bluuebunny/crossref_metadata_2025_split huggingface dataset:
Topography-guided excimer laser ablation
Authors: Onishi Alex C. , Lee-Choi Calisa , Marvasti Amir H. 
Published: April 2023

Purpose of reviewCurrently, the most commonly performed corneal refractive surgery is laser-assisted in-situ keratomileusis (LASIK). Customized forms of LASIK have been developed, which have allowed for improved outcomes and the enhanced correction of higher order aberrations (HOAs). This review discusses one form of custom LASIK, topography-guided LASIK, including factors involved in preoperative planning, and advantages and disadvantages compared with other forms of keratorefractive surgery.Recent findingsVarious treatment-planning approaches addressing discrepancies between the refractive and topographic astigmatic magnitude and axis have been used successfully, although there is debate regarding a superior method in the literature.SummaryThere are many forms of custom LASIK, which provide excellent outcomes. Topography-guided LASIK may be of particular use in highly aberrated corneas and may also provide outstanding outcomes in healthy eyes given its emphasis on treating the primary refractive surface of the eye.
Cold Snare Polypectomy in Small (<10 mm) Pedunculated Colorectal Polyps
Authors: Canakis Andrew , Chandan Saurabh , Bapaye Jay , Canakis Justin , Twery Benjamin , Mohan Babu P. , Ramai Daryl , Facciorusso Antonio , Bilal Mohammad , Adler Douglas G. 
Published: April 2023

Introduction:
Endoscopic removal techniques for colorectal polyps include cold snare polypectomy (CSP) and hot snare polypectomy (HSP). Although HSP is recommended for pedunculated polyps (PPs) larger than 10 mm, data regarding use of CSP for PPs <10 mm continues to emerge. We aimed to investigate outcomes of these techniques in small (<10 mm) pedunculated colorectal polyps.

Methods:
Multiple databases were searched till June 2022 to identify studies involving the removal of small PPs with CSP and HSP. Random effects model was used to calculate outcomes and 95% CI. Primary outcome was the pooled rate of successful en-bloc resection. Secondary outcomes were immediate and delayed bleeding with CSP and HSP as well as prophylactic and post resection clip placement.

Results:
Six studies including 1025 patients (1111 polyps with a mean size 4 to 8.5 mm) were analyzed. 116 and 995 polyps were removed with HSP and CSP, respectively. The overall pooled rate of successful en-bloc resection with CSP was 99.7% (CI 99.1-99.9; I2 0%). Pooled immediate and delayed bleeding after CSP was 49.8% (CI 46.8-52.91; I2 98%) and 0% (CI 0.00-0.00; I2 0%), respectively. Delayed bleeding was higher with HSP, relative risk 0.05 (CI 0.01-0.43; I2 0%), P=0.006, whereas immediate bleeding was higher with CSP, relative risk 7.89 (CI 4.36-14.29; I2 0%), P<0.00001. Pooled rates of prophylactic clip placement and post-procedure clip placement (to control immediate bleeding) were 55.3% and 47.2%, respectively. Finally, right colon polyp location significantly correlated with frequency of immediate bleeding.

Conclusion:
Our analysis shows that CSP is safe and effective for resection of small PPs.
Unraveling the natural history of presymptomatic cystinuria
Authors: Tokhmafshan Fatima , Goodyer Paul R. 
Published: April 2023

Purpose of review
Servais et al. recently published clinical practice recommendations for the care of cystinuria patients. However, these guidelines were largely based on retrospective data from adults and children presenting with stones. Significant questions remain about the natural history of cystinuria in presymptomatic children.

Recent findings
We review the natural history of cystinuria in presymptomatic children followed from birth. In total, 130 pediatric patients were assigned putative genotypes based on parental urinary phenotype: type A/A (N = 23), B/B (N = 6), and B/N (N = 101). Stones were identified in 12/130 (4% of A/A, 17% of B/B, and 1% of B/N patients). Type B/B patients had lower cystine excretion than type A/A patients. Although urine cystine/creatinine fell with age, urine cystine/l rose progressively in parallel with the risk of nephrolithiasis. Each new stone was preceded by 6–12 months of urine specific gravity of more than 1.020. However, average urine specific gravity and pH were not different in stone formers vs. nonstone formers, suggesting that intrinsic stone inhibitors or other unknown factors may be the strongest determinants of individual risk.

Summary
The current study reviews the clinical evolution of cystinuria in a cohort of children identified by newborn screening, who were categorized by urinary phenotype and followed from birth.
Intersectionality and adolescent medicine: an overview
Authors: Mazon Candice , Jimenez-Maldonado Jacqueline , Walters Frinny Polanco 
Published: April 2023

Purpose of review
This review defines intersectionality, discusses recent studies that use an intersectional framework in adolescent health research, and outlines ways where clinicians can use intersectionality to address health disparities in youth of color through clinical practice, research, and advocacy.

Recent findings
Research using an intersectional framework can identify populations at risk for certain disorders or behaviors. Recent studies in adolescent health research using an intersectional lens identified lesbian girls of color as an at-risk population for e-cigarette use, demonstrated lower skin color satisfaction among Black girls of all ages predicted greater binge-eating disorder symptoms, and showed that two-thirds of Latine (gender-neutral term that refers to people with Latin American roots) youth who recently immigrated to the United States experienced at least one traumatic event during their migration journey, putting them at risk for PTSD and other mental health disorders.

Summary
Intersectionality refers to how multiple social identities intersect to produce a specific experience that reflects overlapping systems of oppression. Diverse youth contain multiple identities that intersect to produce unique experiences and health inequities. Using an intersectional framework acknowledges that youth of color are not homogenous. Intersectionality becomes an important tool to care for marginalized youth and advance health equity.
Role of lymphadenectomy during primary surgery for kidney cancer
Authors: Bekku Kensuke , Kawada Tatsushi , Yanagisawa Takafumi , Karakiewicz Pierre I. , Shariat Shahrokh F. 
Published: April 2023

Purpose of review
Lymph node dissection (LND) during radical nephrectomy (RN) for renal cell carcinoma (RCC) is not considered as a standard. The emergence of robot-assisted surgery and effective immune checkpoint inhibitors (ICI) in recent years may change this and lymph node (LN) staging has become easier and has a clinical impact. In this review, we aimed to reconsider the role of LND today.

Recent findings
Although the extent of LND has still not been well established, removal of more LN seems to provide better oncologic outcomes for a select group of patients with high-risk factors such as clinical T3-4. Adjuvant therapy using pembrolizumab has been shown to improve disease free survival if complete resection of metastatic lesions as well as the primary site is obtained in combination. Robot assisted RN for localized RCC has been widespread and the studies regarding LND for RCC has been recently appeared.

Summary
The staging and surgical benefits and its extent of LND during RN for RCC remains unclear, but it is becoming increasingly important. Technologies that allow an easier LND and adjuvant ICI that improve survival in LN-positive patients are engaging the role of LND, a procedure that was needed, but almost never done, is now indicated sometimes. Now, the goal is to identify the clinical and molecular imaging tools that can help identify with sufficient accuracy who needs a LND and which LNs to remove in a targeted personalized approach.
External Scholarship Mentors for DNP-Prepared Faculty
Authors: Dunlap Jayne Jennings , Brewer Tracy L. , Mainous Rosalie O. 
Published: April 2023

Background:
Variability surrounding what practice scholarship should entail and how to incorporate into academic life exists among DNP-prepared faculty teaching across nursing programs.

Problem:
DNP-prepared faculty entering an academic role are expected to maintain a clinical practice, teach/advise students, and fulfill service obligations, often leaving minimal time to build a program of scholarship.

Approach:
Building upon the archetype of external mentors for PhD researchers, we introduce a new model for external mentorship for DNP-prepared faculty to facilitate scholarship.

Outcomes:
In the first dyad to use this model, the mentor-mentee met/exceeded all contractual goals, including presentations, manuscripts, leadership behaviors, and role navigation within higher education. More external dyads are currently in development.

Conclusions:
Securing an external, seasoned mentor as a match for a junior member of the faculty in a yearlong partnership demonstrates promise for positive change in the scholarship trajectory of DNP-prepared faculty in higher education.
The impact of prehospital whole blood on hemorrhaging trauma patients: A multi-center retrospective study
Authors: Braverman Maxwell A. , Schauer Steven G. , Ciaraglia Angelo , Brigmon Erika , Smith Alison A. , Barry Lauran , Bynum James , Cap Andrew D. , Corral Hannah , Fisher Andrew D. , Epley Eric , Jonas Rachelle B. , Shiels Michael , Waltman Elizabeth , Winckler Christopher , Eastridge Brian J. , Stewart Ronald M. , Nicholson Susannah E. , Jenkins Donald H. 
Published: April 2023

BACKGROUND
Whole blood (WB) use has become increasingly common in trauma centers across the United States for both in-hospital and prehospital resuscitation. We hypothesize that prehospital WB (pWB) use in trauma patients with suspected hemorrhage will result in improved hemodynamic status and reduced in-hospital blood product requirements.

METHODS
The institutional trauma registries of two academic level I trauma centers were queried for all patients from 2015–2019 who underwent transfusion upon arrival to the trauma bay. Patients who were dead on arrival or had isolated head injuries were excluded. Demographics, injury and shock characteristics, transfusion requirements, including massive transfusion protocol (MTP) (>10 U in 24 hours) and rapid transfusion (CAT3+) and outcomes were compared between pWB and non-pWB patients. Significantly different demographic, injury characteristics and pWB were included in univariate followed by stepwise logistic regression analysis to determine the relationship with shock index (SI). Our primary objective was to determine the relationship between pWB and improved hemodynamics or reduction in blood product utilization.

RESULTS
A total of 171 pWB and 1391 non-pWB patients met inclusion criteria. Prehospital WB patients had a lower median Injury Severity Score (17 vs. 21, p < 0.001) but higher prehospital SI showing greater physiologic disarray. Prehospital WB was associated with improvement in SI (−0.04 vs. 0.05, p = 0.002). Mortality and (LOS) were similar. Prehospital WB patients received fewer packed red blood cells, fresh frozen plasma, and platelets units across their LOS but total units and volumes were similar. Prehospital WB patients had fewer MTPs (22.6% vs. 32.4%, p = 0.01) despite a similar requirement of CAT3+ transfusion upon arrival.

CONCLUSION
Prehospital WB administration is associated with a greater improvement in SI and a reduction in MTP. This study is limited by its lack of power to detect a mortality difference. Prospective randomized controlled trials will be required to determine the true impact of pWB on trauma patients.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level IV.
Blood component resuscitative strategies to mitigate endotheliopathy in a murine hemorrhagic shock model
Authors: Baucom Matthew R. , Wallen Taylor E. , Ammann Allison M. , England Lisa G. , Schuster Rebecca M. , Pritts Timothy A. , Goodman Michael D. 
Published: April 2023

BACKGROUND
Resuscitation with plasma components has been shown to improve endotheliopathy induced by hemorrhagic shock, but the optimal resuscitation strategy to preserve the endothelial glycocalyx has yet to be defined. The aim of this study was to determine if resuscitation with lactated Ringer's (LR), whole blood (WB), packed red blood cells (RBCs), platelet-rich plasma (PRP), platelet poor plasma, balanced RBC:PRP (1:1), or day 14 (d14) RBC would best minimize endothelial damage following shock.

METHODS
Male C57BL/6 mice were hemorrhaged to a goal mean arterial pressure of 25 mm Hg for 1 hour. Unshocked sham mice served as controls. Mice were then resuscitated with equal volumes of LR, WB, RBC, PRP, platelet poor plasma, 1:1, or d14 RBC and then sacrificed at 1, 4, or 24 hours (n = 5). Serum was analyzed for syndecan-1, ubiquitin C-terminal hydrolase L1, and cytokine concentrations. Lungs underwent syndecan-1 immunostaining, and lung injury scores were calculated after hematoxylin and eosin. Proteolytic cleavage of the endothelial glycocalyx was assessed by serum matrix metalloprotease 9 levels.

RESULTS
Serum syndecan-1 and ubiquitin C-terminal hydrolase L1 levels were significantly increased following resuscitation with d14 RBC compared with other groups. Early elevation in lung syndecan-1 staining was noted in LR-treated mice, while d14 mice showed decreased staining compared with sham mice following shock. Lung injury scores were significantly elevated 4 hours after resuscitation with LR and d14 RBC compared with WB. Serum matrix metalloprotease 9 levels were significantly increased at 1 and 4 hours in d14 mice compared with sham mice. Systemic inflammation was increased in animals receiving LR, 1:1, or d14 RBC.

CONCLUSION
Resuscitation with WB following hemorrhagic shock reduces endothelial syndecan-1 shedding and mitigates lung injury. Aged RBC and LR fail to attenuate endothelial injury following hemorrhagic shock. Further research will be necessary to determine the effect of each of these resuscitative fluids in a hemorrhagic shock model with the addition of tissue injury.
Number of Hepatic Resections and Association with Complication after Metastatic Neuroendocrine Tumor Debulking: An American College of Surgeons NSQIP Database Study
Authors: Schwarz Jason L , Kuchta Kristine M , Rojas Aram , Mehdi Syed , Hoon Choi Sung , Keutgen Xavier M , Talamonti Mark S , Hogg Melissa E 
Published: April 2023

Introduction:
Neuroendocrine tumor liver metastases (NELM) are a major source of morbidity and mortality in neuroendocrine tumor patients and can be treated with hepatic debulking surgery (HDS). This study aims to identify variables associated with postoperative morbidity in NELM HDS.

Methods:
This analysis uses the ACS-NSQIP targeted hepatectomy-specific Participant User File from 2014-2020. Surgeries were grouped by number of hepatic resections performed (1-5, 6-10, >10). Multivariable logistic regression (MVA) and matching was used to identify prognostic factors of morbidity.

Results:
1,163 patients were included. 1,011 (87%) had 1-5 hepatic resections, 101 (8.7%) had 6-10 resections, and 51 (4.4%) had >10 resections. Overall complication rate was 35% while surgical and medical complications reached 30% and 13%, respectively. Mortality occurred in 11 patients (0.9%). Significantly higher rates of any (34% vs 35% vs 53%, p = .021) and surgical complications (29% vs 28% vs 49%, p = .007) were noted for those undergoing >10 resections (1-5 resections, 6-10, >10). “Bleeding requiring transfusion” (p < .0001) occurred more frequently in the >10 resection group. On MVA, >10 resections was an independent risk factor for any (OR 2.53, p = .002; OR 2.52, p = .013) and surgical (OR 2.53, p = .003; OR 2.88, p = .005) complications compared to 1-5 resections and 6-10 resections, respectively. Medical complications (OR 2.34, p = .020) and length of stay (LOS) > 5 days (OR 1.98, p = .032) were also increased with >10 vs 1-5 resections.

Conclusion:
As reported by NSQIP, NELM HDS were performed safely with low mortality. However, more hepatic resections, especially >10, was associated with increased postoperative morbidity and LOS.
Actomyosin-mediated cellular tension promotes Yap nuclear translocation and myocardial proliferation through α5 integrin signaling
Authors: Li Xiaofei , McLain Callie , Samuel Michael S. , Olson Michael F. , Radice Glenn L. 
Published: April 2023

AbstractThe cardiomyocyte phenotypic switch from a proliferative to terminally differentiated state results in the loss of regenerative potential of the mammalian heart shortly after birth. Yet, the molecular mechanisms that regulate this critical developmental process are incompletely understood. Nonmuscle myosin IIB (NM IIB)-mediated actomyosin contractility regulates cardiomyocyte cytokinesis in the embryonic heart, and NM IIB levels decline after birth suggesting a role for cellular tension in the regulation of cardiomyocyte cell cycle activity in the postnatal heart. The Rho kinase (ROCK) serine/threonine protein kinases that act downstream of the RhoA small GTP-binding protein regulate nonmuscle myosin contractile force generation. To investigate the role of actomyosin contractility in cardiomyocyte maturation and cell cycle arrest, we conditionally-activated ROCK2 kinase domain (ROCK2:ER) in the murine postnatal heart. Here we show that cardiac-specific activation of actomyosin contractility shifts the balance from cell-cell to cell-matrix adhesions. Specifically, α5/β1 integrin and fibronectin matrix increase in response to actomyosin-mediated tension. Moreover, activation of ROCK2:ER promotes nuclear translocation of Yap, a mechanosensitive transcriptional co-activator, and enhances cardiomyocyte proliferation. Finally, we show that reduction of myocardial α5 integrin rescues the myocardial proliferation phenotype in ROCK2:ER hearts. These data demonstrate that cardiomyocytes respond to increase intracellular tension by altering their intercellular contacts in favor of cell-matrix interactions leading to Yap nuclear translocation, thus uncovering a novel function for nonmuscle myosin contractility in promoting cardiomyocyte cell cycle activity in the postnatal heart.
Knowledge and Attitude Towards Palliative Care Among Clinical Undergraduate Students of Physiotherapy in Nigerian Universities: A Cross-Sectional Study
Authors: Odetunde Marufat Oluyemisi , Nwankwo Jessie Chiamaka , Owojuyigbe Afolabi Muyiwa , Aaron Olurotimi I. , Okonji Adaobi Magraet 
Published: April 2023

AbstractIntroductionPalliative care demands a special skill from health care providers which begins with the right attitude and adequate knowledge during training. Little is known about knowledge and attitude of physiotherapy undergraduates towards palliative care. Objective of this study was to assess knowledge and attitude of clinical undergraduates of physiotherapy in Nigerian universities towards palliative care.MethodThis was a cross sectional survey involving 281 (132 females and 149 males) clinical physiotherapy undergraduates from 10 purposively selected universities across Nigeria. Palliative care knowledge was assessed with a structured questionnaire while attitude was assessed using FROMMELT attitude towards care of the dying scale. Both questionnaires were administered online via Google forms. Socio-demographic data of each respondent was also collected. Data were analyzed using descriptive and inferential statistics. Level of significance was set at p<0.05.ResultsMajority of respondents were males (53%) aged 21-25 years (87.9%) from Obafemi Awolowo University (40.3%) and had above average knowledge (62%). Almost all, (99.6%) of the respondents displayed favourable attitude. There were significant associations between knowledge and university of respondents (p=0.001), attitude and age of respondents (p=0.003), as well as attitude and geopolitical zone of origin of respondents (p=0.006). There was significant correlation between knowledge and attitude of respondents (r =0.441, p =0.001).ConclusionThere are knowledge gaps, but positive attitudes towards palliative care among clinical physiotherapy undergraduates in Nigeria. This signifies an essential and urgent need for inclusion, reform or improvement in palliative care education in the curriculum of undergraduate physiotherapy training in Nigerian universities.
Epidural stimulation restores muscle synergies by modulating neural drives in participants with motor/sensory complete spinal cord injuries
Authors: Singh Rajat Emanuel , Ahmadi Aliya , Parr Ann , Samadani Uzma , Krassioukov Andrei V. , Netoff Theoden I , Darrow David P. 
Published: April 2023

Multiple studies have corroborated restored volitional motor control after motor-complete spinal cord injury (SCI) through the use of spinal cord stimulation (SCS/eSCS) but rigorous quantitative descriptions have been lacking. Using a structured surface electromyogram based (sEMG) task with and without SCS during the Epidural Stimulation After Neurological Damage (ESTAND) study in participants with chronic, motor and sensory complete SCI, we investigated muscle activity complexity and muscle synergies to better characterize neuro-muscular control.In addition, competition exists between the task and neural origin hypotheses underlying muscle synergies, and this analysis in humans with motor and sensory complete chronic injury provided an opportunity to test these hypotheses. Muscle activity complexity was computed with Higuchi Fractal Dimensional analysis (HFD), and muscle synergies were estimated using non-negative matrix factorization (NNMF) in six participants with AIS A chronic SCI. We found that the complexity of muscle activity is immediately reduced with SCS in the SCI participants. We also found that over the follow-up sessions, the muscle synergy structure of the SCI participants became more defined, and the number of synergies decreased over time, indicating improved coordination between the muscle groups. Lastly, we found that the muscle synergies were restored with SCS, supporting the neural hypothesis of muscle synergies. We conclude that SCS restores muscle movements and muscle synergies that are distinct from healthy, able-bodied controls.
Epigenetic inheritance of gene-silencing is maintained by a self-tuning mechanism based on resource competition
Authors: Karin Omer , Miska Eric A. , Simons Benjamin D. 
Published: April 2023

AbstractBiological systems can maintain memories over long timescales, with examples including memories in the brain and immune system. It is currently unknown how functional properties of memory systems, such as memory persistence, can be established by biological circuits. To address this question, we focus on transgenerational epigenetic inheritance in C. elegans. In response to a trigger, worms silence a target gene for multiple generations, resisting strong dilution due to growth and reproduction. Silencing may also be maintained indefinitely upon selection according to silencing levels. We show that these properties imply fine-tuning of biochemical rates in which the silencing system is positioned near the transition to bistability. We demonstrate that this behavior emerges from a generic mechanism based on competition for synthesis resources, which leads to self-organization around a critical state with broad silencing timescales. The theory makes distinct predictions and offers insights into the design principles of long-term memory systems.