bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multisystem Inflammatory Syndrome in Children in Western Countries? Decreasing Incidence as the Pandemic Progresses?: An Observational Multicenter International Cross-sectional Study
Authors: Buonsenso Danilo , Perramon Aida , Català Martí , Torres Juan P. , Camacho-Moreno Germán , Rojas-Solano Mariela , Ulloa-Gutierrez Rolando , Camacho-Badilla Kattia , Pérez-Corrales Cristian , Cotugno Nicola , Yamazaki-Nakashimada Marco A. , Estripeaut Dora , Buddingh Emilie Pauline , von Asmuth Erik , van Rossum Annemarie M.C. ,   COPP-consortium, Soler-Palacin Pere , Rivière Jacques G. , Prats Clara , Pino Rosa , Paredes-Carmona Fernando , Visa-Reñé Núria , García-Salido Alberto , Martínez-Mejias Abel ,   COPEDI-CAT Research Group, Soriano-Arandes Antoni 
Published: September 2022

Background:
SARS-CoV-2 variations as well as immune protection after previous infections and/or vaccination may have altered the incidence of multisystemic inflammatory syndrome in children (MIS-C). We aimed to report an international time-series analysis of the incidence of MIS-C to determine if there was a shift in the regions or countries included into the study.

Methods:
This is a multicenter, international, cross-sectional study. We collected the MIS-C incidence from the participant regions and countries for the period July 2020 to November 2021. We assessed the ratio between MIS-C cases and COVID-19 pediatric cases in children <18 years diagnosed 4 weeks earlier (average time for the temporal association observed in this disease) for the study period. We performed a binomial regression analysis for 8 participating sites [Bogotá (Colombia), Chile, Costa Rica, Lazio (Italy), Mexico DF, Panama, The Netherlands and Catalonia (Spain)].

Results:
We included 904 cases of MIS-C, among a reference population of 17,906,432 children. We estimated a global significant decrease trend ratio in MIS-C cases/COVID-19 diagnosed cases in the previous month (P < 0.001). When analyzing separately each of the sites, Chile and The Netherlands maintained a significant decrease trend (P < 0.001), but this ratio was not statistically significant for the rest of sites.

Conclusions:
To our knowledge, this is the first international study describing a global reduction in the trend of the MIS-C incidence during the pandemic. COVID-19 vaccination and other factors possibly linked to the virus itself and/or community transmission may have played a role in preventing new MIS-C cases.
Visual outcomes and complications of combined vs sequential cataract surgery and pars plana vitrectomy: multicenter database study
Authors: Elhusseiny Abdelrahman M. , Soliman Mohamed K. , Shakarchi Ahmed F. , Fouad Yousef A. , Yang Yit C. , Sallam Ahmed B. 
Published: September 2022

Purpose:
To compare the visual outcomes and rates of intraoperative complications in eyes that underwent combined cataract extraction (CE) and pars plana vitrectomy (combined group) with those that underwent sequential surgery (sequential group).

Setting:
Multicenter study.

Design:
Retrospective chart review.

Methods:
CE data set pooled from 8 UK sites between 2000 and 2015. The main outcome measures were the mean postoperative visual acuity (VA) and the rate of intraoperative complications in both groups.

Results:
2236 eyes in the combined group and 2270 eyes in the sequential group were included in this study. Mean preoperative VA was 1.0 logMAR in both groups. The mean logMAR postoperative VA was worse in the combined group than in the sequential group (P < .0001) at all timepoints, however, the differences in visual improvement between both groups decreased with longer follow-up time: 1.0 ± 0.7 vs 0.6 ± 0.6, 0.7 ± 0.6 vs 0.4 ± 0.5, and 0.7 ± 0.6 vs 0.5 ± 0.5 at 0 to 4 weeks, 4 to 12 weeks, and 12 to 24 weeks, respectively. Proportions of eyes that gained >3 logMAR units were 49% in the combined group and 66.2% in the sequential group (P < .0001). Logistic regression analysis showed that sequential surgery (odds ratio, 2.1) was a predictor for reaching 20/40 vision by 6 months. In the combined group, there was a statistically significantly higher rate of posterior capsular rupture.

Conclusions:
Postoperative visual gain was less in the combined group with a higher rate of posterior capsular rupture as compared with sequential phacovitrectomy. However, small differences in visual improvements between both groups by 6 months were observed.
Diet and the microbiota–gut–brain-axis: a primer for clinical nutrition
Authors: Ribeiro Gabriela , Ferri Aimone , Clarke Gerard , Cryan John F. 
Published: September 2022

Purpose of review
Diet is an essential modulator of the microbiota–gut–brain communication in health and disease. Consequently, diet-induced microbiome states can impact brain health and behaviour. The integration of microbiome into clinical nutrition perspectives of brain health is sparse. This review will thus focus on emerging evidence of microbiome-targeted dietary approaches with the potential to improve brain disorders.

Recent findings
Research in this field is evolving toward randomized controlled trials using dietary interventions with the potential to modulate pathways of the microbiota–gut–brain-axis. Although most studies included small cohorts, the beneficial effects of Mediterranean-like diets on symptoms of depression or fermented foods on the immune function of healthy individuals shed light on how this research line can grow. With a clinical nutrition lens, we highlight several methodological limitations and knowledge gaps, including the quality of dietary intake information, the design of dietary interventions, and missing behavioural outcomes.

Summary
Findings in diet–microbiome–brain studies can have groundbreaking implications in clinical nutrition practice and research. Modulating brain processes through diet via the gut microbiota raises numerous possibilities. Novel dietary interventions targeting the microbiota–gut–brain-axis can offer various options to prevent and treat health problems such as mental disorders. Furthermore, knowledge in this field will improve current nutritional guidelines for disease prevention.
Sleep in the intensive care unit
Authors: Lee Eugenia Y. , Wilcox M. Elizabeth 
Published: September 2022

Purpose of review
Sleep is particularly important for critically ill patients. Here, we review the latest evidence on how sleep and circadian disruption in the intensive care unit (ICU) affects physiology and clinical outcomes, as well as the most recent advances in sleep and circadian rhythm promoting interventions including therapeutics.

Recent findings
On a molecular level, clock genes dysrhythmia and altered immunity are clearly linked, particularly in sepsis. Melatonin may also be associated with insulin sensitivity in ICU patients. Clinically, changes in sleep architecture are associated with delirium, and sleep-promoting interventions in the form of multifaceted care bundles may reduce its incidence. Regarding medications, one recent randomized controlled trial (RCT) on melatonin showed no difference in sleep quality or incidence of delirium.

Summary
Further investigation is needed to establish the clinical relevance of sleep and circadian disruption in the ICU. For interventions, standardized protocols of sleep promotion bundles require validation by larger multicenter trials. Administratively, such protocols should be individualized to both organizational and independent patient needs. Incorporating pharmacotherapy such as melatonin and nocturnal dexmedetomidine requires further evaluation in large RCTs.
Modifying organs with gene therapy and gene modulation in the age of machine perfusion
Authors: Pavan-Guimaraes Juliana , Martins Paulo N. 
Published: September 2022

Purpose of review
This review aims to highlight current advances in gene therapy methods, describing advances in CRISPR–Cas9 gene editing and RNA interference in relevance to liver transplantation, and machine perfusion.

Recent findings
In order to minimize rejection, increase the donor pool of available organs, and minimize the effects of ischemia–reperfusion injury, gene therapy and gene modification strategies are, thus, required in the context of liver transplantation.

Summary
Gene therapy has been used successfully in a diverse array of diseases, and, more recently, this technique has gained interest in the field of organ transplantation. Biological and logistical challenges reduce the rate of successful procedures, increasing the waiting list even more. We explore the exciting future implications of customized gene therapy in livers using machine perfusion, including its potential to create a future in which organs destined for transplant are individualized to maximize both graft and recipient longevity.
Lethal Neurotoxicity in Lambda-Cyhalothrin Poisoning
Authors: Naveen Alagarasan , Sahu Manas Ranjan , Mohanty Manoj K. , Mohanty Rashmi Ranjan , Sethy Madhusmita , Velayutham Bakialakshmi 
Published: September 2022

Abstract
Agricultural poisons (insecticides and pesticides) are the most common types of poison implicated in the morbidity and mortality associated with acute poisoning. Suicidal ingestion is more frequent than accidental or homicidal poisonings. Pyrethroids are considered relatively safer than other insecticides. Lambda-cyhalothrin (LCH) belongs to the fourth-generation, type II synthetic pyrethroid. To the best of our knowledge, fatalities after LCH exposure have not yet been reported in the literature. Here, we describe a case of LCH poisoning in a 54-year-old male farmer after an accidental pipe burst in a sprayer while spraying in the field. The patient died 10 days after poisoning due to severe neurotoxicity resulting in bilateral parieto-occipital and brainstem infarcts. The histopathological features of the brain associated with LCH poisoning have been discussed in this report.
Assessing Community-Based Public Health Plans: An Example From US Army Injury Prevention
Authors: Courie Anna Fitch , Jones Bruce H. , Canham-Chervak Michelle 
Published: September 2022

Context:
The US Army requires community health coalitions to develop action plans for their top public health priorities.

Objective:
To date, the US Army has not implemented a standardized review process for community action plans.

Design:
This project used the Plan Quality Index (PQI), an evidence-based, standardized tool, to evaluate injury prevention action plans created by injury prevention teams (IPTs).

Setting:
17 Army installations.

Participants:
17 IPT leads; 5 Health Promotion Program Officers.

Intervention:
Implementation of the PQI to evaluate the strength of injury prevention action plans and make recommendations for quality improvement to drive reductions in injuries at 17 Army installations.

Main Outcome Measure:
PQI total scores for high- (≥50 points on the PQI) and low-ranking plans (<50 points on the PQI) were assessed for differences using t tests of the mean PQI score. Chi-square tests were employed to identify differences in meeting criteria between high- and low-scoring plans.

Results:
PQI total scores ranged from 9 to 78 points out of 80. The weakest planning elements among all plans were lack of use of SMART objectives (18%), lack of identification of responsible parties (18%), absent evaluation plan (24%), and lack of timelines (35%). The mean score for the high-ranking plans (64.6 ± 9.5) was significantly higher than the mean score for the low-ranking plans (26.2 ± 12.7) (P < .001). Mean scores for clarity, effectiveness, and quality were all significantly higher for the high-ranking plans than for the low-ranking plans (P = .014, P = .002, and P < .001, respectively).

Conclusions:
The PQI tool provides a framework for objective, standardized, and evidence-based feedback and recommendations for improving community health plans. The project identified examples of high-quality action plans and provided actionable recommendations for plan improvement to facilitate sustainability of initiatives addressing injuries, which have long posed a threat to military health and readiness.
The modifications of the LICAP/LTAP flap technique in partial breast reconstruction for difficult tumor locations.
Authors: Zhygulin Andrii , Fedosov Artem , Palytsia Valentyn 
Published: September 2022

Summary.
We propose the modifications of the LTAP/LICAP (Lateral Thoracic Artery Perforator/Lateral Intercostal Artery Perforator) flap partial breast reconstruction that can help to achieve better aesthetic results of the procedure especially for centrally and medially located tumors. Lumpectomy is performed using the retromammary approach through lateral contour access without skin mobilization from parenchyma. This minimizes trauma and scarring of parenchyma and skin in the lateral part of the breast. In case of tumor’s central or medial location, we propose to move the flap into the tumor bed through a cut (“window”) in the m. pectoralis major. It helps to stabilize the flap in an optimal position, optimally redistribute the tissue without compression on the flap pedicle and bulge in the gland’s lateral sector. We have used this modification in 18 patients. The average tumor size was 2,8 cm (1,2-5,4 cm), the average weight of the specimens – 46,6 g (14-110 g). Two patients had a tumor in the upper-inner quadrant close to the breast meridian; the other two had a central-lateral tumor location; in fourteen cases, a tumor was located in the upper-outer quadrant. We have observed early complications in 4 cases: 2 seromas of the wound, 1 partial flap necrosis with the revision and resection of the flap, and 1 cellulite in the axillary region after axillary dissection because of long-standing lymphorrhea and drainage. The proposed modification of the LICAP/LTAP flap technique in partial breast reconstruction can lead to better aesthetic and safety results of the surgery.
Asymmetric Four Flap Breast Reconstruction with DIEP flaps and PAP flaps
Authors: Evgeniou Evgenious , Teotia Sumeet S. , Haddock Nicholas T. 
Published: September 2022

INTRODUCTION:
Autologous breast reconstruction is considered superior to alloplastic options. In cases of large volume breast reconstruction, stacked flaps from a single or multiple donor areas are required. In bilateral stacked four-flap reconstructions, when a large amount of skin is required, an asymmetric reconstruction involving the use of a conjoined DIEP flap with a uniform skin paddle to reconstruct the side where most skin is required and the use of two independently perfused stacked flaps to reconstruct the side that requires less skin can provide superior aesthetic results compared with the usual hemi-DIEP/PAP four-flap configuration.

MATERIALS-METHODS:
Retrospective review of all asymmetric DIEP-PAP 4-flap breast reconstructions between March 2015 and October 2020

RESULTS:
Seven patients underwent asymmetric DIEP-PAP breast reconstructions. One of the PAP flaps was lost on post-operative day 1 due to thrombosis of the retrograde IMA/IMV. No other immediate, early or late complications were encountered.

CONCLUSIONS:
Asymmetric four-flap breast reconstruction, using a unilateral bipedicled flap combined with 2 PAP flaps, can provide superior aesthetic results, avoiding common problems associated with the classic configuration of DIEP-PAP four-flap breast reconstruction.

LEVEL OF EVIDENCE:
Therapeutic: IV Case series with post test only
Lymph Node Ratio Nomogram-Based Prognostic Model for Resected Distal Cholangiocarcinoma
Authors: Perez Marc , Hansen Carsten Palnaes , Burdio Fernando , Pellino Gianluca , Pisanu Adolfo , Salvia Roberto , Di Martino Marcello , Abu Hilal Mohammad , Aldrighetti Luca , Ielpo Benedetto ,   and the Cholangiocarcinoma Multicenter Study Coauthor Group
Published: September 2022

BACKGROUND:
Several variables have been described as prognostic factors for resected distal cholangiocarcinoma (dCC), including lymph node metastases (N status) and lymph node ratio (LNR). The present study aimed to evaluate the prognostic value of LNR on survival and to establish a novel prognostic nomogram to predict the cancer-specific recurrence-free survival (RFS) of dCC.

STUDY DESIGN:
Between December 2006 and September 2020, 415 consecutive patients who underwent pancreaticoduodenectomy (PD) for dCC in 10 centers were identified. Multivariate Cox analysis was used to identify all independent risk factors among several prognostic factors. A nomogram was then developed and assessed by integrating the independent prognostic factors into the model, and the concordance index (C-index) was used to evaluate its performance.

RESULTS:
According to Cox regression multivariate analysis, a nomogram based on independent prognostic factor for RFS was performed including LNR 15 (hazard ratio [HR] 2.442, 95% CI 1.348–4.425, p = 0.003), perineural invasion (HR 3.100, 95% CI 1.183–8.122, p = 0.025), differentiation grade (HR 2.100, 95% CI 1.172–4.143, p = 0.021), and radicality of PD (HR 2.276, 95% CI 1.223–4.234, p = 0.009). The C-index of the nomogram, tailored based on the previous significant factors, was 0.8.

CONCLUSIONS:
LNR15 yields a high prognostic efficiency for RFS. The nomogram based on LNR can provide an accurate prognosis assessment for patients with resected dCC.
A design-space minimum sampling strategy based on proper-orthogonal-decomposition projection
Authors: Lengani Davide , Petronio Daniele , Simoni Daniele , Ubaldi Marina 
Published: September 2022

A proper-orthogonal-decomposition (POD)-based procedure has been developed to identify the tests/experiments strictly needed for modelling a complex system. The case here studied concerns the aerodynamic efficiency response of a low-pressure-turbine cascade to the variation of the most influencing flow parameters. A large number of experimental tests have been carried out to sample the design space. POD has been applied to reduce data dimensionality, identifying the rank of the problem and defining a vector subspace where data are as compact as possible. Lasso and Gaussian process regressions, complemented by cross-validation and marginal-likelihood criteria, have been used to learn parsimonious efficiency trends in the POD subspace. It will be shown that a model educated with the most orthogonal combination of data projected in the POD space performs as well as the model educated with the entire dataset. Then, it will be shown that the strictly needed tests can be iteratively localized (
a priori
) in the design space by means of the data-driven procedure here proposed, thus allowing for an active application. This will provide significant time reduction in the execution of tests and can be generalized to other complex systems, either of an experimental or numerical nature, even pertaining to other disciplines.
Quantum Biology in Cellular Migration
Authors: Vecheck Amy M. , McNamee Cameron , Reijo Pera Renee , Usselman Robert J. 
Published: September 2022

AbstractThe impact of magnetic fields on cellular function is diverse but can be described at least in part by the Radical Pair Mechanism (RPM), where magnetic field intervention alters reactive oxygen species (ROS) populations and downstream cellular signaling. Here, cellular magnetophoresis within three-dimensional scaffolds was monitored in an applied oscillating 1.4 MHz radiofrequency (RF) magnetic field with an amplitude of 10 μT and a static 50 μT magnetic field. Given that cellular respiration or glycolysis can be increased based on the orientation of the RF magnetic field, this study focused on the parallel orientation to increase ATP synthesis. Results suggest that RF accelerated clustering and elongation after 1 day with increased levels of clustering and cellular linkage after 7 days. Electron microscopy provided additional topological information and verified the development of fibrous networks and extracellular matrix were visualized after 7 days in samples maintained in RF. Analysis of the distribution of cells within the scaffolds revealed that the clustering rate during the first day was increased nearly five times in the RF environment. This work demonstrates time-dependent cellular magnetophoresis that may be influenced by quantum biology (QB) processes and signaling that can further attenuate or enhance cellular bioenergetics and behavior.
Hydrogen Peroxide Production by Epidermal Dual Oxidase 1 Regulates Nociceptive Sensory Signals
Authors: Pató Anna , Bölcskei Kata , Donkó Ágnes , Kaszás Diána , Boros Melinda , Bodrogi Lilla , Várady György , Veronika Pape F.S. , Roux Benoit , Enyedi Balázs , Helyes Zsuzsanna , Watt Fiona M. , Sirokmány Gábor , Geiszt Miklós 
Published: September 2022

AbstractKeratinocytes of the mammalian skin provide not only mechanical protection for the tissues, but also transmit mechanical, chemical, and thermal stimuli from the external environment to the sensory nerve terminals. Sensory nerve fibers penetrate the epidermal basement membrane and function in the tight intercellular space among keratinocytes. Here we show that epidermal keratinocytes produce hydrogen peroxide upon the activation of the NADPH oxidase dual oxidase 1 (DUOX1). This enzyme can be activated by increasing cytosolic calcium levels. Using DUOX1 knockout animals as a model system we found an increased sensitivity towards certain noxious stimuli in DUOX1-deficient animals, which is not due to structural changes in the skin as evidenced by detailed immunohistochemical and electron-microscopic analysis of epidermal tissue. We show that DUOX1 is expressed in keratinocytes but not in the neural sensory pathway. The release of hydrogen peroxide by activated DUOX1 alters both the activity of neuronal TRPA1 and redox-sensitive potassium channels expressed in dorsal root ganglia primary sensory neurons. We describe hydrogen peroxide, produced by DUOX1 as a paracrine mediator of nociceptive signal transmission. Our results indicate that a novel, hitherto unknown redox mechanism modulates noxious sensory signals.
An Arrayed Transposon Library of Ruegeria pomeroyi DSS-3
Authors: Mejia Catalina , Trujillo Rodriguez Lidimarie , Poudel Ravin , Ellington Adam , Rivers Adam R. , Reisch Christopher R. 
Published: September 2022

AbstractThe ability to construct defined genetic mutations in many bacteria is difficult and limited. Transposon mutagenesis is often highly efficient, but is not site specific, thus selections are often needed to identify mutants of interest. The construction of arrayed mutant libraries would help to fill this need, though these libraries are costly and time consuming. To enable easier construction of arrayed libraries we developed a workflow and methodology using a hierarchical barcoding scheme to identify mutants within a multiwell plate. We applied this method to the marine Alphaproteobacterium Ruegeria pomeroyi DSS-3 and created a library with over 2,800 disrupted genes.