bluuebunny/crossref_metadata_2025_split huggingface dataset:
Free Flap Reconstruction of Recalcitrant Defects in Cleft Palate Patients
Authors: Gur Ersin , Tiftikcioglu Yigit Ozer 
Published: March 2023

Introduction:
Defects of the palate can be as a result of oronasal fistula of cleft patients and the ablative surgery of tumors. There are many studies about reconstruction of the defects of plate in the literature and most of them are related to tumor surgery. Despite the use of free flaps in cleft patients being not a new approach, the articles in the literature are very few. The authors describe the experience of oronasal fistula reconstructions with free flaps with a new modification of tensionless inset of the free flap’s pedicle.

Patients and Methods:
Between 2019 and 2022, 2 males and 1 female, 3 consecutive cleft patients underwent free flap surgery because of recalcitrant palatal defects. One patient had 5 and each of remain had 3 unsuccessful reconstructive attempts previously. The age of patients was ranged from 20 to 23 years old. Radial forearm flap was the option of oral lining reconstruction for all patients. In 2 patients, the flap was modified as a skin tail was linked to the flap for covering the pedicle as tensionless closure.

Results:
There was a mucosal swelling in first patient who underwent classical pedicle inset as mucosal tunneling. In 1 patient there was a spontaneous bleeding from the anterior side of the flap and it stopped without medical interventions, spontaneously. There was no additional complication. All flaps survived without anastomosis problems.

Conclusion:
Incision of the mucosa rather than tunneling provides good surgical exposure and bleeding control and modified flap design may be beneficial and reliable for tensionless pedicle inset and covering.
Understanding the burden of traumatic injuries at the United States–Mexico border: A scoping review of the literature
Authors: Keller Benjamin A. , Skubic Jeffrey , Betancourt-Garcia Monica , Ignacio Romeo C. , Radowsky Jason S. , Tyroch Alan H. , Lascano Carlos Palacio , Joseph Bellal , Stewart Collin , Moore Forrest O. , Costantini Todd W. , Rizzo Julie A. , Paul Jasmeet S. , Galindo Roger M. , Silva Aaron , Coimbra Raul , Berndtson Allison E. 
Published: March 2023

ABSTRACT
The US-Mexico border is the busiest land crossing in the world and faces continuously increasing numbers of undocumented border crossers. Significant barriers to crossing are present in many regions of the border, including walls, bridges, rivers, canals, and the desert, each with unique features that can cause traumatic injury. The number of patients injured attempting to cross the border is also increasing, but significant knowledge gaps regarding these injuries and their impacts remain. The purpose of this scoping literature review is to describe the current state of trauma related to the US-Mexico border to draw attention to the problem, identify knowledge gaps in the existing literature, and introduce the creation of a consortium made up of representatives from border trauma centers in the Southwestern United States, the Border Region Doing Research on Trauma Consortium. Consortium members will collaborate to produce multicenter up-to-date data on the medical impact of the US-Mexico border, helping to elucidate the true magnitude of the problem and shed light on the impact cross-border trauma has on migrants, their families, and the US health care system. Only once the problem is fully described can meaningful solutions be provided.
Electroencephalography Findings in Wrong Way Eyes: Unilateral Hemispheric Dysfunction Supporting Smooth Pursuit Asymmetry Hypothesis
Authors: Gilani Kia , Tyndel Felix J. , Wennberg Richard A. 
Published: March 2023

Background:
Conjugate horizontal eye deviation away from the side of the lesion, termed Wrong Way Eyes (WWE), is a rare manifestation of supratentorial lesions. The proposed etiologic hypotheses include seizure activity, compression of contralateral horizontal gaze pathways from mass effect or midline shift, and asymmetry of hemispheric smooth pursuit mechanisms. We present neurophysiological evidence that favors the asymmetry of hemispheric smooth pursuit hypothesis.

Methods:
Electroencephalography (EEG) was performed in 2 patients with large left hemispheric supratentorial lesions, capturing fluctuating periods of (a) unresponsiveness with WWE and (b) relative alertness without WWE. One patient had 5 days of continuous EEG, and the other routine EEG.

Results:
Neither patient had seizures. EEG showed normal right hemispheric activity during both unresponsiveness with WWE and alertness without WWE states. By contrast, more severe left hemispheric dysfunction was evident in the WWE state compared with the non-WWE state in both patients. In one patient, during the relatively alert state, right-beating nystagmus was observed, and drift of the eyes away from the side of the lesion was reliably seen to occur on eyelid closure and after ipsiversive volitional saccades.

Conclusions:
Seizure activity does not account for WWE. Compression of contralateral horizontal gaze pathways is also unlikely to account for WWE as that hypothetical mechanism should produce EEG abnormalities over the nonlesioned hemisphere, which were not seen. The findings suggest instead that a single dysfunctional hemisphere is sufficient to produce WWE. The repeated rightward drift of the eyes and nystagmus seen in one patient during relative alertness, and the observation of unilateral hemispheric dysfunction on EEG during unresponsiveness with WWE in both patients supports the idea that an imbalance of smooth pursuit mechanisms is most likely to account for this rare phenomenon.
MRI Signal Intensity Varies Along the Course of the Normal Optic Nerve
Authors: Prairie Michael L. , Gencturk Mehmet , Lindgren Bruce R. , McClelland Collin M. , Lee Michael S. 
Published: March 2023

Background:
MRI can help distinguish various causes of optic neuropathy including optic neuritis. Importantly, neuromyelitis optica spectrum disorder (NMOSD) has a propensity to cause enhancement of the prechiasmatic optic nerves. To determine whether the prechiasmatic optic nerve (PC-ON) demonstrates a different intensity from the midorbital optic nerve (MO-ON) on MRI among patients without optic neuropathy.

Methods:
Data were retrospectively obtained from 75 patients who underwent brain MRI for an ocular motor nerve palsy between January 2005 and April 2021. Inclusion criteria were patients aged 18 years or older with visual acuities of at least 20/25 and no evidence of optic neuropathy on neuro-ophthalmic examination. A total of 67 right eyes and 68 left eyes were assessed. A neuroradiologist performed quantitative intensity measurements of the MO-ON and PC-ON on precontrast and postcontrast T1 axial images. Normal-appearing temporalis muscle intensity was also measured and used as a reference to calculate an intensity ratio to calibrate across images.

Results:
The mean PC-ON intensity ratio was significantly higher than the MO-ON intensity ratio on both precontrast (19.6%, P < 0.01) and postcontrast images (14.2%, P < 0.01). Age, gender, and laterality did not independently affect measurements.

Conclusions:
The prechiasmatic optic nerve shows brighter intensity ratios on both precontrast and postcontrast T1 images than the midorbital optic nerve among normal optic nerves. Clinicians should recognize this subtle signal discrepancy when assessing patients with presumed optic neuropathy.
Objective Diagnosis of Circadian Rhythm Disorders
Authors: Giordano Alessandra , Duffy Jeanne , Epstein Lawrence J. , Pavlova Milena K. 
Published: March 2023

Summary:
Circadian sleep–wake disorders are common. Because they represent conflict between the timing of the patient's endogenous rhythms and desired timing of sleep, the presenting complaints may include both difficulty of sleep initiation or maintenance and undesired or unplanned daytime or early evening sleepiness. Therefore, circadian disorders may be misdiagnosed as either a primary insomnia or a hypersomnia disorder, depending on which complaint is more troublesome for the patient. Objective information about sleep and wake patterns over long periods is crucial for accurate diagnosis. Actigraphy provides long-term information about the rest/activity pattern about an individual. However, caution should be applied in interpretation of the results because the information provided only includes information of movements, and activity is only an indirect circadian phase marker. Timing of light and melatonin therapy is critical for successful treatment of circadian rhythm disorders. Therefore, results of actigraphy are useful and should be used in conjunction with additional measurements, including 24 hours sleep–wake history, sleep log, and melatonin measurements.
Turn-taking in human face-to-face interaction is multimodal: gaze direction and manual gestures aid the coordination of turn transitions
Authors: Kendrick Kobin H. , Holler Judith , Levinson Stephen C. 
Published: March 2023

Human communicative interaction is characterized by rapid and precise turn-taking. This is achieved by an intricate system that has been elucidated in the field of conversation analysis, based largely on the study of the auditory signal. This model suggests that transitions occur at points of possible completion identified in terms of linguistic units. Despite this, considerable evidence exists that visible bodily actions including gaze and gestures also play a role. To reconcile disparate models and observations in the literature, we combine qualitative and quantitative methods to analyse turn-taking in a corpus of multimodal interaction using eye-trackers and multiple cameras. We show that transitions seem to be inhibited when a speaker averts their gaze at a point of possible turn completion, or when a speaker produces gestures which are beginning or unfinished at such points. We further show that while the direction of a speaker's gaze does not affect the speed of transitions, the production of manual gestures does: turns with gestures have faster transitions. Our findings suggest that the coordination of transitions involves not only linguistic resources but also visual gestural ones and that the transition-relevance places in turns are multimodal in nature.
This article is part of a discussion meeting issue ‘Face2face: advancing the science of social interaction’.
Evaluation of Triglyceride-Glucose Index as a Marker for Severity in New Onset Diabetes in Patients of COVID-19 Pneumonia- a Single Center Study
Authors: Ashraf Faiza , Mehmood Majid , Aurang Zeb Mohammad , Rehman Jehanzeb ur , Siddiqui Fariha Masood 
Published: March 2023

IntroductionSevere Acute Respiratory Syndrome Coronavirus-2 (SARS CoV 2) Covid-19 is responsible for the pandemic affecting the world population since 2019. Starting from Wuhan, China enveloped the globe within a few months. It affected the healthy population, but played havoc in terms of mortality and morbidity for old and diseased populations. Diabetes is a known condition putting patients at high risk of complications, resulting from metabolic syndrome-derived impaired immune responses. The world is still grappling with the challenge of managing diabetic patients with covid pneumonia and newly added Diabetics resulting from post covid complications driven by Covid-19-induced damage to pancreatic beta cells. Resulting in worsening of existing Diabetic control and new onset Diabetes (NOD) in susceptible individuals. The TYG (Triglyceride-Glucose Index) may serve as a marker to identify patients at risk of developing a serious illnessHypothesisTriglyceride Glucose Index is a marker for severity of Covid-19 and new onset of diabetes.Aim To evaluate role of TYG index in prediction of new onset of Diabetes mellitus in Covid-19 patients and as a marker for disease severity in diabetic Covid-19 patients.MethodologyThis cross-sectional study was carried out in Combined Military Hospital (CMH) Rawalakot. Covid-19 patients' diagnosis was confirmed by RT-PCR. Glycosylated hemoglobin (HBA1c), fasting glucose and Triglycerides (TG) were performed at the biochemistry lab using SELECTRA chemical analyzer. TYG index was calculated and related with clinical symptoms of patients.ResultsA total of 2974 samples has been tested by RT-PCR. Three hundred and ninety-three (13%) were positive for COVID-19 infection. Twenty-one patients (5%) developed new-onset Diabetes (NOD) during the COVID infection. A TYG index of 43 people affected with COVID-19 (21 NOD and 22 non-diabetic individuals (control group) was calculated as a marker of severity index. It was found that the higher TYG was associated with severity and mortality in patients with COVID-19 diabetes. ConclusionCovid-19 infection is associated with worsening disease in preexisting diabetic patients and is responsible for new-onset Diabetes in patients. TYG index correlates directly with the severity of Covid-19. TYG index can be used as a predictor marker for mortality and morbidity in Covid-19.
Exploring the Interplay between BOLD Signal Variability, Complexity, and Static and Dynamic Functional Brain Network Features during Movie Viewing
Authors: Ghaderi Amir Hossein , Wang Hongye , Protzner Andrea 
Published: March 2023

AbstractAs the brain is dynamic and complex, knowledge of brain signal variability and complexity is crucial in our understanding of brain function. Recent resting-fMRI studies revealed links between BOLD signal variability or complexity with static/dynamics features of functional brain networks (FBN). However, no study has examined the relationships between these brain metrics. The association between brain signal variability and complexity is still understudied. Here we investigated the association between movie naturalistic-fMRI BOLD signal variability/complexity and static/dynamic FBN features using graph theory analysis. We found that variability positively correlated with fine-scale complexity but negatively correlated with coarse-scale complexity. Hence, variability and coarse-scale complexity correlated with static FC oppositely. Specifically, regions with high centrality and clustering coefficient were related to less variable but more complex signal. Similar relationship persisted for dynamic FBN, but the associations with certain aspects of regional centrality dynamics became insignificant. Our findings demonstrate that the relationship between BOLD signal variability, static/dynamic FBN with BOLD signal complexity depends on the temporal scale of signal complexity. Additionally, altered correlation between variability and complexity with dynamic FBN features may indicate the complex, time-varying feature of FBN and reflect how BOLD signal variability and complexity co-evolve with dynamic FBN over time.
Defining Destigmatizing Design Guidelines for Use in Sexual Health-Related Digital Technologies: A Delphi Study
Authors: Abdulai Abdul-Fatawu , Howard A.Fuchsia , Yong Paul J. , Currie Leanne M. 
Published: March 2023

AbstractObjectiveStigma has been recognized as a significant issue in sexual health, yet no specific guidelines exist to support digital health development teams in creating stigma-alleviating sexual health digital platforms. The purpose of this study was to develop a set of design guidelines that would serve as a reference point for addressing stigma during the design of sexual health-related digital platforms.Materials and MethodsWe conducted a 3-round Delphi study among 14 researchers in stigma and sexual health. A preliminary list of 28 design guidelines was generated from a literature review. Participants appraised and critiqued the clarity and usefulness of the preliminary list and provided comments for each item and for the overall group of items at each round. At each round, a content validity index and an interquartile range were calculated to determine the level of consensus regarding the clarity and usefulness of each guideline. Items were retained if there was high consensus and discarded if there was no consensus after the three rounds.ResultsNineteen design guidelines achieved consensus. Most of them were content-related guidelines and sought to address the emotional concerns of patients that could potentially aggravate stigma. The findings also reflected modern stigma management strategies of making stigma a societal attribute by challenging, exposing, and normalizing stigma attributes via web platforms.ConclusionTo address stigma via digital platforms, developers should not just concentrate on technical solutions but seriously consider content-related and emotional design components that are likely to result in stigma
Perinatal SSRI Exposure Impacts Innate Fear Circuit Activation and Behavior in Mice and Humans
Authors: Zanni Giulia , Van Dijk Milenna , Cagliostro Martha Caffrey , Stevens Gregory S. , Pini Nicolò , Rose Ariel L. , Kesin Alexander L. , Lugo-Candelas Claudia , Goncalves Priscila Dib , MacKay Alexandra S. , Kulkarni Praveen , Ferris Craig F. , Weissman Myrna M. , Talati Ardesheer , Ansorge Mark S. , Gingrich Jay A. 
Published: March 2023

AbstractSerotonin shapes brain structure and function during early development across phylogenetically diverse species. In mice and humans, perinatal SSRI exposure produces brain alterations and increases anxiety/depression-related behaviors in the offspring. It remains unclear whether shared brain circuit changes underlie the behavioral impact of perinatal SSRIs across species. We examine how developmental SSRI-exposure in mice and humans changes fear-related brain activation and behavior. SSRI-administered mice showed increased defense responses to a predator odor that were associated with stronger fMRI-based fear circuit activation when compared to saline controls. Similarly, human adolescents exposed to SSRIsin uteroshowed greater activation of fear brain structures and exhibited higher anxiety and depressive symptoms than unexposed adolescents. Perinatal SSRI enhances innate fear-related responses and fear brain circuit activation that are conserved across species.One Sentence SummarySince SSRI use in pregnancy is common, we determined the effects of altered serotonin signaling during development in mice and humans.
An exploratory factor analysis approach to identifying patient benefits of a cost-of-care conversation tool in routine prenatal care
Authors: Rivelli Anne , Fitzpatrick Veronica , Shields Maureen , Erwin Kim 
Published: March 2023

AbstractTo address the need for cost-of-care conversations in prenatal care, the CONTINUE (cost conversations inroutineprenatal care) study was conducted with prenatal patients to better understand the benefits of implementing a cost-of-care conversation “cost” tool into routine obstetrics (OB) care. This research team conducted a multi-phase, mixed-methods research study to identify 18 target benefits of a cost tool to initiate and standardize cost-of-care conversation and, subsequently, developed and validated a cost tool. The cost tool was piloted and data pertaining to cost tool benefits were collected through interviews and surveys. To comprehensively assess the cost tool’s utility, exploratory factor analysis was performed to classify the underlying factor structure of the 18 benefit item responses. Data includes patients’ self-reported experiences of benefit items, as collected from third trimester prenatal patient participants who received the tool at the beginning of their prenatal care in three midwestern-based hospital clinics within one healthcare system. The present study describes the factor analysis approach used to identify the three final factors that emerged from the data. This analysis provides a framework for exploring patient-specific predictors of experiencing the benefit-related factors of a cost tool incorporated into routine OB care.Statements and DeclarationsThis study was funded by the Robert Wood Johnson Foundation, #77290.
Molecular determinants for Rous sarcoma virus intasome assemblies
Authors: Bera Sibes , Shi Ke , Aihara Hideki , Grandgenett Duane P. , Pandey Krishan K. 
Published: March 2023

AbstractIntegration of retroviral DNA into the host genome involves formation of integrase (IN)-DNA complexes termed intasomes. Here, we report the single-particle cryo-EM structure of the Rous sarcoma virus (RSV) strand transfer complex (STC) intasome produced with IN and a preassembled viral/target DNA substrate. The STC structure had an overall resolution of 3.36 Å and 3 Å in the conserved intasome core (CIC) region. Our structure demonstrated the flexibility of the distal IN subunits relative to the IN subunits in the CIC, similar to previously shown with the RSV octameric cleaved synaptic complex (CSC) intasome produced with IN and viral DNA only. An extensive analysis of higher-resolution STC structure helped in identification of nucleoprotein interactions important for intasome assembly. Using structure-function studies, we determined the mechanisms of several IN-DNA interactions critical for assembly of both RSV intasomes. We determined the role of IN residues R244, Y246 and S124 in CSC and STC intasome assemblies and their catalytic activities, demonstrating differential effects. Taken together, these studies advance our understanding of different RSV intasome structures and molecular determinants involved in their assembly.
Neutrophilic Inflammation in Models of Bronchopulmonary Dysplasia and Chronic Obstructive Pulmonary Disease is Rescued by a Lactobacilli Based Live Biotherapeutic
Authors: Nicola Teodora , Wenger Nancy , Xu Xin , Evans Michael , Rezonzew Gabriel , Qiao Luhua , Yang Youfeng , Ambalavanan Namasivayam , Blalock J Edwin , Gaggar Amit , Lal Charitharth Vivek 
Published: March 2023

AbstractBronchopulmonary dysplasia (BPD) is a chronic lung disease of prematurity. Exposure to noxious stimuli such as hyperoxia, volutrauma, and infection in infancy can have long-reaching impacts on lung health and predispose towards the development of conditions such as chronic obstructive pulmonary disease (COPD) in adulthood. BPD and COPD are both marked by lung tissue degradation, neutrophil influx, and decreased lung function. Both diseases also express a change in microbial signature dominated byProteobacteriaabundance andLactobacillusscarcity. However, the relationship between pulmonary microbial dysbiosis and the mechanisms of downstream disease development has yet to be elucidated. We hypothesized that a double-hit hyperoxia and LPS murine model of BPD would show heightened Ac-PGP pathway and neutrophil activity. Through gain- and loss-of-function studies in the same model we showed that Ac-PGP plays a critical role in driving BPD development. We tested a novel inhaled live biotherapeutic using activeLactobacillusstrains to counteract lung dysbiosis inin vitroandin vivomodels of BPD and COPD. TheLactobacillusLBP is effective in improving lung structure and function, reducing neutrophil influx, and reducing a broad swath of pro-inflammatory markers in these models of chronic pulmonary disease. Live inhaled microbiome-based therapeutics show promise in addressing common pathways of disease progression that in the future can be targeted in a variety of chronic lung diseases.