bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of the esophageal microbiome in patients with achalasia and its changes before and after peroral endoscopic myotomy: A pilot study
Authors: Yeh Chia‐Chu , Chen Chieh‐Chang , Chen Chien‐Chuan , Han Ming‐Lun , Wu Jia‐Feng , Wang Hsiu‐Po , Wu Ming‐Shiang , Tseng Ping‐Huei 
Published: April 2023

AbstractBackground and AimAchalasia often presents with chronic food stasis and fermentation in the esophageal lumen, which may lead to alterations of the esophageal microbiome, with associated mucosal inflammation and dysplastic changes. The study aims to evaluate the characteristics of the esophageal microbiome in achalasia and changes of the esophageal microbiome before and after peroral endoscopic myotomy (POEM).MethodsThis is a prospective case–control study. This study enrolled patients with achalasia and asymptomatic subjects as control group. Endoscopic brushing for esophageal microbiome collection was performed in all subjects, with additional follow‐up endoscopy and brushing 3 months after POEM in achalasia patients. The composition of the esophageal microbiome was determined and compared between (1) achalasia patients and asymptomatic controls and (2) achalasia patients before and after POEM.ResultsThirty‐one achalasia patients (mean age 53.5 ± 16.2 years; male 45.2%) and 15 controls were analyzed. We observed a distinct esophageal microbial community structure in achalasia patients, with increased Firmicutes and decreased Proteobacteria when compared with the control group at the phylum level. The discriminating enriched genera in achalasia patients were Lactobacillus, followed by Megasphaera and Bacteroides, and the amount of Lactobacillus was associated with the severity of achalasia. Twenty patients were re‐examined after POEM, and a high prevalence of erosive esophagitis (55%) was noted, alongside an increase in genus Neisseria and decrease in Lactobacillus and Bacteroides.ConclusionsThe altered esophageal microenvironment in achalasia leads to dysbiosis with a high abundance of genus Lactobacillus. Increased Neisseria and decreased Lactobacillus were observed after POEM. The long‐term effect of microbial changes warrants further study.
Slipping through the cracks‐detection of sex trafficking in the adult emergency department: An integrative review
Authors: Eickhoff Leah , Kelly Jazzolynn , Zimmie Heather , Crabo Emma , Baptiste Diana‐Lyn , Maliszewski Barbara , Goldstein Nancy 
Published: April 2023

AbstractIntroductionCurrent research estimates that over 24 million individuals experience human trafficking worldwide. There is a growing prevalence of sex trafficking in the United States. An estimated 87% of trafficked persons visit the emergency department during their captivity. Emergency departments across the United States use differing screening methods for sex trafficking. Current screening tools return a high rate of false negatives, and the appropriate use of tools or standardised lists remains unclear.AimsTo explore best practices for identifying sex trafficking among adults who visit emergency departments. We sought to answer the practice question: How does the implementation of a multifaceted screening model for sex trafficking, versus the use of a list of standardised screening questions, improve the detection of trafficked persons?MethodsWe conducted an integrative review of articles published after 2016 in PubMed, CINAHL, Embase, SCOPUS, and Web of Science databases. PRISMA checklist and guidelines were used. Whittemore and Knafl's method was used to review the literature.ResultsA final selection of 11 articles were reviewed and appraised using the Johns Hopkins nursing evidence‐based practice model. The synthesis of evidence yielded four themes: (1) Provider and personnel education; (2) Protocol establishment; (3) Legal consultation; and (4) Multidisciplinary teamwork.ConclusionThrough this process, we learned the importance of using multifaceted screening tools for identifying persons who are experiencing sex trafficking. In addition to using multifaceted screening tools, detection is improved when all emergency department personnel receive training on sex trafficking. There is a recognised lack of education on sex trafficking recognition nationwide.Relevance to Clinical PracticeNotably, emergency department nurses play an essential role in sex trafficking identification due to their maximised interaction with patients and the increased perception of trust that patients have with nurses. Steps include the development of an education program to improve recognition.No Patient or Public ContributionThere was no patient or public involvement in the design or drafting of this integrative review.
Reciprocal first night effect on rhythmic and non‐rhythmic oromotor episodes in moderate to severe primary sleep bruxism: A retrospective physiological study
Authors: Haraki Shingo , Tsujisaka Akiko , Shiraishi Yuki , Toyota Risa , Katagiri Ayano , Toyoda Hiroki , Ishigaki Shoichi , Taniike Masako , Kato Takafumi 
Published: April 2023

AbstractBackgroundSleep on the first night in a sleep laboratory is characterized by a lower sleep quality and frequency of rhythmic masticatory muscle activity (RMMA) than that on the second night in moderate to severe sleep bruxism (SB) patients.ObjectiveThe aims of this study was to clarify the physiological factors contributing to the first night effect on oromotor activity during sleep and investigate whether physiological factors involved in the first night effect differed between rhythmic and non‐rhythmic oromotor activities.MethodsPolysomnographic data collected on two consecutive nights from 15 moderate to severe SB subjects (F 7: M 8; age: 23.2 ± 1.3 [mean ± SD] years) were retrospectively analysed. Sleep variables, RMMA and non‐specific masticatory muscle activity (NSMA) were scored in relation to episode types (i.e. phasic or tonic and cluster or isolated), sleep architecture and transient arousals. The relationships between nightly differences in oromotor and sleep variables were assessed. The distribution of oromotor events, arousals, cortical electroencephalographic power, RR intervals and heart rate variability were examined in relation to sleep cycle changes. These variables were compared between the first and second nights and between RMMA and NSMA.ResultsSleep variables showed a lower sleep quality on Night 1 than on Night 2. In comparisons with Night 1, the RMMA index increased by 18.8% (p  < .001, the Wilcoxon signed‐rank test) on Night 2, while the NSMA index decreased by 17.9% (p  = .041). Changes in the RMMA index did not correlate with those in sleep variables, while changes in the NSMA index correlated with those in arousal‐related variables (p  < .001, Spearman's rank correlation). An increase in the RMMA index on Night 2 was found for the cluster type and stage N1 related to sleep cyclic fluctuations in cortical and cardiac activities. In contrast, the decrease in the NSMA index was associated with increases in the isolated type and the occurrence of stage N2 and wakefulness regardless of the sleep cycle.ConclusionDiscrepancies in first night effect on the occurrence of RMMA and NSMA represent unique sleep‐related processes in the genesis of oromotor phenotypes in SB subjects.
The phenomenon of urinary tract infection experienced by women with a kidney transplant
Authors: Gad Mette Marie , Rasmussen Maiken Kildahl , Ladefoged Henriette Braüner , Mathiesen Lotte Løntoft , Finderup Jeanette 
Published: April 2023

AbstractBackgroundUrinary tract infection is the most common infection among people with a kidney transplant and increases the risk of graft rejection. Women have a higher risk. A literature search did not identify any description of the phenomenon of urinary tract infection experienced by women with a kidney transplant.ObjectiveTo examine how women with a kidney transplant experienced the phenomenon of a urinary tract infection.DesignA qualitative study with a phenomenological approach.ApproachEight individual semistructured interviews based on van Manen's four lifeworld existentials and analysed using systematic text condensation.ParticipantsWomen with a kidney transplant and recently been admitted to the hospital due to a urinary tract infection.FindingsWe identified four themes: (1) Feeling both typical and atypical symptoms; (2) Becoming aware of the body and trying her best to prevent urinary tract infection; (3) Having a urinary tract infection is a dual experience, both good and bad; (4) Support from relatives.ConclusionThe urinary tract infection symptoms pathway varied between participants but also between individual episodes of incidents among each participant. Participants felt secure when they experienced a common symptom pattern, but a new symptom pattern made them insecure. Together with their relatives, they experienced a urinary tract infection as a disruption of their everyday life and it decreased their experiences of happiness. They experienced to be supported by relatives but also by healthcare professionals, but needed more information on how to prevent, observe and react to a urinary tract infection in the future.
Imidacloprid‐induced mortality, histopathology and biochemical impairments in the larvae of oriental latrine fly (Chrysomya megacephala)
Authors: Yasmeen Shagufta , Amir Mohammad 
Published: April 2023

AbstractThe concentration–mortality response of third instar larvae of Chrysomya megacephala (Diptera: Calliphoridae) to a synthetic insecticide, imidacloprid, and its impact on histopathological, histochemical, and biochemical parameters were determined in laboratory assays. Larvae displayed a concentration and time‐dependent mortality response for the insecticide. Histopathological studies exhibited quite noticeable modifications in the epithelial cells, peritrophic membrane, basement membrane and muscular layer of the larval midgut. The ultrastructural analysis demonstrated alterations in nuclei, lipid spheres, microvilli, mitochondria, rough endoplasmic reticulum and lysosomes. In addition, histochemical tests on the midgut were performed, which revealed a strong reaction for proteins and carbohydrates in the control group and a weak reaction in the group exposed to imidacloprid in a dose and time‐dependent manner. Imidacloprid also caused a significant reduction in the total midgut content of carbohydrates, proteins, lipids and cholesterol. Larvae treated with imidacloprid also showed a reduction in the activities of acid and alkaline phosphatases at all concentrations compared to untreated larvae.
Primary Cooperative Application of a LARS® Tube and 3D‐Printed Prosthesis for Reconstruction of the Distal Radius after en bloc Resection of Giant Cell Tumor of Bone: A Comparative Retrospective Study
Authors: Shao Xianhao , Ding Hao , Li Jianmin , Lv Zhaorui , Yang Qiang , Chu Qing , Li Ka , Li Zhenfeng 
Published: April 2023

ObjectiveUsing a fibula autograft (FA) to reconstruct defects after en bloc resection of giant cell tumor of bone (GCTB) in the distal radius is classic but has high complication rates. We describe a novel reconstruction method employing the cooperative application of LARS® and a 3D‐printed prosthesis (L‐P) and investigate whether it improves postoperative outcomes.MethodsFrom April 2015 to August 2022, 14 patients who underwent the cooperative L‐P reconstruction method after en bloc resection of distal radial GCTBs and 31 patients who received FA reconstruction were enrolled as two retrospective cohorts in this comparative study. The properties of the implants and critical surgical techniques were elaborated in the L‐P group. Preoperative function, intraoperative data, and postoperative clinical, functional, and radiographic outcomes of all patients were recorded and compared between the two groups. The grip strength and range of wrist motion, including extension, flexion, radial deviation, and ulnar deviation, were measured. The Mayo modified wrist and Musculoskeletal Tumor Society scores were chosen to assess wrist function and surgical functional outcomes, respectively. Kaplan–Meier curves were generated to analyze the significant differences in complication rates and implant survival between the two groups.ResultsIn both groups, all 45 patients underwent the operation without complication with similar average osteotomy lengths and bleeding volumes, while a shorter operative duration was achieved in the L‐P group (201.43 ± 22.87 min vs. 230.16 ± 51.44 min, P = 0.015). At a mean follow‐up of 40.42 ± 18.43 months (range, 14–72 months), both reconstruction methods effectively ameliorated postoperative function. Patients who received L‐P showed higher postoperative modified Mayo wrist scores (81.43 ± 5.49 vs. 71.13 ± 16.10, P = 0.003), Musculoskeletal Tumor Society scores (27.64 ± 1.34 vs. 25.06 ± 2.95, P = 0.004), and grip strength on the normal side (68.71% ± 8.00% vs. 57.81% ± 12.31%, P = 0.005) than the FA group. Better wrist extension (63.21° ± 8.99° vs. 45.32° ± 14.53°, P < 0.001) and flexion (45.36° ± 7.90° vs. 30.48° ± 12.07°, P < 0.001) were also observed in the L‐P group. The complication rate was significantly higher in the FA group (29/31, 93.55%) than in the L‐P group (1/14 7.14%, P < 0.001). The L‐P group showed higher implant survival than the FA group, but the difference was not statistically significant.ConclusionThe cooperative application of LARS® and 3D‐printed prostheses is an effective modality for reconstructing musculoskeletal defects after en bloc resection of distal radial GCTBs, which can improve functional outcomes, diminish complication rates, and promote wrist joint stability and motion.
Potential of closed contour analysis for species differentiation and holotype designation: a case study on lower Norian (Upper Triassic) conodonts
Authors: Virág Attila , Karádi Viktor 
Published: April 2023

AbstractGeometric morphometric approaches become increasingly applied in the fields of biology and palaeontology. Taxonomy is a good example, where a long‐standing intention of scientists is to eliminate subjectivity as much as possible. In the case of biostratigraphically important conodont elements, the application of such methods is not widespread. Only a handful of studies attempted to deal with the morphological variance of conodont elements from this aspect. The detailed description of five lower Norian (Upper Triassic) taxa (Ancyrogondolella quadrata, A. rigoi, A. triangularis, A. uniformis and Metapolygnathus mazzai) is presented here based on landmarks and Fourier analysis of the P1 element and keel outlines. Both methods led to similar outcomes regarding taxonomic differentiation and exposing shape variability. Consensus shapes were generated to objectively reveal the typical contour shape of each taxon, which allowed their comparison with each other, and with the members of their respective sample population including the holotypes. The results demonstrated that the holotype of a taxon is generally not an average representative, but rather a peripheral form with well separable morphological characteristics. Ancyrogondolella quadrata and A. rigoi turned out to represent a morphological continuum with ample transitional forms between these two end‐members that may cause bias in their biostratigraphic applicability, however their combined shape variance seems to be too large for uniting them into a single species. Given the results that may be too subtle to realize based solely on qualitative observations, future taxonomic studies and type material designation could greatly benefit from the application of similar methodologies.
Improving drinking water access and equity in rural Sub‐Saharan Africa
Authors: Zhai Chengcheng , Bretthauer Kurt , Mejia Jorge , Pedraza‐Martinez Alfonso 
Published: April 2023

In 2021, access to clean drinking water was still a luxury for millions of people worldwide. Building new water projects, such as handpumps and small piped systems, is the primary operational response by many nongovernmental organizations (NGOs) to bring people their first access to clean water in rural areas of developing countries. Based on knowledge gained from our collaboration with a local NGO and an international NGO and field research in Ethiopia, our research studies where to build new water projects optimally. We first develop a decentralized water project location optimization model based on current practice of a decentralized decision‐making and project management system and an equal per‐beneficiary budget. We further propose three new models to improve both water access and equity: a minimax model, an equitable budget model, and a centralized model that leverages the existing community involvement. Through numerical studies, we compare the model solutions and generate recommendations for NGOs. Lastly, motivated by the current civil war in Ethiopia, we develop a stochastic model to study how to improve drinking water access while mitigating the negative impact of water project supply shocks such as war. Our work studies the previously overlooked problem of drinking water access in rural areas of developing countries. It provides a generalizable and scalable methodology and managerial insights to NGOs building new water projects by combining large geo‐coded datasets and field data.
The times make a hero: Street‐level policy entrepreneurship in major crisis responses in China
Authors: Tang Na , He Muyu 
Published: April 2023

AbstractStreet‐level bureaucrats are often grassroots officials, and they are regarded as passive practitioners of policy with no authority to change policy or innovate, while policy entrepreneurs are usually high‐level officials. Based on observations of China's responses to two national crises, this study found that the times do make a hero. When acting as innovative frontline technocrats, major transboundary crisis practitioners, and management savvy operators within the top‐down bureaucracy, street‐level bureaucrats can become policy entrepreneurs. To innovate and drive policy change, street‐level policy entrepreneurs will adopt innovative strategies. They will make efficient use of their expertise and discretion, integrate various resources, strive for attention from superiors, consolidate their achievements, and expand their influence.
A frozen oceanic crystal mush
Authors: Basch V. , Ferrando C. , Sanfilippo A. 
Published: April 2023

AbstractThe processes driving the evolution of crystal mushes are often documented in complex systems where crystallization, assimilation, magma replenishment and mixing occur concurrently and are generally overprinted by compaction and deformation. Documenting the characteristics of an undisturbed crystal mush is thus of upmost importance; it highlights the initial conditions with which complex crystal mush processes proceed. We here present the structure and composition of an oceanic crystal mush through detailed petro‐structural and chemical study of metre‐scale intrusions from the Mid‐Atlantic Ridge. Textures, bulk‐rock and mineral compositions indicate closed‐system crystallization of primitive melts, undisturbed by dissolution–precipitation reactions and subsequent deformation. These frozen crystal mushes record the simplest possible evolution of small‐scale intrusions and can be used as a baseline to pinpoint the impact of crystal mush processes on the evolution of complex systems. Any divergence from this reference results from processes occurring concomitantly to the progressive closure of the magmatic system.
Active metal deposition in a giant geothermal system
Authors: Zhang Chuang , Richard Antonin , Hao Weilin 
Published: April 2023

AbstractMetallogenic models are vital to mineral exploration. However, there is debate concerning the origin of hydrothermal‐type ore deposits such as vein‐type U and W deposits. The formation, migration, heating and controls on the composition of metal‐fertile fluids in active geothermal systems provide insights into the formation of ore‐forming fluids. Fluid’s metal contents are relatively high in the Yadong–Yangbajing–Naqu (YYN) geothermal belt of South Tibet, and a similar association of enrichment has been found in saline lakes of the region. This study analysed major ions and trace metal contents together with stable (O, H) isotopes of water samples from geothermal springs and wells and regional saline lakes and rivers along the Beng and YYN fault systems. Results demonstrate that metal‐fertile geothermal brines, were sourced from the Bangor saline lake. This study highlights the role of evaporation of saline lake water in the formation of metal‐fertile brines and the contrasting behaviors of U and W in hydrothermal conditions.
Is your neighbor your friend? Scan methods for spatial social network hotspot detection
Authors: Liang Xiaofan , Baker Joshua , DellaPosta Daniel , Andris Clio 
Published: April 2023

AbstractGIS analyses use moving window methods and hotspot detection to identify point patterns within a given area. Such methods can detect clusters of point events such as crime or disease incidences. Yet, these methods do not account for connections between entities, and thus, areas with relatively sparse event concentrations but high network connectivity may go undetected. We develop two scan methods (i.e., moving window or focal processes), EdgeScan and NDScan, for detecting local spatial‐social connections. These methods capture edges and network density, respectively, for each node in a given focal area. We apply methods to a social network of Mafia members in New York City in the 1960s and to a 2019 spatial network of home‐to‐restaurant visits in Atlanta, Georgia. These methods successfully capture focal areas where Mafia members are highly connected and where restaurant visitors are highly local; these results differ from those derived using traditional spatial hotspot analysis using the Getis–Ord Gi* statistic. Finally, we describe how these methods can be adapted to weighted, directed, and bipartite networks and suggest future improvements.
Factors influencing pediatric transfusion: A complex decision impacting quality of care
Authors: Steffen Katherine M. , Spinella Philip C. , Holdsworth Laura M. , Ford Mackenzie , Lee Grace M. , Asch Steven M. , Proctor Enola K. , Doctor Allan 
Published: April 2023

AbstractBackgroundThe risks of red blood cell transfusion may outweigh the benefits for many patients in pediatric intensive care units (PICUs), but guidelines from the Transfusion and Anemia eXpertise Initiative (TAXI) have not been consistently adopted. We sought to identify factors that influenced transfusion decision‐making in PICUs to explore potential barriers and facilitators to implementing the guidelines.Study Design and MethodsA total of 50 ICU providers working in eight US ICUs of different types (non‐cardiac PICUs, cardiovascular ICUs, combined units) and variable sizes (11–32 beds) completed semi‐structured interviews. Providers included ICU attendings and trainees, nurse practitioners, nurses, and subspecialty physicians. Interviews examined factors that influenced transfusion decisions, transfusion practices, and provider beliefs. Qualitative analysis utilized a Framework Approach. Summarized data was compared between provider roles and units with consideration to identify patterns and unique informative statements.ResultsProviders cited clinical, physiologic, anatomic, and logistic factors they considered in making transfusion decisions. Improving oxygen carrying capacity, hemodynamics and perfusion, respiratory function, volume deficits, and correcting laboratory values were among the reasons given for transfusion. Other sought‐after benefits included alleviating symptoms of anemia, improving ICU throughput, and decreasing blood waste. Providers in different roles approached transfusion decisions differently, with the largest differences noted between nurses and subspecialists as compared with other ICU providers. While ICU attendings most often made the decision to transfuse, all providers influenced the decision‐making.DiscussionImplementation of transfusion guidelines requires multi‐professional approaches that emphasize the known risks of transfusion, its limited benefits, and highlight evidence around the safety and benefit of restrictive approaches.