bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective cohort study on the clinical significance of interferon-γ, D-dimer, LDH, and CRP tests in children with severe mycoplasma pneumonia
Authors: Zhang Yu-xiang , Li Yang , Wang Yong , Ren You-feng , Yang Yue , Qi Jing , Yang Hui , Liang Xuan , Zhang Rong-fang 
Published: October 2024

Background:

Mycoplasma pneumoniae is a significant cause of respiratory infections in children, often leading to severe pneumonia. This study aimed to assess the clinical relevance of interferon-gamma (interferon-γ), D-dimer, lactate dehydrogenase (LDH), and C-reactive protein (CRP) as biomarkers in the severity of mycoplasma pneumonia in pediatric patients.

Methods:
In this prospective study, 203 pediatric patients with mycoplasma pneumonia were classified into mild (123 patients) and severe (80 patients) groups. Biomarkers including interferon-γ, D-dimer, LDH, and CRP were measured and analyzed. Statistical methods employed included Pearson and Spearman correlation analyses, logistic regression, and receiver operating characteristic curve analysis.

Results:
The severe group exhibited significantly higher median and interquartile ranges for interferon-γ, D-dimer, LDH, and CRP compared to the mild group. Logistic regression identified IL-10, IL-6, interferon-γ, tumor necrosis factor-alpha, D-dimer, and LDH as independent predictors of severity, with the model achieving 92% accuracy. Receiver operating characteristic curve analysis showed optimal diagnostic efficacy for interferon-γ, D-dimer, and LDH, with the best threshold values being 8.11, 0.64, and 379, respectively. A significant positive correlation was observed between IL-6 and LDH, as well as between interferon-γ and D-dimer.

Conclusion:
This study showed that interferon-γ >8.11, D-dimer >0.64, and LDH >379 have an important role in the assessment of severe mycoplasma pneumonia.
Efficacy of radial incision combined with tunnel floating line drainage in the treatment of high posterior horseshoe anal fistula and perianal flora: Randomized control trial
Authors: Yi Hang , Zheng Yong , Yan Zhengqing 
Published: October 2024

Background:
Due to the high prevalence of posterior horseshoe anal fistula and causing numerous complications, this study aimed to investigate the clinical effect of radial incision combined with tunnel floating line drainage (RCTD) and arc incision internal drainage in the treatment of the disease and the influence on perianal flora.

Methods:
Ninety-six subjects treated with high posterior horseshoe anal fistula were stochastically assigned to a joint group (RCTD), and control group (arc incision internal drainage). The operation-related conditions, complication rate, anal function, and recurrence rate of 6 months after operation were compared, and perianal secretions were collected before operation and 1 day after operation to detect the changes of microbial flora.

Results:
After operation, it was corroborated notable difference between joint group and control group in operation time, intraoperative blood loss, wound healing time, visual analogue scale score 6 hours after operation and phase I cure rate. Chi square test analysis showed notable difference between control group (27.08%) and joint group (10.40%) in incidence of complications, in terms of number of pathogens detected around anus, significantly smaller of the incremental change for the joint subgroup versus the control subgroup 1 day after operation.

Conclusion:
RCTD can be the best choice for patients with high posterior horseshoe anal fistula. This operation method has the advantages of short operation time, less trauma, fewer complications, fast recovery of anal function, and can also reduce perianal pathogenic bacteria infection.
Bilateral carotid and vertebral rete mirabile with aneurysm misdiagnosed as Moyamoya disease: A case report
Authors: Chen Xiuen , Xiao Chao , Qin Chao 
Published: October 2024

Rationale:
Rete mirabile (RM) is rare in humans, normally existing in lower mammalian arteries. To study its clinical and imaging features, we report an extremely rare case that occurred in humans and review the literature.

Patient concerns:
A 43-year-old female patient was admitted to our hospital because of recurrent dizziness and headache for 4 years.

Diagnoses:
The computed tomography angiography (CTA) of the head and neck indicated that the normal structure of the bilateral cervical and vertebral arteries disappeared, and the microvascular network formed, misdiagnosed as Moyamoya disease.

Interventions:
She underwent cerebral digital subtraction angiography examination and was finally diagnosed as carotid and vertebral RM with aneurysm.

Outcomes:
Following the administration of symptomatic treatment, all of her symptoms dissipated, and she was successfully discharged from the hospital.

Lessons:
RM involving in both anterior and posterior circulation is an extremely rare clinical abnormality of cerebrovascular morphology. The radiologists and clinicians should deepen their awareness of the specific CTA feature of RM. When individual CTA examination is insufficient, the utility of digital subtraction angiography is crucial for making a clear diagnosis.
A case report of effective treatment of intracranial atherosclerotic stenosis treated with the integration of traditional Chinese medicine and Western medicine
Authors: Hu Wen-Wen , Chen Yiran , Cai Cheng-Ke , Li Jian , Chen Zheng-Guang , Zhong Li-Qun 
Published: October 2024

Rationale:
Intracranial atherosclerotic stenosis (ICAS) represents a prevalent global cause of stroke, posing a notably higher risk of stroke recurrence than other stroke etiologies. Herein, we report a case of a 39-year-old male patient diagnosed with ICAS, treated through an integrated approach incorporating Chinese and Western medicine with significant efficacy and satisfied clinical safety.

Patient concerns:
This patient presented with 1 transient ischemic attack and prolonged headache, dizziness and poor sleep quality. In addition, the patient refused to undergo surgery due to the high cost and postoperative risks.

Diagnoses:
Diagnostic methods used to identify ICAS include conventional cerebral angiography, magnetic resonance angiography (MRA), CT angiography (CTA), transcranial Doppler ultrasound (TCD), and High-Resolution Magnetic resonance imaging. Considering the cost and risks associated with conventional angiography, noninvasive imaging has emerged as the method of choice for diagnosing ICAS. After a series of noninvasive examinations (CTA, TCD, and HR-MRI), the patient was diagnosed with ICAS.

Interventions:
The western medical regimen includes antiplatelet coagulation, blood pressure control, lipid regulation, plaque stabilization, and lifestyle modifications such as exercise, weight loss, and adherence to low-salt, low-fat diets. Complementing this, traditional Chinese medicine (TCM) treatment was guided by the principle of strengthening the spleen, resolving dampness, nourishing blood and harmonizing ying, resolving blood stasis and clearing collaterals. This involved the administration oral Chinese medicine such as modified Shenling Baizhu powder and modified Si Wu decoction.

Outcomes:
The efficacy of the treatment was assessed by evaluating the degree of luminal stenosis and peak systolic blood flow velocity in the M1 segment of the left middle cerebral artery (MCA) before and after the intervention. Encouragingly, posttreatment results demonstrated the disappearance of the plaque in the left MCA-M1 segment, with no significant lumen stenosis observed. Moreover, a notable and smooth reduction in blood flow velocity was achieved in the left MCA, indicating positive outcomes from the integrated traditional Chinese and Western medicine approach.

Conclusion:
This case report shows that a combination of traditional Chinese and Western medicine is safe and effective in the treatment of ICAS and is worthy of promotion in the clinic.
Adjuvant non-opioid analgesics decrease in-hospital mortality in targeted patients with acute pancreatitis receiving opioids
Authors: Zeng Jiahui , He Hairong , Song Yiqun , Wei Wanzhen , Han Yimin , Su Xinhao , Lyu Weiqi , Zhao Jinpeng , Han Liang , Wu Zheng , Wang Zheng , Wei Kongyuan 
Published: October 2024

Objectives
Opioid administration in acute pancreatitis (AP) exacerbates its severity, prompting concerns regarding the increased requirement for intensive care and its potential impact on patient survival. We aimed to elucidate the influence of analgesic patterns on mortality among patients with AP hospitalized in the ICU.

Methods
We included 784 patients (198 receiving opioid monotherapy and 586 receiving opioid polytherapy) from the Medical Information Mart for Intensive Care database. The primary outcome was in-hospital mortality. Propensity score matching was used to account for baseline differences. We used Kaplan–Meier survival curves and multivariate regression models to indicate survival discrepancies and potential associations.

Results
Polytherapy group exhibited prolonged hospital survival (79.8 vs. 57.3 days, P < 0.001); polytherapy was associated with decreasing in-hospital mortality adjusted for confounders (HR = 0.49, 95% CI: 0.26–0.92; P = 0.027). Stratification analysis indicated that patients receiving adjunctive acetaminophen had prolonged hospital survival (opioid vs. opioid + acetaminophen, P < 0.001; opioid vs. opioid + NSAIDs + acetaminophen, P = 0.026). Opioid polytherapy benefited patients with APACHE III scores >83 and those with mean oral morphine equivalent >60 mg/day (HR = 0.17, 95% CI: 0.1–0.3, P < 0.001 and HR = 0.32, 95% CI: 0.2–0.52, P < 0.001, respectively).

Conclusion
Our findings suggest that an opioid-based analgesic regimen offers a survival advantage for patients with AP, particularly those in critical condition or with concerns about opioid use. This approach provides a viable clinical strategy for pain management. Further randomized clinical trials are warranted to validate these results.
Intensity of Social Needs Case Management Services and Changes in Hospital and Emergency Department Use Among Adult Medicaid Beneficiaries
Authors: Guo Crystal , Brown Timothy T. , Rodriguez Hector P. , Knox Margae , Fleming Mark D. , Hernandez Elizabeth A. , Brown Daniel M. , Brewster Amanda L. 
Published: October 2024

Objectives:
We identify the association between high- and low-intensity case management services on hospital and emergency department (ED) use among CommunityConnect patients.

Background:
Social needs case management services vary in intensity, including the modality, workforce specialization, and maximum caseload. CommunityConnect is a social needs case management program implemented by Contra Costa Health, a county safety-net health system in California’s San Francisco Bay Area.

Methods:
Due to the endogeneity of high-intensity services assigned to high-risk patients, we instrument for service intensity using the number of specialist case managers hired each month of enrollment. Zero-inflated negative binomial models with 2-stage residual inclusion estimated total and avoidable hospital admissions and ED visits 12 months post-enrollment for adult Medicaid beneficiaries enrolled between August 2017 and December 2018 (n = 19,782).

Results:
Compared with low-intensity case management, high-intensity services were associated with a reduction in the incidence rates of inpatient admissions [incidence rate ratio (IRR) = 0.341, 95% CI: 0.106–1.102; P = 0.072], ED visits (IRR = 0.608, 95% CI: 0.188–1.965; P = 0.058), and avoidable ED visits (IRR = 0.579, 95% CI: 0.179–1.872; P = 0.091). No significant association was found between service intensity and the likelihood of an event being an excess zero.

Conclusions:
High-intensity social needs case management may be more effective than low-intensity service at reducing health care use for individuals with non-zero use, suggesting that intensive case management may be especially helpful in supporting discharge and transitions of care.
Organizational Climate Related to Patient-Perpetrated Sexual Harassment
Authors: Fenwick Karissa M. , Frayne Susan M. , Shekelle Jeanette , Carney Diane V. , Yano Elizabeth M. , Klap Ruth , Hamilton Alison B. 
Published: October 2024

Background:
Patient-perpetrated sexual harassment toward health care providers is common and adversely affects provider well-being, workforce outcomes, and patient care. Organizational climate for sexual harassment—shared perceptions about an organization’s practices, policies, and procedures—is one of the strongest predictors of harassment prevalence. We conducted a pilot survey assessing provider perceptions of the Veterans Health Administration (VA)’s climate related to patient-perpetrated sexual harassment.

Research Design:
Responding providers completed a survey assessing: (1) experiences with patient-perpetrated sexual harassment; (2) beliefs about VA’s responses to patient-perpetrated sexual harassment of staff; and (3) perceptions of VA’s organizational climate related to sexual harassment for each of 4 perpetrator-target pairings (patient-perpetrated harassment of staff, patient-perpetrated harassment of patients, staff-perpetrated harassment of staff, and staff-perpetrated harassment of patients).

Subjects:
Respondents included 105 primary care providers (staff physicians, nurse practitioners, and physician assistants) at 15 facilities in the VA Women’s Health Practice-Based Research Network.

Results:
Seventy-one percent of responding providers reported experiencing patient-perpetrated sexual harassment in the past 6 months. Respondent perceptions of VA’s responses to patient-perpetrated harassment of staff were mixed (eg, indicating that VA creates an environment where harassment is safe to discuss but that it fails to offer adequate guidance for responding to harassment). Respondents rated organizational climate related to patient-perpetrated harassment of staff as significantly more negative compared with climate related to other perpetrator-target pairings.

Conclusions:
Future work with representative samples is needed to corroborate these findings, which have potential ramifications for VA’s ongoing efforts to create a safe, inclusive environment of care.
Cholesterol differentially modulates the activity of opioid and muscarinic receptors via common non-canonical binding site
Authors: Chetverikov Nikolai , Janoušková-Randáková Alena , Nelic Dominik , Jakubík Jan 
Published: October 2024

AbstractG protein-coupled receptors (GPCRs) are membrane proteins representing the largest and most therapeutically targeted receptor class for 30% of currently marketed drugs. Two binding motifs for membrane cholesterol, the ‘cholesterol recognition amino acid consensus (CRAC) domain and ‘cholesterol consensus motif’ (CCM), were postulated. Using a simulation of molecular dynamics we demonstrate the binding of membrane cholesterol to non-canonical sites, distinct from CRAC and CCM, at muscarinic and opioid receptors. We identified a binding site common for muscarinic and opioid receptors at TM6, arginine 6.35 being the principal residue. Effects of depletion of membrane cholesterol on the functional responses of these receptors correlated with effects of mutations arginine 6.35 on functional responses. Exploiting cholesterol-binding sites and variations in receptor-membrane interactions brings novel pharmacotherapeutic opportunities including tissue-specific targeting for sterol-based modulators.
Structural insights into inhibitor mechanisms on immature HIV-1 Gag lattice revealed by high-resolutionin situsingle-particle cryo-EM
Authors: Wu Chunxiang , Meuser Megan E. , Rey Juan S. , Meshkin Hamed , Yang Rachel , Devarkar Swapnil Chandrakant , Freniere Christian , Shi Jiong , Aiken Christopher , Perilla Juan R. , Xiong Yong 
Published: October 2024

AbstractHIV-1 inhibitors, such as Bevirimat (BVM) and Lenacapavir (LEN), block the production and maturation of infectious virions. However, their mechanisms remain unclear due to the absence of high-resolution structures for BVM complexes and LEN’s structural data being limited to the mature capsid. Utilizing perforated virus-like particles (VLPs) produced from mammalian cells, we developed an approach to determinein situcryo-electron microscopy (cryo-EM) structures of HIV-1 with inhibitors. This allowed for the first structural determination of the native immature HIV-1 particle with BVM and LEN bound inside the VLPs at high resolutions. Our findings offer a more accurate model of BVM engaging the Gag lattice and, importantly, demonstrate that LEN not only binds the mature capsid but also targets the immature lattice in a distinct manner. The binding of LEN induces a conformational change in the capsid protein (CA) region and alters the architecture of the Gag lattice, which may affect the maturation process. These insights expand our understanding of the inhibitory mechanisms of BVM and LEN on HIV-1 and provide valuable clues for the design of future inhibitors.
Toxicokinetics for organ-on-chip devices
Authors: Hermann Nathaniel G. , Ficek Richard A. , Markov Dmitry A. , McCawley Lisa J. , Hutson M. Shane 
Published: October 2024

AbstractOrgan-on-chip (OOC) devices are an emerging New Approach Method in both pharmacology and toxicology. Such devices use heterotypic combinations of human cells in a micro-fabricated device to mimicin vivoconditions and better predict organ-specific toxicological responses in humans. One drawback of these devices is that they are typically made from polydimethylsiloxane (PDMS), a polymer known to interact with hydrophobic chemicals. Due to this interaction, the actual dose experienced by cells inside OOC devices can differ strongly from the nominal dose. To account for these effects, we have developed a comprehensive toxicokinetic approach to measure and model chemical-PDMS interactions, including partitioning into and diffusion through PDMS. We use these methods to characterize PDMS interactions for ten chemicals, ranging from fluorescent dyes to persistent organic pollutants to organophosphate pesticides. We further show that these methods return physical interaction parameters that can be used to accurately predict time-dependent doses under continuous-flow conditions, as would be present in an OOC device. These results demonstrate the validity of the methods and model across geometries and flow rates.
Glucose-dependent glycosphingolipid biosynthesis fuels CD8+T cell function and tumor control
Authors: Longo Joseph , DeCamp Lisa M. , Oswald Brandon M. , Teis Robert , Reyes-Oliveras Alfredo , Dahabieh Michael S. , Ellis Abigail E. , Vincent Michael P. , Damico Hannah , Gallik Kristin L. , Compton Shelby E. , Capan Colt D. , Williams Kelsey S. , Esquibel Corinne R. , Madaj Zachary B. , Lee Hyoungjoo , Roy Dominic G. , Krawczyk Connie M. , Haab Brian B. , Sheldon Ryan D. , Jones Russell G. 
Published: October 2024

SUMMARYGlucose is essential for T cell proliferation and function, yet its specific metabolic rolesin vivoremain poorly defined. Here, we identify glycosphingolipid (GSL) biosynthesis as a key pathway fueled by glucose that enables CD8+T cell expansion and cytotoxic functionin vivo. Using13C-based stable isotope tracing, we demonstrate that CD8+effector T cells use glucose to synthesize uridine diphosphate-glucose (UDP-Glc), a precursor for glycogen, glycan, and GSL biosynthesis. Inhibiting GSL production by targeting the enzymes UGP2 or UGCG impairs CD8+T cell expansion and cytolytic activity without affecting glucose-dependent energy production. Mechanistically, we show that glucose-dependent GSL biosynthesis is required for plasma membrane lipid raft integrity and aggregation following TCR stimulation. Moreover, UGCG-deficient CD8+T cells display reduced granzyme expression and tumor controlin vivo. Together, our data establish GSL biosynthesis as a critical metabolic fate of glucose—independent of energy production—required for CD8+T cell responsesin vivo.
Shaping Kale Morphology and Physiology Using Precision LED Light Recipes
Authors: Scandola Sabine , Grubb Lauren E. , Castillo Brigo , Iliscupidez Lexyn , Kennedy Curtis , Boyce Nicholas , Talasila Mohana , Uhrig R. Glen 
Published: October 2024

AbstractLight emitting diodes (LEDs) present an innovative opportunity for manipulating plant growth and development. Light serves as a fundamental energy source and an environmental cue, providing an ability to control plant traits through the precise manipulation of light intensity and quality. Here, we assess effects of light intensity and spectral composition on the growth and physiology of the important model plant: Kale (Brassica oleracea), known for its phenotypic plasticity and nutritional composition, kale is a crop well-suited for indoor cultivation. Here, we employ a combination of advanced phenotyping, computer vision, gas chromatography-mass spectrometry (GC-MS) metabolomics, and liquid chromatography-mass spectrometry (LC-MS)-based quantitative proteomics to characterize the molecular changes that underpin light-dictated differences in the growth and metabolism of two different kale cultivars under different light intensity and spectral composition scenarios. We identify time-of-day and cultivar-specific light intensity and spectral composition-induced changes related to growth, shade avoidance, photosynthesis and several nutritional components including amino acids, glucosinolates and carotenoids. Our results offer a key resource to the plant community and demonstrate the translational potential of light manipulation in tailoring kale growth and nutritional content for enhanced crop productivity and/or health benefits, while simultaneously offering a more cost-effective solution for contemporary agricultural challenges.
PhenoVision: A framework for automating and delivering research-ready plant phenology data from field images
Authors: Dinnage Russell , Grady Erin , Neal Nevyn , Deck Jonn , Denny Ellen , Walls Ramona , Seltzer Carrie , Guralnick Robert , Li Daijiang 
Published: October 2024

AbstractPlant phenology plays a fundamental role in shaping ecosystems, and global change-induced shifts in phenology have cascading impacts on species interactions and ecosystem structure and function. Detailed, high-quality observations of when plants undergo seasonal transitions such as leaf-out, flowering, and fruiting are critical for tracking causes and consequences of phenology shifts, but these data are often sparse and biased globally. These data gaps limit broader generalizations and forecasting improvements in the face of continuing disturbance. One solution to closing such gaps is to document phenology on field images taken by public participants. iNaturalist, in particular, provides global scale research-grade data and is expanding rapidly. Here we utilize over 53 million field images of plants and millions of human annotations from iNaturalist – data spanning all angiosperms and drawn from across the globe – to train a computer vision model (PhenoVision) to detect the presence of fruits and flowers. PhenoVision utilizes a vision transformer architecture pretrained with a masked autoencoder to improve classification success, and it achieves high accuracy for flower (98.5%) and fruit presence (95%). Key to producing research-ready phenology data is post-calibration tuning and validation focused on reducing noise inherent in field photographs, and maximizing the true positive rate. We also develop a standardized set of quality metrics and metadata so that results can be used effectively by the community. Finally, we showcase how this effort vastly increases phenology data coverage, including regions of the globe where data have been limited before. Our end products are tuned models, new data resources, and an application streamlining discovery and use of those data for the broader research and management community. We close by discussing next steps, including automating phenology annotations, adding new phenology targets, e.g., leaf phenology, and further integration with other resources to form a global central database integrating all in-situ plant phenology resources.