bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preservation versus dissection of the intercostobrachial nerve for breast cancer surgeries: a systematic review and meta-analysis
Authors: Al-dardery Nada M. , Khaity Abdulrhman M. , Albakri Khaled A. , Abdelsattar Ahmed T. , Benmelouka Amira Y. , Lee Theodore , Foppiani Jose A. , Lin Samuel J. 
Published: December 2023

Introduction:
This meta-analysis aimed to compare the efficacy of preservation of the intercostobrachial nerve (ICBN) versus its dissection for patients who underwent breast surgery.

Methods:
The authors searched Web of Science, PubMed, Cochrane CENTRAL, and Scopus from inception until March 2023. Records were screened for eligible studies, and all relevant outcomes were pooled as an odds ratio (OR) with the corresponding 95% CI in the meta-analysis models using RevMan version 5.4.

Results:
These results from 11 studies (1021 patients) favored preservation of the ICBN over its dissection in terms of anaesthesia and hypaesthesia [OR 0.50, (95% CI, 0.31–0.82); P = 0.006] and [OR 0.33, (95% CI, 0.16–0.68); P = 0.003], respectively. Whereas the overall effect favored ICBN dissection over preservation in the case of hyperaesthesia [OR 4.34, (95% CI, 1.43–13.15); P = 0.01]. Conversely, no significant variance was detected between the two groups in terms of pain [OR 0.68, (95% CI, 0.28–1.61) P = 0.38], paraesthesia [OR 0.88, (95% CI, 0.49–1.60); P = 0.68], and analgesia [OR 1.46, (95% CI, 0.05–45.69); P = 0.83].

Conclusion:
This meta-analysis revealed that the preservation of the ICBN has a significant effect on the disturbance of sensory parameters of hypaesthesia and anaesthesia when compared to its dissection. Further studies with larger sample sizes are recommended to precisely compare both techniques on a wider range of parameters.
Emotional Dysregulation and Temperament-Character Traits in Adolescents With Functional Neurological Symptom Disorder (Conversion Disorder)
Authors: Ucuz Ilknur , Uzun Cicek Ayla , Komurcu Celik Merve , Akan Mustafa , Kesriklioglu Esma , Gungor Serdal , Ozel Ozcan Ozlem 
Published: December 2023

Abstract
The purpose of this study was to evaluate emotion dysregulation and temperament-character traits in adolescents with functional neurological symptom disorder (FNSD). Forty adolescents with FNSD and 40 healthy adolescents were evaluated by a semiconstructed diagnosis interview, Temperament and Character Inventory (TCI), Difficulties in Emotion Regulation Scale (DERS), Regulation of Emotions Questionnaire (REQ), and Children's Somatization Inventory-24 (CSI-24). The external and internal dysfunctional emotion regulation scores of REQ, all subscales of DERS, except the awareness subscale, and CSI-24 scores were significantly higher in FNSD patients compared with healthy controls. There were significant differences between the groups in terms of harm avoidance and reward dependence subscale scores of TCI. Multiple logistic regression analysis showed that the external dysfunctional emotion regulation strategy, somatization, and reward dependence are significant predictors of FNSD. Our results provide evidence that adolescents with FNSD experience emotional dysregulation and that the differential value of some temperament-character traits in the diagnosis of FNSD.
Neurologic Outcomes and Quality of Life in Children After Extracorporeal Membrane Oxygenation
Authors: Michel Alizée , Vedrenne-Cloquet Meryl , Kossorotoff Manoëlle , Thy Michaël , Levy Raphaël , Pouletty Marie , De Marcellus Charles , Grimaud Marion , Moulin Florence , Hully Marie , Simonnet Hina , Desguerre Isabelle , Renolleau Sylvain , Oualha Mehdi , Chareyre Judith 
Published: December 2023

RATIONALE:Use of life support with extracorporeal membrane oxygenation (ECMO) is associated with brain injury. However, the consequences of these injuries on subsequent neurologic development and health-related quality of life (HRQoL) are poorly described in children.OBJECTIVES:The aim of this preliminary study was to describe short- and long-term neurologic outcomes in survivors of ECMO, as well as their HRQoL.DESIGN:Retrospective identified cohort with contemporary evaluations.SETTING:Necker Children’s Hospital academic PICU.PATIENTS:Forty survivors who underwent ECMO (October 2014 to January 2020) were included in follow-up assessments in May 2021.INTERVENTIONS:None.MEASUREMENT AND MAIN RESULTS:We first reviewed the outcomes of ECMO at the time of PICU discharge, which included a summary of neurology, radiology, and Pediatric Overall/Cerebral Performance Category (POPC/PCPC) scores. Then, in May 2021, we interviewed parents and patients to assess HRQoL (Pediatric Quality of Life Inventory [PedsQL]) and POPC/PCPC for children 3 years old or older, and Denver II test (DTII) for younger children. An evaluation of DTII in the youngest patients 1 year after ECMO decannulation was also added. Median age at ECMO was 1.4 years (interquartile range [IQR], 0.4–6 yr). Thirty-five children (88%) underwent a venoarterial ECMO. At PICU discharge, 15 of 40 patients (38%) had neurologic impairment. Assessment of HRQoL was carried out at median of 1.6 years (IQR, 0.7–3.3 yr) after PICU discharge. PedsQL scores were over 70 of 100 for all patients (healthy peers mean results: 80/100), and scores were like those published in patients suffering with chronic diseases. In May 2021, seven of 15 patients had a normal DTII, and 36 of 40 patients had a POPC/PCPC score less than or equal to 3.CONCLUSIONS:None of our patients presented severe disability at long term, and HRQoL evaluation was reassuring. Considering the risk of neurologic impairment after ECMO support, a systematic follow-up of these high-risk survivor patients would be advisable.
Child Opportunity Index and Pediatric Intensive Care Outcomes: A Multicenter Retrospective Study in the United States*
Authors: McCrory Michael C. , Akande Manzilat , Slain Katherine N. , Kennedy Curtis E. , Winter Meredith C. , Stottlemyre Morgan G. , Wakeham Martin K. , Barnack Kyle A. , Huang Jia Xin , Sharma Meesha , Zurca Adrian D. , Pinto Neethi P. , Dziorny Adam C. , Maddux Aline B. , Garg Anjali , Woodruff Alan G. , Hartman Mary E. , Timmons Otwell D. , Heidersbach R. Scott , Cisco Michael J. , Sochet Anthony A. , Wells Brian J. , Halvorson Elizabeth E. , Saha Amit K. ,   for the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Social Determinants of Health Subgroup
Published: December 2023

OBJECTIVES:To evaluate for associations between a child’s neighborhood, as categorized by Child Opportunity Index (COI 2.0), and 1) PICU mortality, 2) severity of illness at PICU admission, and 3) PICU length of stay (LOS).DESIGN:Retrospective cohort study.SETTING:Fifteen PICUs in the United States.PATIENTS:Children younger than 18 years admitted from 2019 to 2020, excluding those after cardiac procedures. Nationally-normed COI category (very low, low, moderate, high, very high) was determined for each admission by census tract, and clinical features were obtained from the Virtual Pediatric Systems LLC (Los Angeles, CA) data from each site.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:Among 33,901 index PICU admissions during the time period, median patient age was 4.9 years and PICU mortality was 2.1%. There was a higher percentage of admissions from the very low COI category (27.3%) than other COI categories (17.2–19.5%,p< 0.0001). Patient admissions from the high and very high COI categories had a lower median Pediatric Index of Mortality 3 risk of mortality (0.70) than those from the very low, low, and moderate COI groups (0.71) (p< 0.001). PICU mortality was lowest in the very high (1.7%) and high (1.9%) COI groups and highest in the moderate group (2.5%), followed by very low (2.3%) and low (2.2%) (p= 0.001 across categories). Median PICU LOS was between 1.37 and 1.50 days in all COI categories. Multivariable regression revealed adjusted odds of PICU mortality of 1.30 (95% CI, 0.94–1.79;p= 0.11) for children from a very low versus very high COI neighborhood, with an odds ratio [OR] of 0.996 (95% CI, 0.993–1.00;p= 0.05) for mortality for COI as an ordinal value from 0 to 100. Children without insurance coverage had an OR for mortality of 3.58 (95% CI, 2.46–5.20;p< 0.0001) as compared with those with commercial insurance.CONCLUSIONS:Children admitted to a cohort of U.S. PICUs were often from very low COI neighborhoods. Children from very high COI neighborhoods had the lowest risk of mortality and observed mortality; however, odds of mortality were not statistically different by COI category in a multivariable model. Children without insurance coverage had significantly higher odds of PICU mortality regardless of neighborhood.
Spiritual Care in PICUs: A U.S. Survey of 245 Training Fellows 2020–2021*
Authors: Stevens Paige E. , Rassbach Caroline E. , Qin FeiFei , Kuo Kevin W. 
Published: December 2023

OBJECTIVES:
To understand the perspectives of pediatric fellows training in critical care subspecialties about providing spiritual care.

DESIGN:
Cross-sectional survey of United States National Residency Matching Program pediatric fellows training in critical care specialties.

SETTING:
Online survey open from April to May 2021.

SUBJECTS:
A total of 720 fellows (165 cardiology, 259 critical care, and 296 neonatology) were contacted, with a response rate of 245 of 720 (34%).

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We assessed fellows’ survey responses about spiritual care in neonatal and pediatric critical care units. Categorical data were compared using chi-square test or Fisher exact tests. The Wilcoxon rank-sum test was used to compare the percentage correct on ten multiple-choice questions about world religions. Free-text responses were independently coded by two research investigators. A total of 203 of 245 (83%) responding fellows had never received training about spiritual care and 176 of 245 (72%) indicated that they would be likely to incorporate spiritual care into their practice if they received training. Prior training was associated with increased familiarity with a framework for taking a spiritual history (p < 0.001) and increased knowledge of spiritual practices that could influence medical care (p = 0.03). Prior training was also associated with increased self-reported frequency of taking a spiritual history (p < 0.001) and comfort in referring families to spiritual care resources (p = 0.02). Lack of time and training were the most reported barriers to providing spiritual care.

CONCLUSIONS:
Providing spiritual care for families is important in critical care settings. In 2020–2021, in the United States, 245 pediatric critical care fellows responded to a survey about spiritual care in their practice and reported that they lacked training in this subject. An opportunity exists to implement spiritual care curricula into pediatric fellowship training.
Investigation of the validity and reliability of the 3-meter backward walk test in high functional level adults with lower limb amputation
Authors: Yıldırım Şahan Tezel , Aydoğan Arslan Saniye , Söyler Osman 
Published: December 2023

Background:
Backward walk training has an important place in the rehabilitation programs of lower extremity amputees.

Objective:
This study aimed to investigate the test-retest validity and reliability of the 3-meter backward walk test (3MBWT), minimal detectable change, and the cutoff time in high functional level adults with lower limb amputations (LLAs). Adults with LLA (n = 30) and healthy adults (n = 29) were included in the study.

Study design:
This is a randomized cross-sectional study.

Methods:
The Modified Fall Efficacy Score, Rivermead Mobility Index, and Timed Up and Go test with the 3MBWT were used to evaluate the concurrent validity of the test. The second evaluation (retest) was performed by the same physiotherapist 1 week following the first evaluation (test). The validity was assessed by correlating the 3MBWT times with the scores of other measures and by comparing the 3MBWT times between adults with LLA and healthy adults.

Results:
Test-retest reliability of the 3MBWT was excellent. The intraclass correlation coefficient for the 3MBWT was 0.950. The standard error of measurement and minimal detectable change values were 0.38 and 0.53, respectively. A moderate correlation was found between the 3MBWT, Modified Fall Efficacy Score, Timed Up and Go test, and Rivermead Mobility Index (p < 0.001). Significant differences in the 3MBWT times were found between adults with LLA and healthy controls (p < 0.001). The cutoff time of 3.11 s discriminates healthy adults from high functional level adults with LLA.

Conclusions:
The 3MBWT was determined to be valid, reliable, and easy-to-apply tool in high functional level adults with LLA. This assessment is a useful and practical measurement for dynamic balance in high functional level adults with LLA.
Intestinal Autotransplantation for Locally Advanced or Locally Recurrent Colon Cancer Invading Superior Mesenteric Artery
Authors: Wu Guosheng , Zhao Long , Jiang Weiqin , Liu Chaoxu , Zhou Xile , Zhang Wentong , Wang Jinhai , Liang Tingbo 
Published: December 2023

Objective:
To examine the outcomes of intestinal autotransplantation (IATx) in patients with locally advanced (LACC) or locally recurrent (LRCC) colon cancer invading the superior mesenteric artery (SMA).

Background:
SMA involvement in LACC or LRCC is deemed unresectable and is associated with a poor prognosis. Combined extended resections of multiple organs together with SMA, followed by IATx may offer favorable clinical outcomes. However, data on its safety and efficacy are scarce.

Methods:
This retrospective cohort study included patients undergoing IATx between May 2018 and December 2022 in intestinal transplant programs at 2 university-affiliated hospitals in China. Patients with LACC or LRCC concomitantly with SMA contact of more than 180 degrees were included. Patients with a locoregional peritoneal, pelvic, or distal metastasis were excluded.

Results:
Ten patients underwent either IATx combined with pancreaticoduodenectomy (n = 8) or IATx alone (n = 2). Eight patients (80%) were males, and the median age was 55 years (range, 32–71 years). The Kaplan-Meier estimates for recurrence-free survival and overall survival at 3 years after IATx were 68% and 80%, respectively. No perioperative deaths occurred. All 10 patients experienced postoperative complications, including Clavien-Dindo grade I (n = 1), grade II (n = 4), grade IIIa (n = 1), grade IIIb (n = 3), and grade IVa (n = 1), which comprised acute venous thromboses, upper gastrointestinal hemorrhage, anastomotic leak, gastropareses, and significant pleural effusions. With an average follow-up of 23.9 months, 8 patients (80%) were currently alive without evidence of disease.

Conclusion:
Extended resection for LACC or LRCC invading SMA can be performed safely and is associated with prolonged survival.
A Novel Method for Thoracoscopic Overlap Esophagogastric Reconstruction With Pleural Closure following Minimally Invasive Ivor-Lewis Esophagectomy for Esophagogastric Junction Cancer
Authors: Sano Akihiko , Sohda Makoto , Hosoi Nobuhiro , Tateno Kohei , Watanabe Takayoshi , Nakazawa Nobuhiro , Shioi Ikuma , Shibasaki Yuta , Okada Takuhisa , Osone Katsuya , Shiraishi Takuya , Sakai Makoto , Ogawa Hiroomi , Okabe Hiroshi , Shirabe Ken , Saeki Hiroshi 
Published: December 2023

Background:
Intrathoracic esophagogastric anastomosis following minimally invasive Ivor-Lewis esophagectomy is a technically demanding surgical technique that can result in serious intrathoracic infections when anastomotic leakage occurs. Herein, we report a novel side-overlap esophagogastric anastomosis with pleural closure for esophagogastric junction cancer.

Methods:
The 3 key points of our novel technique were the following: (1) overlap esophagogastric anastomosis and closure of the entry hole were all performed using a linear stapler; (2) the pleura was closed to separate the anastomotic site from the thoracic cavity; and (3) the mediastinal drain was inserted transhiatally from the abdominal cavity.

Results:
This modified anastomosis procedure was performed on 8 consecutive patients at our institution. The median overall/thoracoscopic operating time and estimated blood loss were 652.5/241.5 min and 89 mL, respectively. No mortality or serious postoperative complications occurred, and the median postoperative hospital stay was 22 days (range, 17 to 37 d).

Conclusion:
This novel thoracoscopic overlap esophagogastric reconstruction procedure with pleural closure is safe and feasible.
Risk Factors of Acute Pain in Elderly Patients After Laparoscopic Radical Resection of Colorectal Cancer
Authors: Zhu Qian-qian , Qu Li , Su Tao , Zhao Xuan , Ma Xue-ping , Chen Zhe , Fu Juan , Xu Gui-ping 
Published: December 2023

Objective:
To investigate the risk factors of acute pain after laparoscopic radical resection of colorectal cancer (CRC) in elderly patients.

Methods:
Totally, 143 elderly patients (≥ 60 y old) who received laparoscopic radical resection of CRC in the People’s Hospital of Xinjiang Uygur Autonomous Region from March 2021 to August 2022 were retrospectively analyzed. The patients were divided into 2 groups according to visual analog scale (VAS) scores 24 h after surgery: mild pain group (VAS score ≤ 3, n=108) and moderate to severe pain group (VAS score >3, n=35). The data of the patients, including sex, age, height, body mass, intraoperative blood loss, intraoperative urine volume, intraoperative opioid dosage, operation duration, preoperative Hospital Anxiety and Depression Scale (HADS) scores, preoperative Mini-Mental State Examination scores, VAS scores, postoperative nausea and vomiting scores were recorded. Multivariate logistic regression analysis was used to screen the risk factors of postoperative acute pain in elderly patients undergoing laparoscopic radical resection of CRC.

Results:
The preoperative HADS score of the moderate to severe pain group was significantly increased compared with that of the mild pain group (10.8±2.4 vs. 6.2±1.9), as well as the operation duration (226.4±18.3 vs. 186.1±12.7), the intraoperative dosage of remifentanil (3.7±0.2 vs. 3.2±0.4), the preoperative VAS score [4(2, 7) vs. 2 (0, 4)] and postoperative VAS score [5 (4, 6) vs. 3 (2, 3)] (P<0.05). Multivariate logistic regression analysis showed that high preoperative HADS score, long operation duration, and high preoperative VAS score (P<0.05) were independent risk factors for acute pain after laparoscopic radical resection of CRC in elderly patients.

Conclusion:
Preoperative anxiety and depression, preoperative pain, and long operation duration are risk factors for acute pain in elderly patients after laparoscopic radical resection of CRC.
Head Turn During Visual Field Testing to Minimize the Influence of Prominent Facial Anatomy
Authors: Sadegh Mousavi Seyedmostafa , Jamali Dogahe Sepideh , Lyons Lance J. , Khanna Cheryl L. 
Published: December 2023

Background:
Facial contour naturally decreases the visual field. Peripheral visual field defects caused by facial anatomy and ocular pathology can be missed in a routine standard of care. Mathematically calculating the true angle for turning the head to optimize the peripheral visual field has not been studied to date. The purpose of this study was to explore the utility of turning the head during perimetry to maximize the testable visual field.

Methods:
Six healthy study participants aged 18–52 were enrolled, prospectively; the dominant eye of each participant was tested. In total, 60-4 visual fields were obtained from each participant's dominant eye with the head in primary position. Then, the 60-4 tests were repeated with the head turned prescribed degrees toward and away from the tested eye (“manual method”). Based on a photograph of the participant's face, a convolutional neural network (CNN) was used to predict the optimal head turn angle for maximizing the field, and the test was repeated in this position (“automated method”).

Results:
Maximal visual field exposure was found at a head turn of 15° away from the tested eye using the manual method and was found at an average head turn of 12.6° using the automated method; maximum threshold values were similar between manual and automated methods. The mean of threshold in these subjects at the standard direction and the predicted optimum direction was 1,302, SD = 69.35, and 1,404, SD = 67.37, respectively (P = 0.02).

Conclusions:
Turning the head during perimetry maximizes the testable field area by minimizing the influence of prominent facial anatomy. In addition, our CNN can accurately predict each individual's optimal angle of head turn for maximizing the visual field.
miRNA-mediated control of gephyrin synthesis drives sustained inhibitory synaptic plasticity
Authors: Welle Theresa M. , Rajgor Dipen , Garcia Joshua D. , Kareemo Dean , Zych Sarah M. , Gookin Sara E. , Martinez Tyler P. , Dell’Acqua Mark L. , Ford Christopher P. , Kennedy Matthew J. , Smith Katharine R. 
Published: December 2023

ABSTRACTActivity-dependent protein synthesis is crucial for many long-lasting forms of synaptic plasticity. However, our understanding of the translational mechanisms controlling inhibitory synapses is limited. One distinct form of inhibitory long-term potentiation (iLTP) enhances postsynaptic clusters of GABAARs and the primary inhibitory scaffold, gephyrin, to promote sustained synaptic strengthening. While we previously found that persistent iLTP requires mRNA translation, the precise mechanisms controlling gephyrin translation during this process remain unknown. Here, we identify miR153 as a novel regulator ofGphnmRNA translation which controls gephyrin protein levels and synaptic clustering, ultimately impacting GABAergic synaptic structure and function. We find that iLTP induction downregulates miR153, reversing its translational suppression ofGphnmRNA and allowing for increasedde novogephyrin protein synthesis and synaptic clustering during iLTP. Finally, we find that reduced miR153 expression during iLTP is driven by an excitation-transcription coupling pathway involving calcineurin, NFAT and HDACs, which also controls the miRNA-dependent upregulation of GABAARs. Overall, this work delineates a miRNA-dependent post-transcriptional mechanism that controls the expression of the key synaptic scaffold, gephyrin, and may converge with parallel miRNA pathways to coordinate gene upregulation to maintain inhibitory synaptic plasticity.
Single cell sequencing as a general variant interpretation assay
Authors: Xu Hongxia , Chen Ling , Sun Mohan , Jean-Baptiste Ken , Cao Dan , Zhou Xingyan , Wong Sandy , Xiao Carmen , Liu Tong , Quijano Victor , Brandes Nadav , Germino Joe , Ntranos Vasilis , Ye Chun Jimmie , Aguet François , Farh Kyle Kai-How 
Published: December 2023

AbstractThe human genome contains ∼70 million possible protein-altering variants, the vast majority of which are of uncertain clinical significance. Closing this gap is essential for accurate diagnosis of disease-causing variants and understanding their mechanisms of action. Towards this goal, we developed a pooled perturbation approach combining saturation mutagenesis with single cell RNA sequencing to map the effects of every single nucleotide variant in a gene. We sequenced ∼440,000 cells expressing variants inCDKN2A(p16INK4a),TP53, andSOD1, observing almost all possible protein-coding variants, with a mean of 61 cells per variant. Using single cell gene expression signatures, we show that each gene may contain multiple types of pathogenic variants that affect distinct downstream pathways. We demonstrate that single cell expression signatures outperform existing bulk experimental assays and computational models for predicting pathogenicity, and summarize both the utility and potential limitations of single cell sequencing as a general variant interpretation assay.