bluuebunny/crossref_metadata_2025_split huggingface dataset:
FISH probes and labeling techniques
Authors: Bray-Ward Patricia 
Published: November 2023

Abstract
A Fluor is a chemical moiety that, in response to absorption of a photon of energy provided by a light source with a suitable emission wavelength, develops an excited electron singlet state. This creates a transient conformational change and partial dissipation of the excitation energy. This is followed by emission of a photon of lower energy and therefore longer wavelength. Toe difference in energy or wavelength of excitation and emission is called the Stokes shift. This is a critical element in fluorescence imaging since detection systems must exclude wavelengths of light from the excitation source. Stokes shift can be affected by the physical characteristics of the fluor, for example covalent linkage to a protein, the polarity and hydrophobicity of the solvent, and the pH of the solution. Generally fluors with larger Stoke shifts are preferred since they allow filter sets to be used that have wider bandwidths to permit maximum capture sensitivity.
The WY Domain of an RxLr Effector Drives Interactions with a Host Target Phosphatase to Mimic Host Regulatory Proteins and Promote Phytophthora infestans Infection
Authors: Bentham Adam R. , Wang Wei , Trusch Franziska , Varden Freya A. , Birch Paul R. J. , Banfield Mark J. 
Published: November 2023

Plant pathogens manipulate the cellular environment of the host to facilitate infection and colonization that often lead to plant diseases. To accomplish this, many specialized pathogens secrete virulence proteins called effectors into the host cell, which subvert processes such as immune signaling, gene transcription, and host metabolism. Phytophthora infestans, the causative agent of potato late blight, employs an expanded repertoire of RxLR effectors with WY domains to manipulate the host through direct interaction with protein targets. However, our understanding of the molecular mechanisms underlying the interactions between WY effectors and their host targets remains limited. In this study, we performed a structural and biophysical characterization of the P. infestans WY effector Pi04314 in complex with the potato Protein Phosphatase 1-c (PP1c). We elucidate how Pi04314 uses a WY domain and a specialized C-terminal loop carrying a KVxF motif that interact with conserved surfaces on PP1c, known to be used by host regulatory proteins for guiding function. Through biophysical and in planta analyses, we demonstrate that Pi04314 WY or KVxF mutants lose their ability to bind PP1c. The loss of PP1c binding correlates with changes in PP1c nucleolar localization and a decrease in lesion size in plant infection assays. This study provides insights into the manipulation of plant hosts by pathogens, revealing how effectors exploit key regulatory interfaces in host proteins to modify their function and facilitate disease. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Early Prognostication of Critical Patients With Spinal Cord Injury
Authors: Fan Guoxin , Liu Huaqing , Yang Sheng , Luo Libo , Pang Mao , Liu Bin , Zhang Liangming , Han Lanqing , Rong Limin , Liao Xiang 
Published: November 2023

Study Design.
A retrospective case-series.

Objective.
The study aims to use machine learning to predict the discharge destination of spinal cord injury (SCI) patients in the intensive care unit.

Summary of Background Data.
Prognostication following SCI is vital, especially for critical patients who need intensive care.

Patients and Methods.
Clinical data of patients diagnosed with SCI were extracted from a publicly available intensive care unit database. The first recorded data of the included patients were used to develop a total of 98 machine learning classifiers, seeking to predict discharge destination (eg, death, further medical care, home, etc.). The microaverage area under the curve (AUC) was the main indicator to assess discrimination. The best average-AUC classifier and the best death-sensitivity classifier were integrated into an ensemble classifier. The discrimination of the ensemble classifier was compared with top death-sensitivity classifiers and top average-AUC classifiers. In addition, prediction consistency and clinical utility were also assessed.

Results.
A total of 1485 SCI patients were included. The ensemble classifier had a microaverage AUC of 0.851, which was only slightly inferior to the best average-AUC classifier (P=0.10). The best average-AUC classifier death sensitivity was much lower than that of the ensemble classifier. The ensemble classifier had a death sensitivity of 0.452, which was inferior to the top 8 death-sensitivity classifiers, whose microaverage AUC were inferior to the ensemble classifier (P<0.05). In addition, the ensemble classifier demonstrated a comparable Brier score and superior net benefit in the DCA when compared with the performance of the origin classifiers.

Conclusions.
The ensemble classifier shows an overall superior performance in predicting discharge destination, considering discrimination ability, prediction consistency, and clinical utility. This classifier system may aid in the clinical management of critical SCI patients in the early phase following injury.

Level of Evidence:
Level 3.
Three Cases of Catheter-related Bloodstream Infection Caused by Phialemonium curvata: A Case Report and Literature Review
Authors: Özen Seval , Karabiçak Nilgün , Uzuntaş Sema Turan , Kanik-Yüksek Saliha , Yildiz Selin , Güder Latife , Üçkardeş Fatih , Şahin Seda , Dinç Bedia , Özyörük Derya , Parlakay Asli Nur Özkaya , Bayhan Gülsüm İclal 
Published: November 2023

Background:
With recent developments in the field of microbiology, an increasing number of yeasts and molds with the potential to cause infections in humans are identified every year. In addition to the challenges in identifying clinical isolates, there is limited antifungal susceptibility data available for Phialemonium species, leading to uncertainty in optimal treatment recommendations.

Methods:
In this article, catheter-related bloodstream infections caused by Phialemonium curvata (previously Phialemonium curvatum) in 3 immunosuppressed patients are presented. Furthermore, the literature was reviewed to identify the clinical spectrum and treatment approaches for the reported infections.

Results:
The cases presented here were analyzed along with 24 cases reported in the literature. Among all cases, 21 (77.7%) patients had an underlying condition. Nine (33.3%) patients had hematologic/oncologic malignancies and solid organ transplants. Twenty-two (81.4%) patients had a history of device or invasive interventions. Surgical procedures, removal of contaminated devices or tissue were found to reduce the risk of death by 86.7%. Correspondence analysis revealed a significant association between antifungal treatment and outcome (P < 0.001). The correspondence analysis could explain 53.9% of this relationship. Monotherapy and combination therapy were associated with survival. While salvage treatment or no antifungal therapy was associated with mortality, intravitreal injection or topical application of voriconazole was associated with sequelae.

Conclusions:
Surgical intervention and removal of contaminated devices or tissue should be considered at an early stage.
Impact of Respiratory Bacterial Codetection on Outcomes in Ventilated Infants With Bronchiolitis
Authors: Akande Manzilat , Spencer Sandra P. , Moore-Clingenpeel Melissa , Jamieson Nathan , Karsies Todd 
Published: November 2023

Background:
Viral bronchiolitis is a common cause of acute respiratory failure requiring intubation for infants. Bacterial respiratory tract infections can occur with bronchiolitis, although their prevalence and impact on outcomes are unclear, especially with increased use of noninvasive respiratory support.

Methods:
This was a single-center retrospective cohort study of children <2 years old requiring intubation in the emergency department for bronchiolitis from 2012 to 2017 who had viral testing plus a lower respiratory culture obtained. We evaluated the impact of bacterial codetection (positive respiratory culture plus moderate or many polymorphonuclear neutrophils on Gram stain) on mechanical ventilation (MV) duration and intensive care unit length of stay using multivariable gamma regression.

Results:
Of 149 patients enrolled, 52% had bacterial codetection. In adjusted analysis, patients with codetection had shorter MV duration [adjusted relative risk (aRR) 0.819, 95% confidence interval (CI): 0.69–0.98; marginal mean duration of 5.31 days (4.71–5.99) compared to 6.48 days (5.72–7.35) without codetection]. Patients with codetection had a shorter intensive care unit stay [aRR 0.806 (0.69–0.94); marginal mean length of stay 6.9 days (6.21–7.68) vs. 8.57 days (7.68–9.56) without codetection]. The association between codetection and duration of ventilation appears confined to those receiving earlier antibiotics (less than the median time) rather than later antibiotics [aRR 0.738 (0.56–0.95) for earlier vs. aRR 0.92 (0.70–1.18) for later].

Conclusions:
Respiratory bacterial codetection is common and associated with shorter MV duration in infants requiring early intubation for bronchiolitis. Early antibiotics may contribute to these outcomes, but further multicenter studies are needed to understand the role of codetection and antibiotics on bronchiolitis outcomes.
Improvement in Epiphora Using TEARS Grading Following Surgical Treatment of Meibomian Gland Inversion in Patients With Facial Nerve Palsy
Authors: Yvon Camille , Malhotra Raman 
Published: November 2023

Purpose:
To assess epiphora outcomes using the TEARS grading score in patients with concomitant meibomian gland inversion (MGI) and facial nerve palsy (FNP) undergoing correction of MGI.

Methods:
Retrospective, 5-year, noncomparative, single-center study of patients with MGI and FNP, treated with MGI correction, under the supervision of a single surgeon. A validated “TEAR” score was used to assess changes in epiphora.

Results:
Ten patients with FNP, MGI, and epiphora were analyzed from a group of 160 patients with FNP who underwent MGI surgery between 2017 and 2022. The mean age at surgery was 50 years (range, 13–76 years). T, E, and A scores significantly improved (p < 0.05). Eighty percent of patients saw a reduction in tearing frequency (T), with 60% gaining ≥ 2-grade improvement. Improvements in clinical effects (E) and activity limitation (A) were seen in 80% of patients, with 40% and 50% gaining ≥ 2-grade improvement, respectively. R scores (related to reflex tearing) improved by 60%, with 40% seeing ≥ 2-grade improvement. Nine patients (90%) improved symptomatically with an average improvement “S” score of 65% over a mean follow-up period of 30 months. All patients demonstrated restoration of the normal anatomical position of the meibomian glands.

Conclusions:
MGI can cause epiphora in patients with FNP and may explain cases where symptoms persist despite standard surgical intervention. This study provides proof of concept that MGI correction can improve epiphora and that identifying MGI may be considered a critical step in the treatment algorithm for epiphora in patients with FNP.
Flammability of Ocular Surface Lubricants
Authors: Gupta Akash , Mudie Lucy I. , Yen Michael T. 
Published: November 2023

Purpose:
Surgical fires pose a substantial risk to patients and can cause significant injury, especially in oculofacial surgery. Ocular surface lubricants can potentially act as fuel for an operating room fire. We present an experimental analysis of the flammability of 9 commonly used ophthalmic lubricants under 4 ignition sources used in oculofacial surgery with and without supplemental oxygen.

Methods:
The flammability of 9 ophthalmic lubricants were tested under various operating room conditions. Each lubricant was exposed to 4 different ignition sources: an open flame lighter, monopolar cautery, bipolar cautery, and hand-held high temperature cautery, and the response of the lubricant was recorded. The testing was conducted both in room air and with 6 L/minute of 100% oxygen directed at the lubricant through a nasal cannula. Any reaction in which there was ignition, sparking, smoking, or a transient or permanent change in appearance of the lubricant was deemed notable.

Results:
Of the 9 lubricants tested, 4 displayed a reaction to the ignition source. Without supplemental oxygen, 100% petrolatum and neomycin-polysporin-bacitracin-hydrocortisone ointment produced some smoke when applied with the high temperature cautery. Notably, under both the conditions of no supplemental oxygen and with the addition of 6 L/minute of 100% oxygen, the carboxymethylcellulose drops and lidocaine jelly both conducted and sparked with the monopolar cautery leaving visible burn marks on the paper.

Conclusions:
The overall fire hazard posed by ocular surface lubricants is low. Some topical lubricants can conduct electricity from monopolar cautery, which could increase the risk of inadvertent electrical burns. Certain lubricants could potentially become a fuel source when used in combination with hand-held high temperature battery cautery. Bipolar cautery was not associated with either increased conductivity or flammability with any of the lubricants tested.
Barriers to Health Information Exchange Among Ambulatory Physicians: Results From a Nationally Representative Sample
Authors: Matthews Elizabeth B. , Stanhope Victoria , Hu Yuanyuan 
Published: November 2023

ABSTRACT

Purpose:
Health information exchange (HIE) improves healthcare quality, but is underutilized by providers. This study used a nationally representative survey of ambulatory physicians to examine barriers to HIE, and identify which barriers have the greatest impact on providers' use of HIE.

Methods:
A pooled sample of 1,292 physicians from the 2018–2019 National Electronic Health Record Survey was used. Univariate statistics described rates and patterns of eight common barriers to HIE. Multivariate logistic regression examined the relationship between each barrier and the use of HIE.

Results:
Barriers to HIE were common and diverse. Negative attitudes toward HIE's ability to improve clinical quality significantly decreased HIE use (OR = .44, p < .01).

Conclusions:
To increase adoption of HIE, efforts should focus on addressing providers' negative attitudes toward HIE. These findings can guide targeted implementation strategies to improve HIE adoption.
Gender Disparities in the Clinical Trials and Real-World Utilization of Systemic Therapy in the Management of Urothelial Carcinoma
Authors: Miyagi Hiroko , Bozorgmehri Shahab , Batra Nikhil V. , Chatzkel Jonathan A. , Ramnaraign Brian Hemendra , Hitchcock Kathryn , Zlotecki Robert A. , Brisbane Wayne , Crispen Paul L. , O'Malley Padraic 
Published: November 2023

Objectives:
The objectives of this study was (1) to examine the representation of women in clinical trials for systemic therapy in muscle-invasive (MIBC) or metastatic bladder cancer (BC) and (2) to determine the association between sex and systemic therapy in the treatment of MIBC or metastatic BC.

Methods:
A review of bladder cancer systemic therapy clinical trials cited by the National Comprehensive Cancer Network guidelines was performed. Proportions of women were compared with the corresponding proportions in the US population with bladder cancer between 1975 and 2018, based on the Surveillance, Epidemiology, and End Results database. We also used the National Cancer Database (NCDB) to identify 55,951 patients with American Joint Committee on Cancer clinical stage II, III, and IV bladder cancer between 2004 and 2015. We determined the predictors of systemic therapy for bladder cancer treatment using a multivariable logistic regression model.

Results:
26.9% of the US bladder cancer population were women; however, only 17.7% of participants in US clinical trials and 19.9% of participants in all clinical trials were female, indicating an absolute difference of 9.2% (95% confidence interval [CI]: 6.2%-12.1%; P < .001) and 7.0% (95% CI: 6.1%-7.9%; P < .001), respectively. Multivariable analysis of the NCDB showed that women had decreased odds of receiving systemic therapy compared with male patients with MIBC or metastatic BC (odds ratio: 0.93, 95% CI: 0.89-0.96; P < .001).

Conclusion:
Women are underrepresented in MIBC and/or metastatic BC systemic therapy clinical trials. In addition, women are less likely than men to receive systemic therapy for the treatment of MIBC or metastatic BC. Further research is needed to investigate the reasons for gender disparities in treatment of MIBC or metastatic BC as well as the participation in clinical trials.
Bone health: biology and nutrition
Authors: Rizzoli René , Chevalley Thierry 
Published: November 2023

Purpose of review
Recent findings in the influence of dietary patterns, dairy products, beverages and microbiota composition and function on bone health are reviewed and discussed.

Recent findings
Evidence is accumulating on the increased risk of fracture in individuals following a vegan diet. Meta-analysis of randomized controlled trials indicates a favourable, though of low amplitude, effect of dairy products on bone mass accrual during childhood and adolescence. Though mostly based on results from observational studies, it seems that dairy product consumption, particularly fermented dairy products, is associated with a lower risk of hip fracture. Regular green tea drinkers may have a lower fracture risk than tea abstainers. Magnesium intake is beneficial for bone health. Prune supplements prevents bone loss in untreated postmenopausal women. This seems to be associated with modification of gut microbiota.

Summary
This information should help the medical practitioners facing questions from their patients on how to protect bone health through nutrition.
Nivolumab/Relatlimab-rmbw: A Novel Dual Combination Therapy to Treat Adult and Pediatric Patients With Unresectable or Metastatic Melanoma
Authors: Thomas Baily , Burns Madison , Pervanas Helen , Ciurescu Daniel , Dima Lorena 
Published: November 2023

Background:
Immune checkpoint inhibitors control effector mechanisms and work to restore downregulated T-cells in patients with melanoma. Examples of such include programmed death-1 inhibitors and lymphocyte-activating gene 3 inhibitors. The combination of nivolumab, a programmed death-1 inhibitor, and relatlimab-rmbw, a lymphocyte-activating gene 3 inhibitor, has shown antitumor activity and improved progression-free survival in patients with unresectable or metastatic melanoma.

Mechanism of Action & Pharmacokinetics/Pharmacodynamics:
The fixed-dose combination of nivolumab and relatlimab immunotherapy is approved for adults and pediatrics 12 years of age or older with metastatic or unresectable melanoma. Volume of distribution is 6.6 L for relatlimab and nivolumab, and half-life is 27 and 26 days, respectively. Clearance at steady state is 7.6 mL/h for nivolumab and 5.5 mL/h for relatlimab. Sex, age, race, and mild hepatic/renal impairment had no clinical effect on clearance. The exposure–response relationship and pharmacodynamic response for the safety and effectiveness of nivolumab/relatlimab-rmbw have not been fully characterized. Safety concerns include severe and fatal immune-mediated adverse reactions, infusion-related reactions, and complications of allogeneic hematopoietic stem cell transplantation, and fetal toxicity. Dosing is determined by patient's age and weight. Solution is infused over a 30-minute timeframe.

Clinical Trials:
In the RELATIVITY-047 trial, patients received nivolumab or nivolumab/relatlimab-rmbw. Results showed superiority of dual therapy over monotherapy with a progression-free survival of 10.1 months (95% CI, 6.4–15.7) compared with 4.6 months (95% CI, 3.4–5.6) and hazard ratio of 0.75 (95% CI, 0.62–0.92); P = 0.006, respectively. No safety concerns were observed compared with monotherapy with treatment-related adverse events occurring in 18.9% of patients on combination therapy compared with 9.7% on nivolumab alone.

Therapeutic Advance:
The novel mechanism and improvement in progression-free survival compared with standard of care highlight the therapeutic advancement of nivolumab/relatlimab-rmbw in the treatment of unresectable and metastatic melanoma.
Mpox Knowledge, Attitudes, and Practices Among Persons Presenting for JYNNEOS Vaccination—District of Columbia, August to October 2022
Authors: Hassan Rashida , Wondmeneh Sarah , Gonzalez Jimenez Nathalie , Chapman Kelly , Mangla Anil , Ashley Patrick , Willut Christina , Lee Michelle , Rhodes Trevor , Gillani Sarah , Copen Casey , Jackson David A. , Waltenburg Michelle , Delaney Kevin P. , Miles Gillian , Agnew-Brune Christine , Oakley Lisa P. ,   DC PEP++ Project Team
Published: November 2023

Background
More than 30,000 mpox cases have been confirmed in the United States since May 2022. Mpox cases have disproportionally occurred among adult gay, bisexual, and other men who have sex with men; transgender persons; and Black and Hispanic/Latino persons. We examined knowledge, attitudes, and practices regarding mpox vaccination among adults presenting for vaccination to inform prevention efforts.

Methods
We collected mixed-methods data from a convenience sample of adults presenting for JYNNEOS vaccination at 3 DC Health mpox vaccine clinics during August–October 2022. Survey and interview topics included knowledge about mpox symptoms and vaccine protection, beliefs about vaccine access, and trusted sources of information.

Results
In total, 352 participants completed self-administered surveys and 62 participants completed an in-depth interview. Three main themes emerged from survey and interview data. First, most participants had a general understanding about mpox, but gaps remained in comprehensive understanding about mpox symptoms, modes of transmission, vaccine protection, personal risk, and vaccine dosing strategies. Second, participants had high trust in public health agencies. Third, participants wanted more equitable and less stigmatizing access to mpox vaccine services.

Conclusions
Nonstigmatizing, inclusive, and clear communication from trusted sources, including public health agencies, is needed to address mpox knowledge gaps and increase vaccine access and uptake in affected communities. Mpox outreach efforts should continue innovative approaches, including person-level risk assessment tools, to address community needs.
Taking Up the Challenge to Improve Name and Role Recognition in the Operating Room
Authors: Thota Bhavana , Rabinowitz Anna , Guttman Oren 
Published: November 2023

Abstract
The rise of the #TheatreCapChallenge in 2017, which saw participants donning surgical caps labeled with their names and roles, promises to be a seemingly simple intervention aimed at improving operating theater communication and patient safety. This narrative review strives to expand upon the perceived and studied benefits of this intervention and address potential concerns that have arisen with the use of these name and role-labeled surgical caps.