bluuebunny/crossref_metadata_2025_split huggingface dataset:
The European Union’s Public Finances in Times of Crisis
Authors: Crowe Richard 
Published: November 2024

Abstract
Under the pressures of multiple crises, the European Union’s public finances are in a state of flux. In seeking to understand the dynamics that are driving that flux, this chapter draws particular attention to the interplay between the Union’s legislative and budgetary powers in matters of European Union (EU) funding. In circumstances where the Union’s budgetary autonomy is constrained by rigid expenditure ceilings and an outdated revenue system, the legislative authority has been forced to innovate to find alternative sources of financing or to use the budget in new ways to pursue Union policy objectives. Based on an examination of different legal mechanisms and public finance techniques employed in response to recent crises, including recourse to off-budget borrowing and external assigned revenue, it is suggested that this flux is symptomatic of a difficult transition from the rather archaic budgetary architecture of the 1980s to a more modern public finance system for the larger and more diverse ‘geopolitical’ Union that is emerging. Looking to the future, the Union will need to breathe more autonomously with both its legislative and budgetary ‘lungs’ if it is to fully exploit its policy competences and assert the strategic autonomy, or even sovereignty, that some now advocate for it.
SpMS1, a male sterility factor, interacts with SpAP1 to regulate unisexual flower development in dioecious spinach
Authors: Li Ning , Wang Bingxin , Shang Xinran , Yang Qiangwei , Yang Liang , Tao Minjie , Muhammad Shoaib , Shi Ainong , Deng Chuanliang 
Published: November 2024

Abstract
The emergence of unisexual flower is an important event during plant evolution. The molecular mechanism underlying the formation of unisexual flowers remains unclear in dioecious spinach. In this study, we identified the spinach MALE STERILITY1 gene, SpMS1, which serves as a masculine factor to regulate male fertility and sex reversion. Silencing SpMS1 led to stamen sterility in male flowers and the development of masculine traits in female flowers. Overexpression of SpMS1 in wild-type Arabidopsis resulted in sterile stamens and irregular pollen exine. Notably, ectopic expression of SpMS1 in Arabidopsis ms1 mutants restored pollen viability and flower fertility. Furthermore, our findings demonstrate that SpMS1 interacts with MADS-box transcription factor SpAP1 to regulate unisexual flower development. Thus, SpMS1 exhibits a conserved function in pollen fertility akin to bisexual flowers, while also acting as a key regulator of unisexual flower development in spinach. This study sheds light on the mechanism of sex differentiation in dioecious plants and also provides valuable insights for manipulating male sterility in plant breeding programs.
Notch inhibition enhances morphological reprogramming of microRNA-induced human neurons
Authors: Burbach Kyle F , Wu Shanyun , Yoo Andrew S 
Published: November 2024

Abstract
The role of Notch signaling in direct neuronal reprogramming remains unknown despite its importance to brain development in vivo. Here, we use microRNA-induced neurons that are directly reprogrammed from human fibroblasts to determine how Notch signaling contributes to neuronal identity. We found that Notch inhibition during the first week of reprogramming was both necessary and sufficient to enhance neurite outgrowth at a later timepoint, indicating an important role in the erasure of the original cell identity. Accordingly, transcriptomic analysis showed that the effect of Notch inhibition was likely due to improvements in fibroblast fate erasure and silencing of non-neuronal genes. To this effect, we identify MYLIP, whose downregulation in response to Notch inhibition significantly promoted neurite outgrowth. Moreover, Notch inhibition resulted in cells with neuronal transcriptome signatures defined by expressing long genes at a faster rate than the control, demonstrating the effect of accelerated fate erasure on neuronal fate acquisition. Our results demonstrate the antagonistic role of Notch signaling to the pro-neuronal microRNAs 9 and 124 and the benefits of its inhibition to the acquisition of neuronal morphology.
Pharmacogenomic testing and implications for psychiatric medication prescribing
Authors: Xavier Rose Mary 
Published: November 2024

ABSTRACT
A pharmacogenomics-informed prescribing strategy examines genetic variations in individual patients for more personalized selection and dosing of psychiatric medications for which a clinical evidence base and/or clinical guidelines exist. Clinicians who prescribe psychiatric medications should be aware of the pharmacogenomic evidence base and existing guidelines relevant to medication selection, dosing, and interactions to ensure safe and effective treatment. Although pharmacogenomic testing does not replace current prescribing strategies, when used alongside them, it acts as a valuable clinical decision support tool that can improve the selection and dosing of specific psychiatric medications.
Patients with Osteoporotic Vertebral Fractures in Denmark 2010-2018
Authors: Andersen Mikkel Ø. , Andresen Andreas K. , Frølich Jacob Stampe , Hansen Karen Højmark , Nielsen Line , Petersen Tanja Gram , Carreon Leah Y , Hermann Anne Pernille , Sørensen Jan 
Published: November 2024

Study Design.
Register-based cohort study based on linked data from multiple national registries.

Objective.
To describe the sociodemographic and health characteristics of individuals in Denmark with osteoporotic vertebral fractures (OVF) and analyze time trends. The study compares labor market participation and comorbidities between OVF patients and a matched control group without these fractures.

Summary of Background Data.
The incidence and characteristics of OVF patients in Denmark are not well-documented. Multiple national health and economic registries enable linking of individual patient data, providing new insights.

Methods.
We identified individuals with hospital-diagnosed vertebral compression fractures from 2010 to 2018 using the Danish National Patient Register. A control group was matched by sex, age, and municipality. Work status prior to OVF was categorized as employed, on paid sickness benefit, in early retirement, or on old-age pension. Comorbidities were analyzed based on hospital diagnoses within 10 years prior to the fracture.

Results.
During 2010 to 2018, 20.262 individuals had a hospital contact with an OVF. Sixty-four percent were women and the mean age was 73.6 (SD 12.4) years. OVF incidence increased from 86 in 2010 to 142 per 100,000 persons in 2018. In 2018, the regional incidence ranged from 120 to 154 per 100,000. More than a fifth of the patients were working prior to the fracture, while 77% were in early retirement or old-age pension. The population with OVF had more comorbidities than the matched comparison group.

Conclusion.
The incidence of hospital-diagnosed OVFs has risen over the last decade, with regional differences. Notably, over 20% of OVF patients were still employed, highlighting the socioeconomic impact of this condition.
Team-Based Care of the Patient Receiving Venovenous Extracorporeal Membrane Oxygenation
Authors: Presti Carmen Rosa , Casey Jessica 
Published: November 2024

Background
Guideline-based care of patients requiring extracorporeal membranous oxygenation, a form of life support for patients with refractory respiratory and/or cardiac failure, requires a multidisciplinary approach, yet a detailed description of the ideal integration of teams of physicians, acute care nurse practitioners, critical care nurses, and other disciplines is lacking in the literature.

Objectives
We sought to define team-based care of the patient receiving venovenous extracorporeal membrane oxygenation with an emphasis on the roles of the critical care nurse and the acute care nurse practitioner.

Methods
A narrative literature review was conducted using the keywords or MeSH terms “team-based care” AND “ECMO” and “nurse practitioner” AND “ECMO.” Electronic databases searched included PubMed, Cumulative Index for Nursing and Allied Health Literature, and PsycINFO.

Results
Sixty-five articles met the search criteria, with 21% (n = 10) focusing on characteristics of team-based care for patients receiving ECMO. Articles describe the ideal composition of teams and their education and training, frameworks for the formation of ECMO teams, and aspects of communication. One article details the role of the acute care nurse practitioner in managing ECMO, but several omit or barely describe the nurse’s role as a team member.

Discussion
No articles were found that specifically define the key elements, structure, and dynamics of effective team-based care of the patient receiving ECMO. A holistic definition of team-based care of the patient receiving ECMO is proposed. Further research is warranted to correlate aspects of team-based care that optimize patient, team, and organization outcomes.
Surgical Algorithm of Poland Syndrome Based on Thorax, Breast, and Nipple-areola Complex Classification
Authors: Romanini Maria Victoria , Forlini Valentina , Valle Maura , Puliti Aldamaria , Martinoli Carlo , Torre Michele 
Published: November 2024

Background:
Poland syndrome (PS) is a rare congenital syndrome characterized by unilateral pectoralis major muscle defect. In 2016, we proposed the thorax, breast, and nipple-areola complex (TBN) classification and a subsequent treatment algorithm, which included conservative and surgical procedures. Our aim is to report the results we obtained treating all thoracic anomalies according to the proposed algorithm in a cohort of adolescents affected by PS.

Methods:
Between January 2016 and June 2023, 52 patients with PS were treated using the TBN classification in our institute. Each patient was evaluated by a multidisciplinary team composed of pediatric and plastic surgeons and treated according to the algorithm. Surgical procedures included were minimally invasive pectus excavatum repair, open sternochondroplasty, patch, metal plate, 3-dimensional chest wall prosthesis, fat grafting, tissue expanders, and breast and pectoral implants. Conservative treatments included vacuum bell and corset.

Results:
Half of the patients had no thoracic skeletal defect (T1), but all had soft-tissues defects. Nineteen patients required thoracoplasty, all of whom experienced T downstaging after treatment, and 90% were postoperatively reclassified as T1. Conservative treatment for T correction was proposed in 8 patients; 83% underwent fat grafting, and 88% had a breast/pectoral prosthesis implanted. There were no major complications registered. The mean follow-up was 5.9 years.

Conclusions:
The proposed algorithm can be considered a useful tool for standardized surgical decision-making in PS. Fat grafting can play a major role in a pediatric setting. A multidisciplinary and minimally invasive approach, whenever possible, should be prioritized in patients younger than 18 years.
Rapid-printed Three-dimensional Models for Craniomaxillofacial Trauma
Authors: Scharf Isabel M. , Mathis Sydney A. , Bou Zeid Naji , Saini Devansh , Nahass George R. , Arias Eduardo , Purnell Chad A. , Zhao Linping , Patel Pravin K. , Alkureishi Lee W.T. 
Published: November 2024

Background:
Advances in surgical planning and 3-dimensional (3D) printing have benefitted the field of craniomaxillofacial surgery by allowing visualization of patient anatomy in settings of otherwise restricted surgical fields. Long 3D print times limit the usability of surgical planning workflows in acute trauma reconstruction. We sought to identify variables affecting print time and produce rapid-printed models with sufficient quality for prebending osteosynthesis plates.

Methods:
Three-dimensional printing variables, including resolution, print orientation, and region of interest cropping, were optimized on a single mandibular and midface fracture model to maximize print time efficiency. Five mandibular and 5 midface fractures were printed both in the high-resolution and time-efficient protocol. Fixation plates were contoured to fit the optimized models and computed tomography scan. Distances and volumes between the fracture surface and plate were computed.

Results:
High-resolution mandible models were printed in 7.47 hours and maxillae in 7.53 hours. Optimized models were printed in 0.93 and 1.07 hours, respectively. Cropping to regions of interest, rotating the model, and decreasing print resolution significantly reduced print time. The difference (optimized versus high resolution) in distance between the plate and model averaged 0.22 and 0.34 mm for mandibles and maxillae; the air space volume differed by 1.39 and 0.90 mm3, respectively.

Conclusions:
Adjusting size, resolution, and position on the printing platform allows rapid fabrication of 3D models for surgical reconstruction without sacrificing surface quality. These edits reduce printing time, enabling the implementation of 3D-printing workflows for surgical planning in acute craniomaxillofacial trauma settings.
Successful Surgical Management of Grade 4 Gynecomastia in a Renal Transplant Recipient
Authors: Alabdulkarim Abdulaziz 
Published: November 2024

Summary:
This case report details the clinical presentation, surgical intervention, and postoperative management of a 36-year-old male renal transplant recipient with grade 4 gynecomastia, classified by the Rohrich scale. The patient had hypertension and was on nifedipine, metoprolol, allopurinol, prednisol, tacrolimus, and mycophenolate. With a body mass index of 31 kg/m2 and significant breast hypertrophy 4 months posttransplant, surgical intervention was chosen. The patient underwent bilateral breast tissue excision with free nipple grafting under general anesthesia. Postoperative management included overnight admission, and follow-up showed successful graft take and satisfactory wound healing.
Treatment of Genital Lymphedema With Lymphatic System Pedicled SCIP Transfer in Combination With Nanofibrillar Collagen Scaffolfds
Authors: Barrantes Sergi , de la Torre Sílvia , Visconti Giuseppe , Blasi Marc , López-Ojeda Anna 
Published: November 2024

Summary:
Genital lymphedema is a challenging condition often refractory to conservative treatments. This case report presents a novel surgical approach combining a lymphatic system transfer based on a pedicled superficial circumflex iliac perforator flap with nanofibrillar collagen scaffolds to address genital lymphedema secondary to hidradenitis suppurativa. A 47-year-old man with hidradenitis suppurativa–related genital lymphedema, unresponsive to conservative measures, underwent the procedure. Indocyanine green lymphography and ultrahigh-frequency ultrasound were used for preoperative flap planning, including lymphatic vessels in the skin paddle. Nanofibrillar collagen scaffolds were placed to enhance lymphangiogenesis in distal genital areas. The patient experienced significant improvement, with a reduction in lymphedema severity from 5 of 9 to 1 of 9 on the Genital Lymphedema Score and substantial relief of symptoms. Single-photon emission computed tomography demonstrated uptake of 18F-fluorodeoxyglucose at the right inguinal lymph nodes, ipsilateral to the lymphatic flap. This case demonstrates the potential of this combined approach in managing complex genital lymphedema.
Empowering Gynecologists With Artificial Intelligence: Tailoring Surgical Solutions for Fibroids
Authors: Sinha Rooma , Raina Rohit , Bag Moumita , Rupa Bana 
Published: November 2024

(Abstracted from Eur J Obstet Gynecol Reprod Biol 2024:299:72–77)
The development and recent more widespread use of artificial intelligence (AI) has created opportunities for advancement in many fields, including healthcare. Large language models (LLMs) are being used more and more in recommending treatment and providing healthcare information, and have been shown to be acceptable in detecting and recommending treatment to the public.
Efficacy of doxycycline-sitafloxacin sequential therapy for urogenital Mycoplasma genitalium infection in Nanjing, China
Authors: Yuan Mengjin , Le Wenjing , Zhao Yuanyuan , Gan Lu , Li Sai , Su Xiaohong 
Published: November 2024

Abstract

Background
The aim of this study was to evaluate the efficacy of doxycycline-sitafloxacin sequential therapy in the treatment of Mycoplasma genitalium (Mg) urogenital infections in Nanjing, China.

Methods
Potential subjects were tested initially for Mg infection by nucleic acid amplification testing (NAAT) and again at least 21 days after completion of doxycycline (100 mg twice daily for 7 days)-sitafloxacin (100 mg twice daily for 7 days) sequential therapy. The presence of macrolide and quinolone resistance-associated mutations in 23S rRNA, parC, gyrA and gyrB genes in Mg was examined at baseline and upon retesting of specimens from subjects that did not clear Mg.

Results
218 patients were screened for Mg, of whom 65 were positive for Mg; 63 Mg-infected patients were enrolled. 22 (35%) Mg-infected subjects (16 heterosexual men, 5 women, and one man who had sex with men [MSM]) were successfully evaluated with a test of cure (TOC); 20 (91%) cleared Mg infection. In pre-treatment specimens, mutations in: 23S rRNA; parC (G248T [S83I]); gyrA (G277T [G93C]) and gyrB genes were present in: 100% (19/19), 61.1% (11/18), 6.7% (1/15), and 7.1% (1/14), respectively. Mg clearance rates were 4/4 in infected subjects that possessed both wildtype (WT) parC and gyrA genes and 9/10 when a parC G248T mutation and an otherwise WT gyrA gene were identified. Two subjects (9%) reported mild adverse events.

Conclusions
Doxycycline-sitafloxacin sequential therapy was well tolerated and effective against most urogenital Mg infections in Nanjing and may provide an option for treatment.
Dry needling for orofacial pain: a systematic review and meta-analysis of randomized clinical trials
Authors: Kuzdzal Adrian , Ernst Edzard , Posadzki Pawel , Wronski Zbigniew 
Published: November 2024

Abstract
Orofacial pain (OFP) is an ache in the front part of the head and typically has musculoskeletal, dental, neural, or sinogenic origin. Dry needling (DN) is the insertion of a solid sterile fine needle through the skin aimed at deactivating the myofascial trigger points has extensively been studied in randomized clinical trials (RCTs). This systematic review was aimed at evaluating the evidence base for the effectiveness of DN for OFP. We searched Medline, Cochrane Central, and Web of Science (from their respective inceptions to February 2024) for RCTs evaluating the effectiveness of DN in patients with OFP. Studies with individuals suffering from cervicogenic or tension type headaches as well as observational studies were excluded. Primary outcomes were pain intensity and severity; secondary outcomes were disability, quality of life, and adverse effects. The review adhered to the methods described by in the Cochrane Handbook. Twenty-four RCTs with a total of 1,318 patients suffering from OFP were included. Most had an unclear or high risk of bias, and the quality of the evidence ranged from very low to low for all comparisons and outcomes. A meta-analysis suggested that, compared with usual care alone, DN + usual care had no effect on pain intensity (visual analogue scale) (standardized mean difference = −1.89, 95% confidence intervals −5.81 to 2.02, very low certainty evidence) at follow-ups of up to 6 weeks. There is little reliable evidence for the effectiveness of DN in reducing OFP. Future, larger, more rigorous studies might reduce the existing uncertainties.
Concordance of Urogenital Microbiome From Sequentially Self-collected Specimens
Authors: Lukacz Emily S. , McDonald Daniel , Bryant MacKenzie , Putnam Sara , Rudser Kyle , Brennan Caitriona , Meister Melanie , Fok Cynthia S. , Mueller Margaret G. , Knight Rob , Brubaker Linda ,   for the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium
Published: November 2024

Importance
Population-based research is necessary to understand the relationship between the urobiome and bladder health.

Objective
Using advanced contamination controls and ecological metrics, we aimed to evaluate the concordance of microbiota in self-collected urogenital specimens from home versus a clinical research setting.

Study Design
A subset of community-dwelling women was enrolled in a longitudinal cohort study, self-collected urogenital samples at 3 time points: 1-day prior, the day of and during an in-person evaluation. Samples were sequenced with V4 16S rRNA and KatharoSeq removed samples indistinguishable from background contamination. Data were matched to Greengenes2-2022.10 and rarefied to 1000 seqs/sample. Intersample concordance pairs above the KatharoSeq threshold were assessed between samples. Unweighted UniFrac distances, Mantel Pearson correlations, Kruskal-Wallis, and chi-square tests were used for comparisons.

Results
Detectable sequences were obtained in 261 samples from the 114 participants with 186 (71%) above the KatharoSeq threshold. Escherichia_710834, Lactobacillus, and Prevotella were most prevalent. Intersample concordance was determined for samples above the threshold from 38 participants with 2 home samples and 47 with home and clinic samples. Correlations between 2 home and between home and clinic were significant (r = 0.43, P = 0.001; r = 0.362, P = 0.001, respectively). There were no significant differences across time points (X
2 = 2.72, P = 0.256).

Conclusions
Home-collected urine samples for urogenital microbiome ecological analysis have sufficient short-term similarity and concordance with self-collected urine samples from a research clinic setting for use in population-based research, which may facilitate inclusion of participants with limited access to clinic-based research.
Severe traumatic brain injury temporally affects cerebral blood flow, endothelial cell phenotype, and cilia
Authors: Gupta Ankan , Bice Zachary , Chen Vaya , Chen Yiliang , Veltri Anthony J. , Lin Chien-Wei , Ma Xialong , Pan Amy Y. , Zennadi Rahima , Palecek Sean P. , Mohieldin Ashraf M. , Nauli Surya M. , Ramchandran Ramani , Rarick Kevin R. 
Published: November 2024

AbstractBackgroundPrevious clinical work suggested that altered cerebral blood flow (CBF) in severe traumatic brain injury (sTBI) correlates with poor executive function and clinical outcome. However, the molecular consequences of altered CBF on endothelial cells (ECs) and their blood flow-sensor organelle called cilia are not known.MethodsWe performed laser speckle contrast imaging, single cell isolation, and single cell RNA sequencing (scRNAseq) after sTBI in a closed skull, linear impact mouse model. Validation of select ciliary target protein changes was performed using flow cytometry. Additionally,in vitroexperiments modeled the post-injury hypoxic environment to evaluate the effect on cilia protein ARL13B in human brain microvascular ECs.ResultsWe detected immediate reductions in CBF that were sustained for at least 100 minutes in both impacted and non-impacted sides of the brain. Our scRNAseq data detected heterogeneity in the brain cortex-derived EC cluster and demonstrated that two of five unique EC sub-clusters changed their relative proportions post-sTBI. Consistent with flow changes, we identified multiple genes associated with the fluid shear stress pathway that were significantly differentially expressed in brain ECs post-injury. Also, ECs displayed activation of ischemic pathway as early as day 1 post-injury, and enrichment of hypoxia pathway at day 7 and 28 post- injury.Arl13bciliary gene expression was lost on day 1 in ECs cluster and remained lost for the entire course of the injury. We validated the loss of cilia protein ARL13B specifically from brain ECs as early as day 1 post-injury and detected the protein in the peripheral blood of the injured mice. We also determined that hypoxia could induce loss of ARL13B protein from cultured ECs.ConclusionsIn severe TBI, blood flow is disrupted in both impacted and non-impacted regions of the brain, creating a hypoxic environment that may influence ciliary gene and protein expression on ECs.