bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychological Assessment for Gender-Affirming Care in Transgender and Nonbinary Youth: The Companionship Model
Authors: Lee Joonwoo , Kim Hyun-Hee , Budge Stephanie L. 
Published: September 2024

Abstract
This article introduces The Companionship Model as a template for conducting ethical and affirming assessment sessions for transgender and nonbinary youths (TNBY) and their guardians. The Companionship Model emphasizes proactive clinical companionship as TNBY and their guardians navigate access to gender-affirming care. The model offers specific action steps for establishing a therapeutic alliance and centers TNBY and their guardians’ access to resources based on the informed consent/assent process. In this article, we provide sample session questions and illustrative clinical examples.
Novel Trephine for Descemet Membrane Endothelial Keratoplasty Surgery Improves Surgical Preparation Time and Graft Quality: Pilot Data From the “Number 7” Endothelial Keratoplasty Trephine
Authors: Samarawickrama Chameen 
Published: September 2024

Purpose:To report the safety and efficacy of a novel asymmetric marking trephine for Descemet membrane endothelial keratoplasty (DMEK) tissue preparation. The trephine design incorporates optimized curves to distribute mechanical forces and minimize the risk of tears without loss of total endothelial cell volume transplanted compared with a standard 8.00 mm circular transplant.Methods:A retrospective case series of 40 consecutive DMEK operations comparing 20 cases using the “Number 7” trephine against 20 using a modified shark fin technique as standard. Patient and donor characteristics, tissue preparation time and complications, total surgical time, intraoperative and postoperative complications, and endothelial cell counts at 3 months postsurgery are reported.Results:DMEK tissue preparation was significantly faster using the “Number 7” trephine (5.4 vs. 7.6 minutes,P= 0.008). Further, fewer complications arose during tissue preparation (0 vs. 2 complications) despite the faster preparation time. Total surgical time was similar between techniques; however, time spent manipulating the graft was reduced (5.1 vs. 6.8 minutes,P= 0.007) primarily because of the lower tissue preparation complications. Fewer postoperative complications were observed (1 vs. 3, of which 1 in the standard technique group requiring a redo-DMEK), again due to the reduced tissue preparation complications. The 3-month endothelial cell count was comparable between techniques (P> 0.05).Conclusions:Use of the “Number 7” trephine led to faster and safer DMEK tissue preparation, which in turn reduced graft manipulation times and postoperative complications without compromising total endothelial cell volume transplanted. This novel device is ideal for use by surgeons who prepare their own DMEK tissue and within tissue banks who provide prestripped and preloaded DMEK tissue.
Biomarkers of COVID-19 short-term worsening: a multiparameter analysis within the prospective multicenter COVIDeF cohort
Authors: Cancella de Abreu Marta , Ropers Jacques , Oueidat Nathalie , Pieroni Laurence , Frère Corinne , Fontenay Michaela , Torelino Krystel , Chauvin Anthony , Hekimian Guillaume , Marcelin Anne-Geneviève , Parfait Beatrice , Tubach Florence , Hausfater Pierre ,   for the COVIDeF study group
Published: September 2024

Background
During a pandemic like COVID-19, hospital resources are constrained and accurate severity triage of the patients is required.

Objective
The objective of this study is to estimate the predictive performances of candidate biomarkers for short-term worsening (STW) of COVID-19.

Design
Prospective, multicenter (20 hospitals in Paris) cohort study of consecutive COVID-19 patients with systematic biobanking at admission, during the first waves of COVID-19 in France in 2020 (COVIDeF cohort).

Setting and participants
Consecutive COVID-19 patients were screened for inclusion. They were excluded in presence of severity criteria defined by either an ICU admission, mechanical ventilation (including noninvasive ventilation), acute respiratory distress, or in-hospital death before sampling. Routine blood tests measured during usual care and centralized systematic measurement of creatine kinase, C-reactive protein (CRP), procalcitonin, soluble urokinase plasminogen activator receptor (suPAR), high-sensitive troponin T (TnT-hs), N terminal pro-B natriuretic peptide (NT-proBNP), calprotectin, platelet factor 4, mid-regional pro-adrenomedullin (MR-proADM), and proendothelin were performed.

Outcome measures and analyses
The primary outcome was STW, defined by a severity criteria within 7 days. A backward stepwise logistic regression model and a ‘best subset’ approach were used to identify independent association, and the area under the receiving operator characteristics (AUROC) was computed.

Results
Five hundred and eleven patients were analyzed, of whom 60 (11.7%) experienced STW. Median time to occurrence of a severity criteria was 3 days. At admission, lower values of eosinophils, lymphocytes, platelets, alanine aminotransferase, and higher values of neutrophils, creatinine, urea, CRP, TnT-hs, suPAR, NT-proBNP, calprotectin, procalcitonin, MR-proADM, and proendothelin were predictive of worsening. Stepwise logistic regression identified three biomarkers significantly associated with worsening: CRP [adjusted odds ratio (aOR): 1.10, 95% confidence interval (95% CI): 1.06–1.15 for a 10-unit increase, AUROC: 0.73 (0.66–0.79)], procalcitonin [aOR: 0.42, 95% CI: 0.22–0.81, AUROC: 0.69 (0.64–0.88)], and MR-proADM [aOR: 2.85, 95% CI: 1.74–4.69, AUROC: 0.75 (0.69–0.81)]. These biomarkers outperformed clinical variables except diabetes and cancer comorbidities.

Conclusion
In this multicenter prospective study that assessed a large panel of biomarkers for COVID-19 patients, CRP, procalcitonin, and MR-proADM were independently associated with the risk of STW.

Trial registration

ClinicalTrials.gov NCT04352348.
Perioperative platform for muscle-invasive bladder cancer trials: designs and endpoints
Authors: Laukhtina Ekaterina , Moschini Marco , Teoh Jeremy Yuen-Chun , Shariat Shahrokh F. 
Published: September 2024

Purpose of review
This review explores the design and endpoints of perioperative platforms in clinical trials for muscle-invasive bladder cancer (MIBC).

Recent findings
The choice of clinical trial design in perioperative platforms for MIBC must align with specific research objectives to ensure robust and meaningful outcomes. Novel designs in perioperative platforms for MIBC integrate bladder-sparing approaches. Primary endpoints such as pathological complete response and disease-free survival are highlighted for their role in expediting trial results in perioperative setting. Incorporating patient-reported outcomes is important to inform healthcare decision makers about the outcomes most meaningful to patients. Given the growing body of evidence, potential biomarkers, predictive and prognostic tools should be considered and implemented when designing trials in perioperative platforms for MIBC.

Summary
Effective perioperative platforms for MIBC trials are critical in enhancing patient outcomes. The careful selection and standardization of study designs and endpoints in the perioperative platform are essential for the successful implementation of new therapies and the advancement of personalized treatment approaches in MIBC.
Adjuvant Chemotherapy for Stage I Ovarian Clear Cell Carcinoma
Authors: Horikawa Naoki , Inayama Yoshihide , Otsuki Miki , Yamauchi Kota , Mizuno Yukako , Kiyoshige Saya , Taga Yukiko , Yamano Kazuki , Umemiya Maki , Matsubara Motonori , Yamanishi Yukio , Ashihara Takahito , Emoto Ikuko , Mandai Masaki , Kosaka Kenzo , Yamaguchi Ken ,   for the KAMOGAWA Study Group
Published: September 2024

OBJECTIVE:
To assess the association between postoperative chemotherapy and the prognosis of patients with stage I ovarian clear cell carcinoma.

METHODS:
This was a retrospective cohort study of patients with stage I ovarian clear cell carcinoma who underwent surgery, including hysterectomy and bilateral salpingo-oophorectomy, between 2005 and 2019 at 11 affiliated institutions. Patients with preoperative lymph node enlargement, and those who underwent fertility-sparing surgery were excluded. The primary outcome was disease-free survival and overall survival, and was investigated as a secondary outcome. We used propensity score overlap weighting to adjust for confounding factors and estimated the adjusted hazard ratios (HRs) and 95% CIs for the disease-free and overall survival of patients in the control group that did not receive chemotherapy and in the platinum-based multiagent chemotherapy group during the follow-up period.

RESULTS:
In total, 283 patients (64 in the control group and 219 in the chemotherapy group) were included. Five-year disease-free survival was 0.77 (95% CI, 0.66–0.89) in the control group and 0.86 (95% CI, 0.81–0.91) in the chemotherapy group. The unadjusted HR was 0.69 (95% CI, 0.36–1.32; P=.26). After adjustment, patients who received chemotherapy had a significantly lower risk of recurrence than those in the control group (weighted HR for disease-free survival: 0.43; 95% CI, 0.20–0.90; P=.026). There was no difference in overall survival (weighted HR 0.68; 95% CI, 0.27–1.69; P=.40).

CONCLUSION:
Postoperative platinum-based multiagent chemotherapy was associated with improved disease-free survival. These findings provide crucial information for shared decision-making regarding whether to undergo adjuvant chemotherapy.
Clinicopathologic Analysis of HPV-Related Primary Squamous Cell Carcinoma of the Thyroid
Authors: Zhou Chen , Li Feng , Chen Gang , Wu Chao , Jiang Jin-Gui , Duan Jing-Ling 
Published: September 2024

Objective:
This study aims to explore the clinical and pathologic characteristics of HPV-related primary thyroid squamous cell carcinoma (PSCCT), a rare tumor classified by WHO-5 as a subtype of anaplastic thyroid carcinoma (ATC).

Methods:
Clinical data, histomorphology, immunohistochemistry, HPV detection, and B-raf gene point mutations of 3 PSCCT cases were analyzed. Subsequent follow-up was conducted post-treatment.

Results:
All 3 cases involved female patients aged between 60 and 76. Microscopic examination revealed squamous cell carcinoma in cases 1 and 3, whereas case 2 exhibited both squamous cell carcinoma and papillary thyroid carcinoma components. Immunohistochemistry demonstrated CK19, PAX8, and TTF1 expression in the papillary thyroid carcinoma component, and CK5/6, p63, p40, and PAX8 expression in the squamous cell carcinoma component. P16 exhibited diffuse positivity in both squamous cell carcinoma and classic papillary carcinoma. HPV analysis identified low-risk type 6 positivity in cases 1 and 3, while both squamous cell carcinoma and papillary carcinoma areas in case 2 were positive for HPV-33. B-raf gene mutation was exclusive to case 2.

Conclusion:
Diagnosis of PSCCT necessitates multidisciplinary assessment, incorporating clinical symptoms, imaging, histomorphology, and immunohistochemistry. This study, for the first time, reveals the presence of HPV DNA in both PTC and PSCCT, occurring concurrently but separately. Given the limited scope of 3 case reports, definitive conclusions cannot be drawn, warranting further investigation.
Risk of Urinary Tract Infection and Bacteremia in Infants Infected With COVID-19
Authors: Mendez Donna R. , Paul Krishna , Richardson Joan , Jehle Dietrich 
Published: September 2024

Abstract

Objective:
Our objective was to evaluate the risk of urinary tract infection (UTI) and bacteremia in infants 1 year or less of age infected with COVID-19.

Methods:
This was a retrospective study from TriNetX database in the United States. This study was from March 11, 2020, to May 11, 2023, during the COVID-19 pandemic. Patients were included if they were infants, 1 year or less, had a fever, and had a COVID-19 polymerase chain reaction test 1 week before or after presentation to the emergency department (ED) or hospital. We compared outcomes of bacteremia and a UTI in those with COVID-19 and those without COVID-19. Propensity matching was done to account for the confounders of age, gender, race, immune disorders, genitourinary abnormalities, preterm birth, and circumcision.

Results:
Infants who were positive for COVID-19 were at a reduced risk of UTI and bacteremia. There was a significant decreased risk of having a UTI if one had COVID-19 (1.0%) versus those without COVID-19 (2.3%) (risk ratio = 0.37, 95% confidence interval = 0.37–0.50, P < 0.001). For bacteremia, there was also a decreased risk if the infant had COVID-19 (0.4%), versus those without COVID-19 (0.5%) (risk ratio = 0.74, 95% confidence interval = 0.56–0.97, P = 0.03).

Conclusions:
Infants with fever found to have COVID-19 had lower risks of UTI and bacteremia.
Single-cell RNA-sequencing analysis of the effects of frozen-thawed embryo transfer on the transcriptome of trophoblasts
Authors: Su Kai-Zhen , Luo Chuan , Chen Siyue , Zhang Siwei , Li Cheng , Wu Yan-Ting 
Published: September 2024

Objectives:
Frozen-thawed embryo transfer (FET) is widely used in in vitro fertilization (IVF) clinics but is associated with an increased risk of several pregnancy complications, including large-for-gestational age and placenta-related diseases. However, the effects of FET on placentation remain unclear. Therefore, we used single-cell RNA-sequencing (scRNA-seq) technology to investigate the impact of FET on placental gene expression in different subtypes of trophoblasts.

Methods:
A mouse model of IVF and FET was constructed to collect placenta tissues. scRNA-seq was performed on placentas from two dams undergoing IVF-embryo transfer and two dams undergoing IVF-FET. Differentially expressed gene (DEG) analyses were performed in different subtypes of trophoblasts. Identified DEGs were PCR validated.

Results:
The fetal weights and placental efficiency were higher in the FET group than those on the IVF group at E18.5, with no significant difference in placental weights. Subsequently, 55,406 placental cells were captured and annotated. Upregulated DEGs in the FET group in syncytiotrophoblasts (SynTs) and sinusoidal trophoblast giant cells (S-TGCs) within the placental labyrinth were enriched in pathways related to vascular development and oxidative stress, respectively. The expression of the imprinted gene Igf2 in SynTs, S-TGCs, and spongiotrophoblasts was significantly increased. In the junctional zone, FET upregulated the expression of prolactin genes such as Prl3b1 in glycogen trophoblasts (GlyTs) while the downregulated expression of GlyT genes following FET was associated with mesenchyme development.

Conclusion:
This study first identifies DEGs and enriched pathways in different subtypes of trophoblasts following FET. These genes and pathways may contribute to the increased placental efficiency and fetal weights. Future studies are required to confirm these results and further explore the key mechanisms in placental pathologies.
A Prospective Study of Acupuncture Combined With Modified Blood and Vessel Expelling Blood Stasis Tang in Treating Poststroke Facial Paralysis With Insomnia
Authors: Sun Ran , Jiang Zefei , Sun Yiming 
Published: September 2024

Objective:
This study aimed to assess the clinical efficacy of acupuncture combined with modified Blood and Vessel Expelling Blood Stasis Tang in the treatment of poststroke patients experiencing facial paralysis and insomnia.

Methods:
A total of 120 patients with poststroke facial paralysis and insomnia were selected from the Department of Acupuncture and Moxibustion at the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine between January 2021 and January 2023. They were randomly assigned to either a control group or a study group, with 60 patients in each group. The control group received conventional treatment, while the study group received acupuncture combined with modified Blood and Vessel Expelling Blood Stasis Tang. The neurological function, facial paralysis, and sleep quality of the patients in both groups were compared.

Results:
The study group exhibited a significantly higher total effective rate compared with the control group (86.67% versus 66.67%). After treatment, both groups showed a significant reduction in National Institutes of Health Stroke Scale scores, with the study group demonstrating significantly lower scores than the control group. The Functional Disability Index scores for somatic functioning and social life functioning significantly improved in both groups after treatment, with the study group achieving significantly lower scores compared with the control group. The Sleep-Related Symptom Scale and Pittsburgh Sleep Quality Index scores significantly decreased in both groups after treatment, with the study group achieving significantly lower scores than the control group.

Conclusions:
Acupuncture combined with modified Blood and Vessel Expelling Blood Stasis Tang effectively promotes recovery of neurological function and significantly improves facial paralysis and insomnia in patients with poststroke facial paralysis and insomnia. However, further research is warranted to validate these findings.
Effect of Different Insertion Methods on LMA Protector-Related Complications: A Prospective Randomized Double-Blind Clinical Trail
Authors: Liu Shu-Jie , Xiong Si-Yi , Yu Lu , Liu Ying , Zhang Xin-Yi , Chai Ming-Xiao , Xu Pei-Qi , Shi Jing-Hui 
Published: September 2024

Objective:
The authors compared the effect of 2 insertion methods, namely the conventional laryngeal mask airway (LMA) insertion and the index finger–assisted LMA insertion, on the incidence of complications associated with LMA Protector insertion.

Methods:
The authors enrolled 300 patients, who underwent painless bronchoscopy. The patients ranged in age between 18 and 75 and were classified as American Society of Anesthesiologists grade I to III. They were randomly divided into 2 groups: a control group of 150 patients and an assisted group comprising 150 patients. LMA was inserted using the conventional and index finger–assisted insertion methods in both groups, respectively. The primary outcome was postoperative complications, such as oral mucosal injury and pharyngeal pain. Secondary outcomes included the success rate of first-time insertion, the incidence rate of inverse folding of LMA tips, oropharyngeal leak pressure (OLP), and other postoperative complications.

Results:
Compared with the conventional LMA insertion method, index finger–assisted LMA insertion can significantly reduce the incidence rate of oral mucosal injury and pharyngeal pain, with fewer insertion failures. There was a statistically significant difference between the 2 groups in the visual field grading before adjustment for LMA alignment (P<0.0001). The conventional insertion method increased the likelihood of inverse folding of LMA tips. When the conventional insertion method was utilized, there was a significant difference in airway pressure and tidal volume before and after alignment under a fiberoptic bronchoscope (P<0.0001), but no significant difference in visual field grading and respiratory mechanics-related indicators.

Conclusions:
Index finger–assisted insertion can significantly reduce the incidence rate of LMA Protector-related complications and inverse folding of LMA tips.
Dynamic Pathology of Enteric Neural Network using Curcumin-assisted Multiphoton Laser Imaging in Hirschsprung Disease
Authors: Koike Yuhki , Mizoguchi Akira , Uchida Keiichi , Sato Yuki , Higashi Koki , Nagano Yuka , Matsushita Kohei , Sai Kousyoku , Kaito-Yamagishi Aika , Wang Shujie , Kayahara Tetsuro , Okugawa Yoshinaga , Tanaka Kyosuke , Inoue Mikihiro , Funabiki Kazuo , Kimura Kazushi , Goto Hidemasa , Yuge Mizuki , Nishimura Yuhei , Yuasa Hiroto , Toiyama Yuji 
Published: September 2024

Objective:
In living tissue, it has been difficult to make microscopic-level observations without damaging the tissue.

Summary background data:
We have invented a novel intravital fluorescent observation method (IFOM) for real-time tissue observation, combining multi-photon laser scanning microscopy (MPLSM) with curcumin vital staining (CVS-IFOM). The aim of this study was to use CVS-IFOM to analyze the enteric nervous system (ENS) in mice and human patients with hypoganglionosis and Hirschsprung disease.

Methods:
In an initial viability study, we compared live ENS images from non-fluorescent C57BL6 mice stained with curcumin (n=5) and GFP mice (n=5) using MPLSM. We then explored CVS-IFOM for the live examination of resected colon tissues from one hypoganglionosis and three Hirschsprung disease patients.

Results:
In the viability study, detailed ENS histological features were only observed in the curcumin-stained mice. In the hypoganglionosis patient, CVS-IFOM provided ENS details that were not visualized under H&E staining or calretinin immunohistochemistry, allowing the analysis of ENS size, neural bundle number, and neural cell number per plexus. In Hirschsprung disease patients, CVS-IFOM showed a gradual hypoplastic change in the ENS from the oral wedge to the anal wedge, detecting disproportionate changes in the ENS within the same intestinal level, supporting a circumferentially uneven distribution of the intestinal ENS.

Conclusion:
CVS-IFOM may be supportive for intraoperative pathological diagnosis during surgeries in Hirschsprung disease.
The RNA helicase HrpA rescues collided ribosomes inE. coli
Authors: Campbell Annabelle , Esser Hanna F. , Burroughs A. Maxwell , Berninghausen Otto , Aravind L. , Becker Thomas , Green Rachel , Beckmann Roland , Buskirk Allen R. 
Published: September 2024

AbstractAlthough many antibiotics inhibit bacterial ribosomes, loss of known factors that rescue stalled ribosomes does not lead to robust antibiotic sensitivity inE. coli, suggesting the existence of additional mechanisms. Here, we show that the RNA helicase HrpA rescues stalled ribosomes inE. coli.Acting selectively on ribosomes that have collided, HrpA uses ATP hydrolysis to split stalled ribosomes into subunits. Cryo-EM structures reveal how HrpA simultaneously binds to two collided ribosomes, explaining its selectivity, and how its helicase module engages downstream mRNA, such that by exerting a pulling force on the mRNA, it would destabilize the stalled ribosome. These studies show that ribosome splitting is a conserved mechanism that allows proteobacteria to tolerate ribosome-targeting antibiotics.
Synapse-to-synapse plasticity variability balanced to generate input-wide constancy of transmitter release
Authors: Aghi Krisha , Schultz Ryan , Newman Zachary L. , Mendonça Philipe , Li Rachel , Bakshinska Dariya , Isacoff Ehud Y. 
Published: September 2024

AbstractBasal synaptic strength can vary greatly between synapses formed by an individual neuron because of diverse probabilities of action potential (AP) evoked transmitter release (Pr). Optical quantal analysis on large numbers of identifiedDrosophilalarval glutamatergic synapses shows that short-term plasticity (STP) also varies greatly between synapses made by an individual type I motor neuron (MN) onto a single body wall muscle. Synapses with high and lowPrand different forms and level of STP have a random spatial distribution in the MN nerve terminal, and ones with very different properties can be located within 200 nm of one other. While synapses start off with widely diverse basalPrat low MN AP firing frequency and changePrdifferentially when MN firing frequency increases, the overall distribution ofPrremains remarkably constant due to a balance between the numbers of synapses that facilitate and depress as well as their degree of change and basal synaptic weights. This constancy in transmitter release can ensure robustness across changing behavioral conditions.