bluuebunny/crossref_metadata_2025_split huggingface dataset:
Standardized Calcium Replacement in Massive Transfusion: A Quality Improvement Project
Authors: Laing Marisa L. , Burtch Kimberly , Storrer Angie , McCoy Cameron 
Published: September 2023

BACKGROUND:
Hypocalcemia is common in trauma patients receiving massive transfusion protocol and often leads to worsening coagulopathies. Despite the identified problem and recommendations for replacement, few institutions have implemented a standardized calcium replacement protocol.

OBJECTIVE:
This study aims to assess whether a revised massive transfusion protocol, including standardized calcium replacement, increases the incidence of calcium administration in trauma patients receiving massive transfusion protocol.

METHODS:
This quality improvement project used a retrospective pre-/postdesign to study the revision of the current facility's massive transfusion protocol to include calcium replacement and ionized calcium monitoring at an urban Level I academic trauma center. Pre- and postintervention data were collected from January 2022 through October 2022 to determine the number of times massive transfusion protocol was ordered, ionized calcium monitoring, and calcium administration rates. Feedback regarding the protocol was collected throughout the monitoring period and was utilized in the final analysis.

RESULTS:
A total of 40 patients received massive transfusion protocol, preintervention, 18 of 23 (78%) received calcium supplementation, postintervention, 15 of 16 (98%) were treated. The majority of protocol activations occurred in the trauma bay (79%) and postintervention; ionized calcium monitoring dropped by 14%.

CONCLUSION:
This study found that the addition of standardized calcium replacement improved administration rates of calcium in this patient population. Ongoing research will ensure the recommended changes improve the identified shortcomings and that patients maintain adequate ionized calcium levels with the current dosing parameters.
Genetic therapies in cystic fibrosis
Authors: Taylor-Cousar Jennifer L. , Boyd A. Christopher , Alton Eric W.F.W. , Polineni Deepika 
Published: September 2023

Purpose of review
Advances in cystic fibrosis (CF) therapies over the past decade pivotally changed the morbidity and mortality of CF with the advent of cystic fibrosis transmembrane conductance regulator (CFTR) modulators that rescue dysfunctional CFTR protein in individuals with eligible genotypes. However, a significant proportion of the CF population is in need of alternative treatment strategies to address CFTR variants that are ineligible for therapeutic protein correction and/or potentiation. Current drug development efforts of nucleic-acid based therapies (i.e., DNA and RNA based therapies) in CF are informed by historic challenges of CF gene therapy trials, recent FDA guidance informed by non-CF gene therapy trials, and advances in therapeutic applications related to severe acute respiratory syndrome coronavirus 2 vaccine development. These historic and timely developments are of significant relevance for advancing genetic therapies in CF.

Recent findings
This article reviews the main themes of semi-permanent genetic therapy strategies covering recent literature focused on: adenovirus and adeno-associated virus vector delivery, advances in lentivirus vector use and safety considerations, mRNA delivery and antisense oligonucleotide drug development.

Summary
Currently, drug development and clinical trials for genetic therapies in CF are rapidly progressing. This review aims to increase the foundational knowledge of CF genetic therapies.
Brain 18F-FET in a Case of Acute Myeloid Leukemia
Authors: Castello Angelo , Crosta Giacomo , Pacella Sara , Florimonte Luigia , Castellani Massimo 
Published: September 2023

Abstract
A 58-year-old woman, with a history of acute myeloid leukemia in complete response, was referred to the emergency department of our hospital for loss of consciousness. A brain MRI showed an intracranial mass suggestive for either primary brain tumor or brain metastasis. 18F-FET PET/CT revealed increased uptake of the lesion. Metastasis from acute myeloid leukemia was diagnosed after brain biopsy. Whole-body 18F-FDG PET/CT did not demonstrate other abnormal foci of 18F-FDG accumulation, whereas brain lesion had an uptake slightly below the adjacent brain.
Superior Identification of Metastatic Lesions by 68Ga-FAPI-46 to 18F-FDG PET/CT in a Case of SMARCA4-Deficient Undifferentiated Carcinoma of Stomach
Authors: Pang Yizhen , Cai Jiayu , Zhao Liang , Xu Weizhi , Chen Haojun 
Published: September 2023

Abstract
SMARCA4-deficient undifferentiated carcinoma is a new clinical entity characterized by SMARCA4 inactivation and has a dismal prognosis because of rapid growth. In this case, we reported 18F-FDG and 68Ga-FAPI-46 PET/CT imaging findings in a patient with SMARCA4-deficient undifferentiated carcinoma of stomach. 68Ga-FAPI-46 PET/CT showed much higher tumor-to-background contrast of primary tumor and revealed more metastatic lesions than 18F-FDG PET/CT. This case demonstrated the superiority of 68Ga-FAPI PET/CT over 18F-FDG for identifying both primary and metastatic lesions in SMARCA4-deficient undifferentiated carcinoma. This observation may add the information on the benefit of FAPI PET in oncology imaging.
Application of Modified V-Y Advancement Flap in Alar Base Reduction
Authors: Xu Yihao , Fan Fei , You Jianjun , Zheng Ruobing , Wu Lehao , Zhang Xulong , Tian Le , Guo Junsheng , Wang Huan 
Published: September 2023

Background:
A variety of techniques for alar base modification have been described in the literature. Limitations of these techniques include scars, recurrence, asymmetry, etc. An incorrect excision of the lateral alar wall can result in a tear-drop or Q-shaped deformity.

Objectives:
In this study, a modified V-Y advancement flap will be introduced that will avoid the complications discussed above as well as adjust the positional relationship between the nasal alar and the columella using this technique. In addition, this method is reversible; once the nostril is narrow due to excessive advancement of the flap, the reverse V-Y advancement method can be used to enlarge the nostril.

Methods:
In this study, a retrospective review of wide nasal bases in the past 3 years was conducted. A blind analysis of anthropometric points was conducted. There were 3 outcome variables: the width of the alar base, the width of the flare, and the distance between the alar base and columellar base.

Results:
The alar base was reduced with a modified V-Y advancement flap on 65 female patients ranging from 18 to 45 years of age. In 10 cases, an “Inclined Y-arm flap” was used to narrow alar bases and adjust columella-alar positions. In the remaining cases, a “Horizontal Y-arm flap” was performed to narrow the simple nasal alar width. In all cases, the nasal base was reduced without distortion. In the postoperative period, all the effects were seen to persist for a long time, and patients were generally satisfied with the results of the procedure.

Conclusion:
By using this modified V-Y advancement flap technique, the incision can be concealed as thoroughly as possible, thereby avoiding “tear-drop” or “Q” deformities as well as narrowing the nasal alar effectively. Furthermore, this method, in combination with rhinoplasty surgery, will greatly enhance the nasal appearance.
Association of fibrinolysis phenotype with patient outcomes following traumatic brain injury
Authors: Durbin Samantha , Brito Alexandra , Johnson Alicia , Cotton Bryan , Rowell Susan , Schreiber Martin A. 
Published: September 2023

BACKGROUND
Impaired coagulation is associated with elevated risk of mortality in trauma patients. Prior studies have demonstrated increased mortality in patients with hyperfibrinolysis (HF) and fibrinolysis shutdown (SD). In addition, prior studies have demonstrated no effect of tranexamic acid (TXA) on fibrinolysis phenotypes. We examined the association of admission fibrinolysis phenotype with traumatic brain injury (TBI) patient outcomes.

METHODS
Data were extracted from a placebo-controlled multicenter clinical trial. Patients ≥15 years with TBI (Glasgow Coma Scale score, 3–12) and systolic blood pressure ≥90 mm Hg were randomized in the out-of-hospital setting to receive placebo bolus/placebo infusion (Placebo), 1 gram (g) TXA bolus/1 g TXA infusion (bolus maintenance [BM]); or 2 g TXA bolus/placebo infusion (bolus only [BO]). Fibrinolysis phenotypes on admission were determined by clot lysis at 30 minutes (LY30): SD, ≤0.8%; physiologic, 0.9% to 2.9%; HF, ≥3%. Logistic regression was used to control for age, sex, penetrating injury, Injury Severity Score, maximum head AIS, and TXA treatment group.

RESULTS
Seven hundred forty-seven patients met inclusion criteria. Fibrinolysis shutdown was the most common phenotype in all treatment groups and was associated with increased age, Injury Severity Score, and presence of intracranial hemorrhage (ICH). Inpatient mortality was 15.2% for SD and HF, and 10.6% for physiologic (p = 0.49). No differences in mortality, disability rating scale at 6 months, acute kidney injury, acute respiratory distress syndrome, or multi-organ failure were noted between fibrinolysis phenotypes.

CONCLUSION
SD is the most common phenotype expressed in moderate to severe TBI. In TBI, there is no association between fibrinolysis phenotype and mortality or other major complications.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level IV.
Self-expanding foam versus preperitoneal packing for exsanguinating pelvic hemorrhage
Authors: King David Richard , Hwabejire John O. , Pham Quynh P. , Elsharkawy Ahmed E. , Eid Ahmed I. , Duggan Michael J. , Gelsinger Shawn , Fornaciari Michael , Sharma Upma 
Published: September 2023

BACKGROUND
Mortality for pelvic fracture patients presenting with hemorrhagic shock ranges from 21% to 57%. The objective of this study was to develop a lethal and clinically relevant pelvic hemorrhage animal model with and without bony fracture for evaluating therapeutic interventions. ResQFoam is a self-expanding foam that has previously been described to significantly decrease mortality in large-animal models of abdominal exsanguination. We hypothesized that administration of ResQFoam into the preperitoneal space could decrease mortality in exsanguinating pelvic hemorrhage.

METHODS
Two pelvic hemorrhage models were developed using noncoagulopathic swine. Pelvic hemorrhage model 1: bilateral, closed-cavity, major vascular retroperitoneal hemorrhage without bony pelvic fracture. After injury, animals received no treatment (control, n = 10), underwent preperitoneal packing using laparotomy pads (n = 11), or received ResQFoam (n = 10) injected into the preperitoneal space. Pelvic hemorrhage model 2: unilateral, closed-cavity, retroperitoneal hemorrhage injury (with intraperitoneal communication) combined with complex pelvic fracture. After injury, animals received resuscitation (control, n = 12), resuscitation with preperitoneal packing (n = 10) or with ResQFoam injection (n = 10) into the preperitoneal space.

RESULTS
For model 1, only ResQFoam provided a significant survival benefit. The median survival times were 50 minutes and 67 minutes for preperitoneal packing and ResQFoam, compared with 6 minutes with controls (p = 0.002 and 0.057, respectively). Foam treatment facilitated hemodynamic stabilization and resulted in significantly less hemorrhage (21.5 ± 5.3 g/kg) relative to controls (31.6 ± 5.0 g/kg, p < 0.001) and preperitoneal packing (32.7 ± 5.4 g/kg, p < 0.001). For model 2, both ResQFoam and preperitoneal packing resulted in significant survival benefit compared with controls. The median survival times were 119 minutes and 124 minutes for the preperitoneal packing and ResQFoam groups, compared with 4 minutes with controls (p = 0.004 and 0.013, respectively).

CONCLUSION
Percutaneous injection of ResQFoam into the preperitoneal space improved survival relative to controls, and similar survival benefit was achieved compared with standard preperitoneal pelvic packing. The technology has potential to augment the armamentarium of tools to treat pelvic hemorrhage.
Computational synthesis of wheeled vehicles via multi-layer topology optimization
Authors: James Kai A. , Kelley Patrick L. , Kang Ziliang , Bhattacharyya Anurag , Alacoque Lee R. 
Published: September 2023

In current engineering practice, computer-aided design (CAD) tools play a key role in the design and fabrication of most mechanical systems, including the design of most vehicles. This software tends to rely heavily on human designers to provide the basic design concept, with the software being used to computationally render an existing design, or to perform modifications to a design to achieve incremental improvements in performance. However, an emerging class of computational methods, known astopology optimizationmethods, offers the potential for trueblack boxcomputational design. Under this general framework, practitioners provide the algorithm with the constitutive properties of the design materials, and the mechanical function being designed for (e.g. maximum stiffness under a given loading condition), and the algorithm autonomously generates a description of the corresponding structure. With some exceptions, existing topology optimization methods are limited to generating static, single-body designs. In this study, we present a novel method that builds upon the current state of the art by combining multiple collocated planar design domains to achieve automated computational synthesis of multi-body wheeled vehicles. This capability represents an important step on the path toward automated computational design of increasingly complex, innovative and impactful mechanical systems.
Edge resonance: exact results and fresh insights
Authors: Lawrie Jane B. 
Published: September 2023

The eigensystem underpinning the classical edge resonance phenomenon in linear elasticity is studied. Several exact results are presented, the most significant being an identically zero sum demonstrating the linear dependence of the stresses. An exact condition for edge resonance is derived. This is cast into a form that is independent of the Lamb modes, robust and highly convergent, enabling the system to be explored by varying Poisson’s ratio (PR) or frequency. An improved estimate of the value of PR for real resonance is determined, as is the non-Lamé frequency corresponding to resonance when PR is zero. Quasi-resonances are explored. It is demonstrated that, for fixed PR, these occur at more than one frequency, and that they occur for negative PR. It is shown that quasi-resonances are associated with one of two distinct families of complex resonances: real PR and complex frequency or real frequency and complex PR. Higher Lamé frequencies are considered. It is demonstrated that a real pure shear resonance exists at the second Lamé frequency when PR is zero. The corresponding edge displacement is simple in form, and it is anticipated that such resonances exist at every Lamé frequency. Finally, point-wise convergence for Lamb-mode eigenfunction expansions is established.
ENQUIRE RECONSTRUCTS AND EXPANDS CONTEXT-SPECIFIC CO-OCCURRENCE NETWORKS FROM BIOMEDICAL LITERATURE
Authors: Musella Luca , Lai Xin , Widmann Max , Vera Julio 
Published: September 2023

ABSTRACTThe accelerating growth of scientific literature overwhelms our capacity to manually distil complex phenomena like molecular networks linked to diseases. Moreover, biases in biomedical research and database annotation limit our interpretation of facts and generation of hypotheses. ENQUIRE (Expanding Networks by Querying Unexpectedly Inter-Related Entities) offers a time- and resource-efficient alternative to manual literature curation and database mining. ENQUIRE reconstructs and expands co-occurrence networks of genes and biomedical ontologies from user-selected input corpora and network-inferred PubMed queries. The integration of text mining, automatic querying, and network-based statistics mitigating literature biases makes ENQUIRE unique in its broad-scope applications. For example, ENQUIRE can generate co-occurrence gene networks that reflect high-confidence, functional networks. When tested on case studies spanning cancer, cell differentiation and immunity, ENQUIRE identified interlinked genes and enriched pathways unique to each topic, thereby preserving their underlying diversity. ENQUIRE supports biomedical researchers by easing literature annotation, boosting hypothesis formulation, and facilitating the identification of molecular targets for subsequent experimentation.GRAPHICAL ABSTRACT
Genome-wide patterns of homoeologous gene flow in allotetraploid coffee
Authors: Ortiz Andre J. , Sharbrough Joel 
Published: September 2023

ABSTRACTPremiseAllopolyploidy – a hybridization-induced whole-genome duplication event – has been a major driver of plant diversification. The extent to which chromosomes pair with their proper homolog vs. with their homoeolog in allopolyploids varies across taxa, and methods to detect homoeologous gene flow (HGF) are needed to understand how HGF has shaped polyploid lineages.MethodsThe ABBA-BABA test represents a classic method for detecting introgression between closely related species, but here we developed a modified use of the ABBA-BABA test to characterize the extent and direction of HGF in allotetraploidCoffea arabica.ResultsWe found that HGF is abundant in theC. arabicagenome, with both subgenomes serving as donors and recipients of variation. We also found that HGF is highly maternally biased in plastid-targeted – but not mitochondrial-targeted – genes, as would be expected if plastid-nuclear incompatibilities exist between the two parent species.DiscussionTogether our analyses provide a simple framework for detecting HGF and new evidence consistent with selection favoring overwriting of paternally derived alleles by maternally derived alleles to ameliorate plastid-nuclear incompatibilities. Natural selection therefore appears to shape the direction and intensity of HGF in allopolyploid coffee, indicating that cytoplasmic inheritance has long-term consequences for polyploid lineages.
Neurotransmitter signaling specifies sweat gland stem cell fate through SLN-mediated intracellular calcium regulation
Authors: Remark Juliana , Tong Jie , Lin Meng Ju , Concepcion Axel , Mareedu Satvik , Babu Gopal J , Feske Stefan , Lu Catherine P. 
Published: September 2023

AbstractSympathetic nerves co-develop with their target organs and release neurotransmitters to stimulate their functions after maturation. Here, we provide the molecular mechanism that during sweat gland morphogenesis, neurotransmitters released from sympathetic nerves act first to promote sweat duct elongation via norepinephrine and followed by acetylcholine to specify sweat gland stem cell fate, which matches the sequence of neurotransmitter switch. Without neuronal signals during development, the basal cells switch to exhibit suprabasal (luminal) cell features. Sarcolipin (SLN), a key regulator of sarcoendoplasmic reticulum (SR) Ca2+-ATPase (SERCA), expression is significantly down-regulated in the sweat gland myoepithelial cells upon denervation. Loss of SLN in sweat gland myoepithelial cells leads to decreased intracellular Ca2+over time in response to ACh stimulation, as well as upregulation of luminal cell features. In cell culture experiments, we showed that contrary to the paradigm that elevation of Ca2+promote epidermal differentiation, specification of the glandular myoepithelial (basal) cells requires high Ca2+while lowering Ca2+level promotes luminal (suprabasal) cell fate. Our work highlights that neuronal signals not only act transiently for mature sweat glands to function, but also exert long-term impact on glandular stem cell specification through regulating intracellular Ca2+dynamics.
SOX4-SMARCA4 complex promotes glycolysis-dependent TNBC cell growth through transcriptional regulation of Hexokinase 2
Authors: Khanna Pooja , Mehta Rushabh , Mehta Gaurav A. , Bhatt Vrushank , Guo Jessie Y. , Gatza Michael L. 
Published: September 2023

ABSTRACTTumor cells rely on increased glycolytic capacity to promote cell growth and progression. While glycolysis is known to be upregulated in the majority of triple negative (TNBC) or basal-like subtype breast cancers, the mechanism remains unclear. Here, we used integrative genomic analyses to identify a subset of basal-like tumors characterized by increased expression of the oncogenic transcription factor SOX4 and its co-factor the SWI/SNF ATPase SMARCA4. These tumors are defined by unique gene expression programs that correspond with increased tumor proliferation and activation of key metabolic pathways, including glycolysis. Mechanistically, we demonstrate that the SOX4-SMARCA4 complex mediates glycolysis through direct transcriptional regulation of Hexokinase 2 (HK2) and that aberrant HK2 expression and altered glycolytic capacity are required to mediate SOX4-SMARCA4-dependent cell growth. Collectively, we have defined the SOX4-SMARCA4-HK2 signaling axis in basal-like breast tumors and established that this axis promotes metabolic reprogramming which is required to maintain tumor cell growth.
Understanding the Impacts and Perceptions of Alcohol Use in Northern Tanzania: A Mixed-Methods Analysis
Authors: Pauley Alena , Metcalf Madeline , Buono Mia , West Kirstin , Rent Sharla , Nkenguye William , Sawe Yvonne , Mikindo Mariana , Kilasara Joseph , Mchome Bariki , Mmbaga Blandina T. , Nickenig Vissoci João Ricardo , Staton Catherine A. 
Published: September 2023

AbstractBackgroundWorldwide, alcohol is a leading risk factor for death and disability. Tanzania has particularly high rates of consumption and few resources dedicated to minimizing alcohol-related harm. Ongoing policy efforts are hampered by dynamic sociocultural, economic, and regulatory factors contributing to alcohol consumption. Through the voices of Kilimanjaro Christian Medical Center (KCMC) patients and a gender-focused lens, the goal of this project was to investigate community perceptions surrounding alcohol and the impact of its use in this region.MethodsThis was a mixed-methods study conducted at KCMC between October 2021 and May 2022. 678 adult (≥18 years old) Kiswahili-speaking patients who presented to KCMC’s Emergency Department (ED) or Reproductive Health Clinic (RHC) were enrolled through systematic random sampling to participate in quantitative surveys. Nineteen participants were selected for in-depth interviews (IDIs) through purposeful sampling. The impact and perceptions of alcohol use were measured through Drinkers’ Inventory of Consequences (DrInC) scores analyzed in R Studio through descriptive proportions, and IDI responses explored through a grounded theory approach utilizing both inductive and deductive coding methodologies.ResultsED men were found to have the highest average [SD] DrInC scores (16.4 [19.6]), followed by ED women (9.11 [13.1]), and RHC women (5.47 [9.33]), with higher scores indicating greater perceived consequences. Participants noted alcohol has both perceived advantages and clear harms within their community. Increased conflict, long-term health outcomes, financial instability, stigma, and sexual assault were seen as negative consequences. Benefits were primarily identified for men and included upholding cultural practices, economic growth, and social unity. Physical and financial harm from alcohol impacted both genders, however, alcohol-related stigma and sexual assault were found to disproportionately affect women.ConclusionOur findings suggest that perceptions around drinking and alcohol’s social and physical consequences differ significantly by gender. To effectively minimize local alcohol-related harm, future alcohol-focused research and policy efforts should consider the distinct impacts alcohol has between genders.