bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unspoken Truths
Authors: Collins Reagan A. , Herman Tianna , Snyder Rebecca A. , Haines Krista L , Stey Anne , Arora Tania K. , Geevarghese Sunil K. , Phillips Joseph D. , Vicente Diego , Griggs Cornelia L. , McElroy Imani E , Wall Anji E. , Hughes Tasha M. , Sen Srijan , Valinejad Jaber , Alban Andres , Swan J. Shannon , Mercaldo Nathaniel , Jalali Mohammad S. , Chhatwal Jagpreet , Gazelle G. Scott , Rangel Erika , Yang Chi-Fu Jeffrey , Donelan Karen , Gold Jessica A. , West Colin P. , Cunningham Carrie 
Published: November 2023

Objective:
To characterize the current state of mental health within the surgical workforce in the United States (US).

Summary Background Data:
Mental illness and suicide is a growing concern in the medical community; however, the current state is largely unknown.

Methods:
Cross-sectional survey of the academic surgery community assessing mental health, medical error, and suicidal ideation. The odds of suicidal ideation adjusting for sex, prior mental health diagnosis, and validated scales screening for depression, anxiety, post-traumatic stress disorder (PTSD), and alcohol use disorder were assessed.

Results:
Of 622 participating medical students, trainees, and surgeons (estimated response rate=11.4-14.0%), 26.1% (141/539) reported a previous mental health diagnosis. 15.9% (83/523) of respondents screened positive for current depression, 18.4% (98/533) for anxiety, 11.0% (56/510) for alcohol use disorder, and 17.3% (36/208) for PTSD. Medical error was associated with depression (30.7% vs. 13.3%, P<0.001), anxiety (31.6% vs. 16.2%, P=0.001), PTSD (12.8% vs. 5.6%, P=0.018), and hazardous alcohol consumption (18.7% vs. 9.7%, P=0.022). 13.2% (73/551) of respondents reported suicidal ideation in the past year and 9.6% (51/533) in the past two weeks. On adjusted analysis, a previous history of a mental health disorder (aOR: 1.97, 95% CI: 1.04-3.65, P=0.033), and screening positive for depression (aOR: 4.30, 95% CI: 2.21-8.29, P<0.001) or PTSD (aOR: 3.93, 95% CI: 1.61-9.44, P=0.002) were associated with increased odds of suicidal ideation over the past 12 months.

Conclusions:
Nearly 1 in 7 respondents reported suicidal ideation in the past year. Mental illness and suicidal ideation are significant problems among the surgical workforce in the US.
A Conduit for a Culturally Competent Consent
Authors: Allar Benjamin G. , Ponce Cristina , Wallace James , Ortega Gezzer , Reich Amanda J. , Gold-Gomez Shari , Gangadharan Sidhu P. , Kent Tara S. 
Published: November 2023

Objective:
To understand medical interpreter’s perspectives on surgical informed consent discussions and provide feedback for surgeons on improving these conversations.

Summary Background Data:
Informed consent is a critical component of patient-centered surgical decision-making. For patients with limited English proficiency (LEP), this conversation may be less thorough, even with a medical interpreter, leaving patients with an inadequate understanding of their diagnosis or treatment options.

Methods:
A semi-structured interview guide was developed with input from interpreters and a qualitative research expert. We purposively sampled medical interpreters representing multiple languages until thematic saturation was achieved. Participants discussed their experience with the surgical consent discussion and process. Interview transcripts were analyzed using emergent thematic analysis.

Results:
Among 22 interpreters, there were ten languages represented and an average experience of 15 years (range 4-40 y). Four major themes were identified. First, interpreters consistently described their roles as patient advocates and cultural brokers. Second, interpreters reported unique patient attributes that influence the discussion, often based on patients’ cultural values/expectations, anticipated decisional autonomy, and family support. Third, interpreters emphasized the importance of surgeons demonstrating compassion and patience, using simple terminology, conversing around the consent, providing context about the form/process, and initiating a pre-encounter discussion. Finally, interpreters suggested reducing legal terminology on consent forms and translation into other languages.

Conclusions:
Experienced interpreters highlighted multiple factors associated with effective and culturally tailored informed consent discussions. Surgeons should recognize interpreters’ critical and complex roles, be cognizant of cultural variations among patients with LEP, and improve interpersonal and communication skills to facilitate effective understanding.
Evolution in Laparoscopic Gastrectomy from a Randomized Controlled Trial through National Clinical Practice
Authors: Markar Sheraz R. , Visser Maurits , van der Veen Arjen , Luyer Misha , Nieuwenhuijzen Grard AP , Stoot Jan HMB , Tegels Juul JW , Wijnhoven Bas , Lagarde Sjoerd , de Steur Wobbe O. , Hartgrink Henk H. , Kouwenhoven Ewout A. , Wassenaar Eelco B. , Draaisma Werner A. , Gisbertz Suzanne S. , van Berge Henehouwen Mark , van der Peet Donald L. , Ruurda Jelle , van Hillegersberg Richard ,   LOGICA Study group, Dutch Upper Gastrointestinal Cancer Audit Group
Published: November 2023

Objective:
To examine the influence of the LOGICA RCT upon the practice and outcomes from laparoscopic gastrectomy within the Netherlands.

Background:
Following RCTs the dissemination of complex interventions has been poorly studied. The LOGICA RCT included 10 Dutch centers and compared laparoscopic to open gastrectomy.

Methods:
Data were obtained from the Dutch Upper Gastrointestinal Cancer Audit (DUCA) on all gastrectomies performed in the Netherlands (2012–2021), and the LOGICA RCT from (2015–2018). Multilevel multivariable logistic regression analyses were performed to assess the effect of laparoscopic versus open gastrectomy upon clinical outcomes before, during and after the LOGICA RCT.

Results:
211 patients from the LOGICA RCT (105 open vs. 106 laparoscopic) and 4,131 patients from the DUCA dataset (1884 open vs. 2247 laparoscopic) were included. In 2012, laparoscopic gastrectomy was performed in 6% of patients, increasing to 82% in 2021. No significant effect of laparoscopic gastrectomy on postoperative clinical outcomes was observed within the LOGICA RCT. Nationally within DUCA, a shift towards a beneficial effect of laparoscopic gastrectomy upon complications was observed, reaching a significant reduction on overall (aOR:0.62; 95%CI:0.46-0.82), severe (aOR:0.64; 95%CI:0.46-0.90) and cardiac complications (aOR:0.51; 95%CI:0.30-0.89) after the LOGICA trial.

Conclusion:
The wider benefits of the LOGICA trial included safe dissemination of laparoscopic gastrectomy across the Netherlands. The robust surgical quality assurance programme in the design of the LOGICA RCT was crucial to facilitate the national dissemination of the technique following the trial and reducing potential patient harm during surgeons learning curve.
Big Data Analysis of Inflammatory Conditions Associated With Optic Neuritis
Authors: Davis James B. , Henderson Amanda D. , Carey Andrew R. 
Published: November 2023

Background:
Previous studies in the United States established multiple sclerosis (MS) as the most common cause of optic neuritis (ON). ON can be associated with other systemic inflammatory conditions including sarcoidosis, neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD), and lupus; however, prospective studies to establish risk of ON associated with these diseases are lacking. Furthermore, appropriate workup for ON is still debated.

Methods:
A deidentified electronic medical record of a tertiary care academic center was searched for ON and rheumatologic/neuro-inflammatory diseases in the medical history, diagnoses, and laboratory results; followed by the intersection of ON with each condition. We calculated frequency of systemic conditions among patients with ON and prevalence of ON in those conditions. We also calculated relative risk (RR) of underlying systemic conditions among patients with ON compared with the study patient population.

Results:
In 6.7 million charts, 5,344 cases of ON were identified. Among those, MS occurred most commonly (20.6%), followed by NMOSD (10.5%). Conversely, ON occurred in 98.4% of NMOSD cases, 53.3% of MOGAD, and 10.0% of MS. NMOSD (RR = 1,233), MOGAD (RR = 688), and MS (RR = 126) had the highest RR among the conditions we evaluated. The subset analysis showed similar findings.

Conclusions:
The high RR for ON among patients with NMOSD and MOGAD suggests that clinical suspicion for ON should be high among patients with these conditions presenting with vision changes. Conversely, MS and NMOSD should initially be high on the differential diagnosis for any patient presenting with optic neuritis.
Efficacy of Augmented Reality Combined with Indocyanine Green Fluorescence Imaging Guided Laparoscopic Segmentectomy for Hepatocellular Carcinoma
Authors: Wang Dehui , Hu Haoyu , Zhang Yuwei , Wu Xiwen , Zeng Xiaojun , Yang Jian , Fang Chihua 
Published: November 2023

BACKGROUND:
The internal anatomy of the liver is extremely complex. Laparoscopic anatomical segmentectomy requires reference to the position and alignment of intrahepatic vascular. However, the surface of the liver lacks anatomical landmarks and the liver segment boundaries cannot be identified with the naked eye. Augmented reality navigation (ARN) and indocyanine green fluorescence imaging (FI) are emerging navigation tools in liver resection. This study aimed to explore the efficacy and application value of laparoscopic anatomical segmentectomy guided by ARN combined with indocyanine green FI.

STUDY DESIGN:
Ninety-eight patients who were diagnosed with hepatocellular carcinoma and underwent laparoscopic anatomical segmentectomy from January 2018 to January 2022 were retrospectively analyzed. They were divided into the ARN-FI group (45 patients) and the non-ARN-FI group (53 patients) based on whether ARN combined with FI was applied during the operation. The differences in intraoperative and postoperative outcomes were compared.

RESULTS:
There was no significant difference in preoperative baseline data and postoperative complication rates between the 2 groups. Compared with the non-ARN-FI group, the ARN-FI group had much lower intraoperative blood loss (100 vs 200 mL, p = 0.005) and a lower incidence of remnant liver ischemia (13.3% vs 30.2%, p = 0.046). The 1- and 3-year disease-free survival rates in the ARN-FI and non-ARN-FI groups were 91.01% vs 71.15% and 70.01% vs 52.46%, respectively; the differences between the 2 groups were statistically significant (p = 0.047).

CONCLUSIONS:
The ARN-FI technology provides a more standardized approach for liver parenchyma section during laparoscopic liver resection, effectively minimizing intraoperative blood loss, reducing postoperative remnant liver ischemia, and improving oncological prognosis. This method is safe and feasible and has good clinical application prospects.
Distinct evolution of SARS-CoV-2 Omicron XBB and BA.2.86/JN.1 lineages combining increased fitness and antibody evasion
Authors: Planas Delphine , Staropoli Isabelle , Michel Vincent , Lemoine Frederic , Donati Flora , Prot Matthieu , Porrot Francoise , Guivel-Benhassine Florence , Jeyarajah Banujaa , Brisebarre Angela , Dehan Océane , Avon Léa , Boland William Henry , Hubert Mathieu , Buchrieser Julian , Vanhoucke Thibault , Rosenbaum Pierre , Veyer David , Péré Hélène , Lina Bruno , Trouillet-Assant Sophie , Hocqueloux Laurent , Prazuck Thierry , Simon-Loriere Etienne , Schwartz Olivier 
Published: November 2023

AbstractThe unceasing circulation of SARS-CoV-2 leads to the continuous emergence of novel viral sublineages. Here, we isolated and characterized XBB.1, XBB.1.5, XBB.1.9.1, XBB.1.16.1, EG.5.1.1, EG.5.1.3, XBF, BA.2.86.1 and JN.1 variants, representing >80% of circulating variants in January 2024. The XBB subvariants carry few but recurrent mutations in the spike, whereas BA.2.86.1 and JN.1 harbor >30 additional changes. These variants replicated in IGROV-1 but no longer in Vero E6 and were not markedly fusogenic. They potently infected nasal epithelial cells, with EG.5.1.3 exhibiting the highest fitness. Antivirals remained active. Neutralizing antibody (NAb) responses from vaccinees and BA.1/BA.2-infected individuals were markedly lower compared to BA.1, without major differences between variants. An XBB breakthrough infection enhanced NAb responses against both XBB and BA.2.86 variants. JN.1 displayed lower affinity to ACE2 and higher immune evasion properties compared to BA.2.86.1. Thus, while distinct, the evolutionary trajectory of these variants combines increased fitness and antibody evasion.
Transcutaneous Spinal Stimulation and Short-burst Interval Treadmill Training in Children with Cerebral Palsy: A Pilot Study
Authors: Shrivastav Siddhi R. , DeVol Charlotte R. , Landrum Victoria M. , Bjornson Kristie F. , Roge Desiree , Steele Katherine M. , Moritz Chet T. 
Published: November 2023

AbstractThe purpose of this pilot study was to evaluate the effects of transcutaneous spinal cord stimulation (tSCS) and short-burst interval locomotor treadmill training (SBLTT) on spasticity and mobility in children with cerebral palsy (CP). We employed a single-arm design with two interventions: SBLTT only, and tSCS + SBLTT, in four children with CP. Children received 24-sessions each of SBLTT only and tSCS + SBLTT. Spasticity, neuromuscular coordination, and walking function were evaluated before, immediately after, and 8-weeks following each intervention. Spasticity, measured via the Modified Ashworth Scale, reduced in four lower-extremity muscles after tSCS + SBLTT (1.40 ± 0.22,) more than following SBLTT only (0.43 ± 0.39). One-minute walk test distance was maintained during both interventions. tSCS + SBLTT led to improvements in peak hip and knee peak extension (4.9 ± 7.3° and 6.5 ± 7.7°), that drove increases in joint dynamic range of 4.3 ± 2.4° and 3.8 ± 8.7° at the hip and knee, respectively. Children and parents reported reduction in fatigue and improved gait outcomes after tSCS + SBLTT. Improvements in spasticity and walking function were sustained for 8-weeks of after tSCS + SBLTT. These preliminary results suggest that tSCS + SBLTT may improve spasticity while simultaneously maintaining neuromuscular coordination and walking function in ambulatory children with CP. Significance: This work provides preliminary evidence on the effects of tSCS and the combination of tSCS + SBLTT in children with CP.
Validating the efficacy and value proposition of Mental Fitness Vocal Biomarkers in a psychiatric population: prospective cohort study
Authors: Larsen Erik , Murton Olivia , Song Xinyu , Joachim Dale , Watts Devon , Kapczinski Flavio , Venesky Lindsey , Hurowitz Gerald 
Published: November 2023

ABSTRACTThis study represents a practical advancement in the application of vocal biomarkers for mental health tracking in real-world settings. Through a prospective cohort study involving 104 participants from an outpatient psychiatric population, we introduced a novel “Mental Fitness Vocal Biomarker” (MFVB) score, derived from eight preselected vocal features supported by literature review. Our findings demonstrate the MFVB’s efficacy in objectively stratifying individuals based on risk for elevated mental health symptom severity using the M3 Checklist for transdiagnostic assessment (depression, anxiety, post-traumatic stress disorder, and bipolar) as reference standard. Continuous observation over time significantly improves efficacy, yielding a risk ratio of 1.53 (1.09-2.14, p=0.0138) for single 30-second voice samples to 2.00 (1.21-3.30, p=0.0068) for 2-week aggregations, depending on MFVB score. Notably, in the highly engaged subgroup (5-6 MFVB uses per week, 38% of participants), a risk ratio of 8.50 (2.31-31.25, p=0.0013) was observed, underscoring the utility of frequent and continuous observation. Participant feedback confirmed the user-friendliness of the application and perceived benefits, highlighting the MFVB’s potential as a cost-effective, scalable, and privacy-preserving adjunct to traditional psychiatric assessments. These results establish that vocal biomarkers are a promising tool for objective mental health tracking in real-world conditions, offering personalized insights into users’ mental well-being as they engage with clinical therapy or other beneficial activities that are associated with improved mental health risks and outcomes.
A retrospective analysis of climate-based dengue virus transmission suitability and demographic changes over the last four decades
Authors: Nakase Taishi , Giovanetti Marta , Obolski Uri , Lourenço José 
Published: November 2023

AbstractThe geographical range and intensity of dengue virus transmission have significantly increased in recent years due to changes in climate, urbanization and human movement. Using estimates of dengue transmission suitability based on historical climate data, we analyze the effects of climate and demographic changes on the global population living in high-risk areas over the last four decades. We find that climate-related stress has been greatest in the Global South, especially in Africa and Southeast Asia. Although the geographic limits of dengue transmission suitability remained relatively stable in recent years, the global population at risk within those areas has grown by approximately 1.7 billion, driven by population growth in areas with historically dengue-favorable climate conditions. While many studies focus on future changes, we provide oft-overlooked evidence towards understanding how past climate and demographic change may have shaped the current global epidemiology of dengue.TeaserRetrospective analysis of climate and demographic changes reveals growth in global population in high-risk DENV settings.
In children with transfusion-dependent thalassemia, inflammation and neuronal damage biomarkers are associated with affective and chronic fatigue symptoms
Authors: Ridhaa Maha Abdul Saheb , Al-Hakeim Hussein Kadhem , Kahlol Mohammed K. , Al-Naqeeb Tabarek Hadi , Maes Michael 
Published: November 2023

AbstractBackgroundPatients with transfusion-dependent thalassemia (TDT) are vulnerable to neurotoxicity due to frequent blood transfusions and the subsequent iron overload (IO) and inflammation. As a result, affective (depression and anxiety) and chronic fatigue syndrome (CFS) symptoms may develop.AimsTo investigate the potential association between TDT and neuronal injury, as assessed with serum concentrations of neuronal damage biomarkers, including neurofilament light (NFL), glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), and nestin.MethodsWe investigated the associations between those CNS injury biomarkers, neuro-immune markers (C-reactive protein (CRP), interleukin (IL)-6, and IL-10), calcium, magnesium, copper and zinc, and the Fibro-Fatigue (FF), the Children’s Depression Inventory (CDI), and the Spence Children’s Anxiety Scale (SCAS) scores in 126 children with TDT and 41 healthy children.ResultsTDT children show significant increases in IO, FF, CDI, and SCAS scores, serum NSE, GFAP, NF-L, CRP, copper, IL-6, and IL-10, and lowered magnesium, zinc, and calcium as compared with healthy children. There were significant correlations between the CDI score and NFL, NSE and GFAP; SCAS score and NFL, and FF score and NFL and GFAP. The neuronal damage biomarkers (except nestin) were significantly associated with inflammatory, erythron (hematocrit and hemoglobin) and IO (iron and ferritin) biomarkers.ConclusionsTDT is characterized by intertwined increases in neuronal injury biomarkers and neuropsychiatric symptoms suggesting that TDT-associated neurotoxicity plays a role in affective symptoms and CFS due to TDT. Inflammation and neurotoxicity are novel drug targets for the prevention of affective symptoms and CFS due to TDT.
Gender based disparity in performing aortic valve surgery in the united state before availability of percutaneous valve implantation
Authors: Movahed Mohammad Reza , Soltani Arman , Hashemzadeh Mehrnoosh , Hashemzadeh Mehrtash 
Published: November 2023

AbstractBackgroundAortic valve surgery has been performed increasingly in high-risk patients. The goal of this study was to evaluate this trend based on gender in the United States before the availability of percutaneous aortic valve replacement.MethodThe Nationwide Inpatient Sample (NIS) database was utilized to calculate the age-adjusted utilization rate for aortic valve surgery from 1988 to 2011 in the United States using ICD-9 coding for aortic valve surgeryResultsA total population of 258, 506 patients underwent aortic valve between 1988-2011 were available for our study over the age of 20. We found that the age-adjusted rate of aortic valve surgery gradually increased from 1988 until 2009 and stabilized thereafter with a persistently higher rate for men. For men age-adjusted rate in 1988 was 13.3 per 100,000 vs. 27.0 in year in the year 2011 per 100,000. For women, the age-adjusted rate in 1988 was 6.07 per 100,000 vs. 11.4 in year 2011 per 100.000).ConclusionAortic valve surgery utilization has stabilized in recent years in both genders in the United States. However, this rate has been persistently more than double in men. The cause of this higher utilization in males needs further investigation.
Head Direction Cells and Grid Cells as the Core Components of the Core-periphery Structure
Authors: Qian Ruixin , Chen Yunxiang , Wang Tao , Wang Wei , Liu Feng 
Published: November 2023

AbstractHead direction cells and grid cells are neuron types defined by their regular firing patterns in standard experimental arenas. As technology advances, we can record extensive neuronal firing activity over time using electrophysiological or calcium imaging methods. The covariance matrix is a critical measure of this neural population’s discharge activity. We developed a method to identify a core-periphery structure in the covariance matrix, highlighting the central role of grid cells and head direction cells in firing correlations. This method effectively redefines these cell types in terms of firing activity correlations, with core nodes exhibiting a higher mutual information rate for spatial variables. Additionally, we developed a periodic spring network algorithm, which uses the covariance matrix alone to estimate the spatial phases of both head direction cells and grid cells due to their periodic properties. This approach offers a new perspective on utilizing the covariance matrix of the neural population to better understand and identify these specialized cell types, even when traditional firing pattern-based definitions are challenging to apply.
Expanded detection and impact ofBAP1alterations in cancer
Authors: Sturgill Ian R. , Raab Jesse R. , Hoadley Katherine A. 
Published: November 2023

AbstractAberrant expression of theBAP1tumor suppressor gene is a prominent risk factor for several tumor types and is important in tumor evolution and progression. Here we performed integrated multi-omic analyses using data from The Cancer Genome Atlas (TCGA) for 33 cancer types and over 10,000 individuals to identify alterations leading toBAP1disruption. We combined existing variant calls and new calls derived from ade novolocal realignment pipeline across multiple independent variant callers, increasing somatic variant detection by 41% from 182 to 257, including 11 indels ≥40bp. The expanded detection of mutations highlights the power of new tools to uncover longer indels and impactful mutations. We developed an expression-basedBAP1activity score and identified a transcriptional profile associated withBAP1disruption in cancer.BAP1has been proposed to play a critical role in controlling tumor plasticity and normal cell fate. Leveraging human and mouse liver datasets,BAP1loss in normal cells resulted in lowerBAP1activity scores and lower scores were associated with a less-differentiated phenotype in embryonic cells. Together, our expandedBAP1mutant samples revealed a transcriptional signature in cancer cells, supportingBAP1’sinfluences on cellular plasticity and cell identity maintenance.