bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isolation of Brucella inopinata from a White’s tree frog (Litoria caerulea): pose exotic frogs a potential risk to human health?
Authors: Scholz Holger C. , Heckers Kim O. , Appelt Sandra , Geier-Dömling Dorothee , Schlegel Patrick , Wattam Alice R. 
Published: June 2023

IntroductionCold-blooded hosts, particularly exotic frogs, have become a newly recognized reservoir for atypical Brucella species and strains worldwide, but their pathogenicity to humans remains largely unknown. Here we report the isolation and molecular characterization of a B. inopinata strain (FO700662) cultured from clinical samples taken from a captive diseased White’s Tree Frog (Litoria caerulea) in Switzerland. The isolation of B. inopinata from a frog along with other reports of human infection by atypical Brucella raises the question of whether atypical Brucella could pose a risk to human health and deserves further attention.MethodsThe investigations included histopathological analysis of the frog, bacterial culture and in-depth molecular characterization of strain FO700662 based on genome sequencing data.Results and DiscussionOriginally identified as Ochrobactrum based on its rapid growth and biochemical profile, strain FO700622 was positive for the Brucella- specific markers bcsp31 and IS711. It showed the specific banding pattern of B. inopinata in conventional Bruce-ladder multiplex PCR and also had identical 16S rRNA and recA gene sequences as B. inopinata. Subsequent genome sequencing followed by core genome-based MLST (cgMLST) analysis using 2704 targets (74% of the total chromosome) revealed only 173 allelic differences compared to the type strain of B. inopinata BO1T, while previously considered the closest related strain BO2 differed in 2046 alleles. The overall average nucleotide identity (ANI) between the type strain BO1T and FO700622 was 99,89%, confirming that both strains were almost identical. In silico MLST-21 and MLVA-16 also identified strain FO700662 as B. inopinata. The nucleotide and amino acid-based phylogenetic reconstruction and comparative genome analysis again placed the isolate together with B. inopinata with 100% support. In conclusion, our data unequivocally classified strain FO700622, isolated from an exotic frog, as belonging to B. inopinata.
Learning the heterogeneous representation of brain's structure from serial SEM images using a masked autoencoder
Authors: Cheng Ao , Shi Jiahao , Wang Lirong , Zhang Ruobing 
Published: June 2023

IntroductionThe exorbitant cost of accurately annotating the large-scale serial scanning electron microscope (SEM) images as the ground truth for training has always been a great challenge for brain map reconstruction by deep learning methods in neural connectome studies. The representation ability of the model is strongly correlated with the number of such high-quality labels. Recently, the masked autoencoder (MAE) has been shown to effectively pre-train Vision Transformers (ViT) to improve their representational capabilities.MethodsIn this paper, we investigated a self-pre-training paradigm for serial SEM images with MAE to implement downstream segmentation tasks. We randomly masked voxels in three-dimensional brain image patches and trained an autoencoder to reconstruct the neuronal structures.Results and discussionWe tested different pre-training and fine-tuning configurations on three different serial SEM datasets of mouse brains, including two public ones, SNEMI3D and MitoEM-R, and one acquired in our lab. A series of masking ratios were examined and the optimal ratio for pre-training efficiency was spotted for 3D segmentation. The MAE pre-training strategy significantly outperformed the supervised learning from scratch. Our work shows that the general framework of can be a unified approach for effective learning of the representation of heterogeneous neural structural features in serial SEM images to greatly facilitate brain connectome reconstruction.
Modeling homeostatic and circadian modulation of human pain sensitivity
Authors: Crodelle Jennifer , Vanty Carolyn , Booth Victoria 
Published: June 2023

IntroductionMathematical modeling has played a significant role in understanding how homeostatic sleep pressure and the circadian rhythm interact to influence sleep-wake behavior. Pain sensitivity is also affected by these processes, and recent experimental results have measured the circadian and homeostatic components of the 24 h rhythm of thermal pain sensitivity in humans. To analyze how rhythms in pain sensitivity are affected by disruptions in sleep behavior and shifts in circadian rhythms, we introduce a dynamic mathematical model for circadian and homeostatic regulation of sleep-wake states and pain intensity.MethodsThe model consists of a biophysically based, sleep-wake regulation network model coupled to data-driven functions for the circadian and homeostatic modulation of pain sensitivity. This coupled sleep-wake-pain sensitivity model is validated by comparison to thermal pain intensities in adult humans measured across a 34 h sleep deprivation protocol.ResultsWe use the model to predict dysregulation of pain sensitivity rhythms across different scenarios of sleep deprivation and circadian rhythm shifts, including entrainment to new environmental light and activity timing as occurs with jet lag and chronic sleep restriction. Model results show that increases in pain sensitivity occur under conditions of increased homeostatic sleep drive with nonlinear modulation by the circadian rhythm, leading to unexpected decreased pain sensitivity in some scenarios.DiscussionThis model provides a useful tool for pain management by predicting alterations in pain sensitivity due to varying or disrupted sleep schedules.
Prognostic value of extrahepatic metastasis on colon cancer with liver metastasis: a retrospective cohort study
Authors: Bai Shuheng , Chen Ling , Zhu Guixian , Xuan Wang , Hu Fengyuan , Liu Wanyi , Li Wenyang , Lan Ning , Chen Min , Yan Yanli , Li Rong , Yang Yiping , Ren Juan 
Published: June 2023

IntroductionThe occurrence of metastasis is a threat to patients with colon cancer (CC), and the liver is the most common metastasis organ. However, the role of the extrahepatic organs in patients with liver metastasis (LM) has not been distinctly demonstrated. Therefore, this research aimed to explore the prognostic value of extrahepatic metastases (EHMs).MethodsIn this retrospective study, a total of 13,662 colon patients with LM between 2010 and 2015 were selected from the Surveillance, Epidemiology, and End Results database (SEER). Fine and Gray’s analysis and K–M survival analysis were utilized to explore the impacts of the number of sites of EHMs and different sites of EHMs on prognosis. Finally, a prognostic nomogram model based on the number of sites of EHMs was constructed, and a string of validation methods was conducted, including concordance index (C-index), receiver operating characteristic curves (ROC), and decision curve analysis (DCA).ResultsPatients without EHMs had better prognoses in cancer-specific survival (CSS) and overall survival (OS) than patients with EHMs (p &lt; 0.001). Varied EHM sites of patients had different characteristics of primary location site, grade, and histology. Cumulative incidence rates for CSS surpassed that for other causes in patients with 0, 1, 2, ≥ 3 EHMs, and the patients with more numbers of sites of EHMs revealed worse prognosis in CSS (p &lt; 0.001). However, patients with different EHM sites had a minor difference in cumulative incidence rates for CSS (p = 0.106). Finally, a nomogram was constructed to predict the survival probability of patients with EHMs, which is based on the number of sites of EHMs and has been proven an excellent predictive ability.ConclusionThe number of sites of EHMs was a significant prognostic factor of CC patients with LM. However, the sites of EHMs showed limited impact on survival. Furthermore, a nomogram based on the number of sites of EHMs was constructed to predict the OS of patients with EHMs accurately.
Ribociclib in newly diagnosed hepatitis B infection: A case report
Authors: Di Costanzo Fabrizio , Carrano Simone , Iengo Gennaro , Cefaliello Amedeo , Cossiga Valentina , Morisco Filomena , Giuliano Mario , De Angelis Carmine , Arpino Grazia 
Published: June 2023

Breast cancer is the most frequently diagnosed cancer in women worldwide. Actually CDK4/6 inhibitor Ribociclib is approved for the treatment of metastatic hormone-positive and human epidermal growth factor receptor 2 (HER 2)-negative breast cancer, but comorbidities like infectious or cardiovascular diseases may limit its use.Case reportA 45-year-old woman was diagnosed with metastatic breast cancer in September 2021; also, her hepatitis screening resulted positive for hepatitis B infection. Patient assumed eradicative therapy for hepatitis and bit after started oncological therapy with Ribociclib.OutcomeFrequent check of hepatological function was observed since start of eradicative therapy; liver transaminases and bilirubin kept to not rise despite start of oncological treatment with Ribociclib. Patient’s Performance Status was also not compromised and revaluation at 4, 9 and 13 months showed partial response and then stable disease.Discussionhepatotoxicity of Ribociclib is reported as a possible side effect, and often positivity for hepatitis is cause of exclusion from therapy; in our case, no hepatotoxicity was noted and patient obtained response in terms of control of both infectious and oncological diseases.
Timely initiation of complementary feeding practices and associated factors among children aged 6–23 months in Dessie Zuria District, Northeast Ethiopia: a community-based cross-sectional study
Authors: Abate Anteneh Demelash , Hassen Seid Legesse , Temesgen Minwuyelet Marru 
Published: June 2023

IntroductionEthiopia has one of the highest infant and child mortality rates in the world. Starting from the age of 6 months, breast milk alone is not sufficient to cover all nutritional requirements. Infants and young children are at an increased risk of undernutrition. Complementary feeding must, therefore, begin at the age of 6 months. Infant and young child nutrition is a critical factor in human health, nutrition, survival, growth, and development. Therefore, the aim of this study is to evaluate the timely initiation of complementary feeding practices and associated factors in children aged 6–23 months in the Dessie Zuria District of North Ethiopia.MethodsA community-based cross-sectional study design was used for the period between 16 March and 30 March 2019. The study included 770 mother–child pairs aged 6–23 months. A multistage sampling method was used to choose the study participants. Using a simple random sampling technique, nine kebeles in the district were selected from a total of 31, and from 103 Gotts or villages, 31 were selected with 770 HHs out of 2,329 HHs with children aged 6–23 months. Data were collected using a pretested semistructured interviewer-administered questionnaire, which was then entered into Epi Data version 3.1 statistical software before being transferred to SPSS version 21 for further analysis. To summarize the data, descriptive statistics were used, which included a simple frequency table and figures. To evaluate factors, bivariate and multivariable logistic regression were used. A p-value of less than 0.05 was used to determine statistical significance.ResultsThe percentage of children who started complementary feeding practices on time was 70.9. Maternal occupation [AOR = 5.51, 95% CI (1.61–18.81)], radio availability [AOR = 2.03, 95% CI (1.32–3.12)], antenatal care follow-up [AOR = 6.19, 95% CI (4.08–9.40)], place of delivery [AOR = 5.06%, CI (3.34–7.68)], and postnatal care follow-up [AOR = 4.32, 95% CI (2.77–6.72)] were found to be the factors for the timely initiation of complementary feeding.ConclusionWhen compared with WHO cutoff points, timely initiation of complementary feeding practice was relatively low in the study area. Maternal occupation, radio availability, ANC follow-up, place of delivery, and postnatal care visit were all significantly associated with the timely initiation of complementary feeding.
Exploratory study of autophagy inducer sirolimus for childhood cerebral adrenoleukodystrophy
Authors: Luo Xiao-Mei , Liu Li-Ying , Wang Qiu-Hong , Wang Yang-Yang , Wang Jing , Yang Xiao-Yan , Li Shi-Jun , Zou Li-Ping 
Published: June 2023

ObjectivesX-linked adrenoleukodystrophy (ALD) is a peroxisomal disease caused by mutations in the ABCD1 gene. Childhood cerebral ALD (CCALD) is characterized by inflammatory demyelination, rapidly progressing, often fatal. Hematopoietic stem cell transplant only delays disease progression in patients with early-stage cerebral ALD. Based on emergency humanitarianism, this study aims to investigate the safety and efficacy of sirolimus in the treatment of patients with CCALD.MethodsThis was a prospective, single-center, one-arm clinical trial. We enrolled patients with CCALD, and all enrolled patients received sirolimus treatment for three months. Adverse events were monitored and recorded to evaluate the safety. The efficacy was evaluated using the neurologic function scale (NFS), Loes score, and white matter hyperintensities.ResultsA total of 12 patients were included and all presented with CCALD. Four patients dropped out and a total of eight patients in the advanced stage completed a 3-month follow-up. There were no serious adverse events, and the common adverse events were hypertonia and oral ulcers. After sirolimus treatment, three of the four patients with an initial NFS &gt; 10 showed improvements in their clinical symptoms. Loes scores decreased by 0.5–1 point in two of eight patients and remained unchanged in one patient. Analysis of white matter hyperintensities revealed a significant decrease in signal intensity (n = 7, p = 0.0156).ConclusionsOur study suggested that autophagy inducer sirolimus is safe for CCALD. Sirolimus did not improve clinical symptoms of patients with advanced CCALD significantly. Further study with larger sample size and longer follow-up is needed to confirm the drug efficacy.Clinical Trial registration:https://www.chictr.org.cn/historyversionpuben.aspx, identifier ChiCTR1900021288.
Risk-factor analysis and predictive-model development of acute kidney injury in inpatients administered cefoperazone-sulbactam sodium and mezlocillin-sulbactam sodium: a single-center retrospective study
Authors: Zhang Ruiqiu , Gao Liming , Chen Ping , Liu Weiguo , Huang Xin , Li Xiao 
Published: June 2023

Objective: Acute kidney injury (AKI) is a common adverse reaction observed with the clinical use of cefoperazone-sulbactam sodium and mezlocillin-sulbactam sodium. Based upon real-world data, we will herein determine the risk factors associated with AKI in inpatients after receipt of these antimicrobial drugs, and we will develop predictive models to assess the risk of AKI.Methods: Data from all adult inpatients who used cefoperazone-sulbactam sodium and mezlocillin-sulbactam sodium at the First Affiliated Hospital of Shandong First Medical University between January 2018 and December 2020 were analyzed retrospectively. The data were collected through the inpatient electronic medical record (EMR) system and included general information, clinical diagnosis, and underlying diseases, and logistic regression was exploited to develop predictive models for the risk of AKI. The training of the model strictly adopted 10-fold cross-validation to validate its accuracy, and model performance was evaluated employing receiver operating characteristic (ROC) curves and the areas under the curve (AUCs).Results: This retrospective study comprised a total of 8767 patients using cefoperazone-sulbactam sodium, of whom 1116 developed AKI after using the drug, for an incidence of 12.73%. A total of 2887 individuals used mezlocillin-sulbactam sodium, of whom 265 developed AKI after receiving the drug, for an incidence of 9.18%. In the cohort administered cefoperazone-sulbactam sodium, 20 predictive factors (p &lt; 0.05) were applied in constructing our logistic predictive model, and the AUC of the predictive model was 0.83 (95% CI, 0.82–0.84). In the cohort comprising mezlocillin-sulbactam sodium use, nine predictive factors were determined by multivariate analysis (p &lt; 0.05), and the AUC of the predictive model was 0.74 (95% CI, 0.71–0.77).Conclusion: The incidence of AKI induced by cefoperazone-sulbactam sodium and mezlocillin-sulbactam sodium in hospitalized patients may be related to the combined treatment of multiple nephrotoxic drugs and a past history of chronic kidney disease. The AKI-predictive model based on logistic regression showed favorable performance in predicting the AKI of adult in patients who received cefoperazone-sulbactam sodium or mezlocillin-sulbactam sodium.
Personalized smart voice-based electronic prescription for remote at-home feedback management in cardiovascular disease rehabilitation: a multi-center randomized controlled trial
Authors: Zhu Yin-Hua , Xia Li-Ping , Yan Jing , Shou Xiao-Ling , Zhu Li-Yue , Sun Yan , Wang Ju-Fei , Ji Xiao-Jun , Zhu Mei-Li , Feng Bei-Li , Chen Hua-Xian 
Published: June 2023

ObjectiveTo investigate the quality and efficacy of remote at-home rehabilitation for patients with cardiovascular disease (CVD) using personalized smart voice-based electronic prescription, and further explore the standardized health management mode of remote family cardiac rehabilitation. Trial design: A multicenter, randomized (1:1), non-blind, parallel controlled study.MethodsA total of 171 patients with CVD who were admitted to 18 medical institutions in China from April 2021 to October 2022 were randomly divided into a treatment group (86 cases) and a control group (85 cases) in a non-blinded experiment, based on the sequence of enrollment. The control group received routine at-home rehabilitation training, and the treatment group received remote feedback-based at-home cardiac rehabilitation management based on routine at-home rehabilitation training. The primary outcome was the difference in VO2peak (mL/min/kg) after 12 weeks. A linear mixed model was developed with follow-up as the dependent variable. Age and baseline data were utilized as covariates, whereas hospital and patient characteristics were adjusted as random-effect variables. As the linear mixed model can accommodate missing data under the assumption of random missing data, there was no substitute missing value for quantitative data.ResultsA total of 171 participants, with 86 in the experimental group and 85 in the control group, were included in the main analysis. The analysis, which used linear mixing model, revealed significant differences in cardiopulmonary function indexes (VO2/kg peak, VO2peak, AT, METs, and maximum resistance) at different follow-up time (0, 4, and 12 weeks) in the experimental group (p &lt; 0.05). In the control group, there was no significant difference in cardiopulmonary values at different follow-up time (0, 4, and 12 weeks; p &gt; 0.05). VO2/kg peak (LS mean 1.49, 95%CI 0.09–2.89, p = 0.037) and other indicators of cardiopulmonary function (p &lt; 0.05) were significantly different between the experimental group and the control group at week 12. The results were comparable in the complete case analysis.ConclusionThe remote home cardiac rehabilitation management mode using personalized smart voice-based electronic prescription provides several benefits to patients, including improvements in muscle strength, endurance, cardiopulmonary function, and aerobic metabolism. It also helps reduce risk factors for cardiovascular disease and enhances patients’ self-management abilities and treatment compliance.Clinical trial registration: http://www.chictr.org.cn, identifier ChiCTR2100044063.
The SITS framework: sustaining innovations in tertiary settings
Authors: Nadalin Penno Letitia , Graham Ian D. , Backman Chantal , Davies Barbara , Squires Janet 
Published: June 2023

BackgroundTo date, little attention has focused on what the determinants are and how evidence-based practices (EBPs) are sustained in tertiary settings (i.e., acute care hospitals). Current literature reveals several frameworks designed for implementation of EBPs (0–2 years), yet fewer exist for the sustainment of EBPs (&gt;2 years) in clinical practice. Frameworks containing both phases generally list few determinants for the sustained use phase, but rather state ongoing monitoring or evaluation is necessary. Notably, a recent review identified six constructs and related strategies that facilitate sustainment, however, the pairing of determinants and how best to sustain EBPs in tertiary settings over time remains unclear. The aim of this paper is to present an evidence-informed framework, which incorporates constructs, determinants, and knowledge translation interventions (KTIs) to guide implementation practitioners and researchers in the ongoing use of EBPs over time.MethodsWe combined the results of a systematic review and theory analysis of known sustainability frameworks/models/theories (F/M/Ts) with those from a case study using mixed methods that examined the ongoing use of an organization-wide pain EBP in a tertiary care center (hospital) in Canada. Data sources included peer-reviewed sustainability frameworks (n = 8) related to acute care, semi-structured interviews with nurses at the department (n = 3) and unit (n = 16) level, chart audits (n = 200), and document review (n = 29). We then compared unique framework components to the evolving literature and present main observations.ResultsWe present the Sustaining Innovations in Tertiary Settings (SITS) framework which consists of 7 unique constructs, 49 determinants, and 29 related KTIs that influence the sustainability of EBPs in tertiary settings. Three determinants and 8 KTIs had a continuous influence during implementation and sustained use phases. Attention to the level of application and changing conditions over time affecting determinants is required for sustainment. Use of a participatory approach to engage users in designing remedial plans and linking KTIs to target behaviors that incrementally address low adherence rates promotes sustainability.ConclusionsThe SITS framework provides a novel resource to support future practice and research aimed at sustaining EBPs in tertiary settings and improving patient outcomes. Findings confirm the concept of sustainability is a “dynamic ongoing phase”.