bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-level in vitro resistance to gentamicin acquired in a stepwise manner in Neisseria gonorrhoeae
Authors: Golparian Daniel , Jacobsson Susanne , Holley Concerta L , Shafer William M , Unemo Magnus 
Published: May 2023

Abstract

Objectives
Gentamicin is used in several alternative treatments for gonorrhoea. Verified clinical Neisseria gonorrhoeae isolates with gentamicin resistance are mainly lacking and understanding the mechanisms for gonococcal gentamicin resistance is imperative. We selected gentamicin resistance in gonococci in vitro, identified the novel gentamicin-resistance mutations, and examined the biofitness of a high-level gentamicin-resistant mutant.

Methods
Low- and high-level gentamicin resistance was selected in WHO X (gentamicin MIC = 4 mg/L) on gentamicin-gradient agar plates. Selected mutants were whole-genome sequenced. Potential gentamicin-resistance fusA mutations were transformed into WT strains to verify their impact on gentamicin MICs. The biofitness of high-level gentamicin-resistant mutants was examined using a competitive assay in a hollow-fibre infection model.

Results
WHO X mutants with gentamicin MICs of up to 128 mg/L were selected. Primarily selected fusA mutations were further investigated, and fusAR635L and fusAM520I + R635L were particularly interesting. Different mutations in fusA and ubiM were found in low-level gentamicin-resistant mutants, while fusAM520I was associated with high-level gentamicin resistance. Protein structure predictions showed that fusAM520I is located in domain IV of the elongation factor-G (EF-G). The high-level gentamicin-resistant WHO X mutant was outcompeted by the gentamicin-susceptible WHO X parental strain, suggesting lower biofitness.

Conclusions
We describe the first high-level gentamicin-resistant gonococcal isolate (MIC = 128 mg/L), which was selected in vitro through experimental evolution. The most substantial increases of the gentamicin MICs were caused by mutations in fusA (G1560A and G1904T encoding EF-G M520I and R635L, respectively) and ubiM (D186N). The high-level gentamicin-resistant N. gonorrhoeae mutant showed impaired biofitness.
A Comprehensive Quality Evaluation of Cimicifugae Rhizoma Using UPLC–Q-Orbitrap-MS/MS Coupled with Multivariate Chemometric Methods
Authors: Ma Zi Cheng , Liu Mei Qi , Liu Guo Qiang , Zhou Zhen Yu , Ren Xiao Liang , Sun Lili , Wang Meng 
Published: May 2023

Abstract

Background
Cimicifugae Rhizoma, known in Chinese as Shengma, is a common medicinal material in traditional Chinese medicine (TCM), mainly used for treating wind-heat headaches, sore throat, uterine prolapse, and other diseases.

Objectives
An approach using a combination of ultra-performance liquid chromatography (UPLC), MS, and multivariate chemometric methods was designed to assess the quality of Cimicifugae Rhizoma.

Methods
All materials were crushed into powder and the powdered sample was dissolved in 70% aqueous methanol for sonication. Chemometric methods, including hierarchical cluster analysis (HCA), principal component analysis (PCA), and orthogonal partial least-squares discriminant analysis (OPLS-DA), were adopted to classify and perform a comprehensive visualization study of Cimicifugae Rhizoma. The unsupervised recognition models of HCA and PCA obtained a preliminary classification and provided a basis for classification. In addition, we constructed a supervised OPLS-DA model and established a prediction set to further validate the explanatory power of the model for the variables and unknown samples.

Results
Exploratory research found that the samples were divided into two groups, and the differences were related to appearance traits. The correct classification of the prediction set also demonstrated a strong predictive ability of the models for new samples. Subsequently, six chemical makers were characterized by UPLC–Q-Orbitrap-MS/MS, and the content of four components was determined. The results of the content determination revealed the distribution of representative chemical markers caffeic acid, ferulic acid, isoferulic acid, and cimifugin in two classes of samples.

Conclusions
This strategy can provide a reference for assessing the quality of Cimicifugae Rhizoma, which is significant for the clinical practice and QC of Cimicifugae Rhizoma.

Highlights
The HCA, PCA and OPLS-DA models visually classify Cimicifugae Rhizoma by appearance traits and obtain the chemical markers that influence the classification. The training and prediction sets were built to demonstrate the accuracy of the classification. Advanced UPLC-Q-Orbitrap-MS/MS technology provides powerful elucidation of critical chemical markers.
Comparison of Diagnostic Sensitivity and Procedure-Related Pain of Concurrent Ultrasound-guided Fine-needle Aspiration and Core-needle Biopsy of Axillary Lymph Nodes in Patients with Suspected or Known Breast Cancer
Authors: Winkler Nicole , Buxton Jace , Freer Phoebe , Raps Evan , Barraza Gonzalo , Boucher Ken , Riegert Joanna , Factor, Rachel 
Published: May 2023

Abstract

Objective
Conflicting data exist on the diagnostic sensitivity of core-needle biopsy (CNB) compared to fine-needle aspiration (FNA) in the evaluation of axillary lymph node metastasis from breast cancer. Our purpose was to evaluate the sensitivity of CNB and FNA using subsequent axillary surgery as the gold standard and to compare the patients’ subjective pain levels for each biopsy method.

Methods
This IRB-approved prospective study enrolled 140 patients from February 2014 to May 2019 with known or suspected breast cancer. Patients underwent both US-guided FNA and 14-gauge CNB of the same node with clip placement and rated their pain level using a verbal numerical rating scale of 0 to 10. The diagnostic sensitivities were determined by pathology of the surgically excised lymph node using the McNemar test of correlated proportions. Changes in pain scores for CNB and FNA were determined using the Wilcoxon rank sum test.

Results
A total of 94 patients had confirmatory excision of the biopsied node with nodal metastasis detected in 71.3% (67/94). The sensitivity of CNB for detection of nodal metastasis was 95.5% (64/67), while the sensitivity of FNA was 67.2% (45/67) (P &lt; 0.05). Overall pain score ratings for CNB increased by 0.6 from baseline on an 11-point numerical rating scale, while overall pain score rating for FNA decreased by 0.2 from baseline (P &lt; 0.05).

Conclusion
Our study demonstrates that 14-gauge CNB has superior sensitivity for detection of axillary nodal metastases and mildly increased pain compared with 25-gauge FNA in patients with breast cancer.
The Impact of Increased Access to Telemedicine
Authors: Zeltzer Dan , Einav Liran , Rashba Joseph , Balicer Ran D 
Published: May 2023

Abstract
We estimate the impact of increased access to telemedicine following widespread adoption during the March–April 2020 COVID-19 lockdown period. We focus on the post-lockdown period, which was characterized by near-complete reopening. Using a difference-in-differences framework, we compare primary care episodes before and after the lockdown between patients with high and low access to telemedicine, as defined by their primary care physician adoption. Our results show that access to telemedicine leads to slightly more primary care visits but lower spending. Visits involve fewer prescriptions and more follow-ups, but we find no evidence of missed diagnoses or adverse outcomes. Results suggest that telemedicine does not compromise care quality or raise costs.
NAA10 overexpression dictates distinct epigenetic, genetic, and clinicopathological characteristics in adult gliomas
Authors: Le Minh-Khang , Vuong Huy Gia , Nguyen Thao T T , Kondo Tetsuo 
Published: May 2023

Abstract
NAA10 is a novel biomarker of cancer progression. The oncogenic and biological mechanisms of NAA10 in human malignancies are controversial and remain to be elucidated. Herein, we investigated the biological and clinicopathological implications of NAA10 gene expression in adult gliomas. We collected data from The Human Cancer Genome Atlas (TCGA) database, including patients from TCGA-GBM and TCGA-LGG projects. In total, there were 666 patients from the 2 projects (513 and 153 from TCGA-LGG and TCGA-GBM, respectively). Different analyses (pathway, DNA methylation, and survival analyses) require further specific case eliminations. Based on NAA10 expression, we divided 666 tumors into 2 subgroups: NAA10-high and NAA10-low glioma. There were higher activities of cell proliferation, metabolic reprogramming, DNA repair, angiogenesis, epithelial-mesenchymal transition, TNF-α, IL6/JAK/STAT6, mTORC1 signaling, and MYC targets in NAA10-high glioma, while P53, TGF-β, Wnt, and Hedgehog pathways were highly expressed by NAA10-low gliomas. t-distributed stochastic neighbors embedding dimension reduction of DNA methylation also showed a high distribution of NAA10-high gliomas in distinct clusters. Survival analyses showed that high NAA10 expression was an independent prognostic factor. NAA10 expression dictated epigenetic, genetic, and clinicopathological differences in adult glioma. Further studies are required to investigate the detailed NAA10 oncogenic mechanisms and to validate NAA10 immunohistochemistry.
Laparoscopic repair for internal hernia associated with colostomy: a case report
Authors: Shiratori Hiroshi , Onoda Takanobu , Takabayashi Naoki , Harada Chika , Imada Sae , Kita Yusuke , Kazama Shinsuke , Ishihara Yukio , Kobayashi Ryo , Hiramatsu Takeyuki 
Published: May 2023

Abstract
A 63-year-old woman was admitted with abdominal pain two months after laparoscopic abdominoperineal resection for rectal cancer. Computed tomography revealed dilated small intestine had passed through a defect between the lifted sigmoid colon and abdominal wall. She was diagnosed with small bowel obstruction without strangulation due to internal hernia and managed nonoperatively based on her wish. Recurrence of intestinal obstruction occurred for which curative surgery was performed laparoscopically. The herniated intestine was restored to the normal position, and the hernia orifice was closed using barbed suture, on laparoscopic management. Internal hernia is a rare complication after colostomy that requires surgical management. Although laparoscopic approach on re-operation is difficult, laparoscopic surgery may be suitable for patients with IHAC in terms of required less use of adhesiolysis.
The frontiers of medical negligence and diagnosis: an interview-based analysis
Authors: Mackley Annie , Liddell Kathleen , Skopek Jeffrey M , Le Gallez Isabelle , Fritz Zoë 
Published: May 2023

Abstract
While errors in medical diagnosis are common and often litigated, the different dimensions of diagnosis—formation, communication, recording—have received much less legal attention. When the process of diagnosis is differentiated in this way, new and contentious legal questions emerge that challenge the appropriateness of the Bolam/Bolitho standard. To explore these challenges, we interviewed 31 solicitors and barristers and asked them: (i) whether Montgomery should apply to information about alternative diagnoses; and (ii) whether the Bolam/Bolitho standard should be rejected in ‘pure diagnosis’ cases. Our qualitative analysis of the interviews sheds light not only on the two questions posed, but also on three cross-cutting themes. First, Bolam/Bolitho is criticised on two grounds that are often conflated: its paternalism for patients and its deference to medical professionals. Second, adopting different standards for different aspects of treatment and diagnosis may be justified in principle, but it can sometimes be difficult or not make sense in practice. Third, new conceptions of patients, doctors, and courts are being articulated in terms of rights or responsibilities over risks. In mapping these issues at the frontiers of medical negligence, this empirical study identifies potential pressure points for future legal developments.
The membership of stars, density profile, and mass segregation in open clusters using a new machine learning-based method
Authors: Noormohammadi M , Khakian Ghomi M , Haghi H 
Published: May 2023

ABSTRACTA combination of two unsupervised machine learning algorithms, DBSCAN: Density-Based Spatial Clustering of Applications with Noise, and GMM: Gaussian mixture models, are used to find members with a high probability of 12 open clusters, M38, NGC2099, Coma Ber, NGC752, M67, NGC2243, Alessi01, Bochum04, M34, M35, M41, and M48, based on Gaia DR3. These clusters have different ages, distances, and numbers of members which makes a suitable cover of these parameters situation to analyse this method. We have identified 752, 1725, 116, 269, 1422, 936, 43, 38, 743, 1114, 783, and 452, probable and possible members with a higher probability than 0.8 for M38, NGC2099, Coma Ber, NGC752, M67, NGC2243, Alessi01, Bochum04, M34, M35, M41, and M48, respectively. Moreover, we obtained the tidal radius, core radius, and clear evidence of mass segregation in 10 clusters. From an examination of the high-quality colour–magnitude data of the cluster, we obtained one white dwarf for each of NGC752, Coma Ber, and M67. In the young open cluster M38, we found all members inside the tidal radius however in the older clusters we found some members outside of the tidal radius, indicating that the young open clusters had not enough time to form clear tidal tails. It is seen that mass segregation occurs at a higher rate in older clusters than the younger ones.
Resolving the binary components of the outbursting protostar HBC 494 with ALMA
Authors: Nogueira Pedro Henrique , Zurlo Alice , Pérez Sebastián , González-Ruilova Camilo , Cieza Lucas A , Hales Antonio , Bhowmik Trisha , Ruíz-Rodríguez Dary A , Principe David A , Herczeg Gregory J , Williams Jonathan P , Cuadra Jorge , Montesinos Matías , Cuello Nicolás , Chavan Prachi , Casassus Simon , Zhu Zhaohuan , Goicovic Felipe G 
Published: May 2023

ABSTRACT
Episodic accretion is a low-mass pre-main sequence phenomenon characterized by sudden outbursts of enhanced accretion. These objects are classified into two: protostars with elevated levels of accretion that lasts for decades or more, called FUors, and protostars with shorter and repetitive bursts, called EXors. HBC 494 is a FUor object embedded in the Orion Molecular Cloud. Earlier Atacama Large (sub-)Millimeter Array (ALMA) continuum observations showed an asymmetry in the disc at 0${_{.}^{\prime\prime}}$2 resolution. Here, we present follow-up observations at ∼0${_{.}^{\prime\prime}}$03, resolving the system into two components: HBC 494 N (primary) and HBC 494 S (secondary). No circumbinary disc was detected. Both discs are resolved with a projected separation of ∼0${_{.}^{\prime\prime}}$18 (75 au). Their projected dimensions are 84 ± 1.8 × 66.9 ± 1.5 mas for HBC 494 N and 64.6 ± 2.5 × 46.0 ± 1.9 mas for HBC 494 S. The discs are almost aligned and with similar inclinations. The observations show that the primary is ∼5 times brighter/more massive and ∼2 times bigger than the secondary. We notice that the northern component has a similar mass to the FUors, while the southern has to EXors. The HBC 494 discs show individual sizes that are smaller than single eruptive YSOs. In this work, we also report 12CO, 13CO, and C18O molecular line observations. At large scale, the 12CO emission shows bipolar outflows, while the 13CO and C18O maps show a rotating and infalling envelope around the system. At a smaller scale, the 12CO and 13CO moment zero maps show cavities within the continuum discs’ area, which may indicate continuum over-subtraction or slow-moving jets and chemical destruction along the line of sight.
The Proper Objects of Faith and Hope
Authors: Scott Michael 
Published: May 2023

Abstract
Can one have faith that something is the same as itself, or hope that a triangle has four sides? Accounts of the proper object of faith or of hope typically exclude modal cases, where the object of faith or hope is understood by the agent to be either necessary or impossible, on the basis of their intuitive implausibility or their incompatibility with beliefs that the agent has about the probability or possibility of the object of faith or hope. This paper argues that the noncognitive components of the psychology of these attitudes—evidential resistance in the case of faith and desire in the case of hope—provide a more plausible and economical explanation for restrictions on their proper objects.
On the Nature of Faith and Its Relation to Trust and Belief
Authors: Faulkner Paul 
Published: May 2023

Abstract
One can have faith in someone, believe in someone and trust someone, and these notions seem closely related. Any account of faith should then address its relation to trust and belief. Like trust, faith can similarly have propositional and relational forms. One can have faith that God is good and faith in God; one can trust that another will do something and trust them to do it. Starting from a comparison between these forms of faith and trust, this paper proposes a philosophical analysis of faith and its relation to trust and belief.
Rational Faith: How Faith Construed as Trust Does, and Does Not, Go Beyond Our Evidence
Authors: Dormandy Katherine 
Published: May 2023

Abstract
I argue that faith is a type of trust. It is also part of a relationship in which both parties are called on to be faithful, where faithfulness is a type of trustworthiness. What distinguishes faith relationships from trust relationships is that both parties value the faith relationship intrinsically. I discuss how faith on this account can, and cannot, be rational when it goes beyond a person’s evidence. It turns out that faith has the same rationality conditions as trust, differing from it only in the cases that fix our intuitions.
Faith as Trust
Authors: Simpson Thomas W 
Published: May 2023

Abstract
The Reformed theological tradition has maintained that faith consists in trust, with that trust involving belief of certain doctrinal propositions. This paper has two aims. First, it contributes towards rehabilitating this conception of faith. I start, accordingly, by setting out the Reformers’ basic case: faith consists in trust because faith is a response to the promises of God, by which the Christian receives God’s forgiveness and is united with God. This argument is independent of any commitment to nondoxasticism or doxasticism about faith. Second, it argues for a methodological commitment which the Reformers’ conception of faith-as-trust complies with, which I think is independently compelling, and which has significant implications for contemporary debates on faith: the kind of faith that matters is that which enables the individual to stand justified, or righteous, before God. Philosophical accounts of faith are unavoidably entangled with theological disputes about justification.
Chronic kidney disease is a key risk factor for aortic stenosis progression
Authors: Candellier Alexandre , Bohbot Yohann , Pasquet Agnes , Diouf Momar , Vermes Emmanuelle , Goffin Eric , Gun Mesut , Peugnet Fanny , Hénaut Lucie , Rusinaru Dan , Mentaverri Romuald , Kamel Saïd , Choukroun Gabriel , Vanoverschelde Jean-Louis , Tribouilloy Christophe 
Published: May 2023

ABSTRACT

Background
Rapid progression of aortic stenosis (AS) has been observed in patients undergoing dialysis, but existing cross-sectional evidence is contradictory in non-dialysis-dependent chronic kidney disease (CKD). The present study sought to evaluate whether CKD is associated with the progression of AS over time in a large cohort of patients with AS.

Methods
We retrospectively studied all consecutive patients diagnosed with AS [peak aortic jet velocity (Vmax) ≥2.5 m/s] and left ventricular ejection fraction ≥50% in the echocardiography laboratories of two tertiary centers between 2000 and 2018. The estimated glomerular filtration rate (eGFR) (mL/min/1.73 m2) was calculated from serum creatinine values. Patients were divided into five CKD stages according to the baseline eGFR. Annual rates of change in the aortic valve area (AVA) were determined by a linear mixed-effects model.

Results
Among the 647 patients included, 261 (40%) had CKD. After a median follow-up of 2.9 (interquartile range 1.8–4.8) years, the mean overall rate of change in AVA was –0.077 (95% confidence interval –0.082; –0.073) cm2/year. There was an inverse relationship between the progression rate and kidney function. The more severe the CKD stage, the greater the AVA narrowing (P &lt; .001). By multivariable linear regression analysis, the eGFR was also negatively associated (P &lt; .001) with AS progression. An eGFR strata below 45 mL/min/1.73 m2 was associated with higher odds of rapid progression of AS than normal kidney function. During the clinical follow-up, event-free survival (patients free of aortic valve replacement or death) decreased as CKD progressed. Rapid progression of AS in patients with kidney dysfunction was associated with worse outcomes.

Conclusions
Patients with CKD exhibit more rapid progression of AS over time and require close monitoring. The link between kidney dysfunction and rapid progression of AS is still unknown and requires further research.
Migration of silicone catheter into pleural space: a case report
Authors: Wong Chen-Yu , Yang Hsuan-Tzu , Hsin Chun-Hsien 
Published: May 2023

Abstract
Background: The totally implantable venous access port (TIVAP) is widely used for chemotherapy, transfusions and parenteral nutritional support. Dysfunction of TIVAP is not uncommon in clinical practice in cases of several etiologies. Herein, we report a rare case of TIVAP dysfunction due to a catheter that migrated into the pleural space. Case presentation: We present a case of a 70-year-old man of TIVAP dysfunction due to a rare catheter extra-vascular migration into the pleural space, diagnosed by computed tomography. We decided on observation without further utilization of the TIVAP and a shift to oral chemotherapy, after a discussion with patient and his primary care oncologist. Conclusion: Our case highlighted the importance of proper evaluation of TIVAP catheter location before its usage or replacement.
Autonomic neural regulation in mediating the brain–bone axis: mechanisms and implications for regeneration under psychological stress
Authors: Ma C , Zhang Y , Cao Y , Hu C -H , Zheng C -X , Jin Y , Sui B -D 
Published: May 2023

Summary
Efficient regeneration of bone defects caused by disease or significant trauma is a major challenge in current medicine, which is particularly difficult yet significant under the emerging psychological stress in the modern society. Notably, the brain–bone axis has been proposed as a prominent new concept in recent years, among which autonomic nerves act as an essential and emerging skeletal pathophysiological factor related to psychological stress. Studies have established that sympathetic cues lead to impairment of bone homeostasis mainly through acting on mesenchymal stem cells (MSCs) and their derivatives with also affecting the hematopoietic stem cell (HSC)-lineage osteoclasts, and the autonomic neural regulation of stem cell lineages in bone is increasingly recognized to contribute to the bone degenerative disease, osteoporosis. This review summarizes the distribution characteristics of autonomic nerves in bone, introduces the regulatory effects and mechanisms of autonomic nerves on MSC and HSC lineages, and expounds the crucial role of autonomic neural regulation on bone physiology and pathology, which acts as a bridge between the brain and the bone. With the translational perspective, we further highlight the autonomic neural basis of psychological stress-induced bone loss and a series of pharmaceutical therapeutic strategies and implications toward bone regeneration. The summary of research progress in this field will add knowledge to the current landscape of inter-organ crosstalk and provide a medicinal basis for the achievement of clinical bone regeneration in the future.