bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Elephant and the Spandrel
Authors: Compton Zachary T , Ågren J Arvid , Marusyk Andriy , Nedelcu Aurora M 
Published: August 2024

Abstract
Comparative oncology has made great strides in identifying patterns of cancer prevalence and risk across the tree of life. Such studies have often centered on elucidating the evolution of cancer suppression mechanisms, especially in large and/or long-lived animals such as elephants, in which cancer risk is assumed to exert a strong selective pressure. There is a worry, however, that we are overinterpreting these conclusions, as the deep evolutionary origins of these mechanisms and their involvement in cancer-unrelated functions suggest that the preeminent functions of the identified mechanisms may be unrelated to cancer. Instead, cancer suppression may be an evolutionary byproduct, or “spandrel”, of selection acting on development and somatic maintenance. Here, we highlight the importance of development and somatic maintenance as the underlying axis of natural selection. We argue that by shifting the focus of study from cancer suppression to development and somatic maintenance as the ultimate cause, we can gain a deeper understanding of the evolutionary pressures that shaped the mechanisms responsible for the observed variation in cancer prevalence across species.
Theoretical morphospace analysis of neuropteran wings reveals little evidence of optimization for flight performance
Authors: Liu Yuming , Deakin William J , Rayfield Emily J , Donoghue Philip C J 
Published: August 2024

Abstract
The wing is the key evolutionary innovation of pterygote insects and wing morphology is commonly envisaged as finely attuned to functional performance. Here, we use a theoretical morphospace approach to analyse the evolution of disparity and functional optimality in neuropteran wings, thus, investigating how wings are adapted for flight and how varied factors constrain wing shape. Analysing 738 neuropteran wings from the Permian to the present, we construct a theoretical morphospace with 1092 hypothetical shapes. These theoretical wings were subjected to functional analysis, creating performance landscapes for aerodynamic traits. We used a Pareto ranking scheme to create an optimality landscape for the trade-off between functional traits, which identifies wings with a convex leading edge as optimal. After projecting neuropteran wings onto this optimal landscape, we find that neuropterans do not occupy this optimal region. Aerodynamic constraint is evident solely in increasing aspect ratio, increasing the lift-to-drag ratio and therefore flight efficiency. Phylomorphospaces reveal a large overlap between different neuropteran clades, reflecting convergence on these same functionally sub-optimal wing shapes. Forewings and hindwings are subject to different evolutionary constraints with forewings more aerodynamically related and hindwings more phylogenetically related. The theoretical morphology approach facilitates morphological analyses without prior assumptions of adaptive optimality.
The involvement of oral bacteria in inflammatory bowel disease
Authors: Xiang Bingjie , Hu Jun , Zhang Min , Zhi Min 
Published: August 2024

Abstract
Microorganisms play an important role in the pathogenesis of inflammatory bowel disease (IBD). The oral cavity, the second-largest microbial niche, is connected to the gastro-intestinal tract. Ectopic gut colonization by oral microbes is a signature of IBD. Current studies suggest that patients with IBD often report more oral manifestations and these oral issues are closely linked with disease activity. Murine studies have indicated that several oral microbes exacerbate intestinal inflammation. Moreover, intestinal inflammation can promote oral microbial dysbiosis and the migration of oral microbes to the gastro-intestinal tract. The reciprocal consequences of oral microbial dysbiosis and IBD, specifically through metabolic alterations, have not yet been elucidated. In this review, we summarize the relationship between oral bacteria and IBD from multiple perspectives, including clinical manifestations, microbial dysbiosis, and metabolic alterations, and find that oral pathogens increase anti-inflammatory metabolites and decrease inflammation-related metabolites.
The state of health information organizations and plans to participate in the federal exchange framework
Authors: Everson Jordan , Chang Wei , Patel Vaishali , Adler-Milstein Julia 
Published: August 2024

Abstract
In late 2023, the Office of the National Coordinator for Health Information Technology launched the Trusted Exchange Framework and Common Agreement (TEFCA) to enable nationwide health information exchange. Regional, local, and state health information organizations (HIOs) will be key components of nationwide exchange, and TEFCA could broaden HIOs' access to information. However, HIOs can choose whether to participate. We conducted a national survey of HIOs in 2023 to assess their plans to participate in TEFCA and broader measures of maturity. We identified 76 operational HIOs, down from 89 in 2019. These HIOs operated in 47 states and contained over 600 million patient records, indicating some duplication. Sixty-three percent of HIOs planned to participate in TEFCA, up 7 percentage points from 2019, and 32% of HIOs indicated that they did not know if they would participate. Health information organizations already engaged in exchange with other networks were more likely to plan to participate. The most common barrier (44%) was having not developed a strategic plan for TEFCA participation. While TEFCA appears to have successfully engaged the majority of HIOs, achieving nationwide exchange will require policy efforts to either attract the remaining HIOs or ensure that nonparticipating HIOs' providers have another option for TEFCA participation.
Upadacitinib for Acute Severe Ulcerative Colitis: A Systematic Review
Authors: Damianos John A , Osikoya Olufemi , Brennan Gregory 
Published: August 2024

AbstractAcute severe ulcerative colitis (ASUC) remains a clinical challenge associated with considerable morbidity, including colectomy. Upadacitinib (UPA), a selective Janus kinase (JAK)-1 inhibitor, is approved for moderate-to-severe ulcerative colitis in patients intolerant or not responding to tumor necrosis factor-alpha inhibitors. It has also increasingly been used off-label for ASUC. We performed a systematic review of all available literature on UPA in ASUC. We identified 11 studies, with a pooled total of 55 patients. Most patients experienced rapid and sustained improvement. Colectomy rate at 90 days was 16.3%. Among those who did not get colectomy, 80% were in steroid-free remission at follow-up. The reported adverse events were low, including 2 venous thromboembolic events. Overall, UPA appears to represent a safe and effective therapy for ASUC.
Influence of deployment method and maintenance on efficacy of sticky card traps for Halyomorpha halys (Hemiptera: Pentatomidae)
Authors: Nixon Laura J , Acebes-Doria Angelita , Kirkpatrick Danielle , Leskey Tracy C 
Published: August 2024

Abstract
Halyomorpha halys (Stål) (Hemiptera: Pentatomidae) is an invasive pest which feeds on numerous economically significant crops. Many integrated pest management strategies for this species rely on effective season-long monitoring for H. halys populations, including attract-and-kill and threshold-based insecticide sprays. Previous studies have shown that a black pyramid trap effectively captures all mobile life stages of H. halys, however, these bulky, ground-deployed traps can be impractical in active orchard rows. Clear sticky cards have been used as a more practical tool for monitoring when paired with the H. halys aggregation pheromone and synergist. Here, the efficacy of deploying single- or double-sided sticky cards hanging in trees or deployed on wooden stakes was compared to standard black pyramid traps over 2 years. The efficacy of single-sided sticky cards deployed on wooden stakes was also evaluated after occlusion of 25%, 50%, or 75% of the surface area by 2D inert materials and 3D organic matter. Single-sided sticky cards were also exposed to simulated sunlight and rainfall for 0, 4, 8, and 12 wk before deployment on wooden stakes. Captures of H. halys adults using sticky cards deployed on wooden stakes were comparable to pyramid traps. Occlusion of cards by 25% or more of any material type led to a decrease in H. halys captures, however, weathering did not influence capture. These data show that clear sticky cards deployed on wooden stakes are effective for season-long monitoring of H. halys in apple orchards, and card replacement should be driven by maintenance of cleanliness.
The Ongwen Case at the International Criminal Court as a Test of the Court’s Outreach Programming in Northern Uganda
Authors: Jjuuko Dennis , Opio Francis 
Published: August 2024

Abstract
The International Criminal Court’s outreach office remains a central pillar to the legitimacy and relevance of the Court’s activities aimed towards victims’ constituencies. However, the Court’s outreach programmes in the Ongwen case are constrained by a communication strategy used in the context of a fledgling communication infrastructure in northern Uganda. We rely on primary qualitative interviews with victims of Ongwen’s atrocities at Lukodi, Pajule, and Odek to reflect on the need for contextualized outreach activities that are responsive to the needs of victims of the Lord’s Resistance Army insurgency.
Lessons learned from the Sexual Medicine Society of North America fellowship bootcamp
Authors: Köhler Tobias S , Bonakdar Hashemi Milad , Helo Sevann , Morey Allen F , Nelson Christian J , Trost Landon , Ziegelmann Matthew J , Khera Mohit 
Published: August 2024

Abstract

Background
Sexual Medicine Society of North America (SMSNA) fellowships offer variable experience in sexual health domains: erectile dysfunction, Peyronie’s disease, male infertility, male hypogonadism (low testosterone), reconstruction (including male incontinence), benign prostatic hyperplasia, gender affirmation surgery, sexual mental health, and female sexual dysfunction.

Aim
To evaluate baseline and postbootcamp understanding and trust in these domains.

Methods
In 2023, 28 of 31 urologists currently enrolled in SMSNA-endorsed fellowships participated in a 3.5-day training bootcamp in Minneapolis, Minnesota. Participants were asked to complete pre- and postbootcamp surveys. The bootcamp curriculum offered American Urological Association guidelines and case-based lectures, hands-on clinical training with cadavers (penile surgery) and models (collagenase training), and interaction with industry.

Outcomes
Changes in knowledge, independence, and trust in performing the procedures, as well as billing issues and feedback for future bootcamps.

Results
Prebootcamp surveys revealed vastly varied residency experience. Reported time with an expert faculty member was greatest for benign prostatic hyperplasia and least for female sexual dysfunction, gender affirmation surgery, and low testosterone. The lowest prebootcamp confidence in performing surgery independently was for penile grafting procedures and elevating the neurovascular bundle. Postbootcamp results revealed several areas of significant improvement in confidence (P ≤ .03): intralesional injections for Peyronie’s disease, manual modeling, penile plication, penile grafting procedures, and elevating the neurovascular bundle. There was a trend for improved confidence with the insertion of inflatable (P = .05) and semirigid (P = .08) penile prostheses. Nonsignificant improvement occurred in artificial urinary sphincter surgery (P = .12). Participants graded the bootcamp very highly and requested that next year’s bootcamp have more content on female sexual dysfunction, male incontinence, and low testosterone, as well as more hands-on skills sessions and case-based lecture formats.

Clinical Implications
Offering a bootcamp with hands-on instruction could significantly improve urologists’ knowledge and confidence.

Strengths and Limitations
As the main strength, this study was the first specialized bootcamp for urologists in the subject of men’s health, taking into account hands-on and cadaver laboratories, as well as highlighting industrial and pharmaceutical products. The small sample size was the major limitation.

Conclusions
Current SMSNA fellows present with varied levels of experience and confidence across sexual health domains. Notable confidence improvements were seen with topics that combined didactic lectures with hands-on trainings.
Impact of Hepatitis B Virus Point-of-care DNA Viral Load Testing Compared With Laboratory-based Standard-of-care Approaches on Uptake of HBV Viral Load Testing, Treatment, and Turnaround Times: A Systematic Review and Meta-analysis
Authors: Gu Shuqin , Tao Yusha , Fan Chengxin , Dai Yifan , Li Feifei , Conklin Jamie L , Tucker Joseph D , Chou Roger , Moody M Anthony , Easterbrook Philippa , Tang Weiming 
Published: August 2024

Abstract

Background
Point-of-care (PoC) hepatitis B virus (HBV) DNA viral load (VL) assays represent an alternative to laboratory-based standard-of-care (SoC) VL assays to accelerate diagnosis and treatment. We evaluated the impact of using PoC versus SoC approaches on the uptake of VL testing, treatment, and turnaround times from testing to treatment across the HBV care cascade.

Methods
We searched 5 databases, 6 conference websites, and contacted manufacturers for unpublished reports, for articles with or without a comparator (SoC VL testing), and had data on the uptake of VL testing, treatment, or turnaround times between hepatitis B surface antigen (HBsAg) testing, VL testing, and treatment in the cascade. We performed a random-effects meta-analysis on rates of VL testing and treatment initiation.

Results
Six studies, composing 9 arms, were included. Three PoC arms reported less than 1 day between screening for HBsAg positivity and VL testing, and the other one (2 arms) reported it between 7 and 11 days. Five arms reported the time to available VL test results (&lt;1 day). Three studies reported 1–8 days between VL testing results and treatment initiation. Two studies reported the turnaround times between a positive HBsAg screening and treatment initiation (the same day and 27 days). Overall, 84.1% of those with HBsAg positivity were tested for DNA VL and 88.3% of eligible people initiated treatment.

Conclusions
HBV PoC DNA testing appears to be associated with a turnaround time of &lt;1 day for receipt of VL results and appears associated with high rates of DNA testing and initiation of treatment among those eligible.

Clinical Trials Registration
PROSPERO CRD42023398440.
Melatonin alleviates hyperoxia‐induced lung injury through elevating MSC exosomal miR‐18a‐5p expression to repress PUM2 signaling
Authors: Zou Dongmei , Liao Jinwen , Xiao Min , Liu Liang , Xu Mingguo 
Published: August 2024

AbstractMesenchymal stem cells (MSC)‐derived exosomes (Exo) are a possible option for hyperoxia‐induced lung injury (HLI). We wanted to see if melatonin (MT)‐pretreated MSC‐derived exosomes (MT‐Exo) were more effective against HLI, and we also tried to figure out the underlying mechanism. HLI models were established by hyperoxia exposure. HE staining was adopted to analyze lung pathological changes. MTT and flow cytometry were used to determine cell viability and apoptosis, respectively. The mitochondrial membrane potential (MMP) was analyzed using the JC‐1 probe. LDH, ROS, SOD, and GSH‐Px levels were examined by the corresponding kits. The interactions between miR‐18a‐5p, PUM2, and DUB3 were analyzed by molecular interaction experiments. MT‐Exo could effectively inhibit hyperoxia‐induced oxidative stress, inflammatory injury, and apoptosis in lung epithelial cells, while these effects of MT‐Exo were weakened by miR‐18a‐5p knockdown in MSCs. miR‐18a‐5p reduced PUM2 expression in MLE‐12 cells by directly targeting PUM2. In addition, PUM2 inactivated the Nrf2/HO‐1 signaling pathway by promoting DUB3 mRNA decay post‐transcriptionally. As expected, PUM2 overexpression or DUB3 knockdown abolished the protective effect of MT‐Exo on hyperoxia‐induced lung epithelial cell injury. MT‐Exo carrying miR‐18a‐5p reduced hyperoxia‐mediated lung injury in mice through activating Nrf2/HO‐1 pathway. MT reduced PUM2 expression and subsequently activated the DUB3/Nrf2/HO‐1 signal axis by increasing miR‐18a‐5p expression in MSC‐derived exosomes to alleviate HLI.
School refusal
Authors: Heuer Beth 
Published: August 2024

ABSTRACT
School refusal refers to child- or adolescent-motivated refusal to attend school or remain in school for the duration of the school day. Importantly, the child or adolescent does not conceal their absence from school from their caregivers. Root causes for school refusal include anxiety, mood disorders, untreated learning disorders, and social difficulties. Long-term outcomes of school refusal include further social withdrawal, ongoing mental health issues, and unemployment. This article reviews the differences between school refusal and other types of chronic absenteeism, and it describes behaviors that may manifest in a child or adolescent who avoids attending school. The primary care provider's role in evaluation and treatment of this population is discussed.
NP student knowledge and perceptions of medical marijuana
Authors: Cassone Clark , Rissmiller Patricia 
Published: August 2024

ABSTRACT

Objective:
This study aimed to measure NP students' knowledge and perception of medical marijuana (MM) and determine whether they need additional education on the topic.

Methods:
A cross-sectional, descriptive study was implemented. NP students were asked to complete a survey that assessed their knowledge of MM, including adverse reactions and medical indications. Perceptions of recreational marijuana and MM were assessed through a 5-point Likert-scale questionnaire.

Results:
Of the 230 NP students who completed all or part of the questionnaire, 115 met inclusion criteria and were included in results. Most students (94%) felt that MM should be legalized in all US states. Likewise, 97% felt that MM education should be included in NP program curricula; however, only 30% reported receiving in-depth education on the topic. Participants were asked to identify, among 18 provided medical conditions, those which were approved indications for MM use; accurate response rate was low, though cancer, pain, cachexia, nausea/vomiting, posttraumatic stress disorder, and epilepsy were identified correctly as indications by more than half of participants. Previous MM use and religious affiliation had an impact on knowledge and perceptions of MM.

Conclusion:
With an increasing number of states legalizing MM, NP programs must evaluate their current curricula and integrate content that addresses the gap in knowledge of MM mechanism of action, indications, and adverse reactions.
Factor Eight Inhibitor Bypass Activity Use in Cardiac Surgery: A Propensity-matched Analysis of Safety Outcomes
Authors: Nicholas Joshua A. , Harrison Natasha , Chakraborty Dipro , Chang Alan L. , Aghaeepour Nima , Wirtz Katherine , Nielson Elaina , Parsons Cody , Jackson Ethan , Panigrahi Anil K. 
Published: August 2024

Background:
Bleeding during cardiac surgery may be refractory to standard interventions. Off-label use of factor eight inhibitor bypass activity (FEIBA) has been described to treat such bleeding. However, reports of safety, particularly thromboembolic outcomes, show mixed results, and reported cohorts have been small.

Methods:
Adult patients undergoing cardiac surgery on cardiopulmonary bypass between July 1, 2018, and June 30, 2023, at Stanford Hospital (Stanford, California) were reviewed (n = 3,335). Patients who received FEIBA to treat postcardiopulmonary bypass bleeding were matched with those who did not by propensity scores in a 1:1 ratio using nearest neighbor matching (n = 352 per group). The primary outcome was a composite outcome of thromboembolic complications including any one of deep vein thrombosis, pulmonary embolism, unplanned coronary artery intervention, ischemic stroke, and acute limb ischemia, in the postoperative period. Secondary outcomes included renal failure, reoperation, postoperative transfusion, intensive care unit length of stay, and 30-day mortality.

Results:
A total of 704 encounters was included in this propensity-matched analysis. The mean dose of FEIBA administered was 7.3 ± 5.5 U/kg. In propensity-matched multivariate logistic regression models, there was no statistically significant difference in odds ratios for thromboembolic outcomes, intensive care unit length of stay, or mortality. Patients who received more than 750 U FEIBA had an increased odds ratio for acute renal failure (odds ratio, 4.14; 95% CI, 1.61 to 10.36; P < 0.001). In multivariate linear regression, patients receiving FEIBA were transfused more plasma and cryoprecipitate postoperatively. However, only the dose range of 501 to 750 U was associated with an increase in transfusion of erythrocytes (β, 2.73; 95% CI, 0.68 to 4.78; P = 0.009) and platelets (β, 1.74; 95% CI, 0.85 to 2.63; P < 0.001).

Conclusions:
Low-dose FEIBA administration during cardiac surgery does not increase risk of thromboembolic events, intensive care unit length of stay, or mortality in a propensity-matched cohort. Higher doses were associated with increased acute renal failure and postoperative transfusion. Further studies are required to establish the efficacy of activated factor concentrates to treat refractory bleeding during cardiac surgery.
Impact of VO2peak on the Clinical Outcomes of Older Patients With Coronary Heart Disease in China
Authors: Zhang Ying-Yue , Liu Xiao-Li , Hu Xin , Hu Rong , Xu Yong , Ma Jing 
Published: August 2024

Purpose:
The aim of this study was to explore the role of cardiopulmonary exercise test parameters, especially peak oxygen uptake (VO2peak), in predicting the incidence of adverse cardiovascular events in older Chinese patients with coronary heart disease (CHD).

Methods:
Older patients with CHD who underwent cycle ergometer cardiopulmonary exercise test at the Cardiac Rehabilitation Clinic of Chinese PLA General Hospital from July 1, 2015 to January 31, 2020 were enrolled. The follow-up intervals were 6 mo. Cox regression was used to analyze the relationship between VO2peak and adverse cardiovascular events. Restricted cubic splines and subgroup analyses were used to observe the relationship between VO2peak and the hazard ratio (HR) of the primary end point event (PEE), which included a composite of all-cause death, nonfatal recurrent myocardial infarction, unscheduled revascularization, and stroke. The composite end point event was the PEE combined with cardiac rehospitalization.

Results:
A total of 1223 participants (mean age 68 ± 5 yr) were included. Median follow-up was 68 mo. Mean VO2peak was 16.5 ± 4.0 mL/kg/min, and VO2peak was an independent predictor of the PEE (HR = 0.929; 95% CI, 0.891-0.970; P = .001). This association was further validated by restricted cubic spline and subgroup analyses. Peak oxygen uptake was also an independent risk factor for the composite end point event (HR = 0.968; 95% CI, 0.941-0.996; P = .025).

Conclusion:
In conclusion, VO2peak is an independent risk factor for adverse cardiovascular events in older Chinese patients with CHD, and more optimal therapy should be recommended to patients with lower VO2peak.