bluuebunny/crossref_metadata_2025_split huggingface dataset:
Iliac vein recanalisation and stenting accelerate healing of venous leg ulcers associated with severe venous outflow obstruction
Authors: Ruiz Colby S. , Hamrick Melissa F. , McGinigle Katharine L. , Marston William A. 
Published: December 2022

AbstractObstruction involving the iliac veins and/or inferior vena cava is highly comorbid in patients with chronic venous leg ulcers and is a barrier to healing. Intervention with venous stenting is recommended to promote wound healing; however, there is limited data to quantify the effects of venous outflow restoration on wound healing. We retrospectively identified patients with venous ulcers and comorbid venous outflow obstruction. Data regarding demographics, wound size, degree of obstruction, interventions, wound healing and recurrence were collected. Intervention was performed when possible and patients were grouped based on whether or not the venous outflow was reopened successfully and maintained for at least 1 year. Outcomes, including time to wound healing, wound recurrence, stent patency and ulcer‐free time, were measured. Patients who maintained a patent venous outflow tract experienced higher rates of wound healing (79.3%) compared to those with persistent outflow obstruction (22.6%) at 12 months (p < 0.001). Ulcer‐free time for the first year was also greater with patent venous outflow (7.6 ± 4.4 months versus 1.8 ± 3.0 months, p < 0.0025). Patients with severe obstruction of the venous outflow tract experience poor healing of VLUs despite appropriate wound care. Healing time is improved and ulcer‐free time increased after venous intervention with stenting to eliminate obstruction.
Mapping School-Based Coach Education Requirements in the United States
Authors: Atkinson Obidiah , Bates Samantha , Anderson-Butcher Dawn , Mack Sydney , Goodway Jacqueline 
Published: December 2022

To date, there is a critical gap in our understanding of coach licensure and training requirements for school-based coaches across the United States. The current study categorizes the policy landscape for school-based coaches by examining public documents that outline state-specific (N = 51) coach training requirements. In addition, authors engaged in an in-depth curriculum and cost analysis of required coach trainings in the state of Ohio to better understand training topics, costs, time commitments, and state-specific compliance criteria guiding coach education. Findings indicated most states (n = 49, 96%) require training for coaches; however, governing bodies, training topics, and coach-specific training (i.e., assistant, volunteer, and middle school) varied significantly by state. Moreover, our curriculum and cost analysis revealed that licensure processes are costly and time-intensive, and training content predominantly focused on physical health and safety with less emphasis on social–emotional health and youth development. Findings have important education, practice, and policy implications for informing a national coach training agenda.
Nirmatrelvir-resistant SARS-CoV-2 variants with high fitness in an infectious cell culture system
Authors: Zhou Yuyong , Gammeltoft Karen Anbro , Ryberg Line Abildgaard , Pham Long V. , Tjørnelund Helena Damtoft , Binderup Alekxander , Duarte Hernandez Carlos Rene , Fernandez-Antunez Carlota , Offersgaard Anna , Fahnøe Ulrik , Peters Günther Herbert Johannes , Ramirez Santseharay , Bukh Jens , Gottwein Judith Margarete 
Published: December 2022

The oral protease inhibitor nirmatrelvir is of key importance for prevention of severe coronavirus disease 2019 (COVID-19). To facilitate resistance monitoring, we studied severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) escape from nirmatrelvir in cell culture. Resistant variants harbored combinations of substitutions in the SARS-CoV-2 main protease (Mpro). Reverse genetics revealed that E166V and L50F + E166V conferred high resistance in infectious culture, replicon, and Mpro systems. While L50F, E166V, and L50F + E166V decreased replication and Mpro activity, L50F and L50F + E166V variants had high fitness in the infectious system. Naturally occurring L50F compensated for fitness cost of E166V and promoted viral escape. Molecular dynamics simulations revealed that E166V and L50F + E166V weakened nirmatrelvir-Mpro binding. Polymerase inhibitor remdesivir and monoclonal antibody bebtelovimab retained activity against nirmatrelvir-resistant variants, and combination with nirmatrelvir enhanced treatment efficacy compared to individual compounds. These findings have implications for monitoring and ensuring treatments with efficacy against SARS-CoV-2 and emerging sarbecoviruses.
An Unusual cause of Endocarditis
Authors: Watkins Rhys , Marincowitz Carl , Locke Thomas , Hunter Steven 
Published: December 2022

A man in his 20s attended the emergency department with three days of fever, headache, reduced appetite and a sore throat. COVID-19 point-of-care test was negative. Blood cultures grew a gram-negative coccobacillus,Neisseria elongata. Following an episode of confusion, MRI head revealed septic emboli. Prolapse of the mitral valve with regurgitation was noted on echocardiography. Infection was found to have originated from multiple dental caries and treatment required a combination of dental extraction, prolonged antibiotic therapy and surgery for mitral valve repair.N. elongatais part of the normal oropharyngeal flora but is also a rare cause of endocarditis. There are no established treatment guidelines for endocarditis of this aetiology.N. elongataendocarditis may present atypically, with a murmur only developing several days later. ‘Classical’ stigmata should not be relied on to make a diagnosis.N. elongatapredominantly affects the left side of the heart and predisposes to embolic events.
Turn that frown upside down: implementation of a visual cue improves communication during emergency department to inpatient hand-offs
Authors: Burns Beech , Heilman James , Kusin Shana , Chess Laura , Tanski Mary Elizabeth 
Published: December 2022

When a patient is admitted to the hospital from the emergency department (ED), the ED clinician passes on relevant clinical information to the admitting team to transition care, a process known as patient hand-off and commonly referred to as ‘calling report’. This information exchange between clinical teams is not only important for care continuity but also signifies a transition of care.However, there are unique challenges in this hand-off process given the unpredictability of the busy ED environment, ED boarding and discontinuity in physician, nursing and transportation workflows. These challenges create the potential for gaps in communication and can create patient safety concerns, particularly if a patient is transported to an inpatient bed before hand-off takes place.We set out to determine whether introducing a visual cue on the electronic health record (EHR) ED trackboard to communicate that report had been given would improve hand-off compliance. We sought to improve the utility of the visual cue and compliance of calling report prior to patient transport through a series of several Plan Do Study Act (PDSA) cycles.Baseline compliance using the ‘Report Called’ button prior to implementation of our visual intervention was 9.8%. With staff education alone, compliance rose to 41.3%. However, with an easily recognisable visual cue highlighted on the trackboard and an improved workflow compliance immediately rose to >97% and has been sustained for 84 months. Additionally, we have had zero reported incidents of patients being transported to a hospital bed before physician report was called since implementation.Our study demonstrates that simple visual cues and incorporation of a user-friendly process in the workflow can improve compliance with ensuring report is called prior to patient transfer from the ED. This may have a positive impact on physician communication and patient safety during the admission process.
Craniosynostosis, inner ear, and renal anomalies in a child with complete loss ofSPRY1(sprouty homolog 1) function
Authors: Tooze Rebecca S , Calpena Eduardo , Twigg Stephen R F , D’Arco Felice ,   The Genomics England Research Consortium, Wakeling Emma L , Wilkie Andrew O M 
Published: December 2022

IntroductionSPRY1encodes protein sprouty homolog 1 (Spry-1), a negative regulator of receptor tyrosine kinase signalling. Null mutant mice display kidney/urinary tract abnormalities and altered size of the skull; complete loss-of-function of Spry-1 in humans has not been reported.MethodsAnalysis of whole-genome sequencing data from individuals with craniosynostosis enrolled in the 100,000 Genomes Project identified a likely pathogenic variant withinSPRY1. Reverse-transcriptase PCR and western blot analysis were used to investigate the effect of the variant onSPRY1mRNA and protein, in lymphoblastoid cell lines from the patient and both parents.ResultsA nonsense variant inSPRY1,encoding p.(Leu27*), was confirmed to be heterozygous in the unaffected parents and homozygous in the child. The child’s phenotype, which included sagittal craniosynostosis, subcutaneous cystic lesions overlying the lambdoid sutures, hearing loss associated with bilateral cochlear and vestibular dysplasia and a unilateral renal cyst, overlapped the features reported inSpry1−/−null mice. Functional studies supported escape from nonsense-mediated decay, but western blot analysis demonstrated complete absence of full-length protein in the affected child and a marked reduction in both parents.ConclusionThis is the first report of complete loss of Spry-1 function in humans, associated with abnormalities of the cranial sutures, inner ear, and kidneys.
Growth of the aortic root in children and young adults with Marfan syndrome
Authors: van Elsäcker Elroy , Vink Arja S , Menke Leonie A , Pals Gerard , Bokenkamp Regina , Backx Ad C P M , Hilhorst-Hofstee Yvonne , Blom Nicolaas A , van der Hulst Annelies E 
Published: December 2022

ObjectivesThe primary aim was to gain insight into the growth of the aortic root in children and young adults with Marfan syndrome (MFS). Furthermore, we aimed to identify a clinical profile of patients with MFS who require an aortic root replacement at a young age with specific interest in age, sex, height and fibrillin-1 (FBN1) genotype.MethodsAortic root dimensions of 97 patients with MFS between 0 year and 20 years and 30 controls were serially assessed with echocardiography. Trends were analysed using a linear mixed-effect model. Additionally, including only patients with MFS, we allowed trends to differ by sex, aortic root replacement and type ofFBN1mutation.ResultsAverage aortic root dilatation in patients with MFS became more pronounced after the age of 8 years. In the MFS cohort, male patients had a significantly greater aortic root diameter than female patients, which was in close relationship with patient height. There was no difference in aortic root growth between children with dominant negative (DN) or haploinsufficientFBN1mutations. However, DN-FBN1variants resulting in loss of cysteine content were associated with a more severe phenotype. Eleven children needed an aortic root replacement. Compared with patients with MFS without aortic root surgery, these children had a significantly larger aortic root diameter from an early age.ConclusionsThis study provides clinically useful longitudinal growth charts on aortic root growth in children and young adults with MFS. Children requiring prophylactic aortic root replacement during childhood can be identified at a young age. Our growth charts can help clinicians in decision making with regard to follow-up and prophylactic therapy. Loss of cysteine content in theFBN1protein was associated with larger aortic root dimensions.
Effects of dietary supplementation of diacylglycerol on growth performance, nutrient digestibility, fecal noxious gas emission, and hematology parameters in weaned piglets
Authors: Dang De Xin , Kim In Ho 
Published: December 2022

A total of 120 21-day-old weaned piglets ((Yorkshire × Landrace) × Duroc) were used to evaluate the effects of dietary supplementation of diacylglycerol (DAG) on the growth performance, nutrient digestibility, fecal noxious gas emission, and hematology parameters in a 42-day experiment. All pigs were randomly assigned to three groups based on the initial body weight (6.47 ± 0.45 kg). There were eight replicate pens per treatment and five pigs (three barrows and two gilts) per pen. The DAG in the levels of 0%, 0.05%, or 0.10% was used as supplement to the corn–soybean meal-based basal diet. Piglets fed the diet supplemented with graded levels of DAG linearly increased the average daily gain (ADG) during days 22–42 ( P = 0.027) and 1–42 ( P = 0.048). In addition, a tendency in the linear reduction of fecal ammonia ( P = 0.095), hydrogen sulfide ( P = 0.078), and methyl mercaptan ( P = 0.085) emission was observed by increasing the DAG levels in the diet. However, feeding pigs with DAG-containing diet had no significant effects on the nutrient digestibility and hematology parameters. Therefore, the suitable dose of DAG used in the diet of weaned piglets was at 0.10% to improve ADG and reduce fecal gas emission.
Sphingosine Kinase 2 in Stromal Fibroblasts Creates a Hospitable Tumor Microenvironment in Breast Cancer
Authors: Weigel Cynthia , Maczis Melissa A. , Palladino Elisa N.D. , Green Christopher D. , Maceyka Michael , Guo Chunqing , Wang Xiang-Yang , Dozmorov Mikhail G. , Milstien Sheldon , Spiegel Sarah 
Published: December 2022

AbstractReciprocal interactions between breast cancer cells and the tumor microenvironment (TME) are important for cancer progression and metastasis. We report here that the deletion or inhibition of sphingosine kinase 2 (SphK2), which produces sphingosine-1-phosphate (S1P), markedly suppresses syngeneic breast tumor growth and lung metastasis in mice by creating a hostile microenvironment for tumor growth and invasion. SphK2 deficiency decreased S1P and concomitantly increased ceramides, including C16-ceramide, in stromal fibroblasts. Ceramide accumulation suppressed activation of cancer-associated fibroblasts (CAF) by upregulating stromal p53, which restrained production of tumor-promoting factors to reprogram the TME and to restrict breast cancer establishment. Ablation of p53 in SphK2-deficient fibroblasts reversed these effects, enabled CAF activation and promoted tumor growth and invasion. These data uncovered a novel role of SphK2 in regulating non–cell-autonomous functions of p53 in stromal fibroblasts and their transition to tumor-promoting CAFs, paving the way for the development of a strategy to target the TME and to enhance therapeutic efficacy.Significance:Sphingosine kinase 2 (SphK2) facilitates the activation of stromal fibroblasts to tumor-promoting cancer-associated fibroblasts by suppressing host p53 activity, revealing SphK2 as a potential target to reprogram the TME.
Trends of Ovarian Cancer Incidence by Histotype and Race/Ethnicity in the United States 1992–2019
Authors: Phung Minh Tung , Pearce Celeste Leigh , Meza Rafael , Jeon Jihyoun 
Published: December 2022

The effect of risk factors on ovarian cancer differs by histotype, and the prevalence of such risk factors varies by race/ethnicity. It is not clear how ovarian cancer incidence has changed over time by histotype and race/ethnicity.We used the Surveillance, Epidemiology, and End Results Program (SEER-12) 1992–2019 data to examine the trend of ovarian cancer incidence for three histotypes (high-grade serous N = 19,691, endometrioid N = 3,212, and clear cell N = 3,275) and four racial/ethnic groups (Asian/Pacific Islander, Hispanic, non-Hispanic Black, and non-Hispanic White). Joinpoint and age-period-cohort analyses were conducted to analyze ovarian cancer incidence trends.High-grade serous cancer was the most common histotype, but its incidence has significantly decreased over time for all racial/ethnic groups; the decrease was largest for non-Hispanic White women (average annual percent change AAPC during 2010–2019 = −6.1; 95% confidence interval (CI), −8.0 to −4.2). Conversely, clear cell cancer was most common in the Asian/Pacific Islanders, and its incidence has increased over time, particularly among Hispanic and Asian/Pacific Islander women (AAPC during 2010–2019 = 2.8; 95% CI, 0.8 to 4.7, and AAPC = 1.5; 95% CI, 0.7 to 2.2, respectively). Endometrioid cancer incidence has decreased in non-Hispanic White but increased in Hispanic women (AAPC during 2010–2019 = −1.3; 95% CI, −1.9 to −0.8, and AAPC = 3.6; 95% CI, 1.0 to 6.3, respectively).The differential incidence trends by histotype and race/ethnicity underscore the need to monitor incidence and risk factor trends across different groups and develop targeted preventive interventions to reduce the burden of ovarian cancer and disparity by race/ethnicity.Significance:During 1992–2019, high-grade serous ovarian cancer incidence has decreased while clear cell cancer incidence has increased regardless of race/ethnicity. Endometrioid cancer incidence has decreased in non-Hispanic White but increased in Hispanic women. Differential ovarian cancer incidence trends highlight the need for targeted preventive interventions by histotype and race/ethnicity.
A novel examination of limonene detection using plastic fiber optic sensors and the tapered approach
Authors: Anbalagan Thanigai , Haroon Hazura , Abdul Rahim Hazli Rafis , Johari Siti Halma , Idris@ Othman Siti Khadijah , Razak Hanim Abdul , Othman Maisara 
Published: December 2022

A novel tapered plastic optic fiber (POF) biosensor is proposed and demonstrated for monitoring limonene in different concentrations. The mechanism of this device is based on an increase in the light transmission of a sensor submerged in a higher-concentration limonene solution, which also reflects an increase in the refractive index of the sensor. The tapered POF was fabricated using the chemical etching method to accomplish different waist diameters of 0.6 mm, 0.55 mm, and 0.5 mm, with a fiber length of 10 cm and a 2 cm sensing region. An Arduino integrated development environment (IDE) program was used to drive the voltage values from the photodetectors to obtain the measurements. As the limonene concentration solution varied from 20% to 100%, the output voltage of the sensor increased linearly, showing a sensitivity of 0.295 V/%, 0.33 V/%, and 0.46 V/% for tapered waist diameters of 0.6 mm, 0.55 mm, and 0.5 mm, respectively. The proposed sensor is a low-cost solution measurement option with high sensitivity, while it also involves a simple and easy fabrication technique.
Long-Term Patient-Reported Outcomes After Arthroscopic Debridement of Grade 3 or 4 Capitellar Osteochondritis Dissecans Lesions
Authors: Austin Daniel C. , Song Bryant , Rojas Lievano Jorge L. , Rogers Thomas H. , Barlow Jonathan D. , Camp Christopher L. , Morrey Mark E. , Sanchez-Sotelo Joaquin L. , Fitzsimmons James S. , O’Driscoll Shawn W. 
Published: December 2022

Background: Arthroscopic debridement for osteochondritis dissecans (OCD) lesions of the capitellum is a relatively common and straightforward surgical option for failure of nonoperative management. However, the long-term outcomes of this procedure remain unknown. Hypothesis: Arthroscopic debridement of capitellar OCD would provide satisfactory long-term improvement in patient-reported outcomes. Study Design: Case series; Level of evidence, 4. Methods: Patients aged ≤18 years who underwent arthroscopic debridement procedures for OCD lesions (International Cartilage Repair Society grades 3 and 4) were identified. Procedures included loose body removal when needed and direct debridement of the lesion; marrow stimulation with drilling or microfracture was added at the discretion of each surgeon. The cohort consisted of 53 elbows. Patient evaluation included visual analog scale for pain; motion; subjective satisfaction; Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores; reoperation; and rate of return to sports. Results: At a mean 11 years of follow-up (range, 5-23 years), the median visual analog scale score for pain was 0, and 96% of patients reported being improved as compared with how they were before surgery. The mean ± SD QuickDASH score was 4 ± 9 points (range, 0-52 points), and 80% of patients returned to their sports of interest. The arc of motion significantly improved from 115°± 28° preoperatively to 130°± 17° at latest follow-up ( P = .026). Seven elbows (13%) required revision surgery for OCD lesions, resulting in high rates of overall survivorship free of revision surgery: 90% (95% CI, 80%-96%) at 5 years and 88% (95% CI, 76%-94%) at 10 years. At final follow-up, 7 all-cause reoperations were performed without revision surgery on the OCD lesion. Conclusion: Arthroscopic debridement of grade 3 or 4 OCD lesions of the capitellum produced satisfactory patient-reported outcomes in a majority of elbows, although a subset of patients experienced residual symptoms. The inherent selection bias of our cohort should be considered when applying these results to the overall population with OCD lesions, as we do not recommend this procedure for all patients.
Correlation Between Breast Arterial Calcifications and Higher Cardiovascular Risk: Awareness and Attitudes Amongst Canadian Radiologists Who Report Mammography
Authors: Heaney Roisin M. , Zaki-Metias Kaitlin M. , McKee Hayley , Wang Huijuan , Ogunde Barakat , Yong-Hing Charlotte J. , Freitas Vivianne , Ghai Sandeep , Seely Jean M. , Nguyen Elsie T. 
Published: December 2022

Background: Breast arterial calcification (BAC) on mammography correlates with increased cardiovascular risk. Reporting BAC is not standard practice. Our study evaluates the awareness of Canadian radiologists who report mammography of the clinical significance of BAC and their attitudes towards reporting BAC compared to their European and American counterparts. Methods: Following local institutional ethics approval, a 25 question survey (SurveyMonkey) was disseminated to Canadian radiologists via provincial and national society email lists. Responses were collected over 5 weeks (April–June 2022). Results: One hundred and eighty-six complete responses were collected. Sixty percent (112/186) were aware of the association between BAC and cardiovascular risk and 16% (29/186) document its presence in mammogram reports. Thirty five percent (65/186) occasionally document BAC if severe or in a young patient. Four percent (7/186) had local departmental guidelines on BAC reporting and 82% (153/186) agreed there is a need for national BAC reporting guidelines. Fewer Canadian radiologists were aware of the association between BAC and cardiovascular risk compared to European radiologists (60% vs 81%), report the presence of BAC compared to both European (15% vs 62%) and American (15% vs 35%) radiologists, and inform the patient of the presence of BAC compared to European radiologists (1% vs 46%). Conclusion: Canadian radiologists who report mammography were less aware of the association between BAC and cardiovascular risk than their European and American counterparts and were less likely to document the presence of BAC. Given the correlation of BAC with increased cardiovascular event risk, there is increased need for awareness as well as national BAC reporting guidelines.