bluuebunny/crossref_metadata_2025_split huggingface dataset:
Residential Redlining, Neighborhood Trajectory, and Equity of Breast and Colorectal Cancer Care
Authors: Loehrer Andrew P. , Weiss Julie E. , Chatoorgoon Kaveer K. , Bello Oluwaferanmi T. , Diaz Adrian , Carter Benjamin , Akré Ellesse-Roselee , Hasson Rian M. , Carlos Heather A. 
Published: November 2023

Objective:
This study aimed to determine the influence of structural racism, vis-à-vis neighborhood socioeconomic trajectory, on colorectal and breast cancer diagnosis and treatment.

Summary Background Data:
Inequities in cancer care are well documented in the United States but less is understood about how historical policies like residential redlining and evolving neighborhood characteristics influence current gaps in care.

Methods:
This retrospective cohort study included adult patients diagnosed with colorectal or breast cancer between 2010 and 2015 in 7 Indiana cities with available historic redlining data. Current neighborhood socioeconomic status was determined by the Area Deprivation Index (ADI). Based on historic redlining maps and current ADI, we created four “Neighborhood Trajectory” categories: Advantage Stable, Advantage Reduced, Disadvantage Stable, Disadvantage Reduced. Modified Poisson regression models estimated the relative risks (RR) of Neighborhood Trajectory on cancer stage at diagnosis and receipt of cancer-directed surgery (CDS).

Results:
A final cohort derivation identified 4,862 cancer patients with colorectal or breast cancer. Compared to Advantage Stable neighborhoods, Disadvantage Stable neighborhood was associated with late-stage diagnosis for both colorectal and breast cancer (RR=1.30 [95% CI=1.05 – 1.59]; RR=1.41 [1.09 – 1.83], respectively). Black patients had lower likelihood of receiving CDS in Disadvantage Reduced neighborhoods (RR=0.92 [0.86 – 0.99]) than White patients.

Conclusions:
Disadvantage Stable neighborhoods were associated with late-stage diagnosis for breast and colorectal cancer. Disadvantage Reduced (gentrified) neighborhoods were associated with racial-inequity in CDS. Improved neighborhood socioeconomic conditions may improve timely diagnosis but could contribute to racial inequities in surgical treatment.
Early career acute care surgeons' priorities and perspectives: A mixed-methods analysis to better understand full-time employment
Authors: Murphy Patrick B. , Coleman Jamie , Maring Morgan , Pokrzywa Courtney , Deshpande David , Al Tannir Abdul Hafiz , Biesboer Elise A. , Morris Rachel S. , Figueroa Juan , de Moya Marc 
Published: November 2023

BACKGROUND
Understanding the expectations of early career acute care surgeons will help clarify the practice and employment models that will attract and retain high-quality surgeons, thereby sustaining our workforce. This study aimed to outline the clinical and academic preferences and priorities of early career acute care surgeons and to better define full-time employment.

METHODS
A survey on clinical responsibilities, employment preferences, work priorities, and compensation was distributed to early career acute care surgeons in the first 5 years of practice. A subset of agreeable respondents underwent virtual semistructured interviews. Both quantitative and thematic analysis were used to describe current responsibilities, expectations, and perspectives.

RESULTS
Of 471 surgeons, 167 responded (35%), the majority of whom were assistant professors within the first 3 years of practice (80%). The median desired clinical volume was 24 clinical weeks and 48 call shifts per year, 4 weeks less than their median current clinical volume. Most respondents (61%) preferred a service-based model. The top priorities cited in choosing a job were geography, work schedule, and compensation. Qualitative interviews identified themes related to defining full-time employment, first job expectations and realities, and the often-misaligned system and surgeon.

CONCLUSION
Understanding the perspectives of early career surgeons entering the workforce is important particularly in the field of acute care surgery where no standard workload or practice model exists. The wide variety of expectations, practice models, and schedule preferences may lead to a mismatch between surgeon desires and employment expectation. Consistent employment standards across our specialty would provide a framework for sustainability.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
Evaluating the impact of timing to rib fixation in patients with traumatic brain injury: A nationwide analysis
Authors: Lagazzi Emanuele , Argandykov Dias , de Roulet Amory , Proaño-Zamudio Jefferson A. , Romijn Anne-Sophie C. , Abiad May , Rafaqat Wardah , Velmahos George C. , Hwabejire John O. , Paranjape Charudutt N. 
Published: November 2023

BACKGROUND
Early surgical stabilization of rib fractures (SSRF) is associated with improved inpatient outcomes in patients with multiple rib fractures. However, there is still a paucity of data examining the optimal timing of SSRF in patients with concomitant traumatic brain injury (TBI). This study aimed to assess whether earlier SSRF was associated with improved outcomes in patients with multiple rib fractures and TBI.

METHODS
We performed a retrospective analysis of the American College of Surgeons Trauma Quality Improvement Program 2017–2020, including adult patients with TBI and multiple rib fractures who had undergone SSRF. The outcomes were post-procedural length of stay (LOS), hospital LOS, intensive care unit (ICU) LOS, in-hospital mortality, ventilator days, and tracheostomy rate. Multilevel mixed-effects regression analyses accounting for patient, injury, and hospital characteristics as well as institutional SSRF volume were used to assess the association between timing to SSRF and the outcomes of interest. As a sensitivity analysis, propensity-score matching was performed to compare patients who underwent early (<72 hours) versus late SSRF (≥72 hours).

RESULTS
Of 1,041 patients included in this analysis, 430 (41.3%) underwent SSRF within the first 72 hours from admission. Delay to SSRF was associated with an increase in post-procedural LOS (partial regression coefficient (β) = 0.011; p = 0.036; 95% confidence interval [CI], 0.001–0.023), longer hospital LOS (β = 0.053; p < 0.001; 95% CI, 0.042–0.064), prolonged ICU LOS (β = 0.032; p < 0.001; 95% CI, 0.025–0.038), and more ventilator days (β = 0.026, p < 0.001; 95% CI, 0.020–0.032).

CONCLUSION
In patients with concurrent multiple rib fractures and TBI, a delay in SSRF is associated with an increase in postprocedural LOS, hospital LOS, ICU LOS, and ventilator days. These findings suggest that the early patient selection and implementation of SSRF may play a beneficial role in patients presenting with concomitant TBI and multiple rib fractures.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level IV.
Common postbariatric surgery emergencies for the acute care surgeon: What you need to know
Authors: Cheng Vincent , Samakar Kamran , Dobrowolsky Adrian B. , Nguyen James D. , Abel Stuart A. , Pakula Andrea , Bernard Andrew , Martin Matthew J. 
Published: November 2023

ABSTRACT
The field of bariatric and metabolic surgery has changed rapidly over the past two decades, with an exponential increase in case volumes being performed because of its proven efficacy for morbid obesity and obesity-related comorbidities. Although this increased volume of procedures has been accompanied by significant decrease in postoperative complication rates, there are numerous potential complications after bariatric surgery that may require urgent or emergent surgical evaluation or interventions. Many of these risks extend well beyond the early postoperative period and can present months to years after the index procedure. Acute care surgeons are increasingly covering most or all of the emergency general surgery services at many centers and must be familiar with the numerous bariatric surgical procedures being performed and their individual complication profile to provide optimal care for these frequently challenging patients. This article provides a focused and concise review of the common bariatric procedures being performed, their early and late complication profiles, and a practical guide to the optimal diagnostic evaluations, surgical interventions, and perioperative management options. The author group includes both acute care surgeons and bariatric surgeons with significant experience in the emergency management of the complicated postbariatric surgical patient.

LEVEL OF EVIDENCE
Literature Synthesis and Expert Opinion; Level V.
Adversarial Learning for MRI Reconstruction and Classification of Cognitively Impaired Individuals
Authors: Zhou Xiao , Balachandra Akshara R. , Romano Michael F. , Chin Sang P. , Au Rhoda , Kolachalama Vijaya B. 
Published: November 2023

AbstractGame theory-inspired deep learning using a generative adversarial network provides an environment to competitively interact and accomplish a goal. In the context of medical imaging, most work has focused on achieving single tasks such as improving image resolution, segmenting images, and correcting motion artifacts. We present a dual-objective adversarial learning framework that simultaneously (1) reconstructs higher quality brain magnetic resonance images (MRIs) that (2) retain disease-specific imaging features critical for predicting progression from mild cognitive impairment (MCI) to Alzheimer’s disease (AD). We obtained 3-Tesla, T1-weighted brain MRIs of participants from the Alzheimer’s Disease Neuroimaging Initiative (ADNI, N=342) and the National Alzheimer’s Coordinating Center (NACC, N=190) datasets. We simulated MRIs with missing data by removing 50% of sagittal slices from the original scans (i.e., diced scans). The generator was trained to reconstruct brain MRIs using the diced scans as input. We introduced a classifier into the GAN architecture to discriminate between stable (i.e., sMCI) and progressive MCI (i.e., pMCI) based on the generated images to facilitate encoding of AD-related information during reconstruction. The framework was trained using ADNI data and externally validated on NACC data. In the NACC cohort, generated images had better image quality than the diced scans (SSIM: 0.553 ± 0.116 versus 0.348 ± 0.108). Furthermore, a classifier utilizing the generated images distinguished pMCI from sMCI more accurately than with the diced scans (F1-score: 0.634 ± 0.019 versus 0.573 ± 0.028). Competitive deep learning has potential to facilitate disease-oriented image reconstruction in those at risk of developing Alzheimer’s disease.
Tau alters global gene expression affecting chromatin in the early stages of Alzheimer’s disease
Authors: Siano G. , Varisco M. , Terrigno M. , Wang C. , Groth Marco , Galas M.C. , Hoozemans Jeroen J.M. , Cellerino A. , Cattaneo A. , Di Primio C. 
Published: November 2023

AbstractRecent research revealed that Tau plays critical roles in various neuronal functions. Our previous work demonstrated that destabilization and nuclear delocalization of Tau can alter the expression of glutamatergic genes, thereby mediating early neuronal damage.Upon analysing gene coexpression of AD temporal regions at different stages and the transcriptional output in differentiated neuroblastoma cells, we discovered that changes in Tau availability are linked to global alterations in gene expression that affect multiple neuronal pathways. Comparison with the human AD temporal region showed that the Tau-dependent modulation of gene expression closely resembles an intermediate stage of AD that precedes the definitive AD condition. Furthermore, we identified the chromatin remodelling pathway as being significantly affected by Tau in both our cellular model and AD brains, with reductions in heterochromatin markers.We propose that Tau is able to globally affect the neuronal transcriptome and that its availability is linked to changes in gene expression during intermediate stages of AD development. In addition, we found that the epigenetic pathway is strongly affected by Tau during the progression of AD.
PVTAD: ALZHEIMER’S DISEASE DIAGNOSIS USING PYRAMID VISION TRANSFORMER APPLIED TO WHITE MATTER OF T1-WEIGHTED STRUCTURAL MRI DATA
Authors: Akhavan Aghdam Maryam , Bozdag Serdar , Saeed Fahad ,   Alzheimer’s Disease Neuroimaging Initiative
Published: November 2023

ABSTRACTAlzheimer’s disease (AD) is a neurodegenerative disorder, and timely diagnosis is crucial for early interventions. AD is known to have disruptive local and global brain neural connections that may be instrumental in understanding and extracting specific biomarkers. Previous machine-learning approaches are mostly based on convolutional neural network (CNN) and standard vision transformer (ViT) models which may not sufficiently capture the multidimensional local and global patterns that may be indicative of AD. Therefore, in this paper, we propose a novel approach called PVTAD to classify AD and cognitively normal (CN) cases using pretrained pyramid vision transformer (PVT) and white matter (WM) of T1-weighted structural MRI (sMRI) data. Our approach combines the advantages of CNN and standard ViT to extract both local and global features indicative of AD from the WM coronal middle slices. We performed experiments on subjects with T1-weighed MPRAGE sMRI scans from the ADNI dataset. Our results demonstrate that the PVTAD achieves an average accuracy of 97.7% and F1-score of 97.6%, outperforming the single and parallel CNN and standard ViT architectures based on sMRI data for AD vs. CN classification.
CellSAM: A Foundation Model for Cell Segmentation
Authors: Israel Uriah , Marks Markus , Dilip Rohit , Li Qilin , Yu Changhua , Laubscher Emily , Iqbal Ahamed , Pradhan Elora , Ates Ada , Abt Martin , Brown Caitlin , Pao Edward , Li Shenyi , Pearson-Goulart Alexander , Perona Pietro , Gkioxari Georgia , Barnowski Ross , Yue Yisong , Van Valen David 
Published: November 2023

AbstractCells are a fundamental unit of biological organization, and identifying them in imaging data – cell segmentation – is a critical task for various cellular imaging experiments. While deep learning methods have led to substantial progress on this problem, most models are specialist models that work well for specific domains but cannot be applied across domains or scale well with large amounts of data. In this work, we present CellSAM, a universal model for cell segmentation that generalizes across diverse cellular imaging data. CellSAM builds on top of the Segment Anything Model (SAM) by developing a prompt engineering approach for mask generation. We train an object detector, CellFinder, to automatically detect cells and prompt SAM to generate segmentations. We show that this approach allows a single model to achieve human-level performance for segmenting images of mammalian cells, yeast, and bacteria collected across various imaging modalities. We show that CellSAM has strong zero-shot performance and can be improved with a few examples via few-shot learning. Additionally, we demonstrate how CellSAM can be applied across diverse bioimage analysis workflows. A deployed version of CellSAM is available athttps://cellsam.deepcell.org/.
Elevated blood urea nitrogen to creatinine ratio during hospitalization is associated with 90-day poor outcome in ICH patients
Authors: Wei Yamin , Deng Wenjing , Zhao Yanan , Shao Huijie 
Published: November 2023

AbstractBackground and PurposeDehydration is common in hospitalized patients and associated with poor outcome in ischemic stroke patients. Intracerebral hemorrhage patients use hyperosmolar agents frequently after admission, which may lead to dehydration. Since the blood urea nitrogen to creatinine ratio (BUN/Cr) is an indicator of dehydration, it is unknown whether there is a relationship between BUN/Cr ratio during hospitalization and clinical outcome of intracerebral hemorrhage patients.MehtodsA total of 211 patients with supratentorial cerebral hemorrhage were included. Clinical data was collected retrospectively. BUN/Cr ratio on day 7 after onset (7dBUN/Cr) was calculated. Poor outcome was defined as 90-day mRS>2. Univariate and multivariate logistic regression analyses were used to determine the relationship between 7dBUN/Cr ratio and 90-day poor outcome. Receiver operating curve was used to determine the best cutoff of 7dBUN/Cr ratio for predicting poor outcome.ResultsNIHSS score, hematoma volume and 7dBUN/Cr ratio were independently correlated with 90-day poor outcome. Under receiver operating curve, 7dBUN/Cr ratio exhibited similar prognostic capability, as compared to hematoma volume. The best cutoff for 7dBUN/Cr ratio to predict poor outcome was 22 in the hyperosmolar agents subgroup.ConclusionsElevated BUN/Cr ratio at day 7 is associated with 90-day poor outcome in ICH patients. Further prospective study will be required to confirm this result and explore the value of BUN/Cr ratio in the application of hyperosmolar agents and hydration therapy.
High Inspired CO2Target Accuracy in Mechanical Ventilation and Spontaneous Breathing Using the Additional CO2Method
Authors: Magnusson Gustav , Georgiopoulos Charalampos , Cedersund Gunnar , Tobieson Lovisa , Engström Maria , Tisell Anders 
Published: November 2023

ABSTRACTCerebrovascular Reactivity Imaging (CVR) is a diagnostic method for assessment of alterations in cerebral blood flow in response to a controlled vascular stimulus. The principal utility is the capacity to evaluate the cerebrovascular reserve, thereby elucidating autoregulatory functioning. Over the past decade, CVR has accumulated large interest, emerging as an expanding research field and application in a diverse spectrum of patient populations. In CVR, CO2gas challenge is the most prevalent method, which elicits a vascular response by alterations in inspired CO2concentrations. While several systems have been proposed in the literature, only a limited number have been devised to operate in tandem with mechanical ventilation, thus constraining the majority CVR investigations to spontaneous breathing individuals. We have developed a new method, denoted Additional CO2, designed to enable CO2challenge in ventilators. The central idea is the introduction of an additional flow of highly concentrated CO2into the respiratory circuit, as opposed to administration of the entire gas mixture from a reservoir. By monitoring the main respiratory gas flow emanating from the ventilator, the CO2concentration in the inspired gas can be manipulated by adjusting the proportion of additional CO2. We evaluated the efficacy of this approach in controlled settings: 1) in a ventilator coupled with a test-lung and 2) in spontaneous breathing healthy volunteers. Additionally, we made a comparative analysis using a conventional method employing a gas reservoir containing a blend of O2, N2, and CO2in varying concentrations. The methods were evaluated by assessment of the precision in attaining target inspired CO2levels and examination of their performance within a Magnetic Resonance Imaging (MRI) environment. Our investigations revealed that the Additional CO2method consistently achieved a high degree of accuracy in reaching target inspired CO2levels in both mechanical ventilation and spontaneous breathing. We anticipate that these findings will lay the groundwork for a broader implementation of CVR assessments in mechanically ventilated patients.
Forming nephrons promote nephron progenitor maintenance and branching morphogenesis via paracrine BMP4 signalling under the control ofWnt4
Authors: Moreau Julie L.M. , Williams Sarah , Homman-Ludiye Jihane , Mallett Andrew J. , Combes Alexander N. 
Published: November 2023

AbstractKidney development is known to be driven by interactions between stromal, nephron and ureteric epithelium progenitors in the nephrogenic niche. In contrast, the epithelial nephrons generated in this environment have largely been considered a product of niche rather than an active participant in the signalling interactions that maintain it. However, knockout ofWnt4, a gene required for nephron formation and stromal development, results in hypoplastic kidneys. We hypothesised that the forming nephron may play a role in maintaining the nephrogenic niche. In support of this hypothesis, conditional deletion ofWnt4from the nephron lineage resulted in nephron progenitor dispersal and death, reduced branching morphogenesis and nephron progenitor cell number. Bulk and single cell transcriptional profiling ofWnt4mutant kidneys revealed a downregulation of BMP signalling effectorsId1,and Id3in nephron progenitor cells, implicatingWnt4target BMP4 as a paracrine signal mediating feedback from the committing nephron. Recombinant BMP4 restored nephron progenitor compaction in culturedWnt4mutant kidneys and blocked differentiation in wildtype controls mirroring the role of BMP7-MAPK signalling in progenitor self-renewal. Our data supports a revised model of the nephrogenic niche in which forming nephrons promote progenitor maintenance and branching morphogenesis, in part via paracrine BMP4 signalling under the control ofWnt4. This requirement for nephron-derived signals for maintenance of the nephrogenic niche provides new mechanistic insight into kidney morphogenesis and human renal hypodysplasia phenotypes associated with deleteriousWNT4mutations.
Disruption of redox balance in glutaminolytic triple negative breast cancer by inhibition of glutamate export and glutaminase
Authors: Choi Hoon , Gupta Mamta , Hensley Christopher , Lee Hsiaoju , Lu Yu-Ting , Pantel Austin , Mankoff David , Zhou Rong 
Published: November 2023

AbstractIn triple-negative breast cancer (TNBC) that relies on catabolism of amino acid glutamine, glutaminase (GLS) converts glutamine to glutamate, which facilitates glutathione synthesis by mediating the enrichment of intracellular cystine via xCT antiporter activity. To overcome chemo resistant TNBC, we have tested a strategy of disrupting cellular redox balance by inhibition of GLS and xCT by CB839 and Erastin, respectively. Key findings of our study include: 1. Dual metabolic inhibition (CB839+Erastin) led to significant increases of cellular superoxide level in both parent and chemo resistant TNBC cells, but superoxide level was distinctly lower in resistant cells. 2. Dual metabolic inhibition combined with doxorubicin or cisplatin induced significant apoptosis in TNBC cells and is associated with high degrees of GSH depletion.In vivo, dual metabolic inhibition plus cisplatin led to significant growth delay of chemo resistant human TNBC xenografts. 3. Ferroptosis is induced by doxorubicin (DOX) but not by cisplatin or paclitaxel. Addition of dual metabolic inhibition to DOX chemotherapy significantly enhanced ferroptotic cell death. 4. Significant changes in cellular metabolites concentration preceded transcriptome changes revealed by single cell RNA sequencing, underscoring the potential of capturing early changes in metabolites as pharmacodynamic markers of metabolic inhibitors. Here we demonstrated that 4-(3-[18F]fluoropropyl)-L-glutamic acid ([18F]FSPG) PET detected xCT blockade by Erastin or its analog in mice bearing human TNBC xenografts. In summary, our study provides compelling evidence for the therapeutic benefit and feasibility of non-invasive monitoring of dual metabolic blockade as a translational strategy to sensitize chemo resistant TNBC to cytotoxic chemotherapy.