care in oncology. This results in both positive and negative outcomes for youth—spanning multiple domains of health.

Objective
The aim of this study was to explore the caregiving experiences, outcomes, and unmet needs of caregiving youth (aged 12-24 years) in oncology.

Methods
An explanatory sequential mixed-methods study design was used. Fifty-two adults who lived with a parent with cancer as a child were recruited via social media and asked to complete an online survey. A subsample of 18 individuals reporting high to very high amounts of caregiving were subsequently interviewed.

Results
The mean reported caregiving youth age was 16.13 (±4.86) years. They provided care approximately 22.43 h/wk for approximately 3.04 years. Most (71.2%) reported high to very high amounts of caregiving activity. The highest reported categories of unmet needs were information, family, feelings, friends, and time out/recreation. Qualitative findings included 4 themes: stepping into the role, family communication, dealing with feelings, and a new separateness.

Conclusions
Identified needs included a desire for more information to aid in uncertainty, better communication within the family, needing someone to help them process their feelings, and peer-to-peer support.

Implications for Practice
It is important for nurses and researchers to be aware of and acknowledge the needs of families dealing with cancer and aid in the development and implementation of tailored interventions to support caregiving youth.
Virtually Supervised Exercise Programs for People With Cancer
Authors: Smith Gillian V. H. , Myers Samantha A. , Fujita Rafael A. , Yu Christy , Campbell Kristin L. 
Published: April 2024

Background
Exercise has been shown to improve physical function and quality of life for individuals with cancer. However, low rates of exercise adoption and commonly reported barriers to accessing exercise programming have demonstrated a need for virtual exercise programming in lieu of traditional in-person formats.

Objective
The aim of this study was to summarize the existing research on supervised exercise interventions delivered virtually for individuals living with and beyond cancer.

Methods
We conducted a scoping review of randomized controlled trials, pilot studies, or feasibility studies investigating virtually supervised exercise interventions for adults either during or after treatment of cancer. The search included EMBASE, MEDLINE, CINAHL, SPORTDiscus, Cochrane Library, and conference abstracts.

Results
Fifteen studies were included. The interventions were delivered mostly over Zoom in a group format, with various combinations of aerobic and resistance exercises. Attendance ranged from 78% to 100%, attrition ranged from 0% to 29%, and satisfaction ranged from 94% to 100%. No major adverse events were reported, and only 3 studies reported minor adverse events. Significant improvements were seen in upper and lower body strength, endurance, pain, fatigue, and emotional well-being.

Conclusion
Supervised exercise interventions delivered virtually are feasible and may improve physical function for individuals with cancer. The supervision included in these virtual programs promoted similar safety as seen with in-person programming. More randomized controlled trials with large cohorts are needed to validate these findings.

Implications for Practice
Individuals living with and beyond cancer can be encouraged to join virtually supervised exercise programs because they are safe, well enjoyed, and may improve physical function and quality of life.
LGBTI Healthcare in Medical Education
Authors: Elboga Gulcin , Kocamer Sahin Sengul , Demir Bahadır , Ozdamar Unal Gulin , Alparslan Beyza , Altıntaş Ezel , Marangoz Talip Kerem , Guneyligil Kazaz Tanyeli , Altindag Abdurrahman 
Published: April 2024

Abstract
Our aim is to reveal the interaction of cultural and religious influences with professional equipment by determining the level of knowledge, sexual attitudes, and homophobia of medical students about LGBTI+ individuals. The study included 324 students from our faculty of medicine. The Hudson and Ricketts Homophobia scale, the Attitudes Towards Lesbians and Gay Men scale, and the Hendrick Sexual Attitudes scale were used with the sociodemograpic data form. Data were collected and analyzed using descriptive and inferential statistical tests. The mean score of the students from the Hudson and Ricketts Homophobia scale was 58.50. The findings of our study support that medical students consider that the education they receive in this regard is inadequate. One of the goals of undergraduate medical education is the provision of health services to all segments of society; therefore, it is recommended to make improvements in the curriculum in this regard.
Negative impact of a health insurer-mandated de-simplification from a single-tablet regimen to a two-tablet regimen
Authors: Oosterhof Piter , Van Luin Matthijs , Brinkman Kees , Burger David M. 
Published: April 2024

Objectives:
Antiretroviral therapy (ART) accounts for a considerable proportion of HIV care expenses. In June 2021, a Dutch healthcare insurer implemented a mandatory policy to de-simplify branded RPV/TDF/FTC (Eviplera) into a two-tablet regimen containing rilpivirine (Edurant) and generic TDF/FTC as part of cost-saving measures. The objectives of this study were to evaluate the acceptance of this policy, the trends in ART dispensation, and cost developments.

Design:
A retrospective database study.

Methods:
In this study, medication dispensation data were obtained from the Dutch Foundation for Pharmaceutical Statistics (SFK). This database covers 98% of all medication dispensations from Dutch pharmacies including people with HIV who receive ART. We received pseudonymized data exclusively from individuals insured by the insurer for the years 2020–2022. Costs were calculated using Dutch drug prices for each year.

Results:
In June 2021, 128 people with HIV were on branded RPV/TDF/FTC. Following the policy implementation, 59 (46%) had switched to RPV + generic TDF/FTC, but after 1.5 years, only 17 of 128 individuals (13%) used the proposed two-tablet regimen. The other 111/128 used RPV/TDF/FTC with prescriptions for ’medical necessity’ (n = 29), switched to RPV/TAF/FTC (n = 51), or other ART (n = 31). Despite expectations of cost-savings, costs increased from €72 988 in May 2021 to €75 649 in May 2022.

Conclusion:
A mandatory switch from an STR to a TTR in people with HIV proved unsuccessful, marked by low acceptance, and increased costs after 1 year. This underscores the necessity of incorporating patient and prescriber involvement in changing medication policies.
Spectrum of Imaging Findings and Complications After Hepatic Transarterial Chemoembolization for Liver Tumors
Authors: Zandieh Ghazal , Yazdaninia Iman , Afyouni Shadi , Shaghaghi Mohamadreza , Borhani Ali , Mohseni Alireza , Shaghaghi Shiva , Liddell Robert , Kamel Ihab R. 
Published: April 2024

Abstract
This study reviews the spectrum of imaging findings and complications after transarterial chemoembolization (TACE) for the treatment of primary liver tumors (hepatocellular carcinoma, cholangiocarcinoma) and liver metastases. The review encompasses a spectrum of imaging criteria for assessing treatment response, including the modified Response Evaluation Criteria in Solid Tumors guidelines, tumor enhancement, and apparent diffusion coefficient alterations.
We discuss the expected posttreatment changes and imaging responses to TACE, describing favorable and poor responses. Moreover, we present cases that demonstrate potential complications post-TACE, including biloma formation, acute cholecystitis, abscesses, duodenal perforation, arterial injury, and nontarget embolization. Each complication is described in detail, considering its causes, risk factors, clinical presentation, and imaging characteristics.
To illustrate these findings, a series of clinical cases is presented, featuring diverse imaging modalities including computed tomography, magnetic resonance imaging, and digital subtraction angiography.
Loss of Mickey Mouse Ears’ Sign in Progressive Supranuclear Palsy
Authors: Chow Tsz-Kit , Ma Kwok-Man 
Published: April 2024

Abstract
Progressive supranuclear palsy (PSP) is the most prevalent form of degenerative atypical parkinsonism. Clinical manifestations of PSP commonly encompass deficits in vertical gaze, postural stability, akinesia, and cognitive impairment. The characteristic metabolic pattern observed in PSP through FDG PET displays hypometabolism in the midbrain, striatum, thalamus, and frontal lobe. However, visual interpretation of midbrain hypometabolism poses challenges. In this report, we aim to elucidate a novel observation termed the “loss of Mickey Mouse ears’ sign,” which signifies midbrain hypometabolism as detected through visual assessment of FDG PET images.
An Analysis of Medical Malpractice Litigation Involving Orbital Fractures
Authors: Brozynski Martina , Seyidova Nargiz , Oleru Olachi , Rew Curtis , loschpe Anais Di Via , Taub Peter J. 
Published: April 2024

Background:
Orbital fractures frequently require operative management by a plastic and reconstructive surgeon. Due to the proximity to the globe and complexity of the reconstruction, orbital fractures, and related procedures have the potential to be a source of medical litigation. The aim of the present study was to review orbital fracture malpractice litigation, including case outcomes and compensatory damages.

Methods:
The Westlaw and Lexis Nexis databases were queried for jury verdicts and settlements related to orbital fracture malpractice lawsuits. The Boolean terms included “orbit! /10 fracture,” “orbit! & fracture,” and “ocular & fracture” for both databases. Cases were included if they were state or federal cases related to both orbital fracture and medical malpractice involving surgical or medical mismanagement or misdiagnosis of orbital fracture.

Results:
A total of 49 cases from 1994 to 2018 met inclusion criteria between the databases. The most common legal complaint was the defendant’s failure to make a diagnosis either by not ordering the proper radiological tests or by not interpreting radiological tests correctly, seen in 35% of cases. In 57% of the cases, the defendant was a surgeon, 46% of which involved a plastic surgeon specifically. Cases were resolved in favor of the defendant 49% of the time. Most cases (57%) resulted in a monetary outcome of $0. However, cases that were decided in favor of the plaintiff had significant compensatory damages with the majority being over $100,000, and 1 case as high as $8 million.

Conclusion:
Although almost half of the orbital fracture malpractice cases resulted in an outcome favoring the defendant, significant monetary consequences against the defendant were possible in cases when the plaintiff prevailed.
Yard Work and Gardening: A Pastime with Potential for Craniofacial Injury
Authors: Prasad Soumil , Treger Dylan , Mangal Rohan , Gompels Matthew T. , Thaller Seth R. 
Published: April 2024

Introduction:
Yard and garden tools are increasingly used by Americans. Despite the growing popularity of gardening as a leisure activity, the rate of injury associated with these tools remains remarkedly high. Previous research has highlighted the risks associated with improper handling of tools and associated potential long-term consequences. This retrospective study aims to provide a comprehensive analysis of the craniofacial injuries caused by yard and garden equipment. The investigation will emphasize the need for improved safety measures and regulations.

Methods and Materials:
Publicly available data from the National Electronic Injury Surveillance System (NEISS) database were utilized to identify craniofacial injuries related to yard and garden tool handling during a 10-year period (2013–2022). Study population included patients aged 1 to 85+ years who visited emergency departments secondary to these injuries. Data analysis involved queries for specific products and diagnostic codes related to craniofacial injuries.

Results:
Over the study period, a total of 588,384 craniofacial injuries associated with yard and garden tools were recorded, averaging 58,838 injuries annually. Men accounted for a significantly higher proportion of injuries (69.2%) compared to women (30.8%). Elderly population, particularly those aged 60 to 64 years, experienced the highest incidence of craniofacial injuries. Cranium was the most commonly affected anatomical location, comprising 34% of all injuries. Lacerations and contusions were the most frequent injury diagnoses. Greenhouse or gardening supplies and lawnmowers are the most common causative agents, respectively.

Discussion:
Our study highlights the persistent incidence of craniofacial injuries associated with yard and garden tool handling emphasizing the need for standardized safety regulations and guidelines. Sociological and demographic factors, such as differences in gardening habits and behavioral patterns between genders, contribute to the observed disparities in injury rates. Understanding the underlying factors contributing to these craniofacial injuries is crucial to promoting safer practices and reducing the overall burden associated with yard and garden tools.
Should soldiers take oral tranexamic acid before going into battle?
Authors: Cazes Nicolas , Corcostegui Simon-Pierre , Lovi Steven , Romary Emeric , Desrobert Vincent , Lidzborski Lionel , Derkenne Clément 
Published: April 2024

ABSTRACT
Tranexamic acid is an inexpensive antifibrinolytic treatment that reduces morbidity and mortality in civilian and military trauma patients. It must be administered within 3 hours of the injury, and its efficacy is greater the earlier it is given. It is already used preventively in the civilian environment in a number of indications to reduce bleeding and bleeding-related mortality. We wondered about the potential benefits of preventive oral administration of tranexamic acid prior to an assault for military personnel with a potential risk of injury.
Multi-pronged analysis of pediatric low-grade glioma reveals a unique tumor microenvironment associated with BRAF alterations
Authors: Zahedi Shadi , Riemondy Kent , Griesinger Andrea M. , Donson Andrew M. , Fu Rui , Crespo Michele , DeSisto John , Groat Madeline M. , Bratbak Emil , Green Adam , Hankinson Todd C. , Handler Michael , Vibhakar Rajeev , Willard Nicholas , Foreman Nicholas K. , Levy Jean Mulcahy 
Published: April 2024

AbstractPediatric low-grade gliomas (pLGG) comprise 35% of all brain tumors. Despite favorable survival, patients experience significant morbidity from disease and treatments. A deeper understanding of pLGG biology is essential to identify novel, more effective, and less toxic therapies. We utilized single cell RNA sequencing (scRNA-seq), spatial transcriptomics, and cytokine analyses to characterize and understand tumor and immune cell heterogeneity across pLGG. scRNA-seq revealed tumor and immune cells within the tumor microenvironment (TME). Tumor cell subsets revealed a developmental hierarchy with progenitor and mature cell populations. Immune cells included myeloid and lymphocytic cells. There was a significant difference between the prevalence of two major myeloid subclusters between pilocytic astrocytoma (PA) and ganglioglioma (GG). Bulk and single-cell cytokine analyses evaluated the immune cell signaling cascade with distinct immune phenotypes among tumor samples.KIAA1549-BRAFtumors appeared more immunogenic, secreting higher levels of immune cell activators and chemokines, compared toBRAF V600Etumors. Spatial transcriptomics revealed the differential gene expression of these chemokines and their location within the TME. A multi-pronged analysis of pLGG demonstrated the complexity of the pLGG TME and differences between genetic drivers that may influence their response to immunotherapy. Further investigation of immune cell infiltration and tumor-immune interactions is warranted.Key pointsThere is a developmental hierarchy in neoplastic population comprising of both progenitor-like and mature cell types in both PA and GG.A more immunogenic, immune activating myeloid population is present in PA compared to GG.Functional analysis and spatial transcriptomics show higher levels of immune mobilizing chemokines inKIAA1549-BRAFfusion PA tumor samples compared toBRAFV600E GG samples.Importance of the StudyWhile scRNA seq provides information on cellular heterogeneity within the tumor microenvironment (TME), it does not provide a complete picture of how these cells are interacting or where they are located. To expand on this, we used a three-pronged approach to better understand the biology of pediatric low-grade glioma (pLGG). By analyzing scRNA-seq, secreted cytokines and spatial orientation of cells within the TME, we strove to gain a more complete picture of the complex interplay between tumor and immune cells within pLGG. Our data revealed a complex heterogeneity in tumor and immune populations and identified an interesting difference in the immune phenotype among different subtypes.
Testis- and ovary-expressedpolotranscripts and gene duplications affect male fertility when expressed in the germline
Authors: Najera Paola , Dratler Olivia A , Mai Alexander B , Elizarraras Miguel , Vanchinathan Rahul , Gonzales Christopher A. , Meisel Richard P. 
Published: April 2024

AbstractPolo-like kinases (Plks) are essential for spindle attachment to the kinetochore during prophase and the subsequent dissociation after anaphase in both mitosis and meiosis. There are structural differences in the spindle apparatus between mitosis, male meiosis, and female meiosis. It is therefore possible that alleles of Plk genes could improve kinetochore attachment or dissociation in spermatogenesis or oogenesis, but not both. These opposing effects could result in sexually antagonistic selection at Plk loci. In addition, Plk genes have been independently duplicated in many different evolutionary lineages within animals. This raises the possibility that Plk gene duplication may resolve sexual conflicts over mitotic and meiotic functions. We investigated this hypothesis by comparing the evolution, gene expression, and functional effects of the single Plk gene inDrosophila melanogaster(polo) and the duplicated Plks inDrosophila pseudoobscura(Dpse-poloandDpse-polo-dup1). We found that the protein-coding sequence ofDpse-polo-dup1is evolving significantly faster than a canonicalpologene across all functional domains, yet the essential structure of encoded protein appears to be retained.Dpse-polo-dup1is expressed primarily in testis, while otherpologenes have broader expression profiles. Furthermore, over or ectopic expression ofpoloorDpse-poloin theD. melanogastermale germline results in greater male infertility than ectopic expression ofDpse-polo-dup1. Lastly, ectopic expression ofDpse-poloor an ovary-derived transcript ofpoloin the male germline causes males to sire female-biased broods. However, there is no sex-bias in the progeny whenDpse-polo-dup1is ectopically expressed or a testis-derived transcript ofpolois overexpressed in theD. melanogastermale germline. Our results therefore suggest thatDpse-polo-dup1may have experienced positive selection to improve its regulation of the male meiotic spindle, resolving sexual conflict over meiotic Plk functions. Alternatively,Dpse-polo-dup1may encode a hypomorphic Plk that has reduced deleterious effects when overexpressed in the male germline. Similarly, testis transcripts ofD. melanogaster polomay be optimized for regulating the male meiotic spindle, and we provide evidence that the untranslated regions of thepolotranscript may be involved in sex-specific germline functions.
Cross-subject brain entropy mapping
Authors: Del Mauro G. , Wang Z. 
Published: April 2024

AbstractWe present a method to map the regional similarity between resting state fMRI activities of different individuals. The similarity was measured using cross-entropy. Group level patterns were displayed based on the Human Connectome Project Youth data. While we only showed the cross-subject brain entropy (BEN) mapping results in this manuscript, the same concept can be directly extended to map the cross-sessional BEN and the cross-regional cross-subject or subject-session BEN.
DrosophilaHamlet mediates epithelial tissue assembly of the reproductive system
Authors: Wang Huazhen , Bertonnier-Brouty Ludivine , Artner Isabella , Wen Jiayu , Dai Qi 
Published: April 2024

AbstractEpithelial tissue fusion requires coordinated molecular events at the ends of two epithelial structures. Regulatory mechanisms controlling these events remain largely elusive. In theDrosophilareproductive system (RS), this fusion unites the gonad and the genital disc-derived tissues, into a continuous tube. This study unveils the pivotal role of Hamlet (Ham), aDrosophilaPR-domain containing transcription factor, in orchestrating epithelial tissue fusion in the RS. Loss ofhamleads to sterility and disconnection between the testes (TE) and seminal vesicles (SV). Systematic analysis of Ham-downstream genes reveals cytoskeletal, metabolic regulators and signaling pathway components. Ham activates genes for epithelial differentiation and remodeling, while repressing genes required for tissue growth and patterning. Using multiplexed in situ hybridization, we demonstrate spatial-temporal gene expression dynamics in contacting epithelia. Key Ham downstream effectors include E-Cadherin (E-Cad), Toll (Tl) and Wnt2 signaling pathways, regulating tissue interaction and fusion. Our findings present a comprehensive gene network crucial for heterotypic epithelial tissue fusion. Mammalian Ham orthologs PRDM3 and PRDM16 are highly expressed in epithelial tissues, suggesting a conserved role across species.