bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blinded Intraoperative Quantitative Indocyanine Green Metrics Associate With Intestinal Margin Acceptance in Colorectal Surgery
Authors: Adams Evan D. , Salem Jean F. , Burch Miguel A , Fleshner Phillip R , Zaghiyan Karen N. 
Published: December 2023

BACKGROUND:
Indocyanine green is a useful tool in colorectal surgery. Quantitative values may enhance and standardize its application.

OBJECTIVE:
To determine if quantitative indocyanine green metrics correlate with standard subjective indocyanine green perfusion assessment in acceptance or rejection of anastomotic margins.

DESIGN:
Prospective single arm, single institution cohort study. Surgeons viewed subjective indocyanine green images but were blinded to quantitative indocyanine green metrics.

SETTING:
Tertiary academic center.

PATIENTS:
Adults undergoing planned intestinal resection.

MAIN OUTCOME MEASURES:
Accepted perfusion and rejected perfusion of the intestinal margin were defined by absence or presence of ischemia by subjective indocyanine green and gross inspection. The primary outcomes were quantitative indocyanine green values, maximum fluorescence and time to maximum fluorescence in accepted compared to rejected perfusion. Secondary outcomes included maximum fluorescence and time to maximum fluorescence values in anastomotic leak.

RESULTS:
There were 89 perfusion assessments, comprising 156 intestinal segments. Nine segments were subjectively assessed to have poor perfusion by visual inspection and subjective indocyanine green. Maximum fluorescence (% intensity) exhibited higher intensity in accepted perfusion [accepted perfusion 161% (82-351) vs. rejected perfusion 63% (10 – 76); p = 0.03]. Similarly, time to maximum fluorescence (seconds) was earlier in accepted compared to rejected perfusion [10s (1 – 40) vs. 120s (90 – 120); p < 0.01]. Increased body mass index associated with higher maximum fluorescence. Anastomotic leak did not correlate with maximum fluorescence or time to maximum fluorescence.

LIMITATIONS:
Small cohort study, not powered to measure the association between quantitative indocyanine green metrics and anastomotic leak.

CONCLUSION:
We demonstrate blinded quantitative values reliably correlate with subjective indocyanine green perfusion assessment. Time to maximum intensity is an important metric in perfusion evaluation. Quantitative indocyanine green metrics may enhance intraoperative intestinal perfusion assessment. Future studies may attempt to correlate quantitative indocyanine green values with anastomotic leak.
Inter-session repeatability of reading performance measures in patients with neovascular AMD
Authors: Boscia Giacomo , Ricardi Federico , Gelormini Francesco , Marica Valentina , Conte Fabio , Ghilardi Andrea , Viggiano Pasquale , Marolo Paola , Bandello Francesco , Borrelli Enrico , Reibaldi Michele 
Published: December 2023

Purpose:
To assess the inter-session repeatability of reading performance measures in patients with previously treated neovascular age-related macular degeneration (AMD) and good best-corrected visual acuity (BCVA) (≥ 20/40 Snellen).

Methods:
Ninety-one patients (91 eyes) with a diagnosis of previously treated neovascular age-related macular degeneration (AMD) and good BCVA (≥ 20/40 Snellen) were prospectively enrolled. Reading performance metrics were assessed using Radner charts and these measurements were repeated after 7 days in order to obtain the inter-session repeatability. To test repeatability, we calculated the intraclass correlation coefficient (ICC), the 95% coefficient of repeatability (CR) and the coefficient of variation (CV) for each reading parameter: (i) reading acuity (RA - LogRAD); (ii) maximal reading speed (max RS - words per minute); (iii) reading acuity score (RA score - LogRAD); and (iv) critical print size (CPS - LogRAD).

Results:
Mean±SD BCVA was 0.129±0.0098 LogMAR [range: 0.00-0.30 LogMAR]. The ICC values indicated a good reliability for all the analyzed metrics (0.901 for RA; 0.859 for max RS; 0.906 for RA score; and 0.868 for CPS). The CR was 0.2 LogRAD for RA, 63.2 words per minute for max RS, 0.2 LogRAD for RA score, and 0.2 LogRAD for CPS. CV was 5.5% for RA, 8.9% for max RS, 5.8% for RA score and 6.9% for CPS.

Conclusion:
Reading performance metrics are characterized by good values of inter-session repeatability in neovascular AMD patients with good BCVA. Our findings may grant the employment of such measures in trials assessing the visual outcome in these patients.
Differences in the Progression between Myopic Maculoschisis Eyes with and without Macular Detachment in the Natural Course of the Disease: A Retrospective Longitudinal Study based on the New Myopic Traction Maculopathy Staging System
Authors: LI Jun , Lian Ping , Huang Xia , Liu Bingqian , Chen Shida , Lu Lin 
Published: December 2023

Purpose:
To investigate the pace of visual acuity (VA) loss in myopic maculoschisis eyes with or without macular detachment (MD) and identify associated risk factors.

Methods:
1334 eyes of 991 patients with high myopia were reviewed. A new myopic traction maculopathy (MTM) staging system classified four retinal stages and three foveal stages. To the MTM eyes with normal fovea, maculoschisis with and without MD was defined as stage 3a and stage 1a,2a respectively.

Results:
110 (8.25%) eyes with maculoschisis were included, with a follow-up of 24.00 ± 17.47 months. Of them, 84 (76.36%) were stage 1a,2a, and 26 (23.64%) were stage 3a. The VA loss per year during the follow-up period was similar between eyes with stage 1a,2a and stage 3a (3.13 ± 12.21 VS. 3.41 ± 18.42 letters, P = 0.930). Multivariate analyses revealed that vitreomacular interface factors (VIFs) were significantly associated with VA loss during the follow-up, no matter in stage 1a,2a or stage 3a (P = 0.039 and P = 0.038, respectively). In the stage 1a,2a group, the percentage of eyes that lost at least 10 letters at the final visit compared with the baseline visual acuity was higher in eyes with VIFs than in those without VIFs (13 eyes, 50.00% VS. 14 eyes, 24.14%, P = 0.019).

Conclusion:
No differences were found in VA loss pace between stage 1a,2a and stage 3a. Surgical intervention or at least more intensive follow-up should be considered for stage 1a,2a eyes with VIFs, to promote a more favorable visual outcome.
Building Clinical Leadership Competencies When Caring for Hospitalized Adults Experiencing Dementia
Authors: Bilski Patricia B. , Hudson Shawna , MacLellan Margaret 
Published: December 2023

Purpose and Objectives
Attempting to improve the experience of hospitalized adults with dementia and reduce patient attendant costs, we addressed hospital nursing staff confidence managing responsive behaviors through education, mentorship, and individualized patient care planning for adults with dementia.
Responsive behaviors (such as pacing, calling out) is a term used to describe behaviors demonstrated by a person with dementia as a way of responding to something negative, frustrating, or confusing in their social and physical environment.

Description of Project
Under time restraints, we performed a rapid environmental scan and developed internal clinical resources and a learning strategy that informed a quality improvement initiative that focused on dementia care of hospitalized patients.

Outcome
Using quantitative and qualitative evaluation methods, the interventions increased confidence, competency, and leadership in clinical nursing leaders and improved person-centered care planning practices. The cost of patient attendant usage for this patient population decreased by 28% in 1 year.

Conclusion
This intervention, which was not a copyrighted program associated with administration costs, improved hospital-based dementia care and staff confidence in dementia care and reduced annual costs associated with patient attendant useage.
Food Insecurity, Neighborhood Disadvantage, and Hospital Readmission in Health System Adults
Authors: S. Distelhorst Karen , Adams Kristine , Lopez Rocio 
Published: December 2023

Purpose
The purpose of the study was to examine the relationship between food insecurity, neighborhood disadvantage, and hospital readmission within 90 days of discharge for health system patients.

Design
The study used a retrospective, correlational design with a single cohort.

Methods
Records of adult patients with a health system primary care provider and discharged from hospital to home were included. Data were obtained from health system billing database, medical record, and publicly available population databases. A time-to-readmission analysis was conducted with a Kaplan-Meier plot, log-rank test, and Cox regression analysis.

Results
The final sample included 41 566 records; the rate of food insecurity was 1.45%, and 90-day readmission rate was 16.7%. The mean area deprivation index score was 54.4 (SD, 26.0). After adjusting for patient demographics, comorbidity, and length of stay, food insecurity resulted in 1.94 times higher risk of readmission (hazard ratio, 1.94; 95% confidence interval, 1.69–2.23; P < .001). Neighborhood disadvantage and lower food access were not significant in final models.

Conclusions
Food insecurity should be identified and addressed as part of transitional care to improve patient outcomes. Future research should focus on models of care that ensure connection to community resources to resolve food insecurity and evaluate the impact on patient outcomes.
Gastrointestinal Ewing Sarcoma
Authors: Yin Tangchen , Shao Mengyuan , Sun Meng , Zhao Lu , Lao I. Weng , Yu Lin , Wang Jian 
Published: December 2023

Occurrence of extraskeletal Ewing sarcoma (ES) in the gastrointestinal (GI) tract is extremely rare. Here, we report 25 cases of ES arising primarily in the GI tract with a focus on the clinicopathological and molecular features, differential diagnosis, and biological behavior. Thirteen patients (52%) were male, and 12 (48%) were female with age ranging from 9 to 59 years (mean: 36.2 years; median: 38 years). Twenty-one tumors (84%) occurred in the small intestine, 3 (12%) in the stomach, and 1 (4%) in the anal canal. At operation, 8/18 (44.4%) patients presented with abdominopelvic disseminated disease. Tumor size measured from 2 to 25 cm (mean: 8.2 cm; median: 6 cm) in maximum size. Microscopically, the tumors were composed of infiltrative small round, ovoid, or short spindle cells arranged mostly in lobular and solid sheet-like patterns with a rich capillary vasculature. Focal formation of Homer Wright–type rosettes and pseudoalveolar architecture was noted each in 2 (8%) cases and 3 (12%) cases. Besides CD99 (25/25; 100%), Fli-1 (15/15, 100%), and NKX2.2 (14/16; 87.5%), the tumor cells also showed variable staining of CD117 (14/17; 82.4%). Of 25 cases, 23 (92%) demonstrated EWSR1 rearrangement by fluorescence in situ hybridization analysis. The 2 cases with negative fluorescence in situ hybridization results were found to harbor EWSR1::ERG and EWSR1::FLI1 fusion by further RNA sequencing, respectively, with a median follow-up of 12 months (range: 1 to 42 months), 5/19 (26.3%) patients developed visceral metastasis and 12/19 (63.2%) patients died of the disease (range:1 to 33 months; median: 9 months). This study showed that GI ES had a predilection for the small intestine, although other sites of the GI tract could also be involved. GI ES had a poor prognosis with a high rate of mortality, particularly in patients with abdominopelvic disseminated disease. In light of appropriate therapeutic strategies and prognostic considerations, it is essential not to misdiagnose GI ES as gastrointestinal stromal tumor owing to the expression of aberrant CD117.
Later Brain Death Declaration Correlates to Favorable Donor Characteristics but Decreased Heart Acceptance
Authors: Greenberg Jason W. , Kantemneni Eashwar C. , Kulshrestha Kevin , Clothier Jessica S. , Desai Mallika V. , Winlaw David S. , Zafar Farhan , Morales David L.S. 
Published: December 2023

Background.
With rates of potential donor heart discard as high as 66% nationally, quality improvement efforts must seek to optimize donor utilization. Whether the timing of donor brain death declaration (BDD) influences organ acceptance is understudied. The authors sought to characterize the impacts of time between donor hospital admission and BDD on heart utilization and posttransplant outcomes.

Methods.
All potential heart donors and recipients in the United Network for Organ Sharing database were identified (2006–2021). Admission-to-BDD cohorts were: 1 to 2 d (n = 52 469), 3 to 4 d (n = 44 033), 5 to 7 d (n = 24 509), and 8 to 10 d (n = 8576). Donor clinical characteristics were compared between cohorts, and donor acceptance was assessed using multivariable binary logistic regression. Recipient posttransplant survival was assessed with the Kaplan-Meier method.

Results.
Donor demographics and comorbidity profiles (diabetes and hypertension) were comparable across cohorts. Anoxia/overdose deaths were more common (10% > 21% > 24% > 18%, respectively) and cardiopulmonary resuscitation requirements were higher (37% > 52% > 58% > 47%) when BDD occurred longer after admission. Renal dysfunction (44% > 44% > 35% > 29%) and inotrope requirements (52% > 25% > 36% > 29%) were lower in the later BDD cohorts. Proportions of hepatic dysfunction (18%–21%) and left ventricular ejection fraction <50% (13%–16%) were clinically equivalent. Donor acceptance differed by admission-to-BDD cohort (36% [1–2 d], 34% [3–4 d], 30% [5–7 d], and 28% [8–10 d]). Admission-to-BDD >4 d was independently associated with lower odds of acceptance on multivariable analysis (odds ratio 0.79, P < 0.001). Recipients experienced equivalent posttransplant survival for all donor admission-to-BDD cohorts (P = 0.999 adults and P = 0.260 pediatrics).

Conclusions.
Heart donors with later BDD were disproportionately discarded despite similar-to-favorable overall clinical profiles, resulting in nearly 3000 fewer transplants during the study. Increased utilization of donors with later BDD and “high-risk” characteristics (eg, anoxia/overdose, cardiopulmonary resuscitation requirement) can improve rates of transplantation without compromising outcomes.
New Frontier: The First Year of an Adult Neurodevelopmental Disabilities Clinic
Authors: Sanders Jessica S. , Mabry Moriah , Scarbro Sharon , Filley Christopher M. 
Published: December 2023

Background:
As patients with neurodevelopmental disorders (NDDs) transition from pediatric to adult health care systems, they often have difficulty finding physicians to address their NDD-related needs. In response to this care gap, we established a new consultation clinic within a behavioral neurology clinic in an adult neurology department to address the neurodevelopmental concerns of these adult patients.

Objective:
To characterize the population of adult patients with NDDs seen in the adult NDD clinic in its first year.

Method:
Data were obtained by a retrospective chart review of all patients with NDDs seen in the adult NDD clinic from September 2020 through December 2021.

Results:
Of the 86 patients who were seen in the adult NDD clinic, the average age was 34 years (SD = 15, range = 18–74 years). Developmental diagnoses included intellectual disability (63%), autism spectrum disorder (47%), Down syndrome (15%), cerebral palsy (9%), and other genetic disorders (26%). Comorbidities addressed included behavioral concerns (34%), anxiety (29%), seizure disorders (22%), and depression (15%). Behavioral and/or mental health concerns prompted 65% of the initial clinic visits. The most common recommendation made was to begin or increase exercise (59%), followed by facilitating connection to community, social, and employment resources.

Conclusion:
Adults with NDDs have diagnoses, comorbidities, and concerns that are similar to, but also distinct from, those addressed in other adult neurology clinics. This study addresses the need for, and feasibility of, caring for the diverse population of adults with NDDs in an adult neurology setting.
Neuronal connectivity, behavioral, and transcriptional alterations associated with the loss of MARK2
Authors: Caiola Hanna O. , Wu Qian , Soni Shaili , Wang Xue-Feng , Monahan Kevin , Pang Zhiping P. , Wagner George C. , Zhang Huaye 
Published: December 2023

AbstractNeuronal connectivity is essential for adaptive brain responses and can be modulated by dendritic spine plasticity and the intrinsic excitability of individual neurons. Dysregulation of these processes can lead to aberrant neuronal activity, which has been associated with numerous neurological disorders including autism, epilepsy, and Alzheimer’s disease. Nonetheless, the molecular mechanisms underlying aberrant neuronal connectivity remains unclear. We previously found that the serine/threonine kinase Microtubule Affinity Regulating Kinase 2 (MARK2), also known as Partitioning Defective 1b (Par1b), is important for the formation of dendritic spinesin vitro.However, despite its genetic association with several neurological disorders, thein vivoimpact of MARK2 on neuronal connectivity and cognitive functions remains unclear. Here, we demonstrate that loss of MARK2in vivoresults in changes to dendritic spine morphology, which in turn leads to a decrease in excitatory synaptic transmission. Additionally, loss of MARK2 produces substantial impairments in learning and memory, anxiety, and social behavior. Notably, MARK2 deficiency results in heightened seizure susceptibility. Consistent with this observation, RNAseq analysis reveals transcriptional changes in genes regulating synaptic transmission and ion homeostasis. These findings underscore thein vivorole of MARK2 in governing synaptic connectivity, cognitive functions, and seizure susceptibility.
Imputing Single-Cell Protein Abundance in Multiplex Tissue Imaging
Authors: Kirchgaessner Raphael , Watson Cameron , Creason Allison , Keutler Kaya , Goecks Jeremy 
Published: December 2023

AbstractMultiplex tissue imaging are a collection of increasingly popular single-cell spatial proteomics and transcriptomics assays for characterizing biological tissues both compositionally and spatially. However, several technical issues limit the utility of multiplex tissue imaging, including the limited number of molecules (proteins and RNAs) that can be assayed, tissue loss, and protein probe failure. In this work, we demonstrate how machine learning methods can address these limitations by imputing protein abundance at the single-cell level using multiplex tissue imaging datasets from a breast cancer cohort. We first compared machine learning methods’ strengths and weaknesses for imputing single-cell protein abundance. Machine learning methods used in this work include regularized linear regression, gradient-boosted regression trees, and deep learning autoencoders. We also incorporated cellular spatial information to improve imputation performance. Using machine learning, single-cell protein expression can be imputed with mean absolute error ranging between 0.05-0.3 on a [0,1] scale. Finally, we used imputed data to predict whether single cells were more likely to come from pre-treatment or post-treatment biopsies. Our results demonstrate (1) the feasibility of imputing single-cell abundance levels for many proteins using machine learning; (2) how including cellular spatial information can substantially enhance imputation results; and (3) the use of single-cell protein abundance levels in a use case to demonstrate biological relevance.
Aperiodic EEG predicts variability of visual temporal processing
Authors: Deodato Michele , Melcher David 
Published: December 2023

ABSTRACTThe human brain exhibits both oscillatory and aperiodic, or 1/f, activity. Although a large body of research has focused on the relationship between brain rhythms and sensory processes, aperiodic activity has often been dismissed as noise and functionally irrelevant. Prompted by recent findings linking aperiodic activity to the balance between neural excitation and inhibition, we investigated its effects on the temporal resolution of perception. We recorded EEG from participants during resting state and a task in which they detected the presence of two flashes separated by variable inter-stimulus intervals. Two-flash discrimination accuracy typically follows a sigmoid function whose steepness reflects perceptual variability or inconsistent integration/segregation of the stimuli. We found that individual differences in the steepness of the psychometric function correlated with EEG aperiodic exponents over posterior scalp sites. In other words, participants with higher levels of aperiodic activity (i.e., neural excitation) exhibited increased sensory noise, resulting in shallower psychometric curves. Our finding suggest that aperiodic EEG is linked to sensory integration processes usually attributed to the rhythmic inhibition of neural oscillations. Overall, this correspondence between aperiodic neural excitation and behavioral measures of sensory noise provides a more comprehensive explanation of the relationship between brain activity and sensory integration and represents an important extension to theories of how the brain samples sensory input over time.
Loss of PV interneurons in the BLA contributes to altered network and behavioral states in chronically epileptic mice
Authors: Colmers Phillip L.W. , Antonoudiou Pantelis , Basu Trina , Scapa Garrett , Fuller Patrick , Maguire Jamie 
Published: December 2023

AbstractPsychiatric disorders, including anxiety and depression, are highly comorbid in people with epilepsy. However, the mechanisms mediating the shared pathophysiology are currently unknown. There is considerable evidence implicating the basolateral amygdala (BLA) in the network communication of anxiety and fear, a process demonstrated to involve parvalbumin-positive (PV) interneurons. The loss of PV interneurons has been well described in the hippocampus of chronically epileptic mice and in postmortem human tissue of patients with temporal lobe epilepsy (TLE). We hypothesize that a loss of PV interneurons in the BLA may contribute to comorbid mood disorders in epilepsy. To test this hypothesis, we employed a ventral intrahippocampal kainic acid (vIHKA) model of chronic epilepsy in mice, which exhibits profound behavioral deficits associated with chronic epilepsy. We demonstrate a loss of PV interneurons and dysfunction of remaining PV interneurons in the BLA of chronically epileptic mice. Further, we demonstrate altered principal neuron function and impaired coordination of BLA network and behavioral states in chronically epileptic mice. To determine whether these altered network and behavioral states were due to the loss of PV interneurons, we ablated a similar percentage of PV interneurons observed in chronically epileptic mice by stereotaxically injecting AAV-Flex-DTA into the BLA of PV-Cre mice. Loss of PV interneurons in the BLA is sufficient to alter behavioral states, inducing deficits in fear learning and recall of fear memories. These data suggest that compromised inhibition in the BLA in chronically epileptic mice contributes to behavioral deficits, suggesting a novel mechanism contributing to comorbid anxiety and epilepsy.Significance StatementPsychiatric illnesses and epilepsy are highly comorbid and negatively impact the quality of life of people with epilepsy. The pathophysiological mechanisms mediating the bidirectional relationship between mood disorders and epilepsy remain unknown and, therefore, treatment options remain inadequate. Here we demonstrate a novel mechanism, involving the loss of PV interneurons in the BLA, leading to a corruption of network and behavioral states in mice. These findings pinpoint a critical node and demonstrate a novel cellular and circuit mechanism involved in the comorbidity of psychiatric illnesses and epilepsy.