bluuebunny/crossref_metadata_2025_split huggingface dataset:
Robot-Assisted Laparoscopic Adrenal Metastasectomy With Prior Partial or Radical Nephrectomy: Step-by-Step Technique and 1-Year Outcomes
Authors: Xuan Yundong , Cheng Qiang , Liu Kan , Li Xintao , Fan Yan , Zhang Peng , Wang Hanfeng , Zhao Xupeng , Tian Shuo , Wang Jichen , Wang Baojun , Gao Yu , Zhang Xu 
Published: August 2023

Purpose:
The purpose of this study was to elucidate the feasibility and safety of the technique of robot-assisted laparoscopic adrenal metastasectomy (RAL-AME) for adrenal metastasis (AM) originating from renal cell carcinoma (RCC) with surgical history.

Materials and Methods:
From October 2015 to September 2020, RAL-AME was performed on 13 patients with AM from RCC with surgical history by using a transperitoneal approach. Whether metastasis occurs on the left or right side, adhesiolysis is required in the supine position from the contralateral side to the affected side. Three planes were established sequentially to separate the AM with patients converted into a lateral decubitus position. The first dissection plane was between the inferior side of the liver for right AM or spleen for left AM and the posterior side of the colon. The second dissections plane was established between the anterior renal fascia and the lateral aspect of perirenal fat. Care should be taken to avoid damaging the aorta or inferior vena cava when establishing the left or right plane. The third dissection plane was achieved between the retrorenal fascia and the anterior aspect of the psoas major. The metastasis was identified and en bloc–excised.

Results:
The median operative time was 127 minutes (range 60-290), and median estimated blood loss was 50 ml (range 20-500). The average time to oral intake and hospital length of stay were 2.5 and 2.8 days, respectively. Perioperative complications and conversion to open surgery were not observed. All surgical margins were negative.

Conclusions:
RAL-AME for adrenal metastasis is safe and feasible. The therapeutic effect and overall survival rate require further investigation with a larger sample size and longer follow-up.
Variability of Commercial Saw Palmetto–Based Supplements for the Management of Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms
Authors: Chughtai Bilal , Bhojani Naeem , Zorn Kevin C. , Elterman Dean 
Published: August 2023

ABSTRACT

Purpose:
Some men with mild-to-moderate benign prostatic hyperplasia/lower urinary tract symptoms use saw palmetto supplements to proactively manage their symptoms as an alternative to watchful waiting and/or to avoid prescription medication side effects. This study assessed the potency and authenticity of commercially available saw palmetto–based supplements in the United States.

Materials and Methods:
Twenty-eight saw palmetto berry powders, powdered extracts, berry blends, lipid extracts, and multiactive products (lycopene, pumpkin oil, etc) were purchased from major online retailers and retail stores. Total fatty acid content (% weight/weight) and individual fatty acid profile of each product were determined using validated gas chromatography-fatty acid methyl ester methodology and compared with the US Pharmacopeia monograph standards for lipidosterolic extracts of Serenoa repens.

Results:
Total fatty acid content ranged from 0.796% for a berry powder product to 89.923% for a lipid extract product. None of the berry powders or powdered extracts, 6 of 9 lipid extracts, and 1 multiactive product met criteria for ≥80% total fatty acid content. Only 1 of the 28 products met the US Pharmacopeia criteria for a standardized lipidosterolic extract, defined as total fatty acid content ≥80% and a fatty acid profile indicative of authentic S. repens based on the ratios of the lauric acid concentration to 9 other individual fatty acid concentrations.

Conclusions:
There is substantial heterogeneity in fatty acid content and profile in saw palmetto supplements. Lipidosterolic extracts of saw palmetto berries standardized to ≥80% fatty acids are most likely to meet established criteria for quality and identity.
VM-PATHI Correlates With Cognitive Function Improvement After Successful Treatment in Patients With Vestibular Migraine
Authors: Patel Evan J. , Hum Maxwell , Gardi Adam , Steenerson Kristen K. , Rizk Habib G. , Sharon Jeffrey D. 
Published: August 2023

Objective
To assess changes in cognitive function in vestibular migraine patients undergoing treatment.

Study Design
Prospective cohort.

Setting
Single-institution tertiary-care center.

Patients
Thirty-four patients with vestibular migraine were included in the study. Average age at diagnosis was 47.9 years. A majority of patients (91.2%) were female.

Interventions
Vestibular therapies included pharmacologic treatment (67.6%), mindfulness-based stress reduction (58.8%), vestibular physical therapy (20.6%), and lifestyle changes only (2.9%).

Main Outcome Measures
Pretreatment and posttreatment questionnaires were collected including the Cognitive Failures Questionnaire (CFQ), Vestibular Migraine Patient Assessment Tool and Handicap Inventory (VM-PATHI), and Dizziness Handicap Inventory.

Results
Median time between pretreatment and posttreatment questionnaire was 4.4 months (range, 2.8–15.6. mo). CFQ scores decreased in subjects who responded to treatment, as defined by those with a positive change in VM-PATHI score (average decrease, 6.5; p = 0.03). CFQ scores did not improve in subjects who had no improvement in their vestibular condition, as defined by no change or an increase in VM-PATHI score (average increase, 2.0; p = 0.53). Univariate linear regression showed that VM-PATHI score change was highly predictive of CFQ change (p < 0.01, r
2 = 0.36). Multivariate regression demonstrated that the VM-PATHI (p = 0.03) and not the Dizziness Handicap Inventory (p = 0.10) predicted changes in CFQ score.

Conclusions
Self-reported cognitive dysfunction improves with successful treatment of vestibular migraine.
Severe Acute Bacterial Infections in Children With Sickle Cell Disease in Togo
Authors: Gbadoé Adama Dodji , Guédénon Koffi Mawuse , N’zonou Magnoulelen , Adamou Mahamadou , Akolly Djatougbé , Guédéhoussou Têtê , Dagnra Anoumou Yaotsé 
Published: August 2023

Background:
Bacterial infections are considered a major cause of morbidity and mortality in patients, especially children, with sickle cell disease.

Objectives:
This study aims at determining, a year after the introduction of the 13-valent pneumococcal conjugate vaccine the distribution of severe acute bacterial infections and germs in children with sickle cell disease.

Patients and methods:
Records of children 0 to 15 years of age and admitted from January 1, 2015 to December 31, 2019 (5 y), were examined retrospectively in the four sickle cell monitoring units in Lomé.

Results:
The main infections found were pleuropulmonary (46.1%), urinary tract (32.8%), and osteoarticular (9.3%). A germ was isolated in 139 of the 265 cases (52.4%). 65.5% of the microorganisms isolated were Gram-negative organisms, with mostly Escherichia coli (31.6%), and Klebsiella pneumoniae (18%) being the main germs. They were mainly responsible of urinary tract and osteoarticular infections. The majority of these Enterobacteriaceae was Extended-Spectrum Beta-Lactamase-Producing (41.1%, n = 37). Gram-positive cocci were represented by Staphylococcus sp (25.9%), Streptococcus sp (4.3%), Streptococcus pneumoniae (2.9%), and Enterococcus (1.4%). Staphylococcus aureus was the most common germ in pleuropulmonary (40%), osteoarticular (47.3%), and sepsis (28.6%) infections.

Conclusion:
Even if the infections found remained classic, there is a redistribution of germs with a decline in Salmonella and increase of Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus.
The CSN5/HSF/SPI1/PU.1 Axis Regulates Cell Proliferation in Hypocellular Myelodysplastic Syndrome Patients
Authors: Yu Zheng-Ping , Jian Zi-Ying , Sun Ai-Ning , Chen Bao-An , Ge Zheng 
Published: August 2023

Objective:
This study explored the relationship between the activation of the jak/stat3 signaling pathway and the CSN5 gene transcript and protein expression levels in the hematopoietic stem cells of patients with myelodysplastic syndromes (MDSs). This study also aimed to investigate the correlation between the expression level of CSN5 and the deubiquitination of HSF1, as well as the transcript level of the spi1/pu.1 genes to explore the pathogenesis of MDS.

Materials and Methods:
We isolated cells from normal individuals and MDS patients, and the mRNA and protein expression levels of spi1/pu.1 in cd34+ cells (hematopoietic stem cells) were measured by PCR and western blotting, respectively. A ChIP assay was used to detect the binding of HSF1 to the spi1/pu.1 promoter in cd34+ cells. The ubiquitination of HSF1 in cd34+ cells was detected by CO-IP. The binding of HSF1 and Fbxw7α was detected in in cd34+ cells by CO-IP. The binding of HSF1 and CSN5 was evaluated. A luciferase reporter assay was used to detect the effect of STAT3 on CSN5 promoter activation in cd34+ cells. Western blotting was used to detect the phosphorylation of STAT3 in cd34+ cells of MDS patients. The binding of STAT3 and C/EBP beta in cd34+ cells was detected by CO-IP.

Results:
Inhibition of SPI1/PU.1 expression was observed in MDS samples with low proliferation ability. Further experiments proved that phosphorylation of STAT3 affected CSN5 function and mediated the ubiquitination of HSF, the upstream regulator of SPI1/PU.1 transcription, which led to the inhibition of SPI1/PU.1 expression. Restoration of CSN5 rescued the inhibition of HSF1 ubiquitination, causing SPI1/PU.1 transcription to resume and increasing SPI1/PU.1 expression, promoting the recovery of cell proliferation in hypocellular MDS.

Conclusions:
Our research revealed the regulatory role of the CSN5/HSF/SPI1/PU.1 axis in hypocellular MDS, providing a probable target for clinical intervention.
Prevention and treatment of C. difficile in cancer patients
Authors: Puerta-Alcalde Pedro , Garcia-Vidal Carolina , Soriano Alex 
Published: August 2023

Purpose of review
We provide an update on the recent literature on Clostridioides difficile infection (CDI) in cancer patients.

Recent findings
Distinguishing between colonization and infection remains challenging in cancer patients. Many patients with negative toxin analysis are still treated for CDI, and some meet criteria for severe cases. The incidence of CDI is high in cancer patients, especially those with haematological malignancies. Disruption of the gut microbiome due to antibiotic consumption, chemotherapy and radiotherapy is the primary factor contributing to CDI development. The severity of CDI in cancer patients is often unclear due to the absence of well-defined severity criteria. Certain microbiome species predominance and specific ribotypes have been associated with worse outcomes. Whole genome sequencing could be helpful for differentiating recurrence from reinfection and exploring potential nosocomial transmission. While certain new drugs such as fidaxomicin or bezlotoxumab show promise, the optimal treatment and prevention strategies for CDI in cancer patients remain uncertain. Faecal microbiota transplantation (FMT) holds potential for reducing CDI recurrence rates.

Summary
Further studies are needed to provide robust recommendations for diagnosis, grading severity, and therapeutic management of CDI in cancer patients. Recurrences are particularly concerning due to subsequent exposition to CDI risk factors.
Association of Recipient APOL1 Kidney Risk Alleles With Kidney Transplant Outcomes
Authors: Roy Neil , Morales-Alvarez M. Catalina , Anis Karim H. , Goral Simin , Doria Cataldo , Kopp Jeffrey B. , Winkler Cheryl A. , Feng Rui , Rosas Sylvia E. 
Published: August 2023

Background.
Kidney transplant survival in African American recipients is lower compared with non–African American transplant recipients. APOL1 risk alleles (RA) have been postulated as likely contributors. We examined the graft outcomes in kidney transplant recipients (KTRs) stratified by APOL1 RA status in a multicenter observational prospective study.

Methods.
The Renal Transplant Outcome Study recruited a cohort of incident KTRs at 3 transplant centers in the Philadelphia area from 1999–2004. KTRs were genotyped for APOL1 RA. Allograft and patient survival rates were compared by the presence and number of APOL1 RA.

Results.
Among 221 participants, approximately 43% carried 2 APOL1 RA. Recipients carrying 2 APOL1 RA demonstrated lower graft survival compared with recipients with only 1 or none of APOL1 RA at 1 y posttransplant, independently of other donor and recipient characteristics (adjusted hazard ratio 3.2 [95% confidence interval, 1.0-10.4], P = 0.05). There was no significant difference in overall survival or graft survival after 3 y posttransplantation. There was no difference in death by APOL1-risk status (P = 0.11).

Conclusions.
Recipients with 2 APOL1 high-risk alleles exhibited lower graft survival 1 y posttransplantation compared with recipients with only 1 or 0 APOL1 RA. Further research is required to study the combined role of the recipient and donor APOL1 genotypes in kidney transplantation.
Effects of Amantadine Sulfate on Motor Impairment and Execution of Motor Sequences in Patients With Parkinson Disease
Authors: Müller Thomas , Kuhn Wilfried 
Published: August 2023

Background
Intravenous application of amantadine sulfate induces a rapid improvement of motor behavior in patients with Parkinson disease.

Objectives
To determine efficacy of daily infusion of 200 mg amantadine sulfate on scored motor symptoms and performance of standardized movement sequences with components of low and high cognitive efforts.

Methods
Thirty-one participants received infusions of amantadine sulfate in addition to their previous stable drug regimens on 3 consecutive days. Motor symptoms of upper limbs were determined with selected items of the part motor examination of the Unified Parkinson's Disease Rating Scale. Instrumental tasks were executed under cued conditions before and after the infusions.

Results
Scored motor symptoms and components with a need for a higher cognitive load became better. Performance of motion series, characterized by an automated set with low cognitive efforts, did not improve.

Conclusion
Our trial outcomes suggest that the amantadine has a positive impact on cognitive abilities, drive, and vigilance, all of which are necessary for carrying out of higher brain functions.
pyCapsid: Identifying dominant dynamics and quasi-rigid mechanical units in protein shells
Authors: Brown Colin , Agarwal Anuradha , Luque Antoni 
Published: August 2023

Structured AbstractSummarypyCapsid is a Python package developed to facilitate the characterization of the dynamics and mechanical units of protein shells and other protein complexes. The package was developed in response to the rapid increase of high-resolution structures, particularly capsids of viruses, requiring multiscale biophysical analyses. Given a protein shell, pyCapsid generates the collective vibrations of its amino-acid residues, identifies quasi-rigid mechanical regions, and maps the results back to the input proteins for interpretation. pyCapsid summarizes the main results in a report that includes publication-quality figures.Availability and ImplementationpyCapsid’s source code is available under MIT License on GitHub (https://github.com/luquelab/pycapsid). It is compatible with Python 3.8-3.10 and has been deployed in two leading Python package-management systems, PIP (https://pypi.org/project/pyCapsid/) and Conda (https://anaconda.org/luque_lab/pycapsid). Installation instructions and tutorials are available in the GitHub Page-style online documentation (https://luquelab.github.io/pyCapsid). Additionally, a cloud-based implementation of pyCapsid is available as a Google Colab notebook (https://colab.research.google.com/github/luquelab/pyCapsid/blob/main/notebooks/pyCapsid_colab_notebook.ipynb). pyCapsid Colab does not require installation and generates the same report and outputs as the installable version. Users can post issues regarding pyCapsid in the GitHub repository (https://github.com/luquelab/pyCapsid/issues).
Saponin Nanoparticle Adjuvants Incorporating Toll-Like Receptor Agonists Drive Distinct Immune Signatures and Potent Vaccine Responses
Authors: Ou Ben S. , Baillet Julie , Filsinger Interrante Maria V. , Adamska Julia Z. , Zhou Xueting , Saouaf Olivia M. , Yan Jerry , Klich John H. , Jons Carolyn K. , Meany Emily L. , Valdez Adian S. , Carter Lauren , Pulendran Bali , King Neil P. , Appel Eric A. 
Published: August 2023

AbstractOver the past few decades, the development of potent and safe immune-activating adjuvant technologies has become the heart of intensive research in the constant fight against highly mutative and immune evasive viruses such as influenza, SARS-CoV-2, and HIV. Herein, we developed a highly modular saponin-based nanoparticle platform incorporating toll-like receptor agonists (TLRas) including TLR1/2a, TLR4a, TLR7/8a adjuvants and their mixtures. These various TLRa-SNP adjuvant constructs induce unique acute cytokine and immune-signaling profiles, leading to specific Th-responses that could be of interest depending on the target disease for prevention. In a murine vaccine study, the adjuvants greatly improved the potency, durability, breadth, and neutralization of both COVID-19 and HIV vaccine candidates, suggesting the potential broad application of these adjuvant constructs to a range of different antigens. Overall, this work demonstrates a modular TLRa-SNP adjuvant platform which could improve the design of vaccines for and dramatically impact modern vaccine development.TeaserSaponin-TLRa nanoadjuvants provide distinct immune signatures and drive potent, broad, durable COVID-19 and HIV vaccine responses.
Multimodal Molecular Imaging Reveals Tissue-Based T Cell Activation and Viral RNA Persistence for Up to 2 Years Following COVID-19
Authors: Peluso Michael J. , Ryder Dylan , Flavell Robert , Wang Yingbing , Levi Jelena , LaFranchi Brian H. , Deveau Tyler-Marie , Buck Amanda M. , Munter Sadie E. , Asare Kofi A. , Aslam Maya , Koch Wally , Szabo Gyula , Hoh Rebecca , Deswal Monika , Rodriguez Antonio , Buitrago Melissa , Tai Viva , Shrestha Uttam , Lu Scott , Goldberg Sarah A. , Dalhuisen Thomas , Durstenfeld Matthew S. , Hsue Priscilla Y. , Kelly J. Daniel , Kumar Nitasha , Martin Jeffrey N. , Gambir Aruna , Somsouk Ma , Seo Youngho , Deeks Steven G. , Laszik Zoltan G. , VanBrocklin Henry F. , Henrich Timothy J. 
Published: August 2023

ABSTRACTThe etiologic mechanisms of post-acute medical morbidities and unexplained symptoms (Long COVID) following SARS-CoV-2 infection are incompletely understood. There is growing evidence that viral persistence and immune dysregulation may play a major role. We performed whole-body positron emission tomography (PET) imaging in a cohort of 24 participants at time points ranging from 27 to 910 days following acute SARS-CoV-2 infection using a novel radiopharmaceutical agent, [18F]F-AraG, a highly selective tracer that allows for anatomical quantitation of activated T lymphocytes. Tracer uptake in the post-acute COVID group, which included those with and without Long COVID symptoms, was significantly higher compared to pre-pandemic controls in many anatomical regions, including the brain stem, spinal cord, bone marrow, nasopharyngeal and hilar lymphoid tissue, cardiopulmonary tissues, and gut wall. Although T cell activation tended to be higher in participants imaged closer to the time of the acute illness, tracer uptake was increased in participants imaged up to 2.5 years following SARS-CoV-2 infection. We observed that T cell activation in spinal cord and gut wall was associated with the presence of Long COVID symptoms. In addition, tracer uptake in lung tissue was higher in those with persistent pulmonary symptoms. Notably, increased T cell activation in these tissues was also observed in many individuals without Long COVID. Given the high [18F]F-AraG uptake detected in the gut, we obtained colorectal tissue forin situhybridization SARS-CoV-2 RNA and immunohistochemical studies in a subset of participants with Long COVID symptoms. We identified cellular SARS-CoV-2 RNA in rectosigmoid lamina propria tissue in all these participants, ranging from 158 to 676 days following initial COVID-19 illness, suggesting that tissue viral persistence could be associated with long-term immunological perturbations.
Assessing feasibility and risk to translate, de-identify and summarize medical reports using deep learning
Authors: Gauthier Lucas W. , Willems Marjolaine , Chatron Nicolas , Cenni Camille , Meyer Pierre , Ruault Valentin , Wells Constance , Sabbagh Quentin , Genevieve David , Yauy Kevin 
Published: August 2023

AbstractBackgroundPrecision medicine requires accurate phenotyping and data sharing, particularly for rare diseases. However, sharing medical reports across language barriers is challenging. Alternatively, inconsistent and incomplete clinical summary provided by physicians using Human Phenotype Ontology (HPO) can lead to a loss of clinical information.MethodsTo assess feasibility and risk of using deep learning methods to translate, de-identify and summarize medical reports, we developed an open-source deep learning multi-language software in line with health data privacy. We conducted a non-inferiority clinical trial using deep learning methods to de-identify protected health information (PHI) targeting a minimum sensitivity of 90% and specificity of 75%, and summarize non-English medical reports in HPO format, aiming a sensitivity of 75% and specificity of 90%.ResultsFrom March to April 2023, we evaluated 50 non-English medical reports from 8 physicians and 12 different groups of diseases, which included neurodevelopmental disorders, congenital disorders, fetal pathology and oncology. Reports contain in median 15 PHI and 7 HPO terms. Deep learning method achieved a sensitivity of 99% and a specificity of 87% in de-identification, and a sensitivity of 78% and a specificity of 92% in summarizing medical reports, reporting an average number of 6.6 HPO terms per report, which is equivalent to the number of HPO terms provided usually by physicians in databases (6.8 in PhenoDB).ConclusionsDe-identification and summarization of non-English medical reports using deep learning methods reports non-inferior performance, providing insights on AI usage to facilitate precision medicine.Graphical abstractIllustration of the non-inferiority trial for de-identification and summarization of non-english medical reports and main statistical performances.