bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of Synovial Fluid Biomarkers for Culture-Positive Septic Arthritis in a Lyme Disease-Endemic Region
Authors: Dechnik Andzelika , Kahane Caroline G. , Nigrovic Lise E. , Lyons Todd W. 
Published: April 2024

Objective
To evaluate the performance of synovial fluid biomarkers to identify children with culture-positive septic arthritis.

Methods
We identified children 6 months to 18 years old presenting to a single emergency department between 2007 and 2022 undergoing evaluation for septic arthritis defined by having a synovial fluid culture obtained. Our primary outcome was septic arthritis defined by a positive synovial fluid culture. We evaluated the ability of synovial fluid biomarkers to identify children with septic arthritis using area under the receiver operating characteristic curve (AUC) analyses. We measured the sensitivity and specificity of commonly used synovial fluid biomarkers.

Results
We included 796 children, of whom 79 (10%) had septic arthritis. Compared with synovial white blood cell count (AUC, 0.72; 95% confidence interval [CI], 0.65–0.78), absolute neutrophil count (AUC, 0.72; 95% CI, 0.66–0.79; P = 0.09), percent neutrophils (AUC, 0.66; 95% CI, 0.60–0.71; P = 0.12), and glucose (AUC, 0.78; 95% CI, 0.67–0.90; P = 0.33) performed similarly, whereas protein (AUC, 0.52; 95% CI, 0.40–0.63, P = 0.04) had lower diagnostic accuracy. Synovial fluid white blood cell count ≥50,000 cells/μL had a sensitivity of 62.0% (95% CI, 50.4%–72.7%) and a specificity of 67.0% (95% CI, 63.4%–70.4%), whereas a positive synovial fluid Gram stain had a sensitivity of 48.1% (95% CI, 36.5%–59.7%) and specificity of 99.1% (95% CI, 98.1%–99.7%) for septic arthritis.

Conclusions
None of the routinely available synovial fluid biomarkers had sufficient accuracy to be used in isolation in the identification of children with septic arthritis. New approaches including multivariate clinical prediction rules and novel biomarkers are needed.
Pediatric Epistaxis—Effectiveness of Conservative Management
Authors: Hadar Ayalon , Peleg Uri , Ghantous Jameel , Tarnovsky Yehuda , Cohen Adiel , Sichel Jean-Yves , Attal Pierre 
Published: April 2024

Objectives
Epistaxis is an emergency medical condition that sometimes requires admission to the emergency department. Pediatric epistaxis differs from epistaxis in the older population in terms of etiology, severity, and management. Our objective was to identify the distinctive features of pediatric epistaxis and determine the appropriate management.

Methods
This was a retrospective study of 231 medical records of children (<18 years old) with epistaxis of a total of 1171 cases in the general population who presented to our medical center's emergency department between 2013 and 2018.

Results
Among 231 admissions, 10 children (4.3%) presented more than once. Male patients accounted for the majority of cases (64.5%), and the average age was 9.4 years. Two children were treated with aspirin because of cardiac valve disease. Anterior bleeding was detected in 101 cases (43.7%), whereas posterior origin was observed in 8 cases (3.5%). In 122 cases (52.8%), there was no active bleeding observed. Nose injury was the cause of epistaxis in 24 cases (10.4%), and 16 admissions (6.9%) followed nasal surgical interventions. Nineteen children (8%) had abnormal coagulation tests, and 7 patients (3%) received blood transfusions. Chemical cauterization was performed in 89 cases (39.3%), and anterior packing was needed in only 9 cases (3.9%). Nine children required hospitalization (3.9%), and 2 needed surgical intervention to control bleeding. Compared with the adult population, there were significantly fewer cases of active bleeding, recurrent epistaxis, anterior packing, or need for hospitalization in the pediatric population.

Conclusions
Epistaxis is significantly less severe in the pediatric population, with only a few cases requiring major intervention. Endoscopic examination of the entire nasal cavity and routine coagulation tests are not mandatory unless there is a history of recurrent epistaxis, known coagulopathy, antiplatelet/anticoagulation therapy, or a suspicion of juvenile idiopathic angiofibroma. We suggest using absorbable packs, which offer advantages over cauterization or nonabsorbable packs.
Management of Mandibular Condylar Sagittal Fracture Accompanied by Lateral Condylar Crest Defect
Authors: Wu Benxing , Lin Yuxin , Lv Kun 
Published: April 2024

Background:
The sagittal fracture of the mandibular condyle can be fixed with absorbable long screws. Absorbable long screws are generally inserted from the lateral crest of the condyle and are as close as possible to the medial pole of the condyle to obtain sufficient retention force. However, in clinical practice, patients with locally comminuted condylar fractures and partial defects in the lateral crest are often encountered. We validated the use of absorbable plates and long screws to fix mandibular condylar fractures with lateral crest defects, and postoperative follow-up showed good results.

Methods:
The preoperative design indicated that if conventional long screws were used, more soft tissue need to be pulled downward to achieve the appropriate drilling angle. If an absorbable plate was used, the degree of downward pulling of soft tissue was smaller, which can better protect the parotid gland tissue and facial nerve. The surgery was performed according to the preoperative design, using an absorbable plate scheme.

Results and Discussion:
Postoperative CT confirmed a stable anatomical reduction of condyle. Four-month follow-up showed that the patient's facial shape, occlusion, and mouth opening were all good. Follow-up CT showed good fracture healing. It is feasible to use absorbable plates and long absorbable screws to fix mandibular condylar sagittal fracture accompanied by lateral condylar crest defect.
Analysis of the Correlation Between Dynamic Characteristics and Symptoms of Gastroesophageal Reflux Disease
Authors: Tian Yan , Zhang Weihao , Zhang Tingting , Liu Lan , Guo Jianqiang 
Published: April 2024

Objective:
To investigate the esophageal motility characteristics of gastroesophageal reflux disease (GERD) and their relationship with symptoms.

Patients and Methods:
We examined 101 patients diagnosed with GERD by endoscopy and divided them into 3 groups as follows: nonerosive reflux disease (NERD), reflux esophagitis, and Barrett esophagus. Esophageal high-resolution manometry and the GERD Questionnaire were used to investigate the characteristics of esophageal dynamics and symptoms. In addition, the reflux symptom index was completed and the patients were divided into 7 groups according to symptoms. We then determined the correlation between dynamic esophageal characteristics and clinical symptoms.

Results:
Upper (UES) and lower (LES) esophageal sphincter pressures and the 4-second integrated relaxation pressure in the RE group were lower than those in the NERD group. The 4-second integrated relaxation pressure in the Barrett esophagus group was also lower than that in the NERD group. In the analysis of extraesophageal symptoms, high-resolution manometry showed significant differences in UES pressures among all groups. Further subgroup analysis showed that compared with the group without extraesophageal symptoms, the UES pressure of the groups with pharyngeal foreign body sensation, throat clearing, and multiple extraesophageal symptoms was lower.

Conclusions:
As GERD severity increases, motor dysfunction of the LES and esophageal body gradually worsens, and the LES plays an important role in GERD development. Decreased UES pressure plays an important role in the occurrence of extraesophageal symptoms, which is more noticeable in patients with pharyngeal foreign body sensation and throat clearing.
Prophylactic slowly resorbable mesh in midline laparotomy to limit incisional hernia incidence: the prospective ‘Mesh Augmented Reinforcement of Abdominal Wall Suture Line (MARS)’ cohort study protocol
Authors: Van Den Dop Louis Matthijs , Molina-Villar Jose M. , Mäkäräinen Elisa , Torkington Jared , Weyhe Dirk , Koncar Igor , Lange Johan F. 
Published: April 2024

Background:
Incisional hernia (IH) after abdominal surgery is a frequent surgical complication. Risk factors associated with IH are midline incisions, patients with an abdominal aneurysm of the aorta, and high BMI. Preventive measures include the use of the small-bites suture technique and/or placing a prophylactic mesh for reinforcement of the midline closure. Although recommended for high-risk patients, many surgeons are still reluctant to place a prophylactic mesh due to related complications. To counter these concerns, new synthetic resorbable meshes are being developed, such as the Deternia Self-Gripping Resorbable Mesh (“investigational device”). However, the effectiveness of this mesh in IH prevention has not been proved.

Methods:
The Mesh Augmented Reinforcement of Abdominal Wall Suture Line (MARS) study is a European, multicentre, prospective, single-arm study. A total of 120 patients scheduled for elective midline laparotomy, and for that reason at risk of developing IH, will be recruited in ~12 sites after informed consent. The sample size was estimated based on greater than 80% power, two-sided alpha of 0.05, an expected 12 month IH rate of 8% and a predefined performance goal of 18% (10% clinical margin). Midline incisions will be closed by the small bites closure technique with a minimum 4:1 suture-to-wound length ratio and reinforced by mesh placement in the retrorectus position. The primary outcome will be IH occurrence at 12-month postoperatively, evaluated both clinically and by ultrasound. Secondary outcomes will include mesh-related and postoperative complications, surgical characteristics, IH incidence at 2 and 3 years after surgery, and quality of life.

Discussion:
Currently, no conclusive evidence is available for synthetic resorbable meshes in a prophylactic setting to prevent IH. The MARS study will be the first prospective cohort study to investigate resorbable synthetic meshes and small bites closure to reduce IH incidence.
Use of In-Training Examination Scores as a Fellowship Candidate Evaluation Metric: Time for a Change
Authors: Hong Christopher X. , Russell Colin B. , Southworth Elizabeth A. , Fairchild Pamela S. 
Published: April 2024

Abstract
In the field of obstetrics and gynecology (OB/GYN), the Council on Resident Education in Obstetrics and Gynecology (CREOG) administers an annual in-training examination to all OB/GYN residents as a formative educational tool for assessing medical knowledge and promoting self-improvement. Although the CREOG examination is not designed or intended for knowledge certification, many OB/GYN subspecialty fellowship programs request and use CREOG examination scores as a metric to evaluate fellowship candidates. Among the 57 gynecology-based urogynecology fellowship programs, 30 programs (53%) request CREOG examination scores to be submitted by candidates, as of March 2023. Although the use of CREOG examination scores as an evaluation metric may constitute a minor component within the fellowship match process, this practice fundamentally contradicts the intended purpose of the examination as an educational self-assessment. In addition, it introduces the potential for bias in fellowship recruitment, lacks psychometric validity in predicting specialty board examination failure, and shifts the CREOG examination from its original intention as low-stakes self-assessment into a high-stakes examination akin to a certification examination. For these reasons, we call upon the urogynecology community to prioritize the educational mission of the CREOG examination and reconsider the practice of requesting or using CREOG examination scores in the fellowship match progress.
New knowledge on anti-IgLON5 disease
Authors: Gaig Carles , Sabater Lidia 
Published: April 2024

Purpose of review
Anti-IgLON5 disease is characterized by a distinctive sleep disorder, associated with a heterogeneous spectrum of neurological symptoms. Initial autopsies showed a novel neuronal tauopathy predominantly located in the tegmentum of the brainstem. Recently, new diagnostic red flags, biomarkers predictors of response to immunotherapy, and novel insights into the autoimmune pathogenesis of the disease have been reported.

Recent findings
Patients with diagnosis of neurodegenerative dementia, progressive supranuclear palsy (PSP) or with motor-neuron disease (MND)-like syndrome have been reported to have IgLON5 antibodies, which are the hallmark of anti-IgLON5 disease. Second, low levels of neurofilament light chain in serum and cerebrospinal fluid of patients at disease onset could be a predictor of immunotherapy response. Recent neuropathological studies indicate that the neuronal tau deposits occur late in the course of the disease. Moreover, IgLON5 antibodies induce cytoskeletal changes in cultured hippocampal neurons suggesting that the tauopathy could be secondary of the IgLON5 antibody effects.

Summary
Anti-IgLON5 disease can mimic and should be considered in atypical presentations of MND, neurodegenerative dementia and PSP. Neurofilament light chain levels seem promising biomarker for disease prognosis. Finally, the neuropathological and in vitro experimental studies strengthen the autoimmune hypothesis of the disease.
The MET growth signaling complex drives Alzheimer’s Disease-associated brain pathology in aged Shugoshin 1 mouse cohesinopathy model
Authors: Rao Chinthalapally V. , Crane Julie , Fowler Ben , Zhang Yuting , Yamada Hiroshi Y. 
Published: April 2024

AbstractThe understanding on molecular processes toward Late-onset Alzheimer’s Disease (LOAD) has been insufficient to design LOAD intervention drugs. Previously, we discovered transgenic genomic instability model mice Sgo1-/+ accumulate cerebral amyloid-beta in old age. We proposed the “amyloid-beta accumulation cycle” hypothesis, in which cytotoxic, mitogenic and aneuploidgenic amyloid can create an autonomous mitotic cycle leading to accumulation of itself. However, the nature of the growth signaling that drives cells toward pathogenic mitotic cycle remained unidentified. In this study, we hypothesized that the aged Sgo1-/+ mice brains would show signs of mitogenic signaling activation, and searched for growth signaling activated in the vicinity of amyloid-beta, with spatial analysis on the cortex and hippocampus of Sgo1-/+ mice in middle-age and old-age. The analysis indicated activations of kinase signaling p42/44 MAPK ERK1/2, AMPK, JNK, Wnt signaling via GSK3 inactivation, as well as increases of p-TAU and other AD biomarkers, PLCG1, EGFR, MET, Neurofibromin and RAS. Immune activation markers CD45 and CD31 were also elevated in the microenvironment. A majority of activated growth signaling components are of the oncogenic MET signaling complex. The discovery supports repurposing of cancer drugs targeting the MET signaling complex and EGFR-RAS-MAPK axis for intervention and/or treatment of genomic instability-driven AD.
Microbial diversification is maintained in an experimentally evolved synthetic community
Authors: Al-Tameemi Zahraa , Rodriguez-Verdugo Alejandra 
Published: April 2024

AbstractMicrobial communities are incredibly diverse. Yet, the eco-evolutionary processes originating and maintaining this diversity remain understudied. Here, we investigate the patterns of diversification forPseudomonas putidaevolving in isolation and withAcinetobacter johnsoniileaking resources used byP. putida. We experimentally evolved four experimental replicates in monoculture and co-culture for 200 generations. We observed thatP. putidadiversified into two distinct morphotypes that differed from their ancestor by single-point mutations. One of the most prominent mutations hit thefleQgene encoding the master regulator of flagella and biofilm formation. We experimentally confirmed thatfleQmutants were unable to swim and formed less biofilm than their ancestor, but they also produced higher yields. Interestingly, thefleQgenotype and other mutations swept to fixation in monocultures but not in co-cultures. In co-cultures, the two lineages stably coexisted for approximately 150 generations. We hypothesized thatA. johnsoniimodulates the coexistence of the two lineages through frequency-dependent selection. However, invasion experiments with two genotypes in monoculture and co-culture did not support this hypothesis. Instead, we found that, at the population level, the two morphotypes coexisted at similar relative abundances in the presence ofA. johnsoniiwhereas, in its absence, one of the morphotypes was overrepresented in the population. Overall, our study suggests that interspecies interactions play an important role in shaping patterns of diversification in microbial communities.ImportanceIn nature, bacteria live in microbial communities and interact with other species, for example, through the exchange of resources leaked into the external environment (i.e., cross-feeding interactions). The role that these cross-feeding interactions play in shaping patterns of diversification remains understudied. Using a simple bacterial system in which one species cross-feeds resources to a second species (commensal species), we showed that the commensal species diversified into two subpopulations that persisted only when the cross-feeder partner was present. We further observed loss-of-function mutations in flagellar genes that were fixed in monocultures but not in co-cultures. Our findings suggest that cross-feeding species influence patterns of diversification of other species. Given that nutrient leakage is pervasive in microbial communities, the findings from this study have the potential to extend beyond our specific bacterial system. Importantly, our study has contributed to answering the larger question of whether species evolved differently in isolation versus when interacting with other species.
Shared decision-making interventions in the choice of antipsychotic prescription in people living with psychosis (SHAPE): protocol for a realist review
Authors: Fitzgerald Ita , Sahm Laura J. , Howe Jo , Maidment Ian , Wallace Emma , Crowley Erin K. 
Published: April 2024

AbstractBackgroundShared decision-making (SDM) has yet to be successfully adopted into routine use in psychiatric settings amongst people living with severe mental illnesses. Suboptimal rates of SDM are particularly prominent amongst patients with psychotic illnesses during antipsychotic treatment choices. Many interventions have been assessed for their efficacy in improving SDM within this context, although results have been variable and inconsistent.AimsTo generate an in-depth understanding of how, why, for whom, and to what extent interventions facilitating the application of SDM during choice of antipsychotic drug treatment work and the impact of contextual factors on intervention effectiveness.MethodsThis review will use realist review methodology to provide a causal understanding of how and why interventions work when implementing SDM during choice of antipsychotic treatment. The review will take place over five stages; (1) Locating existing theories, (2) Searching for evidence, (3) Selecting articles, (4) Extracting and organising data and (5) Synthesizing evidence and drawing conclusions. An understanding of how and why interventions work will be achieved by developing realist programme theories on intervention effectiveness through iterative literature reviews and engaging with various stakeholder groups, including patient, clinician and carer representatives.DiscussionThis is the first realist review aiming to identify generative mechanisms explaining how and why successful interventions aimed at improving SDM within the parameters outlined work and in which contexts desired outcomes are most likely to be achieved. Review findings will include suggestions for clinicians, policy and decision-makers about the most promising interventions to pursue and their ideal attributes.
Early pregnancy in schools: a socio-ecological analysis of the determinants among teenage girls in Koudougou, Burkina Faso
Authors: Ramde Wendkoaghenda Sophie , Ngangue Patrice , Appolinaire Tonye Kollo , Ly Birama Apho , Bonane Thieba Blandine 
Published: April 2024

ABSTRACTIntroductionEarly pregnancy among adolescents in school has several consequences on the adolescent herself, her family, the whole community, and the child-to-be. This article explores the factors determining early pregnancy among 15-19-year-old secondary school students in Koudougou in Burkina Faso.MethodsA descriptive and exploratory qualitative study was conducted through focus groups with adolescents and youth in schools and individual interviews with parents, teachers, health workers, and community leaders. The socio-ecological model guided all stages of the study. A thematic analysis of the recorded and transcribed data was conducted using Nvivo 12 software.ResultsA lack of knowledge and information and wrong perceptions about sexuality at the individual level; peer pressure and poverty at the interpersonal level; lack of awareness among teachers and students and health workers’ attitudes at the organizational level; the influence of new information technologies or the media and parents’ irresponsibility at the community level; and the insufficient of sexual and reproductive health services for adolescents as well as the lack of sanctions and law against early pregnancy at the political level were found as enablers. Barriers were the use of contraceptive methods and sexual abstinence; parents-children communication; teachers’ training on sexual sensitization, the creation of youth centers on school campuses and the introduction of sexual education courses; education through media and religion; willingness to introduce sexual education courses in school curricula and legal sanctioning of dealing and consuming drugs in schools.ConclusionThe study highlighted that the problem of early pregnancy in schools can be solved by acting on the determinants at all levels of the socioecological model by implementing preventive strategies.
Can social media serve as a potential citizen science source for bird-window collision (BWC) data? A study using a decadal data set in Taiwan
Authors: Hsieh Chi-Heng , Hsu Gen-Chang , Wang Ling-Min 
Published: April 2024

AbstractCitizen science is increasingly used in bird-window collision (BWC) research to collect data. However, few studies have collected BWC data from social media, and it remains unknown whether the data quality is comparable to that of reported on dedicated platforms. To evaluate the potential of social media as a citizen science data source for BWC, we collected BWC data on social media Facebook as well as Taiwan Roadkill Observation Network (TaiRON), the main dedicated citizen science platform for reporting wildlife mortalities in Taiwan. We compared a decade of BWC data (2012–2022) from the two platforms by examining the nationwide geographical coverage and the species compositions of the BWC observations. Overall, we recorded 2,583 BWC cases involving 153 BWC species from Facebook, and 1,000 BWC cases involving 104 BWC species from TaiRON. More than half of the BWC individuals from Facebook were not found dead when observed, whereas all records on TaiRON were dead individuals. The nationwide geographical coverage and the species compositions of the top 80% cumulative BWC individuals were generally similar between the two platforms. Moreover, the sampling completeness of the two platforms both exceeded 95% (Facebook: 98.0%; TaiRON: 96.0%). To our knowledge, this study is among the first to collect BWC data through social media posts, and our results show that the quantity and quality of Facebook data can be comparable to that of the well-developed citizen science platform TaiRON. Taken together, social media Facebook may not only serve as a promising tool for collecting BWC data, but also provide a platform for public education, which can benefit bird conservation. Finally, integrating data from different citizen science sources helps paint a more complete picture of BWC patterns, especially in understudied areas such as Asia.