bluuebunny/crossref_metadata_2025_split huggingface dataset:
Horizontal Gene Transfer, Fitness Costs and Mobility Shape the Spread of Antibiotic Resistance Genes into Experimental Populations ofAcinetobacter Baylyi
Authors: Sezmis Aysha L , Woods Laura C , Peleg Anton Y , McDonald Michael J 
Published: February 2023

AbstractHorizontal gene transfer (HGT) is important for microbial evolution, but how evolutionary forces shape the frequencies of horizontally transferred genetic variants in the absence of strong selection remains an open question. In this study, we evolve laboratory populations of Acinetobacter baylyi (ADP1) with HGT from two clinically relevant strains of multidrug-resistant Acinetobacter baumannii (AB5075 and A9844). We find that DNA can cross the species barrier, even without strong selection, and despite substantial DNA sequence divergence between the two species. Our results confirm previous findings that HGT can drive the spread of antibiotic resistance genes (ARGs) without selection for that antibiotic, but not for all of the resistance genes present in the donor genome. We quantify the costs and benefits of horizontally transferred variants and use whole population sequencing to track the spread of ARGs from HGT donors into antibiotic-sensitive recipients. We find that even though most ARGs are taken up by populations of A. baylyi, the long-term fate of an individual gene depends both on its fitness cost and on the type of genetic element that carries the gene. Interestingly, we also found that an integron, but not its host plasmid, is able to spread in A. baylyi populations despite its strong deleterious effect. Altogether, our results show how HGT provides an evolutionary advantage to evolving populations by facilitating the spread of non-selected genetic variation including costly ARGs.
You exhaust me! Air pollution exposure near schools during pick-up and drop-off times
Authors: Pitt Tona M , Rowe Brian H , Hicks Anne 
Published: February 2023

Abstract

Background
Public and healthcare practitioner awareness of climate change and the longitudinal health impacts of air pollution is growing; however, it is not always clear how to implement practical and feasible steps that individuals and communities can take to help decrease air pollution and protect children, and it can be challenging to request and enforce behaviour changes that the public associates with perceived personal inconvenience. In this context, it is important to consider common, chronic exposures that increase children’s risks, especially when straightforward solutions with minimal negative impact where significant evidence-based positive results are available.

Aims
This article provides simple tips that healthcare providers, parents, and communities can use to advocate for decreased idling in school zones to improve air quality in and around schools.
L’adhérence au traitement de maladies chroniques chez les jeunes – Rôle du niveau d’actualisation et de la tolérance au risque
Authors: Hurtubise Sandrine , Perez Tamara , Drouin Olivier 
Published: February 2023

Abstract
Adolescents with chronic diseases must adhere to medication regimens to control their symptoms and avoid long-term complications. Despite its importance, medication adherence is low among adolescents. This commentary briefly covers the challenges described in the literature associated with measuring and addressing low medication adherence in adolescents. Next, it presents the evidence for the link between medication adherence and two prevalent psychological characteristics that have not been properly assessed so far: delay discounting (i.e., the relative value assigned to the future compared to the present), and risk tolerance. These psychological traits deserve further studies and are potentially amenable to interventions to improve medication adherence in adolescents with chronic conditions.
A More Credible Approach to Parallel Trends
Authors: Rambachan Ashesh , Roth Jonathan 
Published: February 2023

Abstract
This paper proposes tools for robust inference in difference-in-differences and event-study designs where the parallel trends assumption may be violated. Instead of requiring that parallel trends holds exactly, we impose restrictions on how different the post-treatment violations of parallel trends can be from the pre-treatment differences in trends (“pre-trends”). The causal parameter of interest is partially identified under these restrictions. We introduce two approaches that guarantee uniformly valid inference under the imposed restrictions, and we derive novel results showing that they have desirable power properties in our context. We illustrate how economic knowledge can inform the restrictions on the possible violations of parallel trends in two economic applications. We also highlight how our approach can be used to conduct sensitivity analyses showing what causal conclusions can be drawn under various restrictions on the possible violations of the parallel trends assumption.
Regulatory T cells: a new therapeutic link for Sjögren syndrome?
Authors: Ming Bingxia , Zhu Yaowu , Zhong Jixin , Dong Lingli 
Published: February 2023

Abstract
Great advancements have been made in understanding the pathogenesis of SS, but there remain unmet needs for effective and targeted treatments. Glandular and extraglandular dysfunction in SS is associated with autoimmune lymphocytic infiltration that invades the epithelial structures of affected organs. Regulatory T (Treg) cells are a subset of CD4+ T lymphocytes that maintain self-tolerance during physiological conditions. Besides inhibiting excessive inflammation and autoimmune response by targeting various immune cell subsets and tissues, Treg cells have also been shown to promote tissue repair and regeneration in pathogenic milieus. The changes of quantity and function of Treg cells in various autoimmune and chronic inflammatory disorders have been reported, owing to their effects on immune regulation. Here we summarize the recent findings from murine models and clinical data about the dysfunction of Treg cells in SS pathogenesis and discuss the therapeutic strategies of direct or indirect targeting of Treg cells in SS. Understanding the current knowledge of Treg cells in the development of SS will be important to elucidate disease pathogenesis and may guide research for successful therapeutic intervention in this disease.
Epigenetic programming of TBX2/CX43 mediates lower sperm quality in male offspring induced by prenatal dexamethasone exposure
Authors: Liu Yi , Liu Yi , Chen Guanghui , Wang Hui 
Published: February 2023

AbstractDecreased sperm quality is the main cause of male infertility. Studies have found that prenatal dexamethasone exposure (PDE) decreases sperm quality in male offspring after birth, but the mechanism is unclear. Wistar pregnant rats were subcutaneously injected with 0.1, 0.2, and 0.4 mg/kg.d dexamethasone at gestational days 9–20. The testes and sperm of first-generation (F1) offspring were collected, and F1 offspring were mated with wild-type female rats to obtain F2. Compared with the control group, F1 offspring in PDE group had lower sperm count and motility after birth, and the deformity rate increased. F2 fetal rats’ body length and weight decreased, and the intrauterine growth retardation rate increased. Meanwhile, PDE decreased the expression of connexin 43 (CX43) in offspring testes, whereas T-box transcription factor 2 (TBX2) promoter region histone 3 lysine 9 acetylation (H3K9ac) level and its expression were increased. Traced back to F1 fetus testes, PDE increased the expression of glucocorticoid receptor (GR) and P300, activated GR protein into the nucleus, and made GR act on the TBX2 promoter region. Further, a series of Sertoli cell interventions confirmed that dexamethasone promoted GR to recruit P300, increased the H3K9ac level of TBX2 promoter region and its expression, and inhibited the expression of CX43. This study confirmed that PDE decreased sperm quality of male offspring, which is related to the epigenetic programming of TBX2/CX43 in the Sertoli cells, provided a theoretical and experimental basis for guiding the rational use of drugs during pregnancy.
Piecewise model-based adaptive compensation control for high-speed trains with unknown actuator failures
Authors: Tan Chang , Zhang Junhui , Yang Hui , Zhang Leilei 
Published: February 2023

Abstract
In order to deal with the uncertainties caused by different operation conditions and unknown actuator failures of high-speed trains, an adaptive failures compensation control scheme is designed based on the piecewise model. A piecewise constant model is introduced to describe the variable system parameters caused by the variable operation environments, and a multiple-particle piecewise model of high-speed trains, with unknown actuator failures, is then established. An adaptive failure compensation controller is developed for the multiple-particle piecewise constant model, by using a direct model refering to the adaptive control method. Such an adaptive controller can not only compensate the uncertainties from unknown actuator failures, but also effectively deal with the uncertainties caused by different operating conditions. Finally, a CRH380A high-speed train model is taken as the controlled object for the simulation study. The simulation results show that the proposed controller ensures the desired system performance in the presence of unknown actuator failures and uncertain operation conditions.
Multi-component system maintenance optimization of a rail transit train based on opportunistic correlations
Authors: Dai Jisheng , Ding Rongjun , Fu Yong , Qin Yong 
Published: February 2023

Abstract
In order to deal with the problems of insufficient or excessive maintenance in the current maintenance activities of China transit trains, this paper develops a novel multi-component system maintenance optimization approach based on an opportunistic correlation model. Based on the minimal reliability and failure rate change rule of each train component, the novel proposed maintenance optimization benefits from an improved opportunistic maintenance model with system structure correlation, fault correlation and reliability correlation under imperfect maintenance. Then, different maintenance modes can be determined by a proposed maintenance factor under the different conditions of components. Specifically, the reliability threshold of each component is also considered to optimize the maintenance cost by the system reliability and operational availability of the train. Furthermore, as the mentioned problem belongs to the NP-Hard optimization problems, a modified particle swarm optimization (PSO) with the improvement of inertia weight is proposed to cope with the optimization problem. Based on a specific case under the practical recorded failure data, the analysis shows that the proposed model and approach can effectively cut the maintenance cost.
Simulation of fire emergency evacuation in a large-passenger-flow subway station based on the on-site measured data of Shenzhen Metro
Authors: Chen Hua , Zhang Chenyang , Zhang Jieyu , Shu Ya , Qi Xinjian , Jiang Chaozhe 
Published: February 2023

Abstract
Because of its large capacity, high efficiency and energy savings, the subway has gradually become the primary mode of transportation for citizens. A high density of passengers exists within a large-passenger-flow subway station, and the number of casualties and injuries during a fire emergency is substantial. In this paper, Pathfinder software and on-site measured data of Pingzhou station in Shenzhen (China) were utilized to simulate a fire emergency evacuation in a large-passenger-flow subway station. The Required Safe Egress Time (RSET), number of passengers and flow rates of stairs and escalators were analysed for three fire evacuation scenarios: train fire, platform fire and hall fire. The evacuation time of the train fire, which was 1173 s, was the longest, and 3621 occupants needed to evacuate when the train was fully loaded. Occupants could not complete the evacuation within 6 mins in all three fire evacuation scenarios, which does not meet the current standard requirements and codes. By changing the number of passengers and the number of stairs for evacuation, the flow rate capacity and evacuation time were explored, which have reference values for safety management and emergency evacuation plan optimization during peak hours of subway operation.
A High Immediate Postoperative Neutrophil-to-Albumin Ratio is Associated With Unfavorable Clinical Outcomes at Hospital Discharge in Patients With Aneurysmal Subarachnoid Hemorrhage
Authors: Shin Kyung Won , Choi Seungeun , Oh Hyongmin , Hwang So Yeong , Park Hee-Pyoung 
Published: February 2023

Background:
Inflammation is associated with unfavorable clinical outcomes after aneurysmal subarachnoid hemorrhage (aSAH). We evaluated the relationship between postoperative neutrophil-to-albumin ratio (NAR) and unfavorable clinical outcomes (modified Rankin score ≥ 3) at hospital discharge in aSAH patients.

Methods:
Five hundred sixty aSAH patients undergoing surgical or endovascular treatment were included in this retrospective study. Patients were initially allocated to high (n=247) or low (n=313) postoperative NAR groups based on the immediate postoperative NAR cutoff value identified by receiver operating characteristic analysis, and then further subclassified into 4 groups: HH (high pre- and high postoperative NAR, n=156), LH (low preoperative and high postoperative NAR, n=91), HL (high preoperative and low postoperative NAR, n=68), and low pre- and low postoperative NAR (n=245).

Results:
Optimum cutoff values of immediate postoperative and preoperative NAR were 2.45 and 2.09, respectively. Unfavorable clinical outcomes were more frequent in patients with high compared with low postoperative NAR (45.3% vs. 13.4%; P < 0.001). In multivariate analysis, postoperative NAR was a significant predictor of unfavorable clinical outcomes (odds ratio, 2.10; 95% CI, 1.42-3.10; P < 0.001). Unfavorable clinical outcomes were less frequent in group low pre- and low postoperative NAR than in groups HH, LH, and HL (9.4% vs. 44.9%, 46.2% and 27.9%, respectively; all P < 0.001) and also in Group HL compared with groups HH and LH (P=0.026 and P=0.030); clinical outcomes did not differ between Groups HH and LH.

Conclusions:
A high immediate postoperative NAR was associated with unfavorable clinical outcomes at hospital discharge in aSAH patients.
Skeletal Maturity in Legg-Calve-Perthes Disease: Significant Discrepancy Present Between the Hand and the Hip
Authors: Shaw K. Aaron , Herring John A. 
Published: February 2023

Background:
The concept of delayed skeletal maturity in Legg-Calve-Perthes Disease (LCPD) has been well identified with the Greulich and Pyle (GP) atlas showing 1 to 2 years delay. Recently the optimized Oxford hip skeletal age (Optimized Oxford) system has been developed and shown to have similar accuracy as the GP atlas for assessing skeletal maturity. However, this system has not been used to assess skeletal maturity in LCPD.

Methods:
A retrospective review of a prospective, multicenter study of patients with LCPD treated from 1984 to 1991 and followed to skeletal maturity was performed. We identified all patients who had a left-hand radiograph at the time of presentation with an accompanying anteroposterior pelvis radiograph including the contralateral hip. Patients were excluded if their age at presentation fell outside the validated range for the Optimized Oxford system. GP atlas was used to determine bone age using left-hand radiographs and the nonaffected hip radiographs were used to calculate the Optimized Oxford bone age. Skeletal maturity indices were compared with chronological age (CA) to determine the discrepancy between methodologies.

Results:
A total of 71 patients met inclusion criteria (mean 9.5 ± 1.2 y at presentation, 42.2% females). The mean GP bone age was 1.4 years younger than CA (95% CI: 1.01-1.76 y), with the discrepancy being greater for boys than girls (1.8 vs 0.86 y, P = 0.02). The mean Optimized Oxford bone age was 0.31 years older than CA (95% CI: 0.24-0.38 y) and correlated significantly with CA (R = 0.97, P < 0.001). There were no sex differences in the Optimized Oxford bone age relative to CA (P = 0.32). The GP bone age was a mean of 1.7 years younger than the Optimized Oxford bone age (95% CI: 1.35-2.05 y).

Conclusion:
Skeletal maturity assessment in children with LCPD varies according to the utilized maturity system. The Optimized Oxford bone age more closely mirrors the patient's CA and does not correlate with the GP bone age, which reveals a delayed maturation.
Effects of Perioperative Teriparatide Treatment on the Hounsfield Unit Values at the Upper Instrumented Vertebra in Adult Spinal Deformity Surgery
Authors: Maruo Keishi , Arizumi Fumihiro , Kishima Kazuya , Yoshie Norichika , Kusukawa Tomoyuki , Tachibana Toshiya 
Published: February 2023

Study Design:
Retrospective single-center study.

Objective:
This study aimed to assess the effects of pre and postoperative teriparatide (TPTD) treatment on Hounsfield units (HU) after surgery for adult spinal deformity (ASD).

Summary of Background Data:
The most commonly used method for assessing bone mineral density is dual-energy x-ray absorptiometry. HU values at the upper instrumented vertebra (UIV) have been proposed as a surrogate method for assessing bone quality, particularly in patients with ASD. However, the effect of TPTD treatment on vertebral HU values remains unclear.

Materials and Methods:
We identified 57 consecutive patients with ASD who underwent long-instrumented fusion surgery (>5 vertebrae) between 2014 and 2020. Patients were retrospectively divided into a non-TPTD group (n = 31) and a TPTD group (n = 26). HU measurements were obtained at a level above the UIV (UIV + 1). Changes in the HU value at 1-year postoperatively were compared between the TPTD and non-TPTD groups. The duration of preoperative TPTD was compared between the proximal junctional proximal junctional failure (PJF) and non-PJF groups.

Results:
Preoperative HU values were significantly lower in the TPTD group than in the non-TPTD group, despite no significant difference in preoperative bone mineral density of the proximal femur between the two groups. Changes in HU values were significantly higher in the TPTD group than in the non-TPTD group (20.8 ± 15.7% vs −2 ± 10.2%, P < 0.001). In the subanalysis of the TPTD group, the duration of preoperative TPTD treatment was significantly shorter in the PJF group than in the non-PJF group (34.7 ± 16.8 days vs 86.9 ± 34.7 days, P = 0.004).

Conclusions:
Pre and post-operative TPTD treatment increased the average HU value at UIV + 1 by 20.8%. Therefore, more prolonged preoperative TPTD treatment improves bone quality and may help prevent osteoporosis-related complications.
Rod Attachment Induces Significant Strain in Lumbosacral Fixation
Authors: Sawa Anna G.U. , Wangsawatwong Piyanat , Lehrman Jennifer N. , Hostetler Taylor , de Andrada Pereira Bernardo , Godzik Jakub , Hlubek Randall J. , Uribe Juan S. , Turner Jay D. , Kelly Brian P. 
Published: February 2023

Study Design:
This was a laboratory investigation.

Objective:
Rod attachment can induce significant pedicle screw-and-rod pre-strain that may predispose the instrumentation to failure. This study investigated how in vitro L5–S1 rod strain and S1 screw strain during rod-screw attachment (pre-strain) compared with strains recorded during pure-moment bending (test-strain).

Summary of Background Data:
The lumbosacral junction is highly vulnerable to construct failure due to rod fatigue fracture, sacral screw pull-out, and screw fatigue fracture.

Materials and Methods:
Twelve cadaveric specimens were instrumented with L2–ilium pedicle screws and rod. Strain gauges on contoured rods and sacral screws recorded strains during sequential rod-to-screw tightening (pre-strains). The same instrumented constructs were immediately tested in a 6-degree-of-freedom apparatus under continuous loading to 7.5 Nm in multidirectional bending while recording instrumentation test-strains. Rod and screw pre-strains and test-strains were compared using 1-way repeated-measures analysis of variance followed by Holm-Šidák paired analysis (significant at P<0.05).

Results:
The mean first (171±192 µE) and second (322±269 µE) rod attachment pre-strains were comparable to mean test-strains during flexion (265±109 µE) and extension (315±125 µE, P≥0.13). The mean rod attachment pre-strain was significantly greater than mean test-strains during bidirectional lateral bending (40±32 µE ipsilateral and 39±32 µE contralateral, P<0.001) and axial rotation (72±60 µE ipsilateral and 60±57 µE contralateral, P<0.001). The mean first and second sacral screw pre-strains during rod attachment (1.03±0.66 and 1.39±1.00 Nm, respectively) did not differ significantly (P=0.41); however, the mean sacral screw pre-strain during final (second) rod attachment was significantly greater than screw test-strains during all directions of movement (≤0.81 Nm, P≤0.03).

Conclusions:
Instrumentation pre-strains imposed during in vitro rod-screw attachment of seemingly well-contoured rods in L2–ilium fixation are comparable to, and at times greater than, strains experienced during in vitro bending. Spine surgeons should be aware of the biomechanical consequences of rod contouring and attachment on construct vulnerability.
A Practical Statin Recommendation System Based on Real-World Data to Improve LDL-C Management in Secondary Prevention
Authors: Zhang Yunnan , Zhang Dalin , Liu Xinyu , Peng Wenxing , Mu Yu , Li Yuxin , Qiu Qi 
Published: February 2023

Abstract:
Statins are considered the cornerstone of secondary prevention in patients with atherosclerotic cardiovascular disease (ASCVD). However, many patients fail to achieve the guide-recommended goal of low-density lipoprotein cholesterol (LDL-C) after statin monotherapy, leading to a high residual risk of cardiovascular events. Owing to individual differences in statin therapy, it is possible first to consider changing the type of statin before adding nonstatin medications in certain patients to improve LDL-C management. We developed and evaluated a statin recommendation system using real-world data. Ensemble learning was performed to develop the recommendation system that integrated the output results of support vector machines (SVM) and the similarity of patients. Model performance was assessed to investigate whether treatment according to the recommended model would increase the proportion of patients with the primary end point. Finally, a total of 3510 patients were enrolled in the development and validation of the recommender system. Of them, 1240 patients received atorvastatin (35.3%), 1714 patients received rosuvastatin (48.8%), and 556 patients received pitavastatin (15.8%). The statin recommendation system could significantly improve LDL-C target rate achievement in the recommended treatment group compared with the nonrecommended treatment group in the validation set (50.8% vs. 31.5%, P < 0.001). This study demonstrated that the statin recommendation system could significantly improve the achievement of LDL-C goals in ASCVD patients, providing a new approach to improve LDL-C management.