bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variable reliability of the (1,3)-β-d-glucan test for screening Pneumocystis pneumonia in HIV-negative patients depending on the underlying condition
Authors: Kostka Eric , Le Govic Yohann , Damiani Céline , Totet Anne 
Published: November 2024

Abstract
(1,3)-β-d-Glucan (BG) assay is a non-invasive test commonly used in the diagnostic of invasive fungal diseases. Given its high sensitivity, it was suggested that a negative BG result is sufficient for excluding the diagnosis of Pneumocystis pneumonia (PCP). However, suboptimal performance has been described in human immunodeficiency virus (HIV)-negative patients, particularly those with haematological malignancies. We aimed to assess the sensitivity of the BG assay for diagnosing PCP in HIV-negative patients based on their underlying PCP risk factors. We conducted a single-center, retrospective study (2009–2021) enrolling HIV-negative patients diagnosed with PCP and who underwent BG testing. Patients colonized with Pneumocystis jirovecii were included as a control group. In all, 55 PCP patients and 61 colonized patients met the inclusion criteria. Patients were further categorized according to the underlying condition that exposes patients to PCP. Median BG concentration was significantly higher in the PCP group than in the colonization group (500 vs. 31 pg/ml; P &lt; 10−4, Mann–Whitney test) and the BG assay demonstrated a sensitivity of 85% and a specificity of 82% for PCP diagnosis. Notably, sensitivity was significantly higher in non-cancer patients (100%) compared to those with solid cancer (72%) and haematologic cancer (79%) (P &lt; .05, Fischer's exact test). These findings strengthen the high performance of BG testing for screening PCP in non-cancer patients, comparable to that observed in HIV-infected individuals. In contrast, they highlight its low reliability in patients with malignancies, emphasizing the importance of considering underlying conditions when interpreting BG results and refining the role of the test in PCP diagnosis.
Candida tropicalis morphotypes show altered cellular structure and gene expression pre- and post-exposure to fluconazole
Authors: dos Santos Murilo M , de Souza Cássia M , Furlaneto-Maia Luciana , Furlaneto Marcia C 
Published: November 2024

Abstract
A feature of Candida tropicalis is its ability to undergo phenotypic switching that can affect antifungal sensitivity and virulence traits. Here, we investigated the effect of switching on alterations at the cellular structure level of C. tropicalis morphotypes and whether exposure to fluconazole (FLC) in vitro could be associated with these alterations in a morphotype-dependent manner. Candida tropicalis morphotypes included clinical isolate (Parental) and two switch strains (Crepe variant and revertant of Crepe—RC). The minimum inhibitory concentration (MIC50) of fluconazole was determined according to EUCAST. Cell wall porosity, quantification of cell wall components, cell size/complexity, and expression of ERG11 and CDR1 genes in morphotypes pre- and post-exposure to fluconazole were determined. Crepe and RC showed an eightfold higher MIC50 (1 µg/ml) than the Parental (0.125 µg/ml). Exposure to FLC resulted in twofold higher MIC50 for Parental and RC. The Crepe variant exhibited a fourfold higher expression of ERG11, and the RC showed 10-fold higher expression of CDR1 than the clinical isolate. Switch strains showed reduced cell wall porosity compared to Parental, and exposure to FLC resulted in a significant reduction in the porosity of Parental and RC cells. Furthermore, phenotypic switching affected cell wall β-1,3-glucan and chitin contents in a morphotype-dependent manner. Our findings indicate that switching affects cellular structure in C. tropicalis and the occurrence of differential alterations between the clinical isolate and its switched states in response to fluconazole exposure.
Evolution of amplitude and longitude phase of tachocline Rossby waves diffusing to the photosphere
Authors: Dikpati Mausumi , Gilman Peter A , Raphaldini Breno , McIntosh Scott W 
Published: November 2024

ABSTRACT
Physics of magnetohydrodynamic (MHD) Rossby waves in the tachocline-layer were studied by Dikpati et al., using a fluid-particle-trajectory approach along with solving vorticity and induction equations. By extending that model to include a hydrodynamic turbulent convection zone (CZ), we examine how MHD Rossby waves generated in the tachocline might diffuse upward through the CZ to solar surface. We find that pure hydrodynamic Rossby wave amplitudes decline with height due to viscous diffusion at a rate that is independent of viscosity and increases with longitude wavenumber. Fast MHD Rossby waves amplitude declines faster with height for increasing toroidal field, due to their longitude-phase shifting with height, which increases dissipation of kinetic energy in the wave velocities. Slow MHD Rossby waves decline even faster with height because their longitude-phase shifts more rapidly with height, due to their slow phase speed. We conclude that low wavenumber HD and fast MHD Rossby waves, originating in the tachocline, might be detected at the photosphere, but slow MHD Rossby waves should be virtually impossible to detect. We infer from fluid particle trajectories that wave amplitudes declining with height and longitude phase shifting with height associated with decline, implies a powerful mechanism for tangling of magnetic fields, distinct from convective turbulence effects. This could cause a sustained or dissipative local dynamo action triggered by Rossby waves.
Disc distortion revisited
Authors: Binney James 
Published: November 2024

ABSTRACT
We revisit the dynamics of razor-thin, stone-cold, and self-gravitating discs. By recasting the equations into standard cylindrical coordinates, the linearized vertical dynamics of an exponential disc can be followed for several giga years on a laptop in a few minutes. An initially warped disc rapidly evolves into a flat inner region and an outward-propagating spiral corrugation wave that rapidly winds up and would quickly thicken a disc with non-zero radial-velocity dispersion. The Sgr dwarf galaxy generates a similar warp in the Galactic disc as it passes through pericentre, and the warp generated by the dwarf’s last pericentre $\sim 35\, \mathrm{Myr}$ ago is remarkably similar to the warp traced by the Galaxy’s H i disc. The resemblance to the observed warp is fleeting but its timing is perfect. For the adopted parameters, the amplitude of the model warp is a factor 3 too small, but there are several reasons for this being so. The marked flaring of our Galaxy’s low-$\alpha$ disc just outside the solar circle can be explained as a legacy of earlier pericentres.
Transcription factor PagWRKY33 regulates gibberellin signaling and immune receptor pathways in Populus
Authors: Yu Xiao-Qian , Niu Hao-Qiang , Zhang Yue-Mei , Shan Xiao-Xu , Liu Chao , Wang Hou-Ling , Yin Weilun , Xia Xinli 
Published: November 2024

Abstract
Enhanced autoimmunity often leads to impaired plant growth and development, and the coordination of immunity and growth in Populus remains elusive. In this study, we have identified the transcription factors PagWRKY33a/b as key regulators of immune response and growth maintenance in Populus. The disruption of PagWRKY33a/b causes growth issues and autoimmunity while conferring resistance to anthracnose caused by Colletotrichum gloeosporioides. PagWRKY33a/b binds to the promoters of N requirement gene 1.1 (NRG1.1) and Gibberellic Acid-Stimulated in Arabidopsis (GASA14) during infection, activating their transcription. This process maintains disease resistance and engages in GA signaling to reduce growth costs from immune activation. The oxPagWRKY33a/nrg1.1 mutant results in reduced resistance to C. gloeosporioides. Further, PagWRKY33a/b is phosphorylated and activated by mitogen-activated protein kinase kinase 1, which inhibits respiratory burst oxidase homolog D (RBOHD) and respiratory burst oxidase homolog I (RBOHI) transcription, causing reactive oxygen species bursts in wrky33a/b double mutants. This leads to an upregulation of PagNRG1.1 in the absence of pathogens. However, the wrky33a/b/nrg1.1 and wrky33a/b/rbohd triple mutants show compromised defense responses, underscoring the complexity of WRKY33 regulation. Additionally, the stability of PagWRKY33 is modulated by Ring Finger Protein 5 (PagRNF5)-mediated ubiquitination, balancing plant immunity and growth. Together, our results provide key insights into the complex function of WRKY33 in Populus autoimmunity and its impact on growth and development.
Police reform and involuntary hospitalization
Authors: Morabito Melissa S , Savage Jenna , Messina Peter , Harlow Dan , Fisher Courtney E 
Published: November 2024

Abstract
Involuntary hospitalization to receive a psychiatric evaluation is a serious mental health and legal matter that often requires involvement from the local police. It is, however, an understudied part of the police role despite the possibility for the use of force given the involuntary aspect of these encounters. Following the enactment of police reform legislation across Massachusetts in 2020, the Boston Police Department (BPD) has refined its approach to collecting, vetting, executing, and following up on involuntary hospitalization orders, also known as Section 12(a) of the Massachusetts General Laws. As of 2021, all Section 12(a) applications received directly by the BPD from external clinicians have been maintained in a centralized database overseen by the BPD Street Outreach Unit. First, we review the wider context of involuntary hospitalizations. We then review police reform efforts in Massachusetts—the context in which the BPD decided to formalize and make changes to its policy. We then explore the nature of those policy changes. Next, we use quantitative data from the involuntary hospitalization forms received by the Street Outreach Unit submitted by external mental health providers combined with information collected from the vetting of these applications, as well as BPD data detailing the outcomes of the resultant encounters, to closely examine the use and impact of the BPD’s Section 12 policy. The findings associated with these analyses provide a basis for a better understanding of police involvement in involuntary hospitalization.
Awareness and current knowledge of medicinal plants
Authors: Akram Muhammad , Mahmood Khalid 
Published: November 2024

Abstract

Objectives
This research attempts to investigate the historical applications of plants for therapeutic reasons, follow the development of these applications, and comprehend the influence of artificial methods on the use of medicinal plants.

Methods
The study involves the examination of antique writings from Mesopotamia, Egypt, Greece, and the Islamic world, as well as a 5000-year-old Sumerian clay tablet discovered in Nagpur. The study examined historical reports of a number of therapeutic plants, including Glycyrrhiza glabra, Cupressus sempervirens, Commiphora myrrha, Cedrus duham, and Papaver somniferum. It also looked at how improved methods of separating active plant components were developed in the early 19th century, as opposed to more crude treatments like tinctures and powders.

Key findings
Historical evidence reveals that ancient cultures used a wide variety of plants for medicinal reasons, preparing them in different ways. The development of synthetic methods in the 19th century completely changed the manufacture of pharmaceuticals by making it possible to replicate active ingredients precisely and in large quantities. With more than 250 000 plant species recognized, nature’s wide diversity of plant metabolites highlights the importance of plants in both traditional and contemporary medicine.

Conclusions
The development of contemporary synthetic approaches from traditional plant-based medicines serves as an example of how far medicine has come. While modern techniques have increased the effectiveness and scalability of medicinal manufacturing, the historical usage of plants demonstrates a profound grasp of their curative potential. The vast diversity of plant metabolites continues to be important for health and medicine despite advancements in synthetic approaches, highlighting the ongoing importance of natural resources in pharmaceutical research.
Probiotic Formulation for Patients With Bipolar or Schizophrenia Spectrum Disorder: A Double-Blind, Randomized Placebo-Controlled Trial
Authors: Borkent Jenny , Ioannou Magdalini , Neijzen Dorien , Haarman Bartholomeus C M , Sommer Iris E C 
Published: November 2024

Abstract

Background and Hypothesis
Probiotic augmentation offers a promising treatment for bipolar disorder (BD) and schizophrenia spectrum disorder (SSD). By targeting microbiome deviations, they may improve both gut and brain health.

Study Design
In this double-blind, randomized, placebo-controlled trial with the multi-strain probiotic formulation Ecologic BARRIER, we aimed to improve psychiatric and cognitive symptoms, intestinal permeability, and gastrointestinal symptoms in patients with BD or SSD. A total of 131 patients were randomized 1:1 to receive either the probiotic supplement (n = 67) or a placebo (n = 64) for 3 months, in addition to treatment-as-usual. The primary outcomes were symptom severity assessed by the Brief Psychiatric Rating Scale and cognitive functioning by the Brief Assessment of Cognition in Schizophrenia.

Study Results
No significant effect of probiotics was observed on psychiatric symptoms, but borderline significant improvement was observed in the cognition category of verbal memory (Linear Mixed Model (LMM) 0.33; adjusted P = .059). Probiotics beneficially affected markers of intestinal permeability and inflammation, including zonulin (LMMserum = −18.40; adjusted P = .002; LMMfecal = −10.47; adjusted P = .014) and alpha-1 antitrypsin (LMM 9.26; adjusted P = .025). Indigestion complaints significantly decreased in male participants in the probiotics group (LMM = −0.70; adjusted P = .010). Adverse events were similar between groups.

Conclusions
Our study observed significant advantages of probiotics for gut health in BD and SSD, with excellent safety and tolerability. A borderline effect on verbal memory was also indicated. These results underscore the need for further research into microbiome-targeted interventions for patients with complex brain disorders.
Enhancing the Graduate Nursing Student Experience Through Gamification
Authors: Mims Kennedie , Lambert Kenzie , Ross Olivia , Maddox Anna , Funchess Megan , Taylor Ken , Garner Shane , McMullan Susan , Yerdon Amy 
Published: November 2024

Abstract
Gamification, the use of game-styled learning methods in non-game contexts, encourages student participation, increases learning motivation, and maximizes the amount of information students can retain. An intervention was designed utilizing gamification principles to reinforce material learned during a week-long regional anesthesia intensive. Students participated in team-based competitions consisting of knowledge-based questions, critical thinking, and hands-on ultrasound skills. Anonymous survey results demonstrated a statistically significant increase in post-intervention student knowledge, confidence, and motivation. This project’s impact may encourage the integration of gamification in nursing education to increase student motivation and confidence while providing feedback to decrease knowledge gaps.
Racial Disparities in Utilization and Outcomes of Cervical Disc Arthroplasty
Authors: Arroyave Juan Sebastian , Restrepo Mejia Mateo , Ahmed Wasil , Rajjoub Rami , Poeran Jashvant , Stern Brocha Z. , Chaudhary Saad B. 
Published: November 2024

Study Design:
Retrospective study.

Objective:
We examined racial disparities in (1) cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) utilization and (2) CDA in-hospital outcomes.

Summary of Background Data:
ACDF and CDA are established treatments for cervical disc disease. While CDA may offer certain advantages over ACDF, its utilization patterns have not been comprehensively explored.

Methods:
This study of 2012 to 2019 discharges from the National Inpatient Sample included White, Black, and Hispanic patients aged 18 years and older who underwent elective ACDF or CDA. Patient demographics, comorbidities, cervical spine diagnoses, and hospital characteristics were extracted. Survey-weighted logistic regression modeled the adjusted association between race and CDA (vs. ACDF) utilization; an interaction between race and year examined temporal changes in disparities. For CDA outcomes, multivariable logistic regression was used for binary outcomes (nonhome discharge, combined complications, and dysphagia) and linear regression for length of stay.

Results:
The cohort included 712,355 weighted procedures (97.6% ACDF; 84.2% White, 9.7% Black, 6.1% Hispanic). CDA utilization increased from 1.0% of the procedures in 2012 to 3.8% in 2019. Black and Hispanic patients had significantly lower odds than White patients of receiving CDA versus ACDF (OR=0.77, 95% CI: 0.66–0.89, P=0.001; OR=0.80, 95% CI: 0.69–0.93, P=0.003) respectively. There was no statistically significant interaction between race and discharge year (P=0.50). For in-hospital CDA-specific outcomes, Black (vs. White) patients were more likely to experience dysphagia (OR=2.70, 95% CI: 1.53–4.78, P=0.001) and combined complications (OR=3.10, 95% CI: 1.91–5.05, P <0.001). There were no significant differences in any CDA outcome for Hispanic versus White patients.

Conclusions:
This study revealed decreased utilization of CDA versus ACDF in minority patients, a pattern that persisted over time despite overall increasing CDA utilization. In addition, a higher burden of dysphagia and combined complications following CDA in Black patients warrants further examination.

Level of Evidence:
III
Recognition and Management of Postpartum Hemorrhage
Authors: Mohamed Tasabih Ali EL Hassan , Chandraharan Edwin 
Published: November 2024

Abstract
Postpartum hemorrhage (PPH) is an obstetric emergency and refers to excessive blood loss after birth. Loss of blood volume and oxygen-carrying capacity may lead to maternal hypovolemia and hypotension resulting in tissue hypoxia, the onset of anaerobic metabolism, and multiorgan failure. If timely and appropriate action is not taken, cardiac arrest and maternal death may occur. If the amount of blood loss exceeds 500 mL following a vaginal birth or 1000 mL during or following a cesarean section, it is termed PPH. Similar to any other surgical hemorrhage, PPH is classified into primary PPH (occurs within 24 hours of birth) or secondary PPH (between 24 hours and 12 weeks postpartum). PPH is a major contributor to maternal deaths worldwide, and it is estimated that a person dies because of PPH approximately every 5 minutes. Therefore, measures should be directed at prevention and early detection of PPH with prompt management. The prevalence of PPH varies globally and is influenced by location, socioeconomic factors, and the availability and quality of health care. The World Health Organization reported that PPH accounts for a quarter of global maternal deaths. The Mothers and Babies Reducing Risks through Audits and Confidential Enquiries report from the United Kingdom (2023) highlighted that despite rare mortality due to hemorrhage, the number of people dying of obstetric hemorrhage is not decreasing, particularly among people with abnormally invasive placentation. Additionally, substandard care was found to be responsible for more than 50% of deaths due to PPH in the United Kingdom. Therefore, it is vital that adequate healthcare infrastructure, trained and competent healthcare professionals, and immediate access to resources, interventions, and multidisciplinary teams are essential both in well-resourced and resource-restrained healthcare systems. Healthcare professionals must identify the potential risk factors for PPH and initiate preventive measures whenever possible. Additionally, they must respond swiftly if PPH occurs and ensure a multidisciplinary, multilayered approach for a synchronized response to optimize outcomes. This review article emphasizes the etiopathogenesis, diagnosis, and management of PPH based on current scientific evidence as well as international best practice recommendations.
Untangling the Exposure–Response Relationship of Allopurinol in the Setting of Chronic Kidney Disease and Diuretic Use: Implications for Dosing
Authors: Hishe Hailemichael Z. , Stocker Sophie L. , Stamp Lisa K. , Dalbeth Nicola , Merriman Tony R. , Wright Daniel F.B. 
Published: November 2024

Background:
Allopurinol dose reduction proportional to creatinine clearance (CLcr) results in suboptimal urate lowering in patients with gout. Similarly, diuretic therapy reduces oxypurinol clearance but is unexpectedly associated with the need for higher allopurinol doses to achieve the serum urate target (<0.36 mmol/L). The authors aimed to clarify the relationship between oxypurinol exposure and urate-lowering response in patients with gout at different stages of chronic kidney disease and those taking diuretics to determine the implications for maintenance dose selection.

Methods:
Oxypurinol and urate data from 5 clinical studies were available. Model-derived steady-state oxypurinol areas under the concentration–time curves (AUCss0-tau) were estimated using a Bayesian methodology. The observed response metrics included the percentage reduction in urate from baseline and achievement of the target urate level. Exposure–response was explored graphically and using logistic regression. In addition, the influence of chronic kidney disease and diuretic use on the allopurinol dose and oxypurinol AUCss0-tau requirements to achieve the serum urate target were explored.

Results:
Data from 258 patients with gout taking allopurinol representing 1288 paired steady-state oxypurinol and serum urate measurements were available. Higher oxypurinol exposure seems to be required for urate-lowering response normalization and achieve the serum urate target in individuals with reduced kidney function and those taking diuretics. However, allopurinol dose requirements were reduced by 2-fold at the extremes of kidney function and unchanged in those taking or not taking diuretics.

Conclusions:
A lower allopurinol maintenance dose was required in patients with reduced kidney function (CLcr <30 mL/min), but this was not proportional to CLcr. Diuretic therapy did not influence allopurinol dose requirements.
PARS PLANA VITRECTOMY FOR RETINAL DETACHMENT REPAIR AS A LATE COMPLICATION FOR PREVIOUS ABUSIVE HEAD TRAUMA
Authors: Esa Saleh , Rubowitz Alex 
Published: November 2024

Purpose:
The purpose of this study was to document the possibility of late retinal detachment after abusive head trauma (also known as shaken baby syndrome). Abusive head trauma has been associated with different retinal findings, very rarely with retinal detachment.

Methods:
One patient with previous abusive head trauma and current late retinal detachment underwent complete ocular examination, fundus photography with the Optos introduced ultra-widefield retinal imaging before and after pars plana vitrectomy for retinal detachment repair.

Results:
The patient underwent a successful pars plana vitrectomy, posterior hyaloid peeling, endolaser, and silicone oil injection.

Conclusion:
Retinal detachment may occur as late complication of abusive head trauma.