bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shortage of Mental Health Professionals Doing Research
Authors: Vadukapuram Ramu , Perugula Malathi , Trivedi Chintan , Mansuri Zeeshan , Reddy Abhishek 
Published: October 2023

Abstract
Research plays a crucial role in advancing health care. Physician scientists, who bring together clinical and scientific perspectives, are integral to this effort. However, the pursuit of research careers among physicians has declined due to several obstacles, including inadequate support, training, time, and financial constraints. Emergency medicine and psychiatric specialties receive less support than other specialties, and COVID-19 has worsened the challenges. The COVID-19 has made things harder for physician scientists, increasing clinical demands and causing research delays. To tackle this, future physician scientists should receive organized training that includes mandatory research activities during their training. Large-scale studies should identify barriers to research and offer mentoring for young physician scientists. Encouraging female researchers and involving research faculty in residency training is crucial. Collaboration between physician and PhD researchers is essential for the future of medical research. It is vital to address these to advance health care and improve mental health outcomes.
Comparison of Clinical Features of Intussusception in Terms of Age and Duration of Symptoms
Authors: Acer-Demir Tuğba , Güney Lütfi Hakan , Fakıoğlu Ender , Gültekingil Ayşe 
Published: October 2023

Objectives
Intussusception is one of the most common surgical emergencies in children. We aimed to analyze the current clinical characteristics of intussusception.

Methods
We retrospectively reviewed 209 children diagnosed with intussusception, who were admitted to our hospital between January 2009 and August 2022. We grouped the patients according to symptom duration (before and after 12 hours and before and after 24 hours) and age (younger and older than 1 year, and younger and older than 2 years).

Results
The median age at admission was 31 months (2–204 months). The median symptom duration was 12 hours (1–420 hours). Most patients (91.4%) were admitted due to abdominal pain, irritability, and/or vomiting. The most common symptoms were vomiting (70.8%) and abdominal pain (60.6%). The classical triad of symptoms was seen in 9 cases (4.3%). In patients aged younger than 1 year, bloody stool, abnormal abdominal radiography findings, and a longer intussusceptum segment were more frequent. In patients aged younger than 2 years, abdominal pain, fever, and defense on physical examination were less frequent, and irritability, bloody stool, and recurrence were more frequent. Patients aged younger than 2 years had a longer intussusceptum segment and less lymphadenopathy based on ultrasonography (USG). The patients admitted more than 12 hours after symptom onset had more diarrhea, fever, abnormal x-ray, peritoneal fluid on USG, and recurrences, and less vomiting. After the symptoms had lasted for 24 hours, fever, mass palpation, and abnormal abdominal radiography findings were more frequent.

Conclusions
We recommend performing abdominal USG, especially in young children admitted to the emergency department with complaints of abdominal pain and/or vomiting, to rule out intussusception. In countries that have reported a high mortality rate from intussusception, we advise precautions such as increasing the availability of USG in emergency departments and educating the population to seek early medical assistance.
Characteristics and Disease Burden of Patients With Eosinophilic Granulomatosis With Polyangiitis Initiating Mepolizumab in the United States
Authors: Silver Jared , Deb Arijita , Packnett Elizabeth , McMorrow Donna , Morrow Cynthia , Bogart Michael 
Published: October 2023

Background/Objective
Although the high disease burden associated with eosinophilic granulomatosis with polyangiitis (EGPA) has been established, the disease burden in patients initiating mepolizumab in real-world practice is poorly understood. This study aimed to assess characteristics and burden of real-world patients with EGPA initiating mepolizumab.

Methods
This was a database study (GSK study ID: 214156) of US patients (≥12 years old) with EGPA and ≥1 mepolizumab claim (index date) identified from the Merative MarketScan Commercial and Medicare Supplemental Databases (November 1, 2015, to March 31, 2020). Outcomes assessed in the 12-month baseline period before index (inclusive) included patient characteristics, treatment use, EGPA relapses, asthma exacerbations, health care resource utilization, and costs.

Results
In the 103 patients included (mean age, 51.1 years; 63.1% female), the most common manifestations were asthma (89.3%), chronic sinusitis (57.3%), and allergic rhinitis (43.7%). In total, 91.3% of patients had ≥1 oral corticosteroid (OCS) claim (median dose, 7.4 mg/d prednisone-equivalent), 45.6% were chronic OCS users (≥10 mg/d during the 90 days preindex), 99.0% had ≥1 EGPA-related relapse, and 62.1% ≥1 asthma exacerbation. During the baseline period, 26.2% and 97.1% of patients had EGPA-related inpatient admissions and office visits, respectively. Median all-cause total health care costs per patient were $33,298, with total outpatient costs ($16,452) representing the largest driver.

Conclusions
Before initiating mepolizumab, a substantial real-world EGPA disease burden is evident for patients, with resulting impact on health care systems, and indicative of unmet medical needs. Mepolizumab treatment, with a demonstrated positive clinical benefit-risk profile may represent a useful treatment option for reducing EGPA disease burden.
Subunit Reconstruction With Local and Regional Flaps of a Total Cervicofacial Defect From Necrotizing Fasciitis
Authors: Hoerter Jacob E. , Liang Jonathan , Sukato Daniel 
Published: October 2023

A 60-year-old woman with a ∼450 cm2 right cervicofacial defect following successful treatment of necrotizing fasciitis was consulted for reconstruction. She had complete orbital, malar, buccal, labial, submental, and anterolateral neck skin and soft tissue defects and near complete defects of the forehead and nasal sidewall. She underwent reconstruction with a large 24 cm×11 cm supraclavicular, deltopectoral, forehead rotational, and labial advancement flaps with skin grafting of the orbit. Follow-up at 2 months demonstrated complete take of all flaps. The patient was satisfied with her appearance and considered her outcome favorable. She exhibited comparably premorbid speech and oral competence. Large defects of the head and neck require thorough surgical planning and consideration of a subunit reconstruction technique. While free tissue transfer provides a large area of healthy tissue from a suitable donor site, subunit reconstruction with local and regional flaps can provide a superior outcome in the correct patient.
Damage control resuscitation in adult trauma patients: What you need to know
Authors: Lammers Danny T. , Holcomb John B. 
Published: October 2023

ABSTRACT
Death after injury is a worldwide epidemic. Hemorrhage as a cause of death represents the leading potentially preventable condition. Based on hard-won experience from the recent wars, and two decades of military and civilian research, damage-control resuscitation (DCR) is now widely used. This article will briefly describe the history of blood transfusion, outline “why we do DCR,” and then discuss “how we do DCR.” Modern DCR occurs both prehospital and in the hospital and has several main tenants. Currently, DCR focuses on the liberal use of temporary hemorrhage-control adjuncts, early use of whole blood or balanced blood product-based transfusions, mitigation of crystalloid use, hypotensive resuscitation to promote hemostasis and decrease coagulopathy, and correction of ongoing metabolic derangements, followed by rapid definitive hemorrhage control. These concepts have evolved from a series of lessons learned over time from both civilian and military trauma casualties, and DCR is now the standard of care in trauma resuscitation.
Avoidant-restrictive food intake disorder and autism: epidemiology, etiology, complications, treatment, and outcome
Authors: Keski-Rahkonen Anna , Ruusunen Anu 
Published: October 2023

Purpose of review
There is considerable overlap between the features of avoidant-restrictive food intake disorder (ARFID) and autism. The purpose of this scoping review is to provide an overview of studies published on ARFID and autism in 2022 and the first half of 2023.

Recent findings
ARFID and autism are highly heritable conditions that often co-occur. In a large autism cohort, 21% of participants and 17% of their parents presented with avoidant-restrictive features. Of children diagnosed with ARFID, 8.2–54.8% are autistic. More than half of individuals with ARFID also have other neurodevelopmental, psychiatric, or somatic diagnoses. Anxiety, depression, sleep disorders, and learning difficulties are particularly common co-occurring issues. Various strategies have been developed to support autistic children with feeding difficulties. It appears that their feeding difficulties, particularly sensory sensitivities, food preferences, and mealtime rituals and routines frequently persist into adolescence and adulthood, but research on optimal support for adults and adolescents is still scarce. Untreated ARFID in autistic individuals may lead to serious complications.

Summary
Individuals seeking specialist care for autism, eating disorders, or gender dysphoria should be screened for ARFID. More research is needed on how to support autistic adolescents and adults with features of ARFID.
Updates in the care of youths with intellectual disability and autism spectrum disorder
Authors: Bertelli Marco O. , Forte Luciana , Bianco Annamaria 
Published: October 2023

Purpose of review
Since the turn of the new millennium, care for people with intellectual disability/intellectual developmental disorders (IDD) and/or autism spectrum disorder (ASD) has drawn increasing attention because of the continuous prevalence increase of these two conditions, the high health vulnerability, especially mental vulnerability, and the crucial role of care provision in the setting of continued deinstitutionalization and the shift to community care. The present review addresses the main issues related to mental healthcare in youth with IDD and/or ASD with a specific focus on adolescence and transition to adulthood.

Recent findings
Despite the existence of specific recommendations, persons with IDD/ASD lack access to quality mental healthcare within communities, receive inadequate diagnosis and intervention, including medication overuse as well as ineffective residential, educational, employment, financial, and social support services. The lack of a unified care system that provides services across all domains and life ages may be the cause of users’ perceptions and experiences of inefficiencies.

Summary
The scientific community seems to converge on that care should be provided in accordance with principles of interdisciplinarity, life-span view, precision, personalization, and participation. Quality of life appears to be an ideal conceptual reference for care planning and outcome evaluation.
Modeling the Evolution of Populations with Multiple Killer Meiotic Drivers
Authors: Hernández José Fabricio López , Rubinstein Boris Y , Unckless Robert L. , Zanders Sarah E. 
Published: October 2023

ABSTRACTMeiotic drivers are selfish genetic loci that can be transmitted to more than half of the viable gametes produced by a heterozygote. This biased transmission gives meiotic drivers an evolutionary advantage that can allow them to spread over generations until all members of a population carry the driver. This evolutionary power can also be exploited to modify natural populations using synthetic drivers known as ‘gene drives’. Recently, it has become clear that natural drivers can spread within genomes to birth multicopy gene families. To understand intragenomic spread of drivers, we model the evolution of two distinct meiotic drivers in a population. We employ thewtfkiller meiotic drivers fromSchizosaccharomyces pombe, which are multicopy in all sequenced isolates, as models. We find that a duplicatewtfdriver identical to the parent gene can spread in a population unless, or until, the original driver is fixed. When the duplicate driver diverges to be distinct from the parent gene, we find that both drivers spread to fixation under most conditions. Finally, we show that stronger drivers make weaker drivers go extinct in most, but not all, polymorphic populations with absolutely linked drivers. These results reveal the strong potential for natural meiotic drive loci to duplicate and diverge within genomes. Our findings also highlight duplication potential as a factor to consider in the design of synthetic gene drives.
Amphibian mast cells: barriers to chytrid fungus infections
Authors: Hauser Kelsey A. , Garvey Christina N. , Crow Ryley S. , Hossainey Muhammad R.H. , Howard Dustin T. , Ranganathan Netra , Gentry Lindsey K. , Yaparla Amulya , Kalia Namarta , Zelle Mira , Jones Elizabeth J. , Duttargi Anju N. , Rollins-Smith Louise A. , Muletz-Wolz Carly R. , Grayfer Leon 
Published: October 2023

AbstractGlobal amphibian declines are compounded by deadly disease outbreaks caused by the chytrid fungus,Batrachochytrium dendrobatidis(Bd). Much has been learned about the roles of amphibian skin-produced antimicrobial components and microbiomes in controllingBd, yet almost nothing is known about the roles of skin-resident immune cells in anti-Bddefenses. Mammalian mast cells reside within and serve as key immune sentinels in barrier tissues like skin. Accordingly, we investigated the roles ofXenopus laevisfrog mast cells duringBdinfections. Our findings indicate that enrichment ofX. laevisskin mast cells confers significant anti-Bdprotection and ameliorates the inflammation-associated skin damage caused byBdinfection. This includes a significant reduction inBd-infected skin infiltration by neutrophils. Augmenting frog skin mast cells promotes greater mucin content within cutaneous mucus glands and protects frogs fromBd-mediated changes to their skin microbiomes. Mammalian mast cells are known for their production of the pleiotropic interleukin-4 (IL4) cytokine and our findings suggest that the frog IL4 plays a key role in conferring the effects seen following frog skin mast cell enrichment. Together, this work underlines the importance of amphibian skin-resident immune cells in anti-Bddefenses and illuminates a novel avenue for investigating amphibian host-chytrid pathogen interactions.
Uncovering genes involved in pollinator-driven mating system shifts and selfing syndrome evolution inBrassica rapa
Authors: Kofler Xeniya V. , Grossniklaus Ueli , Schiestl Florian P. , Frachon Léa 
Published: October 2023

SummaryBackgroundShifts in pollinator occurrence and their pollen transport effectiveness drive the evolution of mating systems in flowering plants. A decline in pollinator numbers can lead to the phenotypic evolution of floral traits favoring self-pollination (selfing syndrome). Understanding the genomic basis involved in such shifts of the mating system is crucial for predicting a species’ persistence or extinction under changing biotic and abiotic stressors in natural populations. We investigated loci showing high genetic differentiation before and after selection in fast-cyclingBrassica rapathat were associated with rapid phenotypic evolution toward the selfing syndrome (reduction in petal width, stamen and pistil length, and herkogamy). Combining a genotyping-by-sequencing (GBS) approach with a genome-wide association study (GWAS), we shed light onto the genetic basis associated with the mating system shift over nine generations of pollination byEpisyphrus balteatus(hoverflies), an abundant pollinator ofB. rapa. Moreover, we functionally validated the involvement of candidate genes associated with changes in floral morphology by studying corresponding mutants in the model plantArabidopsis thaliana.ResultsWe found that the mating system ofB. rapashifted from predominantly outcrossing to mixed mating with high rates of autonomous selfing, accompanied by a rapid reduction of floral morphological traits and herkogamy involving many loci. We found 31 candidate genes associated with the affected traits that were involved in a wide range of functions from DNA/RNA binding to transport. Our functional validation inA. thalianaconfirmed that four of the identified genes are indeed involved in regulating the size of floral organs. Interestingly, two genes, both coding for the same protein complex responsible for active DNA methylation were successfully validated and closely linked to two correlated phenotypic traits, namely pistil and stamen length.ConclusionsAltogether, our study shows that hoverfly pollination leads to rapid evolutionary changes of the mating system through polygenic changes, highlighting the importance of using genomic approaches to understand pollinator-driven plant adaptation.
Regulation of astrocyte metabolism by mitochondrial translocator protein 18kDa
Authors: Firth Wyn , Robb Josephine L , Stewart Daisy , Pye Katherine R , Bamford Rosemary , Oguro-Ando Asami , Beall Craig , Ellacott Kate LJ 
Published: October 2023

AbstractThe mitochondrial translocator protein 18kDa (TSPO) has been linked to a variety of functions from steroidogenesis to regulation of cellular metabolism and is an attractive therapeutic target for chronic CNS inflammation. Studies in the periphery using Leydig cells and hepatocytes, as well as work in microglia, indicate that the function of TSPO may vary between cells depending on their specialised roles. Astrocytes are critical for providing trophic and metabolic support in the brain as part of their role in maintaining brain homeostasis. Recent work has highlighted that TSPO expression increases in astrocytes under inflamed conditions and may drive astrocyte reactivity. However, relatively little is known about the role TSPO plays in regulating astrocyte metabolism and whether this protein is involved in immunometabolic processes in these cells. Using TSPO-deficient (TSPO-/-) mouse primary astrocytesin vitro(MPAs) and a human astrocytoma cell line (U373 cells), we performed metabolic flux analyses. We found that loss of TSPO reduced basal astrocyte respiration and increased the bioenergetic response to glucose reintroduction following glucopenia, while increasing fatty acid oxidation (FAO). Lactate production was significantly reduced in TSPO-/-astrocytes. Co-immunoprecipitation studies in U373 cells revealed that TSPO forms a complex with carnitine palmitoyltransferase 1a, which presents a mechanism wherein TSPO may regulate FAO in astrocytes. Compared to TSPO+/+cells, inflammation induced by 3h lipopolysaccharide (LPS) stimulation of TSPO-/-MPAs revealed attenuated tumour necrosis factor release, which was enhanced in TSPO-/-MPAs at 24h LPS stimulation. Together these data suggest that while TSPO acts as a regulator of metabolic flexibility in astrocytes, loss of TSPO does not appear to modulate the metabolic response of astrocytes to inflammation, at least in response to the stimulus/time course used in this study.
ASPSCR1-TFE3 reprograms transcription by organizing enhancer loops around hexameric VCP/p97
Authors: Pozner Amir , Verma Shiv Prakash , Li Li , Wang Shuxin , Barrott Jared J. , Nelson Mary L. , Yu Jamie S. E. , Negri Gian Luca , Colborne Shane , Hughes Christopher S. , Zhu Ju-Fen , Lambert Sydney L. , Carroll Lara S. , Smith-Fry Kyllie , Stewart Michael G. , Kannan Sarmishta , Jensen Bodrie , Mortenson Katelyn L. , John Cini , Sikdar Saif , Liu Hongrui , Dang Ngoc Ha , Bourdage Jennifer , Li Jinxiu , Vahrenkamp Jeffery M. , Groundland John S. , Wustrack Rosanna , Senger Donna L. , Zemp Franz J. , Mahoney Douglas J. , Gertz Jason , Zhang Xiaoyang , Lazar Alexander J. , Hirst Martin , Morin Gregg B. , Nielsen Torsten O. , Shen Peter S. , Jones Kevin B. 
Published: October 2023

AbstractThe t(X,17) chromosomal translocation, generating the ASPSCR1-TFE3 fusion oncoprotein, is the singular genetic driver of alveolar soft part sarcoma (ASPS) and some Xp11-rearranged renal cell carcinomas (RCC), frustrating efforts to identify therapeutic targets for these rare cancers. Proteomic analysis showed that VCP/p97, an AAA+ ATPase with known segregase function, was strongly enriched in co-immunoprecipitated nuclear complexes with ASPSCR1-TFE3. We demonstrate that VCP is a likely obligate co-factor of ASPSCR1-TFE3, one of the only such fusion oncoprotein co-factors identified in cancer biology. Specifically, VCP co-distributed with ASPSCR1-TFE3 across chromatin in association with enhancers genome-wide. VCP presence, its hexameric assembly, and its enzymatic function orchestrated the oncogenic transcriptional signature of ASPSCR1-TFE3, by facilitating assembly of higher-order chromatin conformation structures as demonstrated by HiChIP. Finally, ASPSCR1-TFE3 and VCP demonstrated co-dependence for cancer cell proliferation and tumorigenesisin vitroand in ASPS and RCC mouse models, underscoring VCP’s potential as a novel therapeutic target.
Matching maternal and paternal experiences underpin molecular thermal acclimation
Authors: Bonzi L.C. , Donelson J.M. , Spinks R.K. , Munday P.L. , Ravasi T. , Schunter C. 
Published: October 2023

AbstractThe environment experienced by one generation has the potential to affect the subsequent one through non-genetic inheritance of parental effects. Since both mothers and fathers can influence their offspring, questions arise regarding how the maternal, paternal and offspring experiences integrate into the resulting phenotype. We aimed to disentangle the maternal and paternal contributions to transgenerational thermal acclimation in a reef fish,Acanthochromis polyacanthus, by exposing two generations to elevated temperature (+1.5°C) in a full factorial design and analyzing the F2 hepatic gene expression. Paternal and maternal effects showed common but also parent-specific components, with the father having the largest influence in shaping the offspring transcriptomic profile. Fathers contributed to transgenerational response to warming through transfer of epigenetically controlled stress-response mechanisms while mothers influenced increased lipid metabolism regulation. However, the key to acclimation potential was matching thermal experiences of the parents. When both parents were exposed to the same condition, offspring showed increased structural RNA production and transcriptional regulation, whereas environmental mismatch in parents resulted in maladaptive parental condition-transfer, revealed by translation suppression and endoplasmic reticulum stress. Interestingly, the offspring’s own environmental experience had the smallest influence on their hepatic transcription profiles. Taken together, our results show the complex nature of the interplay between paternal, maternal and offspring cue integration, and reveal that acclimation potential to ocean warming depends not only on maternal and paternal contributions, but importantly on congruent parental thermal experiences.