bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency of lymph node metastases at different neck levels in patients with oral squamous cell carcinoma: a systematic review and meta-analysis
Authors: Yu Yi-Fu , Cao Lei-Ming , Li Zi-Zhan , Zhong Nian-Nian , Wang Guang-Rui , Xiao Yao , Wu Qiu-Ji , Liu Bing , Bu Lin-Lin 
Published: July 2024

Background:
Currently, neck dissection is a standard treatment for the majority of oral squamous cell carcinoma (OSCC) patients. However, the procedure can lead to a series of complications, significantly reducing patient quality of life and even affecting the antitumor immune response in patients undergoing immunotherapy. Therefore, in the era of precision surgery, gaining a deeper understanding of the patterns of lymph node metastasis (LNM) in OSCC is crucial.

Materials and methods:
Literature searches were performed on PubMed, Embase, Web of Science, Cochrane Library, WANFANGDATA, and China National Knowledge Infrastructure (CNKI) (inception to 10 April 2024). In addition, a manual searching was conducted in Scopus, Google Scholar, and Education Resources Information Center (ERIC). The authors included observational studies that evaluated the frequency of LNM in OSCC patients. Systematic review and a random effects model meta-analysis were performed.

Results:
The search identified 4694 articles, of which 17 studies included in our study. The authors calculated the frequency of LNM according to the data reported in the articles. Frequency of LNM=number of patients with positive lymph node / number of patients with OSCC. The frequency of LNM was 12% in level I (95% CI: 0.11–0.15, I
2=38.01%), 20% in level II (95% CI: 0.17–0.22, I
2=47.71%), 10% in level III (95% CI: 0.08–0.12, I
2=49.10%), 2% in level IV (95% CI: 0.01–0.03, I
2=27.58%), 1% in level V (95% CI: 0.00–0.01, I
2=11.37%).

Conclusion:
The frequency of LNM is consistent with the ‘cascade theory’ and appears to be no significant difference from different primary sites. The frequency of LNM were low in levels I–III and were very low in level IV–V, which implicated that more conservative treatments may be considered for OSCC in the future. This study will help clinicians better determine the extent of surgery and preserve lymph nodes during neck dissection.
Acute diarrhea in the hospitalized immunocompromised patient: what is new on diagnostic and treatment?
Authors: Castillo Almeida Natalia E. , Gomez Carlos A. 
Published: July 2024

Purpose of review
This article aims to provide an intuitive framework for diagnosing and managing healthcare-associated diarrhea (HCAD) in the immunocompromised (IC) host.

Recent findings
Our understanding of diarrhea in hospitalized IC patients has significantly evolved. However, the challenge lies in distinguishing between these patients’ numerous causes of diarrhea. The incorporation of gastrointestinal (GI) multiplex polymerase chain reaction (PCR) panels has led to a paradigm shift in our approach to diarrhea. However, using these panels judiciously is of utmost importance, as their misuse can lead to over-testing, overtreatment, and increased hospital costs. We propose a stepwise diagnostic algorithm that ensures diagnostic stewardship, optimal patient care, and resource utilization.

Summary
Diarrhea is a common complication in hospitalized IC patients and is associated with significant morbidity and rare mortality. The advent of new diagnostics, such as GI multiplex PCR panels, holds promise in facilitating the detection of recognized pathogens and may allow for improved outcomes using pathogen-targeted therapy.
Enhancing precision in bone metastasis diagnosis for lobular breast cancer: reassessing the role of 18F-FDG PET/CT
Authors: Usmani Sharjeel , Al Riyami Khulood , Jain Anjali , Alajmi Adil Aljarrah , AlBaimani Khalid , Dumasig Paul , Al Busaidi Asiya , Al Sukati Rashid 
Published: July 2024

Purpose
Detection of osseous metastases by imaging can be challenging in patients with invasive lobular breast cancer (ILC). ILC may demonstrate low metabolic rate due to lower tumor cell density, decreased proliferation rate, diffuse infiltration of surrounding tissue, and low level of GLUT-1 expression. The aim of this study is to assess the diagnostic accuracy of 18F-FDG PET/CT in identifying bone metastases in ILC patients.

Material and methods
Out of 52 individuals diagnosed with lobular breast cancer and underwent 18F-FDG PET/CT for evaluation of metastases, 21 patients were included in our study population after applying inclusion and exclusion criteria. The radiological and clinical follow-up of at least 6 months served as the reference standard comparator.

Results
Bone metastases were confirmed in six patients. 18F-FDG PET/CT was true positive in two and false negative in four patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 18F-FDG PET/CT were 33.33, 93.33, 66.67, 77.78, and 76.19%, respectively (95% confidence interval). The tendency of ILC osseous metastases to be more sclerotic explains the low diagnostic accuracy of 18F-FDG PET/CT in detection of bone metastases, making it a less suited method of evaluation.

Conclusion
The results of the present study indicate that 18F-FDG PET/CT has a low diagnostic accuracy in detecting bone metastases in lobular breast cancer and, by inference, new functional modalities can be explored in these patients. The findings contribute valuable insights to optimize the integration of molecular imaging into the diagnostic algorithm for this specific breast cancer subtype.
Patient Harm Events and Associated Cost Outcomes Reported to a Patient Safety Organization
Authors: Miller Susanne , Stockwell David C. ,   the Pascal Metrics PSO Collaborative
Published: July 2024

Objectives
The aims of the study were to describe inpatient harm events detected via an automatic electronic trigger system (ETS) and to consider their financial consequences.

Methods
Over a 27-month period, inpatient harm events were identified and documented in 1 healthcare system with 37 acute care facilities. Patients who experienced harm (all harm or preventable harm only) were compared with similar patients who did not. Clinical, financial, and demographic data were used to identify labor-adjusted direct variable costs (DVC) and potential differences in length of stay (LOS) associated with all-harm, preventable-harm, and nonharmed cohorts. Age-adjusted Charlson Comorbidity Index, case mix index, diagnosis-related groups, major diagnostic category, sex, age, location, diagnosis, adverse event category and subcategory, preventability, and harm severity were used to compare cohorts. Total harm events reported via the ETS and the health system’s voluntary event reporting system were compared.

Results
Nearly 93,000 encounters for all-harm (n = 25,665) and nonharmed cohorts (n = 67,217) were compared by random sampling of diagnosis-related group-matched all-harm and nonharmed groups to ensure similar clinical conditions, as measured by Charlson Comorbidity Index and case mix index. Sampling (2 groups, n = 100 and n = 200) showed that increased LOS was associated with harm; yet other clinical comparators were similar across groups. the preventable-harm subcohort had longer LOS (10.7 versus 5.9 days) and higher DVC ($13,442 versus $8024) than the nonharmed cohort. Identification of harm events was nearly 6-fold higher with the ETS than with the voluntary event reporting system.

Conclusions
Patients with preventable harm had increased LOS that was associated with higher DVC per preventable-harm encounter in a large US healthcare system.
Primary Care Quality Improvement Through Patient-Centered Medical Homes and the Impact on Emergency Department Utilization for Children With Autism and Mental Health Disorders
Authors: Huang Li , Saint Onge Jarron M. 
Published: July 2024

Background and Objectives:
To address health care spending growth, coordinated care, and patient-centered primary care, most states in the United States have adopted value-based care coordination programs such as patient-centered medical homes (PCMHs). The objective of this study was to understand the relationship between having access to PCMHs and emergency department (ED) utilization for high cost/need children with autism and children with mental health disorders (MHDs).

Methods:
This cross-sectional study included 87 723 children between ages 3 and 17 years in the 2016-2018 National Survey for Children's Health. Multivariate-adjusted logistic regression analyses were used to assess the association between ED and PCMH utilization for children with autism, with MHDs without autism, and others without autism or MHDs. Marginal predictions were used to examine whether PCMH utilization was moderated by health conditions.

Results:
The results showed that children with a PCMH had a 16% reduction in the odds to visit the ED (adjusted odds ratio [aOR] = 0.84; confidence interval [CI], 0.77-0.92; P < .001). When compared with the reference group of children without autism and without MHDs, children with MHDs but without autism had 93% higher odds to visit the ED (aOR = 1.93; CI, 1.75-2.13; P < .001) and children with autism had 35% higher odds to visit the ED (aOR = 1.35; CI, 1.04-1.75; P = .023). Marginal effects results suggested that PCMHs reduced the odds of ED visits the most for children with MHDs without autism and reduced the predicted ED visits from 30.1% to 23.7% (P < .001).

Conclusions:
Primary care quality improvement through access to a PCMH reduced ED visits for children, but the effect varied by autism and MHD conditions. Future PCMH efforts should continue to support children with autism and address unmet needs for children with MHDs with a focus on needed care coordination, family-centered care, and referrals.
Leadership Strategies to Increase Psychological Safety of Nurses: A Longitudinal Study
Authors: Hessler Karen L. , Anderson Gwen , Scannell Mary , McNair Bryan , Becker Maude 
Published: July 2024

Background and Objectives:
A work environment where employees feel comfortable taking chances without fear and with sufficient protection from retaliation is psychologically safe. The objective of this study was to investigate the effects of leader training for nurse managers on psychological safety of clinical registered nurses.

Methods:
The study was designed a longitudinal outcomes approach to assess nurse leader intervention (classes on leadership methods and psychological safety) with pre- and post-intervention measurement of nurse psychological safety at each time point.

Results:
The intervention and nurse leader rounding were shown to increase individual psychological safety climate scores of clinical nurses.

Conclusion:
Psychological safety is an important component to consider in a nursing leadership role. Leadership interventions that focus on the tenets of psychological safety and include methods of being present, such as nurse leader rounding, can foster a sense of a psychologically safe environment for clinical registered nurses.
Complexity and Experience Grading to Guide Patient Selection for Minimally Invasive Pancreatoduodenectomy
Authors: Barreto S. George , Strobel Oliver , Salvia Roberto , Marchegiani Giovanni , Wolfgang Christopher L. , Werner Jens , Ferrone Cristina R. , Abu Hilal Mohammed , Boggi Ugo , Butturini Giovanni , Falconi Massimo , Fernandez-Del Castillo Carlos , Friess Helmut , Fusai Giuseppe K. , Halloran Christopher M. , Hogg Melissa , Jang Jin-Young , Kleeff Jorg , Lillemoe Keith D. , Miao Yi , Nagakawa Yuichi , Nakamura Masafumi , Probst Pascal , Satoi Sohei , Siriwardena Ajith K. , Vollmer Charles M. , Zureikat Amer , Zyromski Nicholas J. , Asbun Horacio J. , Dervenis Christos , Neoptolemos John P. , Büchler Markus W. , Hackert Thilo , Besselink Marc G. , Shrikhande Shailesh V. ,   for the International Study Group for Pancreatic Surgery
Published: July 2024

Objective:
To develop a universally accepted complexity and experience grading system to guide the safe implementation of robotic and laparoscopic minimally invasive pancreatoduodenectomy (MIPD).

Background:
Despite the perceived advantages of MIPD, its global adoption has been slow due to the inherent complexity of the procedure and challenges to acquiring surgical experience. Its wider adoption must be undertaken with an emphasis on appropriate patient selection according to adequate surgeon and center experience.

Methods:
The International Study Group for Pancreatic Surgery (ISGPS) developed a complexity and experience grading system to guide patient selection for MIPD based on an evidence-based review and a series of discussions.

Results:
The ISGPS complexity and experience grading system for MIPD is subclassified into patient-related risk factors and provider experience-related variables. The patient-related risk factors include anatomic (main pancreatic and common bile duct diameters), tumor-specific (vascular contact), and conditional (obesity and previous complicated upper abdominal surgery/disease) factors, all incorporated in an A-B-C classification, graded as no, a single, and multiple risk factors. The surgeon and center experience-related variables include surgeon total MIPD experience (cutoffs 40 and 80) and center annual MIPD volume (cutoffs 10 and 30), all also incorporated in an A-B-C classification.

Conclusions:
This ISGPS complexity and experience grading system for robotic and laparoscopic MIPD may enable surgeons to optimally select patients after duly considering specific risk factors known to influence the complexity of the procedure. This grading system will likely allow for a thoughtful and stepwise implementation of MIPD and facilitate a fair comparison of outcomes between centers and countries.
Keys to successful clinical audit and feedback: essential steps to making impactful improvements in patient care
Authors: Delaforce Alana , Moore Diana 
Published: July 2024

ABSTRACT
Up to 40% of care provided to patients is either wasteful or harmful. The practice of audit and feedback can help identify where care can be improved. However, such audits must be executed in a systematic way that engages with clinicians to maximize the impact of feedback, ultimately improving patient outcomes. Currently, audit training is not integrated into formal education pathways and clinicians need guidance to support them in this activity. This paper explores contemporary research, with the aim of providing practical advice for recommendations to maximize the impact of audit and feedback.

Spanish abstract:

http://links.lww.com/IJEBH/A239
The web of conflict-related interactions in Colombia: exploring causal linkages between ecological and social variables by the qualitative loop analysis
Authors: Bodini Antonio , Vivian Jenny , Vargas Juan , Clerici Nicola , Scotti Marco 
Published: July 2024

In Colombia, the long-lasting internal conflict heavily shaped the socio-ecological context and imposed relationships that persisted after the peace agreement was signed in 2016. One question of interest is whether policies or interventions conceived to attain desirable goals for the post-conflict society may be effective or, rather, if the constraints imposed by the conflict scenario might produce unintended effects, either on the environmental or the social side. To explore this issue, we envisaged the socio-ecological system as a parsimonious set of characteristic ecological and social variables within the conflict-related framework and reconstructed their interactions, exploiting elicitation-based information and the literature. We visualized the resulting interactive networks as signed digraphs. Applying the qualitative technique of loop analysis combined with numerical simulations, we predicted the response of the system to policies as drivers of change, such as subsidized credit to capital-intensive activities or policies that increase small farming competitiveness and access to markets. Highlighting causal linkages reveals that the persistence of conflict factors may produce unexpected interdependencies between licit and illicit activities and that, only in a few cases, the persistence of these mechanisms allows synergies between desirable goals.
This article is part of the theme issue ‘Connected interactions: enriching food web research by spatial and social interactions’.
Taklimakanibacter deserti gen. nov., sp. nov. and Taklimakanibacter lacteus sp. nov., isolated from desert soil
Authors: He Huan-Huan , Feng Chu-Ying , Wang Dong , Zheng Zhuo-Huan , Li Shuai , Xu Zi-Xin , Lu Chun-Yan , Lian Wen-Hui , Dong Lei , Li Wen-Jun 
Published: July 2024

Two Gram-stain-negative, aerobic, milk-white coloured, non-motile, short rod-shaped bacteria, designated as strains SYSU D60010T and SYSU D60012T, were isolated from sand samples collected from the Taklimakan Desert of Xinjiang Province in China. Both strains were positive for oxidase, catalase and nitrate reduction, but negative for amylase, H2S production, hydrolysis of gelatin and cellulase. Strains SYSU D60010T and SYSU D60012T grew well at 28 °C, at pH 7 and had the same NaCl tolerance range of 0–1 % (w/v). The major fatty acids (>5 %) of strains SYSU D60010T and SYSU D60012T were summed feature 8 (C18 : 1
ω7c and/or C18 : 1
ω6c), iso-C19 : 0 cyclo ω8c, C16 : 0 and iso-C18 : 1 2-OH. Q-10 was the only respiratory ubiquinone. Strains SYSU D60010T and SYSU D60012T showed high 16S rRNA gene sequence similarities to Aestuariivirga litoralis SYSU M10001T (94.2 and 94.1 %), Rhodoligotrophos jinshengii BUT-3T (92.0 and 91.9 %) and Rhodoligotrophos appendicifer 120-1T (91.8 and 91.7 %), and the genomes were 7.4 and 5.8 Mbp in size with DNA G+C contents of 62.8 and 63.0 mol%, respectively. Phylogenetic, phenotypic and chemotaxonomic characteristics indicated that these two strains represent a novel genus and two novel species within the family Aestuariivirgaceae. We propose the name Taklimakanibacter deserti gen. nov., sp. nov. for strain SYSU D60010T, representing the type strain of this species (=KCTC 52783T =NBRC 113344T) and Taklimakanibacter lacteus gen. nov., sp. nov. for strain SYSU D60012T, representing the type strain of this species (=KCTC 52785T=NBRC 113128T).
Acupuncture triggers earlier recovery from ischemic stroke than sham needling in a rat model
Authors: He Wuxian , Tang Hongtu , Li Jia , Shen Xiaoyan , Li Chenrui , Liu Huafeng , Yu Weichuan 
Published: July 2024

Summary paragraphAcupuncture, a traditional Chinese medical treatment that has been practiced for over 2,000 years, is widely used around the world [1]. However, its efficacy and distinction from random stimulation are still being questioned [2, 3]. Over the years, many studies have reported either favorable, neutral or even skeptical outcomes regarding the treatment effect of acupuncture on diverse ailments [4–7]. The major question behind this controversy is whether acupuncture is different from random needle insertion and whether its efficacy can be attributed to the placebo effect [8, 9]. Here, we use micro-positron emission tomography (microPET) imaging in a randomized controlled animal study to show that acupuncture facilitates faster recuperation in comparison to sham acupuncture and blank control. Based on the microPET imaging of subjects undergoing daily acupuncture over two weeks’ duration, we dynamically monitored the metabolic activity levels in different brain regions and found that both acupoint and non-acupoint stimulation could improve ischemic stroke recovery. This finding is consistent with previous reports that both acupuncture and sham needling show a positive effect in the treatment of diseases [4, 5, 8]. More importantly, we further found that rats receiving acupuncture at Baihui (GV20) and Shuigou (GV26), two commonly used acupoints for stroke rehabilitation based on the concept of the meridian system, showed earlier recovery effects than rats receiving sham needling treatment. This difference mainly appeared in regions involved in motor control and was validated by a balance beam walking test. Our findings, in conjunction with a recent electroacupuncture study that revealed a neuroanatomical pathway to mediate the vagal-adrenal anti-inflammatory axis [10], provide quantitative evidence supporting the specificity of acupoints in acupuncture therapy.
Alternative splicing controls pan-neuronal homeobox gene expression
Authors: Leyva-Díaz Eduardo , Cesar Michael , Pe Karinna , Jordá-Llorens Jose Ignacio , Valdivia Jessica , Hobert Oliver 
Published: July 2024

ABSTRACTThe pan-neuronally expressed and phylogenetically conserved CUT homeobox geneceh-44/CUXorchestrates pan-neuronal gene expression throughout the nervous system ofC. elegans.As in many other species, including humans,ceh-44/CUXis encoded by a complex locus that also codes for a Golgi-localized protein. How gene expression from this complex locus is controlled and, inC. elegans, directed to all cells of the nervous system has not been investigated. We show here that pan-neuronal expression of CEH-44/CUX is controlled by a pan-neuronal RNA splicing factor, UNC-75/CELF, theC. eleganshomolog of vertebrate CELF proteins. UNC-75/CELF temporally and spatially specifies the production of an alternative, CEH-44/CUX homeobox gene-encoding transcript from a ubiquitously expressed gene locus, which also produces a Golgi apparatus-localized golgin protein, CONE-1 (“CASPofnematodes”). During embryogenesis thecone-1/ceh-44locus exclusively produces the Golgi-localized CONE-1/CASP protein in all tissues, but upon the onset of postmitotic terminal differentiation of neurons, UNC-75/CELF induces the production of the alternative CEH-44/CUX CUT homeobox gene-encoding transcript, exclusively in the nervous system. Hence, UNC-75/CELF-mediated alternative splicing not only directs pan-neuronal gene expression, but also excludes a phylogenetically deeply conserved golgin from the nervous system, paralleling surprising spatial specificities of another golgin that we describe here as well. In summary, our findings provide novel insights into how all cells in a nervous system acquire pan-neuronal identity features.
Loss of PINK1 causes age-dependent mitochondrial trafficking deficits in nigrostriatal dopaminergic neurons through aberrant activation of p38 MAPK
Authors: Zhao Jingyu , Chen Yuanxin , Zhi Lianteng , Xu Qing , Zhang Hui , Li Chenjian 
Published: July 2024

AbstractMutations inPTEN-induced putative kinase 1(PINK1) gene cause early-onset, autosomal-recessive familial inherited Parkinson’s disease (PD). Previous studies have shown age-related declines in dopamine release and ATP levels in the striatum ofPink1-/-mice, but the underlying mechanisms remain unclear. While the role of PINK1 in mitochondrial transport has been studied in cell culture andDrosophila, its impacts on axonal transport in dopaminergic neurons and the consequent synaptic and axonal degenerationin vivoremain critical questions that warrant further investigation. In this study, we developed a TH-Mito-Dendra2 transgenic mouse model to label mitochondria in dopaminergic neurons with Dendra2 protein. Using this model, we found that loss of PINK1 causes age-dependent deficits in mitochondrial axonal trafficking, with reduced anterograde movement and increased static mitochondria in acute brain slices. Pharmacological induction of reactive oxygen species (ROS) and calcium release hindered mitochondrial mobility. Additionally,Pink1knockout mice showed increased levels of mitochondrial calcium and ROS. Furthermore,Pink1-/-mice showed p38 MAPK hyperactivation. Treatment with the p38 inhibitor SB202190 restored mitochondrial motility and increased anterograde transport. Taken together, our findings suggest that loss of PINK1 disrupts mitochondrial trafficking by disturbing calcium homeostasis and ROS production via the p38 pathway for PD pathogenesis.