bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative analysis of multiple consensus genomes of the same strain of Marek’s disease virus reveals intrastrain variation
Authors: Ortigas-Vasquez Alejandro , Pandey Utsav , Renner Daniel W , Bowen Chris D , Baigent Susan J , Dunn John , Cheng Hans , Yao Yongxiu , Read Andrew F , Nair Venugopal , Kennedy Dave A , Szpara Moriah L 
Published: June 2024

Abstract
Current strategies to understand the molecular basis of Marek’s disease virus (MDV) virulence primarily consist of cataloging divergent nucleotides between strains with different phenotypes. However, most comparative genomic studies of MDV rely on previously published consensus genomes despite the confirmed existence of MDV strains as mixed viral populations. To assess the reliability of interstrain genomic comparisons relying on published consensus genomes of MDV, we obtained two additional consensus genomes of vaccine strain CVI988 (Rispens) and two additional consensus genomes of the very virulent strain Md5 by sequencing viral stocks and cultured field isolates. In conjunction with the published genomes of CVI988 and Md5, this allowed us to perform three-way comparisons between multiple consensus genomes of the same strain. We found that consensus genomes of CVI988 can vary in as many as 236 positions involving 13 open reading frames (ORFs). By contrast, we found that Md5 genomes varied only in 11 positions involving a single ORF. Notably, we were able to identify 3 single-nucleotide polymorphisms (SNPs) in the unique long region and 16 SNPs in the unique short (US) region of CVI988GenBank.BAC that were not present in either CVI988Pirbright.lab or CVI988USDA.PA.field. Recombination analyses of field strains previously described as natural recombinants of CVI988 yielded no evidence of crossover events in the US region when either CVI988Pirbright.lab or CVI988USDA.PA.field were used to represent CVI988 instead of CVI988GenBank.BAC. We were also able to confirm that both CVI988 and Md5 populations were mixed, exhibiting a total of 29 and 27 high-confidence minor variant positions, respectively. However, we did not find any evidence of minor variants in the positions corresponding to the 19 SNPs in the unique regions of CVI988GenBank.BAC. Taken together, our findings suggest that continued reliance on the same published consensus genome of CVI988 may have led to an overestimation of genomic divergence between CVI988 and virulent strains and that multiple consensus genomes per strain may be necessary to ensure the accuracy of interstrain genomic comparisons.
Effect of Chair Placement on Physicians’ Behavior and Patients’ Satisfaction: Randomized Deception Trial
Authors: Iyer Ruchita , Park Do , Kim Jenny , Newman Courtney , Young Avery , Sumarsono Andrew 
Published: June 2024

(Abstracted from BMJ 2023;383:e076309)
Etiquette-based medicine, which emphasizes good behavior and manners, has been shown to benefit the patient-physician relationship. For example, sitting at the patient’s bedside is associated with improved patient-physician communication, patient satisfaction, and trust.
Learning Plan Use in Undergraduate Medical Education: A Scoping Review
Authors: Romanova Anna , Touchie Claire , Ruller Sydney , Kaka Shaima , Moschella Alexa , Zucker Marc , Cole Victoria , Humphrey-Murto Susan 
Published: June 2024

Abstract

Purpose
How to best support self-regulated learning (SRL) skills development and track trainees’ progress along their competency-based medical education learning trajectory is unclear. Learning plans (LPs) may be the answer; however, information on their use in undergraduate medical education (UME) is limited. This study summarizes the literature regarding LP use in UME, explores the student’s role in LP development and implementation, and identifies additional research areas.

Method
MEDLINE, Embase, PsycInfo, Education Source, and Web of Science databases were searched for articles published from database inception to March 6, 2024, and relevant reference lists were manually searched. The review included studies of undergraduate medical students, studies of LP use, and studies of the UME stage in any geographic setting. Data were analyzed using quantitative and qualitative content analyses.

Results
The database search found 7,871 titles and abstracts with an additional 25 found from the manual search for a total of 7,896 articles, of which 39 met inclusion criteria. Many LPs lacked a guiding framework. LPs were associated with self-reported improved SRL skill development, learning structure, and learning outcomes. Barriers to their use for students and faculty were time to create and implement LPs, lack of training on LP development and implementation, and lack of engagement. Facilitators included SRL skill development, LP cocreation, and guidance by a trained mentor. Identified research gaps include objective outcome measures, longitudinal impact beyond UME, standardized framework for LP development and quality assessment, and training on SRL skills and LPs.

Conclusions
This review demonstrates variability of LP use in UME. LPs appear to have potential to support medical student education and facilitate translation of SRL skills into residency training. Successful use requires training and an experienced mentor. However, more research is required to determine whether benefits of LPs outweigh the resources required for their use.
Perceptions of Individuals with Autism Spectrum Disorder on How Health Care Providers Address Sexual Health
Authors: Sharma Aanchal , Pantalone David W. , Kohn Brooke , Pereida Erin T. , Nadwodny Nicole , Faja Susan 
Published: June 2024

ABSTRACT:

Objective:
Medical providers report barriers that prevent them from discussing sexual health with patients with autism spectrum disorder (ASD). No investigations have examined the perspectives of adults with ASD about their sexual health care experiences.

Methods:
Twenty-five verbal young adults diagnosed with ASD and 40 young adults without ASD participated. An 8-item self-report survey assessed frequency of health care visits, age when sexual health was first discussed, and frequency/content of discussions with providers.

Results:
The likelihood of discussing sexual health topics did not differ by group, χ2s < 3.25; ps > 0.07, except sexual victimization, which the ASD group reported having discussed less than the non-ASD group (32% vs 9%), χ2 (1, N = 57) = 4.36, p = 0.04. Groups did not differ in their reported comfort level discussing sex/sexual health, having a primary care provider, or frequency of visits. The non-ASD group was significantly more likely to have received sexual health counseling (81%) than ASD group (52%), χ2 (1, N = 58) = 5.33, p = 0.02. Participants in both groups reported having received sexual health information from similar sources except the ASD group was more likely to receive information from parents than the non-ASD group (68% vs 30%), χ2 (1, N = 65) = 8.99, p = 0.003.

Conclusion:
Participants in the ASD and non-ASD groups reported similar comfort levels with sexual health discussions and access to health providers. Yet, the ASD group received less counseling related to sexual health—particularly sexual victimization screening—suggesting that critical information may be missing. Future studies should determine how to help providers overcome barriers to providing young adults with ASD sexual health aligned with their needs.
Anti-Thrombotic Effect of Protoparaxotriol Saponins From Panax notoginseng Using Zebrafish Model
Authors: Liu Xin , Fan Wei , Lin Shenghua , Chen Jiayu , Zhang Shanshan , Li Xiaobin , Jin Meng , He Qiuxia 
Published: June 2024

Abstract:

Panax notoginseng has the effect of stimulating circulation to end stasis. Our study was designed to evaluate the anti-thrombotic effect of protoparaxotriol saponins (PTS) from P. notoginseng and the involved mechanisms. A thrombosis model was constructed, and the anti-thrombotic activity of PTS was determined by erythrocyte staining, heart rate, and blood flow velocity. In addition, quantitative real-time polymerase chain reaction was used to identify changes in the expression of genes related to coagulation, inflammation, and apoptosis. PTS alleviated arachidonic acid–induced caudal vein thrombosis, restored blood flow, and increased the area of cardiac erythrocyte staining, heart rate, and blood flow velocity. It reduced the ponatinib-induced cerebral thrombus area and decreased the intensity of erythrocyte staining. The quantitative polymerase chain reaction data showed that the anti-thrombotic effect of PTS was mediated by suppression of genes related to coagulation, inflammation, and apoptosis and also involved inhibition of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) pathways.
Utility of methylated DNA markers for the diagnosis of malignant biliary strictures
Authors: Cooley Matthew A. , Schneider Amber R. , Barr Fritcher Emily G. , Milosevic Dragana , Levy Michael J. , Bridgeman Amber R. , Martin John A. , Petersen Bret T. , Abu Dayyeh Barham K. , Storm Andrew C. , Law Ryan J. , Vargas Eric J. , Garimella Vishal , Zemla Tyler , Jenkins Sarah M. , Yin Jun , Gores Gregory J. , Roberts Lewis R. , Kipp Benjamin R. , Chandrasekhara Vinay 
Published: June 2024

Background and Aims:
Early identification of malignant biliary strictures (MBSs) is challenging, with up to 20% classified as indeterminants after preliminary testing and tissue sampling with endoscopic retrograde cholangiopancreatography. We aimed to evaluate the use of methylated DNA markers (MDMs) from biliary brushings to enhance MBS detection in a prospective cohort.

Approach:
Candidate MDMs were evaluated for their utility in MBS diagnosis through a series of discovery and validation phases. DNA was extracted from biliary brushing samples, quantified, bisulfite-converted, and then subjected to methylation-specific droplet digital polymerase chain reaction.  Patients were considered to have no malignancy if the sampling was negative and there was no evidence of malignancy after 1 year or definitive negative surgical histopathology.

Results:
Fourteen candidate MDMs were evaluated in the discovery phase, with top-performing and new markers evaluated in the technical validation phase. The top 4 MDMs were TWIST1, HOXA1, VSTM2B, and CLEC11A, which individually achieved AUC values of 0.82, 0.81, 0.83, and 0.78, respectively, with sensitivities of 59.4%, 53.1%, 62.5%, and 50.0%, respectively, at high specificities for malignancy of 95.2%–95.3% for the final biologic validation phase. When combined as a panel, the AUC was 0.86, achieving 73.4% sensitivity and 92.9% specificity, which outperformed cytology and fluorescence in situ hybridization (FISH).

Conclusions:
The selected MDMs demonstrated improved performance characteristics for the detection of MBS compared to cytology and FISH. Therefore, MDMs should be considered viable candidates for inclusion in diagnostic testing algorithms.
A Novel Surgical Technique for Macular Manipulation in Highly Myopic Eyes With Long Axial Length
Authors: Baba Takayuki , Nizawa Tomohiro , Iwase Takehito , Shimizu Daisuke 
Published: June 2024

Purpose:
The authors developed a novel surgical technique tailored for highly myopic eyes characterized by extended axial lengths. Myopic eyes are prone to macular complications including macular schisis, full-thickness macular holes, and retinal detachment, which can cause severe vision loss. A pars plana vitrectomy is necessary in these cases. However, because of the considerable distance between the posterior pole and the cannula, regular forceps cannot reach the macula in some cases. To overcome this, the authors inserted a trocar more posteriorly after localizing the ora serrata.

Methods:
First, the authors placed two ports and performed partial vitrectomy without the infusion of balanced salt solution to reduce the intraocular pressure. Subsequently, the authors observed the peripheral retina localized to the ora serrata by scleral indentation using forceps. After the precise marking of the area, a third trocar was inserted and its position and placement confirmed intraoperatively.

Results:
Surgical maneuvers including a removal of the internal limiting membrane were safely performed using regular forceps through the posteriorly located cannula.

Conclusion:
The described technique offers a solution to the challenges posed by the extended axial lengths of highly myopic eyes during vitreoretinal surgery. By inserting the trocar more posteriorly, surgeons can enhance accessibility to the macula without requiring specialized equipment or extensive maneuvers.
RETINAL MIGRATION AND SURGICAL OUTCOME AFTER HEMI-TEMPORAL INTERNAL LIMITING MEMBRANE PEELING VERSUS CONVENTIONAL PEELING FOR MACULAR HOLE
Authors: Jujo Tatsuya , Shiono Akira , Sato Keiji , Sekine Reio , Uchiyama Naoto , Kakehashi Kota , Endo Akiko , Arakawa Akira , Shinkai Youichiro , Kitaoka Yasushi 
Published: June 2024

Purpose:
To investigate the anatomical changes and surgical outcomes of hemi-temporal internal limiting membrane (ILM) peeling and conventional ILM peeling for idiopathic macular hole (MH).

Methods:
This randomized controlled trial was conducted at 3 centers and included 50 participants with MHs of <400 µm in minimum diameter for a duration of <6 months. All participants had undergone vitrectomy with either hemi-temporal ILM peeling (Hemi group) or 360° ILM peeling (360° group) with an injection of 5% sulfur hexafluoride gas, with or without simultaneous cataract surgery, from July 2017 to January 2021. The rate of MH closure and distance of retinal migration were examined.

Results:
Of 50 eyes randomized in the 3 centers, the Hemi group comprised 23 eyes, the 360° group 23 eyes, and 4 eyes were eliminated from final analysis. There was a significantly higher rate of primary MH closure in the 360° group (Hemi group: 73.9% vs. 360° group: 100%, P = 0.009). Retinal migration to the optic disk on the nasal side was significantly shorter in the Hemi group at 1, 3, and 6 months postoperatively than in the 360° group. There was no significant difference between the two groups in retinal migration to the optic disk on the temporal side.

Conclusion:
Nasal retinal migration in patients who underwent the hemi-temporal ILM peeling method was significantly less than in those who underwent the 360° ILM peeling method. However, less nasal retinal migration did not contribute to the MH closure rate.
Efficacy of a smartphone application assisting home-based rehabilitation and symptom management for patients with lung cancer undergoing video-assisted thoracoscopic lobectomy: a prospective, single-blinded, randomised control trial (POPPER study)
Authors: Lv Chao , Lu Fangliang , Zhou Xiugeng , Li Xiang , Yu Wenhua , Zhang Chune , Chen Kaishen , Du Songtao , Han Chao , Wang Jia , Wang Yuzhao , Li Shaolei , Wang Liang , Liu Yinan , Zhang Shanyuan , Huang Miao , Song Dongdong , Zhao Dachuan , Liu Bing , Wang Yaqi , Cui Xinrun , Zhou Zhiwei , Yan Shi , Wu Nan 
Published: June 2024

Background:
Video-assisted thoracoscopic (VATS) lobectomy can affect patients’ pulmonary function and quality of life significantly. No optimal protocol combining patient-reported outcome-based symptom management and postdischarge rehabilitation programme has yet been established. This study aimed to assess the efficacy of a novel smartphone app designed for home-based symptom management and rehabilitation.

Methods:
The app was developed based on three modules: a symptom reporting system with alerts, aerobic and respiratory training exercises, and educational material. Four core symptoms were selected based on a questionnaire survey of 201 patients and three rounds of Delphi voting by 30 experts. The authors screened 265 patients and randomly assigned 136 equally to the app group and usual care group. The primary outcome was pulmonary function recovery at 30 days postoperatively. Secondary outcomes included symptom burden and interference with daily living (both rated using the MD Anderson Symptom Inventory for Lung Cancer), aerobic exercise intensity, emergency department visits, app-related safety, and satisfaction with the app.

Findings:
Of the 136 participants, 56.6% were women and their mean age was 61 years. The pulmonary function recovery ratio 1 month after surgery in the app group was significantly higher than that in the usual care group (79.32 vs. 75.73%; P=0.040). The app group also recorded significantly lower symptom burden and interference with daily living scores and higher aerobic exercise intensity after surgery than the usual care group. Thirty-two alerts were triggered in the app group. The highest pulmonary function recovery ratio and aerobic exercise intensity were recorded in those patients who triggered alerts in both groups.

Interpretation:
Using a smartphone app is an effective approach to accelerate home-based rehabilitation after VATS lobectomy. The symptom alert mechanism of this app could optimise recovery outcomes, possibly driven by patients’ increased self-awareness.
Ultra-short-period perioperative pulmonary rehabilitation on short-term outcomes after surgery in smoking patients with lung cancer: a randomized clinical trial
Authors: Han Dingpei , Wang Xinyi , Sun Xin , Cao Yuqin , Li Chengqiang , Guo Wei , Hu Yanxia , Hang Junbiao , Li Jian , Xie Qing , Li Hecheng 
Published: June 2024

Background:
Pulmonary rehabilitation (PR) is essential for airway management after thoracic surgery. Most current PRs are composed of 2–4-week exercises, which require significant consumption of medical resources and concerns about disease progression.

Materials and methods:
This single-center, prospective, randomized controlled trial enrolled smoking patients with pulmonary masses or nodules suitable for lobectomy, aged 18–80, with a smoking history (≥20 pack-years). Eligible patients were randomized in a 1:1 ratio into two groups. Patients in the intervention group underwent perioperative breathing exercises based on positive pressure vibration expectoration and 3-day preoperative lower limb endurance training. Patients in the control group received routine perioperative care. The primary outcome was in-hospital incidence of postoperative pulmonary complications. Secondary outcomes included postoperative hospital stay, total hospitalization cost, postoperative drainage time, drainage volume, semiquantitative cough strength score, pain score, Borg scale‐assessed fatigue, and walking distance on postoperative days 1 and 2.

Results:
A total of 194 patients were included in the study, with 94 in the intervention group and 100 in the control group. Our ultrashort PR program potentially reduced pulmonary complications incidence (24.5 vs. 33.0%), but without statistical significance (P=0.190). No significant differences were found in other perioperative outcomes, except for postoperative semiquantitative cough strength score (3 [interquartile range, 3–3.75] vs. 3 [interquartile range, 2–3], P<0.001) and change in walking distance from postoperative days 1 to 2 (60 [interquartile range, 40–82.5] vs. 30 [interquartile range, 10–60], P=0.003).

Conclusion:
There were no significant differences in postoperative complications and other hospitalizations, but our ultrashort rehabilitation program improved patients’ semiquantitative cough strength score and walking distance, indicating the potential for better outcomes. This treatment is a safe and effective means of airway management for thoracic surgery in the era of enhanced recovery (ClinicalTrials.gov Identifier: NCT03010033).
Efficacy of knee osteoarthritis by use of laser acupuncture: A systematic review and meta-analysis
Authors: Han Rong , Guo Chunxia , Lau Kit , Hu Jinlian 
Published: June 2024

Background:
Previous studies need to be aggregated and updated. We aim to assess the efficacy of laser acupuncture (LA) in knee osteoarthritis (OA) through a meta-analysis.

Methods:
Electronic databases were searched for studies investigating laser acupuncture’s efficacy in managing OA. Data were collected from the beginning of each database to 2022 (up to March). The “WOMAC total score,” “WOMAC stiffness score,” “WOMAC pain score,” “WOMAC physical function score,” and “VAS score” were the key outcomes of interest. The Der Simonian-Laird method for random effects was used.

Results:
Twenty-five randomized controlled clinical trials met our criteria and were included (2075 patients). Comparisons of interest is the LA versus Sham LA (efficacy), LA versus. A (Acupuncture) (comparative effectiveness), LA combined with A versus A (effectiveness as an adjunct), and any other research used LA in their treatment. Laser irradiation is effective in patients with Knee OA. LA is also effective and has almost the same outcome as laser irradiation. LA can achieve almost the same effect as manual acupuncture, even better than acupuncture in some studies.

Conclusion:
Laser acupuncture is more or less effective in patients with OA; better efficacy will be achieved under appropriate laser parameters (810 nm, 785 nm) in the LA versus Sham LA group. Many studies have diverse results, possibly due to unstaged analysis of patients’ disease, inappropriate selection of acupoints, lack of remote combined acupoints, and unreasonable laser parameters. Furthermore, a combination of acupoints was found to be more effective, which aligns with the combined-acupoints application of traditional Chinese medicine.
Complex delayed blood transfusion reaction: A case report
Authors: Li Qiang , Xie Jinhui , Sun Jiali , Fang Kuo , Li Tongtong 
Published: June 2024

Introduction:
Inefficient blood transfusions present a significant challenge, leading to the wastage of crucial blood resources and increased medical expenses. This study aims to address this issue by providing a comprehensive analysis of a case involving an ineffective clinical transfusion and outlining the significance of identifying multiple alloantibodies in resolving transfusion challenges.

Case report:
We present a detailed follow-up on a patient treatment journey, highlighting the critical role of identifying multiple alloantibodies through various methodologies in addressing the transfusion problem. Subsequently, a strategic intervention was implemented, leading to a successful patient outcome.

Conclusion:
This study underscores the importance of conducting a thorough analysis of ineffective transfusions and implementing scientifically formulated transfusion plans based on rational explanations. Such an approach not only improves hemoglobin levels but also contributes to better patient outcomes, thereby reducing blood resource wastage and medical costs.
Acupuncture treatment for anti-NMDAR encephalitis: A case report
Authors: Yang Tianhong , Cheng Hui , Gu Chunlei 
Published: June 2024

Rationale:
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare disease and common type of autoimmune encephalitis. The prognosis of patients with comorbid disorders of consciousness is poor, and no such acupuncture treatment has been reported. We report a case of acupuncture in anti-NMDAR encephalitis with a high cerebrospinal fluid titer combined with impaired consciousness.

Patient concerns:
A 13-year-old girl with anti-NMDAR encephalitis presented to our hospital with impaired consciousness.

Diagnoses:
Therefore, the patient was diagnosed with anti-NMDAR encephalitis. According to the Chinese medicine theory, the diagnosis was Shenhun(phlegm obstructs the clear orifices).

Interventions:
Depending on the patient’s condition, we used the Xingnao Kaiqiao acupuncture therapeutic method.

Outcomes:
After 16 weeks of acupuncture treatment, the patient awoke and resumed a normal life with no recurrence at one-year follow-up.

Conclusion:
This case demonstrated that acupuncture can be used as a complementary and alternative treatment for anti-NMDAR encephalitis.