bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autologous micro‐fragmented adipose tissue injection provides significant and prolonged clinical improvement in patients with knee osteoarthritis: a case‐series study
Authors: Russo Arcangelo , Cortina Gabriele , Condello Vincenzo , Collarile Marco , Orlandi Roberto , Gianoli Riccardo , Giuliani Emanuele , Madonna Vincenzo 
Published: November 2023

AbstractPurposeAmong the conservative strategies to manage patients with symptomatic knee osteoarthritis (OA), an innovative approach exploiting the regenerative capability of adipose tissue and its resident MSCs (Mesenchymal Stem Cells or Medicinal Signalling Cells) has been proposed with encouraging results. This study aims to demonstrate the benefits of autologous micro‐fragmented adipose tissue (MAT) injection in the conservative treatment of knee osteoarthritis and whether any variables may affect the outcome. This is a case series single‐centre study in which patients underwent intraarticular MAT injection without any associated procedures.MethodsBased on inclusion and exclusion criteria, 49 patients (67 Knees) were included and retrospectively analysed with a mean follow‐up of 34.04 ± 13.62 months (minimum 11 – maximum 59). Patients were assessed through the WOMAC and KOOS questionnaires at baseline (pre‐treatment) and 1‐, 3‐, 6‐, 12‐, 24‐ and 36‐month follow‐up. A minimal clinically important difference (MCID) of at least 7.5 points for the WOMAC pain scale and 7.2 for the WOMAC function scale compared to the baseline value was used.ResultsWOMAC and KOOS scores improved after treatment compared to baseline at all follow‐ups with p < 0.001. Male gender and Kellgren‐Lawrence (KL) grade 2 were associated with smaller improvement in WOMAC and KOOS scores (with respect to females and to KL grade 1, respectively) up to 24 months. The percentage of patients who reach the MCID for WOMAC pain is generally lower than that of patients who reach the MCID for WOMAC function (around 80% at all time points), but it increases significantly over time. Moreover, the baseline score of the WOMAC pain and function influence the outcome. Patients with worse symptoms are more likely to reach the MCID.ConclusionsIntra‐articular knee injection of MAT for the treatment of knee osteoarthritis (KOA), recalcitrant to traditional conservative treatments, proved to be effective in a high percentage of cases. The positive association between a worse pre‐operative score and a better clinical response to the treatment would support the idea that intra‐articular administration of MAT could be considered in patients with very symptomatic KOA in which joint‐replacement surgeries are not indicated (or accepted).Level of EvidenceIV, case series.
Designing a synthetic microbial community through genome metabolic modeling to enhance plant–microbe interaction
Authors: Gonçalves Osiel S. , Creevey Christopher J. , Santana Mateus F. 
Published: November 2023

Abstract
Background
Manipulating the rhizosphere microbial community through beneficial microorganism inoculation has gained interest in improving crop productivity and stress resistance. Synthetic microbial communities, known as SynComs, mimic natural microbial compositions while reducing the number of components. However, achieving this goal requires a comprehensive understanding of natural microbial communities and carefully selecting compatible microorganisms with colonization traits, which still pose challenges. In this study, we employed multi-genome metabolic modeling of 270 previously described metagenome-assembled genomes from Campos rupestres to design a synthetic microbial community to improve the yield of important crop plants.

Results
We used a targeted approach to select a minimal community (MinCom) encompassing essential compounds for microbial metabolism and compounds relevant to plant interactions. This resulted in a reduction of the initial community size by approximately 4.5-fold. Notably, the MinCom retained crucial genes associated with essential plant growth-promoting traits, such as iron acquisition, exopolysaccharide production, potassium solubilization, nitrogen fixation, GABA production, and IAA-related tryptophan metabolism. Furthermore, our in-silico selection for the SymComs, based on a comprehensive understanding of microbe-microbe-plant interactions, yielded a set of six hub species that displayed notable taxonomic novelty, including members of the Eremiobacterota and Verrucomicrobiota phyla.

Conclusion
Overall, the study contributes to the growing body of research on synthetic microbial communities and their potential to enhance agricultural practices. The insights gained from our in-silico approach and the selection of hub species pave the way for further investigations into the development of tailored microbial communities that can optimize crop productivity and improve stress resilience in agricultural systems.
Randomized trial of shunt infection rates comparing intraoperative Vancomycin versus Gentamicin in ventriculoperitoneal shunt system preparation
Authors: Olomo Surajudeen A. , Obande Joseph O. , Bot Gyang M. , Binitie Peter O. 
Published: November 2023

Abstract
Background
Ventriculoperitoneal (VP) shunt is the mainstay of surgical management of patients with hydrocephalus. The insertion of ventriculoperitoneal shunt may be accompanied by many potentially life-threatening complications including shunt infection. Concerted efforts have been made to reduce shunt infection rates, including use of saline- antibiotic solutions containing antibiotics such as Gentamicin, mixture of Gentamicin and Vancomycin in shunt system preparation. We therefore set out to determine the infection rates following the use of intraoperative Gentamicin and Vancomycin in ventriculoperitoneal shunt system preparation and compare the infection rates. Therefore, a randomized single blind comparative study was carried out for a period of seventeen months, among 56 patients that presented to 2 tertiary health centers in Nigeria diagnosed of hydrocephalus. Patients were randomized into Vancomycin- and Gentamicin-shunt preparation groups. The outcome measure was postoperative shunt infection rates. Statistical analysis was performed using SPSS software (version) 21. Group comparisons were made using the Student's t-test for numerical variables, and chi-square test or fisher’s exact test for categorical variables. Statistical significance was inferred at p-value < 0.05.

Result
Fifty-six patients were included in the study. One patient was lost to follow-up in Vancomycin group. Another patient died in Gentamicin group of sudden death without the patient exhibiting symptoms of shunt infection leaving a total of 54 for analysis. All the patients included in the study were followed up for six months. Their mean ages were between 1688.5 ± 665.3 (days) for Vancomycin group and 10,222 ± 6635.8 (days) for Gentamicin group. There was male preponderance of 55.6% as against female of 44.4%. Majority of the hydrocephalus were of congenital cause accounting for 64.8%. There was one shunt infection in the Gentamicin group giving rise to an infection rate of 1.9% which was not statistically significant (P –value—0.313). The organism isolated was Pseudomonas species.

Conclusion
Ventriculoperitoneal shunt infection rates can be reduced to the barest minimum if standard concentration of antibiotics is used to prepare the shunt hardware employing a standard surgical technique.
The sucrose non-fermenting-1 kinase Snf1 is involved in fludioxonil resistance via interacting with the high osmolarity glycerol MAPK kinase Hog1 in Fusarium
Authors: Wang Jing , Wen Ziyue , Chen Yun , Ma Zhonghua 
Published: November 2023

AbstractFusarium head blight (FHB) caused by Fusarium graminearum complex is a worldwide devastating disease of wheat, barley, maize, and other cereals. In the field, application of fungicides is one of the main strategies for management of FHB. With the long-time usage of fungicides, resistant pathogen populations have become a new challenge for disease management. Application of new pesticide is necessary for sustainable control of this disease. The phenylpyrrole fungicide fludioxonil has been registered recently for management of FHB. However, the resistance mechanisms of F. graminearum to this compound are largely unknown. Here we isolated a biocontrol bacterium Burkholderia pyrrocina W1, which produced the antifungal compound pyrrolnitrin and showed greatly antagonistic activity towards FHB. Spontaneous mutants of pyrrolnitrin-resistant F. graminearum were induced and re-sequenced. Single base mutations were identified in the genes encoding the osmoregulation MAP kinase Hog1 and the AMP dependent kinase Snf1 in pyrrolnitrin-resistant mutants. Snf1 was further confirmed to interact with Hog1 and involved in the response of this fungus to pyrrolnitrin and its derivate, the fungicide fludioxonil. This study reveals that the Snf1 interacts with Hog1 to regulate fludioxonil resistance in a pathogenic fungus.
Adapting Connect for Health pediatric weight management program for telehealth in response to the COVID-19 pandemic
Authors: Simione Meg , Aschbrenner Kelly , Farrar-Muir Haley , Luo Man , Granadeno Jazmin , Caballero-Gonzalez Ariadne , Price Sarah N. , Torres Carlos , Boudreau Alexy Arauz , Fiechtner Lauren , Hambidge Simon J. , Sease Kerry , Taveras Elsie M. 
Published: November 2023

Abstract
Background
To address the evolving needs and context changes due to the COVID-19 pandemic, we adapted Connect for Health, an evidence-based, primary care, pediatric weight management intervention. The objective of this study is to describe the planned adaptation process to ensure continued and equitable program uptake during the pandemic.

Methods
Guided by adaptation frameworks, we identified the core functions and forms of Connect for Health and then adapted the intervention in response to a changing healthcare context. We engaged stakeholders and surveyed parents of children with a BMI ≥ 85th percentile and pediatric clinicians and examined their experiences using telehealth for pediatric weight management and needs and preferences. Using multivariable logistic regression, we examined the preferences of parents with limited English proficiency regarding key aspects of pediatric weight management.

Results
We surveyed 200 parents and 43% had a primary language of Spanish. Parents wanted care to be a combination of in-person and virtual visits (80%). We found that parents with limited English proficiency had a higher odds ratio of affirming in-person visits are better than virtual visits for ensuring their child’s health concern can be taken care of (OR: 2.91; 95% CI: 1.36, 6.21), feeling comfortable when discussing personal information (OR: 3.91; 95% CI: 1.82, 8.43), talking about healthy behaviors and setting goals (OR: 3.09; 95% CI: 1.39, 6.90), and talking about mental health and overall well-being (OR: 4.02; 95% CI: 1.83, 8.87) than parents without limited English proficiency. We surveyed 75 clinicians and 60% felt telehealth was a useful tool to provide care for pediatric weight management. Clinicians felt virtual visits did not pose barriers to all aspects of care. Informed by the surveys and stakeholder input, we made clinician- and family-level adaptations while retaining the program’s function.

Conclusions
By engaging stakeholders and adapting the program for telehealth, we optimized the reach and fit of Connect for Health to ensure its continued uptake. We have provided a real-world example of how clinical innovations can evolve and how to systematically plan adaptations in response to changing healthcare contexts.

Trial registration
Clinicaltrials.gov (NCT04042493), Registered on August 2, 2019.
The association between non-alcoholic fatty liver disease and chronic kidney disease in Egyptian patients
Authors: Kasem Heba El Sayed , Abdelatty Ehab Ahmed , Yahia Ahmed Mohamed Mokhtar , Abdalla Ezzat Mohamed 
Published: November 2023

Abstract
Background
NAFLD is a spectrum of disorders ranging from hepatic steatosis to nonalcoholic steatohepatitis (NASH), NASH related cirrhosis and hepatocellular carcinoma (HCC). There is sparse data on the prevalence CKD in Egyptian patients with NAFLD. The aim of this study is to estimate the prevalence of CKD in the subjects with NAFLD and to assess the risk factors of CKD among them.

Methods
A cross-sectional study was conducted on 430 patients from the Internal Medicine Department, Menoufia University Hospitals, including 215 patients with NAFLD, and 215 patients without NAFLD. NAFLD was diagnosed by abdominal ultrasonography. The liver fibrosis was assessed by NAFLD fibrosis score (NFS) and fibrosis-4 index (FIB-4). CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 and/or abnormal albuminuria (urinary albumin-to-creatinine ratio ⩾ 30 mg/gm). The logistic regression analysis was performed to examine the association between NAFLD and risk of CKD.

Results
The prevalence of CKD was higher in individuals with NAFLD than in those without NAFLD (38.1% vs 7.4%, p < 0.001). Logistic regression analysis demonstrated that both NAFLD and CKD were risk factors of each other. The presence of hypertension, high levels of BMI and waist circumference were the other independent risk factors of NAFLD. While the presence of DM, and the high level of BMI were the other significant risk factors of CKD in the NAFLD group.

Conclusion
The presence and severity of NAFLD are associated with an increased risk of CKD.
COVID-19 Post- vaccination infection among hospital attendants in Qena city
Authors: Mohamed Reham Abdallah , Hany Ahmed Mohammed Mahmoud , Nafady Asmaa Abdelhakim 
Published: November 2023

Abstract
Background
The duration of immunological persistence in COVID-19-vaccinated individuals is considered a matter of concern. Some studies have shown that anti-SARS-CoV-2 antibodies degrade rapidly. Due to diminishing immunity after vaccination, some people may catch an infection again after receiving the COVID-19 vaccine.

Objectives
The purpose of the present study was to measure the COVID-19 post-vaccination infection reported by the vaccinated participants and to identify possible associated risk factors among hospital attendants in Qena city.

Material and method
A cross-sectional study was carried out on 285 participants who received COVID-19 vaccines and were aged 18 years or more. A structured questionnaire was used as a tool for data collection.

Results
13.7% of the vaccinated participants reported catching the COVID-19 infection after vaccination. Healthcare workers were more susceptible to the COVID-19 infection after vaccination than non-healthcare workers. Post-vaccination infection among participants who received Viral vector vaccines, Inactivated vaccines, and mRNA vaccines were 16.7%, 15.7%, and 3.6%, respectively.

Conclusion
Healthcare professionals need to take strict preventive measures since, even after receiving the COVID-19 vaccine, they are more vulnerable to infection than non-healthcare personnel. mRNA vaccines can be given in place of viral vector vaccinations because they show a reduced incidence of post-vaccination infection.
Which ultrasound-guided parasternal intercostal nerve block for post-sternotomy pain? Results from a prospective observational study
Authors: Toscano Antonio , Capuano Paolo , Perrucci Chiara , Giunta Matteo , Orsello Alberto , Pierani Tommaso , Costamagna Andrea , Tedesco Mario , Arcadipane Antonio , Sepolvere Giuseppe , Buono Gabriella , Brazzi Luca 
Published: November 2023

Abstract
Background
Parasternal intercostal blocks (PSB) have been proposed for postoperative analgesia in patients undergoing median sternotomy. PSB can be achieved using two different approaches, the superficial parasternal intercostal plane block (SPIP) and deep parasternal intercostal plane block (DPIP) respectively.

Methods
We designed the present prospective, observational cohort study to compare the analgesic efficacy of the two approaches. Cardiac surgical patients who underwent full sternotomy from January to September 2022 were enrolled and divided into three groups, according to pain control strategy: morphine, SPIP, and DPIP group. Primary outcomes were was postoperative pain evaluated as absolute value of NRS at 12 h. Secondary outcomes were the NRS at 24 and 48 h, the need for salvage analgesia (both opioids and NSAIDs), incidence of postoperative nausea and vomiting, time to extubation, mechanical ventilation duration, and bowel disfunction.

Results
Ninety-six were enrolled. There was no significant difference in terms of median Numeric Pain Rating Scale at 24 h and at 48 h between the study groups. Total postoperative morphine consumption was 1.00 (0.00–3.00), 2.00 (0.00–5.50), and 15.60 mg (9.60–30.00) in the SPIP, DPIP, and morphine group, respectively (SPIP and DPIP vs morphine: p < 0.001). Metoclopramide consumption was lower in SPIP and DPIP group compared with morphine group (p = 0.01). There was no difference in terms of duration of mechanical ventilation and of bowel activity between the study groups. Two pneumothorax occurred in the DPIP group.

Conclusions
Both SPIP and DPIP seem able to guarantee an effective pain management in the postoperative phase of cardiac surgeries via full median sternotomy while ensuring a reduced consumption of opioids and antiemetic drugs.
Resection of a rapidly growing chest wall cyst: a case report
Authors: Kato Shumpei , Sakai Takashi , Kusano Megumi , Koezuka Satoshi , Otsuka Hajime , Azuma Yoko , Kurose Yasuko , Tochigi Naobumi , Iyoda Akira 
Published: November 2023

Abstract
Background
When cystic lesions are detected in the chest wall, postoperative seroma and abscesses can be considered in the differential diagnoses. Herein, we present a case of a large chest wall cyst with rapid growth 5 years after thoracic surgery.

Case presentation
A male patient in his 60s was admitted to our hospital complaining of a rapidly enlarging chest wall swelling. He underwent a pleural biopsy for pleural thickening and was diagnosed with pleurisy 5 years ago. Computed tomography revealed a cystic lesion with a capsule measuring 14 cm × 10 cm, and contrast-enhanced magnetic resonance imaging revealed a heterogeneous enhancement effect inside the lesion. Surgical resection was performed for definitive diagnosis and therapeutic purposes. Intraoperatively, a cystic lesion with a thick capsule located outside the thorax was seen. The lesion was resected completely with no remaining adherence to the surrounding tissues and muscles. Histopathological examination revealed that the cyst wall was a non-epithelial fibrous connective tissue with inflammatory cell infiltration, and the contents were viscous liquid and fibrin, suggestive of a chest wall cyst. The cyst wall had abundant CD34-positive vascular endothelium, suggestive of rapid enlargement due to the influx of exudate associated with angiogenesis. No recurrence was observed 1 year postoperatively.

Conclusions
In addition to bacteriology, pathological examination, including immunohistological examination, is useful for the differential diagnosis of chest wall cystic lesions.
Telemonitoring: ethical lessons from the COVID-19 pandemic
Authors: Bolt Ineke , Specker Jona , Schermer Maartje 
Published: November 2023

Abstract
Background
The COVID-19 pandemic accelerated the development and application of telemonitoring, enabling health care providers to continue to provide medical care. Telemonitoring oftentimes replaced face-to-face health care services instead of as being offered as a supplement to regular medical care. Given that pressure on hospitals is expected to remain, telemonitoring is seen as an important means of alleviating those pressures. In this paper, we consider the intensified deployment of telemonitoring during the pandemic as an excellent opportunity to learn how telemonitoring can be implemented in a morally responsible way.

Results
In order to gain concrete, contextual and in-depth knowledge of the ethical issues raised by telemonitoring during the corona pandemic, we explore telemonitoring for two conditions: COVID-19 and Idiopathic pulmonary fibrosis. We conducted interviews with patients and professionals on five important ethical themes: 1. a shift in responsibilities, 2. empowerment and self-management, 3. the value of face-to-face consultations, 4. inclusivity and equal access, and 5. privacy and big data. Based on the findings of this empirical study and medical ethical principles, we formulate lessons for responsible implementation and upscaling: 1. ensure explicit and realistic allocation of responsibilities and avoid expectations that monitoring is more direct and continuous than it actually is; 2. create opportunities for an optimal form of self-management—in particular for patients with chronic conditions—and for meaningful conversations; 3. integrate telemonitoring within an established HCP – patient trust relation and stimulate research on the conditions for face-to-face consultations; 4. take vulnerability into account in inclusion & exclusion criteria and involve patients in design and implementation processes; 5. concerns of collection of data are beyond privacy and identify the risks of dependency on commercial companies.

Conclusions
Our findings show that offering patients choices for telemonitoring will not necessarily result in increased and equal accessibility, good quality of care and patient autonomy. Whether or not these aims and promises will be fulfilled, and the ethical challenges adequately met, is highly dependent on choices regarding the design of specific monitoring systems, the development process and the embeddedness in a trusting physician–patient relationship.
Amplification of Wild-Type RET Represents a Novel Molecular Subtype of Several Cancer Types With Clinical Response to Selpercatinib
Authors: Gandhi Malini M. , Ricciuti Biagio , Harada Guilherme , Repetto Matteo , Gildenberg Melissa S. , Singh Ankit , Li Yvonne Y. , Gagné Andréanne , Wang Xinan , Aizer Ayal , Fitzgerald Kelly , Nishino Mizuki , Alessi Joao , Pecci Federica , Di Federico Alessandro , Fisch Adam , Drilon Alexander , Nardi Valentina , Sholl Lynette , Awad Mark M. , Rotow Julia 
Published: November 2023

PURPOSE RET rearrangements and RET activating point mutations represent targetable genomic alterations in advanced solid tumors. However, the frequency and clinicopathologic characteristics of wild-type RET amplification in cancer and its potential role as a targetable oncogenic driver are not well-characterized. METHODS In two institutional cohorts of patients with solid cancers from the Dana-Farber Cancer Institute (DFCI) and Memorial Sloan Kettering Cancer Center (MSKCC) whose tumors underwent next-generation sequencing (NGS), the frequency and clinicopathologic features of wild-type RET amplification in the absence of RET rearrangements or activating mutations was assessed. The findings were validated using merged data from The Cancer Genome Atlas (TCGA), Genomics Evidence Neoplasia Information Exchange (GENIE), and China Pan-Cancer data sets. RESULTS The frequency of wild-type RET amplification across all solid cancers was 0.08% (26 of 32,505) in the DFCI cohort, 0.05% (26 of 53,152) in the MSKCC cohort, and 0.25% (71 of 28,623) in the cohort from TCGA, GENIE, and China Pan-Cancer. Cancer types with RET amplification included non–small-cell lung cancer (NSCLC), hepatobiliary cancer, prostate cancer, breast cancer, and others. The median RET copy number in RET-amplified cases was 7.5 (range, 6-36) in the DFCI cohort and 5.7 (range, 4-27.7) in the MSKCC cohort. Among 11 RET-amplified NSCLCs, eight had no other concurrent driver mutations. Finally, we report on a 69-year-old man with recurrent NSCLC harboring high-level wild-type RET amplification (22-28 copies) as the only identified putative genomic driver who experienced both a systemic and intracranial confirmed response to the RET inhibitor selpercatinib. CONCLUSION Amplification of wild-type RET represents a novel, targetable molecular subset of cancer.