bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurectomy of the Nerve of Henle Associated with Periarterial Sympathectomy for Management of Intractable Raynaud Phenomenon
Authors: Chen Shih-Heng , Lien Po-Hao , Lee Che-Hsiung , Huang Ren-Wen , Hsu Chung-Cheng , Lin Cheng-Hung , Lin Yu-Te , Tsai Chia-Hsuan , Tsai Hsin-I , Liu Yuan-Chang 
Published: June 2023

Background:
In periarterial sympathectomy for intractable Raynaud phenomenon, the extent of adventitectomy and postoperative outcomes and hand perfusion assessment tools remain debatable. The authors evaluated the outcome of neurectomy of the nerve of Henle combined with ulnar tunnel release and periarterial adventitectomy in the treatment of refractory Raynaud phenomenon using objective measurements and patient-reported outcomes.

Methods:
Nineteen patients with 20 affected hands were prospectively enrolled and underwent the proposed procedures from 2015 to 2021. Relevant data, including Michigan Hand Outcomes Questionnaire and 36-Item Short Form health questionnaire scores, were documented for analysis during a 3-year follow-up.

Results:
The average ingress value of the three measured fingers (index, long, and ring) on indocyanine green angiography increased after surgery (P = 0.02). The median number of ulcers decreased (P < 0.001), and the median digital skin temperature increased (P < 0.001). Questionnaire scores showed improvement in physical aspects, such as overall hand function (P ≤ 0.001), activities of daily living (P = 0.001), work performance (P = 0.02), pain (P < 0.001), physical function (P = 0.053), and general health (P = 0.048), and mental aspects, such as patient satisfaction (P < 0.001) and mental health (P = 0.001). The average indocyanine green ingress value of the three measured fingers significantly correlated with the patient-reported outcomes, including overall hand function (r = 0.46, P = 0.04), work performance (r = 0.68, P = 0.001), physical function (r = 0.51, P = 0.02), and patient satisfaction (r = 0.35, P=0.03).

Conclusions:
The proposed surgical procedures provided satisfactory outcomes, both subjectively and objectively, over a follow-up period of up to 3 years. Indocyanine green angiography may provide rapid and quantitative measurements for perioperative hand perfusion assessment.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
18F-FDG PET/CT Imaging Findings of a Case of Primary Cardiac Chondrosarcoma and Pulmonary Inflammation
Authors: Liu Yi-Ting , Cheng You , Shao Dan 
Published: June 2023

Abstract
Primary cardiac chondrosarcoma invading the right pulmonary vein is very rare, whereas secondary cardiac chondrosarcoma is relatively common. We reported the 18F-FDG PET/CT findings of primary cardiac chondrosarcoma and pulmonary inflammation misdiagnosed as cardiac malignancy and pulmonary metastasis in a 27-year-old man.
Aberrant Vascular Anatomy Associated With Artifactual Focal Avidity in the Liver on PSMA PET
Authors: Lawal Ismaheel O. , Pectasides Melina , Parihar Ashwin Singh , Shah Hardik U. , Halkar Raghuveer K. , Jani Ashesh B. , Schuster David M. 
Published: June 2023

Abstract

68Ga–prostate-specific membrane antigen (PSMA) PET/CT is a valuable tool for staging and restaging of prostate cancer. Prostate-specific membrane antigen expression is not specific to prostate cancer, as it is expressed in normal tissues as well as in neoplastic and nonneoplastic processes. Awareness of the broad possibility of lesions with PSMA avidity is necessary to recognize normal variants and avoid potential pitfalls in image interpretation. We present a series of cases showing physiologic focal PSMA avidity in hepatic segment IVb. We correlate this uptake with aberrant hepatic vasculature. The awareness of this variant is important for accurate image interpretation to prevent additional invasive procedures, undue treatment escalation, and denial of curative treatment to patients.
Comparison of major abdominal emergency surgery outcomes across organizational models of emergency surgical care: Analysis of the UK NELA national database
Authors: Anand Easan , Rahman Saqib A. , Tomlinson Christopher , Mercer Stuart J. , Pucher Philip H. 
Published: June 2023

BACKGROUNDEmergency general surgery (EGS) admissions account for a large proportion of surgical care and represent the majority of surgical patients who suffer in-hospital mortality. Health care systems continue to experience growing demand for emergency services: one way in which this is being increasingly addressed is dedicated subspecialty teams for emergency surgical admissions, most commonly termed “emergency general surgery” in the United Kingdom. This study aims to understand the impact of the emergency general surgery model of care on outcomes from emergency laparotomies.METHODSData was obtained from the National Emergency Laparotomy Audit database. Patients were dichotomized into EGS hospital or non-EGS hospital. Emergency general surgery hospital is defined as a hospital where >50% of in-hours emergency laparotomy operating is performed by an emergency general surgeon. The primary outcome was in-hospital mortality. Secondary outcomes were intensive therapy unit (ITU) length of stay and duration of hospital stay. A propensity score weighting approach was used to reduce confounding and selection bias.RESULTSThere were 115,509 patients from 175 hospitals included in the final analysis. The EGS hospital care group included 5,789 patients versus 109,720 patients in the non-EGS group. Following propensity score weighting, mean standardized mean difference reduced from 0.055 to <0.001. In-hospital mortality was similar (10.8% vs. 11.1%,p= 0.094), with mean length of stay (16.7 days vs. 16.1 days,p< 0.001) and ITU stay (2.8 days vs. 2.6 days,p< 0.001) persistently longer in patients treated in EGS systems.CONCLUSIONNo significant association between the emergency surgery hospital model of care and in-hospital mortality in emergency laparotomy patients was seen. There is a significant association between the emergency surgery hospital model of care and an increased length of ITU stay and overall hospital stay. Further studies are required to examine the impact of changing models of EGS delivery in the United Kingdom.LEVEL OF EVIDENCEPrognostic and Epidemiological; Level III.
Resuscitative endovascular balloon occlusion of the aorta and resuscitative thoracotomy are associated with similar outcomes in traumatic cardiac arrest
Authors: Koh Ezra Y. , Fox Erin E. , Wade Charles E. , Scalea Thomas M. , Fox Charles J. , Moore Ernest E. , Morse Bryan C. , Inaba Kenji , Bulger Eileen M. , Meyer David E. 
Published: June 2023

BACKGROUND
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive alternative to resuscitative thoracotomy (RT) for patients with hemorrhagic shock. However, the potential benefits of this approach remain subject of debate. The aim of this study was to compare the outcomes of REBOA and RT for traumatic cardiac arrest.

METHODS
A planned secondary analysis of the United States Department of Defense-funded Emergent Truncal Hemorrhage Control study was performed. Between 2017 and 2018, a prospective observational study of noncompressible torso hemorrhage was conducted at six Level I trauma centers. Patients were dichotomized by REBOA or RT, and baseline characteristics and outcomes were compared between groups.

RESULTS
A total of 454 patients were enrolled in the primary study, of which 72 patients were included in the secondary analysis (26 underwent REBOA and 46 underwent resuscitative thoracotomy). Resuscitative endovascular balloon occlusion of the aorta patients were older, had a greater body mass index, and were less likely to be the victims of penetrating trauma. Resuscitative endovascular balloon occlusion of the aorta patients also had less severe abdominal injuries and more severe extremity injuries, although the overall injury severity scores were similar. There was no difference in mortality between groups (88% vs. 93%, p = 0.767). However, time to aortic occlusion was longer in REBOA patients (7 vs. 4 minutes, p = 0.001) and they required more transfusions of red blood cells (4.5 vs. 2.5 units, p = 0.007) and plasma (3 vs. 1 unit, p = 0.032) in the emergency department. After adjusted analysis, mortality remained similar between groups (RR, 0.89; 95% confidence interval, 0.71–1.12, p = 0.304).

CONCLUSION
Resuscitative endovascular balloon occlusion of the aorta and RT were associated with similar survival after traumatic cardiac arrest, although time to successful aortic occlusion was longer in the REBOA group. Further research is needed to better define the role of REBOA in trauma.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
Progressive supranuclear palsy: current approach and challenges to diagnosis and treatment
Authors: Veilleux Carpentier Ariane , McFarland Nikolaus R. 
Published: June 2023

Purpose of reviewSince the original description of progressive supranuclear palsy (PSP) by Steele, Richardson and Olszewski, the clinical spectrum of PSP has expanded and now includes multiple phenotypic variants linked by a common disease. In this review, we discuss the evolution of the PSP syndrome and clinical criteria, with a particular focus on the 2017 Movement Disorders Society PSP criteria, its application and limitations. We also discuss our current approach to diagnosis and treatment.Recent findingsThere is a significant overlap between the different variants of PSP and multiple phenotypes that may be applied to the same patient simultaneously. Variant severity and predominance also evolve throughout the course of the disease. Each variant and level of certainty is associated with different specificity and sensitivity for underlying disease. The differential diagnosis of PSP is continuously evolving and includes other tauopathies, neurodegenerative, genetic, autoimmune and infectious disorders. MRI measurements can aid in the diagnosis. The first guidelines to help with clinical management of those patients have been recently published.SummaryAlthough much improved, clinical PSP criteria alone remain insufficient and emphasize the need for improved biomarkers to identify patients at early stages to direct appropriate therapeutic strategies and target potential research.
MRI in the new era of antiamyloid mAbs for the treatment of Alzheimer's disease
Authors: Filippi Massimo , Cecchetti Giordano , Agosta Federica 
Published: June 2023

Purpose of reviewCurrently, three antibeta amyloid (Aβ) mAbs are approved or under examination in USA and in Europe for the treatment of patients with early Alzheimer's disease. The aim of this review is to summarize the role of MRI in the mandatory redefinition of dementia care.Recent findingsDisease-modifying therapies require a reliable biological diagnosis of Alzheimer's disease. Structural MRI should be acquired at the beginning of the diagnostic process as a gateway before subsequent etiological biomarkers. MRI findings, indeed, may support a diagnosis of Alzheimer's disease or suggest alternative non-Alzheimer's disease conditions. Given the high risk/benefit ratio of mAbs and the impact of amyloid-related imaging abnormalities (ARIA), moreover, MRI will be crucial for the appropriate patient selection and safety monitoring. Ad-hoc neuroimaging classification systems of ARIA have been developed and continuous education of prescribers and imaging raters is prompted. MRI measures have been also assessed in clinical trials as potential markers of therapeutic efficacy; results, though, are controversial and still need clarification.SummaryStructural MRI will play a crucial role in the upcoming era of amyloid-lowering mAbs against Alzheimer's disease, from the correct patient selection to the monitoring of adverse events and of disease progression.
Inhibition of inflammatory factor TNF-α by ferrostatin-1 in microglia regulates necroptosis of oligodendrocyte precursor cells
Authors: Chai Zhi , Ma Teng , Li Yunhong , Chen Qiuyuan , Kang Yali , Sun Jinping , Peng Tao , Wang Nina , Yu Chengjun , Wang Lijuan , Hou Xiaolin , Wang Wei , Wang Yin 
Published: June 2023

Objective
Inflammation of the surrounding environment is a major reason causing loss or injury of oligodendrocyte precursor cells (OPCs) in myelin-associated diseases. Lipopolysaccharide-activated microglia can release various inflammatory factors such as tumor necrosis factor-α (TNF-α). One of the ways of OPC death is necroptosis, which can be triggered by TNF-α, a death receptor ligand, by activating receptor-interacting protein kinase 1 (RIPK1)/RIPK3/mixed lineage kinase domain-like protein (MLKL) signaling pathway. This study investigated whether inhibiting microglia ferroptosis can decrease TNF-α release to alleviate OPC necroptosis.

Methods
Lipopolysaccharide and Fer-1 stimulate BV2 cells. The expressions of GPX4 and TNF-α were detected by western blot and quantitative real-time PCR; malondialdehyde, glutathione, iron, and reactive oxygen species were measured by the assay kits. After lipopolysaccharide stimulation of BV2 cells, the supernatant was taken to culture OPC. The protein expression levels of RIPK1, p-RIPK1, RIPK3, p-RIPK3, MLKL, and p-MLKL were detected by western blot.

Results
Lipopolysaccharide administration could induce ferroptosis in microglia by decreasing ferroptosis marker GPX4, while ferroptosis inhibitor Fer-1 could significantly increase GPX4 level. Fer-1 prevented oxidative stress and iron concentration elevation and alleviated mitochondrial damage in lipopolysaccharide-induced BV2 cells. The results revealed that Fer-1 downregulated the release of lipopolysaccharide-induced TNF-α in microglia and attenuated OPC necroptosis by significantly decreasing the expression levels of RIPK1, p-RIPK1, MLKL, p-MLKL, RIPK3, and p-RIPK3.

Conclusion
Fer-1 may be a potential agent for inhibiting inflammation and treating myelin-related diseases.
Low-Impact Laparoscopy vs Conventional Laparoscopy for Appendectomy: A Prospective Randomized Trial
Authors: Etienne Jean-Hubert , Salucki Benjamin , Gridel Victor , Orban Jean-Christophe , Baqué Patrick , Massalou Damien 
Published: June 2023

Background:
Low-impact laparoscopy, or LIL, combining low-pressure insufflation and micro-laparoscopy, is a surgical technique that is still not widely used and that has never been evaluated for the management of acute appendicitis. The aim of this study is to assess the feasibility of an LIL protocol, to compare post-operative pain, average length of stay (LOS), and in-hospital use of analgesics by patients who underwent appendectomy according to a conventional laparoscopy or a LIL protocol.

Study design:
Patients presenting with acute uncomplicated appendicitis who were operated between January 1, 2021 and July 10, 2022 were included in this double-blind, single-centre, prospective study. They were pre-operatively randomized to a group undergoing conventional laparoscopy, i.e. with an insufflation pressure of 12 mmHg and conventional instrumentation, and an LIL group, with an insufflation pressure of 7 mmHg and micro-laparoscopic instrumentation.

Results:
Fifty patients were included in this study, 24 in the LIL group and 26 in the conventional group. There were no statistically significant differences between the two patient groups, including weight and surgical history. The post-operative complication rate was comparable between the two groups (p=0.81). Pain was reported as significantly lower according to the visual analog pain scale (VAS) 2 hours after surgery among the LIL group (p=0.019). For patients who underwent surgery according to the LIL protocol, the study confirms a statistically significant difference for theoretical and actual LOS, i.e. -0.77 days and -0.59 days, respectively (p<0.001 and p=0.03). In-hospital use of analgesics was comparable between both groups.

Conclusion:
In uncomplicated acute appendicitis, the LIL protocol could reduce post-operative pain and average LOS compared to conventional laparoscopic appendectomy.
Gimibacter soli gen. nov. sp. nov., isolated from mangrove soil and insight into its ecological distribution and metabolic potential
Authors: Liu Yang , Pei Tao , Duan Jiao , Du Juan , Zhu Honghui 
Published: June 2023

A Gram-stain-negative, facultatively anaerobic, motile and rod-shaped bacterium, designated as 6D33T, was isolated from mangrove soil. Growth was found to occur at 15–32 °C (optimum, 28 °C), at pH 6–9 (optimum, pH 7) and in 0–3 % NaCl (optimum, 1 %, w/v). The results of 16S rRNA gene-based analysis showed that strain 6D33T belonged to the family

Temperatibacteraceae

, sharing 93.1–94.4 % identity with its close neighbours within the genus

Kordiimonas

. The phylogenomic results indicated that strain 6D33T formed an independent branch distinct from type strains of the genus

Kordiimonas

. The overall genome relatedness indices of digital DNA–DNA hybridization, average nucleotide identity and amino acid identity values showed that strain 6D33T represents a novel species of a novel genus. The results of chemotaxonomic characterization indicated that the major cellular fatty acids of strain 6D33T were summed feature 9 (C16 : 0 10-methyl and/or iso-C17 : 1
ω9c), summed feature 3 (C16 : 1
ω6c and/or C16 : 1
ω7c) and iso-C15 : 0; the polar lipids comprised diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol, an unidentified aminolipid and three unidentified lipids; the only respiratory quinone was ubiquinone-10. The genomic size and DNA G+C contents were 3.59 Mbp and 60.84 mol%, respectively. The 16S rRNA gene sequence reads abundance profiles revealed that the rare taxon is prevalent in marine environments, especially in sediments. Genome-scale metabolic reconstruction of strain 6D33T revealed a heterotrophic lifestyle and many pathways responsible for the degradation of aromatic compounds, suggesting application potential in aromatic hydrocarbon removal. Based on its genotypic and phenotypic characteristics, strain 6D33T is concluded to represent a novel species of the novel genus in the family

Temperatibacteraceae

, for which the name Gimibacter soli gen. nov. sp. nov. is proposed. The type strain of the type species is 6D33T (=GDMCC 1.1959T=KCTC 82335T).
Machine learning in medicine using JavaScript: building web apps using TensorFlow.js for interpreting biomedical datasets
Authors: Pires Jorge Guerra 
Published: June 2023

AbstractContributions to medicine may come from different areas, and most of these areas are filled with researchers eager to contribute. In this paper, we aim to contribute through the intersection of machine learning and web development. We employed TensorFlow.js, a JavaScript-based library, to model biomedical datasets using neural networks obtained from Kaggle. The principal aim of this study is to present the capabilities of TensorFlow.js and promote its utility in the development of sophisticated machine learning models customized for web-based applications. We modeled three datasets: diabetes detection, surgery complications, and heart failure. While Python and R currently dominate, JavaScript and its derivatives are rapidly gaining ground, offering comparable performance and additional features associated with JavaScript. Kaggle, the public platform from which we downloaded our datasets, provides an extensive collection of biomedical datasets. Therefore, readers can easily test our discussed methods by using the provided codes with minor adjustments on any case of their interest. The results demonstrate an accuracy of 92% for diabetes detection, almost 100% for surgery complications, and 80% for heart failure. The possibilities are vast, and we believe that this is an excellent option for researchers focusing on web applications, particularly in the field of medicine.
Laser Coronary Atherectomy and polymeric coronary wires in uncrossable lesions – A word of caution
Authors: Marengo Giorgio , Cortés Carlos , Sánchez-Luna Juan Pablo , Gonzalez-Gutiérrez Jose Carlos , Herrero Javier Gómez , Sanz-Sanchez Jorge , Gutiérrez Hipólito , Serrador Ana , Campo Alberto , Blasco-Turrión Sara , Gasparini Gabriele , San Román J. Alberto , Amat-Santos Ignacio J. 
Published: June 2023

ABSTRACTBackgroundExcimer laser coronary atherectomy (ELCA) represents one of the last available options in case of balloon uncrossable lesions but no bench testing or clinical experience has been reported with polymeric wires. We aimed to assess whether ECLA use can disrupt or melt the cover and coating of coronary wires.MethodsA total of 22 wires (10 polymer-jacketed and 12 hydrophilic non polymeric) were tested in an uncrossable lesion model. Two ELCA tests were performed over each wire at 8 and 4 cms from the tip with low and high settings, respectively. Microscopic analysis was performed at baseline images and after each test. Wire disruption was classified as Grade 1 (superficial scratches), Grade 2 (coil damage or solution of continuity of the polymeric cover) and Grade 3 (wire rupture/core disruption or de-coiling).ResultsAfter 44 ELCA simulations, wire disruption occurred in 16 cases (36.3%). Overall, events were more common for polymer-jacketed than for hydrophilic wires (12 vs 4, p=0.004). No grade 3 events occurred. Grade 2 events occurred in 9 cases (20.5%) and were more frequent with polymer- jacketed wires (8 vs 1, p=0.006). With low ELCA settings only polymer-jacketed wires suffered disruption (5 vs 0, p=0.009). With higher settings 11 events occurred (7 of Grade 2 and 4 of Grade 1) and incidence of grade 2 events was higher for polymer-jacketed wires (6 vs 1, p=0.02).ConclusionsELCA might be a safe option for coronary uncrossable lesions but its use with high settings over polymer-jacketed wires is discouraged.CONDENSED ABSTRACTWe aimed to assess whether ECLA use can disrupt coronary wires in balloon/microcatheter uncrossable lesion model. Forty-four in-vitro experiments were performed over hydrophilic-coated and polymer-jacketed coronary wires with different ELCA settings. Wire disruption was classified as Grade 1 (scratches), Grade 2 (coil or polymeric cover damage) and Grade 3 (core disruption/de- coiling). Wire disruption occurred 36.3% of cases and was more common for polymer-jacketed wires than for hydrophilic-coated wires (p=0.004). With high ELCA settings the incidence of grade 2 events was higher for polymer-jacketed wires (p=0.02). This discourages the use of ELCA with high settings over polymer-jacketed wires.