bluuebunny/crossref_metadata_2025_split huggingface dataset:
Empowering Functional Independence for Children With Severe Cerebral Palsy: A Randomized Controlled Trial Study Protocol
Authors: Kenyon Lisa K. , Farris John P. , Otieno Sango 
Published: February 2025

Purpose:
To explore the effectiveness of a wheelchair skills (PWC) training intervention provided using the IndieTrainer System.

Methods:
This 2-arm, parallel group, single-blinded, pre-test-post-test randomized controlled trial will have 2 groups. Outcomes will be assessed at 3 timepoints. Sixteen child-parent/caregiver dyads will participate in the study. Each child participant will have a diagnosis of severe cerebral palsy (CP), be 5 to 17 years old, and have cause and effect skills. Outcome measures will include the Assessment of Learning Powered mobility use, the Wheelchair Skills Checklist, and the Canadian Occupational Performance Measure.

Impact:
Children with severe CP are often dependent on others for mobility. PWC skills training may allow more children to meet the specifications for obtaining their own PWC, thereby maximizing their functional independence.
Cervical Collar Satisfaction and Functional Impact in Amyotrophic Lateral Sclerosis: A Survey Study
Authors: Burke Katherine M. , Shea Cristina , Arulanandam Vishni , Sullivan Stacey , Ellrodt Amy S. , MacAdam Claire , Carney Kendall , Casagrande Gabriella , Christiansen Elizabeth , Paganoni Sabrina 
Published: February 2025

Abstract

Objectives
Many people with amyotrophic lateral sclerosis (ALS) develop cervical muscle weakness, often managed with cervical collars. Finding supportive and comfortable collars can be challenging. This study aimed to evaluate satisfaction with various collars and their impact on activities of daily living.

Design
This electronic survey study collected demographic information, clinical status, and participant experiences with commonly used cervical collars.

Results
Thirty-four participants (33 with ALS, 1 with primary lateral sclerosis) completed the survey, with 79% reporting neck weakness and 38% experiencing neck pain. Among those who tried cervical collars (65%), many had tried multiple options. The mean satisfaction across all collar types was 5.03 (SD = 2.92) out of 10.

Conclusion
These findings suggest current collars do not fully meet the needs of people living with ALS, emphasizing the importance of improved treatment options. Future research should explore innovative technologies to improve cervical support, function, and quality of life.
Investigating the epigenetic landscape of symptomatic disk degeneration: a case study
Authors: Yeater Taylor D. , Kawarai Yuya , Lee Seunghwan , Belani Kumar G. , Beebe David S. , Sheyn Dmitriy , Pinto Manuel R. , Stone Laura S. 
Published: February 2025

Abstract

Introduction:
This study investigates the epigenetic landscape underlying painful intervertebral disk (IVD) degeneration in a single subject with a history of low back pain (LBP). Intervertebral disk degeneration is associated with LBP in some individuals; however, there is often a discrepancy between degeneration and pain. We hypothesize that DNA methylation, an epigenetic mechanism previously linked to discogenic LBP, is dysregulated in symptomatic vs asymptomatic IVDs.

Objectives:
Identify differentially methylated genes and pathways in symptomatic vs asymptomatic IVDs.

Methods:
Three lumbar IVDs with similar degeneration severity were tested prior to surgery by discography to identify symptomatic IVDs. Methylation analysis was performed on ∼935,000 cytosine guanine dinucleotide sites on nucleus pulposus DNA. We explored differential methylation and pathway enrichment on cytosine guanine dinucleotide sites located within the promoter regions of genes.

Results:
Two IVDs (L3/L4 and L4/L5) evoked pain ratings of 10/10 and 8/10, one IVD (L5/S1) scored 0/10. DNA methylation differed between symptomatic and asymptomatic IVDs. Several identified genes have roles in extracellular matrix remodeling. Other differentially methylated genes were related to immunomodulation and ion channel function. Finally, several long noncoding RNA genes were identified, encouraging further exploration into these regulatory molecules. Enriched pathways were associated with immune response, hormonal regulation, nervous system development, and musculoskeletal development and remodeling.

Conclusion:
This case study provides a promising list of candidate genes for therapeutic development for discogenic LBP and suggests a role for DNA methylation in the development of symptomatic vs asymptomatic IVD degeneration, calling for further research to validate and expand these findings.
Potential of a Genicular Artery Perforator Keystone Flap for the Reconstruction of Defects in the Knee to the Upper Third of the Leg
Authors: Chen Ching-En 
Published: February 2025

Introduction
The reconstruction of defects in the area extending from the knee to the upper third of the leg is challenging due to the intricate anatomy and limited local tissue options in this area. The genicular artery perforator keystone (GAP-K) flap is a promising solution for such reconstructions. In this study, the feasibility and outcomes of GAP-K flap use in the reconstruction of defects in the knee to upper third of the leg were assessed.

Materials and Methods
Data on patients who underwent GAP-K flap reconstruction of defects in the knee to upper third of the leg in a single department between June 2021 and May 2023 were reviewed retrospectively. Patients' demographic characteristics, diagnoses, defect size, complications, and functional outcomes were analyzed.

Results
The sample comprised seven patients with a mean age of 44.9 years. Four GAP-K flaps were harvested from the medial aspect, and the remainder was harvested from the lateral aspect. Three flaps were type IIa, three were omega variants, and one was a Sydney Melanoma Unit variant. Mild wound dehiscence requiring management occurred in one patient. At 6 months postoperatively, the average range of motion of the affected knees was 126.7°, the average revised Musculoskeletal Tumor Society Rating Scale score was 25.5, and the average Eastern Cooperative Oncology Group performance status rating was 0.83.

Conclusions
The GAP-K flap shows promise as a viable option for the reconstruction of defects in the knee to upper third of the leg. It provides reliable tissue coverage and satisfactory aesthetic outcomes. Further research with larger samples is warranted to confirm these findings and refine related surgical techniques.
Customized 3-Dimensional-Printed Finger Splints for Mallet Finger
Authors: Hou Chih-Chun , Yi Chin-Chieh , Wu Chien-Wei , Tsai Sheng-Lin , Huang Dun-Wei , Tzeng Yuan-Sheng 
Published: February 2025

Abstract
We aimed to evaluate the feasibility and effectiveness of customized 3-dimensional (3D)-printed finger splints in the treatment of mallet fingers. We categorized 21 patients into those who received the traditional finger splint (group A) and those treated with a customized 3D-printed finger splint (group B). We retrospectively analyzed the functional outcomes and patient satisfaction in the 2 groups. During the follow-up period, 3 patients in group A failed treatment, of which 2 underwent extended immobilization and one 1 transferred to surgery. All 3 patents in group B who failed treatment received extended immobilization and did not require transfer to surgery. In patient satisfaction assessments, group B patients scored better in dimension and comfort than did group A patients. Customized 3D-printed finger splints provided a more comfortable and fitting treatment option for mallet finger. Although they did not result in a significant difference in treatment success rate, these splints significantly improved patient compliance with treatment and wearing.
Comparison of the Outcomes of Perforator-Based Adipofascial Flaps and Local Muscle Flaps in Distal Lower Extremity Reconstruction
Authors: Lee Chia-Chi , Chang Dun-Hao 
Published: February 2025

Introduction
Soft tissue reconstruction in the distal lower extremities is challenging because of the inherent vulnerability of tendons, bones, and implants to being easily exposed, and scanty local tissue makes it more complicated. Local flaps that avoid the donor-site morbidity and the need of microsurgery gain popularity among the treatment choices. This study aims to compare the outcomes of 2 common local flaps: adipofascial flaps and muscle flaps in distal lower leg reconstruction.

Materials and Methods
From November 2019 to November 2023, the patients with distal lower leg defects undergoing perforator-based adipofascial flaps or muscle flaps were included and reviewed. The patient demographics, injury characteristics, outcomes, and complications were evaluated.

Results
A total of 32 patients were included in the study of which, 17 received perforator-based adipofascial flaps, and 15 received muscle flaps. The backgrounds of the 2 groups were similar, except that the patients in the adipofascial flap group were older and had more comorbidities. All flaps survived except for one muscle flap that failed. The flap survival, infection rates, and donor-site complications were comparable in both groups; however, the adipofascial flap group had less daily drainage volume and seemed to have a shorter hospital stay, although the difference was not significant (8.06 ± 3.33 days vs 11.93 ± 7.63 days, P = 0.085).

Conclusions
For distal lower leg reconstruction, the adipofascial flaps are comparable to the muscle flaps but avoid the functional impairment. If available, the adipofascial flap can be considered as a prior treatment option, even for patients with implant exposure.
Disease-Free Recovery After Limb Salvage Surgery for Synovial Sarcoma With Femoral Vessel Involvement
Authors: Hsieh Hua-Hsin , Shieh Shyh-Jou 
Published: February 2025

Abstract
Synovial sarcoma is a rare soft tissue sarcoma that often arises at a young age in the lower limbs. A large tumor size with neurovascular invasion leads to difficulties in salvaging the limb and achieving tumor-free margins during excision. Limb amputation used to be the only choice in such consideration. In addition, options for vascular reconstruction remain an open debate. Herein, we present a case of a large synovial sarcoma with the encasement of femoral vessels and the limb-salvaging approach, which employed wide excision with vessel reconstruction and their coverage in one stage. The patient recovered well with both satisfactorily aesthetic and functional outcomes at 5-year follow-up following postoperative concurrent chemoradiation therapy, and without any evidence of tumor recurrence.
Could Periodic Laser Doppler Imaging Monitoring Enhance Insights Into Perfusion Challenges in Anterolateral Thigh Flaps? A 5-Year Retrospective Analysis
Authors: Shiue Yow-Jye , Lin Yu-Te , Lee Che-Hsiung 
Published: February 2025

Background
Postoperative monitoring after free flap transfer is challenging, and clinical observation alone remains subjective and unquantifiable. Furthermore, re-explored flaps often have a poor appearance, making it challenging for surgeons to decide whether further aggressive treatments are necessary. Laser Doppler (LD) imaging can provide noninvasive, real-time, and quantifiable monitoring for flap perfusion. This study aimed to utilize fixed-timing LD to assist in postoperative free flap monitoring, especially in re-explored flaps.

Material and Methods
We retrospectively analyzed free anterolateral thigh (ALT) flap transfers with at least 1 re-exploration surgery from 2018 to 2022. Fixed-timing LD scans were conducted once a day on weekdays, and the flux mean of the flap and its adjacent reference healthy skin was obtained via an LD imager. The perfusion index (PI) was calculated as the percentage difference of flux mean between the flap and the reference. Timing of compromise, surgical findings and flap outcomes were recorded. Re-explored cases were matched with non–re-explored cases by propensity score matching for age, sex, and recipient site. Receiver operating characteristic curves and Youden's index were used to identify a PI cutoff value to define flap compromise. Post re-exploration outcomes were categorized into flap survival, partial necrosis, and failure. Post re-exploration LD data were analyzed with the Wilcoxon test.

Results
Forty-seven re-explored free ALT flaps were included. Ten re-explored cases with LD scans before compromise on postoperative day 1 were matched with 20 nonreopened cases. A PI threshold value < −0.62 could identify flap compromise with 80% sensitivity and 70% specificity. In the flap survival group, the mean PI mean was −0.61 ± 0.03 in 32 cases within 24 hours after re-exploration, which was higher than the PI threshold. A significant difference in PI mean was found between the survival and partial necrosis groups (−0.61 ± 0.03 vs −0.86 ± 0.02, P = 0.034).

Conclusions
When facing uncertain circulation after free flap transfers, LD imaging can provide reliable and objective method for postoperative monitoring. A PI value ≤ −0.62 could identify free ALT flap compromise. This PI threshold value could be applied to re-explored flaps, providing an option to evaluate those in which compromise is suspected.
Correction of Secondary Exophthalmos Caused by Lateral Orbital Rim Recession
Authors: Fukuyama Sotatsu , Saito Takafumi , Lo Lun-Jou 
Published: February 2025

Abstract
Improving exophthalmos is a crucial aspect of treatment for patients with syndromic craniosynostosis. However, in patients who have undergone previous treatments including fronto-orbital advancement and Le Fort III distraction osteogenesis and who have reached skeletal maturity, the recurrence of exophthalmos is not uncommon. The severity of the exophthalmos may vary. Whether secondary correction involving osteotomy should be performed or symptomatic treatment strategies should be adopted is a dilemma, and the patient's symptoms and background and the invasiveness of the surgery should also be considered. Additionally, the accurate measurement and treatment of exophthalmos require the expertise of surgeons. This report introduces self-developed orbital wall implants generated through 3-dimensional simulation and 3-dimensional printing. The patient was a 23-year-old woman with Crouzon syndrome and recurrent exophthalmos. After surgery, the exophthalmos and facial appearance were improved. The use of custom-made implants provides advantages over the conventional osteotomy method; it is less invasive, involves a simple surgical procedure, and offers cost and time savings.
Reconstruction of Posterior Trunk Defects Following Sarcoma Excisions—A Dual-Center Experience
Authors: Elfaki Ahmed , Mohamed Dalia , Radotra Ishan , Tullie Sebastian , Sumathi Vaiyapuri , Foong Deborah , Jagadeesan Jagajeevan , Srinivasan Karthikeyan 
Published: February 2025

Background
Sarcomas are malignancies of mesodermal origin that have a propensity for aggressive invasion of local structures and hematogenous spread. Sarcomas of the posterior trunk are problematic because of their insidious growth, lack of patient realization, and proximity to the vertebral column and spinal cord. Reconstruction often requires well-vascularized tissue that can withstand the demands of radiotherapy, without significant complications.

Methods
We assessed the outcomes of 47 patients over a 7-year period with soft-tissue sarcomas of the posterior trunk extending from the neck to the sacrum and their reconstructions. Nine were direct closures, and 2 required split-thickness skin grafts. Thirty-seven patients underwent 39 flap reconstructions (26 myocutaneous, 12 fasciocutaneous, 1 muscle-only). Thirty-five patients required a single flap reconstruction, and 2 required multiple flaps.

Results
There were no recorded flap failures. Thirty-three patients (70%) healed without complications. Twenty-one patients required radiotherapy (preoperative 3, postoperative 18) and wound healing complications occurred in one (33%) and 5 (27%%) patients, respectively. Complications: seroma (10%), dehiscence (12.8%), return to theater (12.8%), infection (12.8%), and partial flap necrosis (10%). No statistical significance was found when comparing sex, smoking status, diabetes, defect location, or radiotherapy exposure with wound complication outcomes. There was no statistical significance when comparing wound complications, return to theater or healing time between those who had received preoperative and postoperative radiotherapy.

Conclusions
Patients with posterior trunk sarcomas often require well-vascularized robust reconstruction that can withstand the potential complications of radiotherapy and pressure. Reconstruction can include fasciocutaneous or musculocutaneous flaps, or a combination of both, to help reduce morbidity.
Arteriogenesis Mechanism in Remodeling of Choke Vessels Within Choke Zone 2 of Delayed Multiterritory Perforator Flap
Authors: Peng Ping , Hu Ya , Guo Wei , Dong Zhonggen , Luo Zhaobiao , Wei Jianwei 
Published: February 2025

Background
The aim of this study is to validate that both morphological and hemodynamic changes in the choke vessels remodeling within the choke zone 2 of delayed multiterritory perforator flap (MPF) in rats are consistent with revascularization through the arteriogenesis mechanism.

Methods
Two hundred seventy-two Sprague-Dawley (SD) rats were randomly divided into 4 groups: group A (classical group with harvested MPF), group B (delay group with ligated perforator in the potential region), group C (delay group with ligated perforator in the dynamic region), and group D (delay group with double fasciocutanoeus pedicles). The morphological changes in the choke vessels were evaluated using integument radiography and H&E staining, while the hemodynamic alterations within the choke zones were assessed utilizing a laser Doppler blood flow imager.

Results
In choke zone 2, the true anastomosis emerged on 5 days postoperatively, and 3, 3, and 5 days after the delay surgery in group A, B, C, and D, respectively. The microvessel densities on each time points postoperatively were lower than those before operation in the 4 groups (P > 0.05). The arteriolar diameters on 5 days after the delay surgery were significantly larger than those before operation in group B, group C, and group D (P < 0.05). In the group B, C, and D, the blood perfusion at 1 day after the delay surgery was significantly higher than that at 6 hours after the delay surgery (P < 0.05).

Conclusions
The arteriogenesis mechanism plays an important role in the remodeling of the choke vessels in the choke zone 2 within the MPF after 3 types of delay procedures.
Characterizing organisms from three domains of life with universal primers from throughout the global ocean
Authors: McNichol Jesse , Williams Nathan L R , Raut Yubin , Carlson Craig , Halewood Elisa R , Turk-Kubo Kendra , Zehr Jonathan P , Rees Andrew P , Tarran Glen , Gradoville Mary R. , Wietz Matthias , Bienhold Christina , Metfies Katja , Torres-Valdés Sinhué , Mock Thomas , Eggers Sarah Lena , Jeffrey Wade , Moss Joseph , Berube Paul , Biller Steven , Bodrossy Levente , Van De Kamp Jodie , Brown Mark , Sow Swan L. S. , Armbrust E. Virginia , Fuhrman Jed 
Published: February 2025

AbstractWe introduce the Global rRNA Universal Metabarcoding Plankton database (GRUMP), which consists of 1194 samples that were collected from 2003-2020 and cover extensive latitudinal and longitudinal transects, as well as depth profiles in all major ocean basins. DNA from unfractionated (> 0.2µm) seawater samples was amplified using the 515Y/926R universal three- domain rRNA gene primers, simultaneously quantifying the relative abundance of amplicon sequencing variants (ASVs) from bacteria, archaea, eukaryotic nuclear 18S, and eukaryotic plastid 16S. Thus, the ratio between taxa in one sample is directly comparable to the ratio in any other GRUMP sample, regardless of gene copy number differences. This obviates a problem in prior global studies that used size-fractionation and different rRNA gene primers for bacteria, archaea, and eukaryotes, precluding comparisons across size fractions or domains. On average, bacteria contributed 71%, eukaryotes 19%, and archaea 8% to rRNA gene abundance, though eukaryotes contributed 32% at latitudes > 40°. GRUMP is publicly available on the Simons Collaborative Marine Atlas Project (CMAP), promoting the global comparison of marine microbial dynamics.
A constellation of dysfunctional hybrid phenotypes enforces reproductive isolation betweenCaenorhabditisnematode species
Authors: Dall’Acqua Maia N. , Peake Amanda L. , Da Silva Jalina Bielaska , Issakova Dina , Cutter Asher D. 
Published: February 2025

AbstractThe evolution of complete reproductive isolation hinges on the cumulative action of reproductive isolating barriers that can manifest throughout the life cycle of an organism. Consequently, a comprehensive understanding of the features underlying the origin and maintenance of species requires assessing the relative contributions of distinct barriers to overall reproductive isolation. Here we characterize multiple interrelated isolating barriers across various developmental stages of nematode sister speciesCaenorhabditis remaneiandCaenorhabditis latens. We quantified F1 hybrid male sterility and characterized multiple phenotypic causes associated with developmental abnormalities in the germline as well as non-germline gonad and somatic tissues, uncovering a complex suite of developmental defects contributing to strong postzygotic reproductive isolation. Despite these multifarious isolating barrier traits, assays testing for interspecies sperm transfer under “choice” conditions did not yield evidence of premating isolation. In contrast to otherCaenorhabditisspecies pairs, we also found no evidence that ectopic sperm migration acts as a postmating-prezygotic barrier. The constellation of phenotypic defects in hybrids points to a polygenic or highly pleiotropic basis for hybrid dysfunction and implicates more rapid evolution of intrinsic postzygotic reproductive isolation than prezygotic isolation in these organisms.
Nearest-neighbor nonnegative spatial factorization to study spatial and temporal transcriptomics
Authors: Shrestha Priyanka , Diaz Luis Chumpitaz , Engelhardt Barbara E 
Published: February 2025

AbstractNonnegative spatial factorization (NSF) is a spatially-aware factorization method that uses Gaussian processes (GPs) as spatial priors in a Poisson latent factor model to robustly identify interpretable, parts-based representations in spatial transcriptomics data. However, NSF scales poorly with modern datasets due to the computational complexity of Gaussian processes, which scales cubically with the number of points used for inferenceO(N3). To address this limitation, we propose a modified version of NSF that leverages variational nearest neighbor Gaussian processes (VNNGPs), resulting in a substantial reduction in inference complexity fromO(NM2)in the current version of NSF toO(MNK2)forMinducing points,Ntotal points andKnearest neighbors. Our method, nearest-neighbor NSF (NNNSF), is benchmarked on synthetic and real-world spatial and temporal transcriptomics datasets. Experimental results demonstrate that NNNSF achieves linear scaling with the number of neighbors and points used for inference in contrast with NSF, which has exponential computational complexity as the number of points used in inference increases. By restricting covariance calculations to theK-nearest neighbors of the points used in inference, NNNSF allows the use of more inducing points, leading to lower reconstruction loss. Nearest-neighbor NSF (NNNSF), which replaces standard variational inference with inducing points in NSF with the VNNGP, leads to a computationally efficient and scalable version of NSF that can be applied to large existing and forthcoming spatial genomics data.We added VNNGP and NNNSF to the GPZoo package, an an ongoing open source project developing a modular Gaussian process library in Python making use of the PyTorch interface. Source code and demonstrations are available athttps://github.com/luisdiaz1997/GPzoo/tree/main.