bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular Point-of-Care Testing in the Emergency Department for Group A Streptococcus Pharyngitis
Authors: Gill Carson , Chui Clement , Goldfarb David M. , Meckler Garth , Doan Quynh 
Published: March 2024

Objectives
To compare clinical and health systems outcomes of rapid molecular testing versus throat culture recovery for the management of group A Streptococcus (GAS) pharyngitis in a pediatric emergency department (PED).

Methods
We conducted a single-center randomized trial of children (3–17 years) presenting to a PED with suspected GAS pharyngitis. A single dual-headed throat swab was collected, and participants were randomized to 1 of 2 parallel treatment groups with 1:1 allocation: point-of-care (POC) nucleic acid amplification testing or standard throat culture. The primary outcomes were time to throat pain +/− fever resolution. Secondary outcomes included absenteeism, length of stay, return visits to care, and antibiotic prescriptions and utilization.

Results
A total of 227 children were randomly assigned to culture (n = 115) or POC (n = 112) testing. Antibiotics were initiated earlier in the POC group by approximately 1 day (95% confidence interval, −0.40 to −1.58). No associated difference in time to throat pain or fever resolution was observed between groups. There was a decrease in the proportion of prescribed antibiotics in the POC group (0.35) compared with the culture group (0.79; P < 0.001). Otherwise, no significant differences in secondary outcomes were observed.

Conclusions
Establishing a POC nucleic acid amplification testing program for GAS in a PED facilitates earlier treatment and fewer antibiotic prescriptions. Although this did not translate to improved clinical and health systems outcomes in our study, it may serve as an important tool amid evolving pediatric febrile illnesses and growing antimicrobial resistance patterns.
A pilot project of a Post Discharge Care Team for firearm injury survivors decreases emergency department utilization, hospital readmission days, and cost
Authors: Biesboer Elise A. , Brandolino Amber , Servi Ashley , Laszkiewicz Rebecca , Herbst Liza , Cronn Susan , Cadman Jennifer , Trevino Colleen , deRoon-Cassini Terri , Schroeder Mary E. 
Published: March 2024

BACKGROUND
Persons of low socioeconomic status are overrepresented in the firearm injury patient population and may experience challenges in accessing complex outpatient health systems. Consequently, outpatient care for these patients is plagued by poor follow-up and increased emergency department (ED) utilization. We developed a Post Discharge Care Team (PDCT) consisting of a dedicated trauma nurse navigator and medical social worker to bridge the gap between hospital discharge and outpatient care to improve recovery.

METHODS
Adult firearm injury survivors admitted to the trauma service were randomized 1:1 to receive either PDCT services or standard of care (SOC) workflows. The PDCT nurse provided education and set expectations regarding injuries, wound care, and outpatient follow-up. The PDCT social worker performed a comprehensive assessment to identify concerns including housing and financial instability, food insecurity, or transportation issues. The primary outcome was ED utilization, with secondary outcomes including readmissions and overall health care costs compared between groups.

RESULTS
In the first 6 months of the study, a total of 44 patients were randomized to PDCT and 47 to SOC. There were 10 patients who visited the ED in the PDCT group compared with 16 in the SOC group (p = 0.23) for a total of 14 and 23 ED visits, respectively. There were 14 patients in the PDCT and 11 patients in the SOC groups who were readmitted (p = 0.31), but the PDCT group was readmitted for 27.9 fewer hospital days. After accounting for programmatic costs, the PDCT had a hospital savings of $34,542.71.

CONCLUSION
A collaborative, specialized PDCT for firearm injury survivors consisting of a dedicated trauma nurse navigator and medical social worker decreased outpatient ED utilization, readmission days, and was cost effective. Trauma centers with high volumes of penetrating trauma should consider a similar model to improve outpatient care for firearm injury survivors.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
Prevalence and outcomes of high versus low ratio plasma to red blood cell resuscitation in a multi-institutional cohort of severely injured children
Authors: Mehl Steven C. , Vogel Adam M. , Glasgow Amy E. , Moody Suzanne , Kotagal Meera , Williams Regan F. , Kayton Mark L. , Alberto Emily C. , Burd Randall S. , Schroeppel Thomas J. , Baerg Joanne E. , Munoz Amanda , Rothstein William B. , Boomer Laura A. , Campion Eric M. , Robinson Caitlin , Nygaard Rachel M. , Richardson Chad J. , Garcia Denise I. , Streck Christian J. , Gaffley Michaela , Petty John K. , Greenwell Cynthia , Pandya Samir , Waters Alicia M. , Russell Robert T. , Yorkgitis Brian K. , Mull Jennifer , Pence Jeffrey , Santore Matthew T. , MacArthur Taleen A. , Klinkner Denise B. , Safford Shawn D. , Trevilian Tanya , Cunningham Megan , Black Christa , Rea Jessica , Spurrier Ryan G. , Jensen Aaron R. , Farr Bethany J. , Mooney David P. , Ketha Bavana , Dassinger Melvin S. , Goldenberg-Sandau Anna , Roman Janika San , Jenkins Todd M. , Falcone Richard A. , Polites Stephanie 
Published: March 2024

BACKGROUND
The benefit of targeting high ratio fresh frozen plasma (FFP)/red blood cell (RBC) transfusion in pediatric trauma resuscitation is unclear as existing studies are limited to patients who retrospectively met criteria for massive transfusion. The purpose of this study is to evaluate the use of high ratio FFP/RBC transfusion and the association with outcomes in children presenting in shock.

METHODS
A post hoc analysis of a 24-institution prospective observational study (April 2018 to September 2019) of injured children younger than 18 years with elevated age-adjusted shock index was performed. Patients transfused within 24 hours were stratified into cohorts of low (<1:2) or high (≥1:2) ratio FFP/RBC. Nonparametric Kruskal-Wallis and χ2 were used to compare characteristics and mortality. Competing risks analysis was used to compare extended (≥75th percentile) ventilator, intensive care, and hospital days while accounting for early deaths.

RESULTS
Of 135 children with median (interquartile range) age 10 (5–14) years and weight 40 (20–64) kg, 85 (63%) received low ratio transfusion and 50 (37%) high ratio despite similar activation of institutional massive transfusion protocols (low–38%, high–46%, p = 0.34). Most patients sustained blunt injuries (70%). Median injury severity score was greater in high ratio patients (low–25, high–33, p = 0.01); however, hospital mortality was similar (low–24%, high–20%, p = 0.65) as was the risk of extended ventilator, intensive care unit, and hospital days (all p > 0.05).

CONCLUSION
Despite increased injury severity, patients who received a high ratio of FFP/RBC had comparable rates of mortality. These data suggest high ratio FFP/RBC resuscitation is not associated with worst outcomes in children who present in shock. Massive transfusion protocol activation was not associated with receipt of high ratio transfusion, suggesting variability in MTP between centers.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
A new lexicon in the age of microbiome research
Authors: Bosch Thomas C. G. , Blaser Martin J. , Ruby Edward , McFall-Ngai Margaret 
Published: March 2024

At a rapid pace, biologists are learning the many ways in which resident microbes influence, and sometimes even control, their hosts to shape both health and disease. Understanding the biochemistry behind these interactions promises to reveal completely novel and targeted ways of counteracting disease processes. However, in our protocols and publications, we continue to describe these new results using a language that originated in a completely different context. This language developed when microbial interactions with hosts were perceived to be primarily pathogenic, as threats that had to be vanquished. Biomedicine had one dominating thought: winning this war against microorganisms. Today, we know that beyond their defensive roles, host tissues, especially epithelia, are vital to ensuring association with the normal microbiota, the communities of microbes that persistently live with the host. Thus, we need to adopt a language that better encompasses the newly appreciated importance of host-microbiota associations. We also need a language that frames the onset and progression of pathogenic conditions within the context of the normal microbiota. Such a reimagined lexicon should make it clear, from the very nature of its words, that microorganisms are primarily vital to our health, and only more rarely the cause of disease.This article is part of the theme issue ‘Sculpting the microbiome: how host factors determine and respond to microbial colonization’.
How infection-triggered pathobionts influence virulence evolution
Authors: Franz Mathias , Regoes Roland R. , Rolff Jens 
Published: March 2024

Host–pathogen interactions can be influenced by the host microbiota, as the microbiota can facilitate or prevent pathogen infections. In addition, members of the microbiota can become virulent. Such pathobionts can cause co-infections when a pathogen infection alters the host immune system and triggers dysbiosis. Here we performed a theoretical investigation of how pathobiont co-infections affect the evolution of pathogen virulence. We explored the possibility that the likelihood of pathobiont co-infection depends on the evolving virulence of the pathogen. We found that, in contrast to the expectation from classical theory, increased virulence is not always selected for. For an increasing likelihood of co-infection with increasing pathogen virulence, we found scenario-specific selection for either increased or decreased virulence. Evolutionary changes, however, in pathogen virulence do not always translate into similar changes in combined virulence of the pathogen and the pathobiont. Only in one of the scenarios where pathobiont co-infection is triggered above a specific virulence level we found a reduction in combined virulence. This was not the case when the probability of pathobiont co-infection linearly increased with pathogen virulence. Taken together, our study draws attention to the possibility that host–microbiota interactions can be both the driver and the target of pathogen evolution.
This article is part of the theme issue ‘Sculpting the microbiome: how host factors determine and respond to microbial colonization’.
Evolutionary immunology to explore original antiviral strategies
Authors: Imler Jean-Luc , Cai Hua , Meignin Carine , Martins Nelson 
Published: March 2024

Over the past 25 years, the field of evolutionary developmental biology (evo–devo) has used genomics and genetics to gain insight on the developmental mechanisms underlying the evolution of morphological diversity of animals. Evo–devo exploits the key insight that conserved toolkits of development (e.g.Hoxgenes) are used in animals to produce genetic novelties that provide adaptation to a new environment. Like development, immunity is forged by interactions with the environment, namely the microbial world. Yet, when it comes to the study of immune defence mechanisms in invertebrates, interest primarily focuses on evolutionarily conserved molecules also present in humans. Here, focusing on antiviral immunity, we argue that immune genes not conserved in humans represent an unexplored resource for the discovery of new antiviral strategies. We review recent findings on the cGAS-STING pathway and explain how cyclic dinucleotides produced by cGAS-like receptors may be used to investigate the portfolio of antiviral genes in a broad range of species. This will set the stage for evo–immuno approaches, exploiting the investment in antiviral defences made by metazoans over hundreds of millions of years of evolution.This article is part of the theme issue ‘Sculpting the microbiome: how host factors determine and respond to microbial colonization’.
Racial and Ethnic Disparities in Clinical Outcomes among Patients with Takotsubo Syndrome; A Nation-Wide Analysis
Authors: Perry Jamal Christopher , Akinti Oluwasegun Matthew , Eneh Chukwuka , Aiwuyo Henry Osarumme , Poluyi Charles , Emmanuel Ukenenye , Doudu Esther , Becerra Henry Alberto , Ozbay Mustafa Bilal , Peterkin Kibwey Roderick , Thachil Rosy , Khan Abdullah 
Published: March 2024

AbstractBackgroundTakotsubo syndrome (TTS), a stress-induced transient left ventricular dysfunction, remains poorly understood, with an estimated incidence of 1-2% among acute coronary syndrome cases. This study investigates racial and ethnic disparities in hospital outcomes and clinical characteristics of TTS.MethodsWe conducted a retrospective cohort study using the National Inpatient Sample data from 2016 to 2020, identifying TTS cases through validated ICD-10 codes. Statistical analysis was performed using Stata 18, with logistic regression models adjusting for confounders to identify disparities in outcomes.ResultsThe study included 32,785 TTS hospitalizations; the majority were White (80.5%), followed by Black (6.7%) and Hispanic (5.8%) patients. Minority groups, mainly Black and Hispanic patients, were younger (average age 63) and predominantly from lower-income brackets, while paradoxical Asians had the highest income bracket. Notable findings include Black patients showed the highest rate of stroke (4.8%, OR 2.1, p = 0.003). The rate of cardiogenic shock was highest among Asians (11%, OR 2, p < 0.001). Mortality rates were elevated in Black (2%, OR 1.5, p < 0.001) and Asian populations (1.8%, OR 1.97, p < 0.001).ConclusionSignificant racial and ethnic disparities exist in TTS outcomes, with minority groups having more in-hospital outcomes. These findings highlight the urgent need for targeted interventions and further research to reduce healthcare inequities in TTS management.
Forelimb movements contribute to hindlimb cutaneous reflexes during locomotion in cats
Authors: Harnie Jonathan , Al Arab Rasha , Mari Stephen , Yassine Sirine , Eddaoui Oussama , Jéhannin Pierre , Audet Johannie , Lecomte Charly , Iorio-Morin Christian , Prilutsky Boris I. , Rybak Ilya A. , Frigon Alain 
Published: March 2024

ABSTRACTDuring quadrupedal locomotion, central circuits interacting with somatosensory feedback coordinate forelimb and hindlimb movements. How this is achieved is not clear. To determine if forelimb movements modulate hindlimb cutaneous reflexes involved in responding to an external perturbation, we stimulated the superficial peroneal nerve in six intact cats during quadrupedal locomotion and during hindlimb-only locomotion (with forelimbs standing on stationary platform) and in two spinal-transected cats during hindlimb-only locomotion. We compared cutaneous reflexes evoked in six ipsilateral and four contralateral hindlimb muscles. Results showed similar occurrence and phase-dependent modulation of short-latency inhibitory and excitatory responses during quadrupedal and hindlimb-only locomotion in intact cats. However, the depth of modulation was reduced in the ipsilateral semitendinosus during hindlimb-only locomotion. Additionally, longer-latency responses occurred less frequently in extensor muscles bilaterally during hindlimb-only locomotion while short-latency inhibitory and longer-latency excitatory responses occurred more frequently in the ipsilateral and contralateral sartorius anterior, respectively. After spinal transection, short-latency inhibitory and excitatory responses were similar to both intact conditions, while mid- or longer-excitatory responses were reduced or abolished. Our results suggest that the absence of forelimb movements suppresses inputs from supraspinal structures and/or cervical cord that normally contribute to longer-latency reflex responses in hindlimb extensor muscles.NEW & NOTEWORTHYDuring quadrupedal locomotion, the coordination of forelimb and hindlimb movements involves central circuits and somatosensory feedback. To demonstrate how forelimb movement affects hindlimb cutaneous reflexes during locomotion, we stimulated the superficial peroneal nerve in intact cats during quadrupedal and hindlimb-only locomotion, as well as in spinal-transected cats during hindlimb-only locomotion. We show that forelimb movement influences the modulation of hindlimb cutaneous reflexes, particularly the occurrence of long-latency reflex responses.
DimericR25CPTH(1-34) Activates the Parathyroid Hormone-1 Receptorin vitroand Stimulates Bone Formation in Osteoporotic Female Mice
Authors: Noh Minsoo , Che Xiangguo , Jin Xian , Lee Dong-Kyo , Kim Hyun-Ju , Park Doo Ri , Lee Soo Young , Lee Hunsang , Gardella Thomas , Choi Je-Yong , Lee Sihoon 
Published: March 2024

AbstractOsteoporosis, characterized by reduced bone density and strength, increases fracture risk, pain, and limits mobility. Established therapies of Parathyroid hormone (PTH) analogs effectively promote bone formation and reduce fractures in severe osteoporosis, but their use is limited by potential adverse effects. In the pursuit of safer osteoporosis treatments, we investigatedR25CPTH, a PTH variant wherein the native arginine at position 25 is substituted by cysteine. These studies were prompted by our finding of high bone mineral density in a hypoparathyroidism patient with the R25C homozygous mutation, and we explored its effects on PTH type-1 receptor (PTH1R) signaling in cells and bone metabolism in mice. Our findings indicate thatR25CPTH(1-84) forms dimers both intracellularly and extracellularly, and the synthetic dimeric peptide,R25CPTH(1-34), exhibits altered activity in PTH1R-mediated cAMP response. Upon a single injection in mice, dimericR25CPTH(1-34) induced acute calcemic and phosphaturic responses comparable to PTH(1-34). Furthermore, repeated daily injections increased calvarial bone thickness in intact mice and improved trabecular and cortical bone parameters in ovariectomized (OVX) mice, akin to PTH(1-34). The overall results reveal a capacity of a dimeric PTH peptide ligand to activate the PTH1Rin vitroandin vivoas PTH, suggesting a potential path of therapeutic PTH analog development.
Isolate-anchored comparisons reveal evolutionary and functional differentiation across SAR86 marine bacteria
Authors: Ramfelt Oscar , Freel Kelle C. , Tucker Sarah J. , Nigro Olivia D. , Rappé Michael S. 
Published: March 2024

AbstractSAR86 is one of the most abundant groups of bacteria in the global surface ocean. However, since its discovery over 30 years ago, it has remained recalcitrant to isolation and many details regarding this group are still unknown. Here we report the cellular characteristics from the first SAR86 isolate brought into culture,CandidatusMagnimaribacter mokuoloeensis strain HIMB1674, and use its closed genome in concert with over 700 environmental genomes to assess the phylogenomic and functional characteristics of this order-level lineage of marine Gammaproteobacteria. The Magnimaribacterales invest significant genomic resources into the capacity for β-oxidation, which is present in most genomes in high gene copy numbers. This cyclical set of reactions is fed by components of cell membranes that includes lipids such as phosphatidylcholine, phosphatidylethanolamine, glycolipids, and sulfolipids. In addition to the widespread capacity to degrade the side chain of steroidal compounds via β-oxidation, several SAR86 sublineages also appear able to fully degrade the steroid polycyclic ring structure as well as other aromatic, polycyclic, and heterocyclic molecules. Read recruitment from publicly available metagenomes reveals that the Magnimaribacterales compose up to 6% of the global surface ocean microbial community. Only a subset of genera drive these high relative abundances, with some more globally dominant and others restricted to specific oceanic regions.CandidatusMagnimaribacter mokuoloeensis provides an unprecedented foundation through which to understand this highly abundant yet poorly understood lineage of marine bacteria, and charts a path to bring more representatives of this order into laboratory culture.
Causal evidence for increased theta and gamma phase consistency in a parieto-frontal network during the maintenance of visual attention
Authors: Bradley Claire , McCann Emily , Nydam Abbey S , Dux Paul , Mattingley Jason B 
Published: March 2024

AbstractEndogenous visuo-spatial attention is under the control of a fronto-parietal network of brain regions. One key node in this network, the intra-parietal sulcus (IPS), plays a crucial role in maintaining endogenous attention, but little is known about its ongoing physiology and network dynamics during different attentional states. Here, we investigated the reactivity of the left IPS in response to brain stimulation under different states of selective attention. We recorded electroencephalography (EEG) in response to single pulses of transcranial magnetic stimulation (TMS) of the IPS, while participants (N=44) viewed bilateral random-dot motion displays. Individual MRI-guided TMS pulses targeted the left IPS, while the left primary somatosensory cortex (S1) served as an active control site. In separate blocks of trials, participants were cued to attend covertly to the motion display in one hemifield (left or right) and to report brief coherent motion targets. The perceptual load of the task was manipulated by varying the degree of motion coherence of the targets. Excitability, variability and information content of the neural responses to TMS were assessed by analysing TMS-evoked potential (TEP) amplitude and inter-trial phase clustering (ITPC), and by performing multivariate decoding of attentional state. Results revealed that a left posterior region displayed reduced variability in the phase of theta and gamma oscillations following TMS of the IPS, but not of S1, when attention was directed contralaterally, rather than ipsilaterally to the stimulation site. Under these same conditions, a right frontal cluster also displayed reduced theta variability and increased amplitude of TEPs after TMS of the IPS but not S1. Reliable decoding of attentional state was achieved after TMS pulses of both S1 and IPS. Taken together, our findings suggest that endogenous control of visuo-spatial attention leads to changes in the intrinsic oscillatory properties of the IPS and its associated fronto-parietal network.
Representing the dynamics of natural marmoset vocal behaviors in frontal cortex
Authors: Li Jingwen , Aoi Mikio C. , Miller Cory T. 
Published: March 2024

SummaryHere we tested the respective contributions of primate premotor and prefrontal cortex to support vocal behavior. We applied a model-based GLM analysis that better accounts for the inherent variance in natural, continuous behaviors to characterize the activity of neurons throughout frontal cortex as freely-moving marmosets engaged in conversational exchanges. While analyses revealed functional clusters of neural activity related to the different processes involved in the vocal behavior, these clusters did not map to subfields of prefrontal or premotor cortex, as has been observed in more conventional task-based paradigms. Our results suggest a distributed functional organization for the myriad neural mechanisms underlying natural social interactions and has implications for our concepts of the role that frontal cortex plays in governing ethological behaviors in primates.