bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal antiseptic skin preparation agents for minimizing surgical site infection following surgery: cost and cost-effectiveness analysis
Authors: Deeming Simon , Dolja-Gore Xenia , Gani Jon , Carroll Rosemary , Lott Natalie , Attia John , Reeves Penny , Smith Stephen R 
Published: February 2024

Abstract

Background
The application of antiseptic skin agents prior to incision minimizes the rate of surgical site infection. Despite their ubiquity, the optimal skin preparation agent remains uncertain. A retrospective economic analysis was conducted to complement the results from the NEWSkin Prep trial which prospectively compared three preparation agents.

Methods
A cost and cost-effectiveness analysis was performed from a healthcare service perspective to compare chlorhexidine with 70% ethanol, and aqueous povidone-iodine, against povidone-iodine with 70% ethanol. Resource use estimates accounted for hospital admissions, readmissions associated with surgical site infection, outpatient and general practitioner attendances, visits from community nurses and therapeutic consumables. The measure of effectiveness comprised the net difference in number of patients with surgical site infections per 1000 patients. Costs were compared using a two-sample Welch's t-test. Deterministic and probabilistic sensitivity analyses were performed to evaluate the incremental cost-effectiveness ratio.

Results
The null hypothesis that the mean costs for the trial arms were significantly different was not rejected (Welch's t-test P value: 0.771 for chlorhexidine with 70% ethanol against povidone-iodine with 70% ethanol; and 0.955 for aqueous povidone-iodine against povidone-iodine with 70% ethanol). Based on bootstrap averages, the chlorhexidine with 70% ethanol intervention generated 8.0 fewer surgical site infections per 1000 patients and net cost savings of €151,698 (Euros) per 1000 patients compared with povidone-iodine with 70% ethanol, and aqueous povidone-iodine produced a net cost saving of €37,494 per 1000 patients but generated an additional 11.6 surgical site infections per 1000 patients compared with povidone-iodine with 70% ethanol. The comparison of chlorhexidine with 70% ethanol to povidone-iodine with 70% ethanol was sensitive to the inclusion of cost outliers, while the comparison of aqueous povidone-iodine to povidone-iodine with 70% ethanol was sensitive to the estimated cost per surgical site infection.

Conclusion
Based on the outcomes from the NEWSkin Prep study, this economic analysis found no definitive evidence in favour of any one of the study comparators. Future model-based economic analyses of alternative skin preparations should critically address the quality of evidence and integrate the results from the NEWSkin Prep study.
Emergence of rapidly spreading antimicrobial-resistant Salmonella in traditional blood-based foods
Authors: Yang Tian , Wu-Chen Ricardo A , Zhang Runrun , Liao Xinyu , Lou Yiyang , Gölz Greta , Ding Tian , Feng Jinsong 
Published: February 2024

Abstract

Objectives
This study aims to investigate the survival ability and risk of Salmonella isolated from traditional blood-based food, using both phtnotypic and genotypic analysis.

Materials and Methods
We characterized and identified seventeen Salmonella isolates using 16s rRNA sequencing, real-time PCR and whole-genome sequencing (WGS). Cell counts were recorded to monitor growth ability and temperature tolerance. Virulence genes and whole genome phylogenies were confirmed by WGS. The minimum inhibitory concentration (MIC) of corresponding strains to different antibiotics and antimicrobial resistance (AMR) genes predicted by WGS were evaluated.

Results
In this study, we characterized 17 Salmonella isolates obtained from contaminated traditional blood-based food in China. Compared to laboratory strain S. Typhimurium ATCC 14028, these Salmonella isolates generally grew more rapidly and developed less biofilm, but their tolerance to food processing-associated cold and heat stresses was distinct. Whole-genome phylogenies pointed out the potential for cross-contamination during food practices. In addition, 21 antibiotic-resistance genes were found among blood-based food isolates, including high-prevalent resistance genes gyrA (including associated mutations D87G and S83F), blaTEM, and aadA1. Antibiotic susceptibility test confirmed the in-silico prediction and revealed a 41.18% (7/17) multidrug resistance (MDR) rate. Resistance to ceftiofur, kanamycin, and nalidixic acid was observed without corresponding resistance genes, suggesting overlooked resistance mechanisms.

Conclusions
This study revisited microbial safety concerns associated with traditional blood-based food and underlined the emergence of high-risk MDR Salmonella strains. It also underscores the importance of implementing better hygiene practices in the production and handling of traditional food products.
Drinfeld’s Lemma forF-isocrystals, I
Authors: Kedlaya Kiran S 
Published: February 2024

AbstractWe prove that in either the convergent or overconvergent setting, an absolutely irreducible $F$-isocrystal on the absolute product of two or more smooth schemes over perfect fields of characteristic $p$, further equipped with actions of the partial Frobenius maps, is an external product of $F$-isocrystals over the multiplicands. The corresponding statement for lisse $\overline{{\mathbb{Q}}}_{\ell }$-sheaves, for $\ell \neq p$ a prime, is a consequence of Drinfeld’s lemma on the fundamental groups of absolute products of schemes in characteristic $p$. The latter plays a key role in V. Lafforgue’s approach to the Langlands correspondence for reductive groups with $\ell $-adic coefficients; the $p$-adic analogue will be considered in subsequent work with Daxin Xu.
A mathematical model of photoinhibition: exploring the impact of quenching processes
Authors: Nies Tim , Matsubara Shizue , Ebenhöh Oliver 
Published: February 2024

Abstract
Plants are constantly exposed to changing environments, sometimes leading to extreme conditions and stress. For example, sudden exposure to high light leads to excess absorbed light energy, causing reactive oxygen species (ROS) formation. ROS damages the photosynthetic machinery, particularly the D1 protein in photosystem II (PSII), which, therefore, needs to be continuously repaired and replaced. The effect of the damage inflicted by high light is a prolonged decrease in photosynthetic efficiency. Hence, it is not surprising that photoinhibition has been subject to numerous experimental studies investigating its effects in the context of crop productivity. However, it has become apparent that classical measures of photoinhibition, that is, changes in the chlorophyll fluorescence parameter Fv/Fm, are not only determined by the loss of PSII core function but also by processes such as energy transfer and quenching. Mathematical models can help dissect the influences on such fluorescence signals and quantify the contributions of various interacting mechanisms. We present a mathematical model with a dynamic description of the photosynthetic electron transport chain, non-photochemical quenching and photoinhibition. With our model, we investigate the interconnection among quenching, photoprotection and fluorescence using simulations and experimental data. We found that different energy-dissipating properties of intact and damaged PSIIs, as well as energy transfer between PSIIs, are critical components that need to be included in the model to ensure a satisfactory fit to the experimental data. We envisage that our model provides a framework for future investigations of photoinhibition dynamics and its importance for plant growth and yield.
A314 UNDIFFERENTIATED PANCREATIC CARCINOMA WITH OSTEOCLAST-LIKE GIANT CELLS: A CASE REPORT
Authors: Parvizian M K , Hurlbut D , Rai M S 
Published: February 2024

Abstract

Background
Pancreatic undifferentiated carcinoma with osteoclast-like giant cells (UCOGC) is a rare form of pancreatic cancer representing under 1% of cases. UCOGC is hypothesized to be a variant of pancreatic adenocarcinoma and while the pathophysiology is incompletely defined, it is felt to be an undifferentiated sarcomatoid carcinoma variant with chemotaxis of osteoclastic giant cells. Clinical, radiographic, or biochemical features do not reliably differentiate this from other tumors. Definitive diagnosis is made by histologic examination demonstrating non-neoplastic multinucleated osteoclastic giant cells (CD68 positive), mononuclear histiocytes, and neoplastic mononuclear cells.

Aims
To describe the case of a patient with UCOGC, highlighting key clinicopathologic features and management.

Methods
Case report and literature review.

Results
A 79-year-old man with atrial fibrillation on Xarelto presented with 4 months of abdominal pain, nausea, vomiting, and weight loss (22 kg). An MRI revealed a dilated main pancreatic duct and side branches with abrupt cutoff in the neck due to an ill-defined lesion. Endoscopic ultrasound confirmed a 36 mm hypoechoic ill-defined mass in the pancreatic neck. Biopsy performed with a 22-gauge needle with dry suction showed tissue fragments consistent with UCOGC (Figure 1).
Unfortunately, the patient presented to hospital with worsened abdominal pain and nausea and was found to have new portal, superior mesenteric, and splenic vein thrombosis. His anticoagulant was changed to Dalteparin. A multidisciplinary cancer conference was held including input from experts in Toronto, and due to surrounding inflammation and new thrombosis he was not considered a surgical candidate at the time and neoadjuvant treatment with standard adenocarcinoma chemotherapy was planned.
Unfortunately, the patient continued to decline and he was treated with palliative intent FOLFIRINOX for 2 cycles before opting for a medical assistance in dying procedure.

Conclusions
Treatment for UCOGC has not been well studied due to its rarity. Surgery is first-line therapy if appropriate based on patient status and cancer stage. The efficacy of chemotherapy and radiation is unclear but as a suspected adenocarcinoma variant, standard chemotherapy regimens are often used. Research is ongoing with an area of interest being PD-L1 inhibition due to high tumor PD-L1 positivity rates. Recognition of this rare entity is crucial due to its distinct diagnostic and therapeutic characteristics with more research needed to establish optimal therapy.

Figure 1: Pathologic examination with HPS and CD68 stains demonstrating UCOGC

Funding Agencies
None
Paediatric dermatofibrosarcoma protuberan—a case report in an Afro-Caribbean boy
Authors: Neblett Carlos , Appiah Kenneth , Jones Javier , Lawrence Tahjeme , Dawkins Shanna Kay , Crookendale Graeme , Thompson Rory 
Published: February 2024

Abstract
Dermatofibrosarcoma protuberans is a rare low-grade sarcoma, which rarely metastasizes, but it is locally aggressive with a propensity to recur. It usually affects persons of African descent and is extremely rare in childhood with a favourable prognosis. We present a case of paediatric dermatofibrosarcoma protuberans to the midline of the lower back of a 9-year-old Afro-Caribbean boy who was biopsied with a 2-mm margin. After histological confirmation, a 4-cm margin was then performed. Surveillance for recurrence, though none has been seen thus far after 6-month follow-up, will be done for at least 5 years and possibly longer, given this is the first case of this nature ever seen in our institution and the Caribbean region.
Migrated biliary stent into the portal vein: a case report
Authors: Christensen Sanne H , Roga Nawal F , Kirkegaard Jakob , Nygaard Jacob 
Published: February 2024

Abstract
Biliary stent insertion is a well-established treatment of bile duct obstruction. Stent migration is a late-onset complication and can be life-threatening. We present a case of proximal biliary stent migration to the portal vein. An upper endoscopy was performed, and the biliary stent was retracted. Bleeding was seen from the papilla of Vater. The hepatoduodenal ligament was explored, and the common bile duct was found fully adherent to the portal vein, with a fistula between the common bile duct and the portal vein. The patient underwent surgery with extrahepatic bile duct resection and hepaticoduodenostomy. The patient survived and was discharged without surgical postoperative complications on postoperative Day 8.
Pre-perihelion observations of long-period comet C/2013 X1 (PANSTARRS)
Authors: Shubina Olena , Ivanova O , Petrov D , Luk’yanyk I , Rosenbush V , Kiselev N 
Published: February 2024

ABSTRACT
We present and analyse the results of quasi-simultaneous spectroscopic, photometric, and polarimetric observations of hyperbolic comet C/2013 X1 (PANSTARRS) obtained at the 6-m Big Telescope Alt-azimuth (BTA) telescope Special Astrophysical Observatory (SAO) and 2.6-m Shajn telescope Crimean Astrophysical Observatory (CrAO). A wide fan-shaped structure and a weak tail were detected in the comet. The mean V − R colour of the coma was estimated to be neutral compared to the solar value. The Afρ parameter, a proxy to the dust production in the comet, was about 1672 ± 21 cm in the R band. Emissions of the CN, C2, C3, and NH2 molecules were identified in the cometary spectrum, which covers the wavelength range 3800 – 7100 Å. When the comet was at a distance of 2.66 au from the Sun, the minimum degree of polarization of about −1.5 per cent was detected in the near-nucleus region of the coma, in the range up to about 10 000 km from the optocentre. Further, polarization gradually increased (in absolute value) with distance from the nucleus, reaching −6.5 per cent at about 50 000 km. To reproduce the observed values of linear polarization and the phase-angle dependence of polarization for long-period comets, we used the Sh-matrix method with conjugated Gaussian random particles as light scatters, and the chemical composition of dust particles in the coma of 74 per cent amorphous carbon, 25 per cent of Mg-rich silicates, and 1 per cent of water ice.
Mergers of double NSs with one high-spin component: brighter kilonovae and fallback accretion, weaker gravitational waves
Authors: Rosswog S , Diener P , Torsello F , Tauris T M , Sarin N 
Published: February 2024

ABSTRACT
Neutron star (NS) mergers where both stars have negligible spins are commonly considered as the most likely ‘standard’ case. In globular clusters, however, the majority of NSs have been spun up to millisecond (ms) periods and, based on observed systems, we estimate that a non-negligible fraction of all double NS mergers ($\sim 4\pm 2\, {{\ \rm per\ cent}}$) contains one component with a spin of a (few) ms. We use the Lagrangian numerical relativity code SPHINCS_BSSN to simulate mergers where one star has no spin and the other has a dimensionless spin parameter of χ = 0.5. Such mergers exhibit several distinct signatures compared to irrotational cases. They form only one, very pronounced spiral arm and they dynamically eject an order of magnitude more mass of unshocked material at the original, very low electron fraction. One can therefore expect particularly bright, red kilonovae. Overall, the spinning case collisions are substantially less violent and they eject smaller amounts of shock-generated semirelativistic material. Therefore, the ejecta produce a weaker blue/ultraviolet kilonova precursor signal, but – since the total amount is larger – brighter kilonova afterglows months after the merger. The spinning cases also have significantly more fallback accretion and thus could power late-time X-ray flares. Since the post-merger remnant loses energy and angular momentum significantly less efficiently to gravitational waves, such systems can delay a potential collapse to a black hole and are therefore candidates for merger-triggered gamma-ray bursts with longer emission time-scales.
An updated fluorescence emission model of CO+ for cometary science
Authors: Bromley S J , Noonan J Wm , Cochran A L , Stachová B , Országh J , Ivanova O , Pierce D M , Fortenberry R C , Bodewits D 
Published: February 2024

ABSTRACT
A new CO$^+$ fluorescence emission model for analysing cometary spectra is presented herein. Accurate line lists are produced using the PGOPHER software for all transitions between the three electronic states (X $^2\Sigma$, A $^2\Pi$, B $^2\Sigma$) with vibrational states up to $v_\textrm {max} = 9, 8, 6$, respectively, and maximum rotational states with rotational quantum numbers $N\le 20$. As a result of improved molecular constants and theoretical transition rates, an expansion of the utilized solar spectrum into the infrared, and the substantial expansion of the included rovibronic states, the model provides an update of the fluorescence efficiencies of the CO$^+$ cation. The dependencies on heliocentric velocity and distance are explicitly included. We report, for the first time, quantification of the fluorescence efficiencies for the ground state rovibrational transitions of CO$^+$ and predict the positions and relative intensities of CO$^+$ lines in windows accessible to both ground- and space-based observatories. The computed fluorescence efficiencies show excellent agreement with UV/optical observations of both C/2016 R2 (PanSTARRS) and 29P/Schwassmann-Wachmann 1. The updated fluorescence efficiencies allow for revised N$_2$/CO abundances for comets 1P/Halley, C/1987 P1 (Bradfield), and C/2016 R2 (PanSTARRS), which can change by up to 30 per cent when accounting for recent improvements to CO$^+$ and N$_2^+$ fluorescence efficiencies. The model code, input files, and fluorescence efficiencies are publicly available and distributed on permanent archives for future uses in cometary analyses.
Intraoperative hypotension and its association with acute kidney injury in patients undergoing elective cardiac surgery: a large retrospective cohort study
Authors: Jung Hilke , Mohr Niklas , Hulde Nikolai , Krannich Alexander , Storm Christian , von Dossow Vera 
Published: February 2024

BACKGROUND
Intraoperative hypotension (IOH) is known to affect renal outcomes in noncardiac surgery. However, it is unclear whether intraoperative hypotension (IOH) causes postoperative acute kidney injury following cardiac surgery.

OBJECTIVE
This study aimed to determine whether the duration of IOH during cardiac surgery is associated with the incidence of postoperative acute kidney injury (AKI) and identify its impact on long-term outcomes.

DESIGN
Retrospective cohort study.

SETTING
Academic university hospital (Heart and Diabetes Center, Bad Oeynhausen, Germany).

PATIENTS
A cohort of 28 909 patients who underwent elective cardiac surgery between 1 January 2009 and 31 December 2018.

INTERVENTIONS
IOH was defined as intraoperative mean arterial blood pressure (MAP) of less than 60 mmHg for more than 2 min. The cumulative duration of these IOH events was recorded each patient.

MAIN OUTCOME MEASURES
The primary outcome was the incidence of AKI according to the KDIGO criteria (Kidney Disease: Improving Global Outcomes). Logistic regression analysis was used to analyse the associations between IOH and the incidence of AKI. Secondary outcomes were the independent predictors for the incidence of AKI.

RESULTS
Postoperative AKI was observed in 42.9% of patients. The cumulative duration of IOH (minutes) had a significant influence on the incidence of AKI [odds ratio (OR) 1.004; 95% confidence interval (CI) 1.003 to 1.005; P < 0.001] (P > 0.001 versus P < 0.001). The survival time was significantly shorter in patients with a higher cumulative duration of IOH, patients aged more than 70 years, and those who developed AKI (P < 0.001). Logistic regression analysis identified eight predictors of AKI: age, cumulative duration of IOH, duration of surgery, chronic obstructive pulmonary disease, body mass index, type of surgery, American Society of Anesthesiologists stage, and Euroscore 2.

CONCLUSIONS
The cumulative duration of IOH is an independent risk factor for the occurrence of postoperative AKI after cardiac surgery.

TRIAL REGISTRATION
Ethics Committee of the Ruhr University Bochum (Register number 2019-491).
An External Validation Study for Automated Segmentation of Vestibular Schwannoma
Authors: Suresh Krish , Luo Guibo , Bartholomew Ryan A. , Brown Alyssa , Juliano Amy F. , Lee Daniel J. , Welling D. Bradley , Cai Wenli , Crowson Matthew G. 
Published: February 2024

ObjectiveTo validate how an automated model for vestibular schwannoma (VS) segmentation developed on an external homogeneous dataset performs when applied to internal heterogeneous data.PatientsThe external dataset comprised 242 patients with previously untreated, sporadic unilateral VS undergoing Gamma Knife radiosurgery, with homogeneous magnetic resonance imaging (MRI) scans. The internal dataset comprised 10 patients from our institution, with heterogeneous MRI scans.InterventionsAn automated VS segmentation model was developed on the external dataset. The model was tested on the internal dataset.Main Outcome MeasureDice score, which measures agreement between ground truth and predicted segmentations.ResultsWhen applied to the internal patient scans, the automated model achieved a mean Dice score of 61% across all 10 images. There were three tumors that were not detected. These tumors were 0.01 ml on average (SD = 0.00 ml). The mean Dice score for the seven tumors that were detected was 87% (SD = 14%). There was one outlier with Dice of 55%—on further review of this scan, it was discovered that hyperintense petrous bone had been included in the tumor segmentation.ConclusionsWe show that an automated segmentation model developed using a restrictive set of siloed institutional data can be successfully adapted for data from different imaging systems and patient populations. This is an important step toward the validation of automated VS segmentation. However, there are significant shortcomings that likely reflect limitations of the data used to train the model. Further validation is needed to make automated segmentation for VS generalizable.