bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Elephant in the Room
Authors: Alimi Yewande , Bevilacqua Lisa A. , Snyder Rebecca A. , Walsh Danielle S. , Jackson Patrick G. , Tuttle J.E. , Altieri Maria S. 
Published: August 2023

Objective:
To examine the association between race, experience of microaggressions, and implicit bias in surgical training.

Summary Background Data:
There is persistent underrepresentation of specific racial and ethnic groups in the field of surgery. Prior research has demonstrated significant gender differences among those who experience microaggressions during training. However, little research has been conducted on the association between race and experiences of microaggressions and implicit bias among surgical trainees.

Methods:
A 46-item survey was distributed to general surgery residents and residents of surgical subspecialties through the Association of Program Directors in Surgery listserv and social media platforms. The questions included general information/demographic data and information about experiencing, witnessing, and responding to microaggressions during surgical training. The primary outcome was the prevalence of microaggressions during surgical training by self-disclosed race. Secondary outcomes were predictors of and adverse effects of microaggressions.

Results:
A total of 1,624 resident responses were obtained. General surgery residents comprised 825 (50.8%) responses. The female-to-male ratio was nearly equal (815:809). The majority of respondents identified as non-Hispanic white (63.4%), of which 5.3% of residents identified as non-Hispanic Black, and 9.5% identified as Hispanic. Notably, 91.9% of non-Hispanic Black residents (n=79) experienced microaggressions. After adjustment for other demographics, non-Hispanic Black residents were more likely than non-Hispanic White residents to experience microaggressions (OR:8.81, P<0.001). Similar findings were observed among Asian/Pacific Islanders (OR:5.77, P<0.001) and Hispanic residents (OR:3.35, P<0.001).

Conclusion:
Race plays an important role in experiencing microaggressions and implicit bias. As the future of our specialty relies on the well-being of the pipeline, it is crucial that training programs and institutions are proactive in developing formal methods to address the bias experienced by residents.
Prevalence and epidemiological characteristics of methicillin-resistant Staphylococcus aureus isolated from cattle as a part of the One Health approach
Authors: Venugopal Nimita , Tewari Rituparna , Ganaie Feroze A. , Mitra Susweta , Shome Rajeswari , Shome Bibek R. 
Published: August 2023

In India, limited studies are available on the epidemiological aspects of methicillin-resistant Staphylococcus aureus (MRSA) infections in both animal and human settings. Herein, we investigated the prevalence, antimicrobial resistance profile, and molecular characteristics of MRSA isolates recovered from cattle using the One Health approach. Out of 66 mecA-positive staphylococci, species-specific multiplex PCR detected 24% (n=16) of isolates as MRSA. Maximum antibiotic resistance was seen against cloxacillin (94%, n=15) and least for enrofloxacin and cephalothin (each 13%, n=2). Overall, 13% (n=2) of MRSA isolates were multidrug-resistant. Molecular characterization by SCCmec typing identified 88% (n=14) of MRSA isolates as type V. Twelve isolates (75%) belonged to novel spa-type t17242, of which 67% (n=8) belonged to agr type I. MLST analysis revealed ST 1687 (50%, n=8) as the most predominant sequence type. Circulation of different MRSA clones among the cattle populace offers a risk of transmission to humans through direct contact, food chain, or environmental contamination. Thus, continuous monitoring of MRSA strains is imperative for early diagnosis and for establishing effective treatment strategies to restrain the disease burden caused by MRSA infections.
A dynamic model of neurovascular coupling network accounting for capillaryK+-sensing vasomotion
Authors: Yuan Zhixuan , Yu Yangyang , Wu Ying 
Published: August 2023

AbstractNeurovascular coupling (NVC) is a fundamental unit that elucidates the regulation of vascular activity by neuronal electrical activity, ensuring adequate blood flow to the brain’s active regions and optimizing neural function. In this article, we propose a comprehensive dynamic model of a neural vascular coupling network that integrates the capillaryK+sensing mechanism and its impact on vascular motion. Our computational framework incorporates the dynamics of neurons, astrocytes, and smooth muscle cells at the cellular level. By integrating recent experimental findings, we have successfully demonstrated the ability of capillary endothelial cells to detect localized fluctuations in extracellular potassium (K+) concentration via the Kir2.1 channel situated on their membranes. Subsequently, these cells transmit this signal to smooth muscle cells, initiating the release of vasoactive substances and thereby facilitating vascular movement. This sequence of events serves as the fundamental basis of our model. Furthermore, the simulation we provide supports the inclusion of a temperature term in our model, enabling accurate replication of experimental observations: variations in neuronal electrical activity resulting from an increase in temperature and subsequent vasoconstriction. In conclusion, our dynamic model presents a valuable tool for investigating the mechanisms underlying neurovascular coupling and the role of capillaryK+sensing in regulating vascular activity. It enhances our understanding of brain function and offers insights for developing therapeutic interventions for neurovascular diseases.Author summaryIt is widely accepted that neuronal activity induces vasodilation, resulting in increased blood flow, while vascular activity provides energy supply to the nervous system. The role of astrocytes in these processes has been extensively studied, revealing their dual involvement in neuronal firing and facilitation of energy delivery to the nervous system through blood vessels. As cellular mediators of bidirectional processes, astrocytes play a crucial role in promoting neurovascular coupling, leading to the formation of neurovascular coupling units. Building upon existing experimental observations and previous theoretical reports, the present study successfully replicates the phenomenon of vasodilation caused by an increase in potassium ion concentration in the perivascular space, as well as vasoconstriction resulting from elevated potassium ion concentration. A new neuron-astrocyte-endothelial-smooth muscle cell coupling network model, incorporating temperature considerations, was constructed to achieve these outcomes. Additionally, by manipulating temperature, the experimental observation of neuronal vasoconstriction during febrile seizures was successfully reproduced. These results highlight the significance of the neurovascular coupling unit as the fundamental entity for investigating the functions and mechanisms of the nervous system and brain.
Differences in pathogenetic mechanism between Tibetan and Han high-altitude polycythemia based on a whole genome-wide association study
Authors: Zhuoma Basang , Shixuan Zhang , Xianwei Ke , Zhuoma Duoji , La Yang , Danzeng Qiangba , Yang De , Zixin Hu , Yanyun Ma , Meng Hao , Zeshan Lin , Yi Li , Jiucun Wang , Juan Wu 
Published: August 2023

AbstractHigh-altitude polycythemia (HAPC) is a common and serious chronic disease affecting people of highland and plains ancestry living at high altitudes. This study investigated genetic susceptibility differences for HAPC among ethnic groups, with 2,248 volunteers participating, including 898 HAPC patients (nHan= 450, nTibetan= 448). The study included a GWAS of 198 cases (nHan= 100, nTibetan= 98), which revealed eight Tibetan HAPC-susceptibility single-nucleotide polymorphisms and four Han HAPC-susceptibility VARIANTs. Among them, the common polymorphism locus rs7618658 (SNX4,Pcombine<5e-8) was found and verified in both Tibetans and Han Chinese. Furthermore, the exploration of TibetanEPAS1suggested that the rs1374749 locus ofEPAS1, alongwith other locus-linked status changes, may be a prevalence factor for HAPC, and the GGTAC haplotype in which it is located is a risk haplotype for HAPC (P = 5.14E-9, OR = 1.85).The study showed significant genetic susceptibility to HAPC between Tibetans and Han Chinese, with Tibetans mainly susceptible in oxygen-sensing pathways such asEPAS1, which are associated with several phenotypes (Hemoglobin, Hematocrit, and Platelets, etc), while Han Chinese patients exhibited susceptibilities mainly in cell differentiation and angiogenesis, such as inSNX4andLPAR1, which are similarly significantly associated with hemoglobin, hematocrit, and platelets.
Dysosmia and dysgeusia as differential diagnostics for clinical triaging of COVID-19 cases
Authors: Hoa Phong Pham Huu Thien , Brai Emanuele , Barve Aatmika , Kouchiar Azarnoush , Annoni Jean-Marie , Auber Lavinia Alberi 
Published: August 2023

AbstractSmell and taste disorders are recognized as frequent, and often the only, signs occurring in the early phase of SARS-Cov-2 infection and in many cases perdure as post-viral symptoms. This evidence raised a general reconsideration of chemosensory deficits, further suggesting that their appearance can be considered as a discriminative and predictive tool to detect COVID-19 cases. In this study, encompassing the first and second pandemic wave, participants estimated their olfactory and gustatory sensitivity, plus they were administered the validated Brief Smell Identification Test (BSIT). We observed that smell and taste impairments were mainly experienced by COVID-19-positive subjects with comparable severity of respiratory symptoms as non-COVID-19 patients. In addition, we noticed that the diagnostic power of subjective olfactory assessments upon SARS-Cov-2 infection is comparable to quantitative evaluation, suggesting that self-reporting could be adopted as the first line of intervention, anticipating more exhaustive procedures aimed at containing COVID-19 diffusion and consequently preserving general health. Overall, results from this work share similarity with other studies, therefore further underlying that olfactory and gustatory disbalance can be distinctive hallmarks in COVID-19 continuum.
Photon Absorption Remote Sensing Imaging of Breast Needle Core Biopsies is Diagnostically Equivalent to Gold Standard H&E Histologic Assessment
Authors: Tweel James E.D. , Ecclestone Benjamin R. , Gaouda Hager , Dinakaran Deepak , Wallace Michael P. , Bigras Gilbert , Mackey John R. , Reza Parsin Haji 
Published: August 2023

STRUCTURED AbstractOBJECTIVEPhoton absorption remote sensing (PARS) is a new laser-based microscope technique that permits cellular level resolution of unstained fresh, frozen, and fixed tissues. Our objective was to determine whether PARS could provide image quality sufficient for diagnostic assessment of breast cancer needle core biopsies (NCB).DESIGNWe PARS imaged and virtually H&E stained seven independent unstained formalin fixed paraffin-embedded breast NCB sections. These identical tissue sections were then subsequently stained with standard H&E and digitally scanned. Both the 40x PARS and H&E whole slide images were assessed by seven breast cancer pathologists, masked to the origin of the images. A concordance analysis was performed to quantify the diagnostic performances of standard H&E and PARS virtual H&E.RESULTSThe PARS images were deemed of diagnostic quality and pathologists were unable to distinguish the origin of the images above that expected by chance. The diagnostic concordance on cancer vs. benign was high between PARS and conventional H&E (98% agreement) and there was complete agreement for within PARS images. Similarly, agreement was substantial (kappa > 0.6) for diagnosis of specific cancer subtypes. PARS virtual H&E inter-rater reliability was broadly consistent with the published literature on diagnostic performance of conventional histology NCBs across all tested histologic features.CONCLUSIONS AND RELEVANCEPARS was able to provide images on unstained tissues slides that were diagnostically equivalent to conventional H&E. Due to its ability to non-destructively image fixed and fresh tissues, and the suitability of the PARS output for artificial intelligence assistance in diagnosis, this technology has the potential to improve both the speed and accuracy of breast cancer diagnosis.
Chikungunya virus antepartum transmission and abnormal infant outcomes in Nigeria
Authors: Sagay Atiene S. , Hsieh Szu-Chia , Dai Yu-Ching , Chang Charlotte Ajeong , Ogwuche Jerry , Ige Olukemi O. , Kahansim Makshwar L. , Chaplin Beth , Imade Godwin , Elujoba Michael , Paul Michael , Hamel Donald J. , Furuya Hideki , Khoury Ricardo , Boaventura Viviane Sampaio , de Moraes Laíse , Kanki Phyllis J. , Wang Wei-Kung 
Published: August 2023

ABSTRACTChikungunya virus (CHIKV) has become a global public health concern since the reemergence of the Indian Ocean lineage and expansion of the Asian genotype. CHIKV infection causes acute febrile illness, rash, and arthralgia and during pregnancy may affect both mothers and infants.The mother-to-child transmission (MTCT) of CHIKV in Africa remains understudied. We screened 1006 pregnant women at two clinics in Nigeria between 2019 and 2022 and investigated the prevalence and MTCT of CHIKV. Of the 1006, 119 tested positive for CHIKV IgM, of which 36 underwent detailed laboratory tests. While none of the IgM reactive samples were RT-PCR positive, 14 symptomatic pregnant women were confirmed by CHIKV neutralization test. Twelve babies were followed with 8 normal and 4 abnormal outcomes, including stillbirth, cleft lip/palate with microcephaly, preterm delivery, polydactyly with sepsis and jaundice. CHIKV IgM testing identified 3 antepartum transmissions, further studies will determine its impact in antepartum infection.
Prevalence of long covid-19 among pediatric age group in Duhok city, Kurdistan region, Iraq
Authors: Khalid Rojeen Chalabi , Jamal Tamara Bassam , Mahdi Sara Ardalan , Mustafa Abdullah Saeed 
Published: August 2023

AbstractBackgroundA range of persistent symptoms that can develop in some people after they have recovered from acute COVID-19, is known as Long COVI-19. It can affect people of all ages and severity of initial illness, including those who had mild or asymptomatic infections.. Dealing with Long COVID-19 can be challenging, and the best course of action will depend on the specific symptoms and individual needs of the patient. This study aims to detect the prevalence of long covid-19 among the children who tested positive for IgG test. If IgG antibodies are detected in a person’s blood sample, it suggests that they have been infected with SARS-CoV-2 at some point in the past and their immune system has responded by producing antibodies against the virus.Material and MethodologyFrom (October 22ndtill December 4th2022) the data of this study had been collected through a face-to-face interview with withdrawing blood samples for serum Immunoglobin-G test in laboratory of (General zakho Teaching Hospital in Zakho) and (Hevi Pediatric Teaching Hospital in Duhok). A total number of 330 children aged between 5-12 ages participated in this study. Moreover, If IgG antibodies are detected in a person’s blood sample, it suggests that they have been infected with SARS-CoV-2 at some point in the past and their immune system has responded by producing antibodies against the virus.Results(Fatigue 12/ 85.7%), (cough 10/ 71.4%), (post exertional malaise 5/ 35.7%) were the most detected symptoms among the 14 positive patients. Followed by (headache, dizziness, hair loss, loss of appetite, loss/change in smell and taste, difficulty in sleep, mood change, abdominal pain, change in bowel habits, chest pain) to lesser extent.Conclusionlong-term sequelae of Covid-19 now is becoming a challenge that needs more continued research and collaboration among healthcare providers, researchers, and patients are essential. Long COVID-19 is a public health concern that requires ongoing attention and resources, as well as support for those who are experiencing its debilitating effects. Out of 330 children only 4.6% (14 children) were experiencing long covid-19 symptoms for more than 4 weeks after acute infections in Duhok city.
Signet ring cell histology is an independent predictor of poor prognosis in gastric adenocarcinoma: A population-based analysis
Authors: Huang Zheyu , Chen Chao , Han Jianglong , Wei Yuxuan , Chen Ruyan , Deng Haiyu , Jian Tingting , Liu Wenmin , Fu Zhenming 
Published: August 2023

ABSTRACTBackgroundTo test the hypothesis that signet ring cell (SRC) histology is an independent predictor of poor prognosis in gastric adenocarcinoma regardless of tumoral clinical presentation.MethodsWe conducted a population-based study to examining the prognostic factors of these two histological subtypes of gastric cancer using data of gastric cancer patients from the Surveillance, Epidemiology, and End Results (SEER) registry between January 2004 and December 2020. Univariate and multivariate Cox regression, and propensity score matching (PSM) models were used to investigate the association between clinical characteristics and prognosis and to calculated hazard ratios (HRs), and corresponding 95% confidence intervals (95% CI).ResultsAmong a total of 38,336 patients, there were 7,979 SRC and 30,357 non-SRC gastric cancer patients. At presentation, SRC significantly differs from non-SRC patients in the distribution of age, sex, race, primary site and stage. Overall, SRC patients confers worse overall survival (OS: HR = 1.21, 95% CI: 1.17-1.24) and cancer-specific survival (CSS: HR = 1.27, 95% CI: 1.23-1.31) than non-SRC patients. Compared with non-SRC gastric cancer, although stage I SRC has overall better survival (mOS: 90vs68 months,P< 0.001), however, this better survival of SRC was mainly driven by younger age at diagnosis. After adjusted for age at diagnosis as a continuous variable, early stage SRC patients even has a higher risk of mortality (HR = 1.13, 95% CI: 1.03-1.23 and HR = 1.26, 95% CI: 1.13-1.40 for AJCC stage I and II, respectively). While at advanced stages (stage IV), SRC directly confers worse prognosis and has poorer responses to chemotherapy (P-heterogeneity< 0.001) in either patients with negative (P-heterogeneity= 0.009) or positive peritoneal cytology (P-heterogeneity= 0.055).ConclusionAfter adjustment of age, SRC confers worse prognosis at all stages. Our study indicates, stage for stage, the SRC histology per se conveys additional risk of mortality. The results support the concept that SRC is a distinct subtype of gastric adenocarcinoma and SRC histology is an independent predictor of poor prognosis for gastric cancer.
The Limits of Prompt Engineering in Medical Problem-Solving: A Comparative Analysis with ChatGPT on calculation based USMLE Medical Questions
Authors: Patel Dhavalkumar , Raut Ganesh , Zimlichman Eyal , Cheetirala Satya Narayan , Nadkarni Girish , Glicksberg Benjamin S , Freeman Robert , Timsina Prem , Klang Eyal 
Published: August 2023

AbstractBackgroundPrompt engineering significantly improves the performance of Large Language Models (LLMs), including GPT-3.5 and GPT-4. However, its utilization remains largely uncharted in the medical field.ObjectiveThis research aimed to assess the influence of different prompt engineering strategies on ChatGPT (GPT-3.5) in solving medical problems, specifically focusing on medical calculations and clinical scenarios.DesignWe utilized three different prompting strategies—direct prompting, the chain of thoughts (CoT), and a modified CoT method—across two sets of USMLE-style questions.SettingThe experiment was conducted using a 1000-question dataset, generated by GPT-4 with a specialized prompt, and a secondary analysis with 95 actual USMLE Step 1 questions.MeasurementsModel performance was assessed based on accuracy in answering medical calculation and clinical scenario questions across varying difficulty levels and medical subjects.ResultsDirect prompting demonstrated non-inferior accuracy compared to the CoT and modified CoT methods in both question categories. This trend remained consistent regardless of difficulty level or subject matter in the GPT-4-generated dataset and USMLE Step 1 sample questions.LimitationsThe study evaluated GPT-3.5 for answering and GPT 4 for question generation, limiting generalizability.ConclusionOur findings indicate that while prompt engineering can facilitate question generation, as exemplified by GPT-4, it does not necessarily improve model performance in answering medical calculation or clinical scenario questions. This suggests that the ChatGPT model is already effectively optimized for such tasks. Additionally, this finding simplifies the use of such models in healthcare settings, allowing practitioners to interact effectively with tools like ChatGPT without the need for complex prompt engineering, potentially encouraging wider adoption in clinical practice for problem-solving, patient care, and continuous learning.
Functional Variation in theFAAHGene is Directly Associated with Subjective Well-being and Indirectly Associated with Problematic Alcohol Use
Authors: Bornscheuer Lisa , Lundin Andreas , Forsell Yvonne , Lavebratt Catharina , Melas Philippe A. 
Published: August 2023

AbstractFatty acid amide hydrolase (FAAH) is an enzyme that degrades anandamide, an endocannabinoid that modulates mesolimbic dopamine release and, consequently, influences states of well-being. Despite these known interactions, the specific role of FAAH in subjective well-being remains underexplored, particularly with longitudinal data. In our study, we analyzed well-being data collected three years apart using the WHO (Ten) Well-Being Index and genotyped a functional polymorphism in theFAAHgene (rs324420, Pro129Thr) in a sample of 2,822 individuals. We found that the A-allele of rs324420, which results in reduced FAAH activity and elevated anandamide levels, was associated with lower well-being scores at both time points. A subsequent phenome-wide association study (PheWAS) validated our well-being findings in the UK Biobank (N=126,132) and revealed an additional association with alcohol dependence. In our cohort, using lagged longitudinal mediation analyses, we uncovered evidence of an indirect association between rs324420 and problematic alcohol use (AUDIT-P) through the pathway of lower well-being. We propose that lifelong elevated anandamide levels can disrupt the endocannabinoid system – a biological contributor to well-being – potentially leading to increased alcohol intake. Further genetic studies and mediation analyses are needed to validate and extend these findings.