bluuebunny/crossref_metadata_2025_split huggingface dataset:
From vaccine to pathogen: Modeling Sabin 2 vaccine virus reversion and evolutionary epidemiology in Matlab, Bangladesh
Authors: Wong Wesley , Gauld Jillian , Famulare Michael 
Published: July 2023

Abstract
The oral poliovirus vaccines (OPVs) are one of the most effective disease eradication tools in public health. However, the OPV strains are genetically unstable and can cause outbreaks of circulating, vaccine-derived Type 2 poliovirus (cVDPV2) that are clinically indistinguishable from wild poliovirus (WPV) outbreaks. Here, we developed a Sabin 2 reversion model that simulates the reversion of Sabin 2 to reacquire a WPV-like phenotype based on the clinical differences in shedding duration and infectiousness between individuals vaccinated with Sabin 2 and those infected with WPV. Genetic reversion is informed by a canonical reversion pathway defined by three gatekeeper mutations (A481G, U2909C, and U398C) and the accumulation of deleterious nonsynonymous mutations. Our model captures essential aspects of both phenotypic and molecular evolution and simulates transmission using a multiscale transmission model that consolidates the relationships among immunity, susceptibility, and transmission risk. Despite rapid Sabin 2 attenuation reversal, we show that the emergence of a revertant virus does not guarantee a cVDPV2 outbreak. When simulating outbreaks in Matlab, Bangladesh, we found that cVDPV2 outbreaks are most likely in areas with low population-level immunity and poor sanitation. In Matlab, our model predicted that declining immunity against Type 2 poliovirus following the cessation of routine OPV vaccination was not enough to promote cVDPV2 emergence. However, cVDPV2 emergencedepended on the average viral exposure dose per contact, which was modeled as a combination of the viral concentration per fecal gram and the average fecal–oral dose per contact. These results suggest that cVDPV2 emergence risk can be mitigated by reducing the amount of infectious fecal material individuals are exposed to. Thus, a combined strategy of assessing and improving sanitation levels in conjunction with high-coverage vaccination campaigns could limit the future cVDPV2 emergence.
Quiescent Infection of Flowers by the Causal Agents of Loquat Fruit Rot, Neopestalotiopsis sp. and Pestalotiopsis sp.
Authors: Nozawa Shunsuke , Komine Masayuki , Takata Yoshiki , Uchikawa Keisuke , Suga Yasuhiro , Watanabe Kyoko 
Published: July 2023

Loquat fruit rot, caused by Pestalotiopsis sensu lato, is a key problem for loquat producers in Nagasaki Prefecture, the area with the highest loquat fruit production in Japan. In a previous study, it was postulated that fruit rot pathogens latently infect flowers, with the corresponding disease symptoms occurring in wounded fruits. To reveal whether the pathogens responsible for the development of fruit rot disease are found in the asymptomatic flowers and immature fruits of loquat trees, we sprayed a conidial suspension of nitrate-nonutilizing mutants, containing strains derived from pathogenic Neopestalotiopsis sp. (TAP18N004) and Pestalotiopsis sp. (TAP18N010), onto the flowers of “Mogi” and “Nagasaki-wase” trees. Both inoculated mutants were reisolated using selective media (minimal media with chlorate) from the part of the asymptomatic immature fruit that includes the flower apex. Symptoms were observed in the mature fruits of both cultivars, and mutants were specifically detected in the symptomatic tissues of all rotted fruits. Additionally, all reisolated mutants were reconfirmed by assessing corresponding nitrate auxotrophy characteristics. Thus, it was revealed that both fruit rot pathogens that latently infect loquat flowers can cause fruit rot after maturation. [Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2023.
Changes in Pelvic Floor Symptoms After Procedural Interventions for Uterine Leiomyomas
Authors: Gupta Ankita , Balk Ethan M. , Lenger Stacy M. , Yang Linda C. , Misal Meenal , Balgobin Sunil , Chang Olivia H. , Sharma Vidya , Stuparich Mallory , Behbehani Sadikah , Nihira Mikio , Alas Alexandriah , Jampa Alekhya , Sheyn David , Meriwether Kate , Antosh Danielle D. 
Published: July 2023

OBJECTIVE:
To conduct a systematic review to evaluate the effect of procedural interventions for leiomyomas on pelvic floor symptoms.

DATA SOURCES:
PubMed, EMBASE, and ClinicalTrials.gov were searched from inception to January 12, 2023, searching for leiomyoma procedures and pelvic floor disorders and symptoms, restricted to primary study designs in humans.

METHODS OF STUDY SELECTION:
Double independent screening for studies of any study design in all languages that reported pelvic floor symptoms before and after surgical (hysterectomy, myomectomy, radiofrequency volumetric thermal ablation) or radiologic (uterine artery embolization, magnetic resonance-guided focused ultrasonography, high-intensity focused ultrasonography) procedures for management of uterine leiomyomas. Data were extracted, with risk-of-bias assessment and review by a second researcher. Random effects model meta-analyses were conducted, as feasible.

TABULATION, INTEGRATION, AND RESULTS:
Six randomized controlled trials, one nonrandomized comparative study, and 25 single-group studies met criteria. The overall quality of the studies was moderate. Only six studies, reporting various outcomes, directly compared two procedures for leiomyomas. Across studies, leiomyoma procedures were associated with decreased symptom distress per the UDI-6 (Urinary Distress Inventory, Short Form) (summary mean change −18.7, 95% CI −25.9 to −11.5; six studies) and improved quality of life per the IIQ-7 (Incontinence Impact Questionnaire, Short Form) (summary mean change −10.7, 95% CI −15.8 to −5.6; six studies). There was a wide range of resolution of urinary symptoms after procedural interventions (7.6–100%), and this varied over time. Urinary symptoms improved in 19.0–87.5% of patients, and the definitions for improvement varied between studies. Bowel symptoms were inconsistently reported in the literature.

CONCLUSION:
Urinary symptoms improved after procedural interventions for uterine leiomyomas, although there is high heterogeneity among studies and few data on long-term outcomes or comparing different procedures.

SYSTEMATIC REVIEW REGISTRATION:
PROSPERO, CRD42021272678.
Directed Versus non-directed Standing Postures in Adolescent Idiopathic Scoliosis: Its Impact on Curve Magnitude, Alignment and Clinical Decision Making
Authors: Cheung Prudence Wing Hang , Wong Hei Lung , Lau Damian S L , Cheung Jason Pui Yin 
Published: July 2023

Study Design:
Prospective study.

Objective:
To investigate the difference in major curve Cobb angle and alignment between directed and non-directed positioning for adolescent idiopathic scoliosis (AIS) and to evaluate implications on treatment decision-making.

Summary of Background Data:
Proper positioning of patients with spinal deformities is important for assessing usual functional posture in standing, so management strategies can be customized accordingly. Whether postural variability affects coronal and sagittal radiological parameters and the impact of posture on management decisions remain unknown.

Methods:
Patients with AIS presenting for initial consultation at the tertiary scoliosis clinic were recruited. They were asked to stand in two positions: passive, non-directed position; and directed position by the radiographer. Radiological assessment included major and minor Cobb angle, coronal balance, spinopelvic parameters, sagittal balance and alignment. Cobb angle difference >5⁰ between directed and non-directed positioning was considered clinically impactful. Patients with or without such difference were compared. Over- or under-estimation of the major curve (at 25⁰ or 40⁰) by non-directed positioning were examined due to relevance to bracing and surgical indications.

Results:
This study included 198 patients, with 22.2% experiencing Cobb angle difference (>5⁰) between positioning. The major curve Cobb angle was smaller in non-directed than directed positioning (median difference: −6.0⁰, upper and lower quartile: −7.8, 5.8), especially for curves ≥30⁰. Patients with a Cobb angle difference had changes in shoulder balance (P=0.007) when assuming a directed position. Non-directed positioning had 14.3% of major Cobb 25⁰ underestimated and 8.8% overestimated, whereas 11.1% of curves >40⁰ were underestimated.

Conclusion:
Strict adherence to a standardized radiographic protocol is mandatory for reproducing spine radiographs reliable for curve assessment, as a non-directed position demonstrates smaller Cobb angles. Postural variation may lead to over-, or under-estimation, of the curve size relevant for both bracing and surgical decision-making.

Level of Evidence:
II.
The experience of the COMRE group (REctal COMmittee): can magnetic resonance imaging and endosonography really help the clinical pathway after NCRT in rectal cancer?
Authors: Scabini Stefano , Romana Chiara , Sartini Marina , Attieh Ali , Marrone Ciro , Cristina Maria L. , Parodi Maria C. 
Published: July 2023

Background:
MRI and rectal endosonography (EUS) are routinely used for preoperative tumor staging and assessment of response to therapy in patients with rectal cancer. This study aimed to evaluate the accuracy of the two techniques in predicting the pathological response compared to the resected specimen and the agreement between MRI and EUS and to define the factors that could affect the ability of EUS and MRI to predict pathological responses.

Materials and methods:
This study included 151 adult patients with middle or low rectal adenocarcinoma treated with neoadjuvant chemoradiotherapy, followed by curative intent elective surgery in the Oncologic Surgical Unit of a hospital in the north of Italy between January 2010 and November 2020. All patients underwent MRI and rectal EUS.

Results:
The accuracy of EUS to evaluate the T stage was 67.48%, and for the N stage was 75.61%; the accuracy of MRI to evaluate the T stage was 75.97%, and that for the N stage was 51.94%. The agreement in detecting the T stage between EUS and MRI was 65.14% with a Cohen’s kappa of 0.4070 and that for the evaluation of the lymph nodes between EUS and MRI was 47.71% with a Cohen’s kappa of 0.2680. Risk factors that affect the ability of each method to predict pathological response were also investigated using logistic regression.

Conclusions:
EUS and MRI are accurate tools for rectal cancer staging. However, after RT-CT, neither method is reliable for establishing the T stage. EUS seems significantly better than MRI for assessing the N stage. Both methods can be used as complementary tools in the preoperative assessment and management of rectal cancer, but their role in the assessment of residual rectal tumors cannot predict the complete clinical response.
Concomitant Mental Illnesses Diagnoses and Likelihood of Trauma Recidivism
Authors: Bauer Molly A. , Mayo Ann M. , Bush Ruth A. 
Published: July 2023

BACKGROUND:
Trauma is the leading cause of death among persons aged 1–44 years. Trauma recidivism occurs when an individual experiences more than one significant injury in a 5-year period. The relationship between a trauma recidivist's perception of recurrent injury has been unclear.

OBJECTIVE:
To describe the association between select sociodemographic and clinical variables, threat orientation, and the perceived likelihood of recurrent injury of individuals recently experiencing a significant injury.

METHODS:
A prospective cross-sectional study was conducted with Level II trauma inpatients (n = 84) in Southern California from October 2021 to January 2022. Participants completed surveys prior to discharge. Clinical variables were extracted from the electronic health record.

RESULTS:
The trauma recidivism rate was 31%. Mental illness and length of hospital stay were associated with trauma recidivism. In individuals with two or more mental illness diagnoses, the odds of trauma recidivism were approximately 6.5 times higher than in those with no mental illness (odds ratio = 6.48, 95% confidence interval: 1.7–24.6).

CONCLUSION:
Trauma is a preventable health care concern with timely recognition of risk factors and intervention. This study confirms mental illness as a predominant factor in injury and should be addressed in clinical practice. This study builds upon previous research and emphasizes the necessity of targeting injury prevention and education in the mentally ill. Trauma providers seeking to practice with an upstream mentality have a responsibility in screening patients for mental illness to help prevent further injury and death.
Postintensive Care Syndrome: Feasibly Bridging Care at a Tertiary Trauma Center
Authors: Stevens Timothy J. , Lee Donna B. 
Published: July 2023

Background:
Advancements in critical care management have improved mortality rates of trauma patients; however, research has identified physical and psychological impairments that remain with patients for an extended time. Cognitive impairments, anxiety, stress, depression, and weakness in the postintensive care phase are an impetus for trauma centers to examine their ability to improve patient outcomes.

Objective:
This article describes one center's efforts to intervene to address postintensive care syndrome in trauma patients.

METHODS:
This article describes implementing aspects of the Society of Critical Care Medicine's liberation bundle to address postintensive care syndrome in trauma patients.

Results:
The implementation of the liberation bundle initiatives was successful and well received by trauma staff, patients, and families. It requires strong multidisciplinary commitment and adequate staffing. Continued focus and retraining are requirements in the face of staff turnover and shortages, which are real-world barriers.

Conclusions:
Implementation of the liberation bundle was feasible. Although the initiatives were positively received by trauma patients and their families, we identified a gap in the availability of long-term outpatient services for trauma patients after discharge from the hospital.
The role of Erzhi Tiangui formula in expected poor ovarian responders undergoing in vitro fertilization-embryo transfer: A multicenter, randomized, double-blind, placebo-controlled trial
Authors: Han Qiao-Song , Zhou Yue , Chen Wen , Song Jing-Yan , Sun Zhen-Gao 
Published: July 2023

Introduction:
Advanced age is one of the primary risk factors for infertility. Poor ovarian response (POR) to exogenous gonadotropin is a prominent characteristic of advanced-age women undergoing in vitro fertilization and embryo transfer (IVF-ET), which results in fewer retrieved oocytes and poor pregnancy outcomes. Traditional Chinese medicine (TCM) has been shown to improve female fertility. Erzhi Tiangui (EZTG) formula, in the form of granules with 10 herbal ingredients, demonstrated potential benefits in improving oocyte and embryo quality and ovarian reserve. Thus, this study aims to evaluate the efficacy and safety of EZTG formula.

Method:
The study is a multicenter, double-blind, placebo-controlled, randomized controlled trial (RCT), which will be conducted at 10 reproductive centers of tertiary hospitals. This study will enroll 480 women with expected POR of advanced age (≥35 years old) who fulfill the 2011 Bologna criteria. Participants will be assigned to either the EZTG group or the placebo group at random in an equal ratio. Each individual will receive conventional IVF-ET with EZTG granules or placebo as a complementary treatment. The primary outcome is the number of oocytes retrieved. Adverse events and safety assessments will be also conducted.

Discussion:
This study aims to provide robust evidence of the efficacy and safety of EZTG formula as a complementary treatment for advanced-age women with expected POR undergoing IVF-ET.
The efficacy of Fuke Qianjin tablets combined with clomiphene citrate on infertility patients with polycystic ovary syndrome: A retrospective analysis
Authors: Zhang Yu , Cao Shan , Liang Jun-Xia , Ge Xin , Hu Shu-Hong , Li Ya-Xue , Li Li-Hui 
Published: July 2023

Purpose:
Clinical efficacy of Fuke Qianjin tablets combined with clomiphene citrate on infertility patients with polycystic ovary syndrome (PCOS) was expected to be retrospectively analyzed in this study.

Methods:
In this paper, 100 infertility patients with PCOS were selected and divided into the observation and control groups based on different medications. Firstly, clinical data of both groups of patients were acquired. Then, the uterine receptivity and ovarian status, the levels of sex hormones, inflammation and oxidative stress, and the pregnancy outcomes between the 2 groups were compared and analyzed before and after treatment.

Results:
After a variety of comparisons and analyses, Fuke Qianjin tablets combined with clomiphene citrate were confirmed to improve the uterine receptivity and ovarian status, levels of sex hormone, inflammation and oxidative stress, and pregnancy outcomes in infertility patients with PCOS.

Conclusions:
Overall, Fuke Qianjin tablets + clomiphene citrate treatment shows good clinical efficacy and is worth promotion in clinical practice.
Case report: Acute submandibular sialadenitis in poorly controlled diabetes mellitus patient fed twenty days by enteral tube
Authors: Iwamoto Yuichiro , Anno Takatoshi , Koyama Katsumasa , Tomoda Koichi , Kimura Tomohiko , Kaneto Hideaki 
Published: July 2023

Introduction:
Enteral tube feeding is an effective method of providing nutrients for patients who are unable to meet their nutritional requirements, and patients with parenteral nutrition are at an increased risk of infection. The submandibular gland is one of the major salivary glands and sialadenitis are often caused by obstruction of the salivary outflow tract.

Patient concerns:
A 91-year-old woman had parenteral nutrition with nasogastric tube feeding. Her history includes angina pectoris, myocardial infarction, type 2 diabetes mellitus (T2DM), heart failure, atrial fibrillation, sick sinus syndrome, and she recently had a pacemaker implanted. She was continued parenteral nutrition with nasogastric tube feeding for 20 days, and her fasting blood glucose ranged from 200 to 400 mg/dL. In the midst of poor glycemic control, she suddenly had high fever and elevated infection markers under poorly glycemic control.

Diagnoses:
She had neck swelling with a feeling of heat. We performed cervical computed tomography, and it revealed swelling of the bilateral submandibular glands and fluffing of surrounding tissue. She was diagnosed with acute submandibular glanditis.

Interventions:
We treated her with antibiotics therapy, extubation, daily massage of the submandibular gland and strict glycemic control.

Outcomes:
Her neck swelling disappeared about 11 days after such treatment.

Lessons:
We reported acute submandibular glanditis induced by nasogastric tube feeding under poorly controlled diabetes mellitus. We have to keep good oral hygiene and also pay attention to glycemic control in subjects under parenteral nutrition with tube feeding management.
Effects of team leaders’ position in cardiopulmonary resuscitation teams on leadership behavior and team performance: A prospective randomized interventional cross-over simulation-based trial
Authors: Kern Peter , Tschan Franziska , Semmer Norbert K. , Marsch Stephan 
Published: July 2023

Background:
Leadership is an important performance factor in resuscitation teams. Medical guidelines for cardiopulmonary resuscitation (CPR) advise team leaders to keep hands off patients. There is little evidence for this recommendation that is based purely on observational data. Accordingly, the aim of this trial was to investigate the effect of leaders’ position during CPR on leadership behavior and team performance.

Method:
This is a prospective randomized interventional crossover simulation-based single center trial. Teams of 3 to 4 physicians each, representing a rapid response team, were confronted with a simulated cardiac arrest. Team leaders were randomly assigned and assigned team leaders were 1:1 randomized to 2 leadership positions: position at the patient’s head; and hands-off position. Data analysis was performed from video-recordings. All utterances during the first 4 minutes of CPR were transcribed and coded based on a modified “Leadership Description Questionnaire.” The primary endpoint was the number of leadership statements. Secondary outcomes included CPR related performance markers like hands-on time and chest compression rate, and the behavioral related endpoints Decision Making, Error Detection, and Situational Awareness.

Results:
Data from 40 teams (143 participants) was analyzed. Leaders in hands-off position made more leadership statements (28 ± 8 vs 23 ± 8; P <.01) and contributed more to their team’s leadership (59 ± 13% vs 50 ± 17%; P = .01) than leaders in the head position. Leaders’ position had no significant effect on their teams’ CPR performance, Decision Making, and Error Detection. Increased numbers of leadership statements lead to improved hands-on time (R = 0.28; 95% confidence interval 0.05–0.48; P = .02).

Conclusions:
Team leaders in a hands-off position made more leadership statements and contributed more to their teams’ leadership during CPR than team leaders actively involved in the head position. However, team leaders’ position had no effect on their teams’ CPR performance.
Effectiveness of traditional Chinese medicine formulas combined with acupuncture in the treatment of ovulation dysfunction infertility: A systematic review and meta-analysis
Authors: Mo Jingwen , Zhang Yiyi , Jin Ni , Zhou Yi 
Published: July 2023

Background:
To evaluate the efficacy and safety of traditional Chinese medicine formulas combined with acupuncture for the treatment of ovulation dysfunction infertility (ODI).

Methods:
From January 1, 2018 to March 12, 2023, 7 electronic databases, PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, Wanfang Database, and CBM, were systematically searched to identify eligible randomized controlled trial studies.

Results:
Meta analysis showed that traditional Chinese medicine combined with acupuncture can more effectively improve sex hormone levels compared to Western medicine alone, including follicle stimulating hormone (FSH) in older patients (standardized mean difference [SMD]: 3.00; 95% confidence interval [CI]: 2.35–3.66; P = .024, I2 = 28%), FSH in younger patients (SMD: 0.45; 95% CI: −0.15, 1.05; P = .03, I2 = 71%), estradiol (E2) (SMD: 7.50; 95% CI: v0.47, 15.48; P < .00001, I2 = 99%), and progesterone (P) (SMD: 2.20; 95% CI: 2.07–2.33; P < .00001, I2 = 29%). Compared to Western medicine alone, traditional Chinese medicine combined with acupuncture also had a better effect to increase ovulation rate (risk ratio [RR]: 2.46; 95% CI: 1.72–3.52; P < .00001, I2 = 0%), pregnancy rate (RR: 2.50; 95% CI: 1.96–3.18; P < .00001, I2 = 0%), maximum follicle diameter (MFD) (SMD: 2.27; 95% CI: 1.37–3.16; P < .00001, I2 = 91%), and endometrial thickness (SMD: 1.71; 95% CI: 1.31–2.11; P < .00001, I2 = 87%). The combination of traditional Chinese medicine and acupuncture also had better effects on quality of life (RR: 0.19; 95% CI: 0.15–0.23; P < .00001, I2 = 0%) and reduced adverse reactions (RR: 0.15; 95% CI: 0.05–0.48; P = .001, I2 = 0%), compared to Western medicine alone.

Conclusion:
This study shows evidence that traditional Chinese medicine formulas combined with acupuncture are an effective and safe treatment approach. However, this conclusion requires further confirmation due to the insufficient quality of the included trials.