bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pneumomediastinum and pneumothorax: a rare complication of laparoscopic total extraperitoneal inguinal hernia repair
Authors: Wallace Lauren , Leigh Ya’acov 
Published: March 2023

AbstractIncreasing utilization of a laparoscopic total extraperitoneal (TEP) approach for inguinal hernia repairs has led to rare complications. We describe a rare case of subcutaneous emphysema, pneumomediastinum and pneumothorax following a laparoscopic TEP inguinal hernia repair in a 29-year-old male. Mechanisms posited include extraperitoneal carbon dioxide migration via the retroperitoneal space and dissection along the fascia transversalis and endothoracic fascia anteriorly to enter the mediastinum. Intra-operatively the patient coughed vigorously, potentially propagating the extent of extraperitoneal gas dissection and exacerbating these complications. Given the potential morbidity, it is important for surgeons and anaesthetists to recognize these complications.
Gas accretion on to galaxies and Kelvin–Helmholtz turbulence
Authors: Goldman Itzhak , Fleck Robert 
Published: March 2023

ABSTRACTContinued star formation over the lifetime of a galaxy suggests that gas is steadily flowing in from the circumgalactic medium. Also, cosmological simulations of large-scale structure formation imply that gas is accreted on to galaxies from the halo inside which they formed. Direct observations are difficult, but in recent years observational indications of gas inflows from a circumgalactic medium were obtained. Here, we suggest an indirect observational probe: looking for large-scale (exceeding few kpc) turbulence caused by the accretion. As a specific example, we consider an accretion flow coplanar with the galaxy disc, and argue that Kelvin–Helmholtz turbulence will be generated. We employ a semi-analytical model of turbulence and derive the expected turbulence power spectrum. The latter turns out to be of a distinctive shape that can be compared with observational power spectra. As an illustrative example, we use parameters of the Milky Way galaxy.
The Calar Alto CAFOS direct imaging first data release
Authors: Cortés-Contreras M , Solano E , Alonso-Hernández J , Cardiel N , Cruz P , Rodrigo C 
Published: March 2023

ABSTRACT
We present the first release of the Calar Alto CAFOS direct imaging data, a project led by the Spanish Virtual Observatory with the goal of enhancing the use of the Calar Alto archive by the astrophysics community. Data Release 1 contains 23 903 reduced and astrometrically calibrated images taken from 2008 March to 2019 July with a median of the mean uncertainties in the astrometric calibration of 0.04 arcsec. The catalogue associated to 6132 images in the Sloan griz filters provides accurate astrometry and PSF calibrated photometry for 139 337 point-like detections corresponding to 21 985 different sources extracted from a selection of 2338 good-quality images. The mean internal astrometric and photometric accuracies are 0.05 arcsec and 0.04 mag, respectively. In this work we describe the approach followed to process and calibrate the images, and the construction of the associated catalogue, together with the validation quality tests carried out. Finally, we present three cases to prove the science capabilities of the catalogue: discovery and identification of asteroids, identification of potential transients, and identification of cool and ultracool dwarfs.
Greedy reduction ofBacillus subtilisgenome yields emergent phenotypes of high resistance to a DNA damaging agent and low evolvability
Authors: Dervyn Etienne , Planson Anne-Gaëlle , Tanaka Kosei , Chubukov Victor , Guérin Cyprien , Derozier Sandra , Lecointe François , Sauer Uwe , Yoshida Ken-Ichi , Nicolas Pierre , Noirot Philippe , Jules Matthieu 
Published: March 2023

AbstractGenome-scale engineering enables rational removal of dispensable genes in chassis genomes. Deviating from this approach, we applied greedy accumulation of deletions of large dispensable regions in the Bacillus subtilis genome, yielding a library of 298 strains with genomes reduced up to 1.48 Mb in size. High-throughput physiological phenotyping of these strains confirmed that genome reduction is associated with substantial loss of cell fitness and accumulation of synthetic-sick interactions. Transcriptome analysis indicated that &lt;15% of the genes conserved in our genome-reduced strains exhibited a twofold or higher differential expression and revealed a thiol-oxidative stress response. Most transcriptional changes can be explained by loss of known functions and by aberrant transcription at deletion boundaries. Genome-reduced strains exhibited striking new phenotypes relative to wild type, including a very high resistance (increased &gt;300-fold) to the DNA-damaging agent mitomycin C and a very low spontaneous mutagenesis (reduced 100-fold). Adaptive laboratory evolution failed to restore cell fitness, except when coupled with a synthetic increase of the mutation rate, confirming low evolvability. Although mechanisms underlying this emergent phenotype are not understood, we propose that low evolvability can be leveraged in an engineering strategy coupling reductive cycles with evolutive cycles under induced mutagenesis.
Youths’ Perceptions of Nicotine Harm and Associations With Product Use
Authors: O’Brien Erin Keely , Roditis Maria , Persoskie Alexander , Margolis Katherine A 
Published: March 2023

Abstract

Introduction
Although nicotine is the main addictive substance in tobacco, tobacco combustion is responsible for most tobacco-related diseases. U.S. adults hold misperceptions about nicotine harm. However, little is known about youth nicotine perceptions.

Aims and Methods
To address this gap, we assessed U.S. youths’ nicotine perceptions and how these perceptions relate to tobacco use. Participants were youth (ages 12–17) in waves 4 (w4; December 2016–January 2018; N = 14 798) and 4.5 (w4.5; December 2017–December 2018; N = 12 918) of the Population Assessment of Tobacco and Health Study, a nationally representative longitudinal cohort study. We describe beliefs about nicotine; perceptions of the nicotine harm in cigarettes, e-cigarettes, and nicotine replacement therapy (NRT); and demographic differences. Regressions assess whether w4 nicotine perceptions predicted w4.5 tobacco use.

Results
Most youth correctly responded that nicotine is the main cause of addiction (77.1%) but incorrectly responded that nicotine is the main substance that causes smoking-related cancer (74.7%). Youth distinguished between the harm of nicotine in different products, and on average rated the nicotine in cigarettes as most harmful, followed by e-cigarettes and NRT. Among youth who did not use at w4, greater harm perceptions of nicotine in cigarettes, e-cigarettes, and NRT were associated with lower likelihood of reporting current tobacco use at w4.5. Among youth who currently used cigarettes or e-cigarettes at wave 4, nicotine perceptions did not predict switching to e-cigarettes or cigarettes, respectively, at wave 4.5.

Conclusions
These findings underscore the challenge of developing effective and comprehensive communication strategies that accurately convey the effects of nicotine without encouraging tobacco use.

Implications
Many U.S. adults have misperceptions about nicotine, incorrectly believing it is the substance that causes most smoking-related cancers; studies have not assessed youth’s perceptions of nicotine and how these perceptions relate to tobacco use. This study found that similar to adults, most youth incorrectly believed nicotine is the main substance that causes smoking-related cancer; youth also distinguish between the harmfulness of nicotine in different products, and rated the nicotine in cigarettes as most harmful, followed by e-cigarettes and NRT. Perceptions of the harm in different nicotine and tobacco products negatively predicted becoming a person who used tobacco a year later, but did not predict switching between e-cigarettes and cigarettes. Findings highlight the challenges of accurately communicating about the harms of nicotine without encouraging tobacco use; findings can be considered in the context of FDA’s potential nicotine product standard that would lower nicotine levels in combustible tobacco products to a minimally or nonaddictive level.
New-type astrophysical tori in the point-mass and logarithmic potentials
Authors: Fukue Jun , Fukue Tsubasa , Fukue Kei 
Published: March 2023

Abstract
We examine the rotating gaseous configurations in the point-mass and logarithmic potentials, using the similarity method, and analytically find new-type solutions for astrophysical tori. We ignore the self-gravity, viscosity, magnetic, and radiation fields, but consider the isothermal and polytropic cases. In the point-mass potential, the gaseous configuration is generally limited within the conical region for both the isothermal and polytropic cases. In the logarithmic potential, on the other hand, the gaseous configuration extends over the whole space for the isothermal case, whereas it is limited within the conical region in the polytropic case. For both potentials, the density contours have toroidal or conical shapes with a self-similar manner. When the rotational speed is high and/or the sound speed is low (cold), the configurations become flat, and vice versa.
Timing of restricted sleep: mood and neurobehavioral outcomes in healthy sleepers
Authors: Dang Rammy , Feng Xiaoming , Haack Monika , Mullington Janet M 
Published: March 2023

AbstractStudy ObjectiveTo evaluate how nocturnal timing of sleep restriction affects vigilant attention and mood in healthy controls with normal sleep–wake patterns.MethodsA convenience sample from two controlled sleep restriction protocols were used to investigate the difference between 4 hours of sleep early in the night, versus 4 hours late in the night. Volunteers stayed in a hospital setting and were randomized to one of the three conditions: a control (8 hours of sleep each night), an early short sleep (ESS, 2300–0300 hours), and a late short sleep (LSS, 0300–0700 hours). Participants were evaluated with psychomotor vigilance task (PVT) and mood ratings via visual analog scales.ResultsShort sleep conditions led to greater performance decrements than control on PVT. LSS performance impairments were greater than control (lapses, p = 0.011; median RT, p = 0.029; fastest 10%, p = 0.038; reciprocal RT, p = 0.014; and reciprocal 10%, p = 0.005), but had higher positive mood ratings (p = 0.005). LSS also had higher positive mood ratings compared with ESS (p &lt; 0.001).ConclusionsThe data underscore the negative mood impact of waking at an adverse circadian phase, for healthy controls. In addition, the paradoxical relationship between mood and performance seen in LSS raises concerns that staying up late and waking at the usual rise time may be rewarding in terms of mood, but nonetheless have performance consequences that may not be fully recognized.
Category 2 blessing applications: developing trends
Authors: Walker Nathaniel , Trezise Joanna 
Published: March 2023

Abstract
A successful application under Public Trustee v Cooper category 2 (a “blessing” application) will protect the trustee(s) from future claims of breach of duty. Given the broad scope of that protection, the role of the court when considering such an application, and the test that is required to be met, has been subject to scrutiny. In this article, the authors reflect on recent developments and encourage a broad, flexible approach by the courts when determining blessing applications.
Neuroendocrine Transdifferentiation in Cutaneous Melanoma: A Case Report and Review of the Literature
Authors: Pisani David , Micallef Daniel , Scerri Jeanesse , Betts Alexandra , Degaetano James , Baldacchino Shawn 
Published: March 2023

Abstract:Neuroendocrine transdifferentiation refers to the progressive transformation of a nonneuroendocrine tumor to the one showing evidence of neuroendocrine differentiation on morphological and immunohistochemical grounds. Although this phenomenon has been well-documented in certain malignancies, particularly prostatic adenocarcinoma after androgen deprivation, cases of neuroendocrine transdifferentiation in melanomas are exceptionally rare. Herein, we report a case of a conventional superficial spreading melanoma occurring on the skin of the leg in a young male which showed progressive neuroendocrine transdifferentiation as it progressed through 2 in-transit metastases and a nodal metastatic deposit over a 4-year period. The tumor retained theBRAFV600E mutation throughout the disease process, and disease control was achieved through dual BRAF inhibition therapy. The possibility of melanoma masquerading as a high-grade neuroendocrine malignancy when investigating tumors of unknown primary should be kept in the mind of clinicians and histopathologist alike as a potential diagnostic pitfall, thus helping avoid misdiagnosis and guide appropriate treatment strategies.
Delayed Thoracodorsal Artery Perforator Free Flap for Calcaneal Degloving Injury Reconstruction
Authors: Huff Mallorie L. , Mansour Ahmed M. , Raj Mamtha S. , Allen Robert J. , Wallace Sean J. 
Published: March 2023

Summary:
The thoracodorsal artery perforator (TDAP) flap has a long vascular pedicle that is ideal for lower extremity reconstruction, but it generally relies on the presence of a dominant septocutaneous perforator vessel. Surgical delay optimizes flap survival by creating relative ischemia to augment perforator vessels. In this report, we describe the use of a delayed free TDAP flap in the setting of an absent dominant perforator vessel for the reconstruction of a calcaneal degloving injury. A 22-year-old actively smoking patient with a body mass index of 33.5 presented with a nonhealing left heel wound with overlying necrotic changes after traumatic degloving injury. The entire weight-bearing portion of the calcaneal fat pad and the flanking regions were debrided. The TDAP flap was elevated, revealing three small thoracodorsal artery perforators. Given that a dominant perforator was absent, the flap was surgically delayed. Free-tissue transfer occurred 8 days later. This operation was conducted entirely in left lateral decubitus with simultaneous wound preparation and flap harvest. The flap was elevated on two perforators to elongate the pedicle’s length and inset to cover exposed calcaneus and pad the heel. Six months postoperatively, the patient is doing well without flap compromise or ulceration. The TDAP flap is a versatile microsurgical tool, and surgical delay extends the utility of this flap when a dominant septocutaneous perforator is unavailable. Recipient site debridement may occur simultaneously with the TDAP delay procedure. Importantly, only one position is required for flap elevation, microsurgical anastomosis, and insetting, thus obviating intraoperative repositioning.
The Neuroma Startle Sign: A Surgical Indicator of Proximity to an Injured Nerve
Authors: Karinja Sarah J. , Gorky Jonathon , Valerio Ian L. , Ruscic Katarina J. , Eberlin Kyle R. 
Published: March 2023

Summary:
During operative intervention for the treatment of symptomatic neuromas, the authors have observed a hypersensitive “startle” response to stimulation in proximity to the painful nerve. This physiologic sign is an indicator of the specific anatomic localization of the painful stimulus, commonly a symptomatic neuroma, that appears to be reproducible. The aim of this article is to describe this “neuroma startle sign,” posit the underlying mechanism for this observation, and propose how this phenomenon could be clinically harnessed for innovation and optimization in both surgery and anesthesia for more effective symptomatic neuroma localization.
The Impact of Nurse Practitioner Care and Accountable Care Organization Assignment on Skilled Nursing Services and Hospital Readmissions
Authors: Meddings Jennifer , Gibbons Jason B. , Reale Bailey K. , Banerjee Mousumi , Norton Edward C. , Bynum Julie P.W. 
Published: March 2023

Background:
Accountable care organizations (ACOs) and the employment of nurse practitioners (NP) in place of physicians are strategies that aim to reduce the cost and improve the quality of routine care delivered in skilled nursing facilities (SNF). The recent expansion of ACOs and nurse practitioners into SNF settings in the United States may be associated with improved health outcomes for patients.

Objectives:
To determine the relationship between ACO attribution and NP care delivery during SNF visits and the relationship between NP care delivery during SNF visits and unplanned hospital readmissions.

Methods:
We obtained a sample of 527,329 fee-for-service Medicare beneficiaries with 1 or more SNF stays between 2012 and 2017. We used logistic regression to measure the association between patient ACO attribution and evaluation and management care delivered by NPs in addition to the relationship between evaluation and management services delivered by NPs and hospital readmissions.

Results:
ACO beneficiaries were 1.26% points more likely to receive 1 or more E&M services delivered by an NP during their SNF visits [Marginal Effect (ME): 0.0126; 95% CI: (0.009, 0.0160)]. ACO-attributed beneficiaries receiving most of their E&M services from NPs during their SNF visits were at a lower risk of readmission than ACO-attributed beneficiaries receiving no NP E&M care (5.9% vs. 7.1%; P<0.001).

Conclusions:
Greater participation by the NPs in care delivery in SNFs was associated with a reduced risk of patient readmission to hospitals. ACOs attributed beneficiaries were more likely to obtain the benefits of greater nurse practitioner involvement in their care.
Venous Thromboembolism Rates After Free Flap Reconstruction of the Head and Neck Region
Authors: Bengur Fuat Baris , Saadoun Rakan , Moroni Elizabeth A. , Khan Nayel I. , Bottegal Matthew T. , Sridharan Shaum , Kubik Mark W. , Solari Mario G. 
Published: March 2023

Background
Venous thromboembolism (VTE) is a major concern for the postoperative hospitalized patient, especially after long and complex procedures. Cancer itself also contributes to the hypercoagulable state, further complicating the management of patients. Despite prophylaxis, breakthrough events can occur. We aimed to assess our institutional VTE and bleeding rates after free flap reconstruction of the head and neck (H&N) region and the factors associated with VTE events.

Methods
A retrospective review of the patients who underwent H&N free flap reconstruction at an academic center from 2012 to 2021 was performed from a prospectively maintained database. Data regarding patient demographics, medical history, surgical details, and overall outcomes were collected. Outcomes studied included postoperative 30-day VTE rates and major bleeding events. Patients who had a VTE event were compared with the rest of the cohort to identify factors associated with VTE.

Results
Free flap reconstruction of the H&N region was performed in 949 patients. Reconstruction after cancer extirpation for squamous cell carcinoma was the most common etiology (79%). The most common flap was thigh based (50%), followed by the fibula (29%). The most common postoperative VTE chemoprophylaxis regimen was enoxaparin 30 mg twice daily (83%). The VTE and bleeding rates over the 10-year period were 4.6% (n = 44) and 8.7% (n = 83), respectively. Body mass index (28.7 ± 5.8 vs 26.2 ± 6.6, P = 0.013) and pulmonary comorbidities were found to be significantly higher in patients who had a VTE event (43% vs 27%, P = 0.017). Patients with a VTE event had a prolonged hospital stay of 8 more days (19.2 ± 17.4 vs 11 ± 7, P = 0.003) and a higher incidence of bleeding events (27% vs 8%, P < 0.001).

Conclusions
Postoperative VTE is a significant complication associated with increased length of hospitalization in patients undergoing free flap reconstruction of the H&N region. Institutional measures should be implemented on an individualized basis based on patient comorbidities to improve the postoperative VTE rates, while balancing the bleeding events.
Black Women’s Maternal Health: Insights from Community Based Participatory Research in Newark, New Jersey
Authors: Kantor Leslie M. , Cruz Naomi , Adams Christiana , Akhimien Constance , Allibay Abdulkadir Fauziyya , Battle Cherriece , Oluwayemi Maria , Salimon Olanike , Hee Won Sang , Lassiter Teri , Niraula Sophee 
Published: March 2023

AbstractThis study on Black women’s maternal health engaged a group of six community members in a community based participatory research project in a state with one of the largest racial disparities in maternal mortality and severe maternal morbidity in the United States. The community members conducted 31 semi-structured interviews with other Black women who had given birth within the past 3 years. Four main themes emerged: (1) challenges related to the structure of healthcare, including insurance gaps, long wait times, lack of co-location of services, and financial challenges for both insured and uninsured people; (2) negative experiences with healthcare providers, including dismissal of concerns, lack of listening, and missed opportunities for relationship building; (3) preference for racial concordance with providers and experiences with discrimination across multiple dimensions; and (4) mental health concerns and lack of social support. CBPR is a research methodology that could be more widely deployed to illuminate the experiences of community members in order to develop solutions to complex problems. The results indicate that Black women’s maternal health will benefit from multi-level interventions with changes driven by insights from Black women.
Unsupervised pattern discovery in spatial gene expression atlas reveals mouse brain regions beyond established ontology
Authors: Cahill Robert , Wang Yu , Xian R. Patrick , Lee Alex J. , Zeng Hongkui , Yu Bin , Tasic Bosiljka , Abbasi-Asl Reza 
Published: March 2023

AbstractThe rapid growth of large-scale spatial gene expression data demands efficient and reliable computational tools to extract major trends of gene expression in their native spatial context. Here, we used stability-driven unsupervised learning (i.e. staNMF) to identify principal patterns (PPs) of 3D gene expression profiles and understand spatial gene distribution and anatomical localization at the whole mouse brain level. Our subsequent spatial correlation analysis systematically compared the PPs to known anatomical regions and ontology from the Allen Mouse Brain Atlas using spatial neighborhoods. We demonstrate that our stable and spatially coherent PPs, whose linear combinations accurately approximate the spatial gene data, are highly correlated with combinations of expert-annotated brain regions. These PPs yield a new brain ontology based purely on spatial gene expression. Our PP identification approach outperforms principal component analysis (PCA) and typical clustering algorithms on the same task. Moreover, we show that the stable PPs reveal marked regional imbalance of brainwide genetic architecture, leading to region-specific marker genes and gene co-expression networks. Our findings highlight the advantages of stability-driven machine learning for plausible biological discovery from dense spatial gene expression data that are infeasible by conventional manual approaches.