bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Reactivation of Scleroderma After Autologous Fat Grafting
Authors: Wang Hayson Chenyu , Long Xiao 
Published: August 2023

Background:
Patients with localized scleroderma (LS) often have to seek plastic surgery to improve facial esthetic impairment.

Aims:
The authors reported a case of the reactivation of LS after autologous fat grafting (AFG).

Patient:
A man presented with facial atrophy and skin fibrosis on the cheek with a history of LS. The disease had remained stable for 9 years and he was suggested to stop oral medication. With irreversible esthetic impairment on the face, he sought plastic surgery for improvement. He underwent twice AFG into the right cheek with about 60 mL fat graft each. The donor sites were the abdomen and both thighs.

Results:
Six months after the last AFG, the patient found new lesions occur on the lateral forehead. The patient was later diagnosed with reactivation of LS.

Conclusion:
The understanding of the surgical risk and perioperative management for patients with LS needs more research.
Predictors of fetal delivery in pregnant trauma patients: A multicenter study
Authors: Santos Jeffrey W. , Grigorian Areg , Lucas Alexa N. , Fierro Nicole , Dhillon Navpreet K. , Ley Eric J. , Smith Jennifer , Burruss Sigrid , Dahan Alden , Johnson Arianne , Ganske William , Biffl Walter L. , Bayat Dunya , Castelo Matthew , Wintz Diane , Schaffer Kathryn B. , Zheng Dennis J. , Tillou Areti , Coimbra Raul , Tuli Rahul , Santorelli Jarrett E. , Emigh Brent , Schellenberg Morgan , Inaba Kenji , Duncan Thomas K. , Diaz Graal , Tay-Lasso Erika , Zezoff Danielle C. , Nahmias Jeffry 
Published: August 2023

BACKGROUND
Pregnant trauma patients (PTPs) undergo observation and fetal monitoring following trauma due to possible fetal delivery (FD) or adverse outcome. There is a paucity of data on PTP outcomes, especially related to risk factors for FD. We aimed to identify predictors of posttraumatic FD in potentially viable pregnancies.

METHODS
All PTPs (≥18 years) with ≥24-weeks gestational age were included in this multicenter retrospective study at 12 Level-I and II trauma centers between 2016 and 2021. Pregnant trauma patients who underwent FD ((+) FD) were compared to those who did not deliver ((−) FD) during the index hospitalization. Univariate analyses and multivariable logistic regression were performed to identify predictors of FD.

RESULTS
Of 591 PTPs, 63 (10.7%) underwent FD, with 4 (6.3%) maternal deaths. The (+) FD group was similar in maternal age (27 vs. 28 years, p = 0.310) but had older gestational age (37 vs. 30 weeks, p < 0.001) and higher mean injury severity score (7.0 vs. 1.5, p < 0.001) compared with the (−) FD group. The (+) FD group had higher rates of vaginal bleeding (6.3% vs. 1.1%, p = 0.002), uterine contractions (46% vs. 23.5%, p < 0.001), and abnormal fetal heart tracing (54.7% vs. 14.6%, p < 0.001). On multivariate analysis, independent predictors for (+) FD included abdominal injury (odds ratio [OR], 4.07; confidence interval [CI], 1.11–15.02; p = 0.035), gestational age (OR, 1.68 per week ≥24 weeks; CI, 1.44–1.95; p < 0.001), abnormal FHT (OR, 12.72; CI, 5.19–31.17; p < 0.001), and premature rupture of membranes (OR, 35.97; CI, 7.28–177.74; p < 0.001).

CONCLUSION
The FD rate was approximately 10% for PTPs with viable fetal gestational age. Independent risk factors for (+) FD included maternal and fetal factors, many of which are available on initial trauma bay evaluation. These risk factors may help predict FD in the trauma setting and shape future guidelines regarding the recommended observation of PTPs.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
Association of High-Deductible Health Plans and Time to Surgery for Breast and Colon Cancer
Authors: Sheckter Clifford C , Rochlin Danielle H , Rubenstein Robyn , Shamsunder Meghana G , Morris Arden M , Wagner Todd H , Matros Evan 
Published: August 2023

BACKGROUND:
High-deductible health plans (HDHPs) have been shown to delay timing of breast and colon cancer screening, although the relationship to the timing of cancer surgery is unknown. The objective of this study was to characterize timing of surgery for breast and colon cancer patients undergoing cancer operations following routine screening.

STUDY DESIGN:
Data from the IBM MarketScan Commercial Claims Database from 2007 to 2016 were queried to identify patients who underwent screening mammogram and/or colonoscopy. The calendar quarters of screening and surgery were analyzed with ordinal logistic regression. The time from screening to surgery (time to surgery, TTS) was evaluated using a Cox proportional hazard function.

RESULTS:
Among 32,562,751 patients who had screening mammograms, 0.7% underwent breast cancer surgery within the following year. Among 9,325,238 patients who had screening colonoscopies, 0.9% were followed by colon cancer surgery within a year. The odds of screening (OR 1.146 for mammogram, 1.272 for colonoscopy; p < 0.001) and surgery (OR 1.120 for breast surgery, 1.219 for colon surgery; p < 0.001) increased each quarter for HDHPs compared to low-deductible health plans. Enrollment in an HDHP was not associated with a difference in TTS. Screening in Q3 or Q4 was associated with shorter TTS compared to screening in Q1 (hazard ratio 1.061 and 1.046, respectively; p < 0.001).

CONCLUSIONS:
HDHPs were associated with delays in screening and surgery. However, HDHPs were not associated with delays in TTS. Interventions to improve cancer care outcomes in the HDHP population should concentrate on reducing barriers to timely screening.
Does Trauma Center Volume Account for the Association Between Trauma Center Verification Level and In-Hospital Mortality among Children Injured by Firearms in California?
Authors: Sullivan Gwyneth A , Reddy Susheel , Reiter Audra J , Zeineddin Suhail , Visenio Michael , Hu Andrew , Mackersie Robert , Kabre Rashmi , Raval Mehul V , Stey Anne M 
Published: August 2023

BACKGROUND:
Heterogeneity in trauma center designation and injury volume offer possible explanations for inconsistencies in pediatric trauma center designation’s association with lower mortality among children. We hypothesized that rigorous trauma center verification, regardless of volume, would be associated with lower firearm injury-associated mortality in children.

STUDY DESIGN:
This retrospective cohort study leveraged the California Office of Statewide Health Planning and Development patient discharge data. Data from children aged 0 to 14 years in California from 2005 to 2018 directly transported with firearm injuries were analyzed. American College of Surgeons (ACS) trauma center verification level was the primary predictor of in-hospital mortality. Centers’ annual firearm injury volume data were analyzed as a mediator of the association between center verification level and in-hospital mortality. Two mixed-effects multivariable logistic regressions modeled in-hospital mortality and the estimated association with center verification while adjusting for patient demographic and clinical characteristics. One model included the center’s firearm injury volume and one did not.

RESULTS:
The cohort included 2,409 children with a mortality rate of 8.6% (n = 206). Adjusted odds of mortality were lower for children at adult level I (adjusted odds ratio [aOR] 0.38, 95% CI 0.19 to 0.80), pediatric (aOR 0.17, 95% CI 0.05 to 0.61), and dual (aOR 0.48, 95% CI 0.25 to 0.93) trauma centers compared to nontrauma/level III/IV centers. Firearm injury volume did not mediate the association between ACS trauma center verification and mortality (aOR/10 patient increase in volume 1.01, 95% CI 0.99 to 1.03).

CONCLUSIONS:
Trauma center verification level, regardless of firearm injury volume, was associated with lower firearm injury-associated mortality, suggesting that the ACS verification process is contributing to achieving optimal outcomes.
Calcification and trophic responses of Mesophotic reefs to carbonate chemistry variability
Authors: Noyes Timothy J. , Garley Rebecca , Bates Nicholas R. 
Published: August 2023

AbstractMesophotic coral ecosystems (MCEs) are extensions of adjacent shallow water coral reefs. Accessibility to these ecosystems is challenging due to their depth limits (∼ 30 – 150 m) and as a result, scientific knowledge of these reef systems is limited. It has been posited that the depth limits of MCEs diminish anthropogenic effects experienced by shallow reef systems. A lack of empirical measurements to date has made this hypothesis impossible to determine for mesophotic reef metabolism. The alkalinity anomaly technique was utilized to determine rates of net ecosystem calcification (NEC) and net ecosystem production (NEP) from 30, 40 and 60 m mesophotic reefs during a 15-month period. Seawater chemistry was determined to be chemically conducive for calcification (average aragonite saturation Ωaragoniteof 3.58, average calcite saturation Ωcalciteof 5.44) with estimates of NEC indicating these reef systems were net accretive and within global average values for shallow coral reefs (< 30 m). The strongest periods of calcification occurred in late summer and were coupled with strong autotrophic signals. These episodes were followed by suppressed calcification and autotrophy and in the case of the 60 m reefs, a switch to heterotrophy. Whilst there was variability between the three reefs depths, the overall status of the mesophotic system was net autotrophic. This determination was the opposite of trophic status estimates previously described for adjacent shallow reefs. Whilst there were periods of net dissolution, the mesophotic reef system was net accretive (i.e., gross calcification > gross CaCO3dissolution). The measured inorganic carbon chemistry and estimates of NEC and NEP represent the first such biogeochemical measurements for MCEs. The values established by this study demonstrate just how close these understudied ecosystems are in terms of the known boundary thresholds for low saturation state reefs. Making predictions on how these ecosystems will respond to future climatic conditions, will require greater sampling effort over long times scales to decouple the environmental controls exerted on such ecosystems.
Characteristics of motor evoked potentials in patients with peripheral vascular disease
Authors: Sarai Pawandeep , Luff Charlotte , Rohani-Shukla Cyrus , Strutton Paul H 
Published: August 2023

AbstractWith an aging population, it is common to encounter people diagnosed with peripheral vascular disease (PVD). Some will undergo surgeries during which the spinal cord may be compromised and intraoperative neuromonitoring with motor evoked potentials (MEPs) is employed to help mitigate paralysis. No data exists on characteristics of MEPs in older, PVD patients, which would be valuable for patients undergoing spinal cord at-risk surgery or participating in neurophysiological research.Transcranial magnetic stimulation, which can be delivered to the awake patient, was used to stimulate the motor cortex of 20 patients (mean (±SD) age 63.2yrs (±11.5) with confirmed PVD, every 10 minutes for one hour with MEPs recorded from selected upper and lower limb muscles. Data were compared to that from 20 healthy volunteers recruited for a protocol development study (28yrs (±7.6)). MEPs did not differ between patient’s symptomatic and non-symptomatic legs. MEP amplitudes were smaller in patients than in healthy participants in the upper limbs muscles, but not in lower limb muscles. Disease severity did not correlate with MEP amplitude. There were no differences over time in the coefficient of variation of MEP amplitude at each time point nor over the paradigm between groups. Latencies of MEPs were longer in patients for brachioradialis and vastus lateralis, but not in the other muscles studied.The results obtained suggest PVD alone does not impact MEPs; there were no differences between more symptomatic and less symptomatic legs. Further, disease severity did not corelate with MEP characteristics. Differences observed in MEPs between patients and healthy participants are more likely a result of ageing.With an aging population, more patients with PVD and cardiovascular risk factors will be participating in neurophysiological studies or undergoing surgery where spinal cord integrity is monitored. Our data show that MEPs from these patients can be easily evoked and interpreted.
LFSPROShiny: an interactive R/Shiny app for prediction and visualization of cancer risks in families with deleterious germlineTP53mutations
Authors: Nguyen Nam H , Dodd-Eaton Elissa B , Peng Gang , Corredor Jessica L. , Jiao Wenwei , Woodman-Ross Jacynda , Arun Banu K. , Wang Wenyi 
Published: August 2023

AbstractPurposeLFSPRO is an R library that implements risk prediction models for Li-Fraumeni syndrome (LFS), a genetic disorder characterized by deleterious germline mutations in theTP53gene. To facilitate the use of these models in clinics, we developed LFSPROShiny, an interactive R/Shiny interface of LFSPRO that allows genetic counselors (GCs) to perform risk predictions without any programming components, and further visualize the risk profiles of their patients to aid the decision-making process.MethodsLFSPROShiny implements two models that have been validated on multiple LFS patient cohorts: a competing-risk model that predicts cancer-specific risks for the first primary, and a recurrent-event model that predicts the risk of a second primary tumor. Starting with a visualization template, we keep regular contact with GCs, who ran LFSPROShiny in their counseling sessions, to collect feedback and discuss potential improvement. Upon receiving the family history as input, LFSPROShiny renders the family into a pedigree, and displays the risk estimates of the family members in a tabular format. The software offers interactive overlaid side-by-side bar charts for visualization of the patients’ cancer risks relative to the general population.ResultsWe walk through a detailed example to illustrate how GCs can run LFSPROShiny in clinics, from data preparation to downstream analyses and interpretation of results with an emphasis on the utilities that LFSPROShiny provides to aid decision making.ConclusionSince Dec 2021, we have applied LFSPROShiny to over 100 families from counseling sessions at MD Anderson Cancer Center. Our study suggests that software tools with easy-to-use interfaces are crucial for the dissemination of risk prediction models in clinical settings, hence serving as a guideline for future development of similar models.
Free energies of the Gln tautomerization and rotation mechanism of dark-state recovery in blue light-using flavin proteins
Authors: Pérez de Alba Ortíz Alberto , Rovira Carme , Ensing Bernd 
Published: August 2023

AbstractBlue light-using flavin (BLUF) proteins are light-sensors that regulate responsive movement, gene expression and enzyme activity in diverse organisms. Their signaling times range from seconds to minutes, indicating a uniquely flexible dark-state recovery mechanism. Unlike other light-sensors, the flavin chromophore is non-covalently bonded to the protein. Hence, the switching occurs via a change in the protein-flavin hydrogen-bond network, involving conserved residues transferring protons, tautomerizing, rotating, and approaching or leaving the chromophore pocket; triggering secondary structure displacements. The specific deactivation steps and residue roles have remained controversial. The detailed process is difficult to probe experimentally, and although simulations can track it, the computational effort is daunting. We combine forefront techniques to simulate, for the first time, explicit dynamics of the deactivation. A hybrid quantum mechanics/molecular mechanics scheme focuses the computational resolution in the flavin’s vicinity, while our path-based methods sample the mechanism of dark-state recovery with high efficiency. Our protocol delivers free-energy profiles for the deactivation of two BLUF proteins, BlrB and AppA; corroborating a proposed mechanism based on the rotation and tautomerization of a conserved Gln. We find that the conformation of a Trp and a Met near the flavin is crucial to modulate the rate-determining barrier, which differs significantly between the BlrB and AppA proteins. Our work evidences how specific variations of the deactivation mechanism control vast differences in signaling times.
Flexible regulation of representations on a drifting manifold enables long-term stable complex neuroprosthetic control
Authors: Natraj Nikhilesh , Seko Sarah , Abiri Reza , Yan Hongyi , Graham Yasmin , Tu-Chan Adelyn , Chang Edward F. , Ganguly Karunesh 
Published: August 2023

AbstractThe nervous system needs to balance the stability of neural representations with plasticity. It is unclear what is the representational stability of simple actions, particularly those that are well-rehearsed in humans, and how it changes in new contexts. Using an electrocorticography brain-computer interface (BCI), we found that the mesoscale manifold and relative representational distances for a repertoire of simple imagined movements were remarkably stable. Interestingly, however, the manifold’s absolute location demonstrated day-to-day drift. Strikingly, representational statistics, especially variance, could be flexibly regulated to increase discernability during BCI control without somatotopic changes. Discernability strengthened with practice and was specific to the BCI, demonstrating remarkable contextual specificity. Accounting for drift, and leveraging the flexibility of representations, allowed neuroprosthetic control of a robotic arm and hand for over 7 months without recalibration. Our study offers insight into how electrocorticography can both track representational statistics across long periods and allow long-term complex neuroprosthetic control.
Mechanism of proton-powered c-ring rotation in a mitochondrial ATP synthase
Authors: Blanc Florian E. C. , Hummer Gerhard 
Published: August 2023

AbstractProton-powered c-ring rotation in mitochondrial ATP synthase is crucial to convert the transmembrane protonmotive force into torque to drive the synthesis of ATP. Capitalizing on recent cryo-EM structures, we aim at a structural and energetic understanding of how functional directional rotation is achieved. We performed multi-microsecond atomistic simulations to determine the free energy profiles along the c-ring rotation angle before and after the arrival of a new proton. Our results reveal that rotation proceeds by dynamic sliding of the ring over the a-subunit surface, during which interactions with conserved polar residues stabilize distinct intermediates. Ordered water chains line up for a Grotthuss-type proton transfer in one of these intermediates. After proton transfer, a high barrier prevents backward rotation and an overall drop in free energy favors forward rotation, ensuring the directionality of c-ring rotation required for the thermodynamically disfavored ATP synthesis. The essential arginine of the a-subunit stabilizes the rotated configuration through a salt-bridge with the c-ring. Overall, we describe a complete mechanism for the rotation step of the ATP synthase rotor, thereby illuminating a process critical to all life at atomic resolution.
Regional and fine-scale local adaptation in salinity tolerance inDaphniainhabiting contrasting clusters of inland saline waters
Authors: Brans Kristien I. , Vad Csaba F. , Horváth Zsófia , Santy Luca , Cuypers Kiani , Ptacnik Robert , De Meester Luc 
Published: August 2023

AbstractUnderstanding the spatial scales at which organisms can adapt to strong natural and human-induced environmental gradients is important. Salinisation is a key threat to biodiversity, ecosystem functioning, and the provision of ecosystem services of freshwater systems. Clusters of naturally saline habitats represent ideal test cases to study the extent and scale of local adaptation to salinisation. We studied local adaptation of the water fleaDaphnia magna, a key component of pond food webs, to salinity in two contrasting landscapes - a dense cluster of sodic bomb crater ponds and a larger-scale cluster of soda pans. We show regional differentiation in salinity tolerance reflecting the higher salinity levels of soda pans versus bomb crater ponds. We found local adaptation to differences in salinity levels at the scale of tens of metres among bomb crater pond populations but not among geographically more distant soda pan populations. More saline bomb crater ponds showed an upward shift of the minimum salt tolerance observed across clones and a consequent gradual loss of less tolerant clones in a nested pattern. Our results show evolutionary adaptation to salinity gradients at different spatial scales and fine-tuned local adaptation in neighbouring habitat patches in a natural landscape.
Variable Gain DNA Nanostructure Charge Amplifiers for Biosensing
Authors: Majikes Jacob M. , Cho Seulki , Cleveland Thomas E. , Liddle J. Alexander , Balijepalli Arvind 
Published: August 2023

AbstractElectronic measurements of engineered nanostructures comprised solely of DNA (DNA nanostructures) enable new signal conditioning modalities in biosensing. Here, we demonstrate how DNA nanostructures that alter their conformation upon binding a nucleic acid analyte drastically, and reversibly, amplify the measured electrochemical signal. This amplification was controlled by the applied electrical field to achieve a response ≈ 2×104times greater than that measured from DNA hybridization. Because the amplification is independent of the interaction between the analyte and the DNA nanostructure, our approach provides a platform for tuning the response of the system for high performance that is agnostic of the end application. These molecularly precise self-assembled DNA nanostructures when paired with scalable electronic readout can therefore lead the way to highly sensitive multiplexed biosensing.
Linking spontaneous and stimulated spine dynamics
Authors: Eggl M. F. , Chater T. E. , Petkovic J. , Goda Y. , Tchumatchenko T. 
Published: August 2023

AbstractOur brains continuously acquire and store memories through synaptic plasticity. However, spontaneous synaptic changes can also occur and pose a challenge for maintaining stable memories. Despite fluctuations in synapse size, recent studies have shown that key population-level synaptic properties remain stable over time. This raises the question of how local synaptic plasticity affects the global population-level synaptic size distribution and whether individual synapses undergoing plasticity escape the stable distribution to encode specific memories. To address this question, we(i)studied spontaneously evolving spines and(ii)induced synaptic potentiation at selected sites while observing the spine distribution pre- and post-stimulation. We designed a stochastic model to describe how the current size of a synapse affects its future size under baseline and stimulation conditions and how these local effects give rise to population-level synaptic shifts. Our study offers a new understanding of how seemingly spontaneous synaptic fluctuations and local plasticity both contribute to population-level synaptic dynamics.