bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chemical quantification of N-acyl alanine methyl ester (NAME) production and impact on temporal gene expression patterns in Roseovarius tolerans EL-164
Authors: Leinberger Janina , Koteska Diana , Boldt Judith , Petersen Jörn , Shivaramu Sahana , Tomasch Jürgen , Schulz Stefan , Brinkhoff Thorsten 
Published: November 2024

Abstract
Background
Previous studies have identified structurally diverse N-acyl amino acid methyl esters (NAMEs) in culture extracts of Roseovarius tolerans EL-164 (Roseobacteraceae). NAMEs are structural analogues of the common signaling compounds N-acyl homoserine lactones (AHLs), but do not participate in AHL-mediated signaling. NAMEs show minor antialgal and antimicrobial activity, but whether this activity serves as the primary ecological role remains unclear.

Results
To enable dose-dependent bioactivity-testing, we have established a chromatographic method for quantification of NAMEs in bacterial culture extracts. The concentrations determined for the two major NAMEs produced by EL-164, C16:1-NAME and C17:1-NAME, ranged between 0.685 and 5.731 mg L− 1 (2.0-16.9 µM) and 5.3–86.4 µg L− 1 (15.0-244.3 nM), respectively. Co-quantification of the C14:1-AHL showed concentrations ranging between 17.5 and 58.7 mg L− 1 (56.6-189.7 µM). We observed distinct production patterns for NAMEs and AHLs, with a continuous NAME production during the entire incubation period. We conducted a spike-in experiment, using the determined metabolite concentrations. By comparing the transcriptomes of pre- and post-metabolite-spikes, we identified three clusters of differentially expressed genes with distinct temporal expression patterns. Expression levels of stress response genes differed between NAME- and AHL-spiked EL-164 cultures in the stationary phase.

Conclusions
Our findings support previous studies suggesting an ecological role for C16:1-NAME as antibiotic, by proving that NAME concentrations in batch cultures were higher than the minimal inhibitory concentrations against Maribacter sp. 62 − 1 (Flavobacteriia) and Skeletonema costatum CCMP 1332 (Coscinodiscophyceae) reported in the literature. Our study further exemplified the broad application range of dose-dependent testing and highlighted the different biological activities of NAMEs and AHLs.
Characterization of non-O157 enterohemorrhagic Escherichia coli isolated from different sources in Egypt
Authors: Bahgat Omnia T. , Rizk Dina E. , Kenawy Hany I. , Barwa Rasha 
Published: November 2024

Abstract
Background
Enterohemorrhagic Escherichia coli (EHEC) O157 is implicated in serious food and water-borne diseases as hemorrhagic colitis (HC), and the potentially fatal hemolytic uremic syndrome (HUS). However, new players of non-O157 EHEC have been implicated in serious infections worldwide. This work aims at analyzing serotype and genotypic-based virulence profile of EHEC local isolates.

Methods
A total of 335 samples were collected from different sources in Egypt. E. coli was isolated and subjected to serotyping. Non-O157 EHEC isolates were tested for virulence genes using PCR, phenotypic examination, phylogenetic typing, and molecular investigation by ERIC typing and MLST to disclose genetic relatedness of isolates. A heat map was used to identify potential associations between the origin of the isolates, their phenotypic and genotypic characteristics.

Results
A total of 105 out of 335 isolates were identified as E. coli. Surprisingly, 49.5% of these isolates were EHEC, where O111, O91, O26 and O55 were the most prevalent serotypes including 38.46% from stool, 21.15% urine, 23.1% cheese, 9.62% meat products, 3.85% from both yogurt and sewage water. Screening 15 different virulence genes revealed that sheA, stx2 and eae were the most prevalent with abundance rates of 85%, 75% and 36%, respectively. Fifteen profiles of virulence gene association were identified, where the most abundant one was stx2/sheA (19%) followed by stx2/stx2g/sheA/eae (11.5%). Both stx2/sheA/eae and stx2/stx2g/sheA were equally distributed in 9.6% of total isolates. Phylogenetic typing revealed that pathogenic phylogroups B2 and D were detected among clinical isolates only. Forty-six different patterns were detected by ERIC genotyping. MLST resolved three sequence types of ST70, ST120 and ST394. The heat map showed that 21 isolates were of 70% similarity, 9 groups were of 100% clonality.

Conclusions
The prevalence of non-O157 EHEC pathotype was marginally higher among the food isolates compared to the clinical ones. The endemic ST120 was detected in cheese, necessitating crucial measures to prevent the spread of this clone. Clinical EHEC isolates exhibited a higher score, and combination of virulence genes compared to food and sewage water isolates, thereby posing a significant public health concern.
Communicating treatment options to older patients with advanced kidney disease: a conversation analysis study
Authors: Selman Lucy E. , Shaw Chloe B. , Sowden Ryann , Murtagh Fliss E. M. , Tulsky James A. , Parry Ruth , Caskey Fergus J. , Barnes Rebecca K. 
Published: November 2024

Abstract
Background
Choosing to have dialysis or conservative kidney management is often challenging for older people with advanced kidney disease. While we know that clinical communication has a major impact on patients’ treatment decision-making, little is known about how this occurs in practice. The OSCAR study (Optimising Staff-Patient Communication in Advanced Renal disease) aimed to identify how clinicians present kidney failure treatment options in consultations with older patients and the implications of this for patient engagement.

Methods
An observational, multi-method study design was adopted. Outpatient consultations at four UK renal units were video-recorded, and patients completed a post-consultation measure of shared decision-making (SDM-Q-9). Units were sampled according to variable rates of conservative management. Eligible patients were ≥ 65 years old with an eGFR of ≤ 20 mls/min/1.73m2 within the last 6 months. Video-recordings were screened to identify instances where clinicians presented both dialysis and conservative management. These instances were transcribed in fine-grained detail and recurrent practices identified using conversation-analytic methods, an empirical, observational approach to studying language and social interaction.

Results
110 outpatient consultations were recorded (105 video, 5 audio only), involving 38 clinicians (doctors and nurses) and 94 patients: mean age 77 (65–97); 61 males/33 females; mean eGFR 15 (range 4–23). There were 21 instances where clinicians presented both dialysis and conservative management. Two main practices were identified: (1) Conservative management and dialysis both presented as the main treatment options; (2) Conservative management presented as a subordinate option to dialysis. The first practice was less commonly used (6 vs. 15 cases), but associated with more opportunities in the conversation for patients to ask questions and share their perspective, through which they tended to evaluate conservative management as an option that was potentially personally relevant. This practice was also associated with significantly higher post-consultation ratings of shared decision-making among patients (SDM-Q-9 median total score 24 vs. 37, p = 0.041).

Conclusions
Presenting conservative management and dialysis as on an equal footing enables patient to take a more active role in decision-making. Findings should inform clinical communication skills training and education.

Clinical trial number
No trial number as this is not a clinical trial.
Barriers and facilitators to high-volume evidence-based innovation and implementation in a large, community-based learning health system
Authors: Durojaiye Cimone , Prausnitz Stephanie , Schneider Jennifer L. , Lieu Tracy A. , Schmittdiel Julie A. , Rouillard Smita , Chen Yi-Fen , Lee Kristine , Corley Douglas A. 
Published: November 2024

Abstract
Background
Broad-scale, rapid health care change is critically needed to improve value-based, effective health care. Health care providers and systems need to address common barriers and facilitators across the evidence to implementation pathway, across diverse specialties. However, most evidence translation / implementation research evaluates single topic areas, and may be of limited value for informing comprehensive efforts. This project’s objective was to identify, characterize, and illustrate common trans-topic facilitators and barriers of translating new health care evidence results to clinical implementation across multiple medical specialties.

Methods
This study was an evaluation of all evidence-based innovation projects completed during 2019–2021. Each project was created with medical group clinical leaders and was intended to inform clinical care. The evaluation took place in a large community-based integrated health care system, and an embedded delivery science and applied research program. Clinical investigators, scientific investigators, and clinical operational leaders received structured questionnaires regarding barriers and facilitators for the operational implementation of new research findings for each project. Responses were mapped to the Consolidated Framework for Implementation Research to identify perceived implementation barriers and facilitators.

Results
All 48 projects completed between 2019 and 2021 were evaluated; responses were received for 45 (94%) and 34 had comments mappable to framework domains. Potential barriers and facilitators to clinical implementation of new research results were identified across all five framework domains and, within these, the 38 constructs or sub-constructs. Among 245 total comments, the most commonly cited facilitators were how the new research evidence generated, compelled change (n = 29), specialty communication networks for disseminating results and initiating change (n = 20), leadership engagement in the project (n = 19), and the innovation’s relative advantage over existing practices (n = 11). The most commonly cited barriers were inadequate resource commitment for next-step implementation (n = 15), insufficient learning/implementation culture (n = 5), and insufficient individual-level willingness/ability for change (n = 5).

Conclusions
A novel large-scale evaluation of barriers and facilitators across the evidence to implementation pathway identified common factors across multiple topic areas and specialties. These common potentially replicable facilitators and modifiable barriers can focus health systems and leaders pursuing large-volume evidence-to-implementation initiatives on those areas with the likely greatest benefit-for-effort, for accelerating health care change.
Prognostic efficacy of lymph node parameters in resected ampullary adenocarcinoma based on long-term follow-up data after adjuvant treatment
Authors: Park Namyoung , Cho In Rae , Lee Sang Hyub , Kim Joo Seong , Choi Jin Ho , Lee Min Woo , Paik Woo Hyun , Joo Kwang Ro , Ryu Ji Kon , Kim Yong-Tae 
Published: November 2024

Abstract
Background
Lymph node (LN) metastasis is an important prognostic factor in the ampulla of Vater (AoV) adenocarcinoma. Various LN parameters have been proposed, but their prognostic efficacy has not been compared in the same population. We aimed to evaluate the prognostic values of LN parameters in AoV adenocarcinoma patients who underwent surgical resection and adjuvant treatment based on the long-term follow-up data.

Methods
A total of 86 patients with surgically resected AoV adenocarcinoma followed by adjuvant treatment were analyzed. We evaluated the prognostic values of various LN parameters such as pathologic N stage, number of metastatic regional LN (LNN), LN ratio (LNR), and log odds of positive LNs (LODDS). Each LN parameter was separately analyzed using Cox regression models with the same confounders.

Results
The median follow-up period was 69.4 months, and the median overall survival (OS) was 114 months. The median number of dissected LNs is 15, with an interquartile range of 8 to 25. In the univariable analyses, all LN parameters showed significant prognostic efficacy for OS, disease-free survival (DFS), and distant metastasis-free survival (DMFS). In the multivariable Cox regression analyses, LNN ≥ 2 was a statistically significant prognostic factor for OS (hazard ratio (HR) 2.10, 95% confidence interval (CI), 1.11–3.97; p = 0.022), DFS (HR 2.51, 95% CI 1.28–4.93; p = 0.007), and DMFS (HR 2.74, 95% CI 1.39–5.41; p = 0.004). LNR showed significant prognostic performance for DFS (HR 2.35, 95% CI 1.23–4.50; p = 0.010), and DMFS (HR 2.26, 95% CI 1.17–4.35; p = 0.015). N stage showed significant prognostic performance in DFS (HR 1.55 for pN1; p = 0.243 and HR 4.31 for pN2; p = 0.003), DMFS (HR 1.46 for pN1; p = 0.323 and 4.59 for pN2; p = 0.002). LODDS and the presence of LN metastasis, did not demonstrate significant prognostic value across survival outcomes.

Conclusions
LN parameters showed good long-term predictive performance in AoV adenocarcinoma patients treated with curative resection and adjuvant treatments. Among LN parameters, LNN ≥ 2 showed better prognostic value than others. Further large-scale studies are needed to validate the clinical usefulness of various LN parameters.
A study on the design of a universal signage system for the Ruijin Soviet cultural heritage site
Authors: Shizhu Lu , Qiuyu Huang , Ziyi Min , Pengjiang Jia 
Published: November 2024

Abstract
Ruijin, the birthplace of China’s first red regime, has always been the core of the central revolutionary base. Integrating the design of cultural heritage sites with universal signage systems is an effective way to protect and pass on red cultural heritage while promoting the continued dissemination of the national image. In heritage site tourism, the signage system is crucial in guiding, indicating, and explaining, serving as a critical component of essential public infrastructure. Given Ruijin’s rich and historic red cultural resources, the design of the signage system must consider the diverse needs of visitors from different nationalities, cultural backgrounds, and age groups. This study adopts a universal design perspective, using the red cultural heritage of the Ruijin Soviet period as a case study. It constructs universal metadata from three key aspects: Cultural Type, Data Attribute, and Data Type. These elements are then visually represented through digital technology. The study also incorporates theoretical support from semiotics, Gestalt psychology, cognitive psychology, and semantics. Through surveys, in-depth interviews, and a “structure-humanity” composite evaluation method, we thoroughly explores the relationships between perception, comprehensibility, visual cognition, and the design of universal signage systems. Additionally, the study analyzes the key factors affecting the universality of the signage system. The results indicate that visual cognition positively impacts the design of universal signage systems. Key factors influencing the universality of signage systems include symbolic element modeling, the familiarity of graphics, the semantic distance of graphics, and the rationality of graphic usage. These findings offer a strategy for creating a universal signage system guided by the heritage routes and based on the dimensions of perception, comprehensibility, and visual cognition. It provides new methods and perspectives for cultural education and heritage preservation in Ruijin and other red cultural heritage sites.
Suppression of hydrodynamic escape of an H2-rich early Earth atmosphere by radiative cooling of carbon oxides
Authors: Yoshida Tatsuya , Terada Naoki , Kuramoto Kiyoshi 
Published: November 2024

AbstractRadiative cooling by molecules is a crucial process for hydrodynamic escape, as it can efficiently remove the thermal energy driving the outflow, acquired through X-ray and extreme UV absorption. Carbon oxides, such as CO and CO2, and their photochemical products are anticipated to serve as vital radiative cooling sources not only in atmospheres dominated by carbon oxides but also in H2-rich atmospheres. However, their specific effects on the hydrodynamic escape, especially in H2-rich atmospheres, have been inadequately investigated. In this study, we conduct 1-D hydrodynamic escape simulations for H2-rich atmospheres incorporating CO, CO2, and their chemical products on an Earth-mass planet. We consider detailed radiative cooling processes and chemical networks related to carbon oxides to elucidate their impacts on the hydrodynamic escape. In the escape outflow, CO2 undergoes rapid photolysis, producing CO and atomic oxygen, while CO exhibits photochemical stability compared to CO2. The H2 oxidation by atomic oxygen results in the production of OH and H2O. Consequently, the hydrodynamic escape is significantly suppressed by the radiative cooling effects of CO, H2O, OH, and H3+ even when the basal mixing fraction of CO and CO2 is lower than ~ 0.01. These mechanisms extend the lifetime of H2-rich atmospheres by about one order of magnitude compared to the case of pure hydrogen atmospheres on early Earth, which also results in negligible escape of heavier carbon- and nitrogen-bearing molecules and noble gases.
Implant-supported fixed prostheses with cantilever: a systematic review and meta-analysis
Authors: Kondo Yusuke , Sakai Kiyoshi , Minakuchi Hajime , Horimai Takuya , Kuboki Takuo ,   JSOI Clinical Guideline Working Group collaborators, Atsuta Ikiru , Hasuike Akira , Takaoka Kazuki , Tanabe Norimasa , Yamauchi Kensuke , Aita Hideki , Akiyama Kentaro , Furuya Junichi , Hiroyasu Kazuhiko , Oshima Masamitsu , Sato Yohei , Sawase Takashi , Yamada Yoichi , Ayukawa Yasunori , Kurosaki Yoko , Mino Takuya , Sakamoto Takashi , Kondo Hisatomo , Miyazaki Takashi , Hosokawa Ryuji 
Published: November 2024

AbstractPurposeThis systematic review (SR) aimed to investigate whether the presence of a cantilever affects the results of implant treatment for partial edentulism, including an analysis of the anterior and posterior regions of the dental arches.MethodsAn electronic search was performed, and original articles published between 1995 and November 2023 were included. The outcomes were the implant survival rate, patient satisfaction, occurrence of mechanical complications, and marginal bone loss around the implants. Two SR members independently examined the validity of the studies, extracted evidence from the included studies, and performed risk of bias assessment, comprehensive evidence evaluation, and meta-analysis.ResultsNine studies met our inclusion criteria. Implant survival rate tended to be lower in the cantilever group, and marginal bone loss tended to be higher in the cantilever group; however, there was no significant difference. There was no significant difference in patient satisfaction based on the presence or absence of a cantilever. Moreover, the incidence of mechanical complications was significantly higher in the cantilever group. According to the analysis of anterior and posterior regions, implant survival rate tended to be lower in the cantilever group of the posterior region, and marginal bone loss around the implants tended to be higher in the cantilever group of the anterior region.ConclusionImplant-supported fixed prostheses with cantilevers did not negatively affect implant survival rate, marginal bone loss, or patient satisfaction. However, the incidence of mechanical complications significantly increased in the cantilever group.
Pylorus-preserving pancreatoduodenectomy preserving blood supply for pancreatic cancer with a history of proximal gastrectomy and sigmoidectomy: a case report
Authors: Nakane Yuto , Minami Takayuki , Kurumiya Yasuhiro , Mizuno Keisuke , Sekoguchi Ei , Sugawara Gen , Inoue Masaya , Kato Takehiro , Akita Naohiro 
Published: November 2024

Abstract
Background
Blood supply to the remnant stomach should be preserved during pancreatectomy in patients with a history of gastrectomy. Moreover, ischemic complications should be considered when performing pancreatoduodenectomy in patients with celiac axis and superior mesenteric artery (SMA) stenosis. However, whether these surgical procedures can be safely performed remains unclear.

Case presentation
A 75-year-old man had a history of laparoscopic proximal gastrectomy (PG) with double-flap technique for gastric cancer and laparoscopic sigmoidectomy for sigmoid cancer treated 4 years ago. Follow-up computed tomography (CT) revealed an irregular nodular tumor measuring 13 mm in the pancreatic head. The patient was diagnosed with resectable pancreatic head cancer without lymph node metastasis (cT1cN0M0, cStageIA) according to the Union for International Cancer Control, 8th edition. As a standard pancreatic cancer treatment, two courses of preoperative chemotherapy with gemcitabine plus S-1 were administered. CT after preoperative chemotherapy identified no significant changes in tumor size but revealed SMA stenosis due to atherosclerosis. Blood flow to the left-sided colon was supplied from the middle colic artery via the SMA because of the past sigmoidectomy with inferior mesenteric artery detachment. Therefore, SMA stent placement was performed 1 day preoperatively. Subsequently, pylorus-preserving pancreatoduodenectomy (PPPD) was performed, preserving the remnant stomach with the right gastroepiploic (RGE) artery and vein. After resection, indocyanine green fluorescence imaging confirmed a good blood supply to the remnant stomach. The operation time was 467 min, and the blood lost was 442 mL. Histopathologically, the tumor was diagnosed as moderate adenocarcinoma and pT1cN0M0, Stage IA. The postoperative course was uneventful. The patient was discharged on postoperative day 23. S-1 as adjuvant chemotherapy was administered on postoperative day 63. The patient has been alive without recurrence for 7 months.

Conclusions
We performed PPPD preserving blood supply for pancreatic head cancer in a patient with benign SMA stenosis and a history of PG and sigmoidectomy. Blood supply was preserved through preoperative SMA stent placement and a surgical procedure preserving the RGE vessels. Furthermore, S-1 adjuvant chemotherapy was successfully initiated. These multimodal therapies contributed to a favorable clinical outcome.