bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aerobic iron-oxidizing bacteria secrete metabolites that markedly impede abiotic iron oxidation
Authors: Baker Isabel R , Matzen Sarick L , Schuler Christopher J , Toner Brandy M , Girguis Peter R 
Published: December 2023

Abstract
Iron is one of the Earth's most abundant elements and is required for essentially all forms of life. Yet, iron's reactivity with oxygen and poor solubility in its oxidized form (Fe3+) mean that it is often a limiting nutrient in oxic, near-neutral pH environments like Earth's ocean. In addition to being a vital nutrient, there is a diversity of aerobic organisms that oxidize ferrous iron (Fe2+) to harness energy for growth and biosynthesis. Accordingly, these organisms rely on access to co-existing Fe2+ and O2 to survive. It is generally presumed that such aerobic iron-oxidizing bacteria (FeOB) are relegated to low-oxygen regimes where abiotic iron oxidation rates are slower, yet some FeOB live in higher oxygen environments where they cannot rely on lower oxygen concentrations to overcome abiotic competition. We hypothesized that FeOB chemically alter their environment to limit abiotic interactions between Fe2+ and O2. To test this, we incubated the secreted metabolites (collectively known as the exometabolome) of the deep-sea iron- and hydrogen-oxidizing bacterium Ghiorsea bivora TAG-1 with ferrous iron and oxygen. We found that this FeOB's iron-oxidizing exometabolome markedly impedes the abiotic oxidation of ferrous iron, increasing the half-life of Fe2+ 100-fold from ∼3 to ∼335 days in the presence of O2, while the exometabolome of TAG-1 grown on hydrogen had no effect. Moreover, the few precipitates that formed in the presence of TAG-1's iron-oxidizing exometabolome were poorly crystalline, compared with the abundant iron particles that mineralized in the absence of abiotic controls. We offer an initial exploration of TAG-1's iron-oxidizing exometabolome and discuss potential key contributors to this process. Overall, our findings demonstrate that the exometabolome as a whole leads to a sustained accumulation of ferrous iron in the presence of oxygen, consequently altering the redox equilibrium. This previously unknown adaptation likely enables these microorganisms to persist in an iron-oxidizing and iron-precipitating world and could have impacts on the bioavailability of iron to FeOB and other life in iron-limiting environments.
Organ damage is a major determinant of work productivity impairment in Behçet’s syndrome: a post hoc analysis of the BODI validation study
Authors: Floris Alberto , Laconi Riccardo , Espinosa Gerard , Lopalco Giuseppe , Serpa Pinto Luisa , Kougkas Nikolaos , Sota Jurgen , Lo Monaco Andrea , Govoni Marcello , Fabiani Claudia , Bertsias George , Correia João , Iannone Florenzo , Cervera Ricard , Vasconcelos Carlos , Mathieu Alessandro , Cauli Alberto , Piga Matteo 
Published: December 2023

Abstract

Objectives
To evaluate the prevalence, magnitude and potential determinants of work productivity impairment in patients with Behçet’s syndrome (BS), focusing on the role of irreversible organ damage.

Methods
A post hoc analysis of the BS Overall Damage Index (BODI) prospective validation study was performed. Demographics and clinical features were recorded in all patients. The Work Productivity and Activity Impairment: General Health (WPAI:GH) questionnaire was administered to assess the work limitation and the BODI to measure organ damage. The independent effect of BS features on WPAI:GH outcomes was evaluated by regression analysis.

Results
Of 148 patients, 34.5% were unemployed, with age [odds ratio (OR) 1.035] and BODI score (OR 1.313 for a 1-unit increase) as the only factors significantly (P &lt; 0.05) associated with the unemployment state. Overall work impairment was reported in ≈64.2% of the employed patients. Indeed, 22.7% reported missing work hours due to their health (absenteeism), with a mean time loss of 34.4%, whereas 60.2% declared reduced performance at work because of their health (presenteeism), with a mean productivity impairment of 45.4%. Ocular damage was associated with absenteeism (β = 0.225); female sex (β = 0.260), physician global assessment of disease activity (β = 0.502) and an increased BODI score (β = 0.166 for 1-point increase) with presenteeism; and fibromyalgia (β = 0.246), Physician Global Assessment (β = 0.469) and musculoskeletal damage (β = 0.325) with overall work impairment.

Conclusions
Disease activity and organ damage accrual remarkably affect work productivity in BS patients. Achieving remission and preventing damage accrual are crucial and complementary objectives.
Decoding the diagnostic potential of T cell repertoires in peripheral blood of patients from amnestic mild cognitive impairment to Alzheimer's disease
Authors: Du Yansheng , Zhang Yichen , Diao Jiuzhou , Fu Pengrui , Jiang Runze , Wang Ping , Yang Hui , Zheng Xiaolei , Zhang Leisheng , Bi Jianzhong , Zhou Qingbo 
Published: December 2023

AbstractAlzheimer's disease (AD) is currently an incurable neurodegenerative disorder and is the most common etiological cause of dementia. Consequently, it has severe burden on its patients and on their caregivers and represents a global health concern. Clinical investigations have indicated that a dysregulation of peripheral T cell immune homeostasis may be involved in the pathogenesis of AD, as well as in the early stages of AD, characterized by mild cognitive impairment (MCI). However, the characteristics and concomitant feasibility of the use of T‐cell receptor (TCR) typing for disease diagnosis remains largely unknown. We employed a high‐throughput sequencing and multidimensional bioinformatics analyses for the identification of TCR repertoires present in peripheral blood samples of 10 patients with amnestic MCI (aMCI), 10 patients with AD, and 10 healthy controls (HCs). Based on the characteristics of the TCR repertoires in the amount and diversity of combinations of V–J, the spectrum of immune defense, and differentially expressed genes (DEGs), single and specific TCR profiles were observed in the patient samples of aMCI and AD compared to profiles of HCs. In particular, the diversity of TCR clonotypes manifested a pattern of “decreased first and then increased” pattern during the progression from aMCI to AD, a pattern that was not observed in HC samples. Additionally, a total of 46 and 35 amino acid CDR3 sequences with consistent and reverse expressive abundance with diversity of TCR clonotypes were identified, respectively. Taken together, we provide novel and essential preliminary evidence demonstrating the presence of diversity of T cell repertoires from differentially expressed V–J gene segments and amino acid clonotypes using peripheral blood samples from patients with AD, aMCI, and from HC. Such findings have the potential to reveal potential mechanisms through which aMCI progresses to AD and provide a reference for the future development of immune‐related diagnoses and therapies for AD.
Orthopaedic Trauma and Anemia: Conservative versus Liberal Transfusion Strategy: A Prospective Randomized Study
Authors: Mullis Brian H. , Mullis Leilani S. , Kempton Laurence B. , Virkus Walter , Slaven James E. , Bruggers Jennifer 
Published: December 2023

OBJECTIVES:To determine whether it is safe to use a conservative packed red blood cell transfusion hemoglobin (Hgb) threshold (5.5 g/dL) compared with a liberal transfusion threshold (7.0 g/dL) for asymptomatic musculoskeletal injured trauma patients who are no longer in the initial resuscitative period.METHODS:Design:Prospective, randomized, multicenter trial.Setting:Three level 1 trauma centers.Patient Selection Criteria:Patients aged 18–50 with an associated musculoskeletal injury with Hgb less than 9 g/dL or expected drop below 9 g/dL with planned surgery who were stable and no longer being actively resuscitated were randomized once their Hgb dropped below 7 g/dL to a conservative transfusion threshold of 5.5 g/dL versus a liberal threshold of 7.0 g/dL.Outcome Measures and Comparisons:Postoperative infection, other post-operative complications and Musculoskeletal Functional Assessment scores obtained at baseline, 6 months, and 1 year were compared for liberal and conservative transfusion thresholds.RESULTS:Sixty-five patients completed 1 year follow-up. There was a significant association between a liberal transfusion strategy and higher rate of infection (P= 0.01), with no difference in functional outcomes at 6 months or 1 year. This study was adequately powered at 92% to detect a difference in superficial infection (7% for liberal group, 0% for conservative,P< 0.01) but underpowered to detect a difference for deep infection (14% for liberal group, 6% for conservative group,P= 0.2).CONCLUSIONS:A conservative transfusion threshold of 5.5 g/dL in an asymptomatic young trauma patient with associated musculoskeletal injuries leads to a lower infection rate without an increase in adverse outcomes and no difference in functional outcomes at 6 months or 1 year.LEVEL OF EVIDENCE:Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Strain on Scarce Intensive Care Beds Drives Reduced Patient Volumes, Patient Selection, and Worse Outcome: A National Cohort Study*
Authors: Brinkman Sylvia , de Keizer Nicolette F. , de Lange Dylan W. , Dongelmans Dave A. , Termorshuizen Fabian , van Bussel Bas C.T. 
Published: December 2023

OBJECTIVES:Strain on ICUs during the COVID-19 pandemic required stringent triage at the ICU to distribute resources appropriately. This could have resulted in reduced patient volumes, patient selection, and worse outcome of non-COVID-19 patients, especially during the pandemic peaks when the strain on ICUs was extreme. We analyzed this potential impact on the non-COVID-19 patients.DESIGN:A national cohort study.SETTING:Data of 71 Dutch ICUsPARTICIPANTS:A total of 120,393 patients in the pandemic non-COVID-19 cohort (from March 1, 2020 to February 28, 2022) and 164,737 patients in the prepandemic cohort (from January 1, 2018 to December 31, 2019).INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:Volume, patient characteristics, and mortality were compared between the pandemic non-COVID-19 cohort and the prepandemic cohort, focusing on the pandemic period and its peaks, with attention to strata of specific admission types, diagnoses, and severity. The number of admitted non-COVID-19 patients during the pandemic period and its peaks were, respectively, 26.9% and 34.2% lower compared with the prepandemic cohort. The pandemic non-COVID-19 cohort consisted of fewer medical patients (48.1% vs. 50.7%), fewer patients with comorbidities (36.5% vs. 40.6%), and more patients on mechanical ventilation (45.3% vs. 42.4%) and vasoactive medication (44.7% vs. 38.4%) compared with the prepandemic cohort. Case-mix adjusted mortality during the pandemic period and its peaks was higher compared with the prepandemic period, odds ratios were, respectively, 1.08 (95% CI, 1.05–1.11) and 1.10 (95% CI, 1.07–1.13).CONCLUSIONS:In non-COVID-19 patients the strain on healthcare has driven lower patient volume, selection of fewer comorbid patients who required more intensive support, and a modest increase in the case-mix adjusted mortality.
Dabrafenib plus trametinib in unselected advanced BRAF V600–mut melanoma: a non-interventional, multicenter, prospective trial
Authors: Richtig Erika , Nguyen Van A. , Koelblinger Peter , Wolf Ingrid , Kehrer Helmut , Saxinger Werner , Ressler Julia M. , Weinlich Georg , Meyersburg Damian , Hafner Christine , Jecel-Grill Elisabeth , Kofler Julian , Lange-Asschenfeldt Bernhard , Weihsengruber Felix , Rappersberger Klemens , Svastics Nina , Gasser Klaus , Seeber Arno , Kratochvill Franz , Nagler Sophie , Mraz Bernhard , Hoeller Christoph 
Published: December 2023

Objective
The efficacy of combined BRAF and MEK inhibition for BRAF V600–mutant melanoma in a broad patient population, including subgroups excluded from phase 3 trials, remains unanswered. This noninterventional study (DATUM-NIS) assessed the real-world efficacy, safety and tolerability of dabrafenib plus trametinib in Austrian patients with unresectable/metastatic melanoma.

Methods
This multicenter, open-label, non-interventional, post-approval, observational study investigated the effectiveness of dabrafenib plus trametinib prescribed in day-to-day clinical practice to patients (N = 79) with BRAF V600–mutant unresectable/metastatic melanoma with M1c disease (American Joint Committee on Cancer staging manual version 7), ECOG > 1, and elevated serum lactate dehydrogenase (LDH). The primary endpoint was 6-, 12- and 18-month progression-free survival (PFS) rates. Secondary endpoints were median PFS, disease control rate and overall survival (OS).

Results
The 6-, 12- and 18-month PFS rates were 76%, 30.6% and 16.2%, respectively. Subgroup analysis showed a significant PFS benefit in the absence of lung metastasis. The median PFS and OS were 9.1 (95% CI, 7.1–10.3) months and 17.9 (95% CI, 12.7–27.8) months, respectively. The 12- and 24-month OS rates were 62.7% and 26.8%, respectively. Subgroup analyses showed significant OS benefits in the absence of bone or lung metastasis and the presence of other metastases (excluding bone, lung, brain, liver and lymph nodes). Furthermore, S100 and Eastern Cooperative Oncology Group performance status (ECOG PS) showed a significant impact on survival. No new safety signals were observed.

Conclusion
Despite an unselected population of melanoma patients with higher M1c disease, ECOG PS > 1 and elevated LDH, this real-world study demonstrated comparable efficacy and safety with the pivotal phase 3 clinical trials for dabrafenib–trametinib.
A specialized health camp (Orthopedics) in rural set up: an experience from a tertiary care institution in Nepal
Authors: Maharjan Sagar , Shrestha Rohit , Shrestha Pramit R. , Acharya Suyash , Khadka Sushant K. , Thapa Sangharsha , Chaudhary Aashutosh 
Published: December 2023

Background:
A health camp is a stationary or mobile short-term medical intervention done for target communities in order to provide medical check-ups and medications to the people in the community. A specialized health camp focuses on a certain group of people for detailed workup and hence better results. Such specialized health camps have not been conducted for orthopedics in Nepal yet.

Methods:
This is a retrospective cross-sectional study conducted from 2016 to 2019. Data recorded on a proforma were stored on an Excel spreadsheet and later analyzed using SPSS 16.0. Chief complaints and other relevant demographic data were analyzed.

Results:
A total of 1554 patients were seen with a mean age group of 49.9 years. The most common complaints were knee pain 544 (35.00%) followed by back pain 513 (33.01%).

Conclusion:
A specialized health camp is beneficial to a community as it results in early diagnosis and prompt management of a disease. It also leads to increased awareness among people belonging to a rural community.
Enhanced Recovery after Surgery Protocol Decreases Length of Stay and Postoperative Narcotic Use in Microvascular Breast Reconstruction
Authors: Muetterties Corbin E. , Taylor Jeremiah M. , Kaeding Diana E. , Morales Ricardo R. , Nguyen Anissa V. , Kwan Lorna , Tseng Charles Y. , Delong Michael R. , Festekjian Jaco H. 
Published: December 2023

Background:Enhanced recovery after surgery (ERAS) protocols have demonstrated efficacy following microvascular breast reconstruction. This study assesses the impact of an ERAS protocol following microvascular breast reconstruction at a high-volume center.Methods:The ERAS protocol introduced preoperative counseling, multimodal analgesia, early diet resumption, and early mobilization to our microvascular breast reconstruction procedures. Data, including length of stay, body mass index, inpatient narcotic use, outpatient narcotic prescriptions, inpatient pain scores, and complications, were prospectively collected for all patients undergoing microvascular breast reconstruction between April 2019 and July 2021. Traditional pathway patients who underwent reconstruction immediately before ERAS implementation were retrospectively reviewed as controls.Results:The study included 200 patients, 99 in traditional versus 101 in ERAS. Groups were similar in body mass index, age (median age: traditional, 54.0 versus ERAS, 50.0) and bilateral reconstruction rates (59.6% versus 61.4%). ERAS patients had significantly shorter lengths of stay, with 96.0% being discharged by postoperative day (POD) 3, and 88.9% of the traditional cohort were discharged on POD 4 (P< 0.0001). Inpatient milligram morphine equivalents (MMEs) were smaller by 54.3% in the ERAS cohort (median MME: 154.2 versus 70.4,P< 0.0001). Additionally, ERAS patients were prescribed significantly fewer narcotics upon discharge (median MME: 337.5 versus 150.0,P< 0.0001). ERAS had a lower pain average on POD 0–3; however, this finding was not statistically significant.Conclusion:Implementing an ERAS protocol at a high-volume microvascular breast reconstruction center reduced length of stay and postoperative narcotic usage, without increasing pain or perioperative complications.
A Practical Guide to Implementing Holistic Review during Surgery Resident Selection
Authors: Reghunathan Meera , Thompson Noelle , Sendek Gabriela , Butler Paris D. , Reid Chris M. , Gosman Amanda A. 
Published: December 2023

Summary:
Provider workforce diversity is a key component of improving healthcare quality and addressing healthcare disparities. Furthermore, the traditional approach of “score-centered” application metrics do not consistently correlate with meeting milestones in surgery, nor do they adequately predict a surgical resident’s clinical strength and operative abilities. We present here an adaptable process by which surgical residency programs can identify their values and incorporate holistic review into their resident selection process to improve resident selection and physician workforce diversity.
Desire for Body Contouring Surgery after Bariatric Surgery: A Nationwide Cross-sectional Study in Saudi Arabia
Authors: Rabah Sari M. , Albrahim Razan A. , Almajed Ebtesam H. , AlZabin Alya K. , Aldawish Reema A. , Alyahiwi Lara S. , Alshabnan Rand A. 
Published: December 2023

Background:
The obesity pandemic in Saudi Arabia has led to a high demand for bariatric surgery (BS). Post-BS patients experience rapid and massive weight loss, with most patients experiencing redundant skin, leading to a desire for body contouring surgery (BCS).

Methods:
A cross-sectional study was conducted from September 2022 to May 2023 among patients who underwent BS in Saudi Arabia, using an online self-administered questionnaire. The questionnaire comprised sociodemographic data, weight, and BS-related questions, and the post-BS appearance questionnaire assessed the desire for BCS, excess skin satisfaction, and overall appearance.

Results:
A total of 410 of the patients electively enrolled. The mean perceived satisfaction of post-BS patients with the body’s excess skin was rated as 4.28 ± 1.69 out of 7 points. The overall desire for BCS among the post-BS population was equal to a collective mean desire of 2.10 ± 0.92 out of 4 points. The desired body sites for BCS were focused on the abdomen/waist, followed by the lower back, then upper arms, buttocks, and thighs. Only 25.1% of the patients fulfilled their desires and recently underwent BCS.

Conclusions:
The study highlights the importance of incorporating plastic and reconstructive surgery as an integral part of the multidisciplinary approach to morbidly obese patients after BS and the need for national guidelines on the referral pathway for post-BS BCS.
Radioactive iodine therapy for follicular thyroid cancer: a 15 years follow-up study of Chinese patients
Authors: Shi He , Yang Bo , Feng Jian-Iin , Li Jian-hua , Cheng Xu , Li Yong-jun , Fu Yu , Xu Xin-dan , Qian Lei-hang , Tang Li-jun , Liu Wei 
Published: December 2023

Purpose
To identify long-term predictors of distant metastases (DM) and the overall survival (OS) of follicular thyroid cancer (FTC) patients who underwent radioactive iodine (RAI) therapy. And to expand the knowledge about the clinical course and experience of RAI treatment for FTC.

Materials
A total of 117 FTC patients who underwent RAI therapy at our institution from 2005 to 2020 were retrospectively studied. Patient characteristics, serum stimulating thyroglobulin (sTg) and thyroglobulin antibody levels, treatment process and follow-up data were collected until 26 April 2022.

Results
A total of 16 patients (13.7%) were lost to follow-up. A total of 23 (19.7%) patients with DM died and all FTC without DM were still alive. DM was seen in 58.4% (59/101) of patients. The most common location for metastatic lesions was the lung. Then was bone. The mean survival time of FTC with RAI was 156 months [95% confidence interval (CI): 142–171]. Five-year and 10-year cumulative survival rates of them were 88.8% and 67.4%, respectively. As for patients with DM were 80.4% and 41.3%, respectively. Age at diagnosis [odds ratio (OR) = 1.080, P = 0.009], RAI therapy sessions (OR = 2.959, P = 0.001) and sTg level (OR = 1.006, P = 0.002) were predictive of DM occurrence in FTC with RAI. In the group of FTC with DM, survival analysis showed that males were more likely to have a lower OS than females (P = 0.039).

Conclusion
Age, number of RAI therapy sessions, and sTg level were predictive of the occurrence of DM in FTC patients with RAI. Sex would influence the OS of FTC patients with DM.
From tutor to future educator: Investigating the role of peer-peer tutoring in shaping careers in medical education
Authors: Stokes Lauren , Singh Harinder 
Published: December 2023

AbstractIn the effort to promote academic excellence and provide authentic teaching experiences and training for medical students, the University of California, Irvine, School of Medicine (UCISOM) built a novel peer tutoring program, Collaborative Learning Communities with Medical Students as Teachers (CLC-MSAT). While the role of peer-assisted learning in student success on academic courses is well established, we wanted to assess the impact of our peer-assisted learning program on tutor’s career interest in medical education. Through a mixed-methods analysis of our peer tutors’ experiences, we found >80% were overall satisfied with their positions; >85% learned new skills; >88% felt they were strong teachers; >88% felt they now had a stronger grasp of the medical curriculum. Our findings suggest that the CLC-MSAT program has a positive impact in exposing medical students to teaching experience and training, which may help prepare the next generation of academic clinicians.