bluuebunny/crossref_metadata_2025_split huggingface dataset:
Very Small Embryonic-Like Stem Cells Transform Into Cancer Stem Cells and Are Novel Candidates for Detecting/Monitoring Cancer by a Simple Blood Test
Authors: Bhartiya Deepa , Sharma Nripen , Dutta Shruti , Kumar Piyush , Tripathi Ashish , Tripathi Anish 
Published: March 2023

Abstract
Cancer continues to remain a “Black Box,” as there is no consensus on how it initiates, progresses, metastasizes, or recurs. Many imponderables exist about whether somatic mutations initiate cancer, do cancer stem cells (CSCs) exist, and if yes, are they a result of de-differentiation or originate from tissue-resident stem cells; why do cancer cells express embryonic markers, and what leads to metastasis and recurrence. Currently, the detection of multiple solid cancers through liquid biopsy is based on circulating tumor cells (CTCs) or clusters, or circulating tumor DNA (ctDNA). However, quantity of starting material is usually adequate only when the tumor has grown beyond a certain size. We posit that pluripotent, endogenous, tissue-resident, very small embryonic-like stem cells (VSELs) that exist in small numbers in all adult tissues, exit from their quiescent state due to epigenetic changes in response to various insults and transform into CSCs to initiate cancer. VSELs and CSCs share properties like quiescence, pluripotency, self-renewal, immortality, plasticity, enrichment in side-population, mobilization, and resistance to oncotherapy. HrC test, developed by Epigeneres, offers the potential for early detection of cancer using a common set of VSEL/CSC specific bio-markers in peripheral blood. In addition, NGS studies on VSELs/CSCs/tissue-specific progenitors using the All Organ Biopsy (AOB) test provide exomic and transcriptomic information regarding impacted organ(s), cancer type/subtype, germline/somatic mutations, altered gene expressions, and dysregulated pathways. To conclude, HrC and AOB tests can confirm the absence of cancer and categorize the rest of subjects into low/moderate/high risk of cancer, and also monitor response to therapy, remission, and recurrence.
Physiological and transcriptomic characterization of cadmium toxicity in Moso bamboo (Phyllostachys edulis), a non-timber forest species
Authors: Yang Fan , Chang Yu Zhen , Zheng Yi Ting , Pan Xianyu , Ji Haibao , Shao Ji Feng 
Published: March 2023

Abstract
Cadmium pollution in Moso bamboo forests poses a potential threat to the sustainable development of the bamboo industry. However, the effects of cadmium toxicity on Moso growth and its mechanisms of adaptation to cadmium stress are poorly understood. In this study, the physiological and transcriptional response of Moso to cadmium stress was investigated in detail using Moso seedlings in a hydroponic system. Cadmium toxicity severely inhibited the growth of roots but had little effect on biomass accumulation in the aerial parts. Cadmium accumulation in roots and aerial parts increased as external cadmium increased, with cadmium mainly localized in the epidermis and pericycle cells in the roots. The uptake and root-to-shoot translocation of cadmium was stimulated, but the photosynthetic process was suppressed under cadmium stress. A total of 3469 differentially expressed genes were identified from the transcriptome profile and those involved in cadmium uptake, transportation and detoxification were analyzed as candidates for having roles in adaptation to cadmium stress. The results suggested that Moso is highly efficient in cadmium uptake, xylem loading and translocation, as well as having a high capacity for cadmium accumulation. This work also provided basic information on physiological and transcriptional responses of Moso to cadmium toxicity.
Genomic Resources of Four Colletotrichum Species (C. fioriniae, C. chrysophilum, C. noveboracense, and C. nupharicola) Threatening Commercial Apple Production in the Eastern United States
Authors: Khodadadi Fatemeh , Giroux Emily , Bilodeau Guillaume J. , Jurick Wayne M. , Aćimović Srđan G. 
Published: March 2023

The genus Colletotrichum includes nine major clades with 252 species and 15 major phylogenetic lineages, also known as species complexes. Colletotrichum spp. are one of the top fungal plant pathogens causing anthracnose and pre- and postharvest fruit rots worldwide. Apple orchards are imperiled by devastating losses from apple bitter rot, ranging from 24 to 98%, which is a serious disease caused by several Colletotrichum species. Bitter rot is also a major postharvest rot disease, with C. fioriniae causing from 2 to 14% of unmarketable fruit in commercial apple storages. Dominant species causing apple bitter rot in the Mid-Atlantic United States are C. fioriniae from the Colletotrichum acutatum species complex and C. chrysophilum and C. noveboracense from the C. gloeosporioides species complex (CGSC). C. fioriniae is the dominant species causing apple bitter rot in the Northeastern and Mid-Atlantic states. C. chrysophilum was first identified on banana and cashew but has been recently found as the second most dominant species causing apple bitter rot in the Mid-Atlantic. As the third most dominant pathogen, C. noveboracense MB 836581 was identified as a novel species in the CGSC, causing apple bitter rot in the Mid-Atlantic. C. nupharicola is a sister group to C. fructicola and C. noveboracense, also causing bitter rot on apple. We deliver the resources of 10 new genomes, including two isolates of C. fioriniae, three isolates of C. chrysophilum, three isolates of C. noveboracense, and two isolates of C. nupharicola collected from apple fruit, yellow waterlily, and Juglans nigra. [Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
A Framework to Develop an Immersive Virtual Reality Simulation Tool for Postpartum Hemorrhage Management Nurse Training
Authors: Lu Zhipeng , Wang Wenjin , Florez-Arango Jose Fernando , Seo Jinsil Hwaryoung , Hamilton D. Kirk , Wells-Beede Elizabeth 
Published: March 2023

Abstract
Postpartum hemorrhage (PPH) is the leading cause of maternal mortality and morbidity. Effective nurse training for PPH management can reduce negative health impacts on childbearing women. This article discusses a framework for the development of an innovative immersive virtual reality simulator for PPH management training. The simulator should consist of: 1) a virtual world, including virtual physical and social environments, and simulated patients, and 2) a smart platform, providing automatic instructions, adaptive scenarios, and intelligent performance debriefing and evaluations. This simulator will provide a realistic virtual environment for nurses to practice PPH management and promote women’s health.
A Cost Overview of Minimally Invasive Total Mesorectal Excision in Rectal Cancer Patients: A Population-based Cohort in Experienced Centres
Authors: Smalbroek Bo , Geitenbeek Ritchie , Burghgraef Thijs , Dijksman Lea , Hol Jeroen , Rutgers Marieke , Crolla Rogier , van Geloven Nanette , Leijtens Jeroen , Polat Fatih , Pronk Apollo , Verdaasdonk Emiel , Tuynman Jurriaan , Sietses Colin , Postma Maarten , Hompes Roel , Consten Esther , Smits Anke 
Published: March 2023

Background:
Total mesorectal excision has been the gold standard for the operative management of rectal cancer. The most frequently used minimally invasive techniques for surgical resection of rectal cancer are laparoscopic, robot-assisted, and transanal total mesorectal excision. As studies comparing the costs of the techniques are lacking, this study aims to provide a cost overview.

Method:
This retrospective cohort study included patients who underwent total mesorectal resection between 2015 and 2017 at 11 dedicated centers, which completed the learning curve of the specific technique. The primary outcome was total in-hospital costs of each technique up to 30 days after surgery including all major surgical cost drivers, while taking into account different team approaches in the transanal approach. Secondary outcomes were hospitalization and complication rates. Statistical analysis was performed using multivariable linear regression analysis.

Results:
In total, 949 patients were included, consisting of 446 laparoscopic (47%), 306 (32%) robot-assisted, and 197 (21%) transanal total mesorectal excisions. Total costs were significantly higher for transanal and robot-assisted techniques compared to the laparoscopic technique, with median (interquartile range) for laparoscopic, robot-assisted, and transanal at €10,556 (8,642;13,829), €12,918 (11,196;16,223), and € 13,052 (11,330;16,358), respectively (P < 0.001). Also, the one-team transanal approach showed significant higher operation time and higher costs compared to the two-team approach. Length of stay and postoperative complications did not differ between groups.

Conclusion:
Transanal and robot-assisted approaches show higher costs during 30-day follow-up compared to laparoscopy with comparable short-term clinical outcomes. Two-team transanal approach is associated with lower total costs compared to the transanal one-team approach.
Therapeutic Evaluation of Induction Chemotherapy for Locoregionally Advanced Nasopharyngeal Carcinoma With Low-risk N Stage
Authors: Zang Jian , Li Yan , Liu Qiufang , Zhu Yong , Luo Shanquan , Li Xiaohua , Wang Jianhua , Hou Bingxin , Su Ning , Zhao Lina , Shi Mei 
Published: March 2023

Objectives:
The role of induction chemotherapy (IC) remains ambiguous in a patient with T3-4N0-1 nasopharyngeal carcinoma (NPC) according to data from the endemic area of China. Here, we conducted a multicenter retrospective study to investigate the value of adding IC to concurrent chemoradiotherapy (CCRT) for T3-4N0-1 NPC from Northwest China.

Methods:
Data were extracted in 3 hospitals from Northwest China between May 1, 2010 and August 30, 2018. The Kaplan-Meier method was used to estimate the endpoints. Survival curves were compared using the log-rank test. Initial propensity matching was conducted with a 1:1 match of IC + CCRT to CCRT. The primary endpoint of this study was overall survival (OS).

Results:
A total of 108 patients with staging T3-4N0-1 were included in this study. The median follow-up time was 50 months (range: 6 to 118 months). IC followed by CCRT did not significantly improve OS compared with CCRT in the whole cohort (89.5% vs 77.6%, hazard ratio: 0.41, 95% CI: 0.16-1.04, P = 0.100). But significantly better OS was found when a well-balanced propensity score-matched cohort was analyzed. Adjusted 4-year OS was 89.5% for IC followed by CCRT versus 71.1% for CCRT (hazard ratio: 0.30, 95% CI: 0.11-0.80, P = 0.027). No significant differences were detected in side effects between the two groups.

Conclusion:
This study suggested IC followed by CCRT had the potential to further improve OS in patients with T3-4N0-1M0 NPC from Northwest China compared with CCRT. However, prospective studies with a large sample are warranted to confirm the results.
Intraoperative Fluoroscopy Radiation Using OEC 9900 Elite C-arm: Risk and Method for Decreasing Exposure
Authors: Keenen Timothy L. , Demirel Shaban , Gheen Angelica , Casabarro Benjamin , Fleishman Daniel 
Published: March 2023

Abstract
The use of intraoperative fluoroscopy in surgery produces scattered radiation that can expose all operating room personnel to measurable and, in some cases, substantial radiation doses. The goal of this work is to assess and document potential radiation doses to various staff positions in a simulated standard operating room environment. Adult-sized mannequins wearing standard lead protective aprons were placed at seven positions around large and small BMI cadavers. Doses were recorded in real time at thyroid level with Bluetooth-enabled dosimeters for a variety of fluoroscope settings and imaging views. A total of 320 images were acquired, resulting in 2,240 dosimeter readings from the seven mannequins. Doses were compared to cumulative air kerma (CAK) calculations provided by the fluoroscope. There was a strong correlation between the CAK and the recorded scattered radiation doses (P < 0.001). Radiation doses could be reduced by manipulating C-arm manual technique settings [e.g., turning off the automatic exposure control (AEC) and using pulse (PULSE) or low dose (LD) settings]. Staff position and patient size also affected the recorded doses. The highest radiation doses were recorded across all settings for the mannequin positioned immediately adjacent to the C-arm x-ray tube. The larger BMI cadaver generated greater scattered radiation than the smaller BMI cadaver for all views and settings. This work provides suggestions for reducing exposure to operating room personnel beyond standard techniques of reducing beam-on time, increasing the distance from the radiation source, and use of shielding. Simple changes in C-arm settings (turning AEC off, avoiding DS setting, use of PULSE or LD settings) can markedly reduce dose to staff.
Effectiveness of Surgical Excision Following Plutonium-contaminated Wounds: Inferences from Historical Cases
Authors: Poudel Deepesh , Dumit Sara , Klumpp John A. 
Published: March 2023

Abstract
As with any medical treatment, the decision to excise a wound contaminated with actinides is a risk-benefit analysis. The potential benefits of surgical excision following such contaminated wounds are reduction in the probability of stochastic effects, avoidance of local effects, and psychological comfort knowing that radioactive material deposited in the wound is prevented from being systemic. These benefits should be balanced against the potential risks such as pain, numbness, infection, and loss of function due to excision. To that end, the responsibility of an internal dosimetrist is to provide advice to both the patient and the treating physician about the likely benefits of excision that include, but not limited to, averted doses. This paper provides a review of the effectiveness of surgical excisions following plutonium-contaminated wounds and finds that excisions are highly effective at removing plutonium from wounds and at averting the doses they would have caused.
Association Between First Attempt Buffalo Concussion Treadmill Test and Days to Recovery in 855 Children With Sport-Related Concussion: A Historical Cohort Study and Prognostic Factors Analysis
Authors: Lalji Rahim , Hincapié Cesar A. , Macpherson Alison , Howitt Scott , Marshall Cameron , Tamim Hala 
Published: March 2023

Objective:
Little is known about the prognostic value of the Buffalo Concussion Treadmill Test (BCTT) after the acute phase of sport-related concussion (SRC). We examined the added prognostic value of the BCTT performed 10 to 21 days after SRC in children, in addition to participant, injury, and clinical process characteristics on days to recovery.

Design:
Historical clinical cohort study.

Setting:
Network of approximately 150 Canadian multidisciplinary primary-care clinics.

Participants:
855 children (mean age 14 years, range 6-17 years, 44% female) who presented between January 2016, and April 2019 with SRC.

Assessment of risk factors:
Participant, injury, and clinical process characteristics, with focus on BCTT exercise intolerance assessed 10 to 21 days after injury.

Outcome:
Days to clinical recovery.

Results:
Children who were exercise intolerant experienced an increase of 13 days to recovery (95% CI, 9-18 days). Each additional day between SRC and first BCTT was associated with a recovery delay of 1 day (95% CI, 1-2 days), and prior history of concussion was associated with a recovery delay of 3 days (95% CI, 1-5 days). Participant, injury, and clinical process characteristics, and the first attempt BCTT result explained 11% of the variation in recovery time, with 4% accounted for by the BCTT.

Conclusion:
Exercise-intolerance assessed 10 to 21 days after SRC was associated with delayed recovery. However, this was not a strong prognostic factor for days to recovery.
Efficacy of Animal-Assisted Therapy in Treatment of Patients With Traumatic Brain Injury: A Randomized Trial
Authors: Horton Leslie , Griffen Margaret , Chang Lui , Newcomb Anna B. 
Published: March 2023

BACKGROUND:
Severe traumatic brain injury carries major public health consequences, with patients suffering long-term disability with physiological, cognitive, and behavioral changes. Animal-assisted therapy, the use of human and animal bonds in goal-directed interventions, has been a suggested therapy, but its efficacy in acute brain injury outcomes remains unknown.

OBJECTIVE:
This study aimed to assess animal-assisted therapy's effects on cognitive outcome scores of hospitalized severe traumatic brain-injured patients.

METHODS:
This single-center, randomized, prospective trial was conducted from 2017 to 2019 and examined the effects of canine animal-assisted therapy on the Glasgow Coma Scale, Rancho Los Amigo Scale, and Levels of Command of adult severe traumatic brain-injured patients. Patients were randomized to receive animal-assisted therapy or usual standard of care. Nonparametric Wilcoxon rank sum tests were used to study group differences.

RESULTS:
Study patients (N = 70) received 151 sessions with a hander and dog (intervention, n = 38) and 156 without (control, n = 32) from a total of 25 dogs and nine handlers. When comparing the patients' response during hospitalization to animal-assisted therapy versus control, we controlled for sex, age, baseline Injury Severity Score, and corresponding enrollment score. Although there was no significant change in Glasgow Coma Score (p = .155), patients in the animal-assisted therapy group reported significantly higher standardized change in Rancho Los Amigo Scale (p = .026) and change commands (p < .001) compared with the control group.

CONCLUSIONS:
Patients with traumatic brain injury receiving canine-assisted therapy demonstrated significant improvement compared with a control group.
Neurological complications of critically ill COVID-19 patients
Authors: Sonneville Romain , Dangayach Neha S. , Newcombe Virginia 
Published: March 2023

Purpose of review
COVID-19 and systemic critical illness are both associated with neurological complications. We provide an update on the diagnosis and critical care management of adult patients with neurological complications of COVID-19.

Recent findings
Large prospective multicentre studies conducted in the adult population over the last 18 months improved current knowledge on severe neurological complications of COVID-19. In COVID-19 patients presenting with neurological symptoms, a multimodal diagnostic workup (including CSF analysis, brain MRI, and EEG) may identify different syndromes associated with distinct trajectories and outcomes. Acute encephalopathy, which represents the most common neurological presentation of COVID-19, is associated with hypoxemia, toxic/metabolic derangements, and systemic inflammation. Other less frequent complications include cerebrovascular events, acute inflammatory syndromes, and seizures, which may be linked to more complex pathophysiological processes. Neuroimaging findings include infarction, haemorrhagic stroke, encephalitis, microhaemorrhages and leukoencephalopathy. In the absence of structural brain injury, prolonged unconsciousness is usually fully reversible, warranting a cautious approach for prognostication. Advanced quantitative MRI may provide useful insights into the extent and pathophysiology of the consequences of COVID-19 infection including atrophy and functional imaging changes in the chronic phase.

Summary
Our review highlights the importance of a multimodal approach for the accurate diagnosis and management of complications of COVID-19, both at the acute phase and in the long-term.
Benefits of an Online Interactive Educational Program Over Traditional Textbooks
Authors: Phillips Beth Cusatis , Johnson Janean , Khalid Nikita , Zapparrata Nicole , Albright Glenn 
Published: March 2023

Background:
Technology has become increasingly prominent in nursing education. Online learning platforms may be more useful than traditional textbooks in promoting active learning, engagement, and satisfaction.

Purpose:
The purpose was to evaluate a new online interactive education program (OIEP) that replaces traditional textbooks and to understand student and faculty satisfaction, perceived efficacy of the program, student engagement, and whether the OIEP can help NCLEX preparation and reduce burnout.

Method:
This retrospective study assessed student and faculty perceptions of the constructs using quantitative and qualitative measures. Perceptions were measured at 2 time points each: halfway through the semester and again at its conclusion.

Results:
Mean efficacy scores of groups were high at both time points. Students showed significant increases in content constructs, which were supported by faculty perceptions of students. Students agreed that using the OIEP throughout their program would significantly increase preparedness for NCLEX.

Conclusion:
The OIEP may better support nursing students throughout school and on NCLEX than traditional textbooks.
Changes in Cost and Insurance Challenges to Cover PrEP Between 2019 and 2021
Authors: D'Angelo Alexa B. , Mirzayi Chloe , Carneiro Pedro B. , Grov Christian 
Published: March 2023

Introduction:
Pre-Exposure Prophylaxis (PrEP) use continues lag estimated need among gay and bisexual men in the United States. Studies report that challenges paying for PrEP may undermine continued use. Our study aimed to measure these challenges over time.

Methods:
Data were taken from a US national cohort study of cisgender gay and bisexual men and transgender individuals aged 16–49 years. We analyzed data from PrEP-using participants between 2019 and 2021 and observed cost-related and insurance-related challenges participants experienced while on PrEP across time points. We report McNemar and Cochrane Q test statistics to compare differences between groups by year(s).

Results:
In 2019, 16.5% (n = 828/5013) of participants were on PrEP; by 2020, 21% (n = 995/4727) were on PrEP, and by 2021, 24.5% (n = 1133/4617) were on PrEP. The proportion of those experiencing challenges paying for PrEP care decreased significantly across time points for clinical appointments, laboratory work, and prescriptions. Those experiencing insurance and copay approval issues did not change significantly. Although not statistically significant, the only proportion that increased over time was those reporting PrEP-related insurance approval issues. In a post hoc analysis, we found that those reporting PrEP use in the past year who were not currently on PrEP were significantly more likely to report experiencing most PrEP challenges, when compared with current PrEP users.

Discussion:
We found significant reductions in insurance and cost-related challenges between 2019 and 2021. However, those who discontinued PrEP within the past year reported greater challenges paying for PrEP, suggesting that cost and insurance issues may undermine PrEP persistence.
Short-Interval, Low-Dose [177Lu]Lu–Prostate-Specific Membrane Antigen in the Treatment of Refractory Glioblastoma
Authors: More Stuart , Naiker Thurandie , Jacobs Nihaad , Oompie Ferdinand , Prasad Vikas 
Published: March 2023

Abstract
Prostate-specific membrane antigen (PSMA) is expressed on the neovasculature as well as to some extent on the glioblastoma cells. With this background, we report the case of a 34-year-old man with recurrent glioblastoma who was treated with 2 cycles of low-dose [177Lu]Lu-PSMA after exhausting all available treatment options in the state sector. Baseline imaging demonstrated intense PSMA signal in the known lesion, which was amenable to therapy. The prospect of [177Lu]Lu-PSMA–based therapy for glioblastoma is warranted going forward.