bluuebunny/crossref_metadata_2025_split huggingface dataset:
Noninvasive serum markers for predicting significant liver histopathology in HBeAg-negative chronic HBV-infected patients with normal alanine aminotransferase
Authors: Gao Yuhua , Wang Mingyang , Liu Xia’nan 
Published: March 2024

ABSTRACT

This study is to explore the proportion of significant liver histopathology in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV)-infected patients with normal alanine aminotransferase (ALT) and investigate noninvasive indicators for predicting significant liver histopathology. A total of 201 HBeAg-negative chronic HBV-infected patients with normal ALT who underwent liver biopsy were involved in this study. Significant liver histological changes were defined as necroinflammation grade ≥2 (G ≥ 2) and/or fibrosis stage ≥2 (S ≥ 2). The results showed that 42.3% (85/201) and 45.8% (92/201) of the HBeAg-negative patients with normal ALT have significant liver necroinflammation (G ≥ 2) and fibrosis (S ≥ 2), respectively. High normal ALT (>22 U/L), high level of serum HBV DNA (>3.42 log IU/mL), and low level of prealbumin (PA) (<170 mg/L) were independent predictors for significant liver necroinflammation, and the predictive value of the combined indicators was 0.750 (
P
< 0.001), while high normal ALT (>24 U/L) and high level of FIB-4 (>1.53) were independent predictors for significant liver fibrosis, and the predictive value of the combined indicators was 0.740 (
P
< 0.001). In conclusion, more than 40% of HBeAg-negative patients with normal ALT have significant liver histopathology and require immediate antiviral treatment. ALT, PA, HBV DNA, and FIB-4 can independently predict significant liver inflammation and fibrosis for HBeAg-negative patients with normal ALT. Lowering the treatment threshold of ALT may benefit the HBeAg-negative chronic HBV-infected patients.

IMPORTANCE
Hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV)-infected patients with normal alanine aminotransferase (ALT) were supposed to have a low risk of progression to cirrhosis or hepatocellular carcinoma, and it was recommended to regularly follow up or undergo liver biopsy to assess liver histopathology according to the major international guidelines. However, this study indicates that a considerable number of HBeAg-negative chronic HBV-infected patients with normal ALT have significant liver histopathology and require immediate antiviral treatment. Besides, several clinical commonly used noninvasive indicators were found that can be used to predict significant liver histopathology; thereby liver biopsy might be avoided for HBeAg-negative chronic HBV-infected patients with normal ALT.
The timing of bacterial mesophyll infection shapes the leaf chemical landscape
Authors: Roman-Reyna Veronica , Heiden Nathaniel , Butchacas Jules , Toth Hannah , Cooperstone Jessica L. , Jacobs Jonathan M. 
Published: March 2024

ABSTRACT

Chemistry in eukaryotic intercellular spaces is shaped by both hosts and symbiotic microorganisms such as bacteria. Pathogenic microorganisms like barley-associated
Xanthomonas translucens
(Xt) swiftly overtake the inner leaf tissue becoming the dominant microbial community member during disease development. The dynamic metabolic changes due to Xt pathogenesis in the mesophyll spaces remain unknown. Genomic group I of Xt consists of two barley-infecting lineages: pathovar translucens (Xtt) and pathovar undulosa (Xtu). Xtu and Xtt, although genomically distinct, cause similar water-soaked lesions. To define the metabolic signals associated with inner leaf colonization, we used untargeted metabolomics to characterize Xtu and Xtt metabolism signatures associated with mesophyll growth. We found that mesophyll apoplast fluid from infected tissue yielded a distinct metabolic profile and shift from catabolic to anabolic processes over time compared to water-infiltrated control. The pathways with the most differentially expressed metabolites by time were glycolysis, tricarboxylic acid cycle, sucrose metabolism, pentose interconversion, amino acids, galactose, and purine metabolism. Hierarchical clustering and principal component analysis showed that metabolic changes were more affected by the time point rather than the individual colonization of the inner leaves by Xtt compared to Xtu. Overall, in this study, we identified metabolic pathways that explain carbon and nitrogen usage during host–bacterial interactions over time for mesophyll tissue colonization. This foundational research provides initial insights into shared metabolic strategies of inner leaf colonization niche occupation by related but phylogenetically distinct phyllosphere bacteria.

IMPORTANCE

The phyllosphere is a habitat for microorganisms including pathogenic bacteria. Metabolic shifts in the inner leaf spaces for most plant–microbe interactions are unknown, especially for
Xanthomonas
species in understudied plants like barley (
Hordeum vulgare
).
Xanthomonas translucens
pv. translucens (Xtt) and
Xanthomonas translucens
pv. undulosa (Xtu) are phylogenomically distinct, but both colonize barley leaves for pathogenesis. In this study, we used untargeted metabolomics to shed light on Xtu and Xtt metabolic signatures. Our findings revealed a dynamic metabolic landscape that changes over time, rather than exhibiting a pattern associated with individual pathovars. These results provide initial insights into the metabolic mechanisms of
X. translucens
inner leaf pathogenesis.
Magnetite-apatite ores record widespread involvement of molten salts
Authors: Xu Xinyue , Bain Wyatt M. , Tornos Fernando , Hanchar John M. , Lamadrid Hector M. , Lehmann Bernd , Xu Xiaochun , Steadman Jeffrey A. , Bottrill Ralph S. , Soleymani Majid , Rajabi Abdorrahman , Li Peng , Tan Xuehai , Xu Shihong , Locock Andrew J. , Steele-MacInnis Matthew 
Published: March 2024

Abstract
The origins of magnetite-apatite deposits are controversial, and the crux of the debate is what types of fluids form these rocks. We present evidence from 20 magnetite-apatite deposits worldwide showing ubiquitous involvement of molten salts. The studied deposits are distributed globally, from various tectonic settings, and from Precambrian to Quaternary in age. In every case, water-poor polycrystalline melt inclusions in ore-stage minerals are dominated by sulfate, chloride, and carbonate components plus variable proportions of calc-silicates, phosphates, and iron ± titanium oxides that re-melt between 285 °C and 1100 °C. These fluids are very different from what is generally expected in most geologic settings, but their ubiquitous presence in magnetite-apatite rocks indicates that molten salts are widespread and essential to the formation of these deposits.
Strong seismic anisotropy due to upwelling flow at the root of the Yellowstone mantle plume
Authors: Wolf Jonathan , Li Mingming , Haws Anne A. , Long Maureen D. 
Published: March 2024

Abstract
The Yellowstone region (western United States) is a commonly cited example of intraplate volcanism whose origin has been a topic of debate for several decades. Recent work has suggested that a deep mantle plume, rooted beneath southern California, is the source of Yellowstone volcanism. Seismic anisotropy, which typically results from deformation, can be used to identify and characterize mantle flow. Here, we show that the proposed plume root location at the base of the mantle is strongly seismically anisotropic. This finding is complemented by geodynamic modeling results showing upwelling flow and high strains in the lowermost mantle beneath the Yellowstone region. Our results support the idea that the Yellowstone volcanism is caused by a plume rooted in the deepest mantle beneath southern California, connecting dynamics in the deepest mantle with phenomena at Earth's surface.
Prognostic implications of T stage in different pathological types of colorectal cancer: an observational study using SEER population-based data
Authors: Yao Nan , Li Wenqiang , Wang Jiwei , Chu Hongyuan , Duan Ning , Niu Xinyu , Yu Guoyong , Qu Jun 
Published: March 2024

ObjectivesColorectal cancer (CRC) encompasses a spectrum of pathological types, each exhibiting distinct biological behaviours that challenge the conventional T-staging system’s predictive efficiency. Thus, this study aims to explore the prognostic significance of the T stage across various CRC pathological types, seeking to unravel insights that could enhance prognostic assessment in this complex disease.Study designWe performed a retrospective analysis using the Surveillance, Epidemiology, and End Results (SEER) database for primary CRC cases from 2010 to 2017.SettingThe SEER database, comprising data from various US regional and state cancer registries, identified 39 321 patients with CRC. Our analysis focused on the three most common CRC pathological types: adenocarcinoma (AC), mucinous adenocarcinoma (MC) and signet ring cell carcinoma (SR).Primary outcome measuresThe study used Cox regression models to evaluate how different pathological characteristics impact mortality risk in patients with CRC. Time-dependent receiver operating characteristic curves were also applied to assess the prognostic accuracy of various tumour node metastasis (TNM)/non-mucinous (NM) stages.ResultsWe observed significant associations between T stage and mortality risk for patients with AC and MC. Notably, in comparison to those at T1 stage, patients with AC in the T4 stage demonstrated a 2.01-fold increase in mortality risk (HR=2.01, 95% CI: 1.89 to 2.15), while patients with MC at T4 stage showed a 1.42-fold increase (HR=1.42, 95% CI: 1.03 to 1.97). However, within the SR group, T stages did not independently impact survival, showing no significant distinction (HR=1.07, 95% CI: 0.59 to 1.95). Intriguingly, the traditional TNM staging systems demonstrated limited discriminatory power in predicting prognosis for patients with SR when compared with the more innovative NM staging systems.ConclusionsThis study uncovers important insights about the prognostic significance of the T stage in different types of CRC, highlighting the need for personalised assessments based on specific histological subtypes.
Prospective study examining the impact of cerebral angiography on quantitative pupillometer values in the interventional radiology suite
Authors: Nguyen Brian , Marshall Jade L , Rana Chahat , Atem Folefac D , Stutzman Sonja E , Olson DaiWai M , Aiyagari Venkatesh , Ray Bappaditya 
Published: March 2024

ObjectivesThe purpose of this pilot study was to obtain baseline quantitative pupillometry (QP) measurements before and after catheter-directed cerebral angiography (DCA) to explore the hypothesis that cerebral angiography is an independent predictor of change in pupillary light reflex (PLR) metrics.DesignThis was a prospective, observational pilot study of PLR assessments obtained using QP 30 min before and after DCA. All patients had QP measurements performed with the NPi-300 (Neuroptics) pupillometer.SettingRecruitment was done at a single-centre, tertiary-care academic hospital and comprehensive stroke centre in Dallas, Texas.ParticipantsFifty participants were recruited undergoing elective or emergent angiography. Inclusion criteria were a physician-ordered interventional neuroradiological procedure, at least 18 years of age, no contraindications to PLR assessment with QP, and nursing transport to and from DCA. Patients with a history of eye surgery were excluded.Main outcome measuresDifference in PLR metric obtained from QP 30 min before and after DCA.ResultsStatistically significant difference was noted in the pre and post left eye readings for the minimum pupil size (a.k.a., pupil diameter on maximum constriction). The mean maximum constriction diameter prior to angiogram of 3.2 (1.1) mm was statistically larger than after angiogram (2.9 (1.0) mm; p<0.05); however, this was not considered clinically significant. Comparisons for all other PLR metrics pre and post angiogram demonstrated no significant difference. Using change in NPi pre and post angiogram (Δpre=0.05 (0.77) vs Δpost=0.08 (0.67); p=0.62), we calculated the effect size as 0.042. Hence, detecting a statistically significant difference in NPi, if a difference exists, would require a sample size of ~6000 patients.ConclusionsOur study provides supportive data that in an uncomplicated angiogram, even with intervention, there is no effect on the PLR.
Using feedback on patient health outcomes to improve orthopaedic physical therapist practice: a quality improvement study
Authors: van der Wees Philip J , Balog Emily J , Irrgang James J , Zeleznik Hallie , McDonald Paige L , Harwood Kenneth J 
Published: March 2024

ObjectiveMeasuring health outcomes plays an important role in patient-centred healthcare. When aggregated across patients, outcomes can provide data for quality improvement (QI). However, most physical therapists are not familiar with QI methods based on patient outcomes. This mixed-methods study aimed to develop and evaluate a QI programme in outpatient physical therapy care based on routinely collected health outcomes of patients with low-back pain and neck pain.MethodsThe QI programme was conducted by three teams of 5–6 physical therapists from outpatient settings. Plan-do-study-act cycles were used based on team-selected goals. Monthly feedback reports of process and outcomes of care, including pre–post treatment changes in Oswestry Disability Index (ODI) and Neck Disability Index (NDI), guided the QI efforts. Primary outcomes were pre-QI and post-QI changes in knowledge and attitudes towards outcome measures through a survey, and administered and self-reported compliance with using the ODI and NDI. Semistructured interviews and a focus group were conducted to evaluate the perceived value of the programme.ResultsPost-QI, the survey showed improvements in two items related to the role of patients and implementation of outcome measures. Registered pre-QI and post-QI completion rates were high at intake (ODI:91% pre, 88% post; NDI:75% pre, 84% post), while completion rates at discharge improved post-QI (ODI:14% pre, 66% post; NDI: 32% pre, 50% post). Perceived benefits of the QI programme included clinician and institutional accountability to processes and strategies aimed at continuous improvement in patient care. An important facilitator for programme participation was autonomy in project selection and development, while a main barrier was the time required to set up the QI project.ConclusionA QI programme based on the feedback of routinely collected health outcomes of patients with low back pain and neck pain was feasible and well accepted by three pilot teams of physical therapists.
AMU patient list generation: from junior scribe to junior doctor
Authors: Ravat Zahra , Sinha Amil , Jellinek Alistair , Page Nigel 
Published: March 2024

This quality improvement project (QIP) aimed to assess the impact of automating patient list generation on the acute medical unit (AMU) at Sandwell and West Birmingham Hospitals NHS Trust. The AMU patient list categorises patients requiring ‘clerking’, ‘post-take’ (PTWR) and ‘post-post-take’ (PPTWR) for the morning ward round. During weekdays, this list need only include the patients in AMU. For weekends, this list must include ‘outliers’, that is, patients transferred to different wards (which may lack resident medical teams over the weekends) but still requiring PTWR/PPTWR. The list is created by the junior doctor on their night shift, a daily necessity due to the high AMU patient turnover.A pilot study, followed by three complete ‘plan-do-study-act’ (PDSA) cycles, was conducted over 2021/2022. Cycle 1 (pre-intervention) and cycle 2 (post-intervention) assessed the impact of the generator on weekdays. This was adapted for the weekend over cycles 2 and 3. The process measure assessed was the time taken for list generation. The outcome measure was the total number of patients clerked per night. The balancing measure was doctors’ attitudes.The intervention reduced the time taken for list generation by an average of 44.3 min (66.3%) during weekdays and 37.8 min (42%) during weekends. Run charts demonstrated significance for the reduction in weekday list generation time. Both weekdays (63.5% decrease, p<0.00001) and weekends (50.5% decrease, p=0.0007) had significant reductions in total negative attitudes. Both weekdays and weekends had ‘time-consuming’ as the most frequently selected attitude pre-intervention, whereas ‘easy to make’ was most frequently selected post-intervention. Some junior doctors reported the generator enabled clerking of extra patients, supported by non-significant increases in the averages for this outcome.This QIP demonstrates how the automation of labour-intensive administrative tasks results in notable time-saving outcomes. Thereby improving doctor attitudes and well-being, and facilitating the delivery of quality patient care.
Socioecological and biological associations of lower levels of physical
activity in 8-year-old children: a 2-year prospective study
Authors: Lahti Amanda , Rosengren Björn E , Dencker Magnus , Nilsson Jan-Åke , Karlsson Magnus K 
Published: March 2024

Objectives
Evaluate if socioecological and biological factors, at the age of
8 years, are associated with lower level of physical activity (PA)
2 years later.

Method
In a study cohort of 199 children aged 7.8±0.6 years, we used
questionnaires and physical measurements to evaluate biological (eg,
sex), social (eg, parental PA) and environmental (eg, school settings)
factors. Objective PA was measured 2 years later with accelerometers.
General PA (GPA) was defined as mean counts per minute (cpm) and
moderate to vigorous PA (MVPA) as min/day >3500 cpm. We used analysis
of covariance to evaluate if socioecological factors at age 8 are
associated with level of PA 2 years later.

Results
Daily GPA was 690.5±216.6 cpm and the children spent 40.9±18.3 min
on MVPA. Female sex is associated with −131.1 (−183.4, –78.7) cpm GPA,
each 10 cm shorter body height with −48.7 (−94.8, –26.5), each unit
higher body mass index (BMI) with −26.0 (−37.5, –14.5) and allocation to
60 min school PA/week with −73.8 (−131.5, –16.2) compared with
allocation to 200 min school PA/week. Female sex is associated with
−10.3 (−14.8, –5.7) min of MVPA and each unit higher BMI with −1.9
(−2.9, –0.9) min.

Conclusion
Female sex, shorter body height and higher BMI are at age 8 years
associated with lower level of PA 2 years later. It appears possible to
increase PA by daily school PA.

Trial registration number
NCT00633828.
Foregrounding pain in self-managed early medication abortion: a qualitative study
Authors: Purcell Carrie , Newton Victoria Louise , Bloomer Fiona , Hoggart Lesley 
Published: March 2024

ObjectiveTo explore experiences of pain in the context of early medical abortion (EMA) in the UK and to guide best practice around anticipatory guidance on pain.MethodsFrom late 2020 to early 2021, we recruited individuals from across the UK who had undergone abortion during the COVID-19 pandemic to participate in in-depth, semi-structured telephone interviews. A storytelling approach was used and data were analysed thematically using NVivo 12 software.ResultsFocused coding and thematic analysis addressed accounts of pain, which were prominent in many interviews. We constructed the following subthemes: expected pain is manageable for some; the problem with unexpected pain; pain (co)produces fear; and problematising ‘period-like pain’. The key issue which our analysis draws out is that while EMA pain experience might vary, for some it may be much worse than anticipated. Moreover, the common trope of likening it to ‘period pain’ can be misleading and a source of additional uncertainty at a potentially already challenging time.ConclusionsFor some individuals, pain experienced in EMA will be severe and/or worse than expected. Insufficient preparation for pain can result in extremely negative experiences of EMA. Alongside development of improved analgesia, improvements should be made to anticipatory guidance on pain, particularly for those self-manging EMA at home. Framings of ‘period-like pain’ do not clarify expectations and should be avoided.
Firearm access, carriage and use in an ethnically diverse sample of young adults in Texas, USA
Authors: Lu Yu , Baumler Elizabeth , DeMello Annalyn Saludares , Wood Leila , McGuire Hillary , Temple Jeff R. 
Published: March 2024

BackgroundDespite the high rates of firearm ownership and firearm-related injuries and mortalities in Southern US states, understandings on the factors contributing to these are lacking.MethodsUsing wave 10 (2021) data from a longitudinal study, we examined firearm-related experiences among 636 ethnically diverse young adults (mean age=26 years; 62% female) in Texas, USA.ResultsJust over half of participants had ready access to firearms, with 22.3% having carried a firearm outside of their home, 4.9% having been threatened with a firearm by a romantic partner and 4.4% by a non-romantic partner. More firearm access and carriage were reported in males, white participants and those with >US$50 000 income. More females than males had been threatened with a firearm by a romantic partner, but more males than females had been threatened by a non-partner. Participants with recent financial difficulties were proportionally more likely to be threatened with a firearm than those without difficulties.ConclusionFindings emphasise the alarming rate of firearm access and carriage in Texas and highlight the disparities in firearms experiences by sociodemographic characteristics.
Impact of screening participation on modelled mortality benefits of a multi-cancer early detection test by socioeconomic group in England
Authors: Smittenaar Rebecca , Quaife Samantha L , von Wagner Christian , Higgins Thomas , Hubbell Earl , Lee Lennard 
Published: March 2024

BackgroundCancer burden is higher and cancer screening participation is lower among individuals living in more socioeconomically deprived areas of England, contributing to worse health outcomes and shorter life expectancy. Owing to higher multi-cancer early detection (MCED) test sensitivity for poor-prognosis cancers and greater cancer burden in groups experiencing greater deprivation, MCED screening programmes may have greater relative benefits in these groups. We modelled potential differential benefits of MCED screening between deprivation groups in England at different levels of screening participation.MethodsWe applied the interception multi-cancer screening model to cancer incidence and survival data made available by the National Cancer Registration and Analysis Service in England to estimate reductions in late-stage diagnoses and cancer mortality from an MCED screening programme by deprivation group across 24 cancer types. We assessed the impact of varying the proportion of people who participated in annual screening in each deprivation group on these estimates.ResultsThe modelled benefits of an MCED screening programme were substantial: reductions in late-stage diagnoses were 160 and 274 per 100 000 persons in the least and most deprived groups, respectively. Reductions in cancer mortality were 60 and 99 per 100 000 persons in the least and most deprived groups, respectively. Benefits were greatest in the most deprived group at every participation level and were attenuated with lower screening participation.ConclusionsFor the greatest possible population benefit and to decrease health inequalities, an MCED implementation strategy should focus on enhancing equitable, informed participation, enabling equal participation across all socioeconomic deprivation groups.Trial registration numberNCT05611632.