bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modified Nuss procedure with a novel steel bar in patients with pectus excavatum post-congenital heart surgery
Authors: Liu Siming , Wang Lei , Zhang Hongkun , Zeng Wenhui , Hu Fengqing , Xiao Haibo , Li Guoqing , Mei Ju , Zhu Jiaquan 
Published: September 2021

Abstract

OBJECTIVES
Pectus excavatum (PE) can be secondary in patients who underwent sternotomy for cardiac surgery. Retrosternal adhesions increase the complexity and risk of traditional Nuss repair. Thus, we summarized the outcomes of our modified Nuss procedure using a newly designed bar.

METHODS
A retrospective analysis was performed on 35 patients who underwent modified PE repair after open heart surgery from January 2011 to July 2019. The surgery was performed using a novel bar with no need for intraoperative reshaping and rotation, assisted by thoracoscopy and subxiphoid incision when necessary.

RESULTS
There were 19 males and 16 females with a median age of 5.3 years (interquartile range, 4.1–10.9) at PE repair. All patients underwent the modified procedure uneventfully with no death. The median operating time was 70 min. Twenty-nine (82.9%) patients required subxiphoid incision assistance. There was 1 case (2.8%) with unexpected sternotomy due to intraoperative bleeding. The median length of postoperative hospital stay was 4 days. During the median 3.5 years of follow-up, no bar dislocation was found and 30 (85.7%) patients had their bars removed with no recurrence recorded. After PE repair, the Haller index improved significantly (2.6 ± 0.4 vs 4.9 ± 1.3, P &lt; 0.05) and further decreased till the time of bar removal (2.5 ± 0.4 vs 2.6 ± 0.4, P &lt; 0.05). All patients were satisfied with the cosmetic outcome.

CONCLUSIONS
The novel bar can be placed and removed easily with a low rate of adverse events. This modified Nuss procedure seems to be a safe, effective and convenient approach for the management of PE after cardiac surgery.
Low-intensity cigarette smoking and mortality risks: a pooled analysis of prospective cohort studies in Japan
Authors: Inoue-Choi Maki , Freedman Neal D , Saito Eiko , Tanaka Shiori , Hirabayashi Mayo , Sawada Norie , Tsugane Shoichiro , Usui Yoshiaki , Ito Hidemi , Wang Chaochen , Tamakoshi Akiko , Takeuchi Taro , Kitamura Yuri , Utada Mai , Ozasa Kotaro , Sugawara Yumi , Tsuji Ichiro , Wada Keiko , Nagata Chisato , Shimazu Taichi , Mizoue Tetsuya , Matsuo Keitaro , Naito Mariko , Tanaka Keitaro , Katanoda Kota , Inoue Manami ,   for the Research Group for the Development and Evaluation of Cancer Prevention Strategies in Japan
Published: September 2021

Abstract

Background
Increasing proportions of smokers in Japan smoke &lt;10 cigarettes per day (CPD). Yet, the health risks of low-intensity smoking in Asia are poorly understood.

Methods
We performed a pooled analysis of 410 294 adults from nine population-based prospective cohort studies participating in the Japan Cohort Consortium. Cigarette-use data were collected at each study baseline in 1983–1994. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality were calculated using multivariable-adjusted Cox regression by CPD among current smokers and by age at cessation among former smokers, with never smokers as the referent group. Pooled HRs and CIs were computed using a random-effect model.

Results
The smoking prevalence was 54.5% in men and 7.4% in women. About 15.5% of male and 50.4% of female current smokers smoked 1–10 CPD (low-intensity). Both male and female low-intensity smokers had higher all-cause mortality risks than never smokers. Risks were further higher with increasing CPD in a dose–response manner. HRs (95% CIs) were 1.27 (0.97–1.66), 1.45 (1.33–1.59) and 1.49 (1.38–1.62) for 1–2, 3–5 and 6–10 CPD, respectively, in men; 1.28 (1.01–1.62), 1.49 (1.34–1.66) and 1.68 (1.55–1.81) for 1–2, 3–5 and 6–10 CPD, respectively, in women. Similar associations were observed for smoking-related causes of death. Among former low-intensity smokers, younger age at cessation was associated with lower mortality risk.

Conclusions
Smoking very low amounts was associated with increased mortality risks in Japan. All smokers should quit, even if they smoke very few CPD.
Genotyping Cyclospora cayetanensis From Multiple Outbreak Clusters With An Emphasis on a Cluster Linked to Bagged Salad Mix—United States, 2020
Authors: Barratt Joel , Ahart Lauren , Rice Marion , Houghton Katelyn , Richins Travis , Cama Vitaliano , Arrowood Michael , Qvarnstrom Yvonne , Straily Anne 
Published: September 2021

Abstract
Cyclosporiasis is a diarrheal illness caused by the foodborne parasite Cyclospora cayetanensis. Annually reported cases have been increasing in the United States prompting development of genotyping tools to aid cluster detection. A recently developed Cyclospora genotyping system based on 8 genetic markers was applied to clinical samples collected during the cyclosporiasis peak period of 2020, facilitating assessment of its epidemiologic utility. While the system performed well and helped inform epidemiologic investigations, inclusion of additional markers to improve cluster detection was supported. Consequently, investigations have commenced to identify additional markers to enhance performance.
Immune discrimination of the environmental spectrum through C-type lectin receptors
Authors: Torigoe Shota , Schutt Charles R , Yamasaki Sho 
Published: September 2021

AbstractOur bodies are continuously assaulted by infection and tissue damage; most of these injurious insults are primarily sensed by immune receptors to maintain tissue homeostasis. Although immune recognition of proteins or nucleic acids has been well characterized, the molecular mechanisms by which immune receptors discriminate lipids to elicit suitable immune responses remain elusive. Recent studies have demonstrated that the C-type lectin receptor family functions as immune sensors for adjuvant lipids derived from pathogens and damaged tissues, thereby promoting innate/acquired immunity. In this review, we will discuss how these receptors recognize lipid components to initiate appropriate, but sometimes deleterious, immune responses against environmental stimuli. We will also discuss an aspect of inhibitory C-type lectin receptors; their ligands might reflect normal self which silences the immune response regarded as “silence”-associated molecular patterns or may be associated with escape strategies of pathogens as “evasion”-associated molecular patterns.
The interaction between the immune system and the peripheral sensory nerves in pruritus
Authors: Irie Hiroyuki , Kabashima Kenji 
Published: September 2021

Abstract
Pruritus is a skin-specific sensation that is observed in various skin diseases, especially in inflammatory skin diseases such as atopic dermatitis, and is deeply involved in their pathogenesis. Pruritus also adversely affects patients’ sleep and mental health, placing a heavy burden on daily life. As such, pruritus control is important to the maintenance of health. The mechanism of pruritus has recently been clarified and the discovery of various pruritus mediators, the identification of specific nerves that transmit pruritus and the accumulation of knowledge on pruritus perception have led to a better understanding of all aspects of pruritus generation, transmission and recognition. In the case of pruritus caused by dermatitis, immune cells infiltrating the skin secrete inflammatory cytokines, which also act on peripheral nerves as pruritus mediators and induce an inflammatory response. Interestingly, there has been accumulating evidence that peripheral nerves are also involved in the inflammation via neuropeptides. In this article, we summarize the findings on pruritus mediators secreted by immune cells and the roles of peripheral nerves in pruritus in terms of their interactions with immunity.
Current and future options for treating complicated skin and soft tissue infections: focus on fluoroquinolones and long-acting lipoglycopeptide antibiotics
Authors: Eckmann Christian , Tulkens Paul M 
Published: September 2021

Abstract
Bacterial skin and soft tissue infections are among the most common bacterial infections and constitute a major burden for patients and healthcare systems. Care is complicated by the variety of potential pathogens, some with resistance to previously effective antimicrobial agents, the wide spectrum of clinical presentations and the risk of progression to life-threatening forms. More-efficient care pathways are needed that can reduce hospital admissions and length of stay, while maintaining a high quality of care and adhering to antimicrobial stewardship principles. Several agents approved recently for treating acute bacterial skin and skin structure infections have characteristics that meet these requirements. We address the clinical and pharmacological characteristics of the fourth-generation fluoroquinolone delafloxacin, and the long-acting lipoglycopeptide agents dalbavancin and oritavancin.
Re-engineering a mobile-CRISPR/Cas9 system for antimicrobial resistance gene curing and immunization inEscherichia coli
Authors: He Yu-Zhang , Kuang Xu , Long Teng-Fei , Li Gong , Ren Hao , He Bing , Yan Jin-Ru , Liao Xiao-Ping , Liu Ya-Hong , Chen Liang , Sun Jian 
Published: September 2021

AbstractObjectivesIn this study, we developed an IS26-based CRISPR/Cas9 system as a proof-of-concept study to explore the potential of a re-engineered bacterial translocatable unit (TU) for curing and immunizing against the replication genes and antimicrobial resistance genes.MethodsA series of pIS26-CRISPR/Cas9 suicide plasmids were constructed, and specific guide RNAs were designed to target the replication gene of IncX4, IncI2 and IncHI2 plasmids, and the antibiotic resistance genes mcr-1, blaKPC-2 and blaNDM-5. Through conjugation and induction, the transposition efficiency and plasmid-curing efficiency in each recipient were tested. In addition, we examined the efficiency of the IS26-CRISPR/Cas9 system of cell immunity against the acquisition of the exogenous resistant plasmids by introducing this system into antimicrobial-susceptible hosts.ResultsThis study aimed to eliminate the replication genes and antimicrobial resistance genes using pIS26-CRISPR/Cas9. Three plasmids with different replicon types, including IncX4, IncI2 and IncHI2 in three isolates, two pUC19-derived plasmids, pUC19-mcr-1 and pUC19-IS26mcr-1, in two lab strains, and two plasmids bearing blaKPC-2 and blaNDM-5 in two isolates were all successfully eliminated. Moreover, the IS26-based CRISPR/Cas9 system that remained in the plasmid-cured strains could efficiently serve as an immune system against the acquisition of the exogenous resistant plasmids.ConclusionsThe IS26-based CRISPR/Cas9 system can be used to efficiently sensitize clinical Escherichia coli isolates to antibiotics in vitro. The single-guide RNAs targeted resistance genes or replication genes of specific incompatible plasmids that harboured resistance genes, providing a novel means to naturally select bacteria that cannot uptake and disseminate such genes.
The impact of non-antimicrobial drug agents on the acquisition of ESBL-producing Enterobacterales in non-critical care wards in a German university hospital: an exploratory, matched case–control study
Authors: Klauke Paula , Schwab Frank , Gastmeier Petra , Maechler Friederike ,   the R-GNOSIS WP5 study group, Behnke M , Blok H , Bonten M J , Brun-Buisson C , Canton R , Cooper B S , Diaz-Agero C , Fankhauser C , Gastmeier P , Golembus J , Goossens H , Hansen S , Harbarth S , Huttner B D , Kloosterman F , Kola A , Kuperberg A , Lammens C , Leus F , Lopez N , Maechler F , Malhotra S , Ruiz-Garbajosa P , Schotsman J , Schwab F , Triay C 
Published: September 2021

AbstractObjectivesTo investigate therapeutical drugs other than antimicrobials as risk factors for the acquisition of ESBL-producing Enterobacterales (ESBL-E).MethodsThis matched case–control study is based on rectal surveillance screening data obtained during a larger trial between 2014 and 2016 upon patients’ admission and at least once before discharge in eight non-ICU wards. Patients with ward-acquired ESBL-E (cases) were matched 1:1 to non-ESBL-E carriers (controls) based on ward, number of screening samples, days at risk and Charlson comorbidity index (CCI). Daily medication data were documented according to the Anatomical Therapeutic Chemical classification system. Multivariable conditional logistic regression models were used to calculate risk factors for ESBL-E acquisition.ResultsOf the 232 cases and 232 controls analysed, baseline characteristics such as gender (male 56.9%), median age (65 years old, IQR 52–74), number of screening samples (N = 3, IQR 2–4), days to first sample (2, IQR 1–2), days at risk (8, IQR 6–11) and CCI (4, IQR 2–6) were similar. Multivariable analysis showed that glucocorticoids, opium alkaloids and selective β-2-adrenoreceptor agonists increased the chance to detect ESBL-E (OR 1.07, 95% CI 1.001–1.13, P = 0.047; OR 1.06, 95% CI 1.007–1.12, P = 0.027; and OR 1.31, 95% CI 1.105–1.55, P = 0.001, respectively), while antihistamines decreased it (OR 0.61, 95% CI 0.39–0.97, P = 0.034). In a sensitivity analysis, including drugs prescribed to at least 50 patients, proton pump inhibitors remained as risk factors (OR 1.049, 95% CI 1.001–1.100, P = 0.047).ConclusionsIn a non-ICU setting, drugs other than antimicrobials were determined as potential independent risk factors for ESBL-E acquisition.
Adverse clinical outcomes associated with carbapenem-resistantAcinetobacter(CRA) infections: a systematic review and meta-analysis
Authors: Ling Weiping , Furuya-Kanamori Luis , Ezure Yukiko , Harris Patrick N A , Paterson David L 
Published: September 2021

AbstractBackgroundCarbapenem-resistant Acinetobacter (CRA) infections have been associated with increased morbidity and mortality in hospitalized patients. This systematic review and meta-analysis aimed to quantify the association between CRA infections and adverse clinical outcomes.MethodsThree databases (i.e. PubMed, EMBASE and Scopus) were searched for epidemiological studies that compared mortality, severe sepsis or shock, or bacteraemia among adult inpatients with CRA infections and those with carbapenem-susceptible Acinetobacter (CSA) infections. The pooled ORs for the three outcomes were estimated using the inverse variance heterogeneity model.ResultsThirty-four studies were included. Patients with CRA infections had higher odds of mortality (31 studies, OR = 2.10, 95% CI: 1.58–2.79, I2=60.6%) and severe sepsis or septic shock (7 studies, OR = 1.51, 95% CI: 1.09–2.09, I2=0%) compared with CSA-infected patients. There was no difference in the odds of bacteraemia (four studies, OR = 1.39, 95% CI: 0.79–2.46, I2=38.1%). CRA-infected patients presented with worse comorbidity at admission (e.g. APACHE score) (eight studies, standardized mean difference = 0.25, 95% CI: −0.01 to 0.52) and had lower frequency of appropriate antibiotic therapy. Results were consistent when pooling 16 study-adjusted risk estimates for mortality. There was no difference in risk of mortality from CRA infection when compared across geographical regions, country income, median year of enrolment and day of mortality from infection onset.ConclusionsCRA-infected patients had worse clinical outcomes. This might be due to delay in appropriate antibiotic therapy, patients being sicker at admission and CRA strains potentially being more virulent than CSA strains. Improving appropriateness of antibiotic therapy in CRA-infected patients could reduce adverse clinical outcomes.
Clinical, Methodological, and Practical Considerations for Algorithmic Testing in Autoimmune Serology
Authors: Sepiashvili Lusia , Kenyon Stacy M 
Published: September 2021

Abstract

Background
Autoimmune serology tests are central to the classification, screening, diagnosis, and monitoring of a variety of autoimmune disorders. To improve the appropriateness of serologic evaluation and support laboratory resource utilization, reflex testing approaches have been proposed and implemented across clinical laboratories. Reflex testing involves a staged approach where an initial test result triggers subsequent tests based on prespecified rules.

Content
Various reflex testing approaches in the context of antinuclear antibody-associated rheumatic disease, antineutrophil cytoplasmic autoantibody-associated vasculitis, celiac disease, and myasthenia gravis are reviewed here. Clinical, analytical, and practical considerations of reflex testing implementation are addressed as well as associated limitations and challenges.

Summary
Serology reflex testing algorithms for the evaluation of autoimmune diseases can support clinical diagnosis and laboratory resource use but may be challenging to implement and are often applied variably across institutions. Assessments of evidence-driven guidelines, clinical impact, and impact on laboratory workflow are essential to this task.
A model for building a national, patient-driven database to track contraceptive use in women with rare diseases
Authors: Josephy Tatiana , Loeffler Deena R , Pam Molly , Godfrey Emily M 
Published: September 2021

AbstractData on the safety and effectiveness of contraception among women with rare diseases are critical and sorely lacking. To fill this gap, we propose a national, patient-driven database that tracks contraceptive safety and effectiveness among women with rare diseases. We built a pilot database focusing on women with cystic fibrosis in 3 phases: (1) database design input from patients and experts, (2) merging of contraceptive survey data with relevant clinical outcomes from the Cystic Fibrosis Foundation Patient Registry (CFFPR), and (3) forming a data guide to facilitate accessible output data. We successfully linked 62 contraceptive survey variables with 362 relevant clinical outcome variables for 150 patients. This pilot represents a breakthrough in linking contraceptive data to disease-specific outcomes and informs how to build a national, patient-driven contraceptive database for women with rare diseases.
Loved As-Is: How God Salience Lowers Interest in Self-Improvement Products
Authors: Grewal Lauren , Wu Eugenia C , Cutright Keisha M 
Published: September 2021

Abstract
Consumers often desire to become better versions of themselves. Reflecting this interest in self-improvement, the marketplace offers consumers a wide range of products and services that promise to improve or better the consumer in some way. But, in a world with unlimited opportunities to spend one’s time and money, what influences whether consumers will invest in products that enable self-improvement? We demonstrate that the degree to which God is salient has a negative effect on individuals’ preferences for consumption choices with self-improvement features compared to equally attractive options that do not include such features. We propose that this is because thoughts of God activate a greater sense of being loved for who you are (“loved ‘as-is’”), making self-improvement a lower priority. We demonstrate this basic effect across several experiments as well as archival data, provide process evidence through mediation and moderation, and address alternative explanations. We also identify important boundary conditions: God salience is less likely to decrease interest in self-improvement products when consumers do not believe in God, and when God is considered to be a punishing (vs. loving) entity.
Limits of buyer-driven governance for sustainability: inherent challenges of fragmented supplier networks
Authors: Alexander Rachel 
Published: September 2021

Abstract
This article questions retailers’ role as buyers driving production. Exploring a network involving Indian suppliers of UK retailers’ cotton garments, limitations preventing coercive buyer power from controlling production practices are identified. Overall, the dominant system of large-scale fragmented supplier networks connecting raw materials to final products accommodates commercially viable practices causing social or environmental challenges. While some pressures effectively span complex networks, buyers’ practice-related demands do not. Dissecting the ‘drivenness’ concept, this study shows multipolar governance within an industry often considered buyer-driven. Also, it furthers critiques of private governance’s effectiveness, indicating the need for alternative governance frameworks or network structures.
Surveillance of patients with stage I or II colorectal cancer in Japan: a JCOG study group questionnaire survey
Authors: Moritani Konosuke , Shida Dai , Kanemitsu Yukihide , Shunsuke Tsukamoto , Hamaguchi Tetsuya , Shimada Yasuhiro ,   Colorectal Cancer Study Group of the Japan Clinical Oncology Group (JCOG)
Published: September 2021

Abstract
Japanese Society for Cancer of the Colon and Rectum guidelines recommend regular, more intensive surveillance of patients who have undergone curative resection of pathological stages I–III colorectal cancer compared with guidelines in Western countries. We conducted a questionnaire survey to clarify the status of surveillance for patients with stage I or II colorectal cancer in high-volume centers in Japan on behalf of the Colorectal Cancer Study Group of the Japan Clinical Oncology Group. Questionnaires were distributed in September 2019. The response rate was 98.3% (59/60 institutions). The survey results indicated that about half of colorectal cancer specialists in Japan perform surveillance for stages I and II colorectal cancer according to the Japanese Society for Cancer of the Colon and Rectum guidelines. For stages I and II disease, 45% and 55% of surgeons, respectively, perform surveillance less intensively than recommended. Our findings suggest the possibility of less intensive surveillance for patients with stage I or II colorectal cancer in Japan.
α1A and α1C form microtubules to display distinct properties mainly mediated by their C-terminal tails
Authors: Diao Lei , Liu Ming-Yi , Song Yin-Long , Zhang Xu , Liang Xin , Bao Lan 
Published: September 2021

Abstract
Microtubules consisting of α/β-tubulin dimers play critical roles in cells. More than seven genes encode α-tubulin in vertebrates. However, the property of microtubules composed of different α-tubulin isotypes is largely unknown. Here, we purified recombinant tubulin heterodimers of mouse α-tubulin isotypes including α1A and α1C with β-tubulin isotype β2A. In vitro microtubule reconstitution assay detected that α1C/β2A microtubules grew faster and underwent catastrophe less frequently than α1A/β2A microtubules. Generation of chimeric tail-swapped and point-mutation tubulins revealed that the carboxyl-terminal (C-terminal) tails of α-tubulin isotypes largely accounted for the differences in polymerization dynamics of α1A/β2A and α1C/β2A microtubules. Kinetics analysis showed that in comparison to α1A/β2A microtubules, α1C/β2A microtubules displayed higher on-rate, lower off-rate, and similar GTP hydrolysis rate at the plus-end, suggesting a contribution of higher plus-end affinity to faster growth and less frequent catastrophe of α1C/β2A microtubules. Furthermore, EB1 had a higher binding ability to α1C/β2A microtubules than to α1A/β2A ones, which could also be attributed to the difference in the C-terminal tails of these two α-tubulin isotypes. Thus, α-tubulin isotypes diversify microtubule properties, which, to a great extent, could be accounted by their C-terminal tails.