bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lethal Phenotype-Based Database Screening Identifies Ceramide as a Negative Regulator of Primitive Streak Formation
Authors: Pu Jing , Kofuji Satoshi , Okamoto-Uchida Yoshimi , Danzaki Keiko , Yu Ruoxing , Suzuki Akira , Kitajima Satoshi , Nishina Hiroshi 
Published: October 2023

Abstract
In early embryogenesis, the primitive streak (PrS) generates the mesendoderm and is essential for organogenesis. However, because the PrS is a minute and transient tissue, elucidating the mechanism of its formation has been challenging. We performed comprehensive screening of 2 knockout mouse databases based on the fact that failure of PrS formation is lethal. We identified 812 genes involved in various cellular functions and responses that might be linked to PrS formation, with the category of greatest abundance being “Metabolism.” In this study, we focused on genes of sphingolipid metabolism and investigated their roles in PrS formation using an in vitro mouse ES cell differentiation system. We show here that elevated intracellular ceramide negatively regulates gene expression essential for PrS formation and instead induces neurogenesis. In addition, sphingosine-1-phosphate (a ceramide derivative) positively regulates neural maturation. Our results indicate that ceramide regulates both PrS formation and the induction of neural differentiation.
Living together in dead coral rocks: macrosymbiotic communities associated with Bonellia echiuran worms (Annelida: Thalassematidae: Bonelliinae), involving new commensal bivalve and amphipod species
Authors: Goto Ryutaro , Hirabayashi Isao , Seike Koji , Yamashita Momo , Shimomura Michitaka 
Published: October 2023

Abstract
Dead coral rocks are prevalent hard substrates in shallow warm waters, providing habitat for various infaunal and boring invertebrates. Despite this, the nature of species interactions, especially symbiotic relationships, among them remains poorly understood. Bonellia (Annelida: Thalassematidae: Bonelliinae) is a group of greenish echiuran worms commonly inhabiting cavities inside dead coral rocks. Although echiuran burrows in marine sediments are known to harbour various host-specific macrosymbionts, it remains unclear whether such associations also occur in hard substrates. To address this, we investigated the diversity of macrosymbionts associated with the burrows of Bonellia sp. aff. minor in the warm-temperate coast of the Kii Peninsula, Japan, and the evolutionary origins of those symbionts. The host’s burrow morphology was also examined using micro-computed tomography (CT) scanning. Our field survey revealed that the burrows of Bo. sp. aff. minor hosted three commensal species including a polychaete, Oxydromus fauveli, and two new species, a bivalve (Basterotia bonelliphila sp. nov.) and an amphipod (Leucothoe bonelliae sp. nov.). Our molecular phylogenetic analyses showed that each symbiont species belongs to a clade comprising commensal species specific to echiurans or annelids. Overall, our findings contribute to a better understanding of symbiotic associations in marine hard substrates.
PA access to provider health programs
Authors: Roman Christopher , Neary Stephanie 
Published: October 2023

ABSTRACT

Objective:
This study assessed the availability of provider health programs (PHPs) for physician associates/assistants (PAs), as well as the accessibility of information about these resources through state licensing boards and PA constituent organizations.

Methods:
Data were collected through audits of the websites of the PA licensing board and state/district constituent group for each state and the District of Columbia from October to November 2022.

Results:
Every state except Massachusetts has a PHP that serves PAs. Review of the 51 respective state licensing board websites revealed that 23 states (45.1%) list PHP information; only 9 states (17.6%) have PHP information listed on state PA constituent organization websites.

Conclusions:
The results of this study indicate that PHPs for PAs are widely available. Unfortunately, the broad availability of PHPs may be limited by the lack of accessible information about these programs in many states.
The Anatomic Position of the Sciatic Nerve During Percutaneous Retrograde Posterior Column Fixation is Determined by Hip Position
Authors: Murasko Marlon J. , Nourie Blake , Cooley Michael R. , Chisena Ernest N. 
Published: October 2023

Abstract

Objectives:
There are multiple established patient positions for placement of a percutaneous retrograde posterior column screw for fixation of acetabulum fractures. The sciatic nerve is at risk of injury during this procedure, as it lies adjacent to the start point at the ischial tuberosity. The purpose of this study is to define how the position of the sciatic nerve, relative to the ischial tuberosity, changes with respect to the patient’s hip position.

Methods:
In a cohort of 11 healthy volunteers, ultrasound was used to measure the absolute distance between the ischial tuberosity and the sciatic nerve. Measurements were made with the hip and knee flexed to 90 degrees to simulate supine and lateral positioning, and with the hip extended to simulate prone positioning. In both positions, the hip was kept in neutral abduction and neutral rotation.

Results:
The distance from the lateral border of the ischial tuberosity to the medial border of the sciatic nerve was greater in all subjects in the hip flexed position versus the extended position. The mean distance was 17 mm (range, 14-27 mm) in the hip extended position, and 39 mm (range, 26-56 mm) in the hip flexed position (P < .001).

Conclusion:
The sciatic nerve demonstrates marked excursion away from the ischial tuberosity when the hip is flexed compared with when it is extended. The safest patient position for percutaneous placement of a retrograde posterior column screw is lateral or supine with the hip flexed to 90 degrees.
Influence of Body Mass Index on Surgical and Patient Outcomes for Cervical Spine Surgery
Authors: Naik Anant , Moawad Christina , Harrop James S. , Dhawan Sanjay , Cramer Samuel W. , Arnold Paul M. 
Published: October 2023

Study Design:
Secondary analysis of prospectively collected registry.

Objective:
We aim to investigate the effects of body mass index (BMI) on postsurgical cervical spine surgery outcomes and identify a potential substratification of obesity with worse outcomes.

Summary of Background Data:
The impact of BMI on cervical spine surgery is unknown, with controversial outcomes for patients high and low BMI.

Methods:
The cervical spine Quality Outcomes Database was queried for a total of 10,381 patients who underwent single-stage cervical spine surgery. Patients were substratified into 6 groups based on BMI. Surgical outcomes, complications, hospitalization outcomes, and patient-reported outcomes for each cohort, including modified Japanese Orthopedic Association Score, Numeric Rating Scale arm pain, Numeric Rating Scale neck pain, Neck Disability Index, and EuroQol Health Survey, were assessed. Univariate analysis was performed for 3- and 12-month follow-up after surgical intervention.

Results:
Obese patients (class I, II, and III) requiring spine surgery were statistically younger than nonobese patients and had higher rates of diabetes compared with normal BMI patients. The surgical length was found to be longer for overweight and all classes of obese patients (P < 0.01). Class III obese patients had higher odds of postoperative complications. Patients with class II and III obesity had lower odds of achieving optimal modified Japanese Orthopedic Association Score at 3 months [OR = 0.8 (0.67–0.94), P < 0.01, OR = 0.68 (0.56–0.82), P < 0.001, respectively] and 12 months [OR = 0.82 (0.68–0.98), P = 0.03, OR = 0.79 (0.64–0.98), P = 0.03, respectively].

Conclusions:
This study investigates the relationship between substratified BMI and postoperative outcomes of cervical spine surgery. Class II and III obese patients have substantially greater risk factors and poor outcomes postoperatively. In addition, low BMI also presents unique challenges for patients. Further research is needed for comprehensive analysis on outcomes of cervical spine surgery after correcting BMI.
Ulnar Nerve Injury during Treatment of Fourth and Fifth Metacarpal Fractures: A Case Report and Anatomical Review
Authors: Muneer Mohammed , Alborno Yahya 
Published: October 2023

Summary:
The deep branch of the ulnar nerve (DBUN) is a pure motor nerve. It passes through a hypothenar fibromuscular tunnel and courses radially on the interossei surface. The DBUN is not frequently considered during hand fracture surgery, despite the anatomical course of the nerve in close relation to the carpal and metacarpal bones, which makes it vulnerable to penetrating injury and being injured during hand surgery fixations. In this article, we describe a case of DBUN injury after percutaneous pinning of the fourth and fifth metacarpal bone fractures complicated by intrinsic muscle wasting of the hand that was treated with neuroma excision and sural nerve graft. We present the case of a 36-year-old man, who had a fracture of the base of the fourth and fifth metacarpal bones, which was treated with multiple K-wires. A few months later, the patient presented with weak abduction/adduction of the three ulnar fingers and prominent wasting in the intrinsic muscles of the hand. On hand exploration, a 2-cm neuroma was found along the course of the DBUN distal to the hypothenar fibromuscular tunnel, which was treated by neuroma excision and nerve grafting. Fractures of the fourth and fifth metacarpals and carpometacarpal dislocations are very common and are often treated surgically. To fix these fractures, awareness of the DBUN course in the hand and its proximity to the carpal and metacarpal bones is important. High caution should be taken during percutaneous pinning by inserting K-wires under radiological guidance, minimizing pining attempts and limiting pin tip protrusion to 1–2 mm.
Differentiate Clinical Characteristics Between Viral Pneumonia and Mycoplasma pneumoniae and Nomograms for Predicting Mycoplasma pneumoniae: A Retrospective Study in Primary Hospitals
Authors: Guo Huixian , Liang Jingyi , Lin Haowen , Zhou Xingyou , Zhang Zhou , Lai Laiqing , Zhang Tao , Wang Zhufeng , Zhou Junhou , Sun Jiaxi , Liao Jiayi , Jiang Mei , Yang Zifeng 
Published: October 2023

Objective:
To identify the difference in clinical characteristics between viral pneumonia and Mycoplasma pneumoniae, providing cues on their differential diagnosis for primary hospitals with the insufficient pathogen detection capacity.

Methods:
We retrospectively reviewed the medical records of hospitalized children with acute respiratory tract infections, and pathogenic microbes test results were analyzed. Clinical characteristics, routine blood parameters and hospitalization duration and fee were compared between M. pneumoniae and viral pneumonia. We used in the multivariable logistic regression to predict the probability of children with M. pneumoniae and graphically represented by a dynamic nomogram. The discrimination and clinical utility of the model were confirmed by receiver operating characteristic and decision curve analysis curves.

Result:
A total of 375 children with community-acquired pneumonia were included. Mycoplasma infection accounted for the largest proportion (22.13%). The incidence of both hypothermia and vomiting was lower in M. pneumoniae compared to viral pneumonia (hypothermia: 10.50% vs. 0.00%; vomiting: 7.90% vs. 0.00%). The prevalence of hyperthermia was higher in M. pneumoniae (hyperthermia: 89.5% vs. 100%). Procalcitonin, peripheral blood white blood cell count and lymphocyte levels were higher in the viral pneumonia group, and eosinophil levels were conversely lower. As for the duration of illness, the mean length of stay was 5.20 ± 2.12 (viral pneumonia) and 6.27 ± 2.48 days (M. pneumoniae). Children with M. pneumoniae had higher overall hospital costs and required more medical treatment. The above were all statistically significant with a P < 0.05. The scoring system was established based on the above results. Receiver operating characteristic curves showed good model-discrimination ability with 0.844 of the area under the curve in the training set and 0.778 in the test set. Decision curve analysis curves demonstrated the discriminative superiority of this model. The web-based dynamic nomogram calculator is accessible at https://zhxylxy0160128.shinyapps.io/Nomogram/.

Conclusion:
Nomograms have satisfactory discrimination, and clinical utility may benefit in predicting the probability of developing M. pneumoniae in children. Children with M. pneumoniae have a higher burden than those with viral pneumonia and may require more intensive in-hospital monitoring.
Assessment of the Clinical Course of Human Rhinovirus/Enterovirus Infections in Pediatric Intensive Care
Authors: Kocoglu Barlas Ulkem , Akcay Nihal , Menentoglu Mehmet Emin , Sevketoglu Esra , Duyu Muhterem , Telhan Leyla , Kangin Murat , Tugrul Hazal Ceren , Erdogan Seher , Durak Cansu , Guney Sahin Ebru , Umur Ozge , Sik Sare Guntulu , Citak Agop , Yaman Ayhan 
Published: October 2023

Background:
This study aims to evaluate the clinical course of human rhinovirus/enterovirus (HRV/EV) infections in the pediatric intensive care unit.

Methods:
The study was conducted as a multicenter, prospective observational study from September 2022 to December 2022. Cases with positive polymerase chain reaction testing for HRV/EV of nasopharyngeal swab samples within the first 24 hours of pediatric intensive care unit admission were recorded. There were 2 groups: 1–24 months and >24 months.

Results:
A total of 75 cases (39 male) were included in the study. The median age for all cases was 21 months. The highest polymerase chain reaction positivity rates were observed in October (37.33%). Among the cases, 32 (42.67%) presented with bronchopneumonia/pneumonia, 24 (32%) presented with acute bronchiolitis/bronchitis and 7 (9.33%) presented with sepsis/septic shock. The frequency of pediatric acute respiratory distress syndrome was found to be 6.67%. In the age group of 1–24 months, mean lymphocyte and liver enzyme levels were higher, while in the age group of >24 months, mean hemoglobin and mean kidney function test levels were higher (P ≤ 0.05). Continuous oxygen therapy was provided to 65.3% of the cases, noninvasive ventilation to 33.3%, high-flow nasal cannula-oxygen therapy to 32% and invasive mechanical ventilation to 16%.

Conclusions:
HRV/EV infections primarily affect the respiratory system and generally exhibit a clinical course with low mortality rates (1, 1.3%). In cases with underlying chronic diseases, more severe clinical conditions such as pediatric acute respiratory distress syndrome and septic shock may occur.
Pediatric Utilization of Methicillin-resistant Staphylococcus aureus Nasal Swabs for Antimicrobial Stewardship
Authors: Braga Shienna , Rajapakse Nipunie , Heyliger Jamie , Dierkhising Ross , Dinnes Laura 
Published: October 2023

Background:
Methicillin-resistant Staphylococcus aureus (MRSA) can cause serious infections and empiric treatment regimens in children frequently include an anti-MRSA antibiotic. Studies in adults have demonstrated a high negative predictive value (NPV) of MRSA nasal swabs (MNS) in a variety of infectious syndromes. Negative MNS have been utilized as a tool to guide de-escalation of anti-MRSA antibiotics in adults, especially in those with lower respiratory tract infections, but data in children is minimal. The primary objective of this study was to determine the NPV and positive predictive value (PPV) of MNS in children hospitalized for treatment of an infection.

Methods:
This was a single-site, retrospective cohort study of pediatric patients admitted with a suspected infectious diagnosis who had an MNS performed during their hospitalization between June 1, 2018 and November 25, 2022.

Results:
This study identified 172 patients who met the inclusion criteria. Eleven (6.4%) nasal swabs were positive for MRSA and 10 (5.8%) microbiological cultures from suspected sources of infection were identified to be positive for MRSA. The MNS was found to have a sensitivity of 20%, specificity of 94%, PPV of 18% and NPV of 95% for all sites of infection.

Conclusion:
MNS has a high NPV and low PPV in children. MNS can be utilized as an antimicrobial stewardship tool to guide the safe de-escalation of anti-MRSA antibiotics in children.
Functional and anatomical analyses of active spinal circuits in a mouse model of chronic pain
Authors: Targowska-Duda Katarzyna M. , Peters Darian , Marcus Jason L. , Zribi Gilles , Toll Lawrence , Ozawa Akihiko 
Published: October 2023

Abstract
Decades of efforts in elucidating pain mechanisms, including pharmacological, neuroanatomical, and physiological studies have provided insights into how nociceptive information transmits from the periphery to the brain and the locations receiving nociceptive signals. However, little is known about which specific stimulus-dependent activated neurons, amongst heterogeneous neural environments, discriminatively evoke the cognate pain behavior. We here shed light on the population of neurons in the spinal cord activated by a painful stimulus to identify chronic pain-dependent activated neuronal subsets using Fos2A-iCreER (TRAP2) mice. We have found a large number of neurons activated by a normally nonpainful stimulus in the spinal cord of spinal nerve–ligated mice, compared with sham. Neuronal activation was observed in laminae I and II outer under heat hyperalgesia. A large number of neurons in laminae II inner were activated in both mechanical allodynia and heat hyperalgesia conditions, while mechanical allodynia tends to be the only stimulus that activates cells at lamina II inner dorsal region. Neuroanatomical analyses using spinal cell markers identified a large number of spinal inhibitory neurons that are recruited by both mechanical allodynia and heat hyperalgesia. Of interest, spinal neurons expressing calretinin, calbindin, and parvalbumin were activated differently with distinct pain modalities (ie, mechanical allodynia vs heat hyperalgesia). Chemogenetic inhibition of those activated neurons significantly and specifically reduced the response to the pain stimulus associated with the stimulus modality originally given to the animals. These findings support the idea that spinal neuronal ensembles underlying nociceptive transmission undergo dynamic changes to regulate selective pain responses.
Trends in Testing and Self-Reported Diagnoses of Sexually Transmitted Infections in Gay and Bisexual Men in Australia, 2017-2021: Analysis of National Behavioural Surveillance Surveys
Authors: Chan Curtis , Holt Martin , Broady Timothy R. , Traeger Michael , Mao Limin , Grulich Andrew E. , Prestage Garrett , MacGibbon James , Rule John , Bavinton Benjamin R. 
Published: October 2023

Abstract

Background
Gay, bisexual, and other men who have sex with men (GBM) are overrepresented in diagnoses of sexually transmitted infections (STI) relative to their population size. This study assessed trends in STI testing and diagnoses among GBM in Australia.

Methods
The Gay Community Periodic Surveys are repeated cross-sectional behavioural surveillance surveys of GBM. Participants reported the number of anal swabs, throat swabs, urine samples, and blood tests for syphilis they undertook in the last year. ‘Frequent comprehensive testing’ was defined as ≥3 of each test in the previous year. Participants reported STI diagnoses of chlamydia, gonorrhoea, syphilis, and other STIs in the last year. Trends in testing and diagnoses from 2017-2020 and 2020-2021 were assessed with logistic regression models.

Results
We analysed 24,488 survey responses from participants reporting casual sex in the last 6 months. Between 2017-2020, frequent comprehensive STI testing decreased among HIV-negative GBM on PrEP from 71.7% to 68.9% and declined further to 58.6% in 2021. Frequent comprehensive STI testing was stable during 2017-2020 among HIV-negative/untested GBM not on PrEP (17.4% to 14.6%) and HIV-positive GBM (30.4% to 35.1%) but declined in 2021 to 7.5% among non-PrEP-users and 25.7% among HIV-positive participants. There were minimal changes in STI diagnoses during 2017-2020, but diagnoses declined in 2021.

Conclusions
Many GBM do not meet Australian STI testing guidelines that recommend quarterly testing. Further evaluation of whether this recommendation is realistic or necessary to reduce STIs among GBM is recommended.
Cardiac Enlargement in a Medicolegal Autopsy Setting
Authors: Beer Torfinn , Eriksson Anders , Wingren Carl Johan 
Published: October 2023

Abstract
A key element for diagnosing cardiac enlargement in an autopsy setting is relevant heart weight references. However, most available references are to a large extent not representative of a medicolegal autopsy population, implying that reference weights are likely lower than those in the relevant population.
To establish more applicable heart weight references in a medicolegal autopsy population, we designed a heart weight model that accounts for undiagnosed cardiac enlargement using data from 11,897 nontraumatic Swedish medicolegal autopsy cases autopsied between 2010 and 2019. The model was validated in 296 nonobese young adult suicidal hanging cases.
For a decedent of average height (174 cm), the evidence that a heart weight was enlarged reached weak support at approximately 430 g, substantial support at approximately 480 g, and strong support at 520 g. The modeled prevalence of cardiac enlargement was very high among elderly and obese decedents.
We believe that our model is more applicable in a medicolegal setting than those previously published. The presented quantification of the degree of uncertainty regarding diagnosis can help the pathologist in diagnosing cardiac enlargement. To facilitate the use of this model, we also made it available through a simple online tool (https://formedum.shinyapps.io/HeartWeightCalc/).
Association of Complex Repetitive Discharges With Chronicity and Clinical Symptoms in Radiculopathies
Authors: Skolka Michael P. , Hass Reece M. , Rubin Devon I. , Laughlin Ruple S. 
Published: October 2023

Purpose:
Complex repetitive discharges (CRDs) are incompletely understood needle electromyography (EMG) waveforms seen in both myopathic and neurogenic disorders including radiculopathies. This study aimed to clarify the significance of CRDs in patients with radiculopathies.

Methods:
This case–control study randomly identified 100 patients with needle EMG evidence of radiculopathy demonstrating at least one CRD in the electrodiagnostically involved myotome between January 2017 and January 2022. These patients were compared with 100 randomly selected patients with EMG evidence of radiculopathy without CRDs controlled for sex, age at EMG testing, and affected nerve root segment. Patient clinical symptoms, neurologic examination, EMG features, and imaging were analyzed. A paired sample t-test for categorial data and χ2 test for nonparametric data were used for statistical analysis with significance defined as P < 0.05.

Results:
Patients with radiculopathies with CRDs had longer disease duration averaging 59 months (range 1–480) compared with patients with radiculopathies without CRDs averaging 26 months (range 1–192, P < 0.01). Clinical symptoms of paresthesias and weakness were both significantly more common in patients with radiculopathies with CRDs than those without CRDs (P < 0.01 and 0.01, respectively). Needle EMG demonstrated a greater average number of muscles with neurogenic motor unit potentials per radiculopathy in patients with radiculopathies with CRDs compared with those without CRDs. Imaging studies of patients with radiculopathies with CRDs were more likely to reveal evidence of nerve root compression (P < 0.01).

Conclusions:
The presence of CRDs in patients with radiculopathies is consistent with clinically more symptomatic radiculopathies and a longer duration of nerve root compromise.