bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutrino propagation in winds around the central engine of sGRB
Authors: Morales G , Fraija N 
Published: May 2021

ABSTRACT
Since neutrinos can escape from dense regions without being deflected, they are promising candidates to study the new physics at the sources that produce them. With the increasing development of more sensitive detectors in the coming years, we will infer several intrinsic properties from incident neutrinos. In particular, we centralize our study in those produced by thermal processes in short gamma-ray bursts (sGRBs) and their interactions within the central engine’s anisotropic medium. On the one hand, we consider baryonic winds produced with a strong magnetic contribution, and on the other hand, we treat only neutrino-driven winds. First, we obtain the effective neutrino potential considering both baryonic density profiles around the central engine. Then, we get the three-flavour oscillation probabilities in this medium to finally calculate the expected neutrino ratios. We find a stronger angular dependence on the expected neutrino ratios, which, incidentally, contrast from the expected theoretical ratios without considering the winds’ additional contribution. The joint analysis of this observable, together with the sGRB ejected jet angle, might lead to an effective mechanism to discriminate between the involved merger progenitors (black hole-neutron star (BH-NS) or neutron-star neutron-star(NS-NS)), acting as an additional detection channel to gravitational waves.
Responding to Discriminatory Patient Requests
Authors: Moore Rachel , Loe Irene M. , Whitgob Emily , Cowden John D. , Nyp Sarah S. 
Published: May 2021

CASE:
Julia is a 13-year-old White adolescent girl who was referred for psychological counseling given concerns related to mood, nonadherence, and adjustment secondary to her new diagnosis of type 1 diabetes. The family lives in a rural town located several hours from the academic medical center where she was diagnosed. After several months on a waitlist, the family was contacted to schedule a telehealth appointment with a predoctoral psychology trainee. When the scheduler informed the mother that her daughter would be scheduled with Ms. Huang, the mother abruptly stopped the conversation stating, “I do not want to waste everyone's time” and initially declined the appointment offered. When the scheduler asked about her hesitance, the mother disclosed previous interactions with doctors at the hospital who were “not born in the United States” that she felt were “textbook” (e.g., smiling even when discussing a new chronic medical condition) and “hard to understand” (i.e., because of different dialect/accent). The mother shared that she found these experiences to be stressful and felt the interactions had negatively affected Julia's care. When informed about the length of the waitlist for another clinician, the mother agreed to initiate services with the trainee.
The supervising psychologist shared the mother's concerns and comments with Ms. Huang. After discussion, Ms. Huang agreed to provide intervention services, “as long as the family was willing.” During the initial telehealth sessions, Ms. Huang primarily focused on building rapport and strengthening the therapeutic alliance with the family. During this time, Julia's mother was reluctant to incorporate suggested parent management strategies at home. Julia also made minimal improvement in her medical management (i.e., A1c levels remained high), had difficulty using behavioral coping strategies, and experienced ongoing mood symptoms (i.e., significant irritability, sleep difficulties, and depressive symptoms). Ms. Huang began to wonder whether the family's resistance and inability to implement recommendations were in some part because of the family's initial concerns and reluctance to engage in therapy with her as a clinician.
Should Ms. Huang address the previously identified concerns with the patient and her family? What should be considered when determining how to approach this situation to ensure provision of both the best care for this patient and support for this trainee?
An Actinomyces Long-Bone Osteomyelitis Case Report and Review
Authors: Bush Larry M. , Viggiano Vico , Tayon Matthew , Sama Nicholas 
Published: May 2021

Abstract
Historically, anaerobic bacteria as monomicrobial pathogens or components of polymicrobial infections have been found to play a minor role in osteomyelitis. Various Actinomyces species reside as constituents of the normal human microbial flora found in the oropharynx and in the most people may also be present as commensal microorganisms in the gastrointestinal, genitourinary, and, to a lesser degree, the upper respiratory tracts. Bone infections due to Actinomyces species are relatively uncommon and usually associated with concomitant cervicofacial disease. To date, only a sparse amount of cases of long bone osteomyelitis due to Actinomyces bacteria have been published in the medical literature. We report a case of monomicrobial subacute late-onset tibia bone osteomyelitis involving Actinomyces presenting 10 years after an open reduction and internal fixation surgical procedure performed to stabilize a traumatic fracture and review actinomycotic osteomyelitis including the rare association of Actinomyces odontolyticus with long bone infections.
Clinical Outcomes for Telavancin for Salvage Therapy in Methicillin-resistant Staphylococcus Aureus Bacteremia
Authors: Garcia Brandon , Gonzalez Jimmy , Chaudhry Saira 
Published: May 2021

Background
Little evidence exists for the use of telavancin in methicillin-resistant Staphylococcus aureus (MRSA) bacteremia as salvage therapy. This study aims to evaluate the efficacy and safety of telavancin as salvage therapy in the treatment of MRSA bacteremia.

Methods
Electronic medical charts of patients who received telavancin for the treatment of MRSA bacteremia at an academic, tertiary care medical center in the United States between January 1, 2015, and May 31, 2019, were reviewed for clinical cure, reinfection, prior antibiotic use, source of infection, microbiological culture clearance, patient mortality, and adverse effects. The primary outcome was clinical cure.

Results
Thirty-eight charts were identified, and 11 met inclusion criteria for this analysis. Vancomycin or daptomycin was given for an average of 5.4 and 2.6 days, respectively, before the initiation of telavancin. The average telavancin dose used was 7.5 mg/kg. All patients achieved clinical cure, and there were no instances of 60-day mortality. Two patients experienced reinfection: 1 patient after 268 days and another after 467 days. Four patients experienced either QTc prolongation or acute renal failure.

Conclusions
The use of telavancin in MRSA bacteremia demonstrated microbiological cure, clinical cure, and minimal reinfection in the reviewed patient population. Telavancin may be a potential treatment option for patients with MRSA bacteremia as salvage therapy.
Absenteeism-Related Wage Loss Associated With Multimorbidity Among Employed Adults in the United States
Authors: Mohamed Rowida , Patel Jayeshkumar , Shaikh Nazneen Fatima , Sambamoorthi Usha 
Published: May 2021

Objective:
To estimate the incremental absenteeism-related wage loss associated with multimorbidity and examine the influence of paid sick leave policy (PSLP) on multimorbidity-associated absenteeism wage loss.

Methods:
We used the Medical Expenditure Panel Survey (MEPS) 2015 data. Two-part generalized linear models (GLM) were employed, using binomial distribution and gamma distribution with a log link.

Results:
Nationally, multimorbidity was associated with a $9 billion incremental absenteeism-related wage loss annually among working adults. Absenteeism-related wage loss was higher among those with multimorbidity than those without multimorbidity. The incremental annual absenteeism-related wage loss associated with multimorbidity was lower in settings that offered paid sick leave than that did not offer paid sick leaves.

Conclusion:
Multimorbidity is associated with higher absenteeism-related wage loss. Paid sick leave policies can reduce the impact of multimorbidity on absenteeism-related wage loss.
Resolution of large vessel stenosis in giant cell arteritis (GCA) by tocilizumab
Authors: Matsumoto Haruki , Fujita Yuya , Asano Tomoyuki , Suzuki Erina , Kiko Yuichiro , Suzuki Osamu , Matsuda Mitsuko , Sato Shuzo , Temmoku Jumpei , Yashiro-Furuya Makiko , Matsuoka Naoki , Suzuki Eiji , Watanabe Hiroshi , Migita Kiyoshi 
Published: May 2021

Abstract

Introduction:
Progressive large vessel involvements including stenosis are commonly associated with giant cell arteritis (GCA). Glucocorticoids (GCs) are the mainstay of therapy for GCA stenosis, however, adverse effects including cardiovascular events are frequent.

Patients concerns:
We describe an 87-years old male patient with a medical history of diabetes mellitus and old cerebral infarction who presented with right temporal headache.

Diagnosis:
Color duplex sonography revealed the thickening of arterial wall and halo sign in the affected temporal arteries. In laboratory data, the elevated levels of acute phase reactants, including C-reactive protein and serum amyloid A were noted. Temporal artery biopsied specimens showed the lymphocytic infiltration and granulomatous inflammation within the arterial media, which are typical findings associated with GCA.

Intervention:
The patient was treated with subcutaneous injections of tocilizumab (TCZ, 162 mg) once weekly. Initially, glucocorticoids were withheld since the patient was diabetic and had a history of cerebral infarction. However, low dose prednisolone was combined with the reduced doses of TCZ (162 mg biweekly) injections due to the TCZ-related leukopenia.

Outcomes:
This treatment strategy resulted in the improvement of the patient's temporal headache and normalized levels of C-reactive protein and serum amyloid A. Follow-up imaging by color duplex sonography revealed the resolution of the temporal artery stenosis after 5 months of TCZ treatment.

Conclusions:
Patients with GCA often require long duration of steroid therapy and commonly suffer steroid-related complications. TCZ monotherapy, could induce early resolution of progressive vascular inflammation and stenosis in untreated GCA cases.
Papillary thyroid carcinoma arising in struma ovarii
Authors: Ioannidis Aristidis , Kourtidis Lazaros , Zatagias Apostolos , Chorti Angeliki , Gourvas Viktoras , Efthimiadis Christoforos , Michalopoulos Antonios 
Published: May 2021

Abstract

Introduction:
Struma Ovarii is one type of mature teratoma in which thyroid tissue represents more than 50% of the ovarian tumor. Diagnosis is very difficult due to lack of typical symptoms. In majority of these patients, diagnosis is incidental.

Patient concerns:
A 65- year-old female presented to our hospital with complaints of uterine bleeding and abdominal pain.

Diagnosis:
Ultrasonography showed no lesions in the uterus and left ovary, while the right ovary was enlarged, comprising a dense mass of 4 cm in diameter. Computed tomography scan revealed a mass, with fatty density and absence of fluid in the Douglas space. The lymph nodes in the posterior peritoneal space showed no enlargement. Additional Magnetic Resonance Imaging confirmed the presence of the mass with clear margins, high T1 signal and T2 sequence indicating dermal cysts. Blood tumor markers were normal. However, beta-human chorionic gonadotropin levels were slightly high.

Interventions:
Total hysterectomy was performed along with bilateral salpingo-oophorectomy.

Outcomes:
The biopsy of the mass revealed features of papillary thyroid carcinoma. The lesion was found to be benign, and the patient showed no recurrence so far.

Conclusion:
Struma Ovarii is a rare condition, found in only 1% of all ovarian tumors; it is benign in 95% of the cases. The clinical presentation can vary in terms of symptoms and signs. Ultrasonography can reveal the differences between a benign struma ovarii and a malignant one. Complete hysterectomy and bilateral salpingo-oophorectomy are the treatment of choice. Specific guidelines for pre- and postoperative management of the patients are yet to be elucidated.
After 800 Mtp Events, Mortality Due to Hemorrhagic Shock Remains High and Unchanged Despite Several In-Hospital Hemorrhage Control Advancements
Authors: Duchesne Juan , Taghavi Sharven , Ninokawa Scott , Harris Charles , Schroll Rebecca , McGrew Patrick , McGinness Clifton , Reily Robert , Guidry Chrissy , Tatum Danielle 
Published: May 2021

ABSTRACT

Background:
Numerous advancements in hemorrhage control and volume replacement that comprise damage control resuscitation (DCR) have been implemented in the last decade to reduce deaths from bleeding. We sought to determine the impact of DCR interventions on mortality over 12 years in a massive transfusion protocol (MTP) population. We hypothesized that mortality would be decreased in later years, which would have used more DCR interventions.

Study Design:
This was a retrospective review of all MTP patients treated at a large regional Level I trauma center from 2008 to 2019. Interventions by year of implementation examined included MTP 1:1 ratio (2009), liquid plasma (2010), tranexamic acid (2012), prehospital tourniquets (2013), REBOA/TEG (2017), satellite blood station (2018), and whole blood transfusion (2019). Relative risk and odds of mortality for DCR interventions were examined.

Results:
There were 824 MTP patients included. The cohort was primarily male (80.6%) injured by penetrating mechanism (68.1%) with median (interquartile range) age 31 years (23–44) and New Injury Severity Score 25 (16–34). Overall mortality was unchanged [(38.3%–56.6%); P = 0.26]. Tourniquets (P = 0.02) and whole blood (WB) (P = 0.03) were associated with lower unadjusted mortality; only tourniquets remained significant after adjustment (OR: 0.39; 95% CI: 0.17–0.89; P = 0.03).

Conclusions:
Despite lower mortality with use of tourniquets and WB, mortality rates due to hemorrhage have not improved at our high MTP volume institution, suggesting implementation of new in-hospital strategies is insufficient to reduce mortality. Future efforts should be directed toward moving hemorrhage control and effective resuscitation interventions to the injury scene.
Phase separation on cell surface: a mechanism of basic fibroblast growth factor signal transduction with heparan sulphate
Authors: Xue Song , Zhou Fan , Zhao Tian , Zhao Huimin , Wang Xuewei , Chen Long , Li Jin-ping , Tan Tianwei , Luo Shi-Zhong 
Published: May 2021

AbstractLiquid-liquid phase separation (LLPS) driven by weak, multivalent interactions among biomolecules is an important means of cellular compartmentation and plays a central role in cellular processes including stress resistance, RNA processing and other cellular activities. Coordination of the condensates and inner membrane was recently revealed, mediating intracellular processes like cell signalling and cargo trafficking. Intracellular LLPS has been observed extensively in vivo, whereas LLPS in extracellular compartments has not been reported under physiological conditions. Here we show, for the first time, that basic fibroblast growth factor (bFGF) undergoes LLPS on the cell surface by interacting with heparan sulphate proteoglycans (HSPG) and the phase transition is required for effective downstream signalling. The condensation is driven by multivalent interactions between bFGF and sulpho-groups on heparan sulphate (HS), and dimerization and oligomerization of bFGF promote the LLPS process. Compared with free bFGF, phase separated bFGF with HS showed higher thermo stability, providing a potential mechanism for the preservation of bFGF activity. Furthermore, we have found that downstream signalling is triggered by phase separation of a ternary complex formed by bFGF, HSPGs and FGFR on cell surface. Our results revealed a molecular mechanism that HS can serve as a platform to promote extracellular proteins like bFGF to condensate on outer membrane, consequently coordinating the signal transduction activities. This novel finding expands the horizons of phase separation in vivo, providing a new dimension on how HSPG may regulate extracellular protein behaviour and cell signalling.
Youth susceptibility to tobacco use: Is it general or specific?
Authors: Cheng Hui G. , Lizhnyak Pavel N. , Knight Natasha A. , Vansickel Andrea R. , Largo Edward G. 
Published: May 2021

AbstractImportanceSusceptibility to tobacco use can help identify youth that are at risk for tobacco use.ObjectiveTo estimate the extent of overlap in susceptibilities across various tobacco products, investigate correlates with susceptibilities, and examine whether the relationship linking susceptibility with the onset of use is product specific or is accounted for by a general susceptibility-onset relationship.DesignProspective cohort study.SettingAnalysis of data from the longitudinal Population Assessment of Tobacco and Health study wave 4 (December 2016 to January 2018) and wave 4.5 youth surveys (December 2017 to November 2018).ParticipantsA nationally representative sample of non-institutionalized youth 12-17 years old who had never used a tobacco product at baseline assessment.Main variable of interestSusceptibility to the use of each type of tobacco product assessed at wave 4.Main outcomesOnset of use of various tobacco products defined as the first use occurring between waves 4 and 4.5 assessments.ResultsCigarettes and e-cigarettes were the most common (∼25%), while snus was the least common (<5%), tobacco product to which youth were susceptible. There was a high degree of overlap in susceptibilities across tobacco products (65% of tobacco-susceptible youth were susceptible to more than one tobacco product). Tobacco-susceptible youth were more likely to have used cannabis or consumed alcohol in the past 30 days or to have tobacco-using peers. Susceptibility to use predicted the onset of use (incidence ratio = 3.2 to 12.9). Estimates for the product-specific path were null, except for e-cigarettes (β=0.08, 95% CI=0.04 to 0.13) and filtered cigars (β= -0.09, 95% CI= -0.13 to -0.05), after accounting for the general susceptibility-to-tobacco-onset relationship (β=0.50, 95% CI=0.42 to 0.58).Conclusions and RelevanceYouth susceptibility to tobacco use overlaps widely across different tobacco products and other risky behaviors. Public health efforts may benefit from a holistic approach to risk behavior prevention planning.Key PointsQuestionIs susceptibility to tobacco use product specific, or does it represent a general openness to tobacco use?FindingsThere was a large degree of overlap in the susceptibility to tobacco use across various product categories. Associations linking susceptibility and the onset of use of a tobacco product were not statistically robust once the general level of susceptibility to tobacco use was considered.MeaningSusceptibility to tobacco use is better conceived as a general openness to tobacco use rather than product specific.
Prenatal Alcohol and THC E-Cigarette Exposure Effects on Motor Development
Authors: Breit Kristen R. , Rodriguez Cristina , Lei Annie , Hussain Samirah , Thomas Jennifer D. 
Published: May 2021

AbstractIt has been well established that prenatal alcohol exposure can lead to a wide range of neurological and behavioral deficits, including alterations in motor domains. However, much less is known about the effects of prenatal cannabis exposure on motor development, despite the fact that cannabis is the most commonly consumed illicit drug among women. Cannabis use among pregnant women has become increasingly popular given the wide-spread perception that consumption is safe during pregnancy. Moreover, alcohol and cannabis are commonly used together, even among pregnant women. Yet, few studies have explored the potential consequences of combined prenatal exposure on behavioral domains. Using our previously established model, pregnant Sprague-Dawley rats were exposed to vaporized alcohol, THC via e-cigarettes, the combination, or a vehicle from gestational days 5-20. Following birth, offspring were tested on early sensorimotor development, adolescent motor coordination, and adolescent activity levels. Prenatal e-cigarette THC exposure delayed sensorimotor development early in life and impaired motor coordination later in adolescence. However, combined prenatal alcohol and THC exposure produced hyperactivity among male offspring. These data suggest that prenatal cannabis exposure may lead to impaired motor skills throughout early development, and that combined exposure with alcohol during gestation may also lead to hyperactivity in adolescence. These findings have important implications for pregnant women and public policy.
Loose ends in cancer genome structure
Authors: Behr Julie M. , Yao Xiaotong , Hadi Kevin , Tian Huasong , Deshpande Aditya , Rosiene Joel , Lange Titia de , Imieliński Marcin 
Published: May 2021

SummaryRecent pan-cancer studies have delineated patterns of structural genomic variation across thousands of tumor whole genome sequences. It is not known to what extent the shortcomings of short read (≤ 150 bp) whole genome sequencing (WGS) used for structural variant analysis has limited our understanding of cancer genome structure. To formally address this, we introduce the concept of “loose ends” - copy number alterations that cannot be mapped to a rearrangement by WGS but can be indirectly detected through the analysis of junction-balanced genome graphs. Analyzing 2,319 pan-cancer WGS cases across 31 tumor types, we found loose ends were enriched in reference repeats and fusions of the mappable genome to repetitive or foreign sequences. Among these we found genomic footprints of neotelomeres, which were surprisingly enriched in cancers with low telomerase expression and alternate lengthening of telomeres phenotype. Our results also provide a rigorous upper bound on the role of non-allelic homologous recombination (NAHR) in large-scale cancer structural variation, while nominatingINO80,FANCA, andARID1Aas positive modulators of somatic NAHR. Taken together, we estimate that short read WGS maps >97% of all large-scale (>10 kbp) cancer structural variation; the rest represent loose ends that require long molecule profiling to unambiguously resolve. Our results have broad relevance for future research and clinical applications of short read WGS and delineate precise directions where long molecule studies might provide transformative insight into cancer genome structure.