bluuebunny/crossref_metadata_2025_split huggingface dataset:
A low-cost culture- and DNA extraction-free method for the molecular detection of pneumococcal carriage in saliva
Authors: Peno Chikondi , Lin Tzu-Yi , Hislop Maikel S. , Yolda-Carr Devyn , Farjado Katherine , York Anna , Pitzer Virginia E. , Weinberger Daniel M. , Bei Amy K. , Allicock Orchid M. , Wyllie Anne L. 
Published: December 2023

AbstractBackgroundMolecular methods have improved the sensitivity of detection of pneumococcal carriage in saliva. However, they typically require sample culture-enrichment and nucleic acid extraction, prior to performing the detection assay. These factors may limit scalability for extensive surveillance of pneumococcus, particularly in low-resource settings. In this study, we evaluated the performance of a DNA-extraction-free method for the detection of pneumococcus in saliva.MethodsWe developed a streamlined qPCR-based protocol for the detection of pneumococcus, omitting culture-enrichment and DNA extraction. Using saliva samples collected from children attending childcare centers (New Haven, CT, USA), we evaluated detection of pneumococcus using saliva lysates as compared to purified DNA extracted from culture-enriched aliquots of the paired samples using qPCR targeting the pneumococcalpiaBgene.ResultsOf 759 saliva samples tested from 92 children (median age 3.65 years; IQR (2.46-4.78), pneumococcus was detected in 358 (47.2%) saliva lysates prepared using the extraction-free protocol and in 369 (48.6%) DNA extracted from the culture-enriched samples. We observed a near-perfect agreement between the two protocols (Cohen’s kappa: 0.92; 95%CI: 0.90-0.95). While we also observed a high correlation between the qPCR CTvalues generated by the two methods (r=0.93,p<0.0001), the CTvalues generated from the extraction-free, saliva lysates were higher (lower concentration) than those obtained from DNA extracted from culture-enriched samples (ΔCT= 6.68,p<0.00001).ConclusionsFor pneumococcal carriage surveillance in children, our findings suggest that a DNA extraction-free approach may offer a cost-effective alternative to the resource-intensive culture-enrichment method. While, as expected, we observed higher qPCR CTvalues (lower bacterial load) in the absence of culture-enrichment, the overall rate of detection remained unaffected.
Buried or Exposed Kirschner Wire for the Management of Hand and Forearm Fractures: A Systematic Review, Meta-Analysis, and Meta-Regression
Authors: Hidajat Nucki Nursjamsi , Magetsari RM. Satrio Nugroho , Prasetiyo Gregorius Thomas , Respati Danendra Rakha Putra , Tjandra Kevin Christian 
Published: December 2023

AbstractBackgroundThe recommendation on whether to bury or expose the Kirschner wire (K-wire) for the management of fractures has still been controversial with inconsistent results in the published studies. This study aims to summarize the comparison between buried and exposed K-wire for the management of hand and forearm fractures.MethodsWe conducted relevant literature searches on Europe PMC, Medline, Scopus, and Cochrane Library databases using specific keywords. The results of continuous variables were pooled into the standardized mean difference (SMD), while dichotomous variables were pooled into odds ratio (OR) along with 95% confidence intervals (95% CI) using random-effect models.ResultsA total of 11 studies were included. Our pooled analysis revealed that buried K-wire was associated with a lower risk of pin site infection [RR 0.49 (95% CI 0.36 – 0.67),p< 0.00001,I2= 0%] and longer duration until pin removal [MD 33.85 days (95% CI 18.68 – 49.02),p< 0.0001,I2= 99%] when compared with exposed K-wire. However, the duration of surgery was significantly longer in the buried K-wire [MD 6.98 minutes (95% CI 2.19 – 11.76),p= 0.004,I2= 42%] with no significant difference in the early pin removal rate [RR 0.73 (95% CI 0.36 – 1.45),p= 0.37,I2= 0%]. Further regression analysis revealed that sample size, age, sex, and duration of follow-up did not affect those relationships.ConclusionBuried K-wire may offer benefits in reducing the infection rate with a longer duration until pin removal. However, further RCTs with larger sample sizes are still needed to confirm the results of our study.
Exploring factors influencing user perspective of ChatGPT as a technology that assists in healthcare decision making: A cross sectional survey study
Authors: Choudhury Avishek , Elkefi Safa , Tounsi Achraf 
Published: December 2023

AbstractAs ChatGPT emerges as a potential ally in healthcare decision-making, it is imperative to investigate how users leverage and perceive it. The repurposing of technology is innovative but brings risks, especially since AI’s effectiveness depends on the data it’s fed. In healthcare, where accuracy is critical, ChatGPT might provide sound advice based on current medical knowledge, which could turn into misinformation if its data sources later include erroneous information. Our study assesses user perceptions of ChatGPT, particularly of those who used ChatGPT for healthcare-related queries. By examining factors such as competence, reliability, transparency, trustworthiness, security, and persuasiveness of ChatGPT, the research aimed to understand how users rely on ChatGPT for health-related decision-making. A web-based survey was distributed to U.S. adults using ChatGPT at least once a month. Data was collected from February to March 2023. Bayesian Linear Regression was used to understand how much ChatGPT aids in informed decision-making. This analysis was conducted on subsets of respondents, both those who used ChatGPT for healthcare decisions and those who did not. Qualitative data from open-ended questions were analyzed using content analysis, with thematic coding to extract public opinions on urban environmental policies. The coding process was validated through inter-coder reliability assessments, achieving a Cohen’s Kappa coefficient of 0.75. Six hundred and seven individuals responded to the survey. Respondents were distributed across 306 US cities of which 20 participants were from rural cities. Of all the respondents, 44 used ChatGPT for health-related queries and decision-making. While all users valued the content quality, privacy, and trustworthiness of ChatGPT across different contexts, those using it for healthcare information place a greater emphasis on safety, trust, and the depth of information. Conversely, users engaging with ChatGPT for non-healthcare purposes prioritize usability, human-like interaction, and unbiased content. In conclusion our study findings suggest a clear demarcation in user expectations and requirements from AI systems based on the context of their use.
Enhancing Patient Safety in Opioid Prescribing: A Systematic Review of Potential Indicators
Authors: Bansal Neetu , Khawagi Wael Y. , Shang Nan , Chen Li-Chia 
Published: December 2023

AbstractBackgroundThis systematic review aimed to identify a comprehensive list of prescribing safety indicators for opioids in any setting from published literature.MethodsLiterature that reported prescribing indicators from 1990-2019 was retrieved from a published systematic review. A subsequent search was conducted from seven electronic databases to identify additional studies from 2019 to 2022. Potential opioid safety prescribing indicators were extracted from studies that reported prescribing indicators of non-injectable opioids and narcotics prescribed to adults with or without specific conditions, concomitant medications, or laboratory monitoring with concerns about the potential safety risk of harm. Retrieved indicators were split by each opioid and merged for the same drugs. Identified indicators were categorised by the type of problem, medication, patient condition/disease, and the risk of the indicators.ResultsOf the 107 indicators retrieved from 48 included articles, 71 were included. Thirty-five (49.3%) opioid prescribing indicators focused on a specific class of opioids, i.e., ‘opioids’ (n=30, 42.3%) and ‘strong opioids’ (n=5, 7.0%); tramadol and fentanyl were the most commonly reported drug (n=6, 8.5%). The indicators account for six types of problems: medication inappropriate to the population (n=16), omission (n=7), inappropriate duration (n=4), inadequate monitoring (n=7), drug-disease interaction (n=16), and drug-drug interaction (n=27). Of all indicators, older age (over 65) is the most common risk factor (n=34, 47.9%). Central nervous system-related adverse effects are the risk of concern for the 27 indicators associated with drug-drug interaction (n=24, 88.9%). Besides, five of the six ‘omission’ indicators are related to ‘without using laxatives’.ConclusionThis review identified a comprehensive list of indicators that can be applied to flag patients with a high risk of opioid-related harm to facilitate complex decision-making in optimising opioids for pain management. Further research is needed to validate and determine the feasibility of identifying hazardous prescribing in various care settings.
Comparison of the diagnostic accuracy among GPT-4 based ChatGPT, GPT-4V based ChatGPT, and radiologists in musculoskeletal radiology
Authors: Horiuchi Daisuke , Tatekawa Hiroyuki , Oura Tatsushi , Shimono Taro , Walston Shannon L , Takita Hirotaka , Matsushita Shu , Mitsuyama Yasuhito , Miki Yukio , Ueda Daiju 
Published: December 2023

AbstractObjectiveTo compare the diagnostic accuracy of Generative Pre-trained Transformer (GPT)-4 based ChatGPT, GPT-4 with vision (GPT-4V) based ChatGPT, and radiologists in musculoskeletal radiology.Materials and MethodsWe included 106 “Test Yourself” cases fromSkeletal Radiologybetween January 2014 and September 2023. We input the medical history and imaging findings into GPT-4 based ChatGPT and the medical history and images into GPT-4V based ChatGPT, then both generated a diagnosis for each case. Two radiologists (a radiology resident and a board-certified radiologist) independently provided diagnoses for all cases. The diagnostic accuracy rates were determined based on the published ground truth. Chi-square tests were performed to compare the diagnostic accuracy of GPT-4 based ChatGPT, GPT-4V based ChatGPT, and radiologists.ResultsGPT-4 based ChatGPT significantly outperformed GPT-4V based ChatGPT (p< 0.001) with accuracy rates of 43% (46/106) and 8% (9/106), respectively. The radiology resident and the board-certified radiologist achieved accuracy rates of 41% (43/106) and 53% (56/106). The diagnostic accuracy of GPT-4 based ChatGPT was comparable to that of the radiology resident but was lower than that of the board-certified radiologist, although the differences were not significant (p= 0.78 and 0.22, respectively). The diagnostic accuracy of GPT-4V based ChatGPT was significantly lower than those of both radiologists (p< 0.001 and < 0.001, respectively).ConclusionGPT-4 based ChatGPT demonstrated significantly higher diagnostic accuracy than GPT-4V based ChatGPT. While GPT-4 based ChatGPT’s diagnostic performance was comparable to radiology residents, it did not reach the performance level of board-certified radiologists in musculoskeletal radiology.
Explaining the stable coexistence of drug-resistant and -susceptible pathogens: the Resistance Acquisition Purifying Selection model
Authors: Pennings Pleuni S 
Published: December 2023

AbstractDrug resistance is a problem in many pathogens. While overall, levels of resistance have risen in recent decades, there are many examples where after an initial rise, levels of resistance have stabilized. The stable coexistence of resistance and susceptibility has proven hard to explain – in most evolutionary models, either resistance or susceptibility ultimately “wins” and takes over the population. Here, we show that a simple stochastic model, mathematically akin to mutation-selection balance theory, can explain several key observations about drug resistance: (1) the stable coexistence of resistant and susceptible strains (2) at levels that depend on population-level drug usage and (3) with resistance often due to many different strains (resistance is present on many different genetic backgrounds). The model works for resistance due to both mutations or horizontal gene transfer (HGT). It predicts that new resistant strains should continuously appear (through mutation or HGT and positive selection within treated hosts) and disappear (due to a fitness cost of resistance). The result is that while resistance is stable,whichstrains carry resistance is constantly changing. We used data from a longitudinal genomic study onE. coliin Norway to test this prediction for resistance to five different drugs and found that, consistent with the model, most resistant strains indeed disappear quickly after they appear in the dataset. Having a model that explains the dynamics of drug resistance will allow us to plan science-backed interventions to reduce the burden of drug resistance.Graphical abstract
Permanent deconstruction of intracellular primary cilia in differentiating granule cell neurons
Authors: Ott Carolyn M. , Constable Sandii , Nguyen Tri M. , White Kevin , Lee Wei-Chung Allen , Lippincott-Schwartz Jennifer , Mukhopadhyay Saikat 
Published: December 2023

ABSTRACTPrimary cilia on granule cell neuron progenitors in the developing cerebellum detect sonic hedgehog to facilitate proliferation. Following differentiation, cerebellar granule cells become the most abundant neuronal cell type in the brain. While essential during early developmental stages, the fate of granule cell cilia is unknown. Here, we provide nanoscopic resolution of ciliary dynamicsin situby studying developmental changes in granule cell cilia using large-scale electron microscopy volumes and immunostaining of mouse cerebella. We found that many granule cell primary cilia were intracellular and concealed from the external environment. Cilia were disassembed in differentiating granule cell neurons in a process we call cilia deconstruction that was distinct from pre-mitotic cilia resorption in proliferating progenitors. In differentiating granule cells, ciliary loss involved unique disassembly intermediates, and, as maturation progressed, mother centriolar docking at the plasma membrane. Cilia did not reform from the docked centrioles, rather, in adult mice granule cell neurons remained unciliated. Many neurons in other brain regions require cilia to regulate function and connectivity. In contrast, our results show that granule cell progenitors had concealed cilia that underwent deconstruction potentially to prevent mitogenic hedgehog responsiveness. The ciliary deconstruction mechanism we describe could be paradigmatic of cilia removal during differentiation in other tissues.
Healthcare Cost Literacy: Exploration of Concept and Initial Development of a Novel Tool in a Representative U.S. Adult Population
Authors: Guttentag Alexandra , Warraich Haider J , van Meijgaard Jeroen 
Published: December 2023

AbstractThere is a growing need for understanding and addressing the issue of healthcare cost literacy (HCL) in the United States. We conducted a survey in partnership with YouGov targeting a representative sample of 1500 American adults (median age 47, 51.4% female, 62.8% white) to help develop a novel tool to assess the prevalence of HCL, and to estimate levels of HCL and health literacy across various sociodemographic and health-related variables. An exploratory factor analysis revealed that the HCL questions mapped to three factors: 1) knowledge on health insurance terminology/interpretation, 2) ability to estimate healthcare costs ahead of time, and 3) confidence in performing cost comparisons between healthcare plans and deductibles. An understanding of Americans’ levels of HCL will help policymakers and various stakeholders in the healthcare system to develop targeted plans to educate consumers on financial planning and evaluation in the healthcare system.
Association of Daily Step Count and Postoperative Surgical Complications Among All of Us Research Participants
Authors: Gehl Carson J. , Verhagen Nathaniel B. , Shaik Tahseen J. , Nimmer Kaitlyn , Yang Xin , Xing Yun , Taylor Bradley W. , Nataliansyah Mochamad M. , Kerns Sarah L. , Kothari Anai N. 
Published: December 2023

ABSTRACTBackgroundThe association between preoperative wearable device step counts and surgical outcomes has not been examined using commercial devices linked to electronic health records (EHR). This study measured the association between daily preoperative step counts and postoperative complications.Study DesignData was obtained using the All of Us (AOU) Research program, a nationwide initiative to collect EHR and health-related data from the population. Included were patients who underwent a surgical procedure included in the National Surgical Quality Improvement Program (NSQIP) targeted procedures dataset. Excluded were patients who did not have available physical activity FitBit data. Primary outcome was the development of a postoperative complication. All analyses were performed in the AOU researcher workbench.ResultsOf 27,150 patients who underwent a surgical procedure, 475 participants with preoperative wearable data were included. 74.7% were female and 85.2% were White. The average age was 57.2 years. The overall rate of postoperative complications was 12.6%. Patients averaging fewer than 7,500 daily steps were at increased odds for developing a postoperative complication (OR 1.83, 95% CI [1.01, 3.31]). Following adjustment for age, sex, race, comorbid disease, body mass index (BMI), and relative procedure risk, patients with a baseline average steps/day < 7,500 were at increased odds for postoperative complication (aOR = 2.06, 95% CI [1.05, 4.06]).ConclusionsThis study found an increase in overall postoperative complication rate in patients recording lower average preoperative step counts. Patients with a baseline of less than 7,500 steps per day had increased odds of postoperative complications in this cohort. This data supports the use of wearable devices for surgical risk stratification and suggests step count may measure preoperative fitness.
Clinical features of cystic neutrophil granulomatous mastitis in 62 cases
Authors: Wang Mengjie , Zhang Dongxiao , Fu Na , Liu Min , Zhang Hongkai , Feng Shuo , Zeng Yifei , Zhao Wenjie , Cui Jianchun , Mansoor Khattak Mazher 
Published: December 2023

AbstractBackgroundCystic Neutrophilic Granulomatous Mastitis (CNGM) is a rare inflammatory condition affecting the breast. Despite its rarity, understanding its pathogenesis and clinical features is crucial for accurate diagnosis and effective management. This study delves into the nuanced aspects of CNGM, shedding light on its unique characteristics and potential underlying mechanisms. Methods: In this meticulous investigation, we meticulously examined and analyzed the biological data, clinical features, ultrasound imaging findings, and histopathological morphological information of 62 patients diagnosed with CNGM after thorough pathological examination. The study cohort was sourced from the Galactophore department of Beijing Hospital of Traditional Chinese Medicine, spanning the period from September 2019 to September 2022. Results: Sixty-two patients, with an average age of 33.30 years, were predominantly female. Among the 52 patients with detailed documentation of onset following the final delivery, various factors were identified, including hyperprolactinemia, pituitary tumors, psychiatric medication history, granulomatous mastitis history, breast trauma history, and a family history of breast cancer. The primary clinical manifestations were characterized by pain and palpable masses, accompanied by localized symptoms such as redness, ulceration, nipple discharge, and nipple retraction. Additionally, systemic symptoms, such as fever, headache, erythema nodosum, and cough, were observed. Ultrasound examinations revealed predominantly hypoechoic masses with heterogeneous echogenicity. Axillary lymphadenopathy, dilated ducts, and thickening of breast tissue were also noted in some cases. Histopathological analyses demonstrated lobular structural destruction, acute and chronic inflammatory cell infiltration, multinucleated giant cell reactions, granulomas, and cyst formation. Gram staining revealed detection rates of 41.94% (26/62) for gram-positive bacteria and 11.29% (7/62) for gram-negative bacteria. Conclusion: This study highlights the occurrence of Chronic Nonspecific Granulomatous Mastitis (CNGM) in women of childbearing age. Factors such as milk stasis, mammary duct secretion overcharge, exogenous trauma, hormonal influences, and bacterial colonization are implicated in the initiation and recurrence of CNGM. Notably, nipple retraction emerged not only as a clinical symptom but also as a potential risk factor for CNGM. The prevalence of multiple hypoechoic regions in CNGM surpassed that observed in breast cancer cases. The detection of gram-positive bacteria underscores the pivotal role of bacterial infections in the development of CNGM.
Expression of mechano-growth factor (MGF) in refractory overactive bladder
Authors: Spiritosanto E , Lemmon B , Mohamedi-Yousufi F , Munasinghe HA , Mahmood A , Bray R , McNeice R , Mackenzie FE , Hill NJ , Cortes E 
Published: December 2023

AbstractOveractive bladder (OAB) is a urological symptom complex defined by urinary urgency. It can have a devastating impact on an individual’s quality of life and leads to significant financial cost. Insulin-like growth factor 1 (IGF-1) is a protein hormone involved in a broad range of processes including cell proliferation and differentiation. IGF-1 is also regulated through alternative splicing. While the primaryIGF-1Eatranscript is highly expressed in liver, the alternativeIGF-1Ectranscript encodes the proteolytically-derived MGF peptide and has been primarily studied in skeletal muscle. MGF has been shown to stimulate satellite cell proliferation following tissue mechanical stretch or injury, but the role of MGF in smooth muscle, such as the detrusor muscle of the bladder, has been little explored. The aim of this study was to explore the expression of MGF in bladder biopsies from patients with OAB and age-matched controls.We show using immunohistochemistry that MGF is widely expressed in bladder tissue. Quantification of MGF expression by western blot showed that average MGF expression is more than doubled in OAB biopsies compared to controls (mean MGF in OAB=0.51±0.1, n=23; mean MGF in controls=0.22±0.07, n=9; p=0.05). Furthermore, there is an inverse correlation between MGF protein levels and symptom severity, as determined by the urodynamic parameter maximum cystometric capacity (correlation=0.53, p=0.03 n=16). MGF expression was highest in OAB biopsies with strong expression of the muscle cell markerDES. Combined with our observation that MGF induces cell proliferation in primary bladder cultures, our data suggests that high MGF expression in OAB patients may represent an attempted protective response in the bladder.