bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence, Clearance, and Persistence of Penile High-Risk Human Papillomavirus Among Rwandan Men Who Have Sex With Men
Authors: Murenzi Gad , Kim Hae-Young , Mivumbi Jean Paul , Gasana Josephine , Munyaneza Athanase , Tuyisenge Patrick , Kanyabwisha Faustin , Zawadi Thierry , Muhoza Benjamin , Kubwimana Gallican , Adedimeji Adebola , Yotebieng Marcel , Mutesa Leon , Shi Qiuhu , Anastos Kathryn , Palefsky Joel M 
Published: April 2024

Abstract

Background
Little is known about penile high-risk human papillomavirus (hrHPV) among men who have sex with men (MSM) in low- and middle-income countries. We aimed to determine the incidence, clearance, and persistence of penile hrHPV among Rwandan MSM.

Methods
We enrolled 350 MSM (345 with valid human papillomavirus [HPV] results) aged ≥18 years. At each visit (6–12 months apart), we collected penile PreservCyt specimens and blood for HPV and HIV testing, as well as sociodemographic and behavioral variables. HPV testing was performed with the Ampfire assay. Penile hrHPV incidence and clearance per 1000 person-months of follow-up, as well as prevalent and incident persistence, were computed and compared by HIV status.

Results
The mean (SD) age was 27.7 (6.7) years and 19.4% were living with HIV. Penile hrHPV incidence was 34.8 (95% CI, 29.1–41.8) per 1000 person-months of follow-up. HPV-16 (11.7; 95% CI, 9.26–14.9) and HPV-59 (6.1; 95% CI, 4.52–8.39) had the highest incidence rates. Prevalent and incident persistence was 47.5% and 46.6%, respectively. HPV-66 (33.3%), HPV-52 (30.8%), and HPV-16 (29.2%) had the highest prevalent persistence and HPV-33 (53.8%), HPV-31 (46.7%), and HPV-16 (42.6%) the highest incident persistence. No differences were found by HIV status except for HPV-45 (higher in MSM with HIV).

Conclusions
We found high incidence and prevalent/incident persistence of penile hrHPV among Rwandan MSM. This highlights the importance of preventive strategies for HPV-associated anogenital cancers.
Linking methanotroph phenotypes to genotypes using a simple spatially resolved model ecosystem
Authors: Beals Delaney G , Puri Aaron W 
Published: April 2024

Abstract
Connecting genes to phenotypic traits in bacteria is often challenging because of a lack of environmental context in laboratory settings. Laboratory-based model ecosystems offer a means to better account for environmental conditions compared with standard planktonic cultures and can help link genotypes and phenotypes. Here, we present a simple, cost-effective, laboratory-based model ecosystem to study aerobic methane-oxidizing bacteria (methanotrophs) within the methane-oxygen counter gradient typically found in the natural environment of these organisms. Culturing the methanotroph Methylomonas sp. strain LW13 in this system resulted in the formation of a distinct horizontal band at the intersection of the counter gradient, which we discovered was not due to increased numbers of bacteria at this location but instead to an increased amount of polysaccharides. We also discovered that different methanotrophic taxa form polysaccharide bands with distinct locations and morphologies when grown in the methane-oxygen counter gradient. By comparing transcriptomic data from LW13 growing within and surrounding this band, we identified genes upregulated within the band and validated their involvement in growth and band formation within the model ecosystem using knockout strains. Notably, deletion of these genes did not negatively affect growth using standard planktonic culturing methods. This work highlights the use of a laboratory-based model ecosystem that more closely mimics the natural environment to uncover bacterial phenotypes missing from standard laboratory conditions, and to link these phenotypes with their genetic determinants.
Prevalence of trace gas-oxidizing soil bacteria increases with radial distance from Polloquere hot spring within a high-elevation Andean cold desert
Authors: Garvin Zachary K , Abades Sebastián R , Trefault Nicole , Alfaro Fernando D , Sipes Katie , Lloyd Karen G , Onstott Tullis C 
Published: April 2024

Abstract
High-elevation arid regions harbor microbial communities reliant on metabolic niches and flexibility to survive under biologically stressful conditions, including nutrient limitation that necessitates the utilization of atmospheric trace gases as electron donors. Geothermal springs present “oases” of microbial activity, diversity, and abundance by delivering water and substrates, including reduced gases. However, it is unknown whether these springs exhibit a gradient of effects, increasing their impact on trace gas-oxidizers in the surrounding soils. We assessed whether proximity to Polloquere, a high-altitude geothermal spring in an Andean salt flat, alters the diversity and metabolic structure of nearby soil bacterial populations compared to the surrounding cold desert. Recovered DNA and metagenomic analyses indicate that the spring represents an oasis for microbes in this challenging environment, supporting greater biomass with more diverse metabolic functions in proximal soils that declines sharply with radial distance from the spring. Despite the sharp decrease in biomass, potential rates of atmospheric hydrogen (H2) and carbon monoxide (CO) uptake increase away from the spring. Kinetic estimates suggest this activity is due to high-affinity trace gas consumption, likely as a survival strategy for energy/carbon acquisition. These results demonstrate that Polloquere regulates a gradient of diverse microbial communities and metabolisms, culminating in increased activity of trace gas-oxidizers as the influence of the spring yields to that of the regional salt flat environment. This suggests the spring holds local importance within the context of the broader salt flat and potentially represents a model ecosystem for other geothermal systems in high-altitude desert environments.
The Politics of International Peace and Security: Introducing a New Dataset on the Creation of United Nations Security Council Subsidiary Bodies
Authors: Lugg Andrew , Lansdale Sloan , Carcelli Shannon 
Published: April 2024

Abstract
This paper introduces new data on the creation of subsidiary bodies (SBs) by members of the United Nations Security Council (UNSC) between 1972 and 2020. Delegation to SBs is one of the principal means through which the UNSC acts, and these bodies are designed to carry out crucial functions such as peacekeeping, implementing sanctions, and investigating crises. Yet, no research has systematically evaluated their creation, design, and use. Our dataset includes a typology of all proposed and created SBs as well as information about their purpose and design. After introducing the data, we empirically analyze the determinants of SB creation. Multivariate regression demonstrates that SBs are more likely to be created when the preferences of the permanent members are aligned. Moreover, stronger bodies are more likely to be created during periods of high preference alignment, while middle- and lower-strength bodies are less influenced by member alignment. These results provide unique evidence demonstrating how politics affects the choice of when and how the UNSC responds to global problems. Our data and analysis paint a picture of a more proactive UNSC than is commonly portrayed in the literature, and these data will enable scholars to further analyze UNSC action.
24 Bleeding Money: Improving Triage and Documentation for Burn Patients in the Emergency Department
Authors: Richerbach Stacey , Hockenberry Tiffany , Foster Kevin N 
Published: April 2024

Abstract

Introduction
Triage acuity is a critical factor in determining resource allocation and prioritizing patient care. Additionally, documented triage acuities are correlated with professional charges and billing codes. Within the emergency department (ED), burn patients comprise a unique population. For a patient with a burn the insult is apparent, however, the resultant physiologic response may be overlooked by ED clinicians. For example, patients with burns may present with severe pain or elevated heart rate, yielding a high acuity level. In 2020, our Burn Center observed an increase in undocumented triage acuity for burn patients to 11.6%. As a result, we instituted a multidisciplinary quality improvement (QI) approach to improve triage related documentation and charge capture, and prioritization of care for patients with burns. The purposes of this project were to pinpoint education needs of nursing staff and improve documentation of triage acuity per the Emergency Severity Index (ESI).

Methods
A survey was disseminated to Burn ED nursing staff to identify barriers to triage documentation. QI interventions included a collaboration between Nursing, Informatics, and Quality Assurance to overcome barriers related to staff knowledge, workflow of the electronic health record (EHR), and dissemination of performance feedback. Education was provided via targeted training, pre-shift nursing huddle, weekly newsletters, and educational posters. Modifications were made to the EHR software modify the order of items in Triage list to avoid bypass of acuity documentation and to embed both a visual algorithm and text descriptors for ESI acuity determination. Quality Assurance furnished reports monthly, enabling nursing leadership to expedite feedback and identify needs for staff-specific education. Triage acuity metrics were added to the quality board. Performance was analyzed from January 2019 through June 2023, and was grouped annually.

Results
Following the QI project, undocumented triage acuity was reduced by 9.6%. Further, we noted an increase in both emergent (level 2) and urgent (level 3) acuity assignments by 11.3% for each.

Conclusions
The accurate assignment of triage acuity using scoring delineated by the ESI impacts both care and compensation. Our multidisciplinary quality improvement project was successful, reducing undocumented triage acuity by 9.7%. Further, we discovered a need to reinforce education related to high ESI triage acuity qualifiers, such as extreme pain and elevated heart rate. In doing so, we observed an increase in documentation of higher acuity levels for patients with burns (emergent and urgent) by 11.2% and 11.3%.

Applicability of Research to Practice
Further research is needed to quantify the impact of triage acuity assignment on charge capture.
83 Outcomes Using Autologous Epidermal Autograft for Wound Closure of Majority Deep Partial Thickness Burns
Authors: Abeln Andrea , Klugh James , Donthula Deepanjli , Almand Catherine , Campbell Taylor , Jiang Chuantao , Freet Daniel J , Huzar Todd F , Wainwright David J , Wade Charles E , Kao Lillian S , Harvin John A 
Published: April 2024

Abstract

Introduction
Autologous epidermal autografting (AEAG) closes wounds with a significantly smaller donor site compared with traditional split thickness autograft (STAG). Theoretically, treatment of large burns with a smaller required donor site may reduce length of stay (LOS) and overall costs. We hypothesized that AEAG would be associated with reduced overall hospital costs in patients with ≥10% total body surface area (TBSA), majority deep partial thickness burns compared to STAG alone.

Methods
Burn center patients from 2018-2023 with ≥10% TBSA, operative, majority deep partial thickness burns were split into two groups based on treatment strategy: Group 1 – patients who underwent STAG only versus Group 2 - patients who underwent AEAG with STAG reserved only for full thickness areas. Primary outcomes included length of stay and overall costs. Groups were stratified by percent TBSA (10-19% and ≥20%). Univariate and multivariate analyses were performed.

Results
The entire cohort included 97 patients, 50 (52%) in Group 1 and 47 (48%) in Group 2. The majority of the cohort (n=63, 65%) had 10-19% TBSA burns and 34 (35%) had ≥20% TBSA burns. In the 10-19% stratum, there were no differences in demographics or injury characteristics. Groups 1 and 2 had similar lengths of stay but Group 2 had higher overall costs. In the ≥20% TBSA stratum, there were no differences in demographics or injury characteristics except that Group 2 had a higher proportion of male patients. In the 10-19% TBSA stratum, after adjusting for age and TBSA, Group 2 was associated with increased costs (RR 1.46, 95% CI 1.18–1.80, p=0.001) and LOS (RR 1.16, 95% CI 1.00–1.34, p=0.045). In the ≥20% TBSA stratum and after adjusting for age and TBSA, Group 2 was associated with no difference in cost (RR 0.89, 95% CI 0.45 – 1.69, p=0.717) and a reduction in LOS (RR 0.78, 95% CI 0.68–0.88, p&lt; 0.001).

Conclusions
For ≥10% TBSA, majority deep partial thickness burns, the use of AEAG with STAG reserved only for full thickness areas was associated with a reduction in the need for STAG. There is a potential for reduced length of stay without increased costs in burns ≥20% TBSA with AEAG use. However, a larger, adequately powered trial is necessary to validate this finding.

Applicability of Research to Practice
AEAG was associated with a reduction in overall STAG requirement in all patients and was not associated with an increased cost for large % TBSA majority deep partial thickness burns.
771 Clinical Practice Guideline: Standard of Care for Cognitive Screening/Evaluation of Patients Following Electrical Injuries
Authors: Regal Hadley A , Frazier Kristina , Orr Mindy , Webb Crystal D , Thompson Callie M 
Published: April 2024

Abstract

Introduction
Electrical injuries account for nearly 3% of burn center admissions and most electrical injuries occur in the workplace; 55% according to the latest ABA Burn Injury Summary Report. No guideline(s) currently exist for a standard of care for comprehensive cognitive screening/evaluation and management of patients after electrical injuries. Research indicates that almost 50% of all patients who experience an electrical injury (without need to delineate low vs. high voltage injuries) report physical, cognitive, and/or emotional/psychosocial challenges after their injuries. These reported cognitive impairments most commonly include difficulty within attention (sustained/alternating/divided), memory (immediate, working, and delayed recall), new learning, and word finding abilities. We sought to utilize existing literature to develop a care pathway for our burn center.

Methods
We performed a literature review and found consistent reports of varying cognitive impairments/decline following electrical injury. Given the lack of a standard of care, we utilized this existing literature to formulate the care pathway in Figure 1 for patients (pediatric through geriatric) that were admitted to our burn center.

Results
We presented the proposed workflow in our monthly Burn Administration meeting and all leaders from the interdisciplinary team agreed on the pathway and for its immediate rollout. This pathway includes screening tool options, comprehensive standardized testing for both pediatric populations as well as adult/geriatric individuals. We aimed to have repeatable testing options that were age appropriate and could also be completed in additional languages to support various patient demographics.

Conclusions
All patients who sustain an electrical injury receive an immediate consultation to Speech Language Pathology upon admission to our burn center for comprehensive screening and evaluation of their cognitive/linguistic profile. Careful selection of testing protocols is completed based on age. Upon completion of testing, cognitive retraining is initiated as appropriate while in the ICU setting; as indicated, cognitive retraining continues in the outpatient setting. Patients may also be referred to Neurorehabilitation and Neuropsychology/Neuropsychiatry.

Applicability of Research to Practice
This workflow has both immediate clinical applicability and will allow us to both set expectations with patients about the typical post injury progression of cognitive function and to intervene to achieve optimal neuropsychological outcomes.
The immunoregulatory effects of total glucosides of peony in autoimmune diseases
Authors: Zhao Mengna , Peng Na , Zhou Yingbo , Qu Yuan , Cao Meng , Zou Qinghua , Yu Qinghong , Lu Liwei , Xiao Fan 
Published: April 2024

Abstract
Total glucoside of peony and its main active ingredient paeoniflorin, extracted from the Chinese herb Paeonia lactiflora Pallas, exhibit potent immunomodulatory effects. Total glucoside of peony has been shown to inhibit inflammatory responses and disease progression in experimental models of multiple autoimmune diseases, including rheumatoid arthritis, systemic lupus erythematosus, Sjögren's syndrome, psoriasis, and so on. Total glucoside of peony shows broad immunomodulatory effects on many immune cells, such as T cells, macrophages, and dendritic cells, by regulating their activation, proliferation, differentiation, and production of effector molecules. Mechanistically, total glucoside of peony modulates intracellular signaling transductions, including JAK/STAT, NF-κB, MAPK, and PI3K/AKT/mTOR pathways. Moreover, total glucoside of peony has been applied in the clinical treatment of various autoimmune diseases with satisfactory therapeutic outcomes and minor side effects. Thus, available studies have demonstrated that total glucoside of peony and its bioactive constituents exhibit anti-inflammatory and immunomodulatory functions and may have extensive applications in the treatment of autoimmune diseases.
Syringaresinol attenuates Tau phosphorylation and ameliorates cognitive dysfunction induced by sevoflurane in aged rats
Authors: Zheng Simin , Teng Yunpeng , Liu Hongtao , He Jiaxuan , Zhang Shaobo , Xiong Hongfei 
Published: April 2024

Abstract
Cognitive dysfunction following anesthesia with agents such as sevoflurane is a significant clinical problem, particularly in elderly patients. This study aimed to explore the protective effects of the phytochemical syringaresinol (SYR) against sevoflurane-induced cognitive deficits in aged Sprague-Dawley rats and to determine the underlying mechanisms involved. We assessed the impact of SYR on sevoflurane-induced cognitive impairment, glial activation, and neuronal apoptosis through behavioral tests (Morris water maze), immunofluorescence, Western blotting for key proteins involved in apoptosis and inflammation, and enzyme-linked immunosorbent assays for interleukin-1β, tumor necrosis factor-α, and interleukin-6. SYR treatment mitigated sevoflurane-induced cognitive decline, reduced microglial and astrocyte activation (decreased Iba-1 and GFAP expression), and countered neuronal apoptosis (reduced Bax, cleaved-caspase3, and cleaved-PARP expression). SYR also enhanced Sirtuin-1 (SIRT1) expression and reduced p-Tau phosphorylation; these effects were reversed by the SIRT1 inhibitor EX527. SYR exerts neuroprotective effects on sevoflurane-induced cognitive dysfunction by modulating glial activity, apoptotic signaling, and Tau phosphorylation through the SIRT1 pathway. These findings could inform clinical strategies to safeguard cognitive function in patients undergoing anesthesia.
Inventing Polio Care at the Colonie de Saint-Fargeau: Disability, Rehabilitation, and the Welfare State in Interwar France
Authors: Scales Rebecca P 
Published: April 2024

Abstract
In 1919, the polio survivor and Red Cross nurse Ellen Poidatz created the Colonie de Saint-Fargeau, France’s first residential rehabilitation facility for children and adolescents paralyzed by polio. This article examines the Colonie’s external politics and internal dynamics, showing how Poidatz framed her work within conventions of maternalist politics to secure private donations and public subventions to anchor the facility within France’s mixed economy of social welfare. Analyzing Poidatz’s contributions to rehabilitation medicine as it developed in the interwar decades and the varied experiences of children at the Colonie, this article illustrates how the provision of polio care remained fraught with tensions. Although Poidatz’s vision of providing physiotherapy, education, and vocational retraining in a single center was not fully realized, she played a critical, if unacknowledged role in the creation of the welfare state by turning the Colonie into a national model for polio care that endured into the post–World War II era.
Interactions between nitrate reductase 2 and catalase 1 fine-tune disease resistance in cassava
Authors: Zhang Xueyi , Liu Guoyin , Zheng Rongjiao , Yan Yu , Shi Haitao 
Published: April 2024

Abstract
Cassava (Manihot esculenta) is one of the most important tuber crops, used for food, starch, and bio-energy. However, it is susceptible to a number of diseases, especially cassava bacterial blight. Nitric oxide (NO) and hydrogen peroxide (H2O2) regulate plant growth and development, as well as stress responses. However, no direct relationship between the enzymes involved in producing and processing these key signaling molecules has been demonstrated. Here, we provide evidence for an interaction between nitrate reductase 2 (MeNR2) and catalase 1 (MeCAT1) proteins in vitro and in vivo, using yeast two-hybrid and bimolecular fluorescence complementation assays, respectively. MeNR2 is a positive regulator and MeCAT1 is a negative regulator of cassava bacterial blight resistance. MeNR2 was localized in the nucleus, cell membrane, and peroxisome, while MeCAT1 was localized in the peroxisomes. The interaction between MeNR2 and MeCAT1 also had effects on their respective enzyme activities. Taken together, our data indicate that there is coordination between H2O2 and NO signaling in cassava disease resistance, through the interactions between MeCAT1 and MeNR2.
Neonatal lupus with complete heart block and long term follow up
Authors: Alhatemi Ahmed Qasim Mohammed , Al-Yacopy Ali Akeel , Hashim Hashim Talib , Abdulhussain Rand K 
Published: April 2024

Abstract
We present the case of a 27-year-old pregnant woman, newly diagnosed with Systemic Lupus Erythematosus (SLE) during pregnancy. The patient delivered a newborn at 38 weeks gestation, who, on the first day of life, manifested complete heart block. This case underscores the clinical challenges associated with neonatal lupus, emphasizing the need for collaborative, multidisciplinary management.
Advancing police professionalism on the front lines with experiments and experience
Authors: Willis James J , Toronjo Heather 
Published: April 2024

Abstract
We juxtapose two different visions for police reform, one based on programs and scientific experiments, the other on street-level practices and experience. Our purpose is to consider a closer marriage between them. To this end, we have outlined a training model based on the police craft, and designed to help patrol officers reflect mindfully on the numerous and varied situational factors that characterize mundane but perplexing encounters with the public. This model is inspired by the Aristotelian concept of perception or discernment. Its focus is not on outcomes but on decision-making processes that lead to choosing well in the kind of complex and uncertain environment of everyday police work.