bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicopathological Impacts of Expression of Neuronal Markers in Lymphangioleiomyomatosis
Authors: Kishi Monami , Hayashi Takuo , Mitani Keiko , Tsuboshima Kenji , Kurihara Masatoshi , Hosoya Masaki , Sekimoto Yasuhito , Okura Makiko K. , Mitsuishi Yoichiro , Okada Yoshinori , Kanno Jun , Yao Takashi , Takahashi Kazuhisa , Seyama Kuniaki 
Published: August 2023

Lymphangioleiomyomatosis (LAM) is a tuberous sclerosis complex (TSC)-associated tumor, characterized by the expression of neural crest lineages including neuronal markers. Neural crest cells can differentiate into multiple cell types that contribute to tissues associated with TSC-related tumors, and TSC-related tumors could be specifically associated with distinct neural crest subtypes. This study aimed to clarify the clinicopathological effects of expression of neuronal markers in LAM. Lung tissues from 40 patients with LAM (of whom 13, 1, and 26 had undergone lung transplantation, lobectomy, and partial lung resection, respectively) were immunohistochemically analyzed. All patients were women, and their median age was 36 years (range: 24–62 y). All patients who underwent lung transplantation or lobectomy were classified as LAM histologic score (LHS)-3, whereas those who underwent partial lung resection were classified as LHS-1. LAM cells expressed peripherin (65%), and neuron-specific βIII-tubulin (43%). A comparison of the early (LHS-1) and advanced (LHS-3) stages of LAM revealed that neuron-specific βIII-tubulin was significantly expressed in the early stage of LAM (P = 0.0009). Neuron-specific βIII-tubulin-positive LAM was associated with younger age (P < 0.0001), the coexistence of renal angiomyolipoma (P = 0.027), and the absence of retroperitoneal LAM (P = 0.045). Furthermore, based on the expression levels of immunohistochemical markers in LAM, 2 distinct clusters with different expression levels of neuronal markers were observed. Approximately 40% to 60% of patients with LAM expressed neuron-specific βIII-tubulin and peripherin. Neuronal expression may be associated with disease severity.
Tracheostomy Timing During Pediatric Cardiac Intensive Care: Single Referral Center Retrospective Cohort
Authors: Fox Miriam T. , Meyer-Macaulay Colin , Roberts Hanna , Lipsitz Stuart , Siegel Bryan D. , Mastropietro Chris , Graham Robert J. , Moynihan Katie M. 
Published: August 2023

OBJECTIVES:To describe associations between the timing of tracheostomy and patient characteristics or outcomes in the cardiac ICU (CICU).DESIGN:Single-institution retrospective cohort study.SETTING:Freestanding academic children’s hospital.PATIENTS:CICU patients with tracheostomy placed between July 1, 2011, and July 1, 2020.INTERVENTIONS:We compared patient characteristics and outcomes between early and late tracheostomy based on the duration of positive pressure ventilation (PPV) before tracheostomy placement, fitting a receiver operating characteristic curve for current survival to define a cutoff.MEASUREMENTS AND MAIN RESULTS:Sixty-one patients underwent tracheostomy placement (0.5% of CICU admissions). Median age was 7.8 months. Eighteen patients (30%) had single ventricle physiology and 13 patients (21%) had pulmonary vein stenosis (PVS). Primary indications for tracheostomy were pulmonary/lower airway (41%), upper airway obstruction (UAO) (31%), cardiac (15%), neuromuscular (4%), or neurologic (4%). In-hospital mortality was 26% with 41% survival at the current follow-up (median 7.8 [interquartile range, IQR 2.6–30.0] mo). Late tracheostomy was defined as greater than or equal to 7 weeks of PPV which was equivalent to the median PPV duration pre-tracheostomy. Patients with late tracheostomy were more likely to be younger, have single ventricle physiology, and have greater respiratory severity. Patients with early tracheostomy were more likely to have UAO or genetic comorbidities. In multivariable analysis, late tracheostomy was associated with 4.2 times greater mortality (95% CI, 1.9–9.0). PVS was associated with higher mortality (adjusted hazard ratio [HR] 5.2; 95% CI, 2.5–10.9). UAO was associated with lower mortality (adjusted HR 0.2; 95% CI, 0.1–0.5). Late tracheostomy was also associated with greater cumulative opioid exposure.CONCLUSIONS:CICU patients who underwent tracheostomy had high in-hospital and longer-term mortality rates. Tracheostomy timing decisions are influenced by indication, disease, genetic comorbidities, illness severity, and age. Earlier tracheostomy was associated with lower sedative use and improved adjusted survival. Tracheostomy placement is a complex decision demanding individualized consideration of risk-benefit profiles and thoughtful family counseling.
The effect of leg length discrepancy on paraspinal muscles activation using surface electromyography
Authors: Kim Hee Soo , Ha Yuna , Lim Jiwoon , Kim Hyun Jin , Kang Heeyung , Ryu Ju Seok 
Published: August 2023

Abstract

Objective
To assess the effects of leg length discrepancy (LLD) on paraspinal muscle activity and kinematic variables during gait.

Design
Thirty-nine healthy participants aged 5 to 12 years performed the 10-m walk test using the surface electromyography and G-walk sensor for the following conditions: 1) non-LLD condition (LLD 0 cm) and 2) LLD condition with an insole on the right leg at three different heights (LLD 0.5 cm, 1.0 cm, and 1.5 cm). The root mean square (RMS) was normalized using maximal voluntary contraction and reference voluntary contraction methods (RMS_MVC and RMS_ref) and compared between the sides.

Results
The mean RMS_MVC of the 12th thoracic erector spinae (EST12) on the right side was significantly higher at an LLD 0.5 cm and 1 cm. Regarding the 3rd lumbar multifidus (MuL3), the mean RMS_MVC on the right side was significantly higher at an LLD 1.5 cm. The mean RMS_ref exhibited similar patterns. Pelvic obliquity and rotation showed asymmetry at an LLD 1.5 cm compared with an LLD 0 cm.

Conclusions
A small LLD significantly affected the asymmetric hyperactivation of the MuL3 and EST12 muscles during gait. Considering the action of these muscles, asymmetric hyperactivation might result in rotation and bending of the lumbar spine and the bending of the thoracolumbar spine.
Changes in Patterns of Referral for Inpatient Rehabilitation Cancer Patients due to COVID-19: A Retrospective Study
Authors: Gupta Ekta , Ng Amy H. , de Moraes Aline Rozman , Fu Jack B. , Tennison Jegy M , Ahmed Maaheen , Fellman Bryan M. , Bruera Eduardo 
Published: August 2023

Abstract
There is a paucity of literature on the effect of COVID-19 on hospital processes. We hypothesized that COVID-19 was associated with decreased cancer physiatry referrals in 2020. This is a retrospective cohort study of consecutive patients from April- July of 2019 and 2020 admitted at an academic quaternary cancer center. The main outcomes were number of hospital admissions, rate and characteristics of inpatient rehabilitation admissions and change in percentage of physiatry referrals as the primary endpoint. Results showed in 2019, there were 387 referrals from 10,274 inpatient admissions (3.8%; 95% CI: 2.4 - 4.2), compared to 337 referrals from 7,051 admissions in 2020 (4.8%; 95% CI: 4.3 - 5.3, p = 0.001). Hematology services referred more patients than neurosurgery in 2020 (20.4% vs 31.4%; 48.2% vs 26.5%; p = 0.01). Discharge disposition reflected an increased frequency of return to acute care service in 2020 (10.2% vs 21.8%; p = 0.03). In conclusion, there was an increase in the rate of physiatry referrals despite a decrease in hospital admissions. There was an increase in referrals by hematology, likely due to emphasis on safe discharge and the populations hospitalized.
Score to Predict the Occurrence of Pneumothorax After Computed Tomography-guided Percutaneous Transthoracic Lung Biopsy
Authors: Lamfichekh Yassine , Lafay Valentin , Hamam Joffrey , Guillien Alicia , Puyraveau Marc , Behr Julien , Manzoni Philippe , Calame Paul , Dalphin Jean-Charles , Eberst Guillaume , Grillet Franck , Westeel Virginie 
Published: August 2023

Purpose:
The main objective of this study was to identify risk factors for post-percutaneous transthoracic lung biopsy (PTLB) pneumothorax and to establish and validate a predictive score for pneumothorax occurrence to identify patients eligible for outpatient care.

Material and Methods:
Patients who underwent PTLB between November 1, 2012 and March 1, 2017 were retrospectively evaluated for clinical and radiologic factors potentially related to pneumothorax occurrence. Multivariate logistic regression was used to identify risk factors, and the model coefficient for each factor was used to compute a score. Then, a validation cohort was prospectively evaluated from March 2018 to October 2019.

Results:
Among the 498 eligible patients in the study cohort, pneumothorax occurred in 124 patients (24.9%) and required drainage in 34 patients (6.8%). Pneumothorax risk factors were chronic obstructive pulmonary disease (OR 95% CI 2.28[1.18–4.43]), several passages through the pleura (OR 95% CI 7.71[1.95–30.48]), an anterior biopsy approach (OR 95% CI 6.36 3.82–10.58]), skin-to-pleura distance ≤30 mm (OR 95% CI 2.25[1.09–6.65]), and aerial effusion >10 mm (OR 95% CI 9.27 [5.16–16.65]). Among the 236 patients in the prospective validation cohort, pneumothorax occurred in 18% and 8% were drained. A negative score (<73 points) predicted a probability of pneumothorax occurrence of 7.4% and late evacuation of 2.5% (OR 95% CI respectively 0.18[0.08–0.39] and 0.15[0.04–0.55]) and suggested a reduced length of hospital stay (P=0.009).

Conclusion:
This predictive score for pneumothorax secondary to PTLB has high prognostic performance and accuracy to direct patients toward outpatient management.

Clinical Trials:
NCT03488043
Safety of Augmenting Breast Volume in Direct-to-Implant Breast Reconstruction With Contralateral Breast Augmentation
Authors: Woo Soo Hyun , Lee Seok Joon , Kim Eun Key , Han Hyun Ho , Eom Jin Sup 
Published: August 2023

Background
Direct-to-implant breast reconstruction is a standard method of implant-based reconstruction; however, the risk of skin necrosis and implant failure exists. During simultaneous contralateral augmentation, an implant larger than the resected tissue must be inserted to balance both sides, which may increase the risk of complications. This study examined the differences in the incidence of complications between the single-stage direct-to-implant reconstruction and 2-stage reconstruction when contralateral augmentation was performed simultaneously.

Methods
This study included 99 patients who underwent implant-based breast reconstruction with contralateral augmentation between 2012 and 2020. A retrospective chart review was conducted and the patients were divided into 2 groups: the single-stage reconstruction (n = 61) and 2-stage reconstruction (TSR, n = 38) groups. Demographic data and surgical and oncological information were collected. Complications including skin necrosis and reconstruction failure were investigated as the primary outcome.

Results
Implant volume and contralateral implant volume were significantly greater in TSR group than in the single-stage reconstruction group. There were no significant differences in the incidence of complications and reconstruction failure rates between both groups. The nipple-sparing mastectomy was the risk factor for complications. Furthermore, the risk factors for mastectomy skin necrosis were implant volume and differences in the volume of both implants.

Conclusions
Single-stage reconstruction did not increase the risk of complications compared with TSR when implants that were larger than the resected tissue were inserted after mastectomy. Proper patient selection and selection of implants that are not excessively large could satisfy patients' cosmetic needs in a single operation.
Higher-Order Dynamics Beyond Repolarization Alternans in Ex-Vivo Human Ventricles are Independent of the Restitution Properties
Authors: Iravanian Shahriar , Uzelac Ilija , Shah Anand D , Toye Mikael J , Lloyd Michael S. , Burke Michael A. , Daneshmand Mani A , Attia Tamer S , Vega J David , El-Chami Michael , Merchant Faisal M. , Cherry Elizabeth M , Bhatia Neal K. , Fenton Flavio H. 
Published: August 2023

AbstractBackgroundRepolarization alternans, defined as period-2 oscillation in the repolarization phase of the action potentials, provides a mechanistic link between cellular dynamics and ventricular fibrillation (VF). Theoretically, higher-order periodicities (e.g., periods 4, 6, 8,…) are expected but have minimal experimental evidence.MethodsWe studied explanted human hearts obtained from recipients of heart transplantation at the time of surgery. Optical mapping of the transmembrane potential was performed after staining the hearts with voltage-sensitive fluorescent dyes. Hearts were stimulated at an increasing rate until VF was induced. Signals recorded from the right ventricle endocardial surface prior to induction of VF and in the presence of 1:1 conduction were processed using the Principal Component Analysis and a combinatorial algorithm to detect and quantify higher-order dynamics. Results were correlated to the underlying electrophysiological characteristics as quantified by restitution curves and conduction velocity.ResultsA prominent and statistically significant global 1:4 peak (corresponding to period-4 dynamics) was seen in three of the six studied hearts. Local (pixel-wise) analysis revealed the spatially heterogeneous distribution of periods 4, 6, and 8, with the regional presence of periods greater than two in all the hearts. There was no significant correlation between the underlying restitution properties and the period of each pixel.DiscussionWe present evidence of higher-order periodicities and the co-existence of such regions with stable non-chaotic areas in ex-vivo human hearts. We infer from the independence of the period to the underlying restitution properties that the oscillation of the excitation-contraction coupling and calcium cycling mechanisms is the primary mechanism of higher-order dynamics. These higher-order regions may act as niduses of instability that can degenerate into chaotic fibrillation and may provide targets for substrate-based ablation of VF.
The Burden of Digestive Diseases in the United States Population
Authors: Unalp-Arida Aynur , Ruhl Constance E. 
Published: August 2023

ABSTRACTBackground and rationale.Digestive diseases are common and lead to significant morbidity, mortality, and health care utilization. We used national survey and claims databases to expand on earlier findings and investigate current trends in the digestive disease burden in the United States.Methods.The National Ambulatory Medical Care Survey, Nationwide Emergency Department Sample, National Inpatient Sample, Vital Statistics of the U.S., Surveillance, Epidemiology, and End Results Program, Optum Clinformatics® Data Mart, and Centers for Medicare and Medicaid Services Medicare 5% Sample databases were used to estimate medical care, mortality, cancer incidence, and claims-based prevalence with a digestive disease diagnosis. Rates were age-adjusted (for national databases) and shown per 100,000 population.Results.For all digestive diseases, prevalence (claims-based, all-listed diagnoses) was 30.5% among commercial insurance enrollees (2020) and 53.1% among Medicare beneficiaries (2019). In the U.S. population, digestive diseases contributed to approximately 126 million ambulatory care visits (2015), 41 million emergency department visits (2018), 16 million hospital discharges (2018), and 472,000 deaths (2019) annually. Prevalence, medical care, and mortality rates with a digestive disease diagnosis were higher among children and younger adults (except for emergency department visits) and then increased with age. Women had higher prevalence and medical care rates with a digestive disease diagnosis, but mortality rates were higher among men. Prevalence and medical care rates with a digestive disease diagnosis were higher among Blacks, followed by Whites, then Hispanics, and lowest among Asians. Mortality rates were higher among Blacks compared with Whites and lower among Hispanics compared with non-Hispanics. Between 2004 and the most recent year, ambulatory care visit rates with a digestive disease diagnosis increased by 4%, hospital discharge rates decreased by 3%, and mortality rates decreased by 7%. Among commercial insurance enrollees, rates were higher compared with national data for ambulatory care visits and hospital discharges, but lower for emergency department visits. The medical care use and mortality burdens varied among individual digestive diseases.Conclusion.The digestive disease burden in the United States is substantial, particularly among Blacks and older adults.
The impact of live dietary microbes on health: a scoping review
Authors: Iyer Ajay , Mukherjee Arghya , Gómez-Sala Beatriz , O’Connor Eibhlís M. , Kenny John G. , Cotter Paul D. 
Published: August 2023

AbstractBackgroundA systematic approach to collect, peruse and summarise the available information relating to the potential benefits of consuming dietary microbes was pursued in this scoping review. This review focused on the research endpoints, experimental designs, and microbial exposure in experimental as well as observational research work.ApproachUsing a structured-set of keywords, scientific databases were systematically searched to retrieve publications reporting outcomes pertaining to the use of dietary-microbes in healthy, non-patient populations. Searches were further tailored to focus on eight different health categories, namely, “antibiotic associated diarrhoea” (AAD), “gastrointestinal health” (GIH), “immunological health” (ImH), “cardiovascular health and metabolic syndrome” (CvHMS), “cancer prevention” (CanPr), “respiratory health” (ReH), “weight management” (WtMgt), and “urogenital health” (UrGH). Quality of evidence available in each publication was assessed using the Jadad scoring system.ResultThe search yielded 228 relevant publications describing 282 experimental cases comprising 62 research endpoints overall. A microbial dose of≥2 × 109CFU·day−1was associated with non-negative reported outcomes. Older population groups with a median age of 39 years were associated with positive outcomes.ConclusionMore high-quality research is required investigating the role of dietary microbes in maintaining general health, particularly in the health categories of urogenital health, weight management and cancer prevention.
Order-of-mutation effects on cancer progression: models for myeloproliferative neoplasm
Authors: Wang Yue , Shtylla Blerta , Chou Tom 
Published: August 2023

AbstractIn some patients with myeloproliferative neoplasms (MPN), two genetic mutations are often found, JAK2 V617F and one in the TET2 gene. Whether or not one mutation is present will influence how the other subsequent mutation affects the regulation of gene expression. When both mutations are present, the order of their occurrence has been shown to influence disease progression and prognosis. We propose a nonlinear ordinary differential equation (ODE), Moran process, and Markov chain models to explain the non-additive and non-commutative mutation effects on recent clinical observations of gene expression patterns, proportions of cells with different mutations, and ages at diagnosis of MPN. These observations consistently shape our modeling framework. Our key proposal is that bistability in gene expression provides a natural explanation for many observed order-of-mutation effects. We also propose potential experimental measurements that can be used to confirm or refute predictions of our models.
Metabolomic Alterations in Crimean Congo Hemorrhagic Fever Explored Through a Nationwide Study Using NMR Spectroscopy
Authors: Göcenler Oktay , Kahraman Kerem , Yapar Derya , Kahraman Yaren , Büyükdağ Cengizhan , Esken Gülen , Ozabrahamyan Serena , Barlas Tayfun , Karadağ Yüksel , Çelikbaş Aysel Kocagül , Can Füsun , Baykam Nurcan , Kuşkucu Mert , Ergönül Önder , Dağ Çağdaş 
Published: August 2023

SUMMARYCrimean-Congo Hemorrhagic Fever (CCHF) is a severe tick-borne viral disease with high mortality rates and significant public health implications. Despite its global prevalence, the mechanisms underlying its pathogenesis remain poorly understood, and effective diagnostic and therapeutic tools are limited. Metabolomics, as a powerful tool for exploring host-pathogen interactions, offers a promising avenue for identifying biomarkers and elucidating disease mechanisms. In this study, we investigated the metabolic alterations in CCHF patients using non-targeted metabolomics to enhance understanding of disease pathogenesis, improve diagnostic capabilities, and identify potential therapeutic targets. A nationwide analysis was conducted on the blood serum of 29 CCHF patients and 10 healthy controls, employing Nuclear Magnetic Resonance (NMR) spectroscopy. Serum samples were collected over four consecutive days, and metabolic profiling was performed using Partial Least Squares Discriminant Analysis (PLS-DA) and Variable Importance in Projection (VIP) scoring to identify key metabolic pathways and compounds. Significant disruptions in metabolic pathways were observed in CCHF patients, particularly in purine and pyrimidine metabolism, the TCA cycle, and redox-related processes. Elevated levels of metabolites such as S-adenosyl homocysteine (SAH), guanosine triphosphate (GTP), inosine monophosphate (IMP), adenosine monophosphate (AMP), carnosine, 2’-deoxyuridine, nicotinamide adenine dinucleotide phosphate (NADP+), and maleate were identified. These metabolites demonstrated potential as biomarkers for disease severity and progression, with distinct metabolic profiles observed between moderate and severe cases. This study provides the first comprehensive metabolomic analysis of CCHF, highlighting critical metabolic pathways disrupted during infection. The findings underscore the utility of NMR-based metabolomics for identifying biomarkers that facilitate early diagnosis, prognosis, and therapeutic development. These results pave the way for future research to validate the identified biomarkers and explore targeted treatment strategies to improve patient outcomes in this severe viral infection.
Does fear of humans predict anti-predator strategies in an ungulate hider species during fawning?
Authors: Faull Jane , Conteddu Kimberly , Griffin Laura L. , Amin Bawan , Smith Adam F. , Haigh Amy , Ciuti Simone 
Published: August 2023

AbstractHumans are a major evolutionary force on wildlife via artificial selection. While often explored through the lens of extractive interactions (e.g., hunting) able to favour certain behavioural traits over others, the implications of non-extractive ones, such as wildlife feeding, remain under-studied. Research has recently shown that people tend to feed (and sometimes favour) a limited subset of bolder individuals within natural populations, although its dynamics and consequences are not fully clear. Using fallow deer living in a peri-urban setting as a model population, we studied whether mother deer that display reduced fear of humans and consistently approach them for food adopt weaker anti-predator strategies by selecting for fawning bedsites that are less concealed and closer to human hotspots, allowing them to take advantage of additional artificial feeding opportunities in comparison to shier mothers in this population. Our dataset encompassed 171 fawns from 109 mothers across 4 years. Contrary to our expectations, we found that mothers that regularly accepted food from humans selected for more concealed bedsites farther away from them, giving their offspring better protection while also taking advantage of additional artificial food during lactating. Our results show marked behavioural adaptation by a subset of females, making this the first time that the link between tendency to approach humans and strategies to protect offspring is explored. Given previous findings that these begging females also deliver heavier fawns at birth, our research adds a piece to the complex puzzle describing human manipulation of behaviour in natural populations and its fitness consequences.