bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rapid Pleurodesis in Patients With Chronic Noninfectious Pleural Effusion
Authors: Pu Chan Yeu , Avendano Camilo A. , Durant Makayla , Ospina-Delgado Daniel , Burbano Alma V. , Swenson Kai E. , Beattie Jason , Parikh Mihir , Majid Adnan 
Published: October 2024

Background:
Small cohort studies have shown rapid pleurodesis protocol's (RPP) effectiveness and capacity to expedite pleurodesis for malignant pleural effusion (MPE). This study intends to evaluate the effectiveness of the RPP in inducing pleurodesis in patients with pleural effusions from either malignant or benign etiologies.

Methods:
In this single-center, retrospective cohort study spanning 2 decades, we assessed patients with recurrent symptomatic chronic noninfectious pleural effusion, both benign and malignant. Post-RPP, chest tubes were removed when fluid output dropped below 150 mL/d, and patients were discharged with daily indwelling pleural catheter (IPC) drainage. Exclusion criteria included nonexpandable lung and active pleural infection. Treatment success was defined as IPC removal on reduced output (<50 mL) on 3 consecutive drainages and radiologic effusion resolution. Recurrence was defined as the occurrence of pleural effusion requiring additional pleural procedures postsuccess. Duration outcome was expressed as median with IPC placement as time zero.

Results:
Of the 210 patients studied, 72% had MPE, and 28% had benign effusions. The median hospital stay was 4 days post-RPP. Treatment was successful in 177 (84%) patients within a median of 12 days, with no significant differences between MPE and benign cases. Nine patients (5%) experienced recurrence within a median of 152 days. Complications included hemothorax in 4 (1.9%) and empyema in 2 (1%). The thirty-day mortality rate was 9%, with a median survival time of 245 days postprocedure.

Conclusion:
The RPP combines the benefit of chemical pleurodesis and IPC and appears to be a reasonable option for patients with recurrent and symptomatic pleural effusion.
Correlation between gut microbiota and pancreatitis: a bidirectional Mendelian randomization
Authors: Nan Boyuan , Jin Luyuan , Wang Tianze , Long Chao , Zhao Hao , Wang Chunhui , Zhang Wei 
Published: October 2024

Objective
The causative role of gut microbiota in pancreatitis remains unknown. This study aimed to investigate potential causal associations between gut microbiota and pancreatitis, using bidirectional Mendelian randomization (MR) analysis.

Methods
We analyzed genome-wide association study (GWAS) summary statistics for gut microbiota (211 taxa from gut microbiota, n = 18 340) and two types of pancreatitis, namely acute pancreatitis (AP, 5509 cases and 301 383 controls) and chronic pancreatitis (CP, 3002 cases and 301 383 controls). A reverse MR analysis was also performed to assess the possibility of reverse causation.

Results
Nine features (one family + eight genera) showed a causal association with AP. According to inverse-variance weighted (IVW) estimates, phylum Firmicutes (P = 4.10 × 10−2), genus Erysipelatoclostridium (P = 4.80 × 10−2), genus Flavonifractor (P = 4.10 × 10−2), genus Methanobrevibacter (P = 3.40 × 10−2), and genus Prevotella9 (P = 4.60 × 10−2) were found to have a protective effect on AP. Additionally, genus Eubacteriumeligensgroup (P = 4.10 × 10−2), genus Eubacteriumfissicatenagroup (P = 4.00 × 10−3), genus Coprococcus3 (P = 4.10 × 10−2), and genus Haemophilus (P = 4.60 × 10−2) exhibited a positive correlation with AP. Four features (two families + two genera) were causally associated with CP. IVW results also confirmed that family Clostridiaceae1 (P = 3.30 × 10−2), genus LachnospiraceaeFCS020group (P = 4.60 × 10−2), and genus Prevotella9 (P = 1.90 × 10−2) were protective factors for CP, whereas the presence of family Victivallaceae (P = 2.60 × 10−2) correlated with CP risk. No causal effects of pancreatitis (AP or CP) on these gut microbiota taxa were found in the reverse MR analysis.

Conclusion
This study confirms a potential causal relationship between gut microbiota and pancreatitis, highlighting the gut microbiota-pancreas axis in the pathogenesis of pancreatitis.
Predictive value of early-stage postoperative albumin–bilirubin grade on the overall survival of hepatocellular carcinoma patients undergoing resection
Authors: Pan Zheng , Ye Yan-Shuo , Wang Zhan-Peng , Li Wei 
Published: October 2024

Objectives
The albumin–bilirubin (ALBI) and ΔALBI grades have attracted substantial attention for their ability to predict the overall survival (OS) of patients with hepatocellular carcinoma (HCC). This retrospective study aimed to evaluate the predictive value of the ALBI grade at different time points for the OS of patients with HCC who underwent surgical resection.

Methods
The clinical data of patients with HCC who underwent radical resection in our hospital were collected and analyzed. The survival rate was analyzed using the Kaplan–Meier method and log-rank test. The risk factors influencing OS were identified via univariate and multivariate Cox regression analyses.

Results
A total of 104 patients with HCC were included in this study. The 1-, 3-, and 5-year OS rates of these patients were 91.3%, 64.0%, and 60.2%, respectively. The OS rates were significantly higher in patients with early-stage postoperative ALBI grade 2 than in those with grade 3 (P < 0.001); however, the preoperative ALBI grade, later-stage postoperative ALBI grade, ΔALBI grade (early stage), or ΔALBI grade (later stage) did not affect the OS rate. Furthermore, resection of ≥3 Couinaud liver segments [hazard ratio (HR) = 4.74; 95% confidence interval (CI), 2.32–9.67; P < 0.001], occurrence of postoperative complications (HR = 2.95; 95% CI, 1.38–6.31; P = 0.005), and early-stage postoperative ALBI grade 3 (HR = 2.50; 95% CI, 1.18–5.31; P = 0.02) were identified as independent risk factors for the OS of patients with HCC.

Conclusion
Early-stage postoperative ALBI grade can be used to predict the OS of patients with HCC who have undergone radical hepatectomy. Early-stage postoperative ALBI grade 3, resection of ≥3 Couinaud liver segments, and occurrence of postoperative complications are independent risk factors affecting the OS of these patients.
Investigating the Risk Factors Associated With Acute Neurologic Dysfunction in Pediatric Hyperglycemic Emergencies on Transport
Authors: Scollay Grant , Cantor Zach , Fraser Douglas D. , MacDonald Russell , McGahern Candice , Reddy Deepti , Webster Richard J. , Alnaji Fuad 
Published: October 2024

Objective
This study aims to identify key characteristics of hyperglycemic emergencies in pediatric patients and those at risk for acute neurologic dysfunction during transport.

Methods
We conducted a retrospective chart review of pediatric patients during interfacility transport by Ornge, Ontario's critical care transport service, from January 1, 2009, to December 31, 2019. Data were extracted from electronic patient care records and included demographic, clinical, and transport-specific variables. Two multiple logistic regression models were utilized to analyze associations between predictor variables and neurologic dysfunction (GCS, <14).

Results
Of the 399 patients included, 24% (n = 95) had a GCS score of <14. Patients with a GCS score of <14 were more acidotic compared with those with a GCS score of ≥14 (median pH, 6.9 [IQR, 6.8–7.1] vs median, pH 7.0 [IQR, 1.0–7.2]; P < 0.001). Higher median corrected sodium for glucose values were observed in patients with a GCS score of <14 compared to those with a GCS score of ≥14 (145.7 mmol/L [IQR, 140.6–149.9 mmol/L] vs 141.7 mmol/L [IQR, 138.3–146.4 mmol/L]; P < 0.001). Multiple logistic regression identified younger age (aOR, 0.91; 95% CI, 0.84–0.98; P = 0.01), severe acidosis (pH <7.10; aOR, 3.56; 95% CI, 1.33–11.62; P = 0.02), and higher creatinine (aOR, 1.01; 95% CI, 1.01–1.02; P < 0.001) as risk factors for acute neurologic dysfunction.

Conclusions
Our findings reveal associations between acute neurologic dysfunction, younger age, severe acidosis, and elevated corrected sodium for glucose values in pediatric hyperglycemic emergencies during transport. Education and adherence to guidelines are recommended to improve outcomes in this population.
Local Supports to Break the Cycle: A Description of Intersectional Interventions to Address Adverse Childhood Experiences and Drug Overdose
Authors: Myrick Amie C. , Adams Camille A. , Cremer Laura J. , Filion Nicole , Haddad Stephanie , Snyder Caroline , Wisdom April 
Published: October 2024

Context:
Adverse childhood experiences (ACEs), substance use disorders (SUDs), and overdose are interconnected issues impacting individuals and communities at multiple levels of the social ecology and across generations. Few studies describe approaches that intentionally and simultaneously address these issues.

Program:
This paper examines activities of 15 sites across the country that were designed to simultaneously prevent ACEs, SUD, and overdose. This paper describes the work at the intersection as well as gaps and opportunities. Describing ways to implement intersectional programming may assist other organizations in taking similar steps in their communities.

Implementation:
From December 2020 through July 15, 2023, funded sites received technical assistance from the National Association of County and City Health Officials and the Centers for Disease Control and Prevention for 18 months to support the implementation, adaptation, and/or expansion of evidence-based programs to address ACEs, SUD, and overdose.

Evaluation:
Activities were coded to identify intersectional interventions that addressed ACEs, SUD, and overdose. Most of the ACEs prevention strategies and overdose prevention priority areas/guiding principles from which communities could choose were represented. Most activities were implemented with caregivers and families and addressed ACEs through interventions to lessen harm or to promote social norms. Primary prevention and coordination of resources were the most used overdose prevention priority area/guiding principle.

Discussion:
It is possible to address the intersection of ACEs, SUD, and overdose on a local level. Opportunities to further address the intersection include incorporating more secondary and tertiary prevention strategies, expanding economic supports, and increasing the work focused on equity.
Multisensory sensitivity in relation to pain: a scoping review of terminology and assessment
Authors: Dunne Harper , Frey-Law Laura A. 
Published: October 2024

Abstract
Chronic pain is a debilitating health problem affecting 20 million Americans annually. Most patients with chronic pain report negative impacts on daily function and quality of life, which can result in devastating emotional and financial stress. Although the causes of chronic pain remain elusive, there is increasing interest in sensitivity to everyday sensory stimuli as it relates to chronic pain, potentially serving as an indirect marker of altered central nervous system sensory processing. However, sensitivity to multiple sensory inputs, eg, bright lights, certain fabrics, loud noises, etc, is described using multiple terminologies. The lack of a common vocabulary makes it difficult to find and summarize related discoveries, potentially inhibiting scientific progress. Thus, the purpose of this scoping review was to identify and characterize the terminology used in publications assessing some form of multisensory sensitivity as it relates to pain (eg, a pain cohort or pain sensitivity). Our review of 6 databases (PubMed, Scopus, Embase, CINAHL, PsycINFO+, and Cochrane) comprehensively cataloged peer-reviewed studies published through March 2023 in this domain. Of 12,841 possible studies identified, 92 met all inclusion criteria, with over 80% being published in the last decade. A wide range of terminology has been used for this construct, likely in part a result of the many different professional disciplines represented. These results provide valuable insights for future development of a standardized vocabulary and serve as a resource to aid future investigators of multisensory sensitivity and pain in their study design.
Mechanism of N-Myc Downstream Regulated Gene-1 regulating Integrin expression to inhibit gastric cancer metastasis
Authors: Wanga Tengkai , Ma Wenlong , Zhang Di , Lv Fenxiao , Zeng Yunqing , Zheng Yuan , Liu Mingru , Lu Jiaoyang 
Published: October 2024

BackgroundN-myc downstream regulated gene-1 (NDRG1), the first member of the NDRG family, is widely distributed in various tissues and organs. In gastric cancer, the hypo-expression of NDRG1 has been positively associated with malignant biological behavior and poor prognosis. In-depth investigation of the potential regulatory mechanism of NDRG1 on gastric cancer is crucial for understanding the pathogenesis of this disease, identifying new therapeutic targets, and developing personalized treatment strategies. This study aims to explore the significance of NDRG1 in regulating the expression of integrins during the progression of gastric cancer.MethodsThe expression of NDRG1 in gastric cancer was analyzed using R software v4.0.3, Boxplot, and the Kaplan-Meier Plotter. Stable cell lines with NDRG1 knockdown and overexpression were subjected to wound healing assays, transwell migration assays, CCK8 assays, and colony formation assays, in order to determine the effects of NDRG1 on the migration and proliferation of gastric cancer cells. Western blotting was employed to examine the impact of NDRG1 on the expression of integrin-related proteins. Immunostaining was used to comprehensively analyze the in vitro experimental results.ResultsThe mRNA and protein levels of NDRG1 were downregulated substantially in gastric cancer, which was inversely correlated with the malignancy of pathological behavior and poor prognosis in gastric cancer. Knockdown of the NDRG1 gene significantly enhanced the proliferation and migration capabilities of gastric cancer cells, whereas overexpression of NDRG1 reduced their metastatic potential and inhibited both migration and proliferation. NDRG1 was found to regulate the expression of fibronectin 1, which in turn influenced the expression of a series of integrins, including αv, α5, β1, and β3. This regulatory mechanism may play a crucial role in the early distant metastasis observed in gastric cancer.ConclusionsThis study demonstrated that NDRG1 could regulate the expression levels of integrins through specific signaling pathways, thereby interfering the adhesive and migratory capacities of gastric cancer cells. NDRG1 could serve as a valuable biomarker for the diagnosis and prognosis of gastric cancer, offering new potential targets for its treatment.
Xpert MTB/RIF Ultra resistant and MTBDRplussusceptible rifampicin results in people with tuberculosis: utility of FluoroType MTBDR and deep sequencing
Authors: Ghebrekristos Yonas , Ahmed Aysha , Beylis Natalie , Singh Sarishna , Opperman Christoffel , Naufal Fahd , Folkerts Megan , Engelthaler David , Auma Erick , Venter Rouxjeane , Booley Ghowa , Metcalfe John , Warren Robin , Theron Grant 
Published: October 2024

SummaryBackgroundXpert MTB/RIF Ultra (Ultra)-detected rifampicin-resistant tuberculosis (TB) is often programmatically confirmed using MTBDRplus. There are limited data on discordant results, including re-tested using newer methods like FluoroType MTBDR (FT-MTBDR) and targeted deep sequencing.MethodsMTBDRplusrifampicin-susceptible isolates from people with Ultra rifampicin-resistant sputum were identified from a South African programmatic laboratory. FT-MTBDR and single molecule-overlapping reads deep (SMOR;rpoB, inhA, katG) on isolate DNA were done (SMOR reference standard).FindingsBetween 01/04/2021-30/09/2022, 8% (109/1347) of Ultra rifampicin-resistant specimens were MTBDRplus-susceptible. Of 89% (97/109) isolates with a sequenceablerpoB, SMOR resolved most in favour of Ultra [79% (77/97)]. Sputum with lower mycobacterial load was associated with Ultra false-positive resistance [46% (11/24) of “very low” Ultras had false-resistance vs. 12% (9/73; p=0.0004) in those ≥“low”], as were Ultra heteroresistance calls (all wild type probes, ≥1 mutant probe) [62% (23/37 vs. 25% (15/60) for Ultra without heteroresistance calls; p=0.0003]. Of the 91% (88/97) of isolates successfully tested by FT-MTBDR, 55% (48/88) were FT-MTBDR rifampicin-resistant and 45% (40/88) susceptible, translating to 69% (47/68) sensitivity and 95% (19/20) specificity. In the 91% (99/109) of isolates withinhAandkatGsequenced, 62% (61/99) were SMOR isoniazid-susceptible.InterpretationWhen Ultra and MTBDRplusrifampicin results are discordant, Ultra is more likely to be correct and FT-MTBDR agrees more with Ultra than MTBDRplus, however, lower load and the Ultra heteroresistance probe pattern were risk factors for Ultra false rifampicin-resistant results. Most people with Ultra-MTBDRplusdiscordant resistance results were isoniazid-susceptible. These data have implications for drug-resistant TB diagnosis.FundingThis work was supported by European & Developing Countries Trial Partnerships (EDCTP2; RIA2020I-3305, CAGE-TB), National Institutes of Health (D43TW010350; U01AI152087; U54EB027049; R01AI136894).
A mixed-methods analysis of the implementation of a new community long-COVID service during the 2020 pandemic: learning from practice
Authors: Williams Stefanie L , Beadle Emily , Williams Paul , Master Harsha , Casarin Annalisa 
Published: October 2024

ABSTRACTIntroductionThe rapidly increasing prevalence of long-COVID (LC), the multisystem complexity of the condition and high patient symptom burden, necessitated an immediate need to develop new clinics for assessment and management. This article reports on the rapid implementation of a reactive and responsive LC care pathway. We mapped patients’ journey through this pathway, identifying the services that were activated according to prevalent symptoms, and assessed the barriers and facilitators to its implementation and delivery, from the perspective of health care professionals (HCPs) and LC patients using the Theoretical Domains Framework (TDF).MethodsMixed methods study, including retrospective quantitative cross-sectional analysis of patient data and semi-structured qualitative interviews. One hundred and sixteen patients who attended long-COVID clinic in Hertfordshire, UK, in the first 5 months of its existence, consented for their data to be analysed for the quantitative study. Six HCPs and five patients participated in semi-structured interviews.ResultsPatients were referred into the service an average of 5.75 months post initial COVID-19 infection. 82% of patients required onward referral to other HCPs, most commonly pulmonary rehabilitation, chronic fatigue specialists, and the specialist COVID-19 Rehab general practitioner embedded within the service. Patients reported having rehabilitation needs, moderate depression and anxiety, and difficulties performing usual activities of daily living at point of care. The TDF domains most relevant to the implementation of the LC pathway werebeliefs about capabilities, environmental context and resources, knowledge, and reinforcement.DiscussionOur study provides novel insight into the development of a reactive multidisciplinary care pathway. Key drivers for successful implementation of LC services were identified, such as leadership, multidisciplinary teamwork, transferable skills, and knowledge exchange. Barriers to rapid set up of the service included funding constraints and the rapid evolution of an emergency context.
AtTOC159 Receptors are Targeted to the Chloroplast Outer Membrane by a β-Signal and Galactolipid-Specific Transit Peptide-Like Sequence at the C-Terminus
Authors: Fish Michael , Saudan George , Chuong Simon D. X. , Jelokhani-Niaraki Masoud , Smith Matthew D. 
Published: October 2024

AbstractChloroplasts, the essential organelles responsible for photosynthesis, rely on the coordinated import of nuclear-encoded proteins for their biogenesis and function. TOC159 receptors are critical components of the translocon at the outer membrane of chloroplasts (TOC complex), responsible for recognizing and importing preproteins. However, the mechanisms by which TOC159 itself is targeted and integrated into the chloroplast outer envelope are only partially understood. In this study, we explore the structural aspects of the C-terminal membrane (M) domain ofArabidopsis thalianaTOC159, with a focus on its role in chloroplast outer envelope targeting and TOC complex integration. Structural predictions using AlphaFold and far-UV circular dichroism (CD) spectroscopy experiments suggested that the M domain forms an integral β-barrel that fuses with the β-barrel of TOC75, forming a hybrid channel at the chloroplast outer envelope. We identified a novel bi-partite targeting signal within the M domain, composed of a C-terminal β-signal with the consensus sequence G-Q-Φ-[ST]-Φ-[RK]-X-[SN]-[ST] and a transit peptide (TP)-like sequence. Using fluorescence microscopy and mutational analyses, we demonstrated that the β-signal is essential for chloroplast targeting, while the TP-like sequence enhances targeting ejiciency. Furthermore, CD spectroscopy and Langmuir-Blodgett trough experiments revealed that the TP-like sequence preferentially interacts with galactolipids unique to the chloroplast outer membrane, particularly sulfoquinovosyl diacylglycerol (SQDG), facilitating chloroplast outer envelope targeting specificity. Overall, our findings provide a deeper understanding of TOC159 receptor targeting mechanisms, TOC complex biogenesis and highlight the broader significance of lipid-mediated targeting in intracellular protein trajicking. These results pave the way for future studies on the role of TP-like sequences in chloroplast outer membrane protein targeting and other novel targeting pathways more generally.
Differential gene expression analysis identifies a group of defensin like peptides fromSolanum chacoenseovules within vitropollen tube attraction activity
Authors: Liu Yang , Joly Valentin , Sabar Mohamed , Matton Daniel Philippe , Morse David 
Published: October 2024

AbstractSolanum chacoenseis a wild potato species with superior genetic resistance to diseases and pests that has been extensively used for introgression into cultivated potato. One determinant of crossing success between wild and cultivated potato species is the effective ploidy of the parents. However, little is known about whether other, prezygotic level, breeding barriers exist. We hypothesize ovular pollen tube guidance may serve as such a checkpoint. Tests for species-specific pollen tube guidance using semi-in vivoassays suggested a positive correlation between species-specificity and taxonomic distance. RNA-seq of ovules hand dissected from wild type plants at anthesis and two days before anthesis, as well as from afrk1mutant lacking an embryo sac identified a list of 284 embryo sac-dependent genes highly expressed in mature ovules and poorly expressed in all other samples. Among these are 17Solanumchacoensecysteine-richproteins (ScCRPs), considered to be good candidates since CRPs are ovular pollen tube attractants in other species. A group of three cloned and purified ScCRP2 sequences belonging to the DEFL protein family showed moderate levels ofin vitropollen tube attraction activity in functional assays. We conclude that ScCRP2s are good candidates for ovular pollen tube guidance inS. chacoense.HighlightsThis work introduces key characteristics of pollen tube guidance inSolanum chacoense, identifies candidate attractants through transcriptome subtraction and reportsin vitropollen tube attraction activity for three defensin-like peptides.