bluuebunny/crossref_metadata_2025_split huggingface dataset:
(073) The New, Undescribed, and Lethal Components of The Genitourinary Syndrome of Menopause
Authors: Dominguez-Bali A , Dominguez-Bali C , Baqer A , Hassan Z , Sharma R , Marquez L 
Published: May 2023

Abstract

Introduction
Genitourinary syndrome of menopause (GSM) has been well described within medical literature and its effects have been well managed by physicians with an extensive understanding of the condition. However, the progression of medicine in each area continues to evolve. We propose new findings that are extremely important to have in consideration of GSM.

Objective
To describe new findings that are not traditionally associated with GSM, some with lethal consequences: * False abnormal pap smears * Total vulvovaginal obliteration and secondary renal damage * Undiagnosed recurrent urinary tract infections (UTI) in the geriatric population without hormone replacement therapy with secondary sepsis, pneumonia, and death.

Methods
Large review of recent literature, diagnosis, treatment and follow up of patients within our facility and nursing homes including geriatric females with and without hormone replacement therapy.

Results
`- Resolution of the abnormal pap smear with the use of local estrogens in more than 1500 cases. - Management of 6 cases of vulvovaginal obliteration with surgery, dilators, increasing penetrative sex, and local estrogens with great results. - Description of some dozens of patients seen and evaluated in home care facilities with undiagnosed UTI by the primary care, showed subsequent findings of sepsis, pneumonia, and even death.

Conclusions
Emphasize the need to inform and educate healthcare providers, especially primary care, internal medicine, OB/GYN physicians, and urologists the ample growing and potentially lethal spectrum of GSM.

Disclosure
No
Identification and analysis of a clinically isolated strain of Halomonas based on whole-genome sequencing and comparative genomics
Authors: Wang Pinjia , Xie Chengbin 
Published: May 2023

Abstract

Objective
The aim of this study was to identify the species of a Halomonas strain isolated from a neonatal blood sample and to understand the potential pathogenicity and characteristic genes of the strain.

Methods
The genomic DNA of strain 18071143 (identified as Halomonas by matrix-assisted laser desorption-ionization time of flight-mass spectrometry and the 16S ribosomal RNA (rRNA) gene sequence) was sequenced using Nanopore PromethION platforms. The average nucleotide identity (ANI) and digital DNA-DNA hybridization (dDDH) were calculated using the complete genome sequences of the strain. Comparative genomic analyses were performed on strain 18071143 and 3 strains of Halomonas (Halomonas stevensii S18214, Halomonas hamiltonii KCTC 22154, and Halomonas johnsoniae KCTC 22157) that were associated with human infections and had high genomic similarity to strain 18071143.

Results
Phylogenetic, ANI, and dDDH similarity analyses based on genome sequence indicated that strain 18071143 belonged to the species H stevensii. Similarities exist between strain 18071143 and the other 3 Halomonas strains in terms of gene structure and protein function. Nonetheless, strain 18071143 has greater potential for DNA replication, recombination, repair, and horizontal transfer.

Conclusion
Whole-genome sequencing holds great promise for accurate strain identification in clinical microbiology. In addition, the results of this study provide data for understanding Halomonas from the perspective of pathogenic bacteria.
Identification of genes essential for bile acid resistance in the probiotic Lacticaseibacillus paracasei strain Shirota
Authors: Shimizu Kensuke , Ito Masahiro , Katto Miyuki , Takada Toshihiko , Oana Kosuke , Makino Hiroshi , Okada Nobuhiko , Kurakawa Takashi , Oishi Kenji 
Published: May 2023

Abstract
Bile acid resistance is crucial to allow probiotic strains to survive in the gastrointestinal tract and exert health-promoting effects on their hosts. Our aim here was to determine the mechanism of this resistance via a genetic approach by identifying the genes essential for bile acid resistance in Lacticaseibacillus paracasei strain Shirota (LcS). We generated 4649 transposon-inserted lines of L. paracasei YIT 0291, which has the same genome sequence as LcS but lacks the pLY101 plasmid, and we screened them for bile-acid-sensitive mutants. The growth of 14 mutated strains was strongly inhibited by bile acid, and we identified 10 genes that could be involved in bile acid resistance. Expression of these genes was not markedly induced by bile acid, suggesting that their homeostatic expression is important for exerting bile acid resistance. Two mutants in which the transposon was independently inserted into cardiolipin synthase (cls) genes, showed strong growth inhibition. Disruption of the cls genes in LcS caused decreased cardiolipin (CL) production and the accumulation of the precursor phosphatidylglycerol in bacterial cells. These data suggest that LcS possesses several mechanisms for exerting bile acid resistance, and that homeostatic CL production is among the factors most essential for this resistance.
Degrees of Epistemic Criticizability
Authors: Boult Cameron 
Published: May 2023

Abstract
We regularly make graded normative judgements in the epistemic domain. Recent work in the literature examines degrees of justification, degrees of rationality, and degrees of assertability. This paper addresses a different dimension of the gradeability of epistemic normativity, one that has been given little attention. How should we understand degrees of epistemic criticizability? In virtue of what sorts of factors can one epistemic failing be worse than another? The paper develops a dual-factor view of degrees of epistemic criticizability. According to the view, degrees of epistemic criticizability are (i) an inverse function of degrees of doxastic justification and (ii) a function of degrees of agent culpability. The paper develops an account of each factor, and explains how they should be weighted. The paper also addresses the importance of modelling degrees of epistemic criticizability in a broader context. I focus on the role that such a model can play in the ethics of epistemic criticism.
Impacts of pregnancy and menopause on COVID-19 severity: a systematic review and meta-analysis of 4.6 million women
Authors: Liu Y , Li H , Peng Y , Gao L , Liu C , Wei B , Luo Z 
Published: May 2023

Summary

Background
Corona Virus Disease 2019 (COVID-19) pandemic is still a public health emergency of international concern. However, whether pregnancy and menopause impact the severity of COVID-19 remain unclear.

Aim
This study is performed to investigate the truth.

Design
Study appraisal and synthesis follows PRISMA guideline. Meta-analysis is performed in random-effects model.

Methods
PubMed, Embase, Cochrane database, Central, CINAHL, ClinicalTrials.gov, WHO COVID-19 database and WHO-ICTRP are searched until 28 March 2023.

Results
In total, 57 studies (4 640 275 COVID-19 women) were analyzed. Pregnant women were at a lower risk of severe COVID-19, intensive care unit (ICU) admission and disease mortality compared to those nonpregnant women with comparable comorbidities. In contrast, pregnant women with more prepregnancy comorbidities were at a higher risk of severe COVID-19, ICU admission and invasive mechanical ventilation (IMV). In addition, pregnant women with pregnancy complications had a significantly increased risk of severe COVID-19 and ICU admission. Menopause increased COVID-19 severity, IMV requirement and disease mortality. Hormone replacement therapy inhibited COVID-19 severity in postmenopausal women. Premenopausal and postmenopausal women had a lower chance of severe illness than age-matched men. The impact of pregnancy on COVID-19 severity was significant in Americans and Caucasians, whereas the effect of menopause on COVID-19 severity was only significant in Chinese.

Conclusions
Pregnancy and menopause are protective and risk factors for severe COVID-19, respectively. The protective role of pregnancy on COVID-19 is minimal and could be counteracted or masked by prepregnancy or pregnancy comorbidities. The administration of estrogen and progesterone may prevent severe COVID-19.
On Idle Possibilities and Missed Chances: Refugee Rights in Egypt
Authors: Habersky Elena , Hetaba-Sabry Amira , McNally Claire 
Published: May 2023

Abstract
This article investigates the rights of refugees in Egypt and the numerous barriers that exist that prevent their enjoyment. Specifically, the article examines the implementation of international and regional legal frameworks relating to refugees and asylum-seekers by two key stakeholders in Egypt, namely the host state and the United Nations High Commissioner for Refugees (UNHCR). In addition, the article explores the current and potential future role of international and regional law in the implementation of these rights, while investigating the national legal framework and practice on the ground in relation to four core rights: obtaining refugee status, issuing documentation, attempting to protect family unity or to reunify with family in case of separation, and accessing public healthcare. In doing this, the article investigates, first, whether the host state and/or UNHCR retains a preference for a legal framework found at one scale of analysis over the other, and second, if international law and in particular, regional law and governance frameworks could be better utilised by all key stakeholders to improve the situation for refugees on the ground. Through the collection of empirical data from interviews and focus groups, a clear picture emerges of regional legal frameworks and norms remaining on the periphery or simply being ignored by the two key stakeholders responsible for implementing protection mechanisms. Instead, the analysed core rights are understood through a complex hybrid of international norms and national policy. This appears like a missed opportunity. The article concludes by arguing that, while in practice regional legal provisions currently only have a limited effect, they have the potential to offer improved protection and rights for a wider group of asylum-seekers and refugees.
Compositional and Functional Alterations in Intestinal Microbiota in Patients with Psychosis or Schizophrenia: A Systematic Review and Meta-analysis
Authors: Murray Nuala , Al Khalaf Sukainah , Bastiaanssen Thomaz F S , Kaulmann David , Lonergan Edgar , Cryan John F , Clarke Gerard , Khashan Ali S , O’Connor Karen 
Published: May 2023

Abstract

Background and Hypothesis
Intestinal microbiota is intrinsically linked to human health. Evidence suggests that the composition and function of the microbiome differs in those with schizophrenia compared with controls. It is not clear how these alterations functionally impact people with schizophrenia. We performed a systematic review and meta-analysis to combine and evaluate data on compositional and functional alterations in microbiota in patients with psychosis or schizophrenia.

Study design
Original studies involving humans and animals were included. The electronic databases PsycINFO, EMBASE, Web of Science, PubMed/MEDLINE, and Cochrane were systematically searched and quantitative analysis performed.

Study results
Sixteen original studies met inclusion criteria (1376 participants: 748 cases and 628 controls). Ten were included in the meta-analysis. Although observed species and Chao 1 show a decrease in diversity in people with schizophrenia compared with controls (SMD = −0.14 and −0.66 respectively), that did not reach statistical significance. We did not find evidence for variations in richness or evenness of microbiota between patients and controls overall. Differences in beta diversity and consistent patterns in microbial taxa were noted across studies. We found increases in Bifidobacterium, Lactobacillus, and Megasphaera in schizophrenia groups. Variations in brain structure, metabolic pathways, and symptom severity may be associated with compositional alterations in the microbiome. The heterogeneous design of studies complicates a similar evaluation of functional readouts.

Conclusions
The microbiome may play a role in the etiology and symptomatology of schizophrenia. Understanding how the implications of alterations in microbial genes for symptomatic expression and clinical outcomes may contribute to the development of microbiome targeted interventions for psychosis.
Theorizing Potential Downstream Cultural Consequences of LGBT+ Activism
Authors: Ayoub Phillip M , Page Douglas , Whitt Samuel 
Published: May 2023

Abstract
To what extent does local LGBT+ activism have impacts beyond its immediate surroundings? We offer a theoretical framework emphasizing how a combination of local movement visibility and LGBT+ cultural receptivity can account for disseminating influences of LGBT+ activism. We illustrate our framework in part through an analysis of the potential diffusion of LGBT+ support in Bosnia in the aftermath of the country’s first-ever Pride. Our model explains why the 2019 Sarajevo Pride increased LGBT+ support locally but had no immediate effects on attitudes in greater Bosnia. It also explains why LGBT+ support has since expanded beyond the capital to Bosnia’s surrounding regions in a follow-up 2021 study. Even when local LGBT+ visibility is low or nonexistent, underlying cultural receptivity can be conducive to the gradual diffusion of LGBT+ support. Moreover, the challenging circumstances of the pandemic did not undermine the expansion of LGBT+ tolerance across Bosnia. Our findings illustrate the persistent power as well as limitations of LGBT+ activism to usher in downstream cultural change.
Selective events at individual sites underlie the evolution of monkeypox virus clades
Authors: Molteni Cristian , Forni Diego , Cagliani Rachele , Arrigoni Federica , Pozzoli Uberto , De Gioia Luca , Sironi Manuela 
Published: May 2023

Abstract
In endemic regions (West Africa and the Congo Basin), the genetic diversity of monkeypox virus (MPXV) is geographically structured into two major clades (Clades I and II) that differ in virulence and host associations. Clade IIb is closely related to the B.1 lineage, which is dominating a worldwide outbreak initiated in 2022. Lineage B.1 has however accumulated mutations of unknown significance that most likely result from apolipoprotein B mRNA editing catalytic polypeptide-like 3 (APOBEC3) editing. We applied a population genetics—phylogenetics approach to investigate the evolution of MPXV during historical viral spread in Africa and to infer the distribution of fitness effects. We observed a high preponderance of codons evolving under strong purifying selection, particularly in viral genes involved in morphogenesis and replication or transcription. However, signals of positive selection were also detected and were enriched in genes involved in immunomodulation and/or virulence. In particular, several genes showing evidence of positive selection were found to hijack different steps of the cellular pathway that senses cytosolic DNA. Also, a few selected sites in genes that are not directly involved in immunomodulation are suggestive of antibody escape or other immune-mediated pressures. Because orthopoxvirus host range is primarily determined by the interaction with the host immune system, we suggest that the positive selection signals represent signatures of host adaptation and contribute to the different virulence of Clade I and II MPXVs. We also used the calculated selection coefficients to infer the effects of mutations that define the predominant human MPXV1 (hMPXV1) lineage B.1, as well as the changes that have been accumulating during the worldwide outbreak. Results indicated that a proportion of deleterious mutations were purged from the predominant outbreak lineage, whose spread was not driven by the presence of beneficial changes. Polymorphic mutations with a predicted beneficial effect on fitness are few and have a low frequency. It remains to be determined whether they have any significance for ongoing virus evolution.
The End of Roe v Wade and New Legal Frontiers on the Constitutional Right to Abortion
Authors: Cohen I.G. , Murray M. , Gostin L.O. 
Published: May 2023

(JAMA. 2022;328:325–326)
In the case Dobbs v Jackson Women’s Health Organization in 2022, the US Supreme Court ended the right to abortion established in 1973 with Roe v Wade. The court majority argued that abortion is not referenced in the constitution, is not “implicit in the concept of ordered liberty,” and that the issue should be resolved in each state by voters.
Risk of Preterm Birth, Small for Gestational Age at Birth, and Stillbirth After COVID-19 Vaccination During Pregnancy: Population-based Retrospective Cohort Study
Authors: Fell D.B. , Dimanligh-Crez S. , Regan A.K. , Haberg S.E. , Christopher A.G. , Oakley L. , Alton G.D. , Torok E. , Dhinsa T. , Shah P.S. , Wilson K , Sprague A.E. , El-Chaar D. , Walker M.C. , Barrett J. , Okun N. , Buchan S.A. , Kwong J.C. , Wilson S.E. , Dunn S.I. , MacDonald S.E. , Dougan S.D. 
Published: May 2023

(BMJ. 2022;378:e071416)
COVID-19 infection during pregnancy increases the risk of preterm birth, fetal growth restriction, postpartum hemorrhage, and stillbirth pregnancies. In addition, women of reproductive age also remain among the lowest to seek the SARS-CoV-2 vaccine since Canada’s introduction of vaccines on December 14, 2020, possibly due to pregnancy risk claims. This study retrospectively researched preterm births, small for gestational age (SGA) births, and stillbirths and the COVID-19 vaccine.
Opioid Dispensing After Cesarean Delivery in British Columbia: A Historical Cohort Analysis From 2004 to 2019
Authors: Ziafat K. , Polderman S. , Nabavi N. , Preston R. , Chau A. , Krausz M.R. , Schwarz S.K.W. , Maclure M. 
Published: May 2023

(Can J Anesth/J Can Anesth. 2022;69:997–1006)
Opioids have been overprescribed in North America, including in the field of obstetrics, over the past two decades. Cesarean delivery (CD) is the most common inpatient surgery performed in Canada and opioids are commonly prescribed at discharge to post-CD patients. In 2008, a warning was issued by Health Canada against the use of codeine in mothers who were breastfeeding. A recent study based in the United States found that opioid prescribing practices varied most by the hospital, rather than current recommendations or patient factors. This study used the Surgical Quality Outcome Reports (SQOR) study and the SQOR Extension Study to identify post-CD prescribing patterns among hospitals, hospital type, and hospital location, to inform quality improvement efforts.
Natural Language Processing of Admission Notes to Predict Severe Maternal Morbidity During the Delivery Encounter
Authors: Clapp M.A. , Kim E. , James K.E. , Perlis R.H. , Kaimal A.J. , McCoy T.H. 
Published: May 2023

(Am J Obstet Gynecol. 2022;227:511.e1–511.e8)
Natural language processing (NLP) is a machine learning technique that has been shown to enhance clinical prediction tasks with improved outcomes. This newer strategy is under investigation for its contribution to address severe maternal morbidity (SMM) beyond already in place predelivery planning, communication, and consultation. Using data inherently generated at a patient encounter, it is hypothesized that NLP may boost more accurate maternal risk stratification for SMM and allow provider alerts. NLP methods are proposed that stratify all patients into relevant risk pools to facilitate planning for appropriate care and potentially avert adverse outcomes.
A Machine-learning–based Algorithm Improves Prediction of Preeclampsia-associated Adverse Outcomes
Authors: Schmidt L.J. , Rieger O. , Nexanski M. , Hackelöer M. , Dröge L.A. , Henrich W. , Higgins D. , Verlohren S. 
Published: May 2023

(Am J Obstet Gynecol. 2022;227:77.e1–30)
Preeclampsia is associated with increased maternal morbidity and mortality. It can be difficult to estimate the severity of preeclampsia and to predict adverse outcomes caused by the disease. A number of biomarkers can be accurate positive predictors for preeclampsia. Previous studies have shown the risk of preeclampsia can be more accurately predicted using a multifactorial analysis with patients’ medical history data and current health data. The current study aimed to demonstrate that using machine-learning with this data can more accurately predict adverse outcomes compared to traditional models.
Hypertension in Pregnancy and Adverse Outcomes Among Low-risk Nulliparous Women Expectantly Managed at or After 39 weeks: A Secondary Analysis of a Randomized Controlled Trial
Authors: Bartal M.F. , Premkumar A. , Rice M.M. , Reddy U.M. , Tita A.T.N. , Silver R.M. , El-Sayed Y.Y. , Wapner R.J. , Rouse D.J. , Saade G.R. , Thorp J.M. , Constantine M.M. , Chien E.K. , Casey B.M. , Srinivas S.K. , Swamy G.K. , Simhan H.N. 
Published: May 2023

(BJOG. 2022;129:1396–1403)
Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal morbidity and mortality. A recent study compared low-risk patients at 39 weeks gestation who were expectantly managed versus those who were induced and found those who were induced had a lower risk of developing HDP. This study aimed to compare the prevalence of the adverse perinatal and maternal outcomes among expectantly managed low-risk patients who developed HDP with those who did not.
Antenatal Betamethasone Regimen for Women at Risk of Preterm Birth
Authors: Melamed N. , Asztalos E. 
Published: May 2023

(Lancet. 2022;400:542–543)
For more than 50 years, antenatal betamethasone has been used as a treatment to reduce neonatal respiratory complications. Evaluating a more recent study examining the risk-to-benefit ratio of the treatment regimen, this article aimed to understand if the dosage of steroids should be reduced in order to minimize risk to the fetus from being exposed to corticosteroids in utero. Some recent studies have indicated correlation between treatment with betamethasone and some physical, mental, or developmental disorders.
Guidelines for Pregnant Individuals With Monkeypox Virus Exposure
Authors: Dashraath P. , Nielsen-Saines K. , Mattar C. , Musso D. , Tambyah P. , Baud D. 
Published: May 2023

(Lancet. 2022;400:21–22)
Monkeypox has recently gained a lot of attention because of its sudden transmission levels in nonendemic countries. Previous interactions of pregnant patients and the monkeypox virus have been recorded. This article describes past cases and uses this information to detail the possible impact of the monkeypox virus on a fetus as well as recommended methods for testing and treating exposed and positive pregnant individuals.
Buprenorphine Versus Methadone for Opioid Use Disorder in Pregnancy
Authors: Suarez E.A. , Huybrechts K.F. , Straub L. , Bateman B.T. 
Published: May 2023

(N Engl J Med. 2022;387:2033–2044)
Opioid use during pregnancy has been on the rise since 2000. The standard care for opioid use disorder during pregnancy is either buprenorphine or methadone treatment, which both have been shown to improve maternal and neonatal outcomes. Buprenorphine may have greater benefits, yet data is limited. This study aimed to analyze the risk of adverse outcomes for mother and baby with buprenorphine treatment compared to methadone treatment for opioid use during pregnancy.