bluuebunny/crossref_metadata_2025_split huggingface dataset:
A finite element analysis of load distribution during donning and orthostatic posture in the ITOP hybrid subischial socket
Authors: Frigo Carlo A. , Bellomo Silvia , Bigatti Matteo , Pellegrini Roberto , Denza Gabriele , Di Stanislao Eugenio 
Published: January 2023

Introduction:
Pressure and shear stresses applied to the stump of a transfemoral amputee wearing a newly designed prosthetic socket have been analyzed by a finite element modeling approach.

Methods:
The new socket was developed by the Istituto Tecnico Ortopedico Preneste, and it was named the “hybrid subischial socket.” This work aimed at understanding the loads' distribution on the stump surface in 2 operative conditions: at the end of the wearing phase and during the orthostatic posture. The model of the stump was composed of 4 different materials: the femoral bone, the muscle tissue, the fat, and the skin layers. Except for the bone (rigid), the biological tissues were modeled as Neo-Hookean, and their mechanical properties were taken from the literature. The socket was composed of a containment frame, made of carbon fiber composite material, a shell made of flexible silicone, and a liner made of hyperelastic silicone.

Results:
The results of our simulation show that the main support areas are located in a proper position, in agreement with the ideal principles of this prosthetic design, and the maximum pressures are well below the pain threshold reported in the literature for the same contact areas.

Conclusions:
We can conclude that although the upper rim of the socket is well below the ischiatic area, the new socket design allows for a safe and comfortable support of the body weight. This is in agreement with the evidence of a good functionality and acceptance of this prosthetics gathered in the many real applications.
Urinary Tract Infections After Urogynecologic Surgery: Risk Factors, Timeline, and Uropathogens
Authors: Jung Carrie E. , Chen Lie H. , Brubaker Linda I. , Menefee Shawn A. 
Published: January 2023

Importance
Urinary tract infection (UTI) is a common and potentially avoidable postoperative (PO) adverse event after urogynecologic surgery. Understanding pathophysiology will help prevent the associated morbidity of the disease and treatment of PO-UTI.

Objective
The objective of this study is to determine the following: (1) risk factors for both PO-UTI and PO recurrent UTI (RUTI) after urogynecologic surgery, (2) temporal distribution of UTI, and (3) uropathogen identification.

Study Design
Women undergoing urogynecologic surgery were retrospectively reviewed. Urinary tract infection was defined by culture or antibiotic prescription for symptoms. Recurrent UTI was defined as occurring outside a 6-week perioperative period. The χ2 test or Fischer exact and Student t tests or Mann-Whitney U test were used as appropriate. Individual odds ratio (OR), 95% confidence interval [CI], and sequential multivariable logistic regression were calculated. Statistical significance was set at P < 0.05.

Results
The 6-week PO-UTI rate after 33,626 procedures was 12.9%. Recurrent UTI increased from 3.7% preoperatively to 4.4% postoperatively (P < 0.001). A 6-week preoperative UTI and RUTI increased the risk of 6-week PO-UTI (OR, 1.65; 95% CI < 1.26–2.16; P = 0.001 and OR, 2.19; 95% CI, 1.84–2.62; P < 0.001, respectively) and PO-RUTI (OR, 2.95; 95% CI, 2.11–4.11; P < 0.001 and OR, 6.79; 95% CI, 5.61–8.23; P < 0.001, respectively). Compared with pelvic organ prolapse (POP) surgery only, stress urinary incontinence (SUI) surgery (OR 1.57[1.30–1.89]), and combined POP/SUI surgery (OR, 1.36; 95% CI, 1.13–1.63]) increased the risk of PO-RUTI (P < 0.001). Urinary tract infection within 1 week preoperatively was protective against 6-week PO-UTI (OR, 0.68; 95% CI, 0.48–0.97; P = 0.035). No perioperative factors were protective of PO-RUTI.

Conclusions
The PO-RUTI rate in the first year after urogynecologic surgery is low; however, SUI procedures may increase PO-RUTI risk. Potentially, modifiable risk factors for both PO-UTI and PO-RUTI include UTI diagnosis within 6 weeks preoperatively or preoperative RUTI diagnosis. Retesting women the week before surgery to ensure adequate treatment of preoperative UTI may reduce 6-week PO-UTI.
Preoperative Simulation of Retropubic Midurethral Sling to Decrease Bladder Perforation Rate Among Obstetrics and Gynecology Residents
Authors: Shah Nemi M. , Florian-Rodriguez Maria E. , Meinhardt Summer S. , Cline L. Sophia , Chang Stephanie Y. , Brown L. Steven , Schaffer Joseph I. 
Published: January 2023

Importance
Bladder perforation is an often avoidable complication of retropubic midurethral sling procedures. Bladder injury rates decrease with surgeon experience, but literature on techniques to train novice surgeons is limited.

Objective
Our objective was to decrease the bladder perforation rate among obstetrics and gynecology residents during retropubic midurethral sling procedures through implementation of an instructional video and low-fidelity simulation.

Study Design
A baseline bladder perforation rate was determined by retrospective chart review. A prospective educational intervention, consisting of a 10-minute instructional video with preoperative simulation using a simple bony pelvis model, was then implemented among residents on the urogynecology service from December 2017 through March 2020. The primary outcome was the change in the bladder perforation rate. Compliance with the intervention protocol was a secondary outcome. Categorical data were evaluated using the χ2 or Fisher exact test. Continuous variables were assessed using the Student t test or Mann-Whitney U test as appropriate.

Results
Two hundred fifteen retropubic midurethral sling cases were included in analysis. There were no significant demographic differences between the patients undergoing surgery preintervention and postintervention. Resident surgeons were in their second (47.4%) and third (52.6%) years of training. The postintervention bladder perforation rate was 6.5%, which is a 35% reduction from the preintervention perforation rate of 10% (P = 0.19). The instructional video and preoperative simulation were successfully implemented in 193 of 215 (89.8%) eligible cases.

Conclusion
Despite high compliance, the combination of the instructional video and preoperative low-fidelity bony pelvis simulation was not effective in reducing tension-free vaginal tape-associated bladder perforations among residents.
Rectocele: Correlation Between Defecography and Physical Examination
Authors: Crowder Carly A. , Sayegh Nichole , Guaderrama Noelani M. , Jeney Sarah E.S. , Buono Kristen , Yao Janis , Whitcomb Emily L. 
Published: January 2023

Importance
There is a lack of consensus regarding the clinical applicability of fluoroscopic defecography in evaluation of pelvic organ prolapse.

Objectives
The aim was to evaluate the association between rectocele on defecography and posterior vaginal wall prolapse (PVWP) on physical examination. The secondary objective was to describe radiologic and clinical predictors of surgical intervention and outcomes.

Study Design
This was a retrospective review of patients enrolled in a large health maintenance organization who underwent defecography and were examined by a urogynecologist within 12 months. The electronic medical record was reviewed for demographic and clinical variables, including pelvic organ prolapse and defecatory symptoms, physical examination, and surgical intervention through 12 months after initial urogynecologic examination or 12 months after surgery if applicable.

Results
One hundred eighty-six patients met inclusion criteria. Of those, 168 (90.3%) had a rectocele on defecography and 31 (16.6%) had PVWP at or beyond the hymen. Rectocele size on defecography was poorly correlated with PVWP stage (spearman ρ = 0.18). Forty patients underwent surgical intervention. Symptoms of splinting, digitation, and stool trapping were associated with surgical intervention (odds ratio, 4.24; 95% confidence interval, 1.59–11.34; P < 0.01) as was advanced PVWP stage (P < 0.01), while rectocele presence and size on defecography were not. Large rectocele size on defecography was correlated with persistent postoperative defecatory symptoms (P = 0.02).

Conclusions
We demonstrated a poor correlation between rectocele size on defecography and PVWP stage. Defecatory symptoms (splinting, digitation, stool trapping) and higher PVWP stage were associated with surgical intervention, while rectocele on defecography was not.
First report of a carbapenemase OXA-48 producing-Hafnia alvei clinical isolate.
Authors: Sevillano Laura , Herrera Cristhian , Valdes Álvaro , de la Hoz Ángela , Cardeñoso Laura , Domingo Diego , Semiglia Maria Auxiliadora 
Published: January 2023

Introduction: Carbapenems are usually used in the treatment of infections caused by cephalosporin-resistant Enterobacterales; however, the increase in carbapenem-resistant enterobacterales (CRE) has become one of the most important problems in public health. Hafnia alvei is associated with intestinal and extraintestinal infections, especially in patients with any chronic disease or some type of inmunosupression. H. alvei is resistant to first-generation aminopenicillins and cephalosporins because of the β-lactamase (Amp C) in their chromosome, the only carbapenem-resistant Hafnia strain described until now was due to the lack of OmpK36 protein that plays an important role in permeability to carbapenems.
Case presentation: We present the case of a 65 years old male diagnosed with acute lithiasic cholecystitis. The culture of the biliary prosthesis yielded a OXA-48-producing H. alvei that was identified by MALDI-TOF (matrix-assisted laser desorption/ionization-time of flight) mass spectrometry. Carbapenemase production was detected by immunochromatography and confirmed by sequencing.
Conclusion: To our knowledge, this is the first report of OXA-48-producing H. alvei probably obtained by horizontal transference from E. cloacae -OXA-48 isolated in previous samples.
Baseline associations between household air pollution exposure and blood pressure among pregnant women in the Household Air Pollution Intervention Network (HAPIN) multi-country randomized controlled trial
Authors: Ye Wenlu , Pillarisetti Ajay , de León Oscar , Steenland Kyle , Peel Jennifer L. , Clark Maggie L. , Checkley William , Underhill Lindsay J. , Quinn Ashlinn , Balakrishnan Kalpana , Garg Sarada S. , McCracken John P. , Thompson Lisa M. , Díaz-Artiga Anaité , Rosa Ghislaine , Davila-Roman Victor G. , de las Fuentes Lisa , Papageorghiou Aris T. , Chen Yunyun , Wang Jiantong , Thomas F. c ,   the Household Air Pollution Intervention Network (HAPIN) trial Investigators
Published: January 2023

ABSTRACTCooking and heating using solid fuels can result in dangerous levels of exposure to household air pollution (HAP). HAPIN is an ongoing randomized controlled trial assessing the impact of a liquified petroleum gas stove and fuel intervention on HAP exposure and health in Guatemala, India, Peru, and Rwanda among households that rely primarily on solid cooking fuels. Given the potential impacts of HAP exposure on cardiovascular outcomes during pregnancy, we seek to characterize the relationship between personal exposures to HAP and blood pressure among pregnant women at baseline (prior to intervention) in the study. We assessed associations between PM2.5(particulate matter with an aerodynamic diameter ≤2.5 μm), BC (black carbon), and CO (carbon monoxide) exposures and blood pressure at baseline, prior to intervention, among 3195 pregnant women between 9 and 19 weeks of gestation. We measured 24-hour personal exposure to PM2.5/BC/CO and gestational blood pressure. Multivariable linear regression models were used to evaluate associations between personal exposures to three air pollutants and blood pressure parameters. Trial-wide, we found moderate increases in systolic blood pressure (SBP) and decreases in diastolic blood pressure (DBP) as exposure to PM2.5, BC, and CO increased. None of these associations, however, were significant at the 0.05 level. HAP exposure and blood pressure associations were inconsistent in direction and magnitude within each country. We observed effect modification by body mass index (BMI) in India and Peru. Compared to women with normal weights, obese women in India and Peru (but not in Rwanda or Guatemala) had higher SBP per unit increase in log transformed PM2.5and BC exposures. We did not find a cross-sectional association between HAP exposure and blood pressure in pregnant women; however, HAP may be associated with higher blood pressure in pregnant women who are obese, but this increase was not consistent across settings.
Acute tubulointerstitial nephritis with or without uveitis: a novel form of post-acute COVID-19 syndrome in children
Authors: Avramescu Marina , Isnard Pierre , Temmam Sarah , Chevalier Agnès , Bastard Paul , Attia Mikael , Berthaud Romain , Fila Marc , Dossier Claire , Hogan Julien , Ulinski Tim , Leguevaques Damia , Louillet Férielle , Martinez Casado Edouard , Halimi Jean-Michel , Cloarec Sylvie , Zaloszyc Ariane , Faudeux Camille , Rousset-Rouvière Caroline , Clavé Stéphanie , Harambat Jérôme , Rollot Edouard , Simon Thomas , Nallet-Amate Megan , Ranchin Bruno , Bacchetta Justine , Porcheret Florence , Bernard Josselin , Ryckewaert Amélie , Jamet Anne , Fourgeaud Jacques , Da Rocha Nicolas , Pérot Philippe , Kuperwasser Nicolas , Bouazza Naïm , Rabant Marion , Duong Van Huyen Jean-Paul , Robert Matthieu P , Zuber Julien , Casanova Jean-Laurent , Eloit Marc , Sermet-Gaudelus Isabelle , Boyer Olivia 
Published: January 2023

ABSTRACTBackgroundCOVID-19 is a complex multisystem disease, frequently associated with kidney injury. Since the beginning of the COVID-19 pandemic, we observed a striking increase in the incidence of acute tubulointerstitial nephritis (aTIN) without or with uveitis (TINUs) among children. This prompted us to examine whether SARS-CoV-2 might be the underlying trigger.MethodsWe conducted a French nationwide retrospective cohort study. We included all consecutive children diagnosed with aTIN or TINUs of undetermined cause between April-2020 and March-2021. SARS-CoV-2 antibody responses were tested by a luciferase immunoprecipitation system and compared to age-matched controls. Immunohistochemistry, immunofluorescence and molecular microbiology analyses were performed on kidney biopsies.ResultsForty-eight children were included with a median age at diagnosis of 14.7 years (9.4-17.6). aTIN and TINUs incidence rates increased 3-fold and 12-fold, respectively, compared to pre-pandemic years. All patients had impaired kidney function with a median eGFR of 31.9 ml/min/1.73m² at diagnosis. Kidney biopsies showed lesions of acute tubulointerstitial nephritis and 25% of patients had fibrosis. No patient had concomitant acute COVID-19. All 16 children tested had high anti-N IgG titers and one had anti-S IgGs. Next-generation sequencing failed to detect any infectious agents in kidney biopsies. However, SARS-CoV-2 RNA was detected by PCR in two kidney samples supporting a potential direct link between SARS-CoV-2 and aTIN/TINUs.ConclusionsWe describe a novel form of post-acute COVID-19 syndrome in children, unique in its exclusive kidney and eye involvement, and its distinctive anti-SARS-CoV-2 N+/S-serological profile. Our results support a causal association linking SARS-CoV-2 infection to this newly-reported burst of renal/eye inflammation.
Multi-region brain transcriptomes uncover two subtypes of aging individuals with differences in Alzheimer risk and the impact ofAPOEε4
Authors: Lee Annie J. , Ma Yiyi , Yu Lei , Dawe Robert J. , McCabe Cristin , Arfanakis Konstantinos , Mayeux Richard , Bennett David A. , Klein Hans-Ulrich , De Jager Philip L. 
Published: January 2023

AbstractThe heterogeneity of the older population suggests the existence of subsets of individuals which share certain brain molecular features and respond differently to risk factors for Alzheimer’s disease, but this population structure remains poorly defined. Here, we performed an unsupervised clustering of individuals with multi-region brain transcriptomes to assess whether a broader approach, simultaneously considering data from multiple regions involved in cognition would uncover such subsets. We implemented a canonical correlation-based analysis in a Discovery cohort of 459 participants from two longitudinal studies of cognitive aging that have RNA sequence profiles in three brain regions. 690 additional participants that have data in only one or two of these regions were used in the Replication effort. These clustering analyses identified two meta-clusters, MC-1 and MC-2. The two sets of participants differ primarily in their trajectories of cognitive decline, with MC-2 having a delay of 3 years to the median age of incident dementia. This is due, in part, to a greater impact of tau pathology on neuronal chromatin architecture and to broader brain changes including greater loss of white matter integrity in MC-1. Further evidence of biological differences includes a significantly larger impact ofAPOEε4risk on cognitive decline in MC-1. These findings suggest that our proposed population structure captures an aspect of the more distributed molecular state of the aging brain that either enhances the effect of risk factors in MC-1 or of protective effects in MC-2. These observations may inform the design of therapeutic development efforts and of trials as both become increasingly more targeted molecularly.One Sentence Summary:There are two types of aging brains, with one being more vulnerable toAPOEε4and subsequent neuronal dysfunction and cognitive loss.
An efficient algorithm for Nash equilibria when harvesting interacting living resources
Authors: Del Santo O’Neill T. J. , Rossberg A. G. , Thorpe R. B. 
Published: January 2023

AbstractNatural ecological communities exhibit complex mixtures of interspecific biological interactions, which makes finding optimal yet sustainable exploitation rates challenging. Most fisheries management advice is at present based on applying the Maximum Sustainable Yield (MSY) target to each species in a community by modelling it as if it was a monoculture. Such application of single-species MSY policies to strongly interacting populations can result in tragic overexploitation. However, the idea of “maximising the yield from each species separately” can be extended to take into account species interactions using a multispecies or ecosystem model and determining a Nash Equilibrium (NE), where the yields of each species taken in isolation are simultaneously maximised. Here we present ‘nash’, anRpackage that streamlines the computation of NE reference points for fisheries and other systems represented by a user-defined multispecies or ecosystem model. We present two real-world fisheries management applications alongside performance benchmarks. Satisfactorily search results are shown across models with an approximate factor 15 increase in performance when compared to the expensive round-robbing sequential optimisation algorithms used by other authors in the literature. We believe that thenashpackage can play an instrumental role in fully implementing ecosystem-based management policies worldwide.Open Research statementThis submission uses novel code, which is provided, per our requirements, in an external repository to be evaluated during the peer review process via the following linkhttps://github.com/ThomasDelSantoONeill/nash
Impact of structural sampling, coupling scheme and state of interest on the energy transfer in CP29
Authors: Petry S. , Tremblay J. C. , Götze J. P. 
Published: January 2023

AbstractThe Qyand Bxexcitation energy transfer (EET) in the minor light harvesting complex CP29 (LHCII B4.1) antenna complex ofPisum sativumwas characterized using a computational approach. We applied Förster theory (FRET) and the transition density cube (TDC) method estimating the Coulombic coupling, based on a combination of classical molecular dynamics and QM/MM calculations.Employing TDC instead of FRET mostly affects the EET between chlorophylls (Chls) and carotenoids (Crts), as expected due to the Crts being spatially more challenging for FRET. Only between Chls, effects are found to be small (about only 0.1 EET efficiency change when introducing TDC instead of FRET). Effects of structural sampling were found to be small, illustrated by a small average standard deviation for the Qystate coupling elements (FRET/TDC: 0.97/0.94 cm−1). Due to the higher flexibility of the Bxstate, the corresponding deviations are larger (FRET/TDC between Chl-Chl pairs: 17.58/22.67 cm−1, between Crt-Chl pairs: 62.58/31.63 cm−1). In summary, it was found for the Q band that the coupling between Chls varies only slightly depending on FRET or TDC, resulting in a minute effect on EET acceptor preference. In contrast, the coupling in the B band spectral region is found to be more affected. Here, the S2(1Bu) states of the spatially challenging Crts may act as acceptors in addition to the Chl B states. Depending on FRET or TDC, several Chls show different Chl-to-Crt couplings. Interestingly, the EET between Chls or Crts in the B band is found to often outcompete the corresponding decay processes. The individual efficiencies for B band EET to Crts vary however strongly with the chosen coupling scheme (e.g., up to 0.29/0.99 FRET/TDC efficiency for the Chla604/neoxanthin pair). Thus, the choice of coupling scheme must involve a consideration of the state of interest.
Heterogeneity of the group B streptococcal type VII secretion system and influence on colonization of the female genital tract
Authors: Spencer Brady L. , Job Alyx M. , Robertson Clare M. , Hameed Zainab A. , Serchejian Camille , Wiafe-Kwakye Caitlin S. , Mendonça Jéssica C. , Apolonio Morgan A. , Nagao Prescilla E. , Neely Melody N. , Korotkova Natalia , Korotkov Konstantin V. , Patras Kathryn A. , Doran Kelly S. 
Published: January 2023

SUMMARYType VIIb secretion systems (T7SSb) in Gram-positive bacteria facilitate physiology, interbacterial competition, and/or virulence via EssC ATPase-driven secretion of small ɑ-helical proteins and toxins. Recently, we characterized T7SSb in group BStreptococcus(GBS), a leading cause of infection in newborns and immunocompromised adults. GBS T7SS comprises four subtypes based on variation in the C-terminus of EssC and the repertoire of downstream effectors; however, the intra-species diversity of GBS T7SS and impact on GBS-host interactions remains unknown. Bioinformatic analysis indicates that GBS T7SS loci encode subtype-specific putative effectors, which have low inter-species and inter-subtype homology but contain similar domains/motifs and therefore may serve similar functions. We further identify orphaned GBS WXG100 proteins. Functionally, we show that GBS T7SS subtype I and III strains secrete EsxAin vitroand that in subtype I strain CJB111,esxA1appears to be differentially transcribed from the T7SS operon. Further, we observe subtype-specific effects of GBS T7SS on host colonization, as subtype I but not subtype III T7SS promotes GBS vaginal persistence. Finally, we observe that T7SS subtypes I and II are the predominant subtypes in clinical GBS isolates. This study highlights the potential impact of T7SS heterogeneity on host-GBS interactions.