bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tumor Size and Lobular Histology Predict for Higher Pathologic Nodal Stage Regardless of Clinical Presentation of Nodal Disease in Patients With Breast Cancer
Authors: Ye Linda , Rünger Dennis , Angarita Stephanie A. , Hadaya Joseph , Baker Jennifer L. , Lee Minna K. , Thompson Carlie K. , Attai Deanna J. , DiNome Maggie 
Published: November 2021

Abstract
Purpose: Omission of axillary lymph node dissection (ALND) is considered for patients with sentinel lymph node-positive (SLN+) breast cancer, but ALND remains the standard of care for clinically node-positive (cN+) patients treated with surgery first. Here, we evaluate differences in patient and tumor characteristics and pathologic nodal stage in patients with positive lymph nodes who underwent ALND. Methods: Retrospective chart review from 2010-2019 identified three groups of patients who underwent ALND for positive nodes: SLN+ (positive node identified at SLN biopsy), cNUS (abnormal preoperative US and biopsy), and cNpalp (palpable adenopathy). Patients who received neoadjuvant chemotherapy or presented with axillary recurrence were excluded. Results: Of 218 patients, 107 were SLN+, 43 were cNUS, and 68 were cNpalp. SLN+ patients compared with cNpalp were more likely to be younger (56 vs 64,p<.01), pre-menopausal (39%vs15%,p<.01), and white (62%vs37%,p<.01) with more tumors that were progesterone receptor-positive (6%vs21%,p=.02), low grade (35%vs6%,p<.01) and without lymphovascular invasion (11%vs27%,p=.02). SLN+ patients had more pN1 disease than cNUS and cNpalp (67.3% vs 39.5% vs 42.6%, p<.01). Greater tumor size and lobular histology were significantly associated with higher nodal stage in univariable regression analysis of SLN+ patients as well as a pooled analysis of the three clinical groups.Conclusion: Patient and tumor characteristics differ on either end of the nodal spectrum, with cNpalp patients having higher risk features than SLN+ patients. These higher risk features have historically resulted in ALND for patients with clinically positive nodes. However, only tumor size and histology are associated with higher pathologic nodal stage.
The Emergence of Linezolid-resistant Staphylococcus Epidermidis in the COVID-19 Hospitalized Intubated Patients in North Khorasan, Iran
Authors: Azimian Amir , Khosrojerdi Mahsa , GhasemZadeh-Moghadam Hamed , NamdarAhmad-Abad Hasan , Hashemi Seyed Ahmad 
Published: November 2021

Abstract
BackgroundIn the COVID-19 pandemic from 2019 to date, we confront secondary bacterial and viral infections in SARS-CoV2 infected patients, especially hospitalized patients. Coagulase-negative staphylococci, are commensals of the human body and can lead to infections in immunocompromised patients. The antimicrobial resistance is increasingly reported in coagulase-negative staphylococci, especially in Staphylococcus epidermidis. One of the most critical problems is resistance to linezolid in S. epidermidis, observed in Europe since 2014. The aim of this study was to evaluation of bacterial Co-infections and determination of antimicrobial resistance pattern of co-infection isolated strains in North Khorasan, Iran, in the last six-month period. MethodsAfter microbiological evaluation of pulmonary samples of hospitalized intubated patients with signs of bacterial pneumonia, we found co-infection in 11 of 185 patients with S. epidermidis, S. aureus, and Acinetobacter baumani, respectively. Interestingly seven of nine S. epidermidis isolates were linezolid resistant. For identification of the isolates at the species level, we used phenotypic methods and also the Polymerase Chain Reaction (PCR) for the atlE gene. Selected isolates were characterized by determining their antimicrobial resistance patterns and using molecular methods including SCCmec typing, detection of ica, mecA, vanA, and cfr genes. ResultsAll isolates were resistant to methicillin, and Seven isolates were resistant to linezolid. It should be noted that all nine isolates were positive for the ica gene. Nine of 11 isolated have belonged to the SCCmec I, and two belonged to the SCCmec IV. It should be noted that all patients had the underlying disease and six patients died.ConclusionThe increasing linezolid resistance in bacterial strains becomes a real threat for patients, and monitoring such infections combined with surveillance and infection prevention programs is very important to decrease the number of linezolid-resistant staphylococcal strains.
Perceptions, Current Practices and Interventions of Community Pharmacists Regarding Antimicrobial Stewardship: A Qualitative Study in France
Authors: Durand Claire , Chappuis Aude , Douriez Eric , Poulain Frédérique , Ahmad Raheelah , Lescure François-Xavier , Peiffer-Smadja Nathan 
Published: November 2021

Abstract
Background: Community health care accounts for the vast majority of antibiotic use in Europe. Given the threat of antimicrobial resistance (AMR), there is an urgent need to develop new antimicrobial stewardship (AMS) interventions in primary care that could involve different health care providers including community pharmacists. This study aimed to explore the perceptions, currents practices and interventions of community pharmacists regarding antimicrobial stewardship.Methods: Semi-structured qualitative interviews were conducted with community pharmacists in France. Participants were recruited through a professional organization of community pharmacists combined with a snowballing technique. Interviews were audio recorded, transcribed and analyzed using thematic analysis. The Consolidated Framework for Implementation Research was used while developing the interview guide and carrying out thematic analysis.Results: Sixteen community pharmacists participated. All the respondents had good awareness about antimicrobial resistance and believed community pharmacists had an important role in tackling AMR. Some barriers to community pharmacists’ participation in AMS were identified such as difficult interactions with prescribers, lack of time and lack of access to patient medical records and diagnosis. Increased patient education, audits and feedback of antibiotic prescribing, increased point-of-care testing and delayed prescribing were interventions suggested by the pharmacists to improve antibiotic use in primary care. Strategies cited by participants to facilitate the implementation of such interventions are increased pharmacist-general practitioner collaboration, specialized training, clinical decision support tools as well as financial incentives. Conclusions: This study suggests that community pharmacists could play a greater role in infection management and AMS interventions. Further interprofessional collaboration is needed to optimize antibiotic prescribing and utilization in community health care.
Ion transport in a charged conical nanopore filled with viscoelastic fluids: ion current rectification
Authors: Trivedi Mohit , Nirmalkar Neelkanth 
Published: November 2021

Abstract
The ionic current rectification (ICR) is a non-linear current-voltage response upon switching the polarity of the potential across nanopore, similar to the I-V response in the semiconductor diode. The ICR phenomenon finds several potential applications in micro/nano-fluidics (e.g., Bio-sensors and Lab-on-Chip applications). From a biological application viewpoint, most biological fluids (e.g., blood, saliva, mucus, etc.) exhibit non-Newtonian visco-elastic behavior; their rheological properties differ from Newtonian fluids. Therefore, the resultant flow-field should show an additional dependence on the rheological material properties of viscoelastic fluids such as fluid relaxation time (λ) and fluid extensibility (ε). Despite numerous potential applications, the comprehensive investigation of the viscoelastic behavior of the fluid on ionic concentration profile and ICR phenomena has not been attempted. ICR phenomena occur when the length scale and Debye layer thickness approaches of the same order. Therefore, this work extensively investigates the effect of viscoelasticity on the flow and ionic mass transfer along with the ICR phenomena in a single conical nanopore. The Poisson-Nernst-Planck (P-N-P) model coupled with momentum equations have been solved, for a wide range of conditions Deborah number, 1 ≤ De ≤ 100, Debye length parameter, 1 ≤ κRt ≤ 50, fluid extensibility parameter, 0.05 ≤ ε ≤ 0.25, applied electric potential, −40 ≤V ≤ 40, and surface charge density σ = −10 and −50. Four distinct novel characteristics of electro-osmotic flow (EOF) in a conical nanopore have been investigated here, namely (1) detailed structure of flow field and velocity distribution in viscoelastic fluids (2) influence of Deborah number and fluid extensibility parameter on ionic current rectification (ICR) (3) volumetric flow rate calculation as a function of Deborah number and fluid extensibility parameter (4) effect of viscoelastic parameters on concentration distribution of ions in the nanopore. At high applied voltage, both the extensibility parameter and Deborah number facilitate the ICR phenomena. In addition, the ICR phenomena are observed to be more pronounced at low values of κRt than the high values of κRt . This effect is due to the overlapping of the electric double layer at low values of κRt.
Hyaluronic Acid injections for Chronic Tennis Elbow
Authors: Zinger Gershon , Bregman Alexander , Safran Ori , Beyth Shaul , Peyser Amos 
Published: November 2021

Abstract
Background
For most patients, tennis elbow (TE) resolves within six months of onset. For those with persistent and painful TE, nonsurgical treatment options are limited. Thousands of studies have tried to find effective treatment for TE, but usually fail. In this study, we test the hypothesis that injections with hyaluronic acid (HA) are effective at treating chronic pain from TE.
Methods
Patients with a minimum of six months of pain from TE were randomized equally into one of two groups, injection with HA or saline control, and followed for one year. Outcome measures included Visual Analogue Score (VAS pain), the shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH) and patient rated tennis elbow evaluation (PRTEE).
Results
Seventeen of the 18 HA-injected patients (94%) completed the study. The average age was 51.9 years and 10 were male. Patients had an average of 28.1 months of pain before entering the study. VAS in the HA group improved from a baseline of 76.4 to 14.3 at 12 months. All 17 patients in the HA group showed VAS improvement above minimal clinically important difference (MCID) of at least 18. PRTEE improved from 67 to 28.1. QuickDASH improved from 53.7 to 22.5. To our knowledge, this improvement is greater than can be seen in any other non-surgical treatment for TE.
Conclusions
HA injections showed significant success in pain relief by three months. Patients continued to improve for the 12-month duration of the study. This study indicates that patients with chronic lateral epicondylitis may benefit from injections of hyaluronic acid rather than having to undergo surgery.
Involvement of trabecular meshwork phagocytic suppression by sympathetic norepinephrine in nocturnal intraocular pressure rise
Authors: Ikegami Keisuke , Masubuchi Satoru 
Published: November 2021

Abstract
Intraocular pressure (IOP) is important in glaucoma development and depends on aqueous humor (AH) dynamics, involving inflow from the ciliary body and outflow through the trabecular meshwork (TM). IOP has a circadian rhythm entrained by sympathetic noradrenaline (NE) or adrenal glucocorticoids (GCs). Here, we investigated the involvement of GC and NE in AH outflow. Pharmacological prevention of inflow/outflow in mice indicated an AH outflow increase during day. Although TM phagocytosis can determine AH drainage, only NE showed a non-self-sustained inhibitory effect in phagocytosis of immortalized human TM cells. Pharmacological approach and RNA interference identified β1-adrenergic receptor (AR)-mediated cAMP-EPAC-SHIP1 signal activation by ablation of phosphatidylinositol triphosphate regulating phagocytic cup formation. Furthermore, pharmacological instillation in mice revealed the role of β1-AR-EPAC-SHIP1 pathway in nocturnal IOP rise. These suggest that IOP rhythm is partially regulated by this pathway. This first demonstration of TM phagocytosis suppression by NE could be useful in glaucoma management.
Long Non-Coding RNA NEAT1 Promotes HCC Progression via PKM2 and Exosome-Mediated Transfer
Authors: Pan Junping , Hu Yingzhe , Yuan Chenlu , Wu Yafu , Zhu Xinhua 
Published: November 2021

Abstract
Background

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors with high mortality and poor prognosis. Long non-coding RNAs NEAT1 (lncRNA NEAT1) have been found to play an important role in HCC progression. However, the role and potential molecular mechanism of lncRNA NEAT1 in HCC remain largely unclear.
Methods

The role of lncRNA NEAT1 both in vitro and in vivo was investigated, with RNA pull-down and RNA immunoprecipitation (RIP) assays being performed to determine the interaction among NEAT1 and FOXO3 and PKM2. In addition, HCC cells were treated with exosomes derived from NEAT1-overexpressing HCC cells, and then cell proliferation, migration and invasion were assessed using in vitro assays.
Results

In this study, overexpression of NEAT1 promoted the proliferation, migration and invasion of HCC cells, whereas NEAT1 knockdown exhibited the opposite effects. Mechanistically, NEAT1 was found to recruit transcription factor FOXO3 to PKM2 promoter region and upregulate PKM2 expression. Meanwhile, overexpression of NEAT1 increased tumor growth and metastasis in a mouse xenograft model of HCC in vivo via upregulation of PKM2. Furthermore, overexpression of NEAT1 promoted exosome release from HCC cells. Exosomes secreted from NEAT1-overexpressing HCC cells promoted the proliferation, migration and invasion of HCC cells.
Conclusion

We found that NEAT1 could promote HCC progression via upregulation of PKM2 and exosome-mediated transfer. These data indicated that NEAT1 may be a therapeutic target in HCC.
Crystalline Hydrogen Bond of Water Molecules Confined in a Metal-Organic Framework
Authors: Bae Jinhee , Park Sun Ho , Moon Dohyun , Jeong Nak Cheon 
Published: November 2021

Abstract
Hydrogen bond (H-bond) of water molecules confined in nanopores is of particular interest because it is expected to exhibit chemical features different from bulk water molecules due to its interaction with the wall lining the pores. Herein, we show a crystalline behavior of hydrogen-bonded water molecules residing in the nanocages of a paddlewheel metal-organic framework, providing in situ and ex situ synchrotron single-crystal X-ray diffraction and Raman spectroscopy studies. The crystalline H-bond is demonstrated by proving the vibrational chain connectivity arising between hydrogen bonding and paddlewheel Cu−Cu bonding in sequentially connected Cu–Cu⋅⋅⋅⋅⋅coordinating H2O⋅⋅⋅⋅⋅H-bonded H2O and proving the spatial ordering of H-bonded water molecules at room temperature, where they are anticipated to be disordered with a high degree of freedom in their molecular motions. Additionally, we show a substantial distortion of the paddlewheel Cu2+ centers that arises simultaneously with water coordination. Also, we suggest the dynamic coordination bond character of the H-bond of the confined water molecules, by which an H-bond transitions to a coordination bond at the Cu2+ center instantaneously after dissociating a previously coordinated water molecule.
A comprehensive thermodynamic model for RNA binding by the Saccharomyces cerevisiae Pumilio protein PUF4
Authors: Sadee Christoph , Hagler Lauren , Becker Winston , Jarmoskaite Inga , Vaidyanathan Pavanapuresan , Denny Sarah , Greenleaf William , Herschlag Daniel 
Published: November 2021

Abstract
Genomic methods have been valuable for identifying RNA-binding proteins (RBPs) and the genes, pathways, and processes they regulate. Nevertheless, standard motif descriptions cannot be used to predict all RNA targets or test quantitative models for cellular interactions and regulation. We present a complete thermodynamic model for RNA binding to the S. cerevisiae Pumilio protein PUF4 derived from direct binding data for 6180 RNAs measured using the RNA on a massively parallel array (RNA-MaP) platform. The PUF4 model is highly similar to that of the related RBPs, human PUM2 and PUM1, with one marked exception: a single favorable site of base flipping for PUF4, such that PUF4 preferentially binds to a non-contiguous series of residues. These results are foundational for developing and testing cellular models of RNA-RBP interactions and function, for engineering RBPs, for understanding the biophysical nature of RBP binding and the evolutionary landscape of RNAs and RBPs.
Comprehensive Echocardiographic and Speckle Tracking Strain Analysis in Rheumatic Mitral Stenosis Patients before and after Transvenous Mitral Commissurotomy
Authors: Roslan Aslannif Bin , Aris Faten A , Sin Tey Yee , Ashari Afif , Shaparudin Abdul A , Shah Wan Faizal W Rahimi , Jhung Lee Tjen , Beng Koh Hui , Aktifanus Ahmad Tantawi Jauhari , Nuruddin Amin Ariff 
Published: November 2021

Abstract
PurposePercutaneous Transvenous Mitral Commissurotomy (PTMC) is the first line treatment for rheumatic mitral stenosis (MS). We sought to evaluate 1) changes in 2-dimensional (2D) echocardiographic and strain values and 2) differences in these values for patients in atrial fibrillation (AF) and sinus rhythm (SR) pre, immediately and 6 months post PTMC.MethodsRetrospective study of 136 patients who underwent PTMC between 2011 and 2021. We analyzed their 2D echocardiogram, Global Longitudinal Strain (GLS), Left Atrial Reservoir Strain (LAr-S) and Right Ventricle Free Wall Strain (RVFW-S) pre, immediately and 6 months post PTMC.ResultsAt 6 months, mitral valve area increases from 0.94 ± 0.23cm2 to 1.50 ± 0.42cm2. Ejection fraction (EF) did not change post PTMC (pre; 55.56 ± 6.62%, immediate; 56.68 ± 7.83%, 6 months; 56.28 ± 7.00%, p=0.218). Even though EF is preserved, GLS is lower pre-procedure; -11.52 ± 3.74% with significant improvement at 6 months; -15.16 ± 4.28% (p<0.001). Tricuspid annular plane systolic excursion (TAPSE) improved at 6 months from 1.95 ± 0.43 to 2.11 ±0.49 (p=0.004). RVFW-S increases at 6 months from -17.37 ± 6.03% to -19.75 ± 7.19% (p<0.001). LAr-S improved from 11.23 ± 6.83% pre PTMC to 16.80 ± 8.82% at 6 months (p<0.001) post PTMC. Pre-procedure patients with AF have lower strain values (More LV, RV and LA dysfunction) with statistically significant difference for LAr-S (p < 0.001), GLS (p <0.001) and RVFW-S (p <0.001) than patients in SR.ConclusionPatients with severe rheumatic MS have subclinical left and right ventricle dysfunction despite preserved EF and relatively normal TAPSE with significant improvement seen at 6 months post PTMC. AF patients have lower baseline strain values than SR patients.
Effectiveness of ACB-IP 1.0 Universal Pathogen Free Concentrated Cocktail Convalescent Plasma in COVID-19 Infection
Authors: Hemsinlioglu Cansu , Pelit Nil Banu , Yalcin Koray , Gunaydin Omur Selin , Sahin Nihal Ozturk , Karagacli Esra Savas , Elibol Omer , Demir Sefa Onur , Safak Evren , Turan Raife Dilek , Celebi Goncagul , Kocaoglu Miyase Ezgi , Karakus Gozde Sir , Yurtsever Bulut , Tastan Cihan , Abanuz Selen , Cakirsoy Didem , Kancagi Derya Dilek , Torun Zeynep , Seyis Utku , Elek Muhammer , Zengin Rehile , Kocagoz Ayse Sesin , Cuhadaroglu Caglar , Birgen Nur , Ratip Siret , Ovali Ercument 
Published: November 2021

Abstract
BACKGROUNDThe efficacy of SARS-CoV2 single donor convalescent plasma (CP) varied according to the application time and the amount of antibody that is administered. Single donor CP has some drawbacks; such as the insufficient levels of neutralizing antibody activities, the requirements of blood group compatibility, and the risk of infection transmission. In this study, the safety and efficacy of pathogen inactivated, isohemagglutinin-depleted (concentrated) and pooled CP product was investigated. MATERIALS AND METHODSA total of sixteen patients were treated with either single donor CP (N:9) or pathogen-free, concentrated, pooled CP (ACB-IP 1.0) (N:7).RESULTSFive out of six single donor plasma SARS-CoV2 antibody titers remained below 12 s/co, but the antibody titers of all ACB-IP 1.0 plasma were above 12 s/co. SARS-CoV2 total antibody titers of ACB-IP 1.0 plasma were statistically higher than the antibody titers of single donor CP. Mean total plasma neutralizing antibody activity of ACB-IP 1.0 plasma (1.5421) was found statistically higher than single donor CP (0.9642) in 1:256 dilution (ρ<0.01)The mortality rates of the patients treated with ACB-IP 1.0 plasma were statistically lower (p< 0.05) than the patients treated with single donor CP. The administration of either single donor CP or ACB-IP 1.0 plasma to the patients within eight days significantly shortened the length of hospitalization (ρ< 0.01).CONCLUSIONThe present study established ACB-IP 1.0 plasma product as a safe and potentially effective treatment for COVID-19, allowing rapid access to patients in need.TRIAL REGISTRATIONTrial Registration Number: NCT04769245Trial Registration Date: 17.03.2021
Key stakeholders’ views, experiences and expectations of patient and public involvement in healthcare professions’ education: a qualitative study
Authors: Cullen Megan , Cadogan Cathal , George Susmi , Murphy Siobhan , Freeney Siobhan , Fitzpatrick Robbie , Strawbridge Judith 
Published: November 2021

Abstract
Background
Patients and the public have an integral role in educating healthcare professionals. Authentic partnerships between higher education institutions and patients and the public are essential. This study examined key stakeholders’ views, experiences and expectations of patient and public involvement (PPI) including the nature of the involvement and requirements for partnership.
Methods
Purposive and snowball sampling was used to recruit key stakeholders, including patients and members of the public involved in health professions education, and academics interested in PPI. Focus groups were held with patient and public participants, providing the opportunity to gain multiple perspectives in an interactive group setting. Academics with an interest in PPI were interviewed using a semi-structured approach. Topic guides were derived from the literature and piloted prior to data collection. Focus groups and interviews were conducted until data saturation was achieved. All data was audio-recorded, transcribed, anonymised and thematically analysed.
Results
Four focus groups were conducted involving 23 patient and public participants (median number of participants per focus group of 6). Nine interviews were conducted with academics (face-to-face [n=8] or by telephone [n=1]). Five themes were developed: previous experiences of PPI, training requirements, challenges/barriers to PPI, facilitators of PPI and future ideas for PPI. All participants held positive views of the value of PPI. Participants had mixed views in terms of training, which depended on the level of involvement, but similar views on the challenges and facilitators for PPI in education. There was agreement that PPI requires institutional vision and investment to build strong relationships and a culture of PPI best practice.
Conclusion
There is a need for more strategic and formal involvement of patients and the public to ensure that that PPI becomes sustainably embedded in health professions education.