bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early grafting using AlloDerm to lengthen the levator aponeurosis and correct upper eyelid retraction due to cosmetic blepharoplasty
Authors: Park Nam Seok , Lee Won , Kim Seong Hwan 
Published: January 2025

Summary:
Upper eyelid retraction (UER) often results from overcorrection of the levator palpebrae muscle during upper eyelid surgery. In such patients, the time between wound healing and reoperation may be prolonged and could result in symptoms, including dry eye. Therefore, the correction surgery, in which the levator aponeurosis which was shortened by cosmetic blepharoplasty is lengthened, should be performed as early as possible for better patient satisfaction and surgical outcomes. Between August 2020 and September 2022, we performed spacer grafting using AlloDerm dermal matrix after detaching the levator palpebrae muscle from the tarsus in 64 patients who experienced UER after bilateral eyelid surgery and cosmetic blepharoplasty. Among 64 patients, 50 (78%) had satisfactory results, 8 (12%) had blepharoptosis, and 6 (10%) had insufficient correction. Our method produced a normalized levator aponeurosis position, symmetric eyes, and reduced adverse effects, including surprised and dry eyes. In addition, the method is easy to follow and safe.
Improving Patient Transfer Quality: A Retrospective Study on a Transfer Center for a Canadian Upper Extremity Revascularization Program
Authors: Arsenault Virginie , Efanov Johnny I. , Lavoie Frédéric , Desrosiers Marie-Eve , Danino Michel A. 
Published: January 2025

Background:
Centralization to trauma centers is the gold standard for digital revascularization, but avoidable transfers constitute a real challenge to the trauma network. Our transfer center is characterized by a 24/7 call center managed by specialized nurses responsible for data collection, pictures and imagery transmissions and arrangement of systematic recorded discussions between referring doctors and surgeons. This study investigated the impact of implementing a dedicated transfer center on avoidable patient transfers to a centralized quaternary care center for upper extremity injuries requiring revascularization.

Methods:
A retrospective study was performed from September 2017 to December 2021. We included all transfer requests from outside facilities to revascularize upper extremity injuries. Transfers were considered avoidable if no exploration or microsurgical vascular procedure was attempted. Univariate and multivariate analysis were employed to compare transfer outcomes before and after the addition of the transfer center in 2019.

Results:
795 transfer requests were analyzed, of which 326 occurred before the implementation of the transfer center and 469 occurred after. Following this addition, the incidence of transfer requests increased from 13.48 requests per month to 16.96 (p=0.016). It improved communications between referring doctors and surgeons and improved triage selection, resulting in an increase of transfer refusals (from 47% to 56%, p=0.009). Avoidable transfers significantly decreased by 7.32% (p=0.047) following the implementation of the standardized protocol and call center.

Conclusions:
Unnecessary interhospital transfers in the context of digital revascularization burden the trauma network. Introducing a dedicated transfer center reduces avoidable transfers by improving triage selection and communications.
Risk of Cancers According to the Use of Biological Agents in Patients With Radiographic Axial Spondyloarthritis
Authors: Kwon Oh Chan , Lee Hye Sun , Yang Juyeon , Park Min-Chan 
Published: January 2025

Objective
As the duration of use of biological disease-modifying antirheumatic drugs (bDMARDs) in patients with radiographic axial spondyloarthritis (r-axSpA) accumulates over time, long-term real-world safety data on cancer risk are needed. This study assessed the association between tumor necrosis factor inhibitors (TNFis) and interleukin 17 inhibitors (IL-17is) exposures and cancer risk in patients with r-axSpA.

Methods
From the Korean nationwide database, we assembled 41,889 patients without prior history of cancer who were diagnosed with r-axSpA from 2010 onwards. Patients were followed up through 2021. Multivariable time-varying Cox models were performed to estimate the adjusted hazards ratios (aHRs) and 95% confidence intervals (CIs) of (1) overall cancers and (2) cancer subtypes according to TNFis exposure versus bDMARDs nonexposure, IL-17is exposure versus bDMARDs nonexposure, and IL-17is exposure versus TNFis exposure.

Results
The incident rates of overall cancers during bDMARDs nonexposure, TNFis exposure, and IL-17is exposure were 53.8, 37.6, and 67.3 per 10,000 person-years, respectively. TNFis exposure versus bDMARDs nonexposure was not associated with an increased risk of overall cancers (aHR = 0.9, 95% CI = 0.8–1.1). IL-17is exposure was not associated with an increased risk of overall cancers compared with bDMARDs nonexposure (aHR = 1.2, 95% CI = 0.5–3.0) or TNFis exposure (aHR = 1.3, 95% CI = 0.6–3.3). Similarly, no significant associations were observed between bDMARDs exposures and the risk of cancer subtypes.

Conclusions
In patients with r-axSpA, there was no evidence of increased cancer risk with TNFis and IL-17is exposures compared with bDMARDs nonexposure, suggesting that the use of bDMARDs is safe with respect to cancer risk in patients with r-axSpA.
Identification of QTL for reproductive success under heat stress conditions through a tomato MAGIC population
Authors: Lin Ya-Ping , Hussain Ehtisham , Hsu Yun-Che , Lin Chen-Yu , Chen You-Syuan , Hsu Lung-Hsin , Hung Ching-Yuan , Huang Shu-Mei , Yen Jo-Yi , Eybishitz Assaf , Hanson Peter , Kang Seung Won , Hoshikawa Ken 
Published: January 2025

AbstractHeat stress threatens tomato productivity by reducing pollen viability, fruit set, and consequently, overall yield. While heat-tolerant traits are predominantly found in wild tomatoes, the introgression of heat tolerance into elite cultivars remains challenging due to linkage drag. To address this issue, the World Vegetable Center developed a Multi-parent Advanced Generation Inter-Cross (MAGIC) population, derived from crosses between four heat-tolerant and disease-resistant cultivars. Phenotypic evaluations revealed that fruit number accounted for approximately 57% of reproductive output, making it a critical selection index for heat tolerance. A total of 16,350 SNPs were developed for the MAGIC population, and genome-wide association studies (GWAS) identified 50 QTLs linked to the evaluated traits. Notably, three QTLs on chromosomes 1, 3 and 11 emerged as hubs influencing multiple reproductive traits, underscoring their critical role in heat tolerance. SL4.0CH11_47205149 associated with fruit number was converted into a Kompetitive Allele-Specific PCR (KASP) marker and validated for its significant association with yield. The identification of key QTLs and the prioritization of fruit number as a primary determinant of reproductive success offer valuable insights for targeted breeding strategies.HighlightNumber of fruits is crucial for selecting heat-tolerant tomatoes in open fields. A marker linked to high fruit production helps develop high-yielding tomatoes better suited to withstand climate change.
Plasma proteomic analysis of intermuscular fat links muscle integrity with processing speed in older adults
Authors: Tanaka Toshiko , Rosano Caterina , Huang Xiaoning , Tian Qu , Landman Bennett A. , Moore Ann Z , Miljkovic Iva , Perry Andrew , Khan Sadiya , Kalhan Ravi , Carr John Jeffrey , Terry James G. , Yaffe Kristine , Walker Keenan , Candia Julián , Ferrucci Luigi 
Published: January 2025

AbstractINTRODUCTIONMore intermuscular fat (IMF) has been associated with lower cognitive performance and faster age-associated decline in cognitive function however, the mechanisms driving this relationship have not been fully elucidated. We utilized proteomic analyses to identify the molecular mediators of the association between IMF and cognition to gain further insight into the mechanisms underlying this association.METHODSIn this cross-sectional study, the plasma proteomic profile of IMF was assessed in the Baltimore Longitudinal Study on Aging (BLSA; n=941, age=66.7±15.2) and validated in the Coronary Artery Risk Development in Young Adults Study (CARDIA; n=2451, age=50.2±3.6). The 7628 plasma proteins were assessed using an aptamer-based assay and tested for association with IMF from the thigh (BLSA) and abdomen (CARDIA). Processing speed assessed by Digit Symbol Substitution Test (DSST). Associations between the main exposures, outcome and mediators were evaluated using linear regression, and mediating effects were assessed by causal mediation analysis adjusting for age, sex, muscle area or muscle volume, self-reported race, and years of education.RESULTSHigher IMF was associated with lower DSST performance both in the BLSA and CARDIA studies. There were 722 plasma proteins associated with IMF in both the discovery and replication cohorts (FDR-adjusted p≤0.05). Of the 722 IMF-associated proteins, 26 (24 unique proteins) mediated the relationship between IMF and processing speed with mediation effects ranging from 2.8 to 20.9% (p≤0.05). Overrepresentation analysis of the IMF-associated proteins showed enrichment of proteins in synaptic function and organization, and growth factor binding (FDR-adjusted p≤0.05).DISCUSSIONThere is a robust proteomic signature explaining, at least in part, the link of IMF with DSST. This signature reflected neurological function and growth factor regulation, which are both implicated in lower processing speed. Reducing IMF through behavioral or pharmacological intervention may improve cognition through reduction in growth factor activity and improvements in synaptic activity.
Towards uniform recognition of child abuse in the Netherlands: implementing the Screening instrument for Child Abuse and Neglect (SCAN)
Authors: van den Heuvel E.A.L. , de Vries D.S. , de Jong- van Kempen B.M. , Bakx R. , Bos R.F. , van Empelen P. , Hoedeman F. , Kappen T.H. , Russel-Kampschoer I.M.B. , Puiman P. , Schouten M.C.M. , Teeuw A.H. , Zwaans C.J. , Nijhof S.L. , van de Putte E.M. 
Published: January 2025

AbstractSTUDY PURPOSEThis study investigates compliance with the Screening Instrument for Child Abuse and Neglect (SCAN screening) and the usability of SCAN screening and its follow-up tool (SCAN-FU) for SCAN-positive outcomes, in 9 Emergency Departments (EDs). It aims to address the decline in child maltreatment recognition observed over the past decade in Dutch EDs.METHODSSCAN screening and SCAN-FU were integrated into the ED-workflow and electronic health records (EHRs), supported by an implementation strategy, e-learning, policy manuals, and an awareness campaign. Compliance was evaluated by comparing pre- and post-implementation screening rates, with clinically relevant improvement defined as a ≥10% increase. Usability was assessed using the Measurement Instrument for Determinants of Innovations and semi-structured interviews. Subgroup analyses were conducted by hospital type, EHR, profession type, and years of working experience.RESULTSAfter implementation the average compliance rate increased from 57.5% to 70.5%, with 3 of 8 sites achieving a ≥10% improvement. Compliance rates varied by site, with academic EDs benefiting most. Compliance was influenced by EHR configurations. Usability analysis identified five facilitators (perception of responsibility, social support, self-efficacy, knowledge, and formal ratification by management) and one barrier (unsettled organisation). Users considered SCAN screening and SCAN-FU user-friendly, though perceived support differed between nurses and physicians due to role-specific factors.RELEVANCESCAN screening can improve compliance in recognising child maltreatment, but tailored strategies are needed for further implementation. SCANs standardised approach enhances uniform data collection, enabling comparative analysis and interdisciplinary collaboration, advancing early detection of child maltreatment.
Development of a Deep-Learning Algorithm for Detecting Suspicious Breast Lesions on Chest CT
Authors: Zhang Hongyi , Johnson Jacob , Ngo Lawrence 
Published: January 2025

AbstractA convolutional neural network (CNN) was trained and evaluated for detecting suspicious breast lesions on a large dataset of chest CT exams from a teleradiology practice covering over 2,000 hospital sites. Radiologists annotated any discrete nodules or masses appearing within breast tissue, and the model was tested on a held-out set. At a threshold achieving 0.99 specificity, the model demonstrated a sensitivity of 0.32 and a positive predictive value (PPV) of 0.50. In a scenario where sensitivity and specificity were balanced, the model achieved sensitivity and specificity of 0.79 each, resulting in a PPV of 0.10. The overall performance, as indicated by the area under the receiver operating characteristic curve (AUC), was 0.87. These results highlight the potential of an automated system to identify suspicious breast lesions on chest CT exams, thereby aiding in the opportunistic detection of malignancies.
Development and Validation of Natural Language Processing Algorithms in the ENACT National Electronic Health Record Research Network
Authors: Wang Yanshan , Hilsman Jordan , Li Chenyu , Morris Michele , Heider Paul M. , Fu Sunyang , Kwak Min Ji , Wen Andrew , Applegate Joseph R , Wang Liwei , Bernstam Elmer , Liu Hongfang , Chang Jack , Harris Daniel R. , Corbeau Alexandria , Henderson Darren , Osborne John D , Kennedy Richard E , Garduno-Rapp Nelly-Estefanie , Rousseau Justin F. , Yan Chao , Chen You , Patel Mayur B. , Murphy Tyler J. , Malin Bradley A. , Park Chan Mi , Fan Jungwei W. , Sohn Sunghwan , Pagali Sandeep , Peng Yifan , Pathak Aman , Wu Yonghui , Xia Zongqi , Loguercio Salvatore , Reis Steven E. , Visweswaran Shyam 
Published: January 2025

AbstractElectronic health record (EHR) data are a rich and invaluable source of real-world clinical information, enabling detailed insights into patient populations, treatment outcomes, and healthcare practices. The availability of large volumes of EHR data are critical for advancing translational research and developing innovative technologies such as artificial intelligence. The Evolve to Next-Gen Accrual to Clinical Trials (ENACT) network, established in 2015 with funding from the National Center for Advancing Translational Sciences (NCATS), aims to accelerate translational research by democratizing access to EHR data for all Clinical and Translational Science Awards (CTSA) hub investigators. The present ENACT network provides access to structured EHR data, enabling cohort discovery and translational research across the network. However, a substantial amount of critical information is contained in clinical narratives, and natural language processing (NLP) is required for extracting this information to support research. To address this need, the ENACT NLP Working Group was formed to make NLP-derived clinical information accessible and queryable across the network. This article describes the implementation and deployment of NLP infrastructure across ENACT. First, we describe the formation and goals of the Working Group, the practices and logistics involved in implementation and deployment, and the specific NLP tools and technologies utilized. Then, we describe how we extended the ENACT ontology to standardize and query NLP-derived data, as well as how we conducted multisite evaluations of the NLP algorithms. Finally, we reflect on the experience and lessons learnt, which may be useful for other national data networks that are deploying NLP to unlock the potential of clinical text for research.
Using consideRATE to Evaluate Patient Experience in a Cancer Center: Psychometric and Healthcare Assessments
Authors: Nano Joseph P. , Stevens Gabrielle , Elwyn Glyn , Petrov Leeza , Gowrishankar Saahithya , Robitaille Shaday , Van Citters Aricca D. , Nelson Eugene C. , Wasp Garrett T. , Kirkland Kathryn B. , MacMartin Meredith A. , Saunders Catherine H. 
Published: January 2025

BackgroundconsideRATE is a patient- and care-partner-reported measure of care experience during serious illness. We usedconsideRATE with patients and care partners at the Dartmouth Cancer Center to assess patient experience, evaluate psychometric properties, and explore scoring approaches.MethodsPatients and care partners aged 18+ and English proficient participated in a cross-sectional survey. Participants completedconsideRATE (8 items), CANHELP-Lite (21 items), and demographic questions. Reliability was assessed using Cronbach’s α, and validity was evaluated with Pearson’s correlations. Continuous and top-box scoring approaches were used. Psychometric properties were analyzed for patients, care partners, and subgroups with lower educational attainment or income.Results244 participants (114 patients,128 care-partners, 2 unspecified) completed the survey.consideRATE has internal reliability (α = 0.86); the correlation (r) betweenconsideRATE continuous scoring and CANHELP Lite scores for all participants was 0.5; p<0.001, for patients 0.5; p<0.001, for care-partners 0.5; p<0.001, for patients (n=71) with lower educational attainment 0.5, p<0.001, and for patients (n=50) with lower income 0.7, p<0.001. We also found correlations betweenconsideRATE top-box scoring and CANHELP Lite scores for all participants (rpb=0.4, p<0.001), with stronger associations among the patient (rpb=0.5, p<0.001) and lower income (rpb=0.4, p=0.005) subgroups. We found discriminant validity betweenconsideRATE and Single-item Health Literacy (SILs) measures for continuous scoring (r = -0.05 to 0.09, p>0.05) and top-box scoring (r = -0.02 to 0.09, p>0.05). We found no significant difference in overall experience between patients with breast and blood cancer.ConclusionWe demonstrated in this sample of patients attending a cancer center thatconsideRATE has good internal reliability and is well correlated with CANHELP-Lite.
ABCA1 activity is associated with reduced Alzheimer’s Disease risk in APOE ε4 non-carriers
Authors: Peña-Tauber Andrés , Hernández Arriaza Ricardo , Le Guen Yann , Park Junyoung , Greicius Michael D. 
Published: January 2025

AbstractBackground and ObjectivesABCA1has been associated with Alzheimer’s Disease (AD) via large-scale genetic studies, but the mechanisms by which it impacts disease risk are unknown. ABCA1 catalyzes apolipoprotein lipidation in the central nervous system and is known to interact molecularly with ApoE. We explored whether variants altering ABCA1 activity depend on the presence of differentAPOEisoforms to modify AD risk.MethodsWe meta-analyzed European- and African-ancestry whole-genome and whole-exome sequencing datasets from the Alzheimer’s Disease Sequencing Project and UK Biobank. We used Cox hazards regression to assess the impact of rare (MAF < 1%) predicted damaging (loss-of-function, or missense with a REVEL score > 0.75) variants inABCA1on AD risk inAPOEsubgroups and performedAPOEinteraction analyses considering allAPOEgenotypes. We then leveraged plasma HDL levels, a phenotype known to be impacted byABCA1variants, as a measure of ABCA1 activity and examined whether cumulative effects on HDL levels byABCA1missense variants predict AD risk.ResultsRare damaging (LOF + REVEL ≥ 75) variants onABCA1increased AD risk inAPOEε2/ε3 and ε3/ε3 but not ε3/ε4 or ε4/ε4 cohorts. Interaction analyses indicated that damagingABCA1variants increase AD risk considering allAPOEisoforms (hazard ratio [HR] = 1.48; 95% confidence interval [CI] = 1.22, 1.79; p = 5.80E-05) and interact with bothAPOEε2 (HR = 1.99; 95% CI = 1.30, 3.05; p = 0.002) and ε4 (HR = 0.76; 95% CI = 0.61, 0.95; p = 0.014). Predicted ABCA1 activity based on a weighted sum of HDL-associatedABCA1missense variants was protective against AD (HR = 0.10; 95% CI = 0.04, 0.27; p = 2.83E-06) and interacted withAPOEε4 to counteract this protective effect (HR = 11.66; 95% CI = 3.81, 35.66; p = 1.67E-05), while there was no significant interaction with ε2.ConclusionsABCA1 activity is protective against AD risk inAPOEε4 non-carriers. Distinct interactions betweenABCA1and the mainAPOEisoforms suggest the proteins may work together to affect AD risk and motivates the development and testing ofABCA1therapeutics in specificAPOEsubpopulations.
The evolution of robustness and fragility during long-term bacterial adaptation
Authors: Chihoub Doha , Pintard Coralie , Lenski Richard E. , Tenaillon Olivier , Couce Alejandro 
Published: January 2025

ABSTRACTMost mutations affecting fitness are harmful, and their inevitable occurrence reduces mean population fitness. Theory predicts that well-adapted populations may evolve mechanisms to minimize this deleterious load. Direct selection to increase mutational robustness can be achieved in the laboratory. However, its spontaneous evolution during general adaptation remains uncertain, with mixed evidence across model systems. Here, we studied the effects of highly pleiotropic point mutations inEscherichia coliover a 15,000-generation adaptive trajectory. The fitness effects of both beneficial and deleterious mutations were attenuated with increased adaptation over time. In contrast, pleiotropic effects in new environments became more severe and widespread with greater adaptation. These results show that trade-offs between robustness and fragility can rapidly evolve in regulatory networks, regardless of whether driven by adaptive or non-adaptive processes. More broadly, these results show that adaptation can generate a hidden potential for phenotypic diversity, unpredictably shaping evolutionary prospects in new environments.
Emergence of high-connectivity states before epileptic seizures: Multi-patient validation, physiological correlates, and network modeling
Authors: Medina Nicolas , Vila-Vidal Manel , Tost Ana , Khawaja Mariam , Carreño Mar , Roldán Pedro , Rumià Jordi , Centeno María , Conde Estefanía , Donaire Antonio , Tauste Campo Adrià 
Published: January 2025

AbstractEpilepsy affects approximately 50 million people worldwide, making it one of the most prevalent neurological disorders. Predicting seizures through reliable pre-seizure biomarkers could greatly enhance neuromodulation therapies for drug-resistant patients. Recent research using stereo-electroencephalography (sEEG) has revealed specific changes in network dynamics during pre-seizure periods. In particular, our previous work demonstrated that day-time dependent alterations preceding seizures are largely driven by an increased occurrence of recurrent, short-lasting (0.6s) high-connectivity network configurations, termed High-Connectivity States (HCS). In this study, we replicated these findings using long-term sEEG recordings from a publicly available database and another patient undergoing presurgical evaluation with depth electrodes. For the latter patient, we leveraged all available monitoring information to validate the robustness of HCS alterations across different recording configurations. Additionally, we compared HCS dynamics with other sEEG measurements (e.g., power activity) and electrocardiogram-derived variables (e.g., heart rate) and developed a low-dimensional statistical network model to capture key network features of the pre-seizure period. Our results confirmed the specific emergence of HCS hours before seizure onset, consistent across monopolar, bipolar, and common average referential recordings. Notably, preictal HCS probability alterations were distributed across the frequency power spectrum and exhibited stronger correlations with heart rate fluctuations than with grand-average functional connectivity. The statistical model indicated that preictal HCS probability changes arise from shifts in network topology rather than changes in mean connectivity, highlighting the role of complex interactions between epileptogenic and non-epileptogenic brain regions. These findings suggest that integrating HCS probability with both invasive and non-invasive monitoring variables could establish it as a promising biomarker for an early detection of upcoming epileptic seizures.