bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric Liver Abscess: Outcomes of Protocol-based Management and Predictors of Poor Outcome
Authors: Anand Mugdha , Sahi Puneet Kaur , Mandal Anirban 
Published: April 2023

Background:
Liver abscess (LA) is an important cause of morbidity in children, especially in tropical countries. There is a paucity of data in pediatric LA with no standard guidelines regarding the best modality of treatment and drainage. With a large influx of patients at our center and protocol-based management; we aimed to study clinic-radiologic profile, risk factors, complications and outcomes of children with liver abscess and assessed possible predictors for poor outcomes.

Materials and methods:
This retrospective observational study was conducted from January 2019 to September 2019 at a tertiary care hospital in India. Records of all children (<12 years of age) with ultrasonographically diagnosed liver abscess were accessed for clinic-radiological and demographic profile, laboratory investigations, treatment, complications and outcomes. Patients were categorized into favorable or unfavorable groups based on predefined criteria and were compared for possible predictors of poor outcomes. Outcomes for the protocol-based management were analyzed.

Results:
There were 120 cases of pediatric liver abscess with a median age of 5 years at presentation. The commonest clinical features were fever (100%) and pain in the abdomen (89.16%). The majority of liver abscesses were solitary (78.4%) and in the right lobe (73.3%). Malnutrition was present in 27.5%, overcrowding for 76.5% of patients and worm infestation in 2.5% of patients. Age-related leukocytosis (P = 0.004), neutrophilia (P = 0.013), elevated Aspartate transaminase (P = 0.008), elevated alanine transaminase (P = 0.007) and hypoalbuminemia (P = 0.014) were significantly more in the unfavorable group. Overall, 29.2% of patients underwent conservative management with antibiotics alone, 25.0% underwent percutaneous needle aspiration (PNA), 49.1% underwent ultrasound-guided percutaneous drain (PCD) insertion and open surgical drainage (OSD) was needed in a single patient. The success rate was 100% for conservative management, 76.6% for PNA, 94.7% for PCD and 100% for OSD with an overall mortality of 2.5%.

Conclusions:
Age-related leukocytosis, neutrophilia, elevated aspartate transaminase or alanine transaminase and hypoalbuminemia at presentation are predictors of poor outcomes in pediatric liver abscess. Protocol-based management leads to the appropriate use of PNA and PCD while decreasing mortality and morbidity related to either.
Modern use of tranexamic acid in facial plastic surgery
Authors: Luetzenberg Friederike S. , Lyford-Pike Sofia 
Published: April 2023

Purpose of review
Although tranexamic acid is commonly used in surgical fields such as obstetrics, orthopedics, and trauma, its utilization in facial plastic surgery is a recently emerging concept, and studies examining its potential impact have been few. This review highlights how tranexamic acid may be employed during facial plastic procedures and the promising impact it may have.

Recent findings
Tranexamic acid is primarily being studied in rhinoplasties and rhytidectomies, with intravenous administration and local infiltration being the most common routs of application, respectively. During rhinoplasties, tranexamic acid has the potential to improve the visualization of the surgical field by decreasing blood loss and to improve postoperative edema and ecchymosis. For rhytidectomies, on the contrary, it may shorten time to attain hemostasis, lessen the rate of hematoma formation, and lead to lower surgical drain output. Its efficacy is preserved at low doses, and significant medication side effects have not been reported after facial plastic procedures.

Summary
Altogether, tranexamic acid may present a valuable adjuvant to facial plastic surgery, as it could increase both surgeon and patient satisfaction while exhibiting a benign safety profile.
The buried guide suture method: a novel technique to correct traumatic facial dimples
Authors: Yuan Ye , Chai Hongli , Wang Lianzhao , Yuan Li , Li Fengyong , Zhou Yu , Cao Yujiao , Liu Meichen , Li Qiang , Li Senkai 
Published: April 2023

Summary
Facial dimple, frequently following blunt trauma, presents as soft tissue depression, which is particularly apparent during facial expression. The displacement of subcutaneous tissue can be detected and measured by high-frequency ultrasound. Limited surgical methods have been applied in these closed injury cases. It is challenging to reposition the subcutaneous tissue without incisions on unscarred skin. The authors propose a novel three-dimensional technique to suture and fix the subcutaneous tissue at a distance through a concealed incision. The buried guide suture method was used in the treatment of 22 patients suffering from traumatic facial dimples on the cheek. All the patients showed great improvement in their depressed deformity with minor complications. This technique provides an option to correct soft tissue depression without leaving visible scar, especially for the mimetic rupture caused by blunt trauma.
Facial contusions occur frequently in children. Treatments for closed soft tissue injury are easily ignored due to no laceration on the epidermis. However, facial soft tissue depression might appear after the swelling subsides. It usually presents as a dimple that is not conspicuous at rest but exaggerates when patients smile or make other expressions.
Deep circumflex iliac artery flap reconstruction in Brown’s Class I defect of mandible using a three-component surgical template system
Authors: Zheng Chongyang , Xu Xiaofeng , Jiang Tengfei , Zhang Xinyu , Yin Xuelai , Yang Rong , Zhang Zhiyuan , Hu Yongjie 
Published: April 2023

Background:
Computer assisted surgery (CAS) is widely used in mandibular reconstruction, but the process is not well-described for cases using deep circumflex iliac artery (DCIA) flap as the donor site. This study aimed to present a DCIA-based three-component surgical template system (3-STS) in patients with mandibular Brown’s Class I defect.

Methods:
This retrospective cohort study compared clinical outcomes of mandibular reconstruction with DCIA flap using 3-STS or conventional surgical templates. The primary outcome of the study was the accuracy of reconstruction, and the secondary outcomes included surgical time and bone flap ischemia time. Surgery-related parameters and functional outcomes were also recorded and compared.

Results:
Forty-four patients (23 in 3-STS; 21 in control group) were included between 2015 and 2021. Compared with the control group, the 3-STS group had higher accuracy of reconstruction, indicated by lower deviation in absolute distance (1.45±0.76 mm vs 2.02±0.89 mm, P=0.034), and less deviation in coronal and sagittal angles (0.86°±0.53° vs 1.27°±0.59°, P=0.039, and 2.52°±1.00° vs 3.25°±1.25°, P=0.047) between pre- and post-operative CT imaging. Surgical time and bone flap ischemia time were significantly reduced in the 3-STS group compared with control group (median time, 385 min vs 445 min and 32 min vs 53 min, respectively; P<0.001). Additionally, masseter attachment was preserved in the 3-STS group but not the control group. No differences were found in adverse events or other clinical variables.

Conclusions:
The 3-STS can improve accuracy, simplify intra-operative procedures to increase surgical efficiency, and preserve functionality in mandibular reconstruction for Brown’s Class I defect.
Functional outcomes and associated factors of individuals with unilateral traumatic lower limb amputation in Sri Lanka: An observational study
Authors: Dasanayaka Dasanayaka Arachchillage Renuka Kusum , Patwary Fazlul Karim , van Ravensberg Clara Dorothea 
Published: April 2023

Background:
Rehabilitation is important after an amputation surgery. This study was conducted to find the level of functional outcomes of individuals with unilateral traumatic lower limb amputation and the impact of sociodemographic, amputation, and rehabilitation characteristics on functional outcomes.

Methods:
An observational cross-sectional study was conducted with 48 participants (aged 20–60 years) who visited the Center for Handicapped from across the country. Functional outcomes were measured using the Locomotor Capabilities Index, Amputee Mobility Predictor with Prosthesis, 6-minute walk distance, and spirometry test and sociodemographic, amputation, and rehabilitation characteristics using a self-constructed questionnaire.

Results:
Amputee Mobility Predictor with Prosthesis K levels showed 65% had the ability to ambulate in the community and could master environmental barriers. Locomotor Capabilities Index scores showed 96% could independently perform basic daily activities with or without using assistive devices and 83% could perform advanced daily activities. None of the individuals had achieved their predicted 6-minute walk distance, but 52% had “good and above” level of maximum oxygen consumption; restrictive respiratory pattern was indicated among 31%. Amputee Mobility Predictor with Prosthesis and Locomotor Capabilities Index scores were significantly (p < 0.005) affected by mobility hours/day, amputation level, prosthesis usage, and satisfaction. Six-minute walk distance was significantly (p < 0.005) related to income, time since amputation, duration of rehabilitation, mobility hours/day, sex, job engagement, previous job, amputation level, K levels, and satisfaction with prosthesis.

Conclusion:
Rehabilitation in Sri Lanka mainly focuses on basic walking training, not on long-term survival, distance walking, and cardiorespiratory endurance, which can lead to future comorbidities. Raising awareness in the society about rehabilitation services and more effective rehabilitation programs are recommended.
Anorexia Nervosa With Comorbid Severe Depression
Authors: Andersson Peter , Jamshidi Esmail , Ekman Carl-Johan , Tedroff Kristina , Björkander Jonnie , Sjögren Magnus , Lundberg Johan , Jokinen Jussi , Desai Boström Adrian E. 
Published: April 2023

Abstract
Major depressive disorder (MDD) is highly prevalent in individuals with anorexia nervosa (AN) and is a predictor of greater clinical severity. However, there is a limited amount of evidence supporting the use of psychotropic medications for its management. A systematic scoping review was conducted to assess the current literature on brain stimulation treatments for AN with comorbid MDD, with a specific focus on MDD treatment response and weight restoration. This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the PubMed, PsycInfo, and MEDLINE databases were searched until July 2022 using specific key words related to AN and brain stimulation treatments. A total of 373 citations were identified, and 49 treatment studies that met the inclusion criteria were included in the review. The initial evidence suggests that electroconvulsive therapy, repetitive transcranial magnetic stimulation, and deep-brain stimulation may be effective in managing comorbid MDD in AN. Emerging evidence suggests that transcranial direct current stimulation may have a positive effect on body mass index in individuals with severe to extreme AN. However, there is a need for the development of better measurement techniques for assessing the severity of depression in the context of AN. Controlled trials that are adequately designed to account for these limitations are highly warranted for deep-brain stimulation, electroconvulsive therapy, and repetitive transcranial magnetic stimulation and hold promise for providing clinically meaningful results.
Performance of ChatGPT, GPT-4, and Google Bard on a Neurosurgery Oral Boards Preparation Question Bank
Authors: Ali Rohaid , Tang Oliver Y. , Connolly Ian D. , Fridley Jared S. , Shin John H. , Zadnik Sullivan Patricia L. , Cielo Deus , Oyelese Adetokunbo A. , Doberstein Curtis E. , Telfeian Albert E. , Gokaslan Ziya L. , Asaad Wael F. 
Published: April 2023

AbstractBackgroundGeneral large language models (LLMs), such as ChatGPT (GPT-3.5), have demonstrated capability to pass multiple-choice medical board examinations. However, comparative accuracy of different LLMs and LLM performance on assessments of predominantly higher-order management questions is poorly understood.ObjectiveTo assess performance of three LLMs (GPT-3.5, GPT-4, and Google Bard) on a question bank designed specifically for neurosurgery oral boards examination preparation.MethodsThe 149-question Self-Assessment Neurosurgery Exam (SANS) Indications Exam was used to query LLM accuracy. Questions were input in a single best answer, multiple-choice format. Chi-squared, Fisher’s exact, and univariable logistic regression tests assessed differences in performance by question characteristics.ResultsOn a question bank with predominantly higher-order questions (85.2%), ChatGPT (GPT-3.5) and GPT-4 answered 62.4% (95% confidence interval [CI]: 54.1-70.1%) and 82.6% (95% CI: 75.2-88.1%) of questions correctly, respectively. In contrast, Bard scored 44.2% (66/149, 95% CI: 36.2-52.6%). GPT-3.5 and GPT-4 demonstrated significantly higher scores than Bard (bothP<0.01), and GPT-4 significantly outperformed GPT-3.5 (P=0.023). Among six subspecialties, GPT-4 had significantly higher accuracy in the Spine category relative to GPT-3.5 and in four categories relative to Bard (allP<0.01). Incorporation of higher-order problem solving was associated with lower question accuracy for GPT-3.5 (OR=0.80,P=0.042) and Bard (OR=0.76,P=0.014), but not GPT-4 (OR=0.86,P=0.085). GPT-4’s performance on imaging-related questions surpassed GPT-3.5’s (68.6% vs. 47.1%,P=0.044) and was comparable to Bard’s (68.6% vs. 66.7%,P=1.000). However, GPT-4 demonstrated significantly lower rates of “hallucination” on imaging-related questions than both GPT-3.5 (2.3% vs. 57.1%,P<0.001) and Bard (2.3% vs. 27.3%,P=0.002). Lack of question text description for imaging predicted significantly higher odds of hallucination for GPT-3.5 (OR=1.45,P=0.012) and Bard (OR=2.09,P<0.001).ConclusionOn a question bank of predominantly higher-order management case scenarios intended for neurosurgery oral boards preparation, GPT-4 achieved a score of 82.6%, outperforming ChatGPT and Google’s Bard.
Transcriptomic and metabolomic characterization of antibacterial activity ofMelastoma dodecandrum
Authors: Poh Wee Han , Ruhazat Nur Syahirah , Yang Lay Kien , Shivhare Devendra , Lim Peng Ken , Kanagasundaram Yoganathan , Rice Scott A. , Mutwil Marek 
Published: April 2023

AbstractAntibacterial resistance poses a significant global threat, necessitating the discovery of new therapeutic agents. Plants are a valuable source of secondary metabolites with demonstrated anticancer and antibacterial properties. In this study, we reveal that Melastoma dodecandrum exhibits both bacteriostatic and bactericidal effects against Pseudomonas aeruginosa and Staphylococcus aureus. Treatment with plant extracts results in membrane damage and a reduction in Pseudomonas swimming and swarming motility. A comparative analysis of bacterial transcriptomes exposed to Melastoma extracts and four distinct antibiotics indicates that the extracts trigger similar transcriptomic responses as triclosan, a fatty acid inhibitor. Activity-guided fractionation suggests that the antibacterial activity is not attributable to hydrolyzable tannins, but to unidentified minor compounds. Additionally, we identified 104 specialized metabolic pathways and demonstrated a high level of transcriptional coordination between these biosynthetic pathways and phytohormones, highlighting potential regulatory mechanisms in plant metabolism.
Using the SSVEP to measure the SNARC-spatial attention effects in a parity judgment task
Authors: Mora-Cortes A. , Gulbinaite R. , Ridderinkhof K.R. , Cohen M X. 
Published: April 2023

ABSTRACTMental representation of numbers in the brain has been described as spatially organized on what is known as the “mental number line,” with small numbers to the left and large numbers to the right. This representation leads to the “SNARC effect” (Spatial-Numerical Association of Response Codes), which refers to (1) improved behavioral performance for “congruent” conditions (e.g., left-handed response to small numbers) as compared to “incongruent” conditions (e.g., right-handed response to small numbers) and (2) perceiving numbers induces an automatic shift in covert spatial attention. Nonetheless, there is scarce physiological evidence for (or against) the prediction that number magnitude induces an automatic shift of spatial attention. Here we recorded EEG during the bimanual SNARC-parity judgment task (classifying numbers as odd or even) in attempt to find electrophysiological evidence for number-magnitude-induced automatic shifts of spatial attention. Attention was measured using the SSVEP (steady-state visual evoked potential) from four task-irrelevant flickering frequencies (two to the left: 15 and 20 Hz and two to the right: 24 and 17.14 Hz) in combination with an optimal spatial filtering method. EEG analysis was performed on the flicker frequencies closest to the fixation point: 20 and 24 Hz for the left and right visual hemifields, respectively. We replicated the expected behavioral patterns predicted by the SNARC effect, such that participants performed better for congruent conditions than on incongruent conditions. We observed significant changes in the SSVEP amplitude with respect to the baseline for the left (20 Hz) and right (24 Hz) flicker for both the congruent and incongruent conditions. Statistically significant differences between the congruent and incongruent conditions were larger for the congruent conditions for the flicker stimuli on the left. Together, these findings support the hypothesis that when numbers are part of the task, but their magnitude is not relevant, the SNARC-spatial attention effect is elicited as a cognitive effect resulting from the mental representation of numbers and its relationship with the space representation, more than merely a motor effect.
PROTHON: A Local Order Parameter-Based Method for Efficient Comparison of Protein Ensembles
Authors: Aina Adekunle , Hsueh Shawn C.C. , Plotkin Steven S. 
Published: April 2023

AbstractThe comparison of protein conformational ensembles is of central importance in structural biology. However, there are few computational methods for ensemble comparison, and those that are readily available, such as ENCORE, utilize methods that are sufficiently computationally expensive to be prohibitive for large ensembles. Here, a new method is presented for efficient representation and comparison of protein conformational ensembles. The method is based on the representation of a protein ensemble as a vector of probability distribution functions (pdfs), with each pdf representing the distribution of a local structural property such as the number of contacts between Cβatoms. Dissimilarity between two conformational ensembles is quantified by the Jensen Shannon distance between the corresponding set of probability distribution functions. The method is validated for conformational ensembles generated by molecular dynamics simulations of ubiquitin, as well as experimentally derived conformational ensembles of a 130 amino acid truncated form of human tau protein. In the ubiquitin ensemble dataset, the method was up to 88 times faster than the existing ENCORE software, while simultaneously utilizing 48 times fewer computing cores. We make the method available as a Python package, called PROTHON, and provide a GitHub page with the Python source code athttps://github.com/PlotkinLab/Prothon.
New paradigms in actomyosin energy transduction: critical evaluation of non-traditional models for orthophosphate release
Authors: Månsson Alf , Usaj Marko , Moretto Luisa , Matusovsky Oleg , Velayuthan Lok Priya , Friedman Ran , Rassier Dilson E 
Published: April 2023

AbstractRelease of the ATP hydrolysis product inorganic phosphate (Pi) from the active site of myosin is central in chemo-mechanical energy transduction and closely associated with the main force-generating structural change, the power-stroke. Despite intense investigations, the relative timing between Pi-release and the power-stroke remains poorly understood. This hampers in depth understanding of the production of force and motion by myosin in health and disease and also our understanding of myosin-active drugs. From the 1990s and up to today, models with the Pi-release either distinctly before or after the power-stroke, in unbranched kinetic schemes, have dominated the literature. However, in recent years, alternative models have emerged to explain apparently contradictory findings. Here, we first compare and critically analyze, three influential alternative models, either characterized by a branched kinetic scheme or by partial uncoupling of Pi-release and the power-stroke. Finally, we suggest critical tests of the models aiming for a unified picture.
The effects of age on neural correlates of recollection: transient versus sustained fMRI effects
Authors: Hou Mingzhu , de Chastelaine Marianne , Rugg Michael D. 
Published: April 2023

AbstractPrior fMRI findings in young adults indicate that recollection-sensitive neural regions dissociate according to the time courses of their respective recollection effects. Here, we examined whether such dissociations are also evident in older adults. Young and older participants encoded a series of word-object image pairs, judging which of the denoted objects was the smaller. At test, participants first judged whether a test word was old or new. For items judged old, they were required to recall the associated image and hold it in mind across a variable delay period. A post-delay cue denoted which of three judgments should be made on the retrieved image. Older adults demonstrated significantly lower associative memory performance than young adults. Replicating prior findings, transient recollection effects were identified in the left hippocampus, medial prefrontal cortex and posterior cingulate, while sustained effects were widespread across left lateral cortex and were also evident in the bilateral striatum. With the exception of those in the left insula, all effects were age-invariant. These findings add to the evidence that recollection-related BOLD effects in different neural regions can be temporally dissociated. Additionally, the findings suggest that both transient and sustained recollection effects are largely stable across much of the healthy adult lifespan.
Automated Protein Affinity Optimization using a 1D-CNN Deep Learning Model
Authors: McWhirter J.Liam , Mukhopadhyay Abhishek , Farber Patrick , Lakatos Greg , Dixit Surjit 
Published: April 2023

AbstractFunctional biologics design is a multi-objective optimization problem often with competing design objectives. We report on a novel deep learning based protein sequence prediction framework, ZymeSwapNet, that can be customized to handle a wide range of quantifiable design objectives, a current limitation of traditional protein design methods. We train a simple convolutional neural network (1D-CNN) on nonredundant curated protein crystal structures, using a set of geometric and topological features that describes a local protein environment, to predict the likelihood of each amino acid type for residue sites in the design region. While the model can be directly used to rank templates derived from mutagenesis campaigns, we extend the scope by developing a sequence/mutation generator that optimizes the desired multivariate distribution using a Monte-Carlo sampling. Using a case study – the design of a stable heterodimeric Fc (HetFc) antibody domain – we show that we can further include a Metropolis criterion to bias the sampling to enhance features such as the heterodimeric binding specificity, in addition to original sampling objective of enhancing stability. We demonstrate that ZymeSwapNet can generate stable HetFc designs, within minutes that had taken several rounds of rational structure and physical force-field based modeling attempts.