bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dual versus Single Innervation of Gracilis Free Functional Muscle Transfer in Facial Paralysis: Long-Term Resting and Dynamic Outcomes
Authors: Thachil Roshni , Wen Y. Edward , Madrazo Adolfo Zamaro , Sanchez Cristina V. , Reisch Joan S. , Rozen Shai M. 
Published: August 2023

Background:
The purpose of this study was to compare long-term tone and excursion in single- versus dual-innervated free functional muscle transfer (FFMT) in patients with longstanding facial paralysis.

Methods:
Patients with longstanding facial palsy treated with an FFMT innervated either by a nerve-to-masseter graft (single-innervation group) or nerve-to-masseter and cross-facial-nerve grafts (dual-innervation group) were included. One-year minimum follow-up was required. Outcome measures, based on standardized photographs, included excursion, smile angle, teeth exposure, commissure height deviation, and upper lip height deviation in repose and in closed and open-teeth smile preoperatively and at 3 months, 1 year, and 3 years postoperatively. Emotrics software and ImageJ software were used to take measurements. Between-group and within-group longitudinal comparisons were analyzed.

Results:
At 3 years (single, n = 24; dual, n = 13), significance was found between groups in commissure position (single, 26.42 mm versus dual, 31.51 mm; P < 0.0001) and excursion with open-mouth smile (single, 31.32 mm versus dual, 26.59 mm; P < 0.001). Single-innervation FFMT within-group analysis lacked significant improvement in commissure height deviation and upper lip height deviation at 3 years in repose, whereas the dual-innervation group revealed significant improvements (3.67 mm [P < 0.001], 3.17 mm [P < 0.001], respectively). Teeth exposure revealed an increase in the dual-innervation group (single, 35.753 mm2 versus dual, 64.177 mm2), but significance was not observed.

Conclusion:
Dual-innervated FFMT revealed improvements in resting tone and teeth exposure with minimal decrease in smile excursion compared with single-innervated FFMT.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Educating Women About Pelvic Floor Disorders During Pregnancy From the First to the “Fourth Trimester”: A Randomized Clinical Trial
Authors: Rutledge Emily , Spiers Alaina , Vardeman Jennifer , Griffin Nickie , Nisar Tariq , Muir Tristi , Antosh Danielle D. 
Published: August 2023

Importance
Pregnancy and childbirth are risk factors for developing pelvic floor disorders (PFDs), and this continues postpartum (“fourth trimester”). Knowledge of PFDs among women of childbearing age is lacking and presents an opportunity for education.

Objectives
The aim of this study was to compare the increase in knowledge of PFDs in patients who received written handouts versus interactive workshops as measured by the Prolapse and Incontinence Knowledge Questionnaire (PIKQ).

Study Design
This was a randomized clinical trial of pregnant patients 18 years or older. Patients either received written handouts only or received handouts and attended an interactive workshop. Handouts were created in collaboration with communication specialists focusing on risk factors and prevention strategies. The primary outcome was the change in PIKQ score. Secondary outcomes were Pelvic Floor Distress Inventory score and postpartum phone interviews of workshop group participants. Questionnaires were assessed at recruitment and 6 weeks postpartum. The nonparametric Wilcoxon test compared continuous variables, and the Fisher exact test compared categorical variables.

Results
One hundred twenty patients were randomized. Demographics were similar between groups. Median PIKQ score change showed no difference between groups (P = 0.37). Pelvic Floor Distress Inventory-20 scores were similar between groups at baseline (P = 0.78) and postpartum (P = 0.82). Quantile regression showed posteducation PIKQ scores were significantly higher in the workshop (21.00 vs 17.00; P = 0.011) and written (21.00 vs 17.00; P < 0.001) groups. Phone interviews showed consistent themes: (1) greater awareness of PFDs, (2) more likely to discuss PFDs, and (3) relief that PFDs are treatable. Fifty-nine percent of patients preferred learning through workshops compared with the handouts.

Conclusions
Both groups showed improvement in knowledge of PFDs. Well-written, illustrated handouts were effective in increasing patient knowledge of PFDs.
Overlapping transmission of group A and C/GStreptococcusfacilitates inter-species mobile genetic element exchange
Authors: Xie Ouli , Zachreson Cameron , Tonkin-Hill Gerry , Price David J , Lacey Jake A , Morris Jacqueline M , McDonald Malcolm I , Bowen Asha C , Giffard Philip M , Currie Bart J , Carapetis Jonathan R , Holt Deborah C , Bentley Stephen D , Davies Mark R , Tong Steven YC 
Published: August 2023

AbstractStreptococcus dysgalactiaesubspeciesequisimilis(SDSE) andStreptococcus pyogenesshare skin and throat niches with extensive genomic homology and horizontal gene transfer (HGT) possibly underlying shared disease phenotypes. It is unknown if cross-species transmission interaction occurs. We conducted a genomic analysis of a longitudinal household survey in remote Australian First Nations communities for patterns of cross-species transmission interaction and HGT. From 4,547 person-consultations, 294 SDSE and 315S. pyogenesisolates were sequenced. SDSE andS. pyogenestransmission intersected extensively among households and the observed co-occurrence and transmission links were consistent with independent transmission without inter-species interference. At least one of three near-identical cross-species mobile genetic elements (MGEs) carrying antimicrobial resistance or streptodornase virulence genes was found in 55 (19%) SDSE and 23 (7%)S. pyogenesisolates. These findings demonstrate extensive co-circulation of both pathogens and HGT and support a need to integrate SDSE andS. pyogenessurveillance and control efforts.
A physiologically-based digital twin for alcohol consumption – predicting real-life drinking responses and long-term plasma PEth
Authors: Podéus Henrik , Simonsson Christian , Nasr Patrik , Ekstedt Mattias , Kechagias Stergios , Lundberg Peter , Lövfors William , Cedersund Gunnar 
Published: August 2023

AbstractAlcohol consumption is associated with a wide variety of preventable health complications and is a major risk factor for all-cause mortality in the age group 15-47 years. To reduce dangerous drinking behavior, eHealth applications have shown promise. A particularly interesting potential lies in the combination of eHealth apps with mathematical models. However, existing mathematical models do not consider real-life situations, such as combined intake of meals and beverages, and do not connect drinking to clinical markers, such asphosphatidylethanol(PEth). Herein, we present such a model which can simulate real-life situations and connect drinking to long-term markers. The new model can accurately describe both estimation data according to a χ2-test (187.0 < Tχ2= 226.4) and independent validation data (70.8 < Tχ2=93.5). The model can also be personalized using anthropometric data from a specific individual and can thus be used as a physiologically-based digital twin. This twin is also able to connect short-term consumption of alcohol to the long-term dynamics of PEth levels in the blood, a clinical biomarker of alcohol consumption. Here we illustrate how connecting short-term consumption to long-term markers allows for a new way to determine patient alcohol consumption from measured PEth levels. An additional use case of the twin could include the combined evaluation of patient-reported AUDIT forms and measured PEth levels. Finally, we integrated the new model into an eHealth application, which could help guide individual users or clinicians to help reduce dangerous drinking.
A risk stratification model for high-flow nasal cannula use in patients with coronavirus disease 2019 in Japan: a single-center retrospective observational cohort study
Authors: Kurihara Ibuki , Sugawara Hitoshi 
Published: August 2023

AbstractBackgroundThe coronavirus disease 2019 (COVID-19) pandemic has put a strain on the healthcare system, and sudden changes in disease status during home treatment have become a serious issue. Therefore, prediction of disease severity and allocation of sufficient medical resources, including high-flow nasal cannula (HFNC), to patients in need are important. We aimed to determine risk factors for the need of HFNC use in COVID-19.MethodsThis was a single-center retrospective observational cohort study including all eligible hospitalized adult patients aged ≥18 years diagnosed with COVID-19 between April 14, 2020 and August 5, 2021 who were treated in the study hospital. The primary outcome was critical respiratory illness meeting one of the following criteria: oxygenation flow rate ≥ 10 L/min, high-flow oxygenation, noninvasive ventilation, invasive ventilation, and death. Nineteen potential predictive variables, including patient characteristics at hospital admission, were screened using least absolute shrinkage and selection operator and logistic regression to construct a predictive risk score. Accuracy of the risk score was determined using area under the receiver operating characteristic curve.ResultsThe study cohort included 148 patients. The rate of critical respiratory illness was 22.9% (all patients needed high-flow device support). Among the 19 potential variables, percutaneous oxygen saturation (SpO2) <92% (odds ratio [OR] 7.50, 95% confidence interval [CI] 2.806–20.82) and IL-6 (OR 1.021, 95% CI 1.010–1.033) were included in developing the risk score, which was termed interleukin (IL)-6-based COVID-19 severity (IBC-S) score.ConclusionsThe IBC-S score, an easy-to-use risk score based on parameters available at the time of hospital admission, predicted critical respiratory failure in patients with COVID-19. In primary care settings, the IBC-S score based on interleukin-6 and SpO2 might aid in determining patients who should be transported to a tertiary medical institution or an isolation facility.
Plasticity, geographic variation and trait coordination in blue oak drought physiology
Authors: Anderegg Leander D.L. , Skelton Robert P. , Diaz Jessica , Papper Prahlad , Ackerly David D. , Dawson Todd E. 
Published: August 2023

SummaryOur ability to predict drought stress across the landscape remains limited. This uncertainty stems in part from an incomplete understanding of within-species variation in hydraulic physiology, particularly coordinated variation across multiple traits. This variation reflects genetic differentiation among populations (ecotypic variation) and phenotypic plasticity. We examined among-population differentiation in morphological and hydraulic traits in California blue oak (Quercus douglasii) using a 30 year-old common garden. We compared trait differentiation and trait-trait coordination in the garden to wild phenotypes from the original source populations. We found remarkably limited among-population differentiation in all traits in the common garden but considerable site-to-site variation in the field that could rarely be explained with site climate variables. Trait-trait relationships were also stronger in the field than in the garden, particularly links between leaf morphology, leaf hydraulic efficiency and stem hydraulic efficiency. Only four trait-trait relationship were present in both the wild and garden, but 12 of 45 relationships showed significant wild phenotypic correlations, with strong coordination among leaf and stem hydraulic efficiency apparently mediated by leaf size. Ultimately, we found limited evidence for ecotypic variation but considerable geographic in phenotypic integration in the wild, suggesting considerable acclimation potential in the face of climate change.
The risk of future mpox outbreaks among men who have sex with men: a modelling study based on cross-sectional seroprevalence data
Authors: Shamier Marc C. , Zaeck Luca M. , Götz Hannelore M. , Vieyra Bruno , Verstrepen Babs E. , Wijnans Koen , Welkers Matthijs R.A. , Hoornenborg Elske , van Royen Martin E. , Jonas Kai J. , Koopmans Marion P.G. , de Vries Rory D. , van de Vijver David A.M.C. , GeurtsvanKessel Corine H. 
Published: August 2023

Structured abstractBackgroundIn the wake of the 2022-2023 mpox outbreak, crucial knowledge gaps exist regarding orthopoxvirus-specific immunity in risk groups and its impact on future outbreaks.AimThis study combined cross-sectional seroprevalence studies in two cities in the Netherlands with mathematical modelling to evaluate the risk of future mpox outbreaks among men who have sex with men (MSM).MethodsSerum samples were obtained from 1,065 MSM visiting the Centres for Sexual Health (CSH) in Rotterdam or Amsterdam after the introduction of vaccination and the peak of the Dutch mpox outbreak. For MSM visiting the CSH in Rotterdam, sera were linked to epidemiological and vaccination data. An in-house developed ELISA was used to detect vaccinia virus (VACV)- specific IgG. These observations were combined with literature data on infection dynamics and vaccine effectiveness to inform a stochastic transmission model to estimate the risk on future mpox outbreaks.ResultsThe seroprevalence of VACV-specific antibodies was 45.4% and 47.1% in Rotterdam and Amsterdam, respectively. Transmission modelling showed that the impact of risk group vaccination on the original outbreak was likely small; however, the number of mpox cases in a future outbreak would be markedly reduced because of vaccination. Simultaneously, the current level of immunity alone may not prevent future outbreaks. Maintaining a short time-to-diagnosis will be a key component of any strategy to prevent new outbreaks.DiscussionOur findings indicate a reduced likelihood of future mpox outbreaks among MSM in the Netherlands under the current conditions, but emphasise the importance of maintaining population immunity, diagnostic capacities, and disease awareness.
Findings from a Pilot of a Near Real Time Disease Surveillance Tool on the NATO Mission in Kosovo
Authors: Lindfield Robert , Biendl Claudia , Toth Mate , Ruhl Silke 
Published: August 2023

AbstractNATO has a requirement for a near real time surveillance (NRTS) tool to rapidly identify disease outbreaks but no deployable tool is available. The NATO Centre of Excellence for Military Medicine (MILMED COE) developed a NRTS tool and piloted it on the NATO Mission in Kosovo (KFOR).Ten medical treatment facilities (MTFs) in KFOR piloted the tool which is an app on a smart device. All first presentations were eligible for inclusion into the app. Primary presenting symptoms were mapped to one or more of 40 symptoms. No patient identifiable information was collected. Analysis was available to each MTF and the Medical HQ staff (JMED) which provided a summary of the data collected. Combinations of symptoms resulted in an alert email to the JMED and MTF.An evaluation was conducted at two time points consisting of data analysis and semi-structured interviews with key informants from each participating MTF and JMED team.1351 patients were entered during the pilot. 851 reports had symptoms recorded. The leading symptoms were pain-in-throat, cough and temperature. Two investigations were launched based on reporting in the app; a cluster of skin lesions and two cases of diarrhoea. No significant outbreaks were reported during the pilot or detected by the app.Interviews revealed that the app was easy to use and the symptom list was comprehensive. The analysis tool was not regularly viewed by MTFs however the JMED team used it frequently. Alerts were considered extremely valuable by both the MTFs and JMED team.The KFOR pilot provided an excellent opportunity to pilot the tool in a NATO Mission and established that the way it collected data and alerted issues worked well. Further validation and analysis of the tool is required before it can be rolled out further.
Relationship of plasma biomarkers to digital cognitive tests in alzheimer’s disease
Authors: Toniolo Sofia , Zhao Sijia , Scholcz Anna , Amein Benazir , Ganse-Dumrath Akke , Heslegrave Amanda J , Thompson Sian , Manohar Sanjay , Zetterberg Henrik , Husain Masud 
Published: August 2023

AbstractIntroductionA major limitation in Alzheimer’s disease (AD) research is the lack of the ability to measure cognitive performance at scale - robustly, remotely, and frequently. Currently, there are no established online digital platforms validated against plasma biomarkers of AD.MethodsWe used a novel web-based platform that assessed different cognitive functions in AD patients (N=46) and elderly controls (N=53) who were also evaluated for plasma biomarkers (amyloid β42/40 ratio, pTau181, GFAP, NfL). Their cognitive performance was compared to a second, larger group of elderly controls (N=352).ResultsPatients with AD were significantly impaired across all digital cognitive tests, with performance correlating with plasma biomarker levels, particularly pTau181. The combination of pTau181 and the single best-performing digital test achieved high accuracy in group classification.DiscussionThese findings show how online testing can now be deployed in patients with AD to measure cognitive function effectively and related to blood biomarkers of the disease.
Insights into the Mechanisms and Structure of Breakage-Fusion-Bridge Cycles in Cervical Cancer using Long-Read Sequencing
Authors: Rodriguez Isabel , Rossi Nicole M. , Keskus Ayse , Xie Yi , Ahmad Tanveer , Bryant Asher , Lou Hong , Paredes Jesica Godinez , Milano Rose , Rao Nina , Tulsyan Sonam , Boland Joseph F. , Luo Wen , Liu Jia , O’Hanlon Tim , Bess Jazmyn , Mukhina Vera , Gaykalova Daria , Yuki Yuko , Malik Laksh , Billingsley Kimberley , Blauwendraat Cornelis , Carrington Mary , Yeager Meredith , Mirabello Lisa , Kolmogorov Mikhail , Dean Michael 
Published: August 2023

SummaryCervical cancer is caused by human papillomavirus (HPV) infection, has few approved targeted therapeutics, and is the most common cause of cancer death in low-resource countries. We characterized 19 cervical and four head and neck cell lines using long-read DNA and RNA sequencing and identified the HPV types, HPV integration sites, chromosomal alterations, and cancer driver mutations. Structural variation analysis revealed telomeric deletions associated with DNA inversions resulting from breakage-fusion-bridge (BFB) cycles. BFB is a common mechanism of chromosomal alterations in cancer, and this is one of the first analyses of these events using long-read sequencing. Analysis of the inversion sites revealed staggered ends consistent with exonuclease digestion of the DNA after breakage. Some BFB events are complex, involving inter- or intra-chromosomal insertions or rearrangements. None of the BFB breakpoints had telomere sequences added to resolve the dicentric chromosomes and only one BFB breakpoint showed chromothripsis. Five cell lines have a Chr11q BFB event, withYAP1/BIRC2/BIRC3gene amplification. Indeed,YAP1amplification is associated with a 10-year earlier age of diagnosis of cervical cancer and is three times more common in African American women. This suggests that cervical cancer patients withYAP1/BIRC2/BIRC3-amplification, especially those of African American ancestry, might benefit from targeted therapy. In summary, we uncovered new insights into the mechanisms and consequences of BFB cycles in cervical cancer using long-read sequencing.
Patients Accessing their Online Records in England: A Survey of General Practitioners’ Experiences and Opinions
Authors: Blease Charlotte , Kharko Anna , Dong Zhiyong , Jones Ray , Davidge Gail , Hägglund Maria , Turner Andrew , DesRoches Catherine M. , McMillan Brian 
Published: August 2023

AbstractObjectiveTo describe the experiences and opinions of general practitioners (GPs) in England regarding patients having access to their full online GP health record.DesignConvenience sample, online survey.Participants400 registered GPs in England.Main outcome measuresInvestigators measured GPs’ experiences and opinions about online record access (ORA) including on patient care, and on their practice.ResultsA total of 400 GPs from all regions of England responded. A minority (130, 33%) believed ORA was a good idea. Most GPs believed a majority of patients would worry more (364, 91%) or find their GP records more confusing than helpful (338, 85%). In contrast, most GPs believed a majority of patients would find significant errors in their records (240, 60%), would better remember their care plan (280, 70%), and feel more in control of their care (243, 60%). The majority believed they will/already spend more time addressing patients’ questions outside of consultations (357, 89%), that consultations will/already take significantly longer (322, 81%), and reported they will be/already are less candid in their documentation (289, 72%) after ORA. Nearly two thirds of GPs believed ORA would increase their litigation (246, 62%).ConclusionsSimilar to clinicians in other countries, GPs in our sample were sceptical of ORA believing patients would worry more and find their records more confusing than helpful. Most GPs also believed the practice would exacerbate work burdens. However, the majority of GPs in this survey also agreed there were multiple benefits to patients having online access to their primary care health record.
While they wait: A cross-sectional survey on wait times for mental health treatment for anxiety and depression for Australian adolescents
Authors: Subotic-Kerry Mirjana , Borchard Thomas , Parker Belinda , Li Sophie H. , Choi Jayden , Long Emma V. , Batterham Philip J , Whitton Alexis E. , Gokiert Aniela , Spencer Lucinda , O’Dea Bridianne 
Published: August 2023

ABSTRACTBackgroundWait times are reported to impede adolescents’ access to mental health treatment for anxiety and depression. However, there is limited quantitative research on current wait times for the treatment of anxiety and depression for Australian adolescents and the impact of these on young help-seekers.AimsThis study examined Australian adolescents’ experiences of wait times for the treatment of anxiety and depression, including the providers they were waiting to access, the self-reported duration and perceived acceptability of wait times, the association between these wait times and psychological distress, and the support and coping behaviours used by adolescents during this time.MethodFrom April to June 2022, 375 Australian adolescents aged 13-17 years who were currently waiting, or had previously waited in the past 12 months, for mental health treatment for anxiety and depression completed an anonymous cross-sectional online survey.ResultsThe mean wait time across all treatment providers was 94.1 days (SD: 69.65). Psychologists and psychiatrists were the most utilised services. Most participants felt their wait times were ‘too long’ and longer wait times were significantly associated with increased psychological distress. Many participants perceived their mental health to have worsened during the wait time and engaged in maladaptive and risky coping behaviours while waiting. Most participants did not receive any support from their healthcare providers during the wait time. However, self-reported treatment attendance remained high.ConclusionsMany Australian adolescents face lengthy wait periods when trying to access mental health treatment and this period may exacerbate distress and maladaptive coping.