bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Antinuclear Antibody and Subserology Reflex Testing for the Diagnosis of Systemic Autoimmune Rheumatic Disorders in an Academic Teaching Hospital
Authors: Duff Delicia , Vyas Niti , Enderle Janet , Rajendran Rajkumar 
Published: February 2023

Abstract

Objective
The aim of this study was to examine appropriate utilization of antinuclear antibody (ANA) screening tests with follow-up subserology tests (reflex testing) for diagnosing systemic autoimmune rheumatic disorder (SARD).

Methods
We conducted a retrospective chart review of 3003 SARD-test orders at an academic teaching hospital from January to December 2019. Testing patterns were categorized as American College of Rheumatology (ACR)-recommended reflex testing, panel testing, or single subserology testing. We described testing patterns, assessed their diagnostic accuracy, and explored factors associated with reflex testing.

Results
Reflex testing accounted for 79.7% of SARD test-ordering, whereas improper testing (panel or single subserology) accounted for the other 20.3%. Reflex testing was associated with significantly more SARD diagnoses than improper testing (P = .004). Testing patterns were significantly associated with race/ethnicity (P = .008), with reflex testing being less frequent than improper testing in Hispanics and Whites.

Conclusion
In summary, one-fifth (20.3%) of testing patterns for suspected SARD did not follow the ACR-recommended guidelines for using reflex testing. Use of reflex testing was associated with an increased frequency of SARD diagnosis.
Lemongrass Essential Oil Attenuates Perfluorooctane Sulfonate-Induced Jejunal Mucosal Injury in Rat: A Histological, Immunohistochemical, and Biochemical Study
Authors: Shalaby Amany Mohamed , Albakkosh Abdulfatah Mohammed , Shalaby Rania H , Alabiad Mohamed Ali , Elshamy Amira Mostafa , Alorini Mohammed , Jaber Fatima A , Tawfeek Shereen Elsayed 
Published: February 2023

AbstractPerfluorooctane sulfonate (PFOS) has harmful impacts on various organs, including the intestine. Lemongrass essential oil (LGEO) has anti-inflammatory, anti-oxidant, antibacterial, and immunomodulatory effects. This study investigated the impact of PFOS on the mucosa of the jejunum of rats and evaluated LGEO’s protective impact. Four groups of rats were created: control, LGEO (100 mg/kg/day), PFOS (5 mg/kg/day), and LGEO-PFOS group. The agents were given orally for 28 days. Oxidative stress parameters, pro-inflammatory cytokines, and caspase-3 were measured in jejunal homogenates. Rat jejunal sections were evaluated histologically (light and electron microscopic examination) and immunohistochemically [for tumor necrosis factor-α (TNF-α), Proliferating cell nuclear antigen (PCNA), cyclooxygenase-2 (COX2), and Bcl2]. PFOS significantly elevated oxidative stress, pro-inflammatory cytokines, caspase-3, and gene expression of nuclear factor kappa B (NF-kB) and inducible nitric oxide synthetase (iNOS). The disturbed architecture of jejunal villi and crypts was demonstrated. Immunohistochemically, a significant rise in TNF-α, PCNA, and COX2 and a significant decrease in Bcl2 expression were revealed compared to control group. Further ultrastructural alterations included dilated RER, mitochondria with destroyed cristae, vacuolated cytoplasm, and shrunken condensed nuclei of enterocytes. LGEO treatment significantly reduced these harmful effects. LGEO protected against PFOS–induced jejunal damage by reducing the oxidative, inflammatory, and apoptotic impacts.
Further evidence that galaxy age drives observed Type Ia supernova luminosity differences
Authors: Wiseman P , Sullivan M , Smith M , Popovic B 
Published: February 2023

ABSTRACT
Type Ia supernovae (SNe Ia) are explosions of white dwarf stars that facilitate exquisite measurements of cosmological expansion history, but improvements in accuracy and precision are hindered by observational biases. Of particular concern is the apparent difference in the corrected brightnesses of SNe Ia in different host galaxy environments. SNe Ia in more massive, passive, older environments appear brighter after having been standardized by their light-curve properties. The luminosity difference commonly takes the form of a step function. Recent works imply that environmental characteristics that trace the age of the stellar population in the vicinity of SNe show the largest steps. Here, we use simulations of SN Ia populations to test the impact of using different tracers and investigate promising new models of the step. We test models with a total-to-selective dust extinction ratio RV that changes between young and old SN Ia host galaxies, as well as an intrinsic luminosity difference between SNe from young and old progenitors. The data are well replicated by a model driven by a galaxy-age varying RV and no intrinsic SN luminosity difference, and we find that specific star formation rate measured locally to the SN is a relatively pure tracer of this galaxy-age difference. We cannot rule out an intrinsic difference causing part of the observed step and show that if luminosity differences are caused by multiple drivers then no single environmental measurement is able to accurately trace them. We encourage the use of multiple tracers in luminosity corrections to negate this issue.
A case of systemic lupus erythematosus having concurrent Evans syndrome and acquired thrombotic thrombocytopenic purpura
Authors: Motoyama Ryo , Higuchi Tomoaki , Hirahara Shinya , Konda Naoko , Yamada Risa , Watanabe Kotaro , Fujisaki Mayuko , Yamaguchi Rei , Katsumata Yasuhiro , Kawaguchi Yasushi , Harigai Masayoshi 
Published: February 2023

ABSTRACT
An 18-year-old Japanese woman with systemic lupus erythematosus experienced dyspnoea, headache, tinnitus, and purpura for 2 weeks and was admitted to our hospital. The patient had been diagnosed with systemic lupus erythematosus and secondary immune thrombocytopenia 8 years before and treated with high-dose prednisolone and mycophenolate mofetil. Since the blood test on admission showed haemolytic anaemia with a positive direct Coombs test and anti-glycoprotein IIb/IIIa antibodies, the patient was initially diagnosed with Evans syndrome (ES). The patient was treated with pulse intravenous methylprednisolone followed by 45 mg/day prednisolone; however, the patient’s platelet count did not normalise. Based on a low level of a disintegrin-like and metalloproteinase with thrombospondin type 1 motif 13 (ADAMTS-13) activity and a high level of ADAMTS-13 inhibitors, a diagnosis of acquired thrombotic thrombocytopenic purpura (TTP) was confirmed. After undergoing therapeutic plasma exchange for 6 consecutive days, the patient’s platelet count recovered rapidly. Although concurrent acquired TTP and ES have not been reported previously, the findings from this case highlight the importance of measuring ADAMTS-13 activity and inhibitors to rule out acquired TTP, especially when ES is refractory to glucocorticoids.
Negatively charged, intrinsically disordered regions can accelerate target search by DNA-binding proteins
Authors: Wang Xi , Bigman Lavi S , Greenblatt Harry M , Yu Binhan , Levy Yaakov , Iwahara Junji 
Published: February 2023

Abstract
In eukaryotes, many DNA/RNA-binding proteins possess intrinsically disordered regions (IDRs) with large negative charge, some of which involve a consecutive sequence of aspartate (D) or glutamate (E) residues. We refer to them as D/E repeats. The functional role of D/E repeats is not well understood, though some of them are known to cause autoinhibition through intramolecular electrostatic interaction with functional domains. In this work, we investigated the impacts of D/E repeats on the target DNA search kinetics for the high-mobility group box 1 (HMGB1) protein and the artificial protein constructs of the Antp homeodomain fused with D/E repeats of varied lengths. Our experimental data showed that D/E repeats of particular lengths can accelerate the target association in the overwhelming presence of non-functional high-affinity ligands (‘decoys’). Our coarse-grained molecular dynamics (CGMD) simulations showed that the autoinhibited proteins can bind to DNA and transition into the uninhibited complex with DNA through an electrostatically driven induced-fit process. In conjunction with the CGMD simulations, our kinetic model can explain how D/E repeats can accelerate the target association process in the presence of decoys. This study illuminates an unprecedented role of the negatively charged IDRs in the target search process.
BRAF V600EandRNF43Co-mutations Predict Patient Outcomes with Targeted Therapies in Real-World Cases of Colorectal Cancer
Authors: Quintanilha Julia C F , Graf Ryon P , Oxnard Geoffrey R 
Published: February 2023

AbstractAnti-BRAF/EGFR therapy is approved for metastatic colorectal cancer (mCRC) with BRAFV600E mutations, although not all patients respond. Novel recent findings indicate the potential of RNF43 mutations to predict outcomes in patients with BRAF-mutated microsatellite stable (MSS) mCRC treated with anti-BRAF/EGFR therapy. This study aimed to independently and rapidly validate BRAFV600E/RNF43 co-mutations as predictive biomarkers of benefit to anti-EGFR/BRAF therapy. Clinical data were derived from electronic health record data from ~280 US cancer clinics between January 2011 and March 2022 from the Flatiron Health-Foundation Medicine real-world clinico-genomic mCRC database. Real-world cases of BRAFV600E-mutated mCRC, with patients receiving anti-BRAF/EGFR therapy (n = 49), were included. Patients who were MSS, with RNF43 mutations, had favorable progression-free survival (hazard ratio [HR] 0.29; 95% CI [CI], 0.13-0.65) and overall survival (HR 0.32, 95% CI, 0.12-0.84) compared with wild type. No difference in outcomes was observed between patient groups with RNF43-mutant versus wild-type receiving standard-of-care chemotherapy. BRAFV600E/RNF43 co-mutations predict mCRC anti-BRAF/EGFR outcomes in diverse clinical settings.
Pain Medicine Milestones 2.0: a step into the future
Authors: Aggarwal Anuj , Barad Meredith , Braza Diane W , McKenzie-Brown Anne Marie , Lee Debbie , Mayer Robert Samuel , Przkora Rene , Kohan Lynn , Koka Anjali , Szabova Alexandra 
Published: February 2023

Abstract

Objective
To describe the process of revising the Pain Medicine Milestones 1.0 and implementing changes into the Pain Medicine Milestones 2.0 along with implications for pain medicine trainees.

Background
Competency-based medical education has been implemented in graduate medical education, including pain medicine. Milestones 1.0, introduced by the Accreditation Council for Graduate Medical Education (ACGME), has been used to assess learners in six competencies and respective sub-competencies. Recognizing areas for improvement in Milestones 1.0, the ACGME initiated the process of Milestones 2.0 and a working group was created to execute this task for pain medicine. The working group discussed revisions; consensus was sought when changes were introduced. Final milestones were agreed upon and made available for public comment prior to publication.

Results
Redundant sub-competencies were either merged or eliminated, reducing the number of sub-competencies. A maximum of three rows representing skill, knowledge, behavior and attitude were included for each sub-competency. Harmonized Milestones, aligning with other specialties in a predetermined ACGME framework, were adopted and modified to meet the needs of pain medicine. A supplemental guide was developed to assist educators in implementation of Milestones 2.0 and assessment of trainees.

Conclusions
The intent of the Milestones 2.0 was to create an improved tool that is comprehensive, easier to utilize, and of increased value for pain medicine training programs. It is expected that implementation of Milestones 2.0 will streamline pain medicine trainee assessments by educators and prepare trainees for the future practice of pain medicine while serving to be the foundation of an iterative process to match the evolution of the specialty.
Taxonomic practice, creativity and fashion: what’s in a spider name?
Authors: Mammola Stefano , Viel Nathan , Amiar Dylan , Mani Atishya , Hervé Christophe , Heard Stephen B , Fontaneto Diego , Pétillon Julien 
Published: February 2023

AbstractThere is a secret pleasure in naming new species. Besides traditional etymologies recalling the sampling locality, habitat or morphology of the species, names may be tributes to some meaningful person, pop culture references and even exercises of enigmatography. Using a dataset of 48 464 spider etymologies, we tested the hypothesis that species names given by taxonomists are deeply influenced by their cultural background. Specifically, we asked whether naming practices change through space or have changed through time. In absolute terms, etymologies referring to morphology were the most frequently used. In relative terms, references to morphology peaked in 1850–1900 and then began to decline, with a parallel increase in etymologies dedicated to people and geography. We also observed a dramatic increase in etymologies referring to pop culture and other cultural aspects in 2000–2020, especially in Europe and the Americas. While such fashionable names often carry no biological information regarding the species itself, they help give visibility to taxonomy, a discipline currently facing a profound crisis in academia. Taxonomy is among the most unchanged disciplines across the last centuries in terms of tools, rules and writing style. Yet, our analysis suggests that taxonomists remain deeply influenced by their living time and space.
Improving Evidence-Based Methods of Characterizing Shoulder-Related Quality of Life for Survivors of Breast Cancer
Authors: Maciukiewicz Jacquelyn M. , Dickerson Clark R. 
Published: February 2023

Background:
Breast cancer is prevalent among Canadian women, but treatments may cause functional impairments among survivors. Despite a substantial number of survivors joining the population yearly, minimal research has approached the challenges faced by this population after primary treatment. The purpose of this study was to classify the different function of survivors of breast cancer and determine factors that differed across groups of survivors.

Methods:
Thirty-five survivors of breast cancer within 2 years since the conclusion of their treatment participated in this cross-sectional study. Participants completed quality-of-life questionnaires, followed by a full-body dual-energy x-ray absorptiometry scanning. The collection concluded with maximal force exertions at the shoulder and maximum shoulder range of motion.

Results:
This study determined, through feature reduction, that internal rotation force production, active extension range of motion, and 3 shoulder-related quality-of-life variables (energy/fatigue, social functioning, and pain) separated survivors within 2 years of treatment into 2 clusters (low- and high-score clusters [LSC/HSC], respectively). The LSC participants had higher self-reported disability, lower shoulder-related quality of life, force production, and flexion range of motion.

Conclusion:
Clustering survivors of breast cancer allows for a better understanding of deficits experienced by some individuals, as well as brings awareness to factors to monitor, and address in rehabilitation efforts.
Participation in breast cancer screening and its influence on other cancer screening invitations: study in women aged 56 years old in four French departments
Authors: Poiseuil Marie , Moutel Grégoire , Cosson Mathilde , Quertier Marie-Christine , Duchange Nathalie , Darquy Sylviane 
Published: February 2023

Background
Today, women 50 years of age are offered three types of cancer screening in France. However, participation is not optimal. The aim was to describe (1) participation in organised breast cancer screening (OS) of women aged 56 years old, and the influence of this participation on colorectal and cervical cancer screening, (2) the reasons for non-participation in breast cancer OS, and (3) the reasons for screening before age 50.

Methods
A questionnaire was sent to 56-year-old women in four French departments to identify their participation behaviour in three breast cancer OS invitations and their reasons for non-participation. Three groups were determined according to the number of participations in breast cancer OS (3, 1–2 and 0). We described the quantitative responses and grouped the qualitative responses thematically.

Results
A total of 4634 women responded to the questionnaire. Seventy-six percent had undergone all three breast cancer OS, 16% irregular and 7% non-participant. Among women who irregularly perform breast cancer OS, 50.5% also irregularly perform colorectal cancer OS. Women who participated in all three invitations for the breast cancer OS performed more smear tests than women in the other groups. Many of the irregular participants or non-participants underwent opportunistic screening, often initiated before the age of 50. The reasons for non-participation in breast cancer OS were mainly medical or participation in opportunistic screening.

Conclusion
There is no fundamental opposition to participation in breast cancer screening. However, it remains of the utmost importance that women should be better informed about OS and its benefits.
Experimental Design of Vertical Distraction Osteogenesis Using Simple 3 Screws
Authors: Li Zeyu , Jiang Dongbo , Yao Yusheng 
Published: February 2023

Distraction osteogenesis devices are complicated. To simplify these devices, we used 3 simple screws and 1 rubber band to realize the idea and analyzed histologic changes induced by mechanical forces. Ten female New Zealand white rabbits were studied. A left or right side of the mandible was randomly selected as the experimental side (ES). The unilateral mandible was distracted, and 2 fixation screws and 1 traction screw were implanted. When the traction screw was rotated downward, the opposite force made the osteotomy block move in opposite directions to increase the bone height. The control side (CS) was not processed. The results were assessed after 20 days of traction. Bone height in the ES increased by 5 mm. Toluidine blue staining showed that the number of osteoblasts per unit area on the ES was higher than that of the CS (P<0.01). PerkinElmer showed that the expressions of proliferating cell nuclear antigen (P=0.016) and collagen-I (P=0.000) on the ES were higher than those on the CS. Transmission electron microscopy showed that the number of mitochondria, endoplasmic reticulum, and Golgi apparatus on the ES was significantly greater than the CS. The results confirmed that the 3 screws vertically increase the bone height. Mechanical force signals stimulate tissue activity and lead to significant cell proliferation and differentiation in the traction zone. Collagen-I may induce osteogenesis in the early stage of traction.
Conflict resolution in a pediatric inpatient unit: a best practice implementation project
Authors: Sinclair Jessica , Palokas Michelle 
Published: February 2023

ABSTRACT

Objectives:
The aim of this project was to promote evidence-based practices regarding conflict resolution in the hospital setting on a pediatric inpatient unit.

Introduction:
Conflict is an inevitable reality in healthcare organizations. Evidence suggests that to facilitate constructive conflict resolution among staff, organizational-level education, as well as formal policies and procedures are both necessary.

Methods:
A baseline audit on conflict resolution utilizing the JBI Practical Application of Clinical Evidence System program was undertaken and involved 34 nurses and two nursing assistants. The implementation project used a three-phase approach, with audits and feedback for the evaluation of compliance with best practices. Following baseline audits, an intervention, including conflict resolution education, was implemented, and recommendations to update the current policy and procedure were communicated to unit leadership. Then a postimplementation audit was undertaken.

Results:
Postimplementation audits revealed improvements in compliance across all seven audit criteria. The greatest improvement was for audit criterion 4, having a structured formal process for remediation if conflict occurs, and criterion 7, having a follow-up of agreed solutions occur, which garnered 75 and 83% improvements, respectively.

Conclusion:
For all seven audit criteria, compliance improved from 24% at baseline to 71% after the implementation of an educational module regarding conflict resolution strategies, tools, and best practices and a recommendation to update the existing policy to include the use of a conflict resolution documentation tool. Recommendations for the next steps include making educational materials and visual reminders about conflict resolution strategies readily available and easily accessible to staff.
Experimentally probing the stability of thin-shell structures under pure bending
Authors: Royer Fabien , Pellegrino Sergio 
Published: February 2023

This paper studies the stability of space structures consisting of longitudinal, open-section thin-shells transversely connected by thin rods subjected to a pure bending moment. Localization of deformation, which plays a paramount role in the nonlinear post-buckling regime of these structures and is extremely sensitive to imperfections, is investigated through probing experiments. As the structures are bent, a probe locally displaces the edge of the thin shells, creating local dimple imperfections. The range of moments for which the early buckling of the structures can be triggered by this perturbation is determined, as well as the energy barrier separating the pre-buckling and post-buckling states. The stability of the local buckling mode is then illustrated by a stability landscape, and probing is extended to the entire structure to reveal alternate buckling modes disconnected from the structure’s fundamental path. These results can be used to formulate efficient buckling criteria and pave the way to operating these structures close to their buckling limits, and even in their post-buckling regime, therefore significantly reducing their mass.
This article is part of the theme issue ‘Probing and dynamics of shock sensitive shells’.
Probing the stability landscape of cylindrical shells for buckling knockdown factors
Authors: Groh R. M. J. , Pirrera A. 
Published: February 2023

The buckling response of axially compressed cylindrical shells is well known for its imperfection sensitivity. Mapping out a stability landscape by localized probing has recently been proposed as a rational means for establishing shell buckling knockdown factors. Probing using a point force directed radially inwards and perpendicular to the cylinder wall is based on the insight that a localized single dimple exists as an edge state in the basin boundary of the stable prebuckling equilibrium. Here, we extend the idea of probing to bi-directional inwards and outwards forces to trigger both single-dimple and double-dimple edge states. We identify key features of the ensuing probing stability landscape and generalize these to derive three design curves of varying conservatism that are a function of the non-dimensional Batdorf parameter only. Interestingly, the most conservative of the three knockdown curves bounds a large dataset of experimental buckling results from below, despite being derived from probing features of geometrically perfect cylinders. Overall, the three design curves permit a more nuanced design approach than legacy knockdown factors, as different levels of conservatism can be chosen based on expected manufacturing quality. For instance, the most and least conservative of the three design guidelines differ by a factor of 3 for the most slender cylinder geometries, and the associated reduction in safety factor has profound implications for efficient structural design.This article is part of the theme issue ‘Probing and dynamics of shock sensitive shells’.