bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beyond the Operating Room: Exploring Gender Bias in Leadership Positions in German Plastic Surgery
Authors: Saadoun Rakan , Soqia Jameel , Ataya Jamal , Fischer Katharina S. , De La Cruz Carolyn , Kamal Abdallah , Knoedler Leonard , Risse Eva-Maria 
Published: November 2023

Background:
Despite efforts to promote gender equity in medicine, gender disparities persist in various medical specialties, including plastic surgery. This study aimed to investigate the representation of female physicians in leadership positions in German plastic surgery departments.

Methods:
This cross-sectional study collected data about the physician workforce in the German plastic surgery field. The primary outcome was the proportion of female physicians in plastic surgery departments. Data were collected from 94 departments. The physician workforce was stratified based on gender and leadership.

Results:
We included 812 physicians working in different German plastic surgery departments. Of those, 76.8% were in leadership positions, and 35.1% were women. There was a significant association between being male sex and holding a leadership position (n = 158/188, 84% versus n = 30/188, 16%, P < 0.0001). This association persisted even after accounting for the academic grade of each physician in a multivariable regression model (OR 2.565; 95% confidence interval, 1.628–4.041)

Conclusions:
Women are significantly underrepresented in leadership positions in German plastic surgery, with only 16% of female physicians holding such positions. Furthermore, being male sex was significantly associated with holding a leadership position, even after adjusting for the academic grade. These findings emphasize the existence of gender bias in the selection process for leadership positions in plastic surgery.
Cardiovascular disease prevention in women – the current state in 2023
Authors: Purohit Aarti , Kim Yoo Jin , Michos Erin D. 
Published: November 2023

Purpose of review
Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality for women globally. The purpose of this review is to provide an updated overview of CVD prevention in women, focusing on what is currently understood about female-specific or female-predominant CVD risk factors and the importance of tailored strategies for risk assessment and medical interventions.

Recent findings
Recent studies have demonstrated the need to account for risk factors specific to women in current risk assessment models for CVD, including early menarche, polycystic ovary syndrome, adverse pregnancy outcomes, early menopause, and chronic inflammatory conditions. Incorporation of these findings has led to advancements in sex-specific guidelines, diagnostic tools, and treatment approaches that have led to improvement in the precision of CVD prevention strategies. At-risk women benefit similarly to lipid-lowering and other preventive therapies as men but are less likely to be treated.

Summary
CVD prevention in women has made substantial progress over the past decade, marked by increasing awareness among clinicians, improved understanding of sex-specific risk-enhancing factors, and incorporation of sex-specific guidelines for management. However, there remain knowledge gaps that warrant ongoing efforts to optimize CVD prevention strategies in women, which will ultimately lead to improved cardiovascular health outcomes.
Baseline Liver Ultrasound Findings in Preschool Children From the Praziquantel in Preschoolers Trial in Lake Albert, Uganda
Authors: Pach Sophie , Webb Emily L. , Edielu Andrew , Nagawa Roy , Anguajibi Victor , Mpooya Simon , Wu Hannah , Colt Susannah , Mawa Patrice , Richter Joachim , Friedman Jennifer F. , Bustinduy Amaya L. 
Published: November 2023

Background:Periportal fibrosis is a late-stage manifestation of chronic infection withSchistosoma mansoni. Praziquantel (PZQ), the only drug available for the treatment of schistosomiasis, has limited effect in treating established morbidity. Preschool-age children (PSAC) are not considered to be an at-risk population for severe morbidity. However, the prevalence of periportal fibrosis in PSAC inS. mansoniendemic settings is unknown.Methods:As part of a phase II clinical trial comparing different dosing regimens of PZQ in children age 12–47 months infected withS. mansoniin Uganda (“praziquantel in preschoolers” trial), we present baseline results assessing liver ultrasound (US) findings as per the WHO Niamey Protocol.Results:A total of 7/347 (2%) PSAC had Image Pattern C with pipe stems and echogenic rings suggestive of periportal fibrosis, 29/347 (8%) had Image Pattern B and 58 (17%) had evidence of periportal thickening There were higher adjusted odds of periportal thickening with older age [odds ratio (OR): 1.04; 95% confidence interval (CI): 1.00–1.07], primary maternal education (OR: 1.04; 95% CI: 1.00–1.07) and being taken to the lake weekly (OR: 3.02; 95% CI: 1.19–7.63). A further 44/347 children (13%) had a rounded caudal liver edge which was associated with highS. mansoniinfection intensity (adjusted OR: 3.31; 95% CI: 1.46–7.51).Conclusions:Incipient schistosomiasis-related liver morbidity was detected in young children enrolled in the praziquantel in preschoolers trial. Adequate age-adjusted reference measurements for liver ultrasound findings in very small children are lacking but urgently needed. Schistosomiasis-related fibrosis may be delayed or averted with early and repeated PZQ treatment.
Atypical Cat Scratch Disease With Splenic Lesion Mimicking Kawasaki Disease in a Healthy 5-Year-old Girl
Authors: Ma Minjae , Aoki Yoshihiro , Kitazawa Katsuhiko 
Published: November 2023

Background:
Atypical cat scratch disease (CSD) and Kawasaki disease (KD) are differential diagnoses of pediatric febrile illnesses. Diagnosing atypical CSD can be challenging because of its wide range of symptoms. However, its similarity to KD has rarely been addressed.

Methods:
We present the case of a 5-year-old girl with atypical CSD and splenic lesions who fulfilled the diagnostic criteria for KD. We also conducted a literature review of previous cases in which CSD was suspected alongside KD and detailed the diagnosis and treatment processes.

Results:
A previously healthy 5-year-old girl with prolonged fever and symptoms resembling those of KD was admitted to our hospital. There was no evidence of an abnormal coronary artery, and her condition did not improve after the initial treatment for KD and bacterial infection. A history of contact with cats and multiple granulomatous lesions in the spleen on abdominal ultrasonography led to a clinical diagnosis of atypical CSD. Trimethoprim-sulfamethoxazole treatment resulted in symptom resolution. Elevated serum Bartonella henselae IgG and IgM antibodies confirmed the diagnosis of CSD. In this case, we avoided second-line treatment for KD with an alternative CSD diagnosis. Additionally, we identified 4 documented cases of CSD presenting with KD-like features in the literature. Intravenous immunoglobulin was ineffective in all cases, including the present case.

Conclusions:
In cases of atypical CSD where KD is suspected, actively seeking organ-specific symptoms may facilitate an early clinical diagnosis of CSD. Adopting this approach could yield multiple advantages, including reduced invasiveness for the patient and decreased healthcare-related expenditures.
Oxygen Targets After Cardiac Arrest: A Meta-analysis of Randomized Controlled Trials
Authors: Singh Sahib , Rout Amit , Chaudhary Rahul , Garg Aakash , Tantry Udaya S. , Gurbel Paul A. 
Published: November 2023

Background:
Optimal oxygen saturation target in patients resuscitated after cardiac arrest is unknown. Previous randomized controlled trials (RCTs) comparing restrictive oxygen therapy with liberal therapy have shown conflicting results.

Study Question:
We performed a meta-analysis of available RCTs to consolidate the contrasting findings regarding the oxygen targets after cardiac arrest.

Data Sources:
We searched electronic databases for RCTs comparing restrictive versus liberal oxygen targets in patients resuscitated after cardiac arrest.

Study Design:
End points of interest were mortality, unfavorable neurological outcomes, and rearrests. Random-effects meta-analysis was performed to estimate the risk ratio (RR) with a 95% confidence interval (CI).

Results:
Eight RCTs with 1641 patients (restrictive n = 833, liberal n = 808) were included in the analysis. The oxygen targets were defined by either saturation, partial pressure (PaO2), or supplementation rates. The mean age and male percentage were 63 years and 80%, respectively. There was no significant difference observed in the 2 groups for overall mortality (RR = 0.91, 95% CI = 0.75–1.10, P = 0.33), unfavorable neurological outcomes (RR = 0.93, 95% CI = 0.74–1.18, P = 0.56), and rearrests (RR = 0.67, 95% CI = 0.22–1.98, P = 0.47).

Conclusions:
Overall, this meta-analysis shows no significant difference in mortality, unfavorable neurological outcomes, and rearrests when using restrictive or liberal oxygen targets in patients after cardiac arrest. The limitations in the newer trials should be kept in mind while interpreting the overall results.
Vaccine Immunity in Children After Hematologic Cancer Treatment: A Retrospective Single-center Study
Authors: Cetin Melissa , Gumy-Pause Fabienne , Gualtieri Renato , Posfay-Barbe Klara M. , Blanchard-Rohner Geraldine 
Published: November 2023

Background:
Children lose their vaccine-induced protection and are particularly vulnerable to vaccine-preventable diseases after chemotherapy. However, revaccination guidelines are heterogeneous, and there is often a lack of revaccination post-treatment.

Aims:
We conducted a retrospective study of children with hematologic cancer to evaluate vaccine immunity before and after the end of treatment and to determine whether the current institutional revaccination program based on vaccine serology results was followed and effective.

Materials and Methods:
Data of all children treated by chemotherapy between April 2015 and July 2021 were extracted from hospital medical records for analysis. Serum antibody levels and time of vaccination were evaluated for diphtheria, tetanus, Streptococcus pneumoniae, Haemophilus influenzae type b (Hib), measles, varicella, and hepatitis B.

Results:
We included 31 patients (median age, 9 years). At cancer diagnosis, 90% of children were protected against tetanus, diphtheria, and measles; 65% to 67% were protected against pneumococcus and varicella; and 25% against hepatitis B. At the end of chemotherapy, 67% to 71% of patients were protected against tetanus, varicella, and measles; 40% remained protected against hepatitis B; and 27% to 33% against pneumococcus and diphtheria. Patients were revaccinated at various times after the end of treatment but not systematically. During the first-year post-treatment, 20% to 25% of children remained unprotected against pneumococcus, measles, and hepatitis B, one third against diphtheria, but all were protected against tetanus and varicella.

Conclusions:
An effective individualized vaccination program post-cancer based on serology results should be accompanied by an appropriate serology tracking method and follow-up to assess if booster doses are necessary. Our study supports vaccinating all children with a dose of the 13-valent pneumococcal conjugate at cancer diagnosis and at 3 months post-treatment with the combined diphtheria-tetanus-acellular pertussis/poliomyelitis vaccine/hepatitis B virus plus or minus Hib and 13-valent pneumococcal conjugate and meningococcal vaccine, including measles/mumps/rubella-varicella zoster virus vaccine if good immune reconstitution is present.
Dedifferentiated Leiomyosarcoma-morphology, Immunohistochemistry, and Molecular Findings of a Case and Review of Literature
Authors: Kousar Aisha , Wald Abigail I. , Heayn Michelle , Cardillo Nicholas D. , Elishaev Esther , Bhargava Rohit 
Published: November 2023

We present a case of uterine dedifferentiated leiomyosarcoma in a 42-yr-old woman who presented with severe abdominal pain and vaginal bleeding. The mass measured 10.5 cm. The “differentiated” tumor component ranged from leiomyoma-like areas to smooth muscle tumor of uncertain malignant potential to frank leiomyosarcoma. The undifferentiated tumor component showed extreme hypercellularity, intermediate to large polygonal cells, with significant cytologic atypia and numerous mitotic figures (67 mitotic figures per 10 high-power fields). This undifferentiated component imperceptibly blended into more recognizable smooth muscle areas. In contrast to the differentiated component, the undifferentiated component lacked staining for smooth muscle markers. Targeted next-generation sequencing revealed TP53, NF1, and NOTCH2 mutations in both differentiated and undifferentiated components. In addition, the undifferentiated tumor component also harbored multiple additional chromosomal abnormalities including gains in 1q, 22q, and copy number losses in 3p, 9p, and 11q. The undifferentiated tumor component was also identified in an adhesion involving the small bowel and omentum at complete staging. The patient was subsequently treated with 6 cycles of adriamycin chemotherapy. Computerized tomography scan after 3 cycles showed no residual disease. Published literature regarding dedifferentiated leiomyosarcoma is reviewed.
A randomized, double-blind, placebo-controlled study of histone deacetylase type 6 inhibition for the treatment of painful diabetic peripheral neuropathy
Authors: Michelson David , Chin William W. , Dworkin Robert H. , Freeman Roy , Herrmann David N. , Mazitschek Ralph , Pop-Busui Rodica , Shaibani Aziz , Vornov James , Jones Melissa , Jarpe Matthew , Hader Brittany , Viera Theresa , Hylan Michelle , Kachmar Tim , Jones Simon 
Published: November 2023

Abstract

Introduction:
Current treatments for painful diabetic peripheral neuropathy (DPN) are insufficiently effective for many individuals and do not treat nonpain signs and symptoms. The enzyme histone deacetylase type 6 (HDAC6) may play a role in the pathophysiology of painful DPN, and inhibition of HDAC6 has been proposed as a potential treatment.

Objectives:
To assess the efficacy and safety of the novel HDAC6 inhibitor ricolinostat for the treatment of painful diabetic peripheral neuropathy.

Methods:
We conducted a 12-week randomized, double-blind, placebo-controlled phase 2 study of the efficacy of ricolinostat, a novel selective HDAC6 inhibitor, in 282 individuals with painful DPN. The primary outcome was the change in the patient-reported pain using a daily diary, and a key secondary outcome was severity of nonpain neuropathic signs using the Utah Early Neuropathy Scale (UENS) score.

Results:
At the 12-week assessment, changes in average daily pain and UENS scores were not different between the ricolinostat and placebo groups.

Conclusion:
These results do not support the use of the HDAC6 inhibitor ricolinostat as a treatment for neuropathic pain in DPN for periods up to 12 weeks.
Detection of Brain Metastases by Contrast-Enhanced MRI: Comparison of Gadopiclenol and Gadobenate in a Mouse Model
Authors: Robert Philippe , Vives Véronique , Rasschaert Marlène , Hao Jing , Soares Miguel , Lemaître Marjorie , Dencausse Anne , Catoen Sarah 
Published: November 2023

ObjectivesThe aim of this study was to evaluate the capacity of gadopiclenol, a high-relaxivity gadolinium-based contrast agent to detect brain metastases in mice as a function of dose (0.08 mmol/kg or 0.1 mmol/kg) compared with gadobenate at 0.1 mmol/kg.Materials and MethodsBrain metastases were induced by ultrasound-guided intracardiac implantation of 1.105MDA-MB-231Br cells in the left ventricle of 18 anesthetized Balb/c Nude nu/nu female mice. At day 28 ± 3 after cell injection, each mouse received 2 crossover intravenous injections at 24-hour intervals, randomly selected from 2 doses of gadopiclenol (0.08 mmol/kg or 0.1 mmol/kg) and gadobenate (0.1 mmol/kg) with n = 6 mice/group (3 groups). Brain magnetic resonance imaging sessions were performed at 4 weeks on a 2.35 T magnet with a 3-dimensional T1-weighted high-resolution gradient echo sequence, before and after each injection. Images were blindly and randomly analyzed to detect enhancing lesions. Contrast-to-noise ratio between the metastases and the surrounding healthy parenchyma was calculated, based on region-of-interest signal measurements. In 2 animals per group, an early time point was added to the protocol (day 22 ± 3) to evaluate the sensitivity of detection as a function of time. After the last imaging session, the presence and location of whole-brain metastases were confirmed by histology in 4 mice.ResultsAfter gadopiclenol, approximately twice as many metastases were detected compared with gadobenate, regardless of the dose. Contrast-to-noise ratios of the detected metastases were 2.3 and 3.3 times higher with gadopiclenol at 0.08 mmol/kg and 0.1 mmol/kg, respectively, compared with gadobenate at 0.1 mmol/kg (P< 0.0001). Gadopiclenol at the dose of 0.1 mmol/kg resulted in a 1.4-fold higher contrast compared with gadopiclenol at 0.08 mmol/kg (P< 0.02). In a subset of mice that were imaged 1 week earlier, 2 metastases were detected with gadopiclenol and not with gadobenate.ConclusionsThe high-relaxivity macrocyclic gadolinium-based contrast agent gadopiclenol allowed higher diagnostic performance for detecting brain enhancing metastases in terms of contrast-to-noise ratio and number of detected metastases compared with gadobenate, at both equal (0.1 mmol/kg) dose and 20% lower Gd dose (0.08 mmol/kg). Tumor detection was higher after gadopiclenol at the dose of 0.1 mmol/kg compared with 0.08 mmol/kg.
Duplications and retrogenes are numerous and widespread in modern canine genomic assemblies
Authors: Nguyen Anthony K. , Blacksmith Matthew S. , Kidd Jeffrey M. 
Published: November 2023

AbstractRecent years have seen a dramatic increase in the number of canine genome assemblies available. Duplications are an important source of evolutionary novelty and are also prone to misassembly. We explored the duplication content of nine canine genome assemblies using both genome self-alignment and read-depth approaches. We find that 8.58% of the genome is duplicated in the canFam4 assembly, derived from the German Shepherd Dog Mischka, including 90.15% of unplaced contigs. Highlighting the continued difficulty in properly assembling duplications, less than half of read-depth and assembly alignment duplications overlap, but the mCanLor1.2 Greenland wolf assembly shows greater concordance. Further study shows the presence of multiple segments that have alignments to four or more duplicate copies. These high-recurrence duplications correspond to gene retrocopies. We identified 3,892 candidate retrocopies from 1,316 parental genes in the canFam4 assembly and find that approximately 8.82% of duplicated base pairs involve a retrocopy, confirming this mechanism as a major driver of gene duplication in canines. Similar patterns are found across eight other recent canine genome assemblies, with multiple metrics supporting the high-quality of the mCanLor1.2 wolf assembly constructed using PacBio HiFi reads. Comparison between the wolf and other canine assemblies found that approximately 92% of retrocopy insertions are shared between assemblies. By calculating the number of generations since genome divergence, we estimate that new retrocopy insertions appear, on average, in 1 out of 3,514 births. Together, our analyses illustrate the impact of retrogene formation on canine genomes and highlight the variable representation of duplicated sequences among recently completed canine assemblies.SignificanceDuplications are highly influential on evolution, but are commonly misassembled, especially in lagging genomic groups like canines. We assessed nine canine assemblies for duplication presence, and found enrichment for acrocentric regions, misattribution of duplications to unplaced contigs, and the presence of short, high-recurrence duplications. Investigating further, we find high numbers of retrocopies retaining hallmarks present in the canine assemblies, and determine a rate of novel retrocopy insertion at 1 in 3,514 births.
The human mitochondrial mRNA structurome reveals mechanisms of gene expression
Authors: Conor Moran J. , Brivanlou Amir , Brischigliaro Michele , Fontanesi Flavia , Rouskin Silvi , Barrientos Antoni 
Published: November 2023

SummaryThe mammalian mitochondrial genome encodes thirteen oxidative phosphorylation system proteins, crucial in aerobic energy transduction. These proteins are translated from 9 monocistronic and 2 bicistronic transcripts, whose native structures remain unexplored, leaving fundamental molecular determinants of mitochondrial gene expression unknown. To address this gap, we developed a mitoDMS-MaPseq approach and used DREEM clustering to resolve the native human mitochondrial mt-mRNA structurome. We gained insights into mt-mRNA biology and translation regulatory mechanisms, including a unique programmed ribosomal frameshifting for theATP8/ATP6transcript. Furthermore, absence of the mt-mRNA maintenance factor LRPPRC led to a mitochondrial transcriptome structured differently, with specific mRNA regions exhibiting increased or decreased structuredness. This highlights the role of LRPPRC in maintaining mRNA folding to promote mt-mRNA stabilization and efficient translation. In conclusion, our mt-mRNA folding maps reveal novel mitochondrial gene expression mechanisms, serving as a detailed reference and tool for studying them in different physiological and pathological contexts.
The mechanistic basis of evolutionary transitions between grey, slate, and blue colour in Tanagers (Thraupidae)
Authors: Babarovic Frane , Cooney Christopher R , Zinn Thomas , Drobniak Szymon M. , Janas Katarzyna , Kennedy Jonathan D , Nadeau Nicola J , Parnell Andrew J , Thomas Gavin Huw , Burg Stephanie 
Published: November 2023

AbstractBoth pigmentary and structural colours share many common elements of their feather anatomy, i.e. keratin, air and melanin packed in the melanosomes, despite utilizing different mechanisms of the colour production. This means that evolutionary transitions between pigmentary and structural colours can be achieved through a simple adjustment of these elements. Recently, an evolutionary hypothesis for the transition between pigmentary grey, through slate and finally to structural blue colour has been proposed and confirmed in the clade Tanagers on a macroevolutionary level. Here, we investigate mechanistic basis of this evolutionary pathway. By using SAXS (small-angle X-ray scattering) we have quantified important elements of spongy layer in medullary cells that is crucial for colour production by coherent scattering of light wavelengths. We have quantified five elements of the spongy layer: nanostructure complexity, average hard block thickness, average soft block thickness, filling fraction and Iovalue. We report that across different categories of feather colour, i.e. blue, slate and grey, nanostructure complexity, filling fraction and Iovalue explained variation in the chromatic component of the colour (between the three colour categories). Chromatic variation within the colour category was explained by filling fraction in the case of slate colour and by nanostructure complexity and average hard block thickness in the case of blue colour. We propose that variation in different elements or combination of elements of the spongy nanostructure has been utilised in feather colour evolution, both within and between colour categories, to overcome developmental constraints imposed by self-assembly processes.