bluuebunny/crossref_metadata_2025_split huggingface dataset:
Three Strikes
Authors: Gelfand Michael S. , Hobbs Athena L.V. , Cleveland Kerry O. 
Published: January 2025

Abstract
A 56-year-old female patient presented with severe abdominal pain and intra-abdominal/retroperitoneal fluid collections growing Escherichia coli and vancomycin-resistant Enterococcus faecium; oral linezolid and cefdinir were prescibed. Pancreatic enzymes, lactate, serum chemistry studies, and blood glucose were unremarkable during initial hospitalization. The patient remained afebrile and leukocytosis resolved with antibiotics. On day 37 of linezolid therapy, serum glucose was 56 mg/dL and serum bicarbonate was 17 mEq/L (normal 23–30 mEq/L). As the patient was asymptomatic, infectious disease consultants recommended cessation of antibiotics, but they were unfortunately continued on transfer to a rehabilitation facility. On day 41 of treatment, the patient became lethargic, with serial serum glucose levels 33–34 mg/dL. Serum bicarbonate was 6 mEq/L, lactate was >15 mmol/L, and blood pressure was 80/36 mm Hg. Admission blood cultures were negative. Supportive care was instituted, but the patient continued to clinically deteriorate. Computed tomography scan of the abdomen showed hepatic steatosis and no residual fluid collections or pancreatic abnormalities. The patient expired on the third day of hospitalization.
Assessment of simulation training efficacy in improving microsurgical skills: a retrospective analysis
Authors: He Xuecheng , Gao Tao , Tang Jianfei , Jiang Zengxin , Zhang Zeng , Lin E. , Yuan Hengfeng 
Published: January 2025

Background:
Microsurgery demands an intensive period of skill acquisition due to its inherent complexity. The development and implementation of innovative training methods are essential for enhancing microsurgical outcomes. This study aimed to evaluate the impact of a simulation training program on the clinical results of fingertip replantation surgeries.

Materials and methods:
A total of 276 replanted digits from 232 patients were included in this study, with a follow-up period of 6 months. Surgeons were identified and divided into trained and control groups, with the trained group receiving the rat tail training program. Primary outcomes included survival rates, replantation duration for each fingertip, degrees of flexion, Semmes–Weinstein monofilament test results, static two-point discrimination scores, Michigan Hand Questionnaire (MHQ) scores, and the incidence rates of complications such as arterial insufficiency and pulp atrophy.

Results:
Out of 1191 patients screened, 232 met the criteria for analysis. The average patient age was 41.3 years, predominantly male (87.1%). Trained microsurgeons performing Zone 1A replantation had higher success rates, shorter surgery durations, and fewer arterial complications compared to their untrained counterparts. For Zone 1B, they also showed improved operation times, decreased venous congestion and pulp atrophy, and better sensation outcomes. The results of trained group remained consistent across both single and multiple replantation, while the control group’s outcomes varied in multiple replantation with less favorable results. The trained group reported better scores on the MHQ at 6-month follow-ups, particularly regarding work performance, pain levels, aesthetics, and satisfaction.

Conclusions:
The simulation training program using a rat tail model has proven effective in enhancing the skills necessary for improved fingertip replantation. Participants in the program performed surgeries more efficiently and achieved better clinical outcomes. The structure of the training has demonstrated benefits, which may lead to improvements in various microsurgical procedures, positively impacting trainee surgeons, patient care, and the broader medical community.
Pan-neurofascin autoimmune nodoparanodopathy: A case report and literature review
Authors: Krim Elsa , Masri Alexandre , Delmont Emilien , Le Masson Gwendal , Boucraut Joseph , Mathis Stéphane 
Published: January 2025

Rationale:
Locked-in syndrome (and its variant, completely locked-in state) generally has a high mortality rate in the acute setting; however, when induced by conditions such as acute inflammatory polyradiculoneuropathy, it may well be curable such that an attempt at cure should be systematically sought by clinicians.

Patient concerns:
A 52-year-old man presented with acute tetraparesia and areflexia, initially diagnosed as Guillain–Barré syndrome. Despite appropriate treatment, his condition deteriorated, evolving into a completely locked-in state.

Diagnoses:
The detection of anti-pan-neurofascin antibodies led to the correct diagnosis, acute pan-neurofascin autoimmune nodoparanodopathy.

Interventions:
Immunosuppressive treatment (rituximab) and plasma exchanges were performed.

Outcomes:
After several months, the patient’s neurological symptoms almost completely subsided, without any major sequelae.

Lessons:
In patients with locked-in syndrome (or its variant), neurologists and intensive care physicians must be aware of, and look for, the main etiologies (including pan-neurofascin autoimmune nodoparanodopathy), to allow the prompt initiation of treatment and thus a rapid recovery for these ultimately curable conditions. Despite causing major disability, pan-neurofascin autoimmune nodoparanodopathy is curable if the appropriate treatment is given.
Gluteus medius contracture: A case report and review of the literature
Authors: Ma Yang , Gao Jiahao , Zheng Fuwen , Tang Jinshuo , Wang Chenyu , Guo Fengshuo , Liu Tong , Zuo Jianlin 
Published: January 2025

Rationale:
Bilateral gluteus medius contractures in adults are rare in clinical practice, with only a few cases reported. These contractures may result from repeated intramuscular injections during childhood. Understanding the clinical manifestations, diagnostic process, treatment, and outcomes can provide insights into effective management strategies.

Patient concerns:
A 28-year-old female presented with an abnormal walking posture characterized by an out-toeing gait. She reported long-standing difficulties in walking and sought medical attention to improve her mobility and quality of life.

Diagnoses:
The patient was diagnosed with bilateral gluteus medius contractures.

Interventions:
The patient underwent open surgical release of the contractures on both sides, followed by a structured rehabilitation program to restore muscle function and improve gait. Postoperative exercise guidance was provided to ensure optimal recovery.

Outcomes:
At the 1-year follow-up, the patient demonstrated significant improvement in gait, functional abilities, and overall quality of life. She expressed high satisfaction with the surgical and rehabilitative outcomes.

Lessons:
Once diagnosed with gluteus medius contracture, early surgical intervention is recommended. Through case reports and literature review, we have summarized the etiology, diagnostic methods, clinical characteristics, and existing treatment options for this condition.
Performance of the quantitative pupillary light reflex and neurological pupil index for predicting neurological outcomes in cardiac arrest patients: A systematic review and meta-analysis
Authors: Feng Chang Sheng 
Published: January 2025

Background:
The performance of quantitative pupillary light reflex (qPLR) and the neurological pupil index (NPi) was used to predict neurological outcomes in cardiac arrest (CA) patients.

Methods:
Eligible studies on the ability of the qPLR and NPi to predict neurological outcomes in CA patients were searched from the PubMed and China National Knowledge Infrastructure databases until July 2023. The pooled odds ratio (OR) and its 95% confidence interval (95% CI), area under the curve, sensitivity analysis, and publication bias were analyzed via Stata 14.0 software.

Results:
Twelve studies involving 1530 CA patients (968 in the qPLR study and 1025 in the NPi study) satisfied the inclusion criteria. qPLR (OR: 24.50, 95% CI: 13.08–45.86%, P < .001) and NPi (OR: 15.55, 95% CI: 7.92–30.55%, P < .001) were significantly associated with neurological outcome. The pooled area under the curves of the qPLR and NPi for predicting neurological outcome were 0.89 (95% CI: 0.86–0.92%) and 0.66 (95% CI: 0.62–0.70%), respectively. The pooled results were robust according to the sensitivity analysis. The funnel plots for qPLR (P = .94) and NPi (P = .10) did not reveal any publication bias.

Conclusion:
Compared with the NPi, the qPLR has greater diagnostic accuracy in predicting favorable neurologic outcomes.
A national survey on gastroenterology and hepatology training reveals dissimilar perceptions between trainees and trainers and an important need for improvement in training programs
Authors: Prosenz Julian , Grabherr Felix , Semmler Georg , Fickert Peter , Hofer Harald , Maieron Andreas , Zessner-Spitzenberg Jasmin 
Published: January 2025

Objective
We aimed to collect data on gastroenterology and hepatology training from the viewpoint of trainees and trainers.

Methods
A national online survey was distributed among trainees and specialists at certified training institutions between February and May 2024.

Results
Overall, 226 respondents – 98 trainees, 78 trainers, 50 program directors, and department heads responded, with a national coverage of 70% of trainees and 85% of specialty-department heads. A training curriculum was reported by 56% of trainees and 84% of curriculum organizers, regular feedback and training progress meetings by 11% of trainees (57% if considered without assessment of training progress), but 88% of curriculum organizers. Training was rated as very good or good by 65% of trainees, 79% of trainers, and 100% of department heads. Quality of functional diagnostics, endoscopy, and ultrasound training was rated as very good or good by trainees in 16, 61, and 54%, by trainers in 27, 79, and 58%, and by department heads in 74, 89, and 85%. Much agreement was found concerning the wish for external rotations (trainees 65%, trainers 70%, and department heads 89%) and a new postcertification advanced-endoscopy training and accreditation.

Conclusion
Department heads seem to overestimate the quality of their training programs. Consequently, we found large discrepancies in the perception of specialty training that should stimulate efforts to standardize training and boost necessary train-the-trainer programs. Diagnosis of functional gastrointestinal disorders and abdominal ultrasound skills are areas with the largest room for improvement. Increased flexibility of hospital providers will be crucial for significant improvement of external training possibilities.
The Early Steps to Transplant Access Registry (E-STAR) dashboard: center-specific reporting on prewaitlisting data to improve access to kidney transplantation
Authors: Kelty Catherine E. , Buford Jade , Di Mengyu , Drewry Kelsey M. , Urbanski Megan , Harding Jessica L. , Wilk Adam S. , Pastan Stephen O. , Patzer Rachel E. 
Published: January 2025

Purpose of review
The 2022 National Academies of Sciences, Engineering, and Medicine report highlighted inequities in access to kidney transplantation and called for a comprehensive dashboard highlighting early transplant steps, yet data on steps such as referral and evaluation start are limited. Addressing this gap is crucial for improving equity in access to transplantation.

Recent findings
The Early Steps to Transplant Access Registry (E-STAR) provides a model for how prewaitlisting data can be used to inform quality improvement to drive equity in access to transplantation. E-STAR includes data from 37 transplant centers across 13 states and four regions (Southeast, New York, New England, and the Ohio River Valley), representing ∼217 000 adults with end-stage kidney disease (ESKD) treated in 4365 dialysis facilities, in addition to patients preemptively referred. Similar to the Scientific Registry of Transplant Recipients center-specific reports, the E-STAR dashboard was developed as an interactive website offering center-specific and regional insights into pretransplant access measures within and across centers with the intention to improve access to transplantation. Publicly available de-identified reports illustrate trends in referral, evaluation, and waitlisting by subgroup (e.g., race, sex, age, insurance status), while password-protected features enable transplant centers to benchmark their performance against anonymized peers.

Summary
The E-STAR dashboard demonstrates how centralized, standardized data collection can support transplant centers, policymakers, community partners, and regional organizations to identify disparities, drive quality improvement, and develop interventions for the advancement of equity in transplant access. This work may inform future center-specific reports once prewaitlisting data are collected nationally.
Xenotransplantation: future frontiers and challenges
Authors: Jaffe Ian S. , Aljabban Imad , Stern Jeffrey M. 
Published: January 2025

Purpose of review
Recent advancements in genetic engineering have propelled the field of xenotransplantation from preclinical models to early compassionate use cases. As first-in-human clinical trials (FIHCTs) approach, we examine recent developments, ethical and regulatory challenges, immunological considerations, and the clinical infrastructure necessary for successful xenotransplantation trials.

Recent findings
Expanded access transplants of pig hearts, kidneys, and livers have identified key challenges. Heart xenotransplants revealed risks of antibody-mediated rejection and zoonotic infections, while kidney xenotransplants suggest that patient selection, rather than immune rejection, may have caused failures. While there has been a report of auxiliary liver transplantation conducted abroad, profound thrombocytopenia poses an obstacle. As FIHCTs draw near, critical clinical challenges include determining the optimal donor genetic constructs and immunosuppressive regimens. Enrollment criteria and patient selection pose additional complexity, alongside ethical concerns such as lifelong zoonosis monitoring. Only a limited number of centers have the expertise needed to conduct these complex trials.

Summary
Xenotransplantation holds great promise as a solution to organ shortages, but success in FIHCTs will require careful design, multidisciplinary collaboration, and strong infrastructure. Addressing immunologic, ethical, and patient selection challenges will be critical. With proper preparation, xenotransplantation could transform organ transplantation.
Public Health Travel Restrictions Implemented for Persons at Risk of Transmitting SARS-CoV-2 Infection—United States, January 1, 2020-April 6, 2022
Authors: Surpris Amethyst Clare A. , Jungerman M. Robynne , Preston Leigh Ellyn , Gertz Alida M. , Duong Krista K. , Roy Sheila , Morales Mayra , Olmstead John , Delea Kristin , Alvarado-Ramy Francisco , Brown Clive , Chen Tai-Ho 
Published: January 2025

Context:
Federal public health travel restrictions (FPHTR) in the United States are implemented for persons who meet specific criteria to prevent spread of communicable diseases of public health concern. FPHTR can mitigate the risk of disease transmission during air travel and mitigating disease translocation between geographic areas.

Objective:
To characterize and determine the extent of FPHTR implementation during the COVID-19 pandemic.

Design:
Secondary data analysis.

Setting and Participants:
This report reviewed the U.S. public health response for 3010 persons traveling within, into, and out of, the U.S. who were placed on federal public health travel restrictions during the COVID-19 outbreak from January 1, 2020 to April 6, 2022.

Main Outcome Measure:
Total number and characteristics of persons with SARS-CoV-2 infection or high-risk exposure added to FPHTR.

Results:
During this period, FPHTR were implemented for 3010/5460 (55%) persons who were reported to CDC as having tested positive for SARS-CoV-2, or being identified as close contacts of a person with COVID-19, with intention to travel. Of those added to FPHTR lists, 2023/3010 (67%) had confirmed SARS-CoV-2 infection, 975/3010 (32%) were close contacts, and 12/3010 (0.4%) were reasonably believed to have COVID-19 but later confirmed to have another diagnosis and removed. Twenty-six percent (793/3010) of SARS-CoV-2-related FPHTR were for persons reported to CDC after testing positive for SARS-CoV-2 at a testing site located within a U.S. airport.

Conclusions:
The extensive application of FPHTR for more than 3000 persons over a period of 29 months during the COVID-19 pandemic was unprecedented. The additional use of FPHTR required extraordinary effort and collaboration among CDC staff and local/state public health agencies for case investigation, reporting, exchange of information, and communication with travelers for case management. Use of this tool should be considered within the context current transmission risk and disease severity.
False-Positive FAPI Expression in Benign Breast Adenosis
Authors: Gunasekaran Vinisha , Subrhamanian Avanthiga , Ambalavanan Nivetha , Singh Harmandeep , Kumar Rajender , Mittal Bhagwant Rai , Shukla Jaya , Walia Rama , Mitra Suvradeep 
Published: January 2025

Abstract
Breast adenosis is a benign glandular proliferative disorder. Due to its imaging similarities with other malignant breast lesions, differentiating adenosis from other invasive carcinomas of the breast poses a diagnostic challenge. Fibroblast activation protein inhibitor (FAPI) expression is observed in various benign and malignant lesions, increasing the risk of false-positive results. We present a case of FAPI-avid benign breast adenosis in a patient with adrenal adenocarcinoma in 68Ga-FAPI-46 PET/CT.
Incidental Detection of Choroid Plexus Metastasis From Neuroblastoma Demonstrated by 68Ga-DOTATATE PET/CT
Authors: Li Siqi , Xu Yanfeng , Lu Xia , Wang Wei , Yang Jigang 
Published: January 2025

Abstract
An 8-year-old girl with refractory high-risk neuroblastoma underwent 68Ga-DOTATATE PET/CT to evaluate the feasibility of potential 177Lu-DOTATATE therapy. The scan showed multiple foci of abnormal 68Ga-DOTATATE accumulation in the bone region, indicating the presence of bone metastases. Unexpectedly, an abnormal tracer uptake was noted in the left lateral ventricle area. The contrast-enhanced brain MRI showed obvious enhancement of this lesion, suggesting the diagnosis of choroid plexus metastasis. Our case shows that 68Ga-DOTATATE PET/CT might be useful in diagnosing choroid plexus metastasis.
All-Optical Strategies to Minimize Photo-Bleaching in Reversibly Switchable Fluorescent Proteins
Authors: Marín-Aguilera Guillem , Pennacchietti Francesca , Volpato Andrea , Papalini Alessia , Kulkarni Abhilash , Bagheri Niusha , Minet Guillaume , Widengren Jerker , Testa Ilaria 
Published: January 2025

AbstractPhoto-bleaching is a general hurdle of fluorescence-based techniques that becomes even more severe in high- resolution microscopy that relies on prolonged, focused and complex illumination sequences. Strategies to reduce photo-bleaching require chemical modifications of the cell media, which often stave off physiological cellular conditions. Here, we outline an all-optical strategy to minimize photo-bleaching in reversibly switching fluorescent proteins (RSFPs), a class of probes used in several super-resolution and protein-multiplexing imaging techniques. By identifying the photobleaching pathways, we developed novel imaging schemes to increase the number of ON- OFF photo-switching cycles based on a designed modulation of the on-switching light or a co-irradiation with red- shifted light. By rationalizing the photo-cycle, we expand multiplexing strategies with RSFPs to high- spatiotemporal resolutions while maintaining the accuracy and recording longer time-lapse imaging of sub-cellular structures with both confocal microscopy and parallelized RESOLFT nanoscopy.
Local time statistics and permeable barrier crossing: From Poisson to birth-death diffusion equations
Authors: Kay Toby , Giuggioli Luca 
Published: January 2025

Barrier crossing is a widespread phenomenon across natural and engineering systems. While abundant cross-disciplinary literature on the topic has emerged over the years, the stochastic underpinnings of the process have yet to be linked quantitatively to easily measurable observables. We bridge this gap by developing a microscopic representation of Brownian motion in the presence of permeable barriers that allows us to treat barriers with constant asymmetric permeabilities. Our approach relies upon reflected Brownian motion and on the crossing events being Poisson processes subordinated by the local time of the underlying motion at the barrier. Within this paradigm, we derive the exact expression for the distribution of the number of crossings and find an experimentally measurable statistical definition of permeability. We employ Feynman-Kac theory to derive and solve a set of governing birth-death diffusion equations and extend them to the case when barrier permeability is constant and asymmetric. As an application, we study a system of infinite, identical, and periodically placed asymmetric barriers for which we derive analytically effective transport parameters. This periodic arrangement induces an effective drift at long times whose magnitude depends on the difference in the permeability on either side of the barrier as well as on their absolute values. As the asymmetric permeabilities act akin to localized ratchet potentials that break spatial symmetry and detailed balance, the proposed arrangement of asymmetric barriers provides an example of a noise-induced drift without the need to time modulate any external force or create temporal correlations on the motion of a diffusing particle. By placing only one asymmetric barrier in a periodic domain, we also show the emergence of a nonequilibrium steady state.

Published by the American Physical Society
2025
Winding topology of multifold exceptional points
Authors: Yoshida Tsuneya , König J. Lukas K. , Rødland Lukas , Bergholtz Emil J. , Stålhammar Marcus 
Published: January 2025

Despite their ubiquity, a systematic classification of multifold exceptional points, n-fold spectral degeneracies (EPns), remains a significant unsolved problem. In this article, we characterize the Abelian eigenvalue topology of generic EPns and symmetry-protected EPns for arbitrary n. The former and the latter emerge in (2n−2)- and (n−1)-dimensional parameter spaces, respectively. By introducing topological invariants called resultant winding numbers, we elucidate that these EPns are stable due to topology of a map from a base space (momentum or parameter space) to a sphere defined by resultants. In a D-dimensional parameter space (D≥c), the resultant winding numbers topologically characterize (D−c)-dimensional manifolds of generic (symmetry-protected) EPns, whose codimension is c=2n−2 (c=n−1). Our framework implies fundamental doubling theorems for both generic EPns and symmetry-protected EPns in n-band models.

Published by the American Physical Society
2025