bluuebunny/crossref_metadata_2025_split huggingface dataset:
A 49-Year-Old Man With Cough, Dyspnea, and Right-Sided Chest Pain
Authors: Aragon Pinto Catarina N. , Antharam Phanindra , Midthun David E. 
Published: February 2024

Abstract
Clinical presentation, radiologic findings, and pleural fluid analysis are essential to differentiate a simple effusion from a complicated pleural effusion or empyema and can guide therapeutic management. Cultures from pleural fluid samples help guide antibiotic therapy but are not mandatory for initiation of antibiotic therapy. False-negative culture results may occur depending on which loculation in the pleural space is aspirated and analyzed. One loculation may be serous while a neighboring loculation may contain pus. Intrapleural fibrinolytic therapy is a highly valuable management option for patients concurrently treated with antibiotics. Pleural drainage and lytic therapy can be an alternative to surgical intervention and eliminate the need for surgery for the majority of patients.
A 45-Year-Old Woman With Respiratory Failure and Septic Shock
Authors: Fonseca Fuentes Xavier E. , Shaughnessy Gaja F. , Peikert Tobias 
Published: February 2024

Abstract
Pleural involvement in multiple myeloma is a rare condition that is frequently associated with a poor prognosis. The diagnostic strategy includes pleural fluid cytology and electrophoresis or histologic confirmation with pleural biopsy. Management involves treatment of multiple myeloma and relief of respiratory symptoms with drainage of pleural fluid or pleurodesis.
An 81-Year-Old Man With Chronic Dyspnea and Recurrent Pleural Effusion
Authors: Norton Mark S. , Utz James P. , Kern Ryan M. 
Published: February 2024

Abstract
Recurrent exudative pleural effusion of unclear etiology is a commonly encountered entity with a wide differential diagnosis. Expedient evaluation and diagnosis are necessary. Pleural fluid analysis is the first step because a lymphocyte-predominant exudate is most commonly associated with malignancy or tuberculosis. Cytology is helpful, but sensitivity decreases with each subsequent sampling. Advanced cross-sectional imaging with CT of the chest is needed if a diagnosis is not made after initial evaluation and analysis of the pleural fluid. This will help in differentiating between benign and malignant pleural disease and in providing guidance for tissue acquisition. Medical pleuroscopy is a safe and effective procedure for pleural biopsy.
A 25-Year-Old Man With Sudden Onset of Severe Dyspnea
Authors: Kelly Bryan T. , Mullon John J. 
Published: February 2024

Abstract
Pneumothorax is a common pulmonary disease that may occur spontaneously, iatrogenically, or traumatically. Although multiple guidelines exist to guide appropriate interventions, there is no overall consensus about when conservative treatment is appropriate, when intervention is necessary, or which intervention should be performed initially. However, the most widely accepted indication for therapy is the presence of clinically significant symptoms. If an alveolopleural fistula leads to prolonged air leaks, healing usually occurs within 2 weeks, but additional interventions may be pursued to treat an unresolved leak.
A 71-Year-Old Woman With Cough, Night Sweats, and Fevers
Authors: Albitar Hasan A. , de Moraes Alice Gallo 
Published: February 2024

Abstract
Tuberculous pleural effusion (TPE) is an exudative effusion with a predominance of lymphocytes. When TPE is suspected, pleural fluid must be obtained and evaluated. The results of laboratory testing are usually characterized by elevated LDH concentration, low pH, and elevated protein concentration. When the clinical suspicion for TPE is high, a presumptive diagnosis can be made without pathologic confirmation when the pleural effusion has a predominance of lymphocytes and an adenosine deaminase level greater than 40 IU/L. In general, treatment of TPE is the same as standard treatment of active pulmonary tuberculosis.
A 79-Year-Old Woman With Shortness of Breath, Fatigue, Near Syncope, and Chest Tightness
Authors: McCambridge Amanda J. , Ekstein Samuel F. , Lim Kaiser G. 
Published: February 2024

Abstract
Pulmonary torsion is a rare but potentially life-threatening condition. It usually occurs after intrathoracic surgery or chest trauma, but it can occur spontaneously. Diagnosis is made with the use of contrast computed tomography of the chest or bronchoscopy, and urgent or emergent definitive management with thoracic surgery is usually required.
A 68-Year-Old Woman With Dyspnea and Pleuritic Chest Pain
Authors: Gary Phillip J. , Odeyemi Yewande E. 
Published: February 2024

Abstract
Patients presenting with acute pulmonary embolism require immediate risk stratification to determine the need for more intensive monitoring and consideration of additional therapies besides only anticoagulation. Thorough investigation can help stratify seemingly borderline cases, which, at some institutions, may be arbitrated by multidisciplinary teams. In most cases, testing for inherited thrombophilias is not warranted in the acute setting, and the use of inferior vena cava filters should be avoided unless the patient has a contraindication to anticoagulation. Many patients with symptomatic acute PE have persistent dyspnea and exercise limitations that often warrant further testing to rule out chronic thromboembolic pulmonary hypertension or chronic thromboembolic disease.
A 71-Year-Old Man With Dyspnea and Hypoxemia
Authors: Stroh Gregory R. , DuBrock Hilary M. 
Published: February 2024

Abstract
Hypoxemia is a common clinical issue that occasionally presents a diagnostic challenge to clinicians. An understanding of the underlying mechanisms of hypoxemia is essential to appropriately and effectively evaluate patients. When a patient has a rare underlying disease, an understanding of the mechanism of hypoxemia can assist with the diagnostic approach.
A 91-Year-Old Man With a Pulmonary Nodule, Abdominal Pain, and Anorexia
Authors: Azevedo Gross Luiza , de Moraes Alice Gallo 
Published: February 2024

Abstract
Asbestosis is an interstitial lung disease that is associated with an increased risk of malignancy. That risk is even higher if patients smoke tobacco. There are no lung cancer screening recommendations for patients who have asbestosis. However, the suspicion for malignancy should be low. Patients with asbestosis and an incidental lung nodule are definitely at high risk, and a nodule larger than 8 mm warrants follow-up computed tomography at 3 to 6 months.
On the cusp of cusps: a universal model for extreme scattering events in the ISM
Authors: Jow Dylan L , Pen Ue-Li , Baker Daniel 
Published: February 2024

ABSTRACT
The scattering structures in the interstellar medium responsible for so-called extreme scattering events (ESEs), observed in quasars and pulsars, remain enigmatic. Current models struggle to explain the high-frequency light curves of ESEs, and a recent analysis of a double lensing event in PSR B0834+06 reveals features of ESEs that may also be challenging to accommodate via existing models. We propose that these features arise naturally when the lens has a cusp-like profile, described by the elementary A3 cusp catastrophe. This is an extension of previous work describing pulsar scintillation as arising from A2 fold catastrophes in thin, corrugated plasma sheets along the line of sight. We call this framework of describing the lens potentials via elementary catastrophes ‘doubly catastrophic lensing’, as catastrophes (e.g. folds and cusps) have long been used to describe universal features in the light curves of lensing events that generically manifest, regardless of the precise details of the lens. Here, we argue that the lenses themselves may be described by these same elementary structures. If correct, the doubly catastrophic lensing framework would provide a unified description of scintillation and ESEs, where the lenses responsible for these scattering phenomena are universal and can be fully described by a small number of unfolding parameters. This could enable their application as giant cosmic lenses for precision measurements of coherent sources, including fast radio bursts and pulsars.
Structure, kinematics, and time evolution of the Galactic warp from Classical Cepheids
Authors: Cabrera-Gadea Mauro , Mateu Cecilia , Ramos Pau , Romero-Gómez Mercé , Antoja Teresa , Aguilar Luis 
Published: February 2024

ABSTRACT
The warp is a well-known undulation of the Milky Way disc. Its structure has been widely studied, but only since Gaia DR2 has it been possible to reveal its kinematic signature beyond the solar neighbourhood. In this work, we present an analysis of the warp traced by Classical Cepheids by means of a Fourier decomposition of their height (Z) and, for the first time, of their vertical velocity (Vz). We find a clear but complex signal that in both variables reveals an asymmetrical warp. In Z, we find the warp to be almost symmetric in amplitude at the disc’s outskirts, with the two extremes never being diametrically opposed at any radius and the line of nodes presenting a twist in the direction of stellar rotation for R &gt; 11 kpc. For Vz, in addition to the usual m = 1 mode, an m = 2 mode is needed to represent the kinematic signal of the warp, reflecting its azimuthal asymmetry. The line of maximum vertical velocity is similarly twisted as the line of nodes and trails behind by ≈25°. We develop a new formalism to derive the pattern speed and change in amplitude with time $\dot{A}$ of each Fourier mode at each radius, via a joint analysis of the Fourier decomposition in Z and Vz. By applying it to the Cepheids we find, for the m = 1 mode, a constant pattern speed in the direction of stellar rotation of 9.2 ± 3.1 km s−1 kpc−1, a negligible $\dot{A}$ up to R ≈ 14 kpc and a slight increase at larger radii, in agreement with previous works.
Study of star formation in dual nuclei galaxies using UVIT observations
Authors: Rubinur K , Das M , Kharb P , Yadav J , Mondal C , Rahna P T 
Published: February 2024

ABSTRACT
We have used the Ultraviolet Imaging Telescope (UVIT) aboard AstroSat to study star formation in a sample of nine dual nuclei galaxies with separations ⪅ 11 kpc, which is an expected outcome of galaxy mergers. To minimize the contribution of active galactic nuclei (AGN) emission, we have used mid-IR colour cut-offs and masked the AGN-dominated nuclei. The UV continuum slope (β) is used to calculate the internal extinction (AV) which ranges from 0.53 to 4.04 in the FUV band and 0.44 to 3.10 in the NUV band for the sample. We have detected 1−20 star-forming clumps in our sample galaxies. The extinction-corrected total FUV star formation rate (SFR) ranges from ∼0.35 to ∼32 M⊙ yr−1. Our analyses of AV, specific SFR (sSFR) show that dual nuclei sources are associated with dusty, star-forming galaxies. The FUV − NUV colour maps show redder colour in the nuclear and disc regions while bluer colour is observed in the outskirts of most galaxies which can be due to embedded dust or different stellar populations. We have found some signatures of possible stellar/AGN feedback like a ring of star formation, a redder ring around blue nuclei, etc. However, further observations are required to confirm this.
Extracellular G-quadruplexes and Z-DNA protect biofilms from DNase I, and G-quadruplexes form a DNAzyme with peroxidase activity
Authors: Minero Gabriel Antonio Salvador , Møllebjerg Andreas , Thiesen Celine , Johansen Mikkel Illemann , Jørgensen Nis Pedersen , Birkedal Victoria , Otzen Daniel Erik , Meyer Rikke Louise 
Published: February 2024

Abstract
Many bacteria form biofilms to protect themselves from predators or stressful environmental conditions. In the biofilm, bacteria are embedded in a protective extracellular matrix composed of polysaccharides, proteins and extracellular DNA (eDNA). eDNA most often is released from lysed bacteria or host mammalian cells, and it is the only matrix component most biofilms appear to have in common. However, little is known about the form DNA takes in the extracellular space, and how different non-canonical DNA structures such as Z-DNA or G-quadruplexes might contribute to its function in the biofilm. The aim of this study was to determine if non-canonical DNA structures form in eDNA-rich staphylococcal biofilms, and if these structures protect the biofilm from degradation by nucleases. We grew Staphylococcus epidermidis biofilms in laboratory media supplemented with hemin and NaCl to stabilize secondary DNA structures and visualized their location by immunolabelling and fluorescence microscopy. We furthermore visualized the macroscopic biofilm structure by optical coherence tomography. We developed assays to quantify degradation of Z-DNA and G-quadruplex DNA oligos by different nucleases, and subsequently investigated how these enzymes affected eDNA in the biofilms.
Z-DNA and G-quadruplex DNA were abundant in the biofilm matrix, and were often present in a web-like structures. In vitro, the structures did not form in the absence of NaCl or mechanical shaking during biofilm growth, or in bacterial strains deficient in eDNA or exopolysaccharide production. We thus infer that eDNA and polysaccharides interact, leading to non-canonical DNA structures under mechanical stress when stabilized by salt. We also confirmed that G-quadruplex DNA and Z-DNA was present in biofilms from infected implants in a murine implant-associated osteomyelitis model. Mammalian DNase I lacked activity against Z-DNA and G-quadruplex DNA, while Micrococcal nuclease could degrade G-quadruplex DNA and S1 Aspergillus nuclease could degrade Z-DNA. Micrococcal nuclease, which originates from Staphylococcus aureus, may thus be key for dispersal of biofilm in staphylococci. In addition to its structural role, we show for the first time that the eDNA in biofilms forms a DNAzyme with peroxidase-like activity in the presence of hemin. While peroxidases are part of host defenses against pathogens, we now show that biofilms can possess intrinsic peroxidase activity in the extracellular matrix.
Large-scale duplication events underpin population-level flexibility in tRNA gene copy number in Pseudomonas fluorescens SBW25
Authors: Khomarbaghi Zahra , Ngan Wing Y , Ayan Gökçe B , Lim Sungbin , Dechow-Seligmann Gunda , Nandy Pabitra , Gallie Jenna 
Published: February 2024

Abstract
The complement of tRNA genes within a genome is typically considered to be a (relatively) stable characteristic of an organism. Here, we demonstrate that bacterial tRNA gene set composition can be more flexible than previously appreciated, particularly regarding tRNA gene copy number. We report the high-rate occurrence of spontaneous, large-scale, tandem duplication events in laboratory populations of the bacterium Pseudomonas fluorescens SBW25. The identified duplications are up to ∼1 Mb in size (∼15% of the wildtype genome) and are predicted to change the copy number of up to 917 genes, including several tRNA genes. The observed duplications are inherently unstable: they occur, and are subsequently lost, at extremely high rates. We propose that this unusually plastic type of mutation provides a mechanism by which tRNA gene set diversity can be rapidly generated, while simultaneously preserving the underlying tRNA gene set in the absence of continued selection. That is, if a tRNA set variant provides no fitness advantage, then high-rate segregation of the duplication ensures the maintenance of the original tRNA gene set. However, if a tRNA gene set variant is beneficial, the underlying duplication fragment(s) may persist for longer and provide raw material for further, more stable, evolutionary change.
Intra-amniotic Candida albicans Infection Treated With Liposomal Amphotericin B With a Successful Neonatal Outcome
Authors: Gutiérrez Norma Urbano , Vergara López María José , Bustos Camila Álvarez , Vidal Cristian Contreras , Carvajal Jorge A , Severino Nicolás , Giordano Ady , Baquedano Soledad Urzúa , Feuerhake Teo , Rabagliati Ricardo , Balcells María Elvira 
Published: February 2024

Abstract
Intra-amniotic infection with Candida species is an uncommon but severe condition with high fetal morbimortality and no established clinical guidelines for its management. We report a Candida albicans intra-amniotic infection diagnosed in a 25-week pregnant woman, successfully treated with high-dose liposomal amphotericin B. Pregnancy was prolonged until 30 weeks, and despite persistently positive Candida cultures in amniotic fluid, a healthy newborn was delivered without evidence of systemic infection. Amphotericin concentration was determined at birth, revealing levels over 30 times higher in mother's and cord blood than in the amniotic fluid, probably explaining the clinical protection despite failure in obtaining fungal clearance.
Policy dissidents: Understanding girl activism as creating “Tactical Crevices”
Authors: Khoja-Moolji Shenila , Chacko Mary Ann 
Published: February 2024

Abstract
Global policymaking often seeks to create processes for the effective delivery of public goods and services. What happens when individuals critique or dissent such policies? In this paper, we examine the case of two activists—Greta Thunberg and Disha Ravi—who have been mobilizing attention toward climate change since their teenage years, and who have been both celebrated and vilified for it. While climate change policies emphasize the importance of gender mainstreaming and youth participation, reactions garnered by these two activists are instructive in highlighting the narrow notion of “participation” that undergirds climate policy. Specifically, we show that Greta and Disha’s tactics do not readily jive with the postfeminist, neoliberal conceptualization of youth participation that emphasizes apolitical exercise of citizenship; valorizes girls’ activism only insofar as it enhances national economic growth; and views girls as symbols of hopeful futurities. Greta and Disha are instead what we call, “policy dissidents,” whose activism creates “tactical crevices.” We theorize tactical crevices as tentative and fleeting interruptions by the powerless that puncture prevailing logics through strikes and protests, and through consumption of discourses and materials in ways that those in power do not intend. The paper contributes to the study of girl activism broadly, and to notions of youth engagement (or disengagement) specifically, within the spheres of local and global politics.
Sleep as a prognostic factor in low back pain: a systematic review of prospective cohort studies and secondary analyses of randomized controlled trials
Authors: Silva Samuel , Hayden Jill A , Mendes Gabriel , Verhagen Arianne P , Pinto Rafael Z , Silva Andressa 
Published: February 2024

Abstract
Sleep problems are common in individuals with low back pain (LBP) and sleep restriction seems to be associated with impaired pain processing. Our objective was to investigate whether sleep is associated with future LBP outcomes (i.e. pain intensity, disability, and recovery) in adults. We conducted a systematic review of prospective cohort studies and secondary analyses of randomized controlled trials (registration—PROSPERO CRD42022370781). In December 2022, we searched the MEDLINE, Embase, CINAHL, and PsycINFO databases. Fourteen studies, totaling 19 170 participants were included. Thirteen studies were rated as having high risk of bias (QUIPS tool). We used vote-counting and meta-analysis approaches to synthesize the data. We found associations between baseline sleep with future pain intensity, recovery, and between changes in sleep with changes in pain intensity, changes in disability, and recovery. We further synthesized outcomes as “overall LBP improvement” outcomes. Baseline poor sleep was moderately associated with non-improvement in LBP in the long-very long term (OR 1.55, 95% CI: 1.39 to 1.73; three studies providing unadjusted effect sizes), and non-improvement in sleep was largely associated with non-improvement in LBP in the short-moderate term (OR 3.45, 95% CI: 2.54 to 4.69; four studies providing unadjusted effect sizes). We found no association between baseline sleep with future disability and overall LBP improvement in the short-moderate term. Therefore, sleep may be a prognostic factor for pain intensity and recovery from LBP. All findings were supported by low to very low-quality evidence. Better-conducted studies are needed to strengthen our certainty about the evidence.
Association Between Neighborhood Deprivation in Early Pregnancy and Gestational Diabetes Mellitus
Authors: Liu Emily F. , Ferrara Assiamira , Sridhar Sneha B. , Greenberg Mara B. , Hedderson Monique M. 
Published: February 2024

OBJECTIVE:
To evaluate whether having a pregnancy in a deprived neighborhood was associated with an increased risk of gestational diabetes mellitus (GDM) compared with having a pregnancy in the least-deprived neighborhoods.

METHODS:
This was a retrospective observational cohort study of pregnant individuals within Kaiser Permanente Northern California from 2011 to 2018 with residential history from prepregnancy through 24 weeks of gestation and clinical data from prepregnancy through delivery. The primary outcome was a diagnosis of GDM. Neighborhood deprivation was characterized with an index aggregating multiple indicators of Census tract–level sociodemographic information. Mediation analysis using inverse odds ratio weighting estimated the mediation effects of prepregnancy body mass index (BMI), gestational weight gain, smoking tobacco, and illegal drug use before GDM diagnosis.

RESULTS:
Overall, 214,375 pregnant individuals were included, and 11.3% had a diagnosis of GDM. Gestational diabetes prevalence increased with neighborhood deprivation from 10.0% in the lowest Neighborhood Deprivation Index quintile to 12.7% in the highest quintile. Compared with pregnant individuals in the least deprived neighborhoods (quintile 1), pregnant individuals in quintiles 2–5 had elevated risk of GDM (relative risk [95% CI]) when adjusted for maternal age, parity, insurance type, and residential history (quintile 2, 1.17 [1.10–1.23]; quintile 3, 1.38 [1.30–1.46]; quintile 4, 1.54 [1.45–1.63]; quintile 5, 1.71 [1.62–1.82]). There was a dose-response relationship between relative risk of GDM and increasing quintile of neighborhood deprivation (P for trend <.001). Prepregnancy BMI mediated 45.8% (95% CI, 40.9–50.7%) of the association. Other potential mediators were found to mediate a small if not negligible proportion of this association (2.4–3.6%).

CONCLUSION:
Neighborhood deprivation was associated with GDM, and a considerable proportion of this relationship was mediated by prepregnancy BMI.
Sacubitril/valsartan improves the prognosis of acute myocardial infarction: a meta-analysis
Authors: Wang Fang , Li Chengde , Zhang Xuezheng 
Published: February 2024

Objective
To systematically evaluate the effect of sacubitril/valsartan (SV) on the prognosis of patients with acute myocardial infarction (AMI), and to provide evidence for expanding the clinical application of SV.

Methods
PubMed, EMbase, Web of Science, and Cochrane Library were searched from inception to October 2023 for randomized controlled trials (RCTs) of SV in patients with AMI. The article was screened and evaluated by the Cochrane 5.1.0 bias risk assessment tool. RevMan5.3 was used for meta-analysis of the outcome indicators.

Results
Ten RCTs involving 7230 patients were included. The results showed that SV increased left ventricular eject fraction (MD = 2.86, 95% CI [1.81–3.90], P < 0.00001) and reduced readmission rate (RR = 0.46, 95% CI [0.32–0.68], P < 0.0001), decreased N-terminal pro-brain natriuretic peptide (MD = −477.46, 95% CI [−914.96 to −39.96], P = 0.03), and reduced major adverse cardiovascular and cerebrovascular event (MACCE) (RR = 0.48, 95% CI [0.27–0.85], P = 0.01). There was no significant difference in the rate of adverse reaction (AR) between the trial group and the control group (RR = 0.88, 95% CI [0.60–1.30], P = 0.52).

Conclusion
SV can effectively improve the prognosis of AMI, prevent complications, and there is no significant difference in safety compared with angiotensin-converting enzyme inhibitor/angiotensin receptor blocker.