bluuebunny/crossref_metadata_2025_split huggingface dataset:
Caduceus vs. Rod of Asclepius: A Serpentine Dilemma in Medical Iconography
Authors: Shah Muhammad Hamza , Usman Salim , Roy Sakshi , Ahluwalia Arjun , Harky Amer 
Published: October 2023

Abstract
This scholarly inquiry delves into the historical significance of two enduring medical symbols: the Rod of Asclepius and the Caduceus. Tracing their origins back to ancient Greek mythology, we uncover their distinct identities and profound meanings as symbols of healing, unity among medical practitioners, and ethical responsibilities. Beyond aesthetics, these emblems serve as powerful educational tools, fostering universal understanding and connecting modern medicine to its historical heritage. Consequently, embracing their true essence can inspire genuine dedication to the noble mission of caring for others.
Finding the world’s oldest mammals: sieving, dialectical materialism, and squabbles
Authors: Benton Michael J , Gill Pamela G , Whiteside David I 
Published: October 2023

Abstract
Mammals (or properly, mammaliaforms) originated in the Late Triassic and the first 50 Myr of their evolution through Late Triassic and Early Jurassic are best documented by rich faunas from numerous localities around Bristol in south-west England and in South Wales. The mode of preservation of the fossils, in sediment washed into karst features such as caves, is unusual but has led to a demand for specialized processing methods to extract the exquisitely preserved tiny teeth and bones from huge volumes of sediment. This rich documentation of the oldest mammals has made them especially important for mammalian palaeobiology on a global scale. The first specimens were found in the 1860s, and collection and study has been sporadic, with especially fruitful times in the 1860s, and then from 1938–1979. Throughout, the field collecting, processing, and interpretation of the fossils has been fraught, with heated debates between leading protagonists during the second half of the past century. Here, we track the substantial contributions made by Charles Moore, Walter Kühne, Rex Parrington, Kenneth Kermack, Pamela Robinson, and others, using published sources, unpublished letters and notebooks, and interviews, to establish some of the facts about the most heated public disputes.
An Efficient Method for Screening Rice Breeding Lines Against Races of Magnaporthe oryzae
Authors: Oliveira-Garcia Ely , Budot Bernard Orense , Manangkil Jennifer , Lana Felipe Dala , Angira Brijesh , Famoso Adam , Jia Yulin 
Published: October 2023

Rice blast, caused by Magnaporthe oryzae, is the most destructive rice disease worldwide. The disease symptoms are usually expressed on the leaf and panicle. The leaf disease intensity in controlled environmental conditions is frequently quantified using a 0 to 5 scale, where 0 represents the absence of symptoms, and 5 represents large eyespot lesions. However, this scale restricts the qualitative classification of the varieties into intermediate resistant and susceptible categories. Here, we develop a 0 to 6 scale for blast disease that allows proper assignment of rice breeding lines and varieties into six resistance levels (highly resistant, resistant, moderately resistant, moderately susceptible, susceptible, and highly susceptible). We evaluated 40 common rice varieties against four major blast races (IB1, IB17, IB49, and IE1-K). Varieties carrying the Pi-ta gene were either highly resistant, resistant, or moderately resistant to IB17. The IE1-K race was able to break Pi-ta-mediated resistance of the rice varieties. The Pi-z gene conferred resistance to the IB17 and IE1-K races. The varieties M201, Cheniere, and Frontier were highly susceptible (score 6; 100% disease) to the race IE1-K. Moreover, varieties that were resistant or susceptible to all four blast races also showed similar levels of resistance/susceptibility to blast disease in the field. Taken together, our data proved that the 0 to 6 blast scale can efficiently determine the resistance levels of rice varieties against major blast races. This robust method will assist rice breeding programs to incorporate durable resistance against major and emerging blast races. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Assessment of Endophytic Fungal Community in Palm Leaves and Their Biocontrol Potential
Authors: Dhillon Braham , Graham Franchesca , Laughinghouse H. Dail , Chakrabarti Seemanti 
Published: October 2023

Microbial endophytes live asymptomatically within a host plant and contribute positively to its fitness. Endophytes associate ubiquitously with all plants examined so far and form an integral part of the host for processes such as nutrient uptake and stress response and traits like disease resistance. Well-characterized host–endophyte interaction models exist, but little is known about the microbiome of the monocot plant host, palm. In this study, we identified the endophytic fungal community associated with mule palm leaves with an objective to test their antagonist effects on lethal pathogens of palms. The leaflets of mule palms were sampled across five sites in Central and South Florida, and fungal endophytes were identified using culture-dependent (CD) and amplicon sequence-based culture-independent (CI) methods. Operational taxonomic units (OTUs) corresponding to phylum Ascomycota were identified by both approaches, whereas Basidiomycota were only detected using the CI method. Among the ascomycetes, a small (22%) overlap in the OTUs at the genus level was observed between the two methods, whereas the majority (64%) of OTUs were detected using the CI approach. In vitro cocultivation of endophytes with palm pathogens was observed to produce three distinct interaction phenotypes: inhibition zone, niche establishment, and overlapping growth. Eight endophytes capable of inhibiting fungal pathogen growth in vitro were also identified, suggesting a biocontrol potential for endophyte-derived secondary metabolites. A better understanding of the composition, assembly, and ecology of palm-associated microbial communities would eventually lead to healthy and resilient palms. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Atypical Cleft Hand: Surgical Technique for Grasping Improvement
Authors: de Novaes França Bisneto Edgard , Filippini Lorimier Fernandes Laura , Leomil de Paula Emygdio José , Mattar Júnior Rames 
Published: October 2023

Introduction:
We present 6 cases of children with atypical cleft hand and discuss a surgical technique. Clinically, participants presented with a lack of pulp-to-pulp pinch due to metacarpophalangeal ligament insufficiency and difficulty grasping large objects because of the narrowed first web.

Materials and Methods:
Second metacarpal resection and Z-plasty, creating a wide first web. The second extensor digitorum communis tendon was transferred to improve the thumb metacarpophalangeal joint stability.

Conclusions:
The surgical technique presented in this paper did improve function in oligodactyly or type-IIA atypical cleft hand.
Current opinion: postpartum urinary disorders
Authors: Dong Shirley M. , Hickman Lisa C. 
Published: October 2023

Purpose of review
The aim of this study was to describe the common postpartum urinary sequelae including urinary retention and incontinence, and to summarize the management of these conditions.

Recent findings
Despite the high frequency of urinary disorders in obstetrics, screening and management protocols are rarely utilized by providers. Large variation exists in the literature regarding assessment of postpartum urinary retention, values of postvoid residuals and management of indwelling catheters in the immediate postpartum population. Recent expert guidance outlines a strategy for managing this condition.
Research also highlights that screening for peripartum urinary incontinence is not a routine practice. The diagnosis is made more challenging by the fact that patients commonly understate and over-normalize their symptoms. Emerging studies have found that pelvic floor muscle training is cost-effective, preventive, and may improve symptoms in the postpartum setting.

Summary
Increased awareness of urinary disorders in pregnancy and postpartum is imperative for appropriate diagnosis and management. Instituting standardized voiding protocols postpartum will allow providers to avoid undiagnosed postpartum urinary retention and its repercussions. Improved screening and education regarding urinary incontinence in the peripartum is important for early management, such as pelvic floor muscle training, and improved quality of life.
Wise-pattern Split-reduction Incision to Facilitate Mastectomy and Direct-to-Implant Reconstruction for Superficial Breast Cancers
Authors: Schwartz Jean-Claude D. 
Published: October 2023

Summary:
The split reduction allows for oncoplastic breast conserving surgery using a modified Wise-pattern closure in ptotic patients with cancers in close proximity to a skin margin. Although cancers involving skin within the Wise pattern are conveniently resected during closure, cancers in close proximity to skin outside the Wise pattern require a modified closure. This modified Wise-pattern closure preserves skin near the inferior pole of the breast which is normally resected and shifts this resection superiorly over the cancer. This also shifts the final medial or lateral inframammary scar onto the visible breast mound. Although this split-reduction Wise pattern has been well described for resecting advanced cancers in patients who undergo oncoplastic breast conserving surgery, this approach has not been described in patients who require mastectomy. Here, we report on 10 consecutive patients with ptosis and advanced breast cancers that require skin resection outside the standard Wise pattern, where we used the split-reduction incision to facilitate mastectomy and direct-to-implant reconstruction.
Influence of Closed-incision Negative Pressure Wound Therapy on Abdominal Site Complications in Autologous Breast Reconstruction
Authors: Dunson Blake , Kogan Samuel , Grosser Joshua A. , Davidson Amelia , Llull Ramon 
Published: October 2023

Background:
Closed-incision negative pressure wound therapy (ciNPWT) has shown promise in reducing surgical wound complications. Among its numerous benefits, it allows for exudate management and tension offloading from wound edges. The purpose of this systematic review and meta-analysis was to assess the efficacy of prophylactic ciNPWT versus conventional dressings on abdominal donor site complications in microsurgical breast reconstruction (MR).

Methods:
A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in January 2023. PubMed and Embase were searched to identify all relevant studies. Data collected included rates of total wound complications, wound dehiscence, infection, seroma, and length of hospital stay.

Results:
A total of 202 articles were screened, and eight studies (1009 patients) met the inclusion criteria. Use of ciNPWT was associated with a significantly lower rate of wound dehiscence (OR, 0.53; 95% confidence interval, 0.33–0.85; P = 0.0085, I
2 = 0%). There was no significant difference in the rate of total wound complications [odds ratio (OR), 0.63; 95% CI, 0.35–1.14; P = 0.12, I
2 = 69%], donor site infection (OR, 0.91; 95% CI, 0.42–1.50; P = 0.47, I
2 = 13%), seroma (OR, 0.74; 95% CI, 0.22–2.49; P = 0.63, I
2 = 57%), or length of hospital stay (SMD, 0.089; 95% CI, –0.13–0.35; P = 0.37, I
2 = 29%).

Conclusions:
Although exudate management by ciNPWT fails to reduce surgical site infection, seroma formation, and overall length of stay, ciNPWT tension offloading properties seem to be associated with lower rates of wound dehiscence when compared with conventional dressings in abdominal-based autologous breast reconstruction.
Oncological Surveillance After Radical Cystectomy: a Narrative Review of the Enhanced Recovery After Surgery Cystectomy Committee
Authors: Kaufmann Ernest , Black Peter C. , Catto James W.F. , Djaladat Hooman , Ghodoussipour Saum , Hamilton-Reeves Jill M. , Jensen Bente Thoft , Kassouf Wassim , Lauridsen Susanne Vahr , Lerner Seth P. , Llorente Carlos , Loftus Katherine , Lucca Ilaria , Martini Alberto , Preston Mark A. , Psutka Sarah P. , Sfakianos John P. , Shah Jay , Wettstein Marian Severin , Williams Stephen B. , Daneshmand Siamak , Fankhauser Christian D. ,   on behalf of the Enhanced Recovery After Surgery (ERAS) Cystectomy Committee
Published: October 2023

Purpose:
Follow-up after cystectomy aims to detect relapse, but there are discrepancies in recommendations among guidelines. Routine follow-up for asymptomatic recurrences in urothelial cancer is primarily based on nonvalidated risk factors from retrospective cohort studies in single institutions. This review provides an overview of follow-up investigations, schedules, and potential risk factors of recurrence.

Materials and methods:
We conducted a narrative literature search on PubMed and reviewed guidelines (European Society for Medical Oncology, European Association of Urology, National Comprehensive Cancer Network, American Urology Association, and National Institute for Health and Care Excellence) and institutional protocols for cystectomy patients.

Results:
Our analysis included 29 studies with 23,218 patients. Most relapses occurred within 2 years, either locally or as distant recurrences in the chest, liver, bones, or brain. Factors increasing relapse risk included higher tumor stage, nodal involvement, histological subtypes, and lymphovascular invasion. Surveillance protocols varied in frequency and type of investigation. Limited recommendations were available for patients with ypT0, pT0, or non–muscle-invasive bladder cancer.

Conclusions:
Further research is needed to evaluate the impact of postcystectomy follow-up protocols on oncological outcomes and establish optimal surveillance procedures.
Protein and amino acids in obesity: friends or foes?
Authors: Boirie Yves , Pinel Alexandre , Guillet Christelle 
Published: October 2023

Purpose of review
Nutritional interventions using protein and amino acids in obesity are popular therapeutical strategies to limit obesity development. However, the effects of dietary protein intake and amino acid metabolic alterations involved in obesity pathophysiology have not been completely unravelled. Significant recent studies have brought to light new findings in these areas, which are the primary focus of this review.

Recent findings
We describe the effects of protein intake on weight regain prevention, the influence on gut microbiota, the response to low-protein highly processed foods, and the contrasting impacts of a high-protein diet on adults and children. We also explore newly discovered correlations between amino acids, liver fat accumulation, and the dysregulation of the liver–pancreas axis due to alterations in amino acid levels in the context of obesity. Lastly, we consider branched-chain amino acids, along with glycine and tryptophan, as significant biomarkers during periods of positive or negative energy balance.

Summary
Interventions using dietary protein in obesity may be useful, especially during energy restriction but also in sarcopenic obesity. Furthermore, metabolic profiles that encompass alterations in certain amino acids can provide valuable insights into the metabolic condition of patients with obesity, particularly in relation to insulin resistance and the risk of developing type 2 diabetes.
Updates in endoscopic management of ampullary and duodenal adenomas
Authors: Chadalavada Pravallika , Shah Tilak Upendra 
Published: October 2023

Purpose of review
Adenomas are the most common benign lesions of the gastrointestinal tract. The current review aims to summarize recent literature regarding risk factors, natural history, diagnostic and staging technique, and management strategies for ampullary and nonampullary duodenal adenomas.

Recent findings
Recent studies identified several possible risks factors for duodenal adenomas (e.g., cholecystectomy, proton pump inhibitor use), although these associations require corroboration. Chromoendoscopy and endocystoscopy may offer accuracy comparable to biopsies in expert hands. Recent publications underscore the reduction in morbidity with endoscopic resection for lesions without signs of malignancy with submucosal invasion. Submucosal injection did not improve safety of endoscopic ampullectomy.

Summary
Surveillance may be a reasonable strategy for sub-centimeter ampullary adenomas occurring in familial adenomatous polyposis, as they carry a relatively low risk of malignancy. Endoscopic resection is the preferred strategy over surgery in patients without lesions suggestive of invasive malignancy. For nonampullary duodenal adenomas, several endoscopic resection techniques are available, each with their unique advantages and trade-offs. In patients who are not operative candidates but have intraductal extension, endoscopic ablation is an emerging option.
A Survey of PICU Clinician Practices and Perceptions regarding Respiratory Cultures in the Evaluation of Ventilator-Associated Infections in the BrighT STAR Collaborative
Authors: Sick-Samuels Anna C. , Koontz Danielle W. , Xie Anping , Kelly Daniel , Woods-Hill Charlotte Z. , Aneja Anushree , Xiao Shaoming , Colantuoni Elizabeth A. , Marsteller Jill , Milstone Aaron M. ,   the BrighT STAR Authorship Group
Published: October 2023

OBJECTIVES:
To characterize respiratory culture practices for mechanically ventilated patients, and to identify drivers of culture use and potential barriers to changing practices across PICUs.

DESIGN:
Cross-sectional survey conducted May 2021–January 2022.

SETTING:
Sixteen academic pediatric hospitals across the United States participating in the BrighT STAR Collaborative.

Subjects:
Pediatric critical care medicine physicians, advanced practice providers, respiratory therapists, and nurses.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We summarized the proportion of positive responses for each question within a hospital and calculated the median proportion and IQR across hospitals. We correlated responses with culture rates and compared responses by role. Sixteen invited institutions participated (100%). Five hundred sixty-eight of 1,301 (44%) e-mailed individuals completed the survey (median hospital response rate 60%). Saline lavage was common, but no PICUs had a standardized approach. There was the highest variability in perceived likelihood (median, IQR) to obtain cultures for isolated fever (49%, 38–61%), isolated laboratory changes (49%, 38–57%), fever and laboratory changes without respiratory symptoms (68%, 54–79%), isolated change in secretion characteristics (67%, 54–78%), and isolated increased secretions (55%, 40–65%). Respiratory cultures were likely to be obtained as a “pan culture” (75%, 70–86%). There was a significant correlation between higher culture rates and likelihood to obtain cultures for isolated fever, persistent fever, isolated hypotension, fever, and laboratory changes without respiratory symptoms, and “pan cultures.” Respondents across hospitals would find clinical decision support (CDS) helpful (79%) and thought that CDS would help align ICU and/or consulting teams (82%). Anticipated barriers to change included reluctance to change (70%), opinion of consultants (64%), and concern for missing a diagnosis of ventilator-associated infections (62%).

CONCLUSIONS:
Respiratory culture collection and ordering practices were inconsistent, revealing opportunities for diagnostic stewardship. CDS would be generally well received; however, anticipated conceptual and psychologic barriers to change must be considered.
A Comprehensive Overview of the Efficacy and Safety of Gadopiclenol: A New Contrast Agent for MRI of the CNS and Body
Authors: Hao Jing , Pitrou Camille , Bourrinet Philippe 
Published: October 2023

Abstract
This review describes the pharmacokinetics, efficacy, and safety of gadopiclenol, a new macrocyclic gadolinium-based contrast agent (GBCA) recently approved by the Food and Drug Administration at the dose of 0.05 mmol/kg. Gadopiclenol is a high relaxivity contrast agent that shares similar pharmacokinetic characteristics with other macrocyclic GBCAs, including a predominant renal excretion. In pediatric patients aged 2–17 years, the pharmacokinetic parameters (assessed through a population pharmacokinetics model) were comparable to those observed in adults, indicating no need for age-based dose adjustment. For contrast-enhanced magnetic resonance imaging (MRI) of the central nervous system (CNS) and body indications, gadopiclenol at 0.05 mmol/kg was shown to be noninferior to gadobutrol at 0.1 mmol/kg in terms of 3 lesion visualization parameters (ie, lesion border delineation, internal morphology, and contrast enhancement). Moreover, for contrast-enhanced MRI of the CNS, compared with gadobenate dimeglumine at 0.1 mmol/kg, gadopiclenol exhibited superior contrast-to-noise ratio at 0.1 mmol/kg and comparable contrast-to-noise ratio at 0.05 mmol/kg. A pooled safety analysis of 1047 participants showed a favorable safety profile for gadopiclenol. Comparative studies showed that the incidence and nature of adverse drug reactions with gadopiclenol were comparable to those observed with other GBCAs. Importantly, no significant safety concerns were identified in pediatric and elderly patients, as well as in patients with renal impairment. Overall, these findings support the clinical utility and safety of gadopiclenol for MRI in adult and pediatric patients aged 2 years and older in CNS and body indications.
TXA does not affect levels of TBI-related biomarkers in blunt TBI with ICH: A secondary analysis of the prehospital TXA for TBI trial
Authors: Hoefer Lea E. , Benjamin Andrew J. , Polcari Ann M. , Schreiber Martin A. , Zakrison Tanya L. , Rowell Susan E. 
Published: October 2023

BACKGROUND
Brain specific biomarkers such as glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase L1 (UCH-L1), and microtubule-associated protein-2 (MAP-2) have been identified as tools for diagnosis in traumatic brain injury (TBI). Tranexamic acid (TXA) has been shown to decrease mortality in patients with intracranial hemorrhage (ICH). The effect of TXA on these biomarkers is unknown. We investigated whether TXA affects levels of GFAP, UCH-L1, and MAP-2, and whether biomarker levels are associated with mortality in patients receiving TXA.

METHODS
Patients enrolled in the prehospital TXA for TBI trial had GFAP, UCHL-1 and MAP-2 levels drawn at 0 hour and 24 hours postinjury (n = 422). Patients with ICH from blunt trauma with a GCS <13 and SBP >90 were randomized to placebo, 2 g TXA bolus, or 1 g bolus +1 g/8 hours TXA infusion. Associations of TXA and 24-hour biomarker change were assessed with multivariate linear regression. Association of biomarkers with 28-day mortality was assessed with multivariate logistic regression. All models were controlled for age, GCS, ISS, and AIS head.

RESULTS
Administration of TXA was not associated with a change in biomarkers over 24 hours postinjury. Changes in biomarker levels were associated with AIS head and age. On admission, higher GFAP (odds ratio [OR], 1.75; confidence interval [CI], 1.31–2.38; p < 0.001) was associated with increased 28-day mortality. At 24 hours postinjury, higher levels of GFAP (OR, 2.09; CI, 1.37–3.30; p < 0.001 and UCHL-1 (OR, 2.98; CI, 1.77–5.25; p < 0.001) were associated with mortality. A change in UCH levels from 0 hour to 24 hours postinjury was also associated with increased mortality (OR, 1.68; CI, 1.15–2.49; p < 0.01).

CONCLUSION
Administration of TXA does not impact change in GFAP, UCHL-1, or MAP-2 during the first 24 hours after blunt TBI with ICH. Higher levels of GFAP and UCH early after injury may help identify patients at high risk for 28-day mortality.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.