bluuebunny/crossref_metadata_2025_split huggingface dataset:
An ACS-NSQIP Data Analysis of 30-Day Outcomes Following Surgery for Bell’s Palsy
Authors: Knoedler Samuel , Knoedler Leonard , Hoch Cosima C. , Kauke-Navarro Martin , Kehrer Andreas , Friedman Leigh , Prantl Lukas , Machens Hans-Guenther , Orgill Dennis P. , Panayi Adriana C. 
Published: September 2023

Background:
There exists a paucity of large-scale, multi-institutional studies that investigate the outcomes of surgery for Bell’s palsy (BP). Here, we utilize a large, multi-institutional database to study the risk factors and early-stage outcomes following surgical procedures in BP.

Methods:
We reviewed the American College of Surgeons National Surgical Quality Improvement Program database (2008–2019) to identify patients who underwent surgery for the diagnosis of BP. We extracted data on comorbidities and preoperative blood values, and 30-day postoperative outcomes.

Results:
Two hundred fifty-seven patients who underwent surgery for BP symptoms over the 12-year review period were identified. Muscle grafts (n=50; 19%) and fascial grafts (n=48; 19%) accounted for the majority of procedures. The most common comorbidities were hypertension (n=89; 35%) and obesity (n=79; 31%). Complications occurred in 26 (10.1%) cases. Additionally, length of hospital stay was significantly associated with both surgical and medical complications (3.9±4.7 versus 1.5±2.0; P<0.01) and (3.2±3.8 versus 1.4±2.0; P<0.01), respectively. Preoperative creatinine, blood urea nitrogen, and alkaline phosphatase were identified as potential predictors of poor postoperative outcomes.

Conclusion:
Based on multi-institutional analysis, complication rates following surgery for BP were found to be overall low and seen to correlate with length of hospital stay. Reoperations and readmissions were the most frequent complications after surgery for BP. The preoperative evaluation of routine laboratory values may help refine patient eligibility and risk stratification. In addition, our findings call for future large-scale prospective studies in the field of facial palsy surgery to further improve the quality of care and optimize perioperative protocols.
INITIATION TIMING OF VASOPRESSOR IN PATIENTS WITH SEPTIC SHOCK: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Ye Enci , Ye Hui , Wang Shengyao , Fang Xiangming 
Published: September 2023

ABSTRACTBackground:Vasopressor plays a crucial role in septic shock. However, the time for vasopressor initiation remains controversial. We conducted a systematic review and meta-analysis to explore its initiation timing for septic shock patients.Methods:PubMed, Cochrane Library, Embase, and Web of Sciences were searched from inception to July 12, 2023, for relevant studies. Primary outcome was short-term mortality. Meta-analysis was performed using Stata 15.0.Results:Twenty-three studies were assessed, including 2 randomized controlled trials and 21 cohort studies. The early group resulted in lower short-term mortality than the late group (OR [95% CI] = 0.775 [0.673 to 0.893],P= 0.000,I2= 67.8%). The significance existed in the norepinephrine and vasopressin in subgroup analysis. No significant difference was considered in the association between each hour’s vasopressor delay and mortality (OR [95% CI] = 1.02 [0.99 to 1.051],P= 0.195,I2= 57.5%). The early group had an earlier achievement of target MAP (P< 0.001), shorter vasopressor use duration (P< 0.001), lower serum lactate level at 24 h (P= 0.003), lower incidence of kidney injury (P= 0.001), renal replacement therapy use (P= 0.022), and longer ventilation-free days to 28 days (P< 0.001).Conclusions:Early initiation of vasopressor (1–6 h within septic shock onset) would be more beneficial to septic shock patients. The conclusion needs to be further validated by more well-designed randomized controlled trials.
Metabolomic and Proteomic Changes in Trauma-induced Hypocalcemia
Authors: Schaid Terry R. , LaCroix Ian , Cohen Mitchell J. , Hansen Kirk C. , Moore Ernest E. , Sauaia Angela , Cralley Alexis L. , Thielen Otto , Hallas William , Erickson Christopher , Mitra Sanchayita , Dzieciatkowska Monika , Silliman Christopher C. , D’Alessandro Angelo 
Published: September 2023

Abstract

Background
Trauma-induced hypocalcemia is common and associated with adverse outcomes, but the mechanisms remain unclear. Thus, we aimed to characterize the metabolomic and proteomic differences between normo- and hypocalcemic trauma patients to illuminate biochemical pathways that may underlie a distinct pathology linked with this clinical phenomenon.

Methods
Plasma was obtained on arrival from injured patients at a Level 1 Trauma Center. Samples obtained after transfusion were excluded. Multiple regression was used to adjust the omics data for injury severity and arrival base excess prior to metabolome- and proteome-wide comparisons between normo- (ionized Ca2+ > 1.0 mmol/L) and hypocalcemic (ionized Ca2+ ≤ 1.0 mmol/L) patients using partial least squares-discriminant analysis. OmicsNet and Gene Ontology were used for network and pathway analyses, respectively.

Results
Excluding isolated traumatic brain injury and penetrating injury, the main analysis included 36 patients (n = 14 hypocalcemic, n = 22 normocalcemic). Adjusted analyses demonstrated distinct metabolomic and proteomic signatures for normo- and hypocalcemic patients. Hypocalcemic patients had evidence of mitochondrial dysfunction (TCA cycle disruption, dysfunctional fatty acid oxidation), inflammatory dysregulation (elevated DAMPs, activated endothelial cells), aberrant coagulation pathways, and proteolytic imbalance with increased tissue destruction.

Conclusions
Independent of injury severity, hemorrhagic shock, and transfusion, trauma-induced hypocalcemia is associated with early metabolomic and proteomic changes that may reflect unique pathology in hypocalcemic trauma patients. This study paves the way for future experiments to investigate mechanisms, identify intervenable pathways, and refine our management of hypocalcemia in severely injured patients.
Predictive value of neutrophil extracellular traps components for 28-day all-cause mortality in patients with cardiac arrest: A pilot observational study
Authors: Li Peijuan , Liang Shuangshuang , Wang Ling , Guan Xiaolan , Wang Jin , Gong Ping 
Published: September 2023

ABSTRACTBackgroundIschemia–reperfusion after cardiac arrest activates peptidyl arginine deiminase and citrullinates histone H3 (CitH3), which leads to the formation of neutrophil extracellular traps (NETs). This study attempted to determine the alterations in NET components in post-cardiac arrest patients as well as analyze the association of NETs with 28-day all-cause mortality.MethodsIn this study, 95 patients with return of spontaneous circulation (ROSC) after cardiac arrest were included. They were categorized into the survivor group (n= 32) and the nonsurvivor group (n= 63) according to their 28-day survival statuses. The control group comprised 20 healthy individuals. The blood samples were collected from the patients on Days 1, 3, and 7 after ROSC and from the control subjects at the time of enrollment. The serum cell-free DNA (cfDNA) level was determined using the fluorescent labeling method, and the serum concentrations of NETs components, including CitH3, myeloperoxidase (MPO), neutrophil elastase (NE), and nucleosomes, were estimated using the enzyme-linked immunosorbent assay.ResultsCompared with the control group, the serum NET components were significantly increased in the patients 1 week after ROSC (allP< 0.05). These components were significantly higher in the nonsurvivor group than in the survivor group (allP< 0.05). Spearman’s correlational analysis revealed that the components were positively correlated with APACHE II scores (bothP< 0.05). Binary logistic regression analysis indicated that serum cfDNA, CitH3, and nucleosomes on Days 1 and 3 after ROSC were independent predictors of 28-day all-cause mortality. Furthermore, these parameters on Day 1 after ROSC had the biggest areas under the ROC curves (0.876, 0.862, and 0.861, respectively).ConclusionsElevated serum levels of cfDNA, CitH3, MPO, NE, and nucleosomes were positively correlated with disease severity after ROSC. However, only serum CitH3, cfDNA, and nucleosomes on Day 1 after ROSC showed a good predictive value for 28-day all-cause mortality.
Changes of Serum C-Reactive Protein Level in Patients With Depressive Disorders After Treatment With Agomelatine Combined With Aerobic Exercise and Its Significance
Authors: Sun Zhuping , Chen Silu , Zhang Hui , Gu Xiaoqing , Ge Haiyan , Chen Jinglei 
Published: September 2023

ObjectiveDepressive disorders constitute a series of debilitating diseases. This study investigated the therapeutic effect of agomelatine (AG) combined with aerobic exercise (AE) on patients with moderate-severe depression (MSD) and the changes of the serum C-reactive protein (CRP) level in patients after treatment as well as its significance.MethodsA total of 178 MSD patients were randomly assigned to the AG group (N = 90) and AG + AE group (N = 88). The severity of depressive disorders and anhedonia was assessed using the Hamilton Rating Scale for Depression (HAM-D), Beck Depression Inventory, and Snaith-Hamilton Pleasure Scale scores. The serum CRP level in MSD patients was detected by turbidity assay. Patients were defined as remitters, responders, and nonresponders according to the HAM-D17score, and the treatment efficacy was analyzed, followed by evaluation of the serum CRP level in patients with different treatment responses. Finally, the adverse reactions of patients during treatment were statistically analyzed.ResultsAfter treatment, the HAM-D, Beck Depression Inventory, and Snaith-Hamilton Pleasure Scale scores and the serum CRP level of the 2 groups were reduced, and changes in the AG + AE group was more significant than that in the AG group. The clinical efficacy of the AG + AE group was better than that of the AG group. After treatment, the serum levels of CRP in remitters and responders were reduced, but not significantly in nonresponders. The incidence of adverse events in the AG + AE group was lower than that in the AG group.ConclusionAG + AE reduced the serum level of CRP in MSD patients and had good therapeutic effects on MSD patients.
Burnout and Its Consequences among Vascular Surgeons and Trainees: A Danish National Survey
Authors: Møller Cecilie M , Clausen Thomas , Aust Birgit , Budtz-Lilly Jacob W , Eiberg Jonas P 
Published: September 2023

Background:
Burnout among physicians has widespread negative consequences. Little is known about burnout among European vascular surgeons (VS). A previously published study found that 82% of VS and vascular surgical trainees (VST) in Denmark experience burnout symptoms. The present study aimed to investigate work- and health-related consequences of burnout.

Study Design:
An electronic survey was distributed to all VS/VST in Denmark in January 2020. Validated assessment tools were used to measure burnout, mental health and psychosocial work environment aspects.

Results:
Of 104 invited VS/VST, 82% (n=85) completed the survey. VS accounted for 72% (n=61) of the respondents, and 40% (n=33) were female. Statistically significant associations were found between higher levels of burnout and a range of work- and health-related outcomes, including a sense of meaning at work, workplace commitment, conflicts between work and private life, work stress, sick leave, and depressive symptoms. VS/VST using pain medication daily or weekly had significantly higher burnout scores than respondents who rarely or never use pain medication. A significant association between burnout and job satisfaction and retention was found, with respondents indicating an intention to stay within the specialty having significantly lower burnout scores than those who considered leaving within five years. Among those who indicated leaving the specialty, 35% (n=13) attributed this to their current working conditions.

Conclusion:
Burnout among VS/VST in Denmark is negatively associated with various work- and health-related outcomes. The work environment seems to play an essential role in these associations, and alterations workplace organization may remedy this situation.
Molecular interactions in short-chain perfluoroalkyl carboxylic acids and aqueous solutions
Authors: Benmore Chris J. , Wang Yuqin , Darling Seth B. , Chen Junhong 
Published: September 2023

The presence of short-chain per- and polyfluoroalkyl substances in water poses a major health and environmental challenge. Here, we have performed high-energy small- and wide-angle X-ray scattering measurements on CF
3
[CF
2
]

n

COOH (where
n
= 1, 2, 3 represents the chain length) and their aqueous solutions at 10% mole concentrations to characterize their molecular interactions at the atomic and nanometer length scales. The experimental wide-angle structure factors have been modelled using Empirical Potential Structural Refinement. The oxygen–oxygen partial X-ray pair distribution functions show that the coordination number between the hydroxyl oxygen on the acid and surrounding oxygen water molecules increases significantly with acid chain length, rising from 3.2 for
n
= 1 to 4.1 for
n
= 3. The small-angle scattering is dominated by a sharp, high-intensity peak at
Q
1
∼ 0.2 Å
−1
and a smaller peak at
Q
2
= 1.2 Å
−1
for
n
= 3, both of which decrease with decreasing chain length. The
Q
2
peak is attributed to groups of adjacent non-bonded acid molecules, and
Q
1
has contributions from both correlations between acid molecules and water–water interactions. In all cases, the models show nanoscale aggregation occurs in the form of denser channels of winding hydrogen-bonded chains, approximately 20 water molecules in length, surrounding clusters of acid molecules.

This article is part of the theme issue 'Exploring the length scales, timescales and chemistry of challenging materials (Part 2)'.
Canyon Diablo lonsdaleite is a nanocomposite containing c/h stacking disordered diamond and diaphite
Authors: Németh Péter , Garvie Laurence A. J. , Salzmann Christoph G. 
Published: September 2023

In 1967, a diamond polymorph was reported from hard, diamond-like grains of the Canyon Diablo iron meteorite and named lonsdaleite. This mineral was defined and identified by powder X-ray diffraction (XRD) features that were indexed with a hexagonal unit cell. Since 1967, several natural and synthetic diamond-like materials with XRD data matching lonsdaleite have been reported and the name lonsdaleite was used interchangeably with hexagonal diamond. Its hexagonal structure was speculated to lead to physical properties superior to cubic diamond, and as such has stimulated attempts to synthesize lonsdaleite. Despite numerous reports, several recent studies have provided alternative explanations for the XRD, transmission electron microscopy and Raman data used to identify lonsdaleite. Here, we show that lonsdaleite from the Canyon Diablo diamond-like grains are a nanocomposite material dominated by subnanometre-scale cubic/hexagonal stacking disordered diamond and diaphite domains. These nanostructured elements are intimately intergrown, giving rise to structural features erroneously associated with h diamond. Our data suggest that the diffuse scattering in XRD and the hexagonal features in transmission electron microscopy images reported from various natural and laboratory-prepared samples that were previously used for lonsdaleite identification, in fact arise from cubic/hexagonal stacking disordered diamond and diaphite domains.
This article is part of the theme issue 'Exploring the length scales, timescales and chemistry of challenging materials (Part 2)'.
Quantification of fragmentation capture materials and an assessment of the viability of economical alternatives: a preliminary study
Authors: Read James , Ritchie Thomas , Brown Laura , Bloodworth-Race Susie , Thawani Bonny , Critchley Richard , Hazael Rachael 
Published: September 2023

High pressure, high-temperature events need to be quantified experimentally. Where fragmentation occurs, i.e. against personal protective equipment, there is a requirement for both a reliable and repeatable measurement of numerous experimental metrics. Typically, the most critical is calculating the energy absorbed by the target material, to characterize target performance. This is achieved by detonating a device and capturing a proportion of the fragmentation in a suitable material that can achieve successful recovery of all fragmentation produced. Therefore, allowing the estimation of the target's response using the depth of penetration within the capture material which allows the calculation of energy absorption. The current standardized fragmentation capture material used within the UK is known as strawboard. Although effective, this material is both expensive and limited in its availability. This study explores the classification of strawboard to provide a suitable baseline to compare against medium density fibreboard (MDF) and flooring underlay, which represent two more economically friendly alternatives on the openmarket. It was found that the uniformity of response for the MDF material was better than that of strawboard, due to its reproducibility between batches and velocity ranges. To further explore this phenomena, high explosive trials were conducted, further demonstrating MDF to be a viable, reliable and cheaper alternative.
This article is part of the theme issue 'Exploring the length scales, timescales and chemistry of challenging materials (Part 2)'.
Exploring the length scales, timescales and chemistry of challenging materials (Part 2)
Authors: Wilding Martin C. , Sella Andrea , Howard Christopher A. , Sobrido Ana Jorge , Catlow C. R. A. 
Published: September 2023

This themed issue explores the different length and timescales that determine the physics and chemistry of a variety of key of materials, explored from the perspective of a wide range of disciplines, including physics, chemistry materials science, Earth science and biochemistry. The topics discussed include catalysis, chemistry under extreme conditions, energy materials, amorphous and liquid structure, hybrid organic materials and biological materials. The issue is in two parts, with this second set of contributions exploring hybrid organic materials, catalysis low-dimensional and graphitic materials, biological materials and naturally occurring, super-hard material as well as dynamic high pressure and new developments in imaging techniques pressure.This article is part of the theme issue 'Exploring the length scales, timescales and chemistry of challenging materials (Part 2)'.
High fusion and cytopathy of SARS-CoV-2 variant B.1.640.1
Authors: Bolland William , Michel Vincent , Planas Delphine , Hubert Mathieu , Guivel-Benhassine Florence , Porrot Françoise , Staropoli Isabelle , N’Debi Mélissa , Rodriguez Christophe , Fourati Slim , Prot Matthieu , Planchais Cyril , Hocqueloux Laurent , Simon-Lorière Etienne , Mouquet Hugo , Prazuck Thierry , Pawlotsky Jean-Michel , Bruel Timothée , Schwartz Olivier , Buchrieser Julian 
Published: September 2023

ABSTRACTSARS-CoV-2 variants with undetermined properties have emerged intermittently throughout the COVID-19 pandemic. Some variants possess unique phenotypes and mutations which allow further characterization of viral evolution and spike functions. Around 1100 cases of the B.1.640.1 variant were reported in Africa and Europe between 2021 and 2022, before the expansion of Omicron. Here, we analyzed the biological properties of a B.1.640.1 isolate and its spike. Compared to the ancestral spike, B.1.640.1 carried 14 amino acid substitutions and deletions. B.1.640.1 escaped binding by some anti-NTD and -RBD monoclonal antibodies, and neutralization by sera from convalescent and vaccinated individuals. In cell lines, infection generated large syncytia and a high cytopathic effect. In primary airway cells, B.1.640.1 replicated less than Omicron BA.1 and triggered more syncytia and cell death than other variants. The B.1.640.1 spike was highly fusogenic when expressed alone. This was mediated by two poorly characterized and infrequent mutations located in the spike S2 domain, T859N and D936H. Altogether, our results highlight the cytopathy of a hyper-fusogenic SARS-CoV-2 variant, supplanted upon the emergence of Omicron BA.1.ImportanceOur results highlight the plasticity of SARS-CoV-2 spike to generate highly fusogenic and cytopathic strains with the causative mutations being uncharacterized in previous variants. We describe mechanisms regulating the formation of syncytia and the subsequent consequences in cell lines and a primary culture model, which are poorly understood.
Targeted mutations in IFNα2 improve its antiviral activity against various viruses
Authors: Karakoese Zehra , Le-Trilling Vu-Thuy Khanh , Schuhenn Jonas , Francois Sandra , Lu Mengji , Liu Jia , Trilling Mirko , Hoffmann Daniel , Dittmer Ulf , Sutter Kathrin 
Published: September 2023

AbstractDuring viral infections, type I interferons (IFN) are induced and play a key role in counteracting initial viral spread. Twelve different human IFNα subtypes exist that bind the same receptor; however, they elicit unique host responses and display distinct potencies of antiviral activities. Our previous studies on HIV and HBV demonstrated that the clinically used IFNα2 is not the most effective one among the IFNα subtypes. By sequence modeling, we identified a region in helix B with mainly conserved residues at the outside facing IFNAR1, but variable residues at the inside facing the core of IFNα, potentially representing a putative tunable anchor to tune pleiotropic IFN responses. Using site-directed mutagenesis various mutations were introduced into the IFNα2b backbone targeting sites which are important for binding to IFNAR1 and IFNAR2, the putative tunable anchor, or outside these three regions. Selected mutations were based on sequence differences to high antiviral subtypes IFNα6 and IFNα14. Treatment assays against HBV and HIV identified several critical residues for the antiviral activity of IFNα mainly in the IFNAR1 binding region. Combined mutations of the IFNα2 IFNAR1/2 binding sites or the IFNAR1 binding region plus the putative tunable anchor by those of IFNα14 further augmented activation of different downstream signaling cascades providing a molecular correlate for the enhanced antiviral activity. We describe here important functional residues within IFNα subtype molecules, which enabled us to design novel and innovative drugs that may have the potential to be used in clinical trials against a variety of different viral infections.ImportanceThe potency of IFNα to restrict viruses was already discovered in 1957. However, until today only IFNα2 out of the 12 distinct human IFNα subtypes has been therapeutically used against chronic viral infections. There is convincing evidence that other IFNα subtypes are far more efficient than IFNα2 against many viruses. In order to identify critical antiviral residues within the IFNα subtype sequence, we designed hybrid molecules based on the IFNα2 backbone with individual sequence motifs from the more potent subtypes IFNα6 and IFNα14. In different antiviral assays with HIV or HBV, residues binding to IFNAR1 as well as combinations of residues in the IFNAR1 binding region, the putative tunable anchor, and residues outside these regions were identified to be crucial for the antiviral activity of IFNα. Thus, we designed artificial IFNα molecules, based on the clinically approved IFNα2 backbone, but with highly improved antiviral activity against several viruses.