bluuebunny/crossref_metadata_2025_split huggingface dataset:
Individual glioblastoma cells harbor both proliferative and invasive capabilities during tumor progression
Authors: Ratliff Miriam , Karimian-Jazi Kianush , Hoffmann Dirk C , Rauschenbach Laurèl , Simon Matthias , Hai Ling , Mandelbaum Henriette , Schubert Marc C , Kessler Tobias , Uhlig Stefanie , Dominguez Azorin Daniel , Jung Erik , Osswald Matthias , Solecki Gergely , Maros Máté E , Venkataramani Varun , Glas Martin , Etminan Nima , Scheffler Björn , Wick Wolfgang , Winkler Frank 
Published: June 2023

Abstract

Background
Glioblastomas are characterized by aggressive and infiltrative growth, and by striking heterogeneity. The aim of this study was to investigate whether tumor cell proliferation and invasion are interrelated, or rather distinct features of different cell populations.

Methods
Tumor cell invasion and proliferation were longitudinally determined in real-time using 3D in vivo 2-photon laser scanning microscopy over weeks. Glioblastoma cells expressed fluorescent markers that permitted the identification of their mitotic history or their cycling versus non-cycling cell state.

Results
Live reporter systems were established that allowed us to dynamically determine the invasive behavior, and previous or actual proliferation of distinct glioblastoma cells, in different tumor regions and disease stages over time. Particularly invasive tumor cells that migrated far away from the main tumor mass, when followed over weeks, had a history of marked proliferation and maintained their proliferative capacity during brain colonization. Infiltrating cells showed fewer connections to the multicellular tumor cell network, a typical feature of gliomas. Once tumor cells colonized a new brain region, their phenotype progressively transitioned into tumor microtube-rich, interconnected, slower-cycling glioblastoma cells. Analysis of resected human glioblastomas confirmed a higher proliferative potential of tumor cells from the invasion zone.

Conclusions
The detection of glioblastoma cells that harbor both particularly high proliferative and invasive capabilities during brain tumor progression provides valuable insights into the interrelatedness of proliferation and migration—2 central traits of malignancy in glioma. This contributes to our understanding of how the brain is efficiently colonized in this disease.
Balancing Privacy and Competition: Evaluating the Competitive Effects of India’s Data Protection Bill
Authors: Dixit Priyansh , Sharma Sukarm 
Published: June 2023

Abstract
Data protection and competition law are perhaps two of the most enmeshed legal arenas in the contemporary data-driven world. This essay ingresses into this intersection, appraising the competitive implications of India’s Data Protection Bill, 2022 through key arenas of conflict such as jurisdictional tussles, data portability, the remedy of mandatory data sharing, and compliance costs. Although the intersection of privacy and competition law has been discussed in Indian scholarship, an analysis of the competitive implications of the Data Protection Bill has been absent. This is precisely the gap that this piece aims to fill, by appraising the host of new implications of the Digital Personal Data Protection Bill (DPDPB) on Indian competition and providing a framework to evaluate various competition concerns such as jurisdiction, compliance, and data sharing of any subsequent data protection bill in India. It does this by first analyzing the extent to which competitive concerns can be addressed in the Indian data protection system. With this premise, it secondly considers the question of jurisdictional primacy between the Competition Commission and the Data Protection Board, arguing for the primacy of the Competition Commission. Thirdly, it discusses the questions of data portability, mandatory data sharing and compliance costs in the DPDBP which could affect India’s competition, critically discussing the trade-offs and suggesting potential solutions. The goal of the piece is to critically examine the implications of the 2022 version of the bill to suggest ways forward for its future iterations in India.
The association of intraleucocytic malaria pigment and disease severity in Papua New Guinean children with severe P. falciparum malaria
Authors: Lufele Elvin , Manning Laurens , Lorry Lina , Warrel Jonathan , Aipit Susan , Robinson Leanne J , Laman Moses 
Published: June 2023

ABSTRACT

Background
Plasmodium falciparum pigment-containing leucocytes (PCLs) are associated with adverse clinical manifestations of severe malaria in African children. However, limited data exist on the association of PCLs in settings outside of Africa.

Methods
Thin films on peripheral blood slides obtained from children ages 6 months–10 y with severe malaria were examined for PCLs. The intraleucocytic pigment data were correlated with clinical phenotypic data such as severe anaemia, metabolic acidosis and coma to determine the association of PCLs with clinical phenotypes of severe malaria and outcome.

Results
Of the 169 children with severe P. falciparum malaria confirmed by microscopy, 76% (129/169) had PCLs. Compared with children without PCLs, the presence (adjusted odds ratio [AOR] 3.2 [95% confidence interval {CI} 1.5 to 6.9], p≤0.01) and quantity (AOR 1.0 [95% CI 1.0 to 1.1], p=0.04) of pigment-containing monocytes (PCMs) was significantly associated with severe anaemia, while the quantity of both PCMs (AOR 1.0 [95% CI 1.0 to 1.1], p≤0.01) and pigment-containing neutrophils (AOR 1.0 [95% CI 1.0 to 1.1], p=0.01) was significantly associated with metabolic acidosis. Plasma P. falciparum histidine-rich protein-2 level negatively correlated with the platelet count (r=−0.5, p≤0.01) in patients with PCLs and no PCLs.

Conclusions
In Papua New Guinean children with severe P. falciparum malaria, the presence and quantity of PCLs are predictors of disease severity, severe anaemia and metabolic acidosis.
Environmental sustainability in the operating room
Authors: Gonzalez-Pizarro Patricio , Koch Susanne , Muret Jane , Trinks Alexandra , Brazzi Luca , Reinoso-Barbero Francisco , Diez Sebastian Jesus , MRF Struys Michel 
Published: June 2023

BACKGROUND
The healthcare industry carbon footprint is 5.2% of total CO2 equivalent emissions worldwide. The operating rooms are the most resource demanding areas in hospital care and the higher energy demands, lack of effective waste management, and inhaled anaesthetic use, lead to a high carbon footprint. There is wide variation in the carbon footprint of inhaled gases, with desflurane ranking 40 times higher than sevoflurane. Other inhaled agents, including N2O and isoflurane, have additional ozone-depleting properties.

OBJECTIVE
To describe what factors influence the implementation of sustainable anaesthetic strategies.

DESIGN
An international survey.

SETTING
Anaesthesia clinicians worldwide between April 2021 and April 2022.

PARTICIPANTS
One thousand two hundred and thirty-seven anaesthesia clinicians from 75 countries.

MAIN OUTCOME MEASURES
The primary outcome was a determination of the most used anaesthetic plans among anaesthesia practitioners. Secondary outcomes included an assessment of the influence of various socioeconomic variables on anaesthetic decision-making, and on the level of the practitioners’ awareness of peri-operative environmental sustainability.

RESULTS
Sixty-four percent of respondents use inhaled anaesthetics on a daily basis, with 83% preferring sevoflurane, and only 5% using N2O regularly. Forty-five percent do not know which halogen gas has the highest carbon footprint. Fifty-one percent do not use low flow anaesthesia regimes (<1.0 l min-1) due to concerns about CO2 rebreathing (30%), hypoxia (25%), compound A related renal failure (12%) or CO generation (10%). Only 15% use minimal flow anaesthesia (<0.5 l min-1). There is a correlation between higher income countries and implementation of more sustainable strategies, probably due to better access to updated technology and sustainability education programmes. Desflurane is used in 6 to 12% of the cases regardless of the GDP index.

CONCLUSIONS
Halogen gases are the most frequently used anaesthetic drugs worldwide. The majority of respondents are unaware of their global warming impact, or are not influenced in their anaesthetic choices by environmental concerns. More sustainable alternatives of anaesthesia are under-implemented, and vary significantly among countries depending on their GDP index. Further education and training in sustainability is needed.
Validation of the C-DU(KE) Calculator as a Predictor of Outcomes in Patients Enrolled in Steroids for Corneal Ulcer and Mycotic Ulcer Treatment Trials
Authors: Arboleda Alejandro , Prajna N. Venkatesh , Lalitha Prajna , Srinivasan Muthiah , Rajaraman Revathi , Krishnan Tiruvengada , Mousa Hazem M. , Feghali James , Acharya Nisha R. , Lietman Thomas M. , Perez Victor L. , Rose-Nussbaumer Jennifer 
Published: June 2023

Purpose:
The aim of this study was to validate the C-DU(KE) calculator as a predictor of treatment outcomes on a data set derived from patients with culture-positive ulcers.

Methods:
C-DU(KE) criteria were compiled from a data set consisting of 1063 cases of infectious keratitis from the Steroids for Corneal Ulcer Trial (SCUT) and Mycotic Ulcer Treatment Trial (MUTT) studies. These criteria include corticosteroid use after symptoms, visual acuity, ulcer area, fungal etiology, and elapsed time to organism-sensitive therapy. Univariate analysis was performed followed by multivariable logistic regressions on culture-exclusive and culture-inclusive models to assess for associations between the variables and outcome. The predictive probability of treatment failure, defined as the need for surgical intervention, was calculated for each study participant. Discrimination was assessed using the area under the curve for each model.

Results:
Overall, 17.9% of SCUT/MUTT participants required surgical intervention. Univariate analysis showed that decreased visual acuity, larger ulcer area, and fungal etiology had a significant association with failed medical management. The other 2 criteria did not. In the culture-exclusive model, 2 of 3 criteria, decreased vision [odds ratio (OR) = 3.13, P < 0.001] and increased ulcer area (OR = 1.03, P < 0.001), affected outcomes. In the culture-inclusive model, 3 of 5 criteria, decreased vision (OR = 4.9, P < 0.001), ulcer area (OR = 1.02, P < 0.001), and fungal etiology (OR = 9.8, P < 0.001), affected results. The area under the curves were 0.784 for the culture-exclusive model and 0.846 for the culture-inclusive model which were comparable to the original study.

Conclusions:
The C-DU(KE) calculator is generalizable to a study population from large international studies primarily taking place in India. These results support its use as a risk stratification tool assisting ophthalmologists in patient management.
Characterization of Extended-Release Lorazepam
Authors: Mathew Sanjay J. , Jean-Lys Shedly , Phull Rupinder , Yarasani Rama 
Published: June 2023

Purpose/Background
Once-daily extended-release (ER) lorazepam was developed to reduce fluctuations in plasma levels compared with lorazepam immediate-release (IR) for short-term anxiety relief. Here we report a series of phase 1 randomized, open-label, multiperiod crossover studies characterizing ER lorazepam pharmacokinetics and safety in healthy adults.

Methods/Procedures
These phase 1 studies assessed the pharmacokinetics of ER lorazepam administered: (study 1) 3 mg once daily versus IR lorazepam 1 mg 3 times a day (TID; every 8 hours), (study 2) with or without food, and (study 3) intact versus sprinkled onto food. Study 3 further evaluated the proportionality of 1 × 4- versus 4 × 1-mg doses. Safety was also monitored.

Findings/Results
There were 43, 27, and 29 subjects who completed studies 1, 2, and 3, respectively. The 90% confidence intervals for C
max,SS, C
min, and AUCTAU,SS of once-daily ER lorazepam compared with IR given TID were within 80% to 125% limits establishing steady-state bioequivalence. Maximum mean lorazepam concentrations were achieved at 11 hours compared with 1 hour after dosing for ER versus IR lorazepam, respectively. Pharmacokinetic parameters (C
max, AUClast or AUC0–t
, AUCinf or AUC0–inf) of ER lorazepam were bioequivalent whether taken with or without food, administered intact or sprinkled onto food, or administered as intact 1 × 4- versus 4 × 1-mg capsules. No serious safety concerns were found.

Implications/Conclusions
Once-daily ER lorazepam provided a pharmacokinetic profile bioequivalent to IR lorazepam given TID and was well tolerated in healthy adults across all phase 1 studies. These data suggest that ER lorazepam could be an alternative for patients currently treated with IR lorazepam.
The nicotine and tobacco epidemic among adolescents: new products are addicting our youth
Authors: Heinly Allison , Walley Susan 
Published: June 2023

Purpose of review
New nicotine and tobacco products such as electronic cigarettes and oral nicotine products have increased in use and threaten to addict a new generation of youth. This review summarizes current literature on nicotine and tobacco products used by youth, epidemiology, health effects, prevention and treatment of nicotine dependence, and current policies and regulations.

Recent findings
Electronic cigarettes and oral nicotine products are popular among youth, attracting adolescents through exposure to deceptive marketing and fruit, candy and dessert flavors. Electronic cigarettes and oral nicotine product use can lead to nicotine addiction and is associated with respiratory, cardiovascular, and oral health problems, although long-term health effects are not fully known. The Food and Drug Administration (FDA) has authority to regulate nicotine and tobacco products; however, thousands of unregulated and unauthorized products remain on the market.

Summary
Millions of adolescents continue to use nicotine and tobacco products, which puts them at risk for health problems, including nicotine addiction. Pediatric providers can provide prevention messages, screen youth for tobacco and nicotine use, and offer appropriate treatment options. Regulation of tobacco and nicotine products by the FDA is critical to reverse this public health epidemic of youth nicotine and tobacco use.
Investigating Same-Day Discharge For Postmastectomy Immediate Breast Reconstruction: A National Surgical Quality Improvement Program Study
Authors: Miller Amanda , Jain Nirbhay S. , Wells Michael W. , Da Lio Andrew , Roostaeian Jason , Crisera Christopher , Slack Ginger , Tseng Charles , Delong Michael , Festekjian Jaco H. 
Published: June 2023

Background:
Patients undergoing immediate breast reconstruction with tissue expanders are frequently admitted after surgery for monitoring and pain control, which introduces additional costs and risks of nosocomial infection. Same-day discharge could conserve resources, mitigate risk, and return patients home for faster recovery. We used large data sets to investigate the safety of same day discharge after mastectomy with immediate postoperative expander placement.

Methods:
A retrospective review of patients in the National Surgical Quality Improvement Program NSQIP database who underwent tissue expander breast reconstruction between 2005 and 2019 was performed. Patients were grouped based on date of discharge. Demographic information, medical comorbidities, and outcomes were recorded. Statistical analysis was performed to determine efficacy of same-day discharge and identify factors that predict safety.

Results:
Of the 14,387 included patients, 10% were discharged same-day, 70% postoperative day one, and 20% later. Most common complications were infection, reoperation, and readmission and trended upward with length of stay (6.4% v 9.3% v 16.8%), though statistically equivalent between same-day and next-day discharge. The complication rate for later-day discharge was statistically higher. Patients discharged later had significantly more comorbidities than same or next-day discharge counterparts. Predictors of complication included hypertension, smoking, diabetes, and obesity.

Conclusions:
Immediate tissue expander reconstruction patients are usually admitted overnight. However, we demonstrate same-day discharge has equivalent risk of perioperative complications as next-day discharge. For the otherwise healthy patient, going home the day of surgery is a safe and cost-effective option, though the decision should be made in the context of each patient.
Staged Mastopexy Before Nipple-Sparing Mastectomy: Improving Safety and Appearance in Implant-Based and Autologous Breast Reconstruction
Authors: Awaida Cyril J. , Bernier Christina , Bou-Merhi Joseph S. , Trabelsi Nadia O. , Gagnon Alain , El-Khatib Arij , Harris Patrick G. , Odobescu Andrei 
Published: June 2023

Background:
Breast reconstruction following nipple sparing mastectomy in patients with large or ptotic breasts remains challenging because of the risk of ischemic complications and the difficulty in managing the redundant skin envelope. Staged mastopexy or breast reduction before the mastectomy/reconstruction has been shown to decrease the risk of complications and improve clinical outcomes.

Methods:
A retrospective analysis was conducted of patients with a genetic predisposition to breast cancer who underwent staged breast reduction/mastopexy before nipple sparing mastectomy and reconstruction in our institution. In patients with in situ disease or invasive cancer, the first stage consisted of lumpectomy and oncoplastic reduction/mastopexy. Breast reconstruction at the second stage was performed with free abdominal flaps or breast implants and acellular dermal matrix. Data regarding the ischemic complications were recorded.

Results:
In total, 47 patients (84 breasts) underwent this staged approach. All patients had a genetic predisposition to breast cancer. The time interval between the two stages was 11.5 months (range, 1.3 to 23.6 months). Twelve breasts (14.3 percent) were reconstructed with free abdominal flaps, 6 (7.1 percent) with tissue expanders and 66 (78.6 percent) with permanent subpectoral implants and acellular dermal matrix. There was one postoperative superficial nipple areolar complex epidermolysis (1.2 percent), and two partial mastectomy skin flap necrosis (2.4 percent). The mean follow-up time after completion of reconstruction was 8.3 months.

Conclusion:
Mastopexy or breast reduction before nipple sparing mastectomy and reconstruction is a safe procedure with a low risk of ischemic complications.
Bilateral Simultaneous LAP Flaps in Breast Reconstruction: Perioperative anesthetic outcomes addressing safety and feasibility
Authors: Haddock Nicholas T. , Ercan Alp , Teotia Sumeet S. 
Published: June 2023

Introduction
The lumbar artery perforator flap (LAP flap) has emerged as an excellent option for breast reconstruction, but its steep learning curve makes it less approachable. Furthermore, length of the operation, flap ischemia time, need for composite vascular grafts, complex microsurgery, multiple position changes, and general concern for safety has led experienced surgeons to stage bilateral reconstructions. In our experience, simultaneous bilateral LAP flaps are successfully feasible, but overall peri-operative safety has not been fully explored.

Methods:
Thirty-one patients (62 flaps) underwent simultaneous bilateral LAP flaps and were included in the study (excluding stacked 4-flaps and unilateral flaps). Patients underwent two position changes in the OR: supine to prone and then supine again. A retrospective review of patient demographics, intraoperative details and complications was performed.

Results:
Overall flap success rate was 96.8%. Five flaps were compromised postoperatively. Intra-operative anastomotic revision rate was 24.1% per flap (4.3% per anastomoses). Significant complication rate was 22.6%. The number of sustained hypothermic episodes and hypotensive episodes correlated with intra-operative arterial thrombosis (p<0.05). The number of hypotensive episodes and increased intra-operative fluid correlated with flap compromise (p<0.05). High BMI correlated with overall complications (p<0.05). The presence of diabetes correlated with intra-operative arterial thrombosis (p<0.05).

Conclusion:
Simultaneous bilateral LAP flaps can be safely performed with an experienced and trained microsurgical team. Hypothermia and hypotension negatively impact the initial anastomotic success. In this complex operation, a coordinated approach between the anesthesia and nursing team is paramount for patient safety.
“Multiplane L-Scar Augmentation Mastopexy: An Individualized Approach to Muscle, Glandular Tissue and Skin”
Authors: Bark Adel A. , Minikowski Guilherme C. , Mujahed Isaac B. U. 
Published: June 2023

Background:
Augmentation mastopexy focus on restoring the youthful appearance of the female breast. Despite those benefits, there is large scarring to be considered, and the reduction of this side effect is the main goal to enhance the aesthetic result. This article aims to describe a variation of the L-shaped mastopexy technique without complex marking and performed in planes, which brings long-term results for patients undergoing this approach.

Methods:
This is a retrospective, observational study, based on a series of cases conducted by the author. The preoperative appointment and the surgical technique are described, and divided into steps according to their components: cutaneous, glandular tissue, and muscular.

Results:
Between January 2016 and July 2021, 632 women underwent surgery. The mean age was 38 years (18-71 years). The mean volume of implants was 285cc (175-550cc). All the implants used were round with a nanotextured surface. The mean tissue resected from each breast was 117g (5-550g). Follow-ups ranged from 12 to 84 months, and photographic documentation was performed from 30 days after surgery. Complications totaled 19.30% and were divided into minor - treated with expectant treatment, non-invasive or with the possibility of correction with local anesthesia, corresponding to 10.44%; and major - in which it was necessary to return to the operating room, corresponding to 8.86%.

Conclusion:
Multiplane L-Scar Mastopexy is a versatile and safe technique with predictable results, which allows the systematic treatment of the most diverse breast types, with complications similar to other already described and solidified techniques.
Primary Urethra Non-Hodgkin Lymphoma in a 46-Year-Old Man on FDG PET/CT
Authors: Zhao Weiwei , Li Peng , Li Yanmei , He Yueming , Yang Jianwei 
Published: June 2023

Abstract
Primary lymphoma of the male urethra is exceptionally rare. A 46-year-old man complained of low back pain, hematuria, and dysuria. Cystourethroscopy revealed a pale, annular thickening of the urethral mucosa. A biopsy revealed that the patient had diffuse large B-cell lymphoma. Before treatment, an 18F-FDG PET/CT was used for staging. The urethra and left inguinal lymph nodes showed increased FDG uptake. The patient was then diagnosed with primary urethral lymphoma that had invaded the left inguinal lymph node.
Extrastriatal Accumulation of 18F-FP-CIT at Cerebral Infarction in a Patient With Suspected Parkinson Disease
Authors: Yoo Jihye , Chun In Kook 
Published: June 2023

Abstract

18F-FP-CIT PET/CT is a useful diagnostic tool for differentiating between idiopathic Parkinson disease and atypical Parkinson syndrome by visualizing the striatum, where the nerve endings of nigrostriatal dopaminergic neurons are located. We present an unusual accumulation of 18F-FP-CIT in the infarct and peri-infarct brain area of an 83-year-old man who was referred for the management of suspected cerebral infarction due to sudden dysarthria and delirium.