bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral exposure to benzalkonium chlorides in male and female mice reveals alteration of the gut microbiome and bile acid profile
Authors: Lopez Vanessa A , Lim Joe J , Seguin Ryan P , Dempsey Joseph L , Kunzman Gabrielle , Cui Julia Y , Xu Libin 
Published: October 2024

Abstract
Benzalkonium chlorides (BACs) are commonly used disinfectants in a variety of consumer and food-processing settings, and the COVID-19 pandemic has led to increased usage of BACs. The prevalence of BACs raises the concern that BAC exposure could disrupt the gastrointestinal microbiota, thus interfering with the beneficial functions of the microbes. We hypothesize that BAC exposure can alter the gut microbiome diversity and composition, which will disrupt bile acid (BA) homeostasis along the gut-liver axis. In this study, male and female mice were exposed orally to d7-C12- and d7-C16-BACs at 120 µg/g/d for 1 wk. UPLC-MS/MS analysis of liver, blood, and fecal samples of BAC-treated mice demonstrated the absorption and metabolism of BACs. Both parent BACs and their metabolites were detected in all exposed samples. Additionally, 16S rRNA sequencing was carried out on the bacterial DNA isolated from the cecum intestinal content. For female mice, and to a lesser extent in males, we found that treatment with either d7-C12- or d7-C16-BAC led to decreased alpha diversity and differential composition of gut bacteria with notably decreased actinobacteria phylum. Lastly, through a targeted BA quantitation analysis, we observed decreases in secondary BAs in BAC-treated mice, which was more pronounced in the female mice. This finding is supported by decreases in bacteria known to metabolize primary BAs into secondary BAs, such as the families of Ruminococcaceae and Lachnospiraceae. Together, these data signify the potential impact of BACs on human health through disturbance of the gut microbiome and gut-liver interactions.
Profiling the endocrine-disrupting properties of triazines, triazoles, and short-chain PFAS
Authors: Carlier Maxim P , Cenijn Peter H , Baygildiev Timur , Irwan Jenny , Escher Sylvia E , van Duursen Majorie B M , Hamers Timo 
Published: October 2024

Abstract
Persistent, mobile, and toxic compounds released to the environment are likely to pollute drinking water sources due to their slow environmental degradation (persistency) and high water solubility (mobility). The aim of the present study was to create in vitro hazard profiles for 16 triazoles, 9 triazines, and 11 poly- and perfluoroalkyl substances (PFAS) based on their agonistic and antagonistic effects in estrogen receptor (ER), androgen receptor (AR), and thyroid hormone receptor (TR) reporter gene assays, their ability to bind human transthyretin (TTR), and their effects on steroidogenesis. The triazole fungicides tetraconazole, bitertanol, fenbuconazole, tebuconazole, cyproconazole, difenoconazole, propiconazole, paclobutrazol, and triadimenol had agonistic or antagonistic effects on the ER and AR. Difenoconazole, propiconazole, and triadimenol were also found to be TR antagonists. The triazine herbicide ametryn was an ER, AR, and TR antagonist. The same 9 triazole fungicides and the triazines atrazine, deethyl-atrazine, and ametryn affected the secretion of steroid hormones. Furthermore, PFAS compounds PFBS, PFHxS, PFHxA, PFOS, PFOA, and GenX and the triazoles bitertanol, difenoconazole, and 4-methyl benzotriazole were found to displace T4 from TTR. These results are in line with earlier in vitro and in vivo studies on the endocrine-disrupting properties of triazines, triazoles, and PFAS. The present study demonstrates that this battery of in vitro bioassays can be used to profile compounds from different classes based on their endocrine-disrupting properties as a first step to prioritize them for further research, emission reduction, environmental remediation, and regulatory purposes.
RNA Sequencing Analysis of Monocytes Exposed to Airway Fluid From Children With Pediatric Acute Respiratory Distress Syndrome
Authors: Grunwell Jocelyn R. , Huang Min , Stephenson Susan T. , Tidwell Mallory , Ripple Michael J. , Fitzpatrick Anne M. , Kamaleswaran Rishikesan 
Published: October 2024

OBJECTIVES:
Monocytes are plastic cells that assume different polarization states that can either promote inflammation or tissue repair and inflammation resolution. Polarized monocytes are partially defined by their transcriptional profiles that are influenced by environmental stimuli. The airway monocyte response in pediatric acute respiratory distress syndrome (PARDS) is undefined. To identify differentially expressed genes and networks using a novel transcriptomic reporter assay with donor monocytes exposed to the airway fluid of intubated children with and at-risk for PARDS. To determine differences in gene expression at two time points using the donor monocyte assay exposed to airway fluid from intubated children with PARDS obtained 48–96 hours following initial tracheal aspirate sampling.

DESIGN:
In vitro pilot study carried out using airway fluid supernatant.

SETTING:
Academic 40-bed PICU.

PARTICIPANTS:
Fifty-seven children: 44 children with PARDS and 13 children at-risk for PARDS.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We performed bulk RNA sequencing using a transcriptomic reporter assay of monocytes exposed to airway fluid from intubated children to discover gene networks differentiating PARDS from at-risk for PARDS and those differentiating mild/moderate from severe PARDS. We also report differences in gene expression in children with PARDS 48–96 hours following initial tracheal aspirate sampling. We found that interleukin (IL)-10, IL-4, and IL-13, cytokine/chemokine signaling, and the senescence-associated secretory phenotype are upregulated in monocytes exposed to airway fluid from intubated children with PARDS compared with those at-risk for PARDS. Signaling by NOTCH, histone deacetylation/acetylation, DNA methylation, chromatin modifications (B-WICH complex), and RNA polymerase I transcription and its associated regulatory apparatus were upregulated in children with PARDS 48–96 hours following initial tracheal aspirate sampling.

CONCLUSIONS:
We identified gene networks important to the PARDS airway immune response using bulk RNA sequencing from a monocyte reporter assay that exposed monocytes to airway fluid from intubated children with and at-risk for PARDS. Mechanistic investigations are needed to validate our findings.
Safety and efficacy of high thoracic epidural analgesia for chest wall surgery in young adolescents
Authors: Coppens Steve , Dewinter Geertrui , Hoogma Danny Feike , Raudsepp Marc , Vogelaerts Randy , Brullot Liesbeth , Neyrinck Arne , Van Veer Hans , Dreelinck Rebekka , Rex Steffen 
Published: October 2024

BACKGROUND
Chest wall surgery for the correction of pectus excavatum or pectus carinatum has gained increased interest in recent years. Adequate pain treatment, respiratory physiotherapy and early ambulation are key to improving the outcomes. Although thoracic epidural analgesia is highly effective, its safety is controversial, leading to extensive scrutiny and questioning of its role.

OBJECTIVE(S)
We hypothesise that thoracic epidural analgesia is effective and well tolerated to use in adolescents, with a high success rate and low pain scores.

DESIGN
Observational retrospective cohort study.

SETTING
All adolescent cases in a high-volume academic tertiary chest wall surgery centre between March 1993 and December 2017 were included.

PATIENTS
A total of 1117 patients aged from 12 to 19 years of age and receiving either Ravvitch, Nuss or Abramson chest wall reconstruction for pectus excavatum were identified in our institutional chest wall surgery database. After applying selection and exclusion criteria, 532 patients were included in the current analysis.

MAIN OUTCOME MEASURES
The primary endpoint of this study was the safety of epidural analgesia, assessed by the incidence of acute adverse events. Secondary endpoints were block success rates using a specific novel definition, and analgesic efficacy using recorded postoperative pain scores.

RESULTS
More than 60% of patients experienced one or more adverse events. However, all events were minor and without consequences. No serious or long-term adverse events were detected. The success rate of thoracic epidural placement was 81%. Low postoperative pain scores were observed.

CONCLUSION
Thoracic epidural analgesia is an extremely effective pain control technique, with a surprisingly high number of minor adverse events but safe with regard to serious adverse events.

TRIAL REGISTRATION
The local research ethics committee approved and registered this study on 16 May 2022 (registration number: S66594).
Effects of the COVID-19 Pandemic on Microbial Keratitis: A 5-Year Comparative Study
Authors: Haro-Morlett Luis , Vera-Duarte Guillermo Raul , Oliveros-Valdes Francisco , Cortes-Moreno Thelma Noemi , Ramirez-Miranda Arturo , Navas Alejandro , Graue-Hernandez Enrique O. 
Published: October 2024

Purpose:
To report the clinical and microbiological profiles of microbial keratitis and its antimicrobial resistance before, during, and after COVID-19.

Methods:
This was a retrospective case-note review of all corneal scrape specimens collected from patients with microbial keratitis from January 2018 to December 2023. Case records were analyzed for demographic characteristics, microbiological diagnosis, and antibiograms. All outcome variables were collected, stratified, and compared between 3 periods: the pre–COVID-19 group (January–December 2019), the COVID-19 group (January 2020–December 2022), and the post–COVID-19 group (January–December 2023).

Results:
A total of 947 corneal cultures from 947 patients were reviewed. Gram-positive bacteria predominated in all periods, with no significant differences in their distribution. Staphylococcus epidermidis was the most frequently identified organism. Pseudomonas aeruginosa was the most common Gram-negative bacterium, with its incidence significantly lower in the post-COVID period. Fungal infections showed a significant increase in the post-COVID group, with Fusarium sp. being the most common fungus and showing a significant increase in incidence in the post-COVID group.

Conclusions:
Despite a stable incidence of microbial keratitis, this study highlights a concerning trend in antibiotic resistance. Although some pathogens became less common, those that persisted have become increasingly difficult to treat. Understanding the clinical and microbiological profiles of microbial keratitis and antimicrobial resistance patterns before and after the COVID-19 pandemic is crucial for informed treatment decisions.
The application of mass defect percentage in the evaluation of acute coronary syndrome
Authors: Zhang Man , Sun Yinuo , Zhang Limeng , Xu Yu , Liu Yifan , Li Kun 
Published: October 2024

Objectives
White blood cells, neutrophils, lymphocytes, and neutrophil-to-lymphocyte ratio (NLR) distribution patterns in patients with anatomic coronary disease have previously been associated with cardiac events such as myocardial infarct size, complications, and prognosis. However, it remains unknown whether myocardial perfusion mass defect percentage (MDP) obtained from gated myocardial perfusion imaging (G-MPI) correlates with these hematological parameters. Therefore, our research aimed to investigate the application of MDP in the evaluation of acute coronary syndrome (ACS).

Methods
Thirty-six patients with ACS underwent single-photon emission computed tomography/computed tomography using retrospective electrocardiography gating during the resting state. The primary outcome was the percentage of left ventricular mass with abnormal myocardial perfusion (i.e. MDP) in G-MPI. Furthermore, the correlation between myocardial perfusion MDP and lymphocyte count, neutrophil count, white blood cell count, and NLR was calculated. In addition, we explored the relationship of myocardial perfusion MDP with other cardiac function parameters obtained from G-MPI, such as summed rest score, left ventricular ejection fraction, end-systolic volume, and end-diastolic volume.

Results
Myocardial perfusion MDP significantly correlated with white blood cell count, neutrophil count, and NLR (P < 0.01). Furthermore, these hematological parameters were significantly different between low and high MDP groups. Additionally, myocardial perfusion MDP negatively correlated with end-systolic volume (r = −0.615) and left ventricular ejection fraction (r = −0.657).

Conclusion
Myocardial perfusion MDP has a high correlation with inflammatory cell counts and cardiac function parameters obtained from G-MPI in ACS; this may be of help in the evaluation and treatment of these patients.
Solid versus liquid pulmonary micro-aspiration of reflux disease. Does it make a difference in determining the need for intervention?
Authors: Burton Leticia , Khoma Oleksandr , Gooley Susannah , Falk Gregory L. , Weerasinghe Daminda , Van der Wall Hans 
Published: October 2024

Background
Pulmonary micro-aspiration (PMA) is a feared complication of gastroesophageal reflux disease (GORD). A novel scintigraphic test for GORD has been developed and validated. It can demonstrate contamination of the upper and lower airways by refluxate. Current observations have led to the hypothesis that prolongation in solid gastric emptying (SGE) is crical in pulmonary micro-aspiration.

Methods
Standard LGE and SGE studies and the novel reflux test were evaluated in paired studies in patients with severe GORD to measure rates of PMA after each meal. Either water labeled with 99m Technetium Phytate for the LGE or a labeled egg sandwich for the solid meal was utilized. Major symptoms were noted and the cough and reflux severity index (CSI & RSI) was obtained in all patients.

Results
A total of 131 patients were enrolled (59M/72F) with age range of 21–83 years (mean: 52 years). Patients were in the overweight range for BMI (mean: 26.8). Major symptoms were bloating, nausea, belching, and dyspepsia (< 20% had heartburn). SGE was abnormal in 92% (mean 766 min) and LGE abnormal in 53% (mean 82 min). PMA was shown in 35% after the SGE and in 71% after the LGE. PMA+ patients were older. A significant correlation was found between SGE and PMA (P < 0.00) but not LGE. The only significant symptom in the PMA group was bloating. RSI was abnormal in 64% and CSI in 46%.

Conclusion
The majority of patients with PMA do not complain of heartburn. Bloating in patients with severe GORD should raise the possibility of gastroparesis and PMA.
Deep infections after low-velocity ballistic tibia fractures are frequently polymicrobial and recalcitrant
Authors: Chintalapudi Nainisha , Fram Brianna R. , Odum Susan , Seymour Rachel B. , Karunakar Madhav A. ,   EMIT
Published: October 2024

Abstract

Objectives:
To identify risk factors for developing a fracture-related infection in operatively treated ballistic tibia fractures and to report the microbiologic results of intraoperative cultures.

Design:
Retrospective review.

Setting:
Level 1 trauma center.

Patients/Participants:
One hundred thirty-three adults with operatively treated low-velocity ballistic tibia fractures, from 2011 to 2021.

Intervention:
One dose of prophylactic cefazolin or equivalent as well as perioperative prophylaxis.

Main Outcome Measurements:
Deep infection rate.

Results:
The deep infection rate was 12% (16/134) with no significant difference in injury characteristics, index surgical characteristics, or time to antibiotics between the groups (P > 0.05). Patients who were slightly older (35.5 vs. 27 median years, P = 0.005) and with higher median body mass indexes (BMIs) (30.09 vs. 24.51, P = 0.021) developed a deep infection. 56.3% of patients presented with signs of infection within the first 100 days after injury. Nine patients had polymicrobial infections. There were 29 isolated organisms, 69% were uncovered by first-generation cephalosporin prophylaxis (anaerobes, gram-negative rods, Enterococcus, methicillin resistant Staphylococcus Aureus [MRSA]), and 50% of patients developed recalcitrant infection and required a second reoperation where 6 organisms were isolated, half of which were not covered by first-generation prophylaxis (Enterococcus, Staphylococcus Aureus MRSA).

Conclusions:
We found a deep infection rate of 12% among ballistic tibia fractures receiving standard-of-care antibiotic prophylaxis. Increased age and body mass index were associated with deep infections. Half became recalcitrant requiring a second reoperation. 66.7% of isolated organisms were not covered by first-generation cephalosporin prophylaxis. Consideration should be given to treatment options such as broader prophylaxis or local antibiotic treatment.

Level of Evidence:
IV.
Tumor Lysis Syndrome Following PSMA Radioligand Therapy
Authors: Sahafi Pegah , Saeed Michael , Samadi Mohammad Hadi , Aryana Kamran , Askari Emran 
Published: October 2024

Abstract
Tumor lysis syndrome (TLS) is a rare complication following treatment in prostate cancer patients. We present a 65-year-old man with history of castration-resistant prostate cancer who developed TLS following 2 sessions of 177Lu-PSMA therapy. The patient presented with bulky axillary and mediastinal lymphadenopathies, an unusual site for prostate cancer metastasis. Although his PSA levels declined following treatment, he reported excessive weakness leading to immobility. Laboratory correlation showed markedly increased lactate dehydrogenase, from 413 to 543,000 U/L, suggesting the occurrence of TLS. Although being considered a relatively safe treatment, 177Lu-PSMA can sometime lead to life-threatening events, which is reviewed here.
Variable Tracer Avidity and Interlesional Heterogeneity on 18F-FDG, 68Ga-DOTATATE, and 68Ga-DOTA-FAPi-04 PET/CT Imaging in a Single Individual Patient With Progressive Metastatic Medullary Thyroid Carcinoma
Authors: Edamadaka Yeshwanth , Parghane Rahul V. , Basu Sandip 
Published: October 2024

Abstract
In medullary thyroid carcinoma (MTC), distant metastases have few therapeutic options with low success rates and substantial toxicity in many patients, warranting exploration of alternate systemic treatments with fewer adverse effects. The fibroblast activation protein inhibitor (FAPI)–based PET/CT opens new avenues for several cancers, including MTC. A case of MTC with varying tracer avidity and interlesional heterogeneity on 18F-FDG, 68Ga-DOTATATE, and 68Ga-DOTA-FAPI-04 PET/CT imaging is presented. 68Ga-DOTA-FAPI-04 PET/CT exhibited superior efficacy in terms of visualization of metastatic soft tissue, lymph nodal, and skeletal lesions, with enhanced target-to-background ratio compared with the other two, facilitating the detection of these lesions, thereby demonstrating the potential for theranostic translation.
A Challenging Case of Hyperfunctioning Submandibular Ectopic Thyroid Successfully Treated With 131I
Authors: Pisano Giusi , Sassano Serena , Rossi Esther Diana , D'Amore Annamaria , Zagaria Luca 
Published: October 2024

Abstract
Ectopic thyroid tissue is a rare condition, caused by aberrancy during thyroid gland embryogenesis. Any pathology involving the thyroid gland can also affect the ectopic tissue, including tumorigenesis. We report a challenging case of relapsed hyperthyroidism in a woman who already underwent subtotal thyroidectomy in 1995 and surgical revision in 2020 for multinodular toxic goiter. 99mTc-pertechnetate scan revealed an area of radiotracer focal uptake at submandibular level, posing a differential diagnosis between salivary gland tumor and ectopic thyroid. Correlation with clinical history and ultimately histopathology led to diagnosis of hyperfunctioning submandibular ectopic tissue, successfully treating the patient with 131I.
16S rRNA Gene Sequencing Reveals Bacterial Diversity in Khewra Salt Mine Walls
Authors: Noor Syeda Wardah , Arshad Sara , Abdullah Syed Muhammad , Kayani Bushra Khudadad , Fazal Sahar 
Published: October 2024

The Khewra Salt Mine, also known as the source of Himalayan Pink Salt, is the second-largest salt mine in the world and a significant site for salt export. The mine's salt exhibits both amorphous and crystalline textures, with colors ranging from white to deep red, contributing to its distinctive pink hue. While previous research has extensively explored the mine's soil, plants, and brine samples, little attention has been given to the salt walls, which are a major tourist attraction. This study aimed to investigate the bacterial diversity within the salt walls from four distinct locations, including an under-construction area sampled for the first time.
From these four collection points, seven samples were gathered, yielding 19 isolates cultured on 2% NaCl nutrient agar. Bacterial isolates from the under-construction area (US1-1, US1-2, US2-1, and US2-2) and the museum walls (MS1-1 and MS1-2) underwent further biochemical, antibiotic sensitivity, and salt requirement testing, followed by 16S rRNA sequencing. Biochemical assays identified these isolates as gram positive, catalase and oxidase positive rods. All isolates were sensitive to chloramphenicol (30μg/ml). Salt tolerance tests classified them as slightly halophilic, thriving at 2-4% NaCl concentrations.
Molecular characterization revealed two strains from the under-construction area, US1-1 and US2-2, as uncultured Bacillus species and Bacillus thuringiensis, respectively, both with 94% sequence similarity. These sequences have been submitted to NCBI under accession numbers OQ295687 and OQ692139. The phylogenetic results show monophyletic associations between these two strains which could be due to their shared salt location and common ancestors.
The sequences of US1-2, US2-1, and MS1-1 were 100% identical to Bacillus licheniformis, while MS1-2 matched Staphylococcus saprophyticus with 100% similarity. These sequences have been submitted to NCBI as OQ978592, OQ978561, OQ978562, and OQ978593, respectively.
The results of this study point towards significant diversity of bacteria, slightly halophilic, cocci or bacillus shaped. These halophilic bacterial strains, possessing salt-tolerant genes, present the need for further identification of bacterial colonies in the mine and their evolutionary patterns, which could also help uncover the role these microbes play in the ecosystem of the salt mine. Additionally, they show promise for industrial enzyme production.