bluuebunny/crossref_metadata_2025_split huggingface dataset:
HPB SO59 - How do Previous Biliary Interventions Affect the Operative and Postoperative Outcomes Of Patients Undergoing Laparoscopic Cholecystectomy (LC) and Bile Duct Exploration (LCBDE)?
Authors: Hayyawi Israa , Omran Asmaa , Khan Khurram S , Nassar Ahmad 
Published: November 2024

Abstract

Background
Laparoscopic biliary surgery is perceived to be difficult in patients who had undergone previous biliary interventions; ERCP, cholecystostomy or cholecystectomy. Our objective was to evaluate the referral pattern, the preoperative characteristics and operative and postoperative outcomes in such patients.

Method
Analysis of prospectively collected data from patients treated by a specialist biliary unit dedicated to index admission LC and single session laparoscopic management of bile duct stones. In spite of a policy of no preoperative endoscopic clearance of bile duct stones the unit inevitably received some patients who had had previous ERCP at other hospitals prior to referral or were initially unfit when admitted to the base hospital and required ERCP. In a series of 6140 LC and LCBDE 158 patients (2.57%) had already undergone ERCP and 31 (0.5%) had undergone cholecystectomies (18), cholecystostomies (9) or attempted cholecystectomy.

Results
Of 158 pre-referral ERCPs, 130 (82.3%) were referred from other hospitals, 36 (22.8%) having had more than one ERCP. 83.5% had suspected CBD stones. LC difficulty grade was IV to V in 48.7%. 112 patients (70.9%) required LCBDE. There were 10.1% biliary related complications, 3 re-operations, one conversion and one mortality. of 31 patients with previous biliary interventions, 58% came from other units or hospitals. A third had already undergone ERCP. 61.3% had LC difficulty grades IV or V. The 18 un-cholecystectomised patients needed LCBDE with no conversions or bile duct injuries. There were only 2 (6.5%) biliary related complications.

Conclusion
While previous biliary interventions understandably increased the difficulty of LC they did not adversely affect operative and postoperative outcomes. Such surgery should be undertaken in the specialist setting as 70.9% of those with previous endoscopic and 58.1% of those with previous surgical or radiologically guided biliary interventions require LCBDE. Implementing definitive surgical interventions during the index admission can achieve a substantial reduction in re-admission rates, and overall decrease in hospital episodes without significant morbidity, re-interventions or mortality. This enhances the quality of life for patients who would otherwise be subjected to multiple repeat ERCPs and yields significant cost benefits.
The strategy of using heme proteins and synthetic porphyrins as injectable antidotes for fire gas poisoning
Authors: Mao Qiyue , Nakagami Atsuki , Kodera Masahito , Kitagishi Hiroaki 
Published: November 2024

Abstract
During fire accidents, 2 highly toxic components of fire smoke, carbon monoxide (CO) and hydrogen cyanide (HCN), are produced simultaneously, and more than 50% of fire-related deaths can be attributed to the inhalation of these toxic gases. Despite the different CO and HCN detoxification mechanisms, oxygen (O2) ventilation is currently the primary clinical treatment, and no alternative methods are available at present. In this review, the toxicological mechanisms of CO and HCN are investigated with an emphasis on the toxic effects of their combination. On the basis of these toxic mechanisms, the advantages and disadvantages of the current clinical detoxification methods are analyzed and discussed. We also summarize the latest advancements in the development of CO- and HCN-scavenging antidotes, highlighting the strategy of using synthetic iron porphyrins that have been synthesized mainly in our laboratory as water-soluble synthetic hemoglobin biomimetics.
‘They Never had a Chance’: Unequal Opportunities and Fair Redistributions
Authors: Dong Lu , Huang Lingbo , Lien Jaimie W 
Published: November 2024

Abstract
A meritocratic fairness ideal typically asserts that income inequality is justifiable if it arises from differences in performance rather than mere luck. In this study, we present experimental evidence that reveals how merit judgements are influenced by the sources of performance differentials, while holding fixed the underlying impact on incentives to perform. Drawing inspiration from real-world factors that create inequality, we investigate unequal opportunities in education and employment that impact performance. Contrary to some earlier findings suggesting that merit judgements are unaffected by unequal circumstances, our study demonstrates that individuals’ redistributive behaviour is responsive to both the nature and extent of these unequal opportunities. This research thus provides fresh insights into the nuanced factors that motivate people to endorse income redistribution.
The pangenome analysis of the environmental source Salmonella enterica highlights a diverse accessory genome and a distinct serotype clustering
Authors: Aguirre-Sánchez José Roberto , Chaidez Cristóbal , Castro-del Campo Nohelia 
Published: November 2024

Abstract
Salmonella remains the leading cause of foodborne infections globally. Environmental reservoirs, particularly aquatic bodies, serve as conduits for the fecal–oral transmission of this pathogen. While the gastrointestinal tract is traditionally considered the primary habitat of Salmonella, mounting evidence suggests the bacterium’s capacity for survival in external environments. The application of advanced technological platforms, such as next-generation sequencing, facilitates a comprehensive analysis of Salmonella’s genomic features. This study aims to characterize the genomic composition of Salmonella isolates from river water, contributing to a potential paradigm shift and advancing public health protection. A total of 25 river water samples were collected and processed, followed by microbiological isolation of Salmonella strains, which were then sequenced. Genomic characterization revealed adaptive mechanisms, including gene duplication. Furthermore, an open pangenome, predisposed to incorporating foreign genetic material, was identified. Notably, antibiotic resistance genes were found to be part of the core genome, challenging previous reports that placed them in the accessory genome.
Toward a National Profile of Loneliness in Old-Age China: Prevalence and Lonely Life Expectancy
Authors: Wang Xueqing 
Published: November 2024

Abstract

Objectives
Loneliness presents a significant challenge for many older adults in China. Understanding the national scale and patterns of loneliness is critical to inform and guide policy interventions. This study builds a national profile of loneliness among Chinese adults aged 55 and above, illustrating the prevalence of loneliness and the average years expected to feel lonely, and examining how these measures vary by urban/rural residence and gender.

Methods
This study uses the China Health and Retirement Longitudinal Study (2011–2018, N = 25,563) to estimate the loneliness prevalence across different gender and urban/rural residences. Drawing on Sullivan’s method for calculating Healthy Life Expectancy, the author estimate the Lonely Life Expectancy (LLE), which quantifies the expected years an individual will live with loneliness.

Results
Approximately 30% of older Chinese aged 55 and above reported experiencing loneliness during 2011–2018. At age 55, Chinese adults anticipate spending about 7–10 years feeling lonely, representing over one-third of their remaining lifespan. By age 75, this proportion may increase to more than half. Estimates of prevalence and LLE exhibit marked disparities with respect to gender and urban/rural residency. Rural women emerged as the most disadvantaged, facing the highest prevalence and largest proportion of remaining lifetime feeling lonely.

Discussion
Older adults in China spend a significant proportion of their remaining lives feeling lonely. Marked disparities in LLEs underscore the potential role of loneliness in perpetuating health inequalities across different gender and urban/rural residences. These results highlight the urgent need for targeted interventions to mitigate the consequences of prolonged loneliness.
The Bidirectional Relationship Between Sleep and Pain in Crohn’s Disease: A Daily Diary Study
Authors: Salwen-Deremer Jessica K , Westvold Sarah J , Siegel Corey A , Smith Michael T 
Published: November 2024

Abstract

Background
Pain is common in Crohn’s disease (CD) even after endoscopic healing is achieved. Depression, sleep disturbances, fatigue, and worry about pain impact the pain experience. There is a bidirectional relationship between sleep and pain, though it has received minimal attention in CD. Herein, we sought to comprehensively assess this relationship in CD using daily diaries.

Method
Patients with active symptoms of insomnia and CD were recruited as part of an ongoing clinical trial. Participants completed 14-day diaries on sleep patterns and CD symptoms. Temporal associations between sleep and pain were assessed using cross-lagged path analysis and controlled for age, sex, and menstrual cycle.

Results
Overall, 26 participants completed 14-day diaries. All assessed aspects of sleep continuity disturbance were associated with worse next-day abdominal pain (Ps &lt; 0.01). When assessed microlongitudinally, sleep onset latency predicted next-day pain (P = 0.07) and vice versa (P = 0.03). Similarly, nightly awakenings predicted next day pain (P = 0.02) and vice versa (P = 0.04). Sleep efficiency (P = 0.003), sleep quality (P &lt; 0.001), and total sleep time (P = 0.04) predicted next-day pain whereas models with pain as the predictor were not significant.

Conclusions
Sleep continuity and abdominal pain are closely related, with sleep efficiency, total sleep time, and sleep quality potentially driving next-day abdominal pain. As interventions for pain in IBD are limited, it may be important to capitalize on the impact of sleep disturbances on pain to optimize overall wellbeing in people with CD.
Epidemiologic and Genomic Characterization of an Outbreak of Rift Valley Fever Among Humans and Dairy Cattle in Northern Tanzania
Authors: Madut Deng B , Rubach Matthew P , Allan Kathryn J , Thomas Kate M , de Glanville William A , Halliday Jo E B , Costales Cristina , Carugati Manuela , Rolfe Robert J , Bonnewell John P , Maze Michael J , Mremi Alex R , Amsi Patrick T , Kalengo Nathaniel H , Lyamuya Furaha , Kinabo Grace D , Mbwasi Ronald , Kilonzo Kajiru G , Maro Venance P , Mmbaga Blandina T , Lwezaula Bingileki , Mosha Calvin , Marandu Annette , Kibona Tito J , Zhu Feng , Chawla Tanu , Chia Wan Ni , Anderson Danielle E , Wang Lin-Fa , Liu Jie , Houpt Eric R , Martines Roosecelis B , Zaki Sherif R , Leach Austin , Gibbons Aridth , Chiang Cheng-Feng , Patel Ketan , Klena John D , Cleaveland Sarah , Crump John A 
Published: November 2024

Abstract

Background
A periurban outbreak of Rift Valley fever virus (RVFV) among dairy cattle from May through August 2018 in northern Tanzania was detected through testing samples from prospective livestock abortion surveillance. We sought to identify concurrent human infections, their phylogeny, and epidemiologic characteristics in a cohort of febrile patients enrolled from 2016 to 2019 at hospitals serving the epizootic area.

Methods
From September 2016 through May 2019, we conducted a prospective cohort study that enrolled febrile patients hospitalized at 2 hospitals in Moshi, Tanzania. Archived serum, plasma, or whole blood samples were retrospectively tested for RVFV by PCR. Human samples positive for RVFV were sequenced and compared to RVFV sequences obtained from cattle through a prospective livestock abortion study. Phylogenetic analysis was performed on complete RVFV genomes.

Results
Among 656 human participants, we detected RVFV RNA in 4 (0.6%), including 1 death with hepatic necrosis and other end-organ damage at autopsy. Humans infected with RVFV were enrolled from June through August 2018, and all resided in or near urban areas. Phylogenetic analysis of human and cattle RVFV sequences demonstrated that most clustered to lineage B, a lineage previously described in East Africa. A lineage E strain clustering with lineages in Angola was also identified in cattle.

Conclusions
We provide evidence that an apparently small RVFV outbreak among dairy cattle in northern Tanzania was associated with concurrent severe and fatal infections among humans. Our findings highlight the unidentified scale and diversity of interepizootic RVFV transmission, including near and within an urban area.
Emission line velocity, metallicity, and extinction maps of the Small Magellanic Cloud
Authors: Lah Philip , Colless Matthew , D’Eugenio Francesco , Groves Brent , Gelfand Joseph D 
Published: November 2024

ABSTRACT
Optical emission lines across the Small Magellanic Cloud (SMC) have been measured from multiple fields using the Australian National University 2.3m telescope with the wide-field spectrograph. Interpolated maps of the gas-phase metallicity, extinction, H $\alpha$ radial velocity, and H $\alpha$ velocity dispersion have been made from these measurements. There is a metallicity gradient from the centre to the north of the galaxy of $\sim$−0.095 dex kpc−1 with a shallower metallicity gradient from the centre to the south of the galaxy of $\sim$−0.013 dex kpc−1. There is an extinction gradient of $\sim$−0.086 E(B − V)/kpc from the centre going north and shallower going from the centre to the south of $\sim$−0.0089 E(B − V)/kpc. The SMC eastern arm has lower extinction than the main body. The radial velocity of the gas from the H $\alpha$ line and the H i line have been compared across the SMC. In general there is good agreement between the two measurements, though there are a few notable exceptions. Both show a region that has different radial velocity to the bulk motion of the SMC in the southern western corner by at least 16 km s$^{-1}$. The velocity dispersion from H $\alpha$ and H i across the SMC have also been compared, with the H $\alpha$ velocity dispersion usually the higher of the two. The eastern arm of the SMC generally has lower velocity dispersion than the SMC’s main body. These measurements enable a detailed examination of the SMC, highlighting its nature as a disrupted satellite galaxy.
JWST/NIRSpec WIDE survey: a z = 4.6 low-mass star-forming galaxy hosting a jet-driven shock with low ionization and solar metallicity
Authors: D’Eugenio Francesco , Maiolino Roberto , Mahatma Vijay H , Mazzolari Giovanni , Carniani Stefano , de Graaff Anna , Maseda Michael V , Parlanti Eleonora , Bunker Andrew J , Ji Xihan , Jones Gareth C , Helton Jakob M , Morganti Raffaella , Scholtz Jan , Tacchella Sandro , Tadhunter Clive , Übler Hannah , Venturi Giacomo 
Published: November 2024

ABSTRACT
We present NIRSpec/micro-shutter assembly observations from the JWST large-area survey WIDE, targeting the rest-frame UV–optical spectrum of Ulema, a radio-active galactic nucleus host at redshift $z=4.6348$. The low-resolution prism spectrum displays high equivalent width nebular emission, with remarkably high ratios of low-ionization species of oxygen, nitrogen, and sulphur, relative to hydrogen; auroral O$^+$ emission is clearly detected, possibly also C$^+$. From the high-resolution grating spectrum, we measure a gas velocity dispersion of $\sigma \sim 400$$\mathrm{km\, s^{-1}}$, broad enough to rule out star-forming gas in equilibrium in the gravitational potential of the galaxy. Diagnostics based on emission-line ratios suggest that the nebular emission is due to a shock which ran out of pre-shock gas. To infer the physical properties of the system, we model simultaneously the galaxy spectral energy distribution and shock-driven line emission under a Bayesian framework. We find a relatively low-mass, star-forming system ($M_\star = 1.4 \times 10^{10}~{\rm M}_\odot$, $\mathrm{SFR} = 70~{\rm M}_\odot ~{\rm yr^{-1}}$), where shock-driven emission contributes 50 per cent to the total H β luminosity. The nebular metallicity is near solar – three times higher than that predicted by the mass–metallicity relation at $z=4.6$, possibly related to fast-paced chemical evolution near the galaxy nucleus. We find no evidence for a recent decline in the star-formation rate of the galaxy, meaning that, already at this early epoch, fast radio-mode active galactic nucleus feedback was poorly coupled with the bulk of the star-forming gas; therefore, most of the feedback energy must end up in the galaxy halo, setting the stage for future quenching.
The conformation of FOXM1 homodimers in vivo is crucial for regulating transcriptional activities
Authors: Hsu Chia-Chan , Yao Xiang , Chen Shang-Yao , Tsuo Tsui-Chun , Wang I-Ching 
Published: November 2024

Abstract
Conformational changes in a transcription factor can significantly affect its transcriptional activity. The activated form of the FOXM1 transcription factor regulates the transcriptional network of genes essential for cell cycle progression and carcinogenesis. However, the mechanism and impact of FOXM1 conformational change on its transcriptional activity in vivo throughout the cell cycle progression remain unexplored. Here, we demonstrate that FOXM1 proteins form novel intermolecular homodimerizations in vivo, and these conformational changes in FOXM1 homodimers impact activity during the cell cycle. Specifically, during the G1 phase, FOXM1 undergoes autorepressive homodimerization, wherein the αβα motif in the C-terminal transcriptional activation domain interacts with the ββαβ motif in the N-terminal repression domain, as evidenced by FRET imaging. Phosphorylation of the αβα motif by PLK1 at S715/S724 disrupts ββαβ–αβα hydrophobic interactions, thereby facilitating a conserved αβα motif switch binding partner to the novel intrinsically disordered regions, leading to FOXM1 autostimulatory homodimerization persisting from the S phase to the G2/M phase in vivo. Furthermore, we identified a minimal ββαβ motif peptide that effectively inhibits cancer cell proliferation both in cell culture and in a mouse tumor model, suggesting a promising autorepression approach for targeting FOXM1 in cancer therapy.
Immunotherapy-related neurotoxicity in the central nervous system of children with cancer
Authors: He Jiasen , Connors Jeremy , Meador Andrew , Xu Shuo , Meador Heather , Jiang Hong , Fueyo Juan , Gomez-Manzano Candelaria , Friedman Gregory K , Zaky Wafik , Sadighi Zsila , Slopis John M , Ahmad Ali H 
Published: November 2024

Abstract
Significant gaps remain in our understanding of immunotherapy-related neurotoxicity in pediatric patients, largely because much of our knowledge comes from studies in adults. Accurately identifying the adverse effects of immunotherapy in children is also challenging, owing to variations in terminology and grading systems. Moreover, the manifestation of immunotherapy-related neurotoxicity differs greatly across different diseases, various modalities, dosages, and delivery methods. Combining immunotherapy with other treatments might improve outcomes but introduces new complexities and potential for increased toxicities. Additionally, pediatric patients with intracranial malignancy have unique responses to immunotherapies and distinct neurotoxicity compared to those with extracranial malignancy. Consequently, we must enhance our understanding of the pathophysiology, prevalence, severity, and management of immunotherapy’s neurotoxic effects in this vulnerable group. This review consolidates the current knowledge of immunotherapy-related neurotoxicity in pediatric oncology, highlighting various types of neurotoxicity including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and tumor inflammation-associated neurotoxicity (TIAN), among others. Furthermore, we examine the unique features of neurotoxicity associated with adoptive cellular therapy (ACT), antibody-based therapies, immune checkpoint inhibitors (ICIs), oncolytic viruses (OV), and cancer vaccines.
From Detached Concern to Love: Reconsidering Physician-Patient Boundaries
Authors: Onadipe Anjola , Curlin Farr 
Published: November 2024

Abstract
Developing appropriate professional boundaries is part of becoming a mature clinician. Boundaries help physicians fulfill their duties in relationally complex and emotionally fraught situations. The concept of “detached concern” has been used to characterize physician-patient relationships in which physicians show empathy and concern while maintaining due emotional distance. However, if the default tendency of trainees and clinicians is toward detachment, then emphasis on professional boundaries may do less to promote proper detachment than to diminish human connections with patients, thereby leading to clinician disenchantment and patient dissatisfaction. The authors propose that the physician-patient relationship is better characterized by love—specifically the kind of ordered love described by the fourth- and fifth-century bishop and philosopher Augustine of Hippo. Augustine’s vision of love has influenced many social reformers through the centuries, including, notably, Martin Luther King Jr. Importantly, such love is consistent with safeguards for which professional boundaries in the clinical context are corollaries, including guarding against forms of compassion that interfere with reasonable judgment, acknowledging humans' finite capacity to love, and recognizing potential harms of disordered love. Against a horizon of love, however, such boundaries are transformed from walls that prevent human connection and concern to walls that create spaces for and encourage any human connection that does not hinder healing and the patient’s good. By shifting their emphasis from detached concern to love, medical educators can re-enchant medicine for trainees by encouraging the human connections that make the practice of medicine its own reward.
A Comparison of Clinical and Laboratory Features in Neonatal Proven Sepsis and COVID-19
Authors: Sangsari Razieh , Saeedi Maryam , Mirnia Kayvan , Eshaghi Hamid , Sareh Shiva , Afkhaminia Ali 
Published: November 2024

Background:
The clinical manifestations of COVID-19 in neonates are generally mild and commonly require only supportive treatment. However, it is important to note that they can sometimes present with symptoms like bacterial sepsis, which can lead to confusion in diagnosis. In this study, our objective was to compare laboratory data and clinical manifestations between 2 groups to identify opportunities for reducing the unnecessary use of antibiotics.

Methods:
The study was conducted as a cross-sectional study between January 2020 and 2023 on neonates who were admitted to the neonatal intensive care unit or the neonatal ward of Children’s Medical Center in Tehran, Iran. We specifically compared the laboratory data and clinical characteristics of neonates who tested positive for either a blood culture or a reverse transcription polymerase chain reaction for COVID-19.

Results:
Sixty-seven neonates in COVID-19 group and 68 neonates in the bacterial sepsis group entered. Prominent symptoms in the bacterial sepsis group include vomiting, seizure, apnea, mottling, increased need for ventilation and laboratory findings showing elevated levels of C-reactive protein and thrombocytopenia. In the COVID-19 group, patient exhibit symptoms such as cough, diarrhea, fever and laboratory findings that indicate neutropenia and leukopenia. Symptoms of nervous involvement were rare in this group.

Conclusion:
It is crucial to carefully assess the symptoms, laboratory results and overall condition of the patient before deciding on antibiotic initiation. By combining rapid COVID-19 testing and clinical variables, it is possible to identify low-risk infants who are unlikely to have bacterial infections.