bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between vaginal microbiota and vaginal inflammatory immune markers in postmenopausal women
Authors: Byrne Elizabeth H. , Song Hoseung , Srinivasan Sujatha , Fredricks David N. , Reed Susan D. , Guthrie Katherine A. , Wu Michael , Mitchell Caroline M. 
Published: May 2024

AbstractObjectiveIn premenopausal individuals, vaginal microbiota diversity and lack ofLactobacillusdominance are associated with greater mucosal inflammation, which is linked to a higher risk of cervical dysplasia and infections. It is not known if the association between the vaginal microbiota and inflammation is present after menopause, when the vaginal microbiota is generally higher-diversity and fewer people haveLactobacillusdominance.MethodsThis is a post hoc analysis of a subset of postmenopausal individuals enrolled in a randomized trial for treatment of moderate-severe vulvovaginal discomfort that compared vaginal moisturizer, estradiol, or placebo. Vaginal fluid samples from 0, 4, and 12 weeks were characterized using 16S rRNA gene sequencing (microbiota) and MesoScale Discovery (vaginal fluid immune markers: IL-1b, IL-1a, IL-2, IL-6, IL-18, IL-10, IL-9, IL-13, IL-8, IP10, MIP1a, MIP1b, MIP3a). Global associations between cytokines and microbiota (assessed by relative abundance of individual taxa and Shannon index for alpha, or community, diversity) were explored, adjusting for treatment arm, using linear mixed models, principal component analysis, and Generalized Linear Mixed Model + Microbiome Regression-based Kernel Association Test (GLMM-MiRKAT).ResultsA total of 119 individuals with mean age of 61 years were included. At baseline, 29.5% of participants had aLactobacillus-dominant vaginal microbiota. Across all timepoints, alpha diversity (Shannon index,P= 0.003) was highly associated with immune markers. Individual markers that were associated withLactobacillusdominance were similar to those observed in premenopausal people: IL-10, IL-1b, IL-6, IL-8 (false discovery rate [FDR] < 0.01), IL-13 (FDR = 0.02), and IL-2 (FDR = 0.09). Over 12 weeks, change in alpha diversity was associated with change in cytokine concentration (Shannon,P= 0.018), with decreased proinflammatory cytokine concentrations observed with decreasing alpha diversity.ConclusionsIn this cohort of postmenopausal individuals,Lactobacillusdominance and lower alpha diversity were associated with lower concentrations of inflammatory immune markers, as has been reported in premenopausal people. This suggests that after menopause lactobacilli continue to have beneficial effects on vaginal immune homeostasis, despite lower prevalence.
Operating Room Waste Generated From Corneal and Conjunctival Surgeries
Authors: Thakur Shambhawi , Sheppard John D. , Eslani Medi , Pavilack Mark A. , Philippy Brian , Ramanathan Gautam C. , Cheung Albert Y. 
Published: May 2024

Purpose:
The purposes of this study were to bring awareness to the surgical waste generated from corneal and conjunctival surgeries and to compare those findings with the waste generated from cataract surgeries.

Methods:
This was an observational prospective pilot cohort study at a tertiary corneal/anterior segment private practice. All waste related to cataract, cornea, and conjunctival surgical procedures (including anesthesia waste and corneal tissue storage) was weighed. The primary outcome was total waste generated while other outcomes included surgical setting (ambulatory surgical center, hospital, and minor operating room) and comparison of corneal/conjunctival surgeries with cataract surgery.

Results:
Surgical waste data were collected from 119 surgeries (82 corneal/conjunctival surgeries and 37 cataract surgeries). Hospital surgeries produced more waste than ambulatory surgical center and minor operating room surgeries. Penetrating keratoplasty (2.22 kg, P = 0.483) and Descemet stripping only (2.11 kg, P = 0.326) procedures generated comparable mean waste with cataract surgery (2.07 kg) while endothelial keratoplasties produced more (P < 0.001, 0.002). (Deep) anterior lamellar keratoplasty results depended on the surgical setting. All conjunctival surgeries produced less waste than cataract surgery.

Conclusions:
In comparison with cataract surgery, keratoplasties overall produced comparable or more waste while conjunctival surgeries produced less waste. The surgical setting and type of anesthesia played a substantial role in the amount of waste generated. Assessing waste production from different ophthalmic surgeries may increase awareness of the negative environmental impact of surgical waste and promote practice or legal changes to improve environmental sustainability.
Recent developments and challenges in positron emission tomography imaging of gliosis in chronic neuropathic pain
Authors: Emvalomenos Gaelle M. , Kang James W.M. , Jupp Bianca , Mychasiuk Richelle , Keay Kevin A. , Henderson Luke A. 
Published: May 2024

Abstract
Understanding the mechanisms that underpin the transition from acute to chronic pain is critical for the development of more effective and targeted treatments. There is growing interest in the contribution of glial cells to this process, with cross-sectional preclinical studies demonstrating specific changes in these cell types capturing targeted timepoints from the acute phase and the chronic phase. In vivo longitudinal assessment of the development and evolution of these changes in experimental animals and humans has presented a significant challenge. Recent technological advances in preclinical and clinical positron emission tomography, including the development of specific radiotracers for gliosis, offer great promise for the field. These advances now permit tracking of glial changes over time and provide the ability to relate these changes to pain-relevant symptomology, comorbid psychiatric conditions, and treatment outcomes at both a group and an individual level. In this article, we summarize evidence for gliosis in the transition from acute to chronic pain and provide an overview of the specific radiotracers available to measure this process, highlighting their potential, particularly when combined with ex vivo/in vitro techniques, to understand the pathophysiology of chronic neuropathic pain. These complementary investigations can be used to bridge the existing gap in the field concerning the contribution of gliosis to neuropathic pain and identify potential targets for interventions.
Integrated management of stage III in nonsmall cell lung cancer: where do perioperative chemotherapy and immunotherapy fit?
Authors: Collazo-Lorduy Ana , Blanco Mariola , Calvo Virginia , Provencio Mariano 
Published: May 2024

Purpose of review
Early-stage nonsmall cell lung cancer (NSCLC) accounts for 30% of the total NSCLC, being the stage III a heterogeneous disease that represents a challenge in the management of these patients. Multidisciplinary approach is essential for an adequate treatment strategy, with surgery being the only curative treatment. Neoadjuvant or adjuvant chemotherapy has been the standard of care for a long period, with modest results.

Recent findings
Combination of chemotherapy and immunotherapy has revolutionized the neoadjuvant setting of resectable NSCLC, improving pathologic complete responses and survival outcomes in this scenario. Furthermore, perioperative treatment with immunotherapy has also recently shown promising results in several phase III trials.

Summary
The landscape of early-stage resectable NSCLC has evolved in recent years, with an improvement in the survival of these patients since the incorporation of immunotherapy in this scenario.
A case report of ansa cervicalis to spinal accessory transposition graft: a new surgical technique to prevent shoulder dysfunction
Authors: Noel Leon M. , Medford Steve C. , Juman Solaiman 
Published: May 2024

Introduction and importance:
The spinal accessory nerve is at risk when performing neck dissections for head and neck cancers. Injury to this nerve can result in shoulder syndrome, which can be challenging to manage. Various nerve repair or grafting methods are available to prevent this condition. A safe, simple, and cost-effective option is the ansa cervicalis to spinal accessory transposition graft.

Case presentation:
A 60-year-old Afro-Trinidadian female presented to the Outpatient clinic for evaluation of a scalp lesion and a large neck mass for a duration of one year. Preoperative tissue biopsies confirmed she had squamous cell cancer with metastatic spread to the cervical nodes. The patient underwent surgical excision of the scalp lesion and left neck dissection with the sacrifice of the sternocleidomastoid and the left spinal accessory nerve due to tumour involvement. During the procedure, the ansa cervicalis was successfully joined to the distal remainder of the spinal accessory nerve. After the surgery, the patient fully recovered and achieved a good quality of life during the 24-month follow-up.

Clinical discussion:
This is the first reported case of using the ansa cervicalis to reinnervate the trapezius muscle through the spinal accessory nerve. This procedure aims to prevent pain, muscle wasting, and adhesive capsulitis. A quality-of-life questionnaire and adequate range of motion proved the success of this procedure, demonstrating that this option provides practical, functional, and aesthetic benefits for patients.

Conclusion
The ansa cervicalis to spinal accessory transposition nerve graft is a valuable option for reinnervation. This case report highlights the effectiveness of this single-stage procedure in preventing shoulder syndrome.
Interleukin-6-Positive Immune Cells as a Possible New Immunologic Marker Associated With the Colorectal Cancer Prognosis
Authors: Gulubova Maya , Chonov Dimitur , Aleksandrova Elina , Ivanova Koni , Ignatova M. Magdalena , Vlaykova Tatyana 
Published: May 2024

Chronic inflammation creates tumor microenvironment (TME) that facilitates colorectal cancer (CRC) cell proliferation, migration, metastasis, and tumor progression. Interleukin-6 (IL-6) is a proinflammatory cytokine with a pleiotropic effect on CRC development. We aimed to evaluate IL-6 expression in tumor cells and in immune cells in TME, to assess the serum level and IL6 -174 G/C genotype distribution and to correlate the results with selected morphologic and clinical parameters that may add useful information in understanding the mechanisms of human CRC progression. A total of 153 patients with CRC were recruited in the current study. We assessed the IL-6 serum concentration through the ELISA method, the expression of IL-6 in tumor and in immune cells by immunohistochemical and double immunofluorescence staining, the MSI status by immunоhistochemistry for 4 mismatch repair (MMR) proteins, and the genotype distributions for IL6 -174G/C (rs1800795) single-nucleotide polymorphism through PCR-RFLP method. Our results showed that serum IL-6 level were increased in CRC patients as compared with healthy controls (P<0.0001), and in patients with cancers with advanced histologic type (type IV). However, the higher concentration (above the median of 55.71 pg/mL) was with borderline association with longer survival of the patients after surgical therapy (P=0.055, Log rank test). We also found that IL-6+ immune cells prevailed in the invasive front (IF) of tumors compared with the tumor stroma (TS) (P<0.0001). More IL-6+ cells were recruited in the tumors with less advanced histologic type (I+II), with stronger inflammatory infiltrate in the IF, in early pTNM stages (I+II), without lymph node and distant metastases and the higher levels of IL-6+ cells, especially in the IF, were associated with longer survival (P=0.012). The results of our study suggest that although the serum levels of IL-6 are higher in CRC, the increased IL-6+ cells in tumor microenvironment, both in the invasive front and in tumor stroma, as well as the higher serum levels are associated with good prognostic variables and longer survival of the patients mainly in the early stages of CRC.
Implementation of a Suicide Risk Screening Clinical Pathway in a Children's Hospital
Authors: Brahmbhatt Khyati , Devlin Gabriel , Atigapramoj Nisa , Bekmezian Arpi , Park Chan , Han Tina , Dentoni-Lasofsky Brian , Mangurian Christina , Grupp-Phelan Jacqueline 
Published: May 2024

Objectives
Youth suicide is a pressing global concern. Prior research has developed evidence-driven clinical pathways to screen and identify suicide risk among pediatric patients in outpatient clinics, emergency departments (ED) and inpatient hospital units. However, the feasibility of implementing these pathways remains to be established. Here, we share the results of a hospital-wide “youth suicide risk screening pathway” implementation trial at an urban academic pediatric hospital to address this gap.

Methods
A 3-tier “youth suicide risk screening pathway” using The Ask Suicide-Screening Questions (ASQ) was implemented for patients aged 10 to 26 years who received care at an urban academic pediatric hospital's emergency department or inpatient units. We retrospectively reviewed implementation outcomes of this pathway from January 1 to August 31, 2019. The feasibility of this implementation was measured by assessing the pathway's degree of execution, fidelity, resource utilization, and acceptability.

Results
Of 4108 eligible patient encounters, 3424 (83%) completed the screen. Forty-eight (1%) screened acute positive, 263 (8%) screened nonacute positive and 3113 (91%) screened negative. Patients reporting positive suicide risk were more likely to be older and female, although more males required specialty mental health evaluations. Pathway fidelity was 83% among all positive screens and 94% among acute positive screens. The clinical pathway implementation required 16 hours of provider training time and was associated with slightly longer length of stay for inpatients that screened positive (4 vs 3 days). Sixty-five percent of nurses and 78% of social work providers surveyed supported participation in this effort.

Conclusions
It is feasible to implement a youth suicide risk screening pathway without overburdening the system at an urban academic pediatric hospital.
Ultrasound Investigation of the Fifth Intercostal Space Landmark for Chest Tube Thoracostomy Site Selection in Pediatric Patients
Authors: Ruthford Mason R. , Shah Aalap , Wolf Bethany J. , Kane Ian D. , Borg Keith , Moake Matthew M. 
Published: May 2024

Objectives
Chest tube thoracostomy site selection is typically chosen through landmark identification of the fifth intercostal space (ICS). Using point-of-care ultrasound (POCUS), studies have shown this site to be potentially unsafe in many adults; however, no study has evaluated this in children. The primary aim of this study was to evaluate the safety of the fifth ICS for pediatric chest tube placement, with the secondary aim to identify patient factors that correlate with an unsafe fifth ICS.

Methods
This was an observational study using POCUS to evaluate the safety of the fifth ICS for chest tube thoracostomy placement using a convenience sample of pediatric emergency department patients. Safety was defined as the absence of the diaphragm appearing within or above the fifth ICS during either tidal or maximal respiration. Univariate and multivariable analyses were used to identify patient factors that correlated with an unsafe fifth ICS.

Results
Among all patients, 10.3% (95% confidence interval [CI] 6.45–16.1) of diaphragm measurements crossed into or above the fifth ICS during tidal respiration and 27.2% (95% CI 19.0–37.3) during maximal respiration. The diaphragm crossed the fifth ICS more frequently on the right when compared with the left, with an overall rate of 45.0% (95% CI 36.1–54.3) of right diaphragms crossing during maximal respiration. In both univariate and multivariate analyses, a 1-kg/m2 increase in body mass index was associated with an increase of 10% or more in the odds of crossing during both tidal and maximal respiration (P = 0.003 or less).

Conclusions
A significant number of pediatric patients have diaphragms that cross into or above the fifth ICS, suggesting that placement of a chest tube thoracostomy at this site would pose a significant complication risk. POCUS can quickly and accurately identify these unsafe sites, and we recommend it be used before pediatric chest tube thoracostomy.
Quantitative Musculoskeletal Imaging of the Pediatric Shoulder
Authors: Cordes Caleb M.A. , Leonardis Joshua M. , Samet Jonathan , Mukherjee Shubhra , Seitz Amee L. , Slavens Brooke A. 
Published: May 2024

Abstract
Pediatric acquired and congenital conditions leading to shoulder pain and dysfunction are common. Objective, quantitative musculoskeletal imaging-based measures of shoulder health in children lag recent developments in adults. We review promising applications of quantitative imaging that tend to be available for common pediatric shoulder pathologies, especially brachial plexus birth palsy and recurrent shoulder instability, and imaging-related considerations of musculoskeletal growth and development of the shoulder. We highlight the status of quantitative imaging practices for the pediatric shoulder and highlight gaps where better care may be provided with advances in imaging technique and/or technology.
EFFECT OF GENDER ON 28-DAY SURVIVAL RATES AND TRANSFUSION VOLUME IN SEVERE TRAUMA PATIENTS: A MULTICENTER OBSERVATIONAL STUDY
Authors: Tsuchida Takumi , Mizugaki Asumi , Tanaka Shohei , Semba Akiko , Nakajima Takuma , Wada Takeshi 
Published: May 2024

ABSTRACT

Background: This study clarified the relationship between sex with survival and transfusion volume in severe trauma cases. Methods: A multicenter, collaborative post hoc analysis of patients with trauma in Japan was conducted. Patients aged ≥18 years with severe trauma indicated by an Injury Severity Score (ISS) of 16 or higher were enrolled. Patients were matched and analyzed by gender based on propensity score with factors determined at the time of injury. Subgroup analysis was performed on patients younger than 50 years and older than 50 years. The significance level was defined as P < 0.05. Results: The 1,189 patients included in this registry were divided into adjusted groups of 226 male and female patients each. In the main analysis, 28-day survival rates in females were significantly higher than those in males (P = 0.046). In the subgroup analyses, there was no statistically significant prognostic effect of gender. Secondary outcomes, including transfusion volume, showed no significant gender-based variations. Logistic regression analyses consistently demonstrated that female sex was a significant favorable prognostic factor in all ages. This was true for the over-50 group on subgroup analysis, but no significant gender-prognosis relationship was identified in the under-50 age group. High ISSs were associated with poorer outcomes across all age groups. Conclusion: In severe trauma, survival at 28 days was significantly lower in males. However, this trend was not observed in patients aged <50 years. Factors other than sex hormones may be responsible for differences in posttraumatic outcomes by gender.
TRANSCRIPTOMIC DIFFERENCES IN PERIPHERAL MONOCYTE POPULATIONS IN SEPTIC PATIENTS BASED ON OUTCOME
Authors: Barrios Evan L. , Rincon Jaimar C. , Willis Micah , Polcz Valerie E. , Leary Jack R. , Darden Dijoia B. , Balch Jeremy A. , Larson Shawn D. , Loftus Tyler J. , Mohr Alicia M. , Wallet Shannon , Brusko Maigan A. , Balzano-Nogueira Leandro , Cai Guoshuai , Sharma Ashish , Upchurch Gilbert R. , Kladde Michael P. , Mathews Clayton E. , Maile Robert , Moldawer Lyle L. , Bacher Rhonda , Efron Philip A. 
Published: May 2024

ABSTRACT
Postsepsis early mortality is being replaced by survivors who experience either a rapid recovery and favorable hospital discharge or the development of chronic critical illness with suboptimal outcomes. The underlying immunological response that determines these clinical trajectories remains poorly defined at the transcriptomic level. As classical and nonclassical monocytes are key leukocytes in both the innate and adaptive immune systems, we sought to delineate the transcriptomic response of these cell types. Using single-cell RNA sequencing and pathway analyses, we identified gene expression patterns between these two groups that are consistent with differences in TNF-α production based on clinical outcome. This may provide therapeutic targets for those at risk for chronic critical illness in order to improve their phenotype/endotype, morbidity, and long-term mortality.
Altered blood microbiome in patients with HCV-related decompensated cirrhosis
Authors: Brochado-Kith Oscar , Rava Marta , Berenguer Juan , González-García Juan , Rojo David , Díez Cristina , HontaÑon Victor , Virseda-Berdices Ana , Ibañez-Samaniego Luis , Llop-Herrera Elba , Olveira Antonio , Perez-Latorre Leire , Barbas Coral , Fernández-Rodríguez Amanda , Resino Salvador , Jiménez-Sousa María Angeles ,   ESCORIAL Study Group
Published: May 2024

AbstractBackgroundAltered bacterial translocation is associated with transitioning from compensated to decompensated cirrhosis. Thus, we aimed to study differences in the blood microbiome of HCV-infected patients with and without hepatic decompensation.MethodsWe conducted a cross-sectional study in patients with advanced HCV-related cirrhosis with or without human immunodeficiency virus (HIV) infection (n=88). MiSeq Illumina technology for bacterial 16S rRNA sequencing was used. Non-targeted metabolomics was performed by GC-MS and LC-MS ESI+ and ESI-.ResultsPatients with decompensated cirrhosis had lower levels of richness (Chao1), and alpha diversity (Shannon and Simpson indexes) at phylum level, than patients without decompensation. Likewise, we observed significant differences in beta diversity between groups at phylum, class and order levels, being lower in decompensated cirrhotic patients. Higher relative abundance of Proteobacteria (Fold Change (FC)=1.54, p=0.012), Alphaproteobacteria (FC=1.57, p=0.016) and Sphingomonadales (FC=1.61, p=0.050) were significantly associated with hepatic decompensation. The phylum Proteobacteria was positively correlated with ethanolamine and oleic acid (p=0.005 and p=0.004, respectively) and negatively with p-cresol (p=0.006). In addition, the order Sphingomonadales was also negatively correlated with p-cresol (p=0.001).ConclusionsBlood microbial diversity was significantly decreased in patients with decompensated cirrhosis, who presented an enrichment of Proteobacteria, Alphaproteobacteria, and Sphingomonadales, compared to patients with compensated cirrhosis.
High-angular-momentum Rydberg states in a room-temperature vapor cell for dc electric-field sensing
Authors: Duspayev Alisher , Cardman Ryan , Anderson David A. , Raithel Georg 
Published: May 2024

We prepare and analyze Rydberg states with orbital quantum numbers ℓ≤6 using three-optical-photon electromagnetically induced transparency (EIT) and radio frequency (rf) dressing, and employ the high-ℓ states in electric-field sensing. Rubidium-85 atoms in a room-temperature vapor cell are first promoted into the 25F5/2 state via Rydberg-EIT with three infrared laser beams. Two rf dressing fields then (near-)resonantly couple the 25F, 25H(ℓ=5), and 25I(ℓ=6) Rydberg states. The dependence of the rf-dressed Rydberg-state level structure on rf powers, rf and laser frequencies is characterized using EIT. Furthermore, we discuss the principles of dc-electric-field sensing using high-ℓ Rydberg states and experimentally demonstrate the method using test electric fields of ≲50 V/m induced via photo-illumination of the vapor-cell wall. We measure the highly nonlinear dependence of the dc-electric-field strength on the power of the photo-illumination laser. Numerical calculations, which reproduce our experimental observations well, elucidate the underlying physics. Our paper is relevant to high-precision spectroscopy of high-ℓ Rydberg states, Rydberg-atom-based electric-field sensing, and plasma electric-field diagnostics.

Published by the American Physical Society
2024