bluuebunny/crossref_metadata_2025_split huggingface dataset:
Questions of Well-Being and Inclusion in Online Undergraduate Medical Education During COVID-19: A 2-Phased Focused Scoping Review
Authors: MacLeod Anna , Cameron Paula , Luong Victoria , Parker Robin , Li Vinson , Munroe-Lynds Cora-Lynn 
Published: December 2022

PurposeUndergraduate medical education (UGME) was transformed by the rapid move to online curriculum delivery during the COVID-19 pandemic. Most research on online UGME has focused on measuring its effectiveness. However, medical educators also require evidence regarding its implications with respect to well-being and inclusion.MethodTo explore online learning transition, particularly the effect on well-being and inclusion, this 2-phased focused scoping review employed a revised Joanna Briggs Institute approach: (1) developing review questions and objectives; (2) determining eligibility criteria; (3) developing the search strategy; (4) extracting, analyzing, and discussing findings; (5) drawing conclusions; and (6) discussing implications for practice and further research.ResultsThe review ultimately included 217 articles, of which 107 (49%) explored student and staff well-being during online UGME, 64 (30%) focused on inclusion in this context, and 46 (21%) examined both well-being and inclusion. Additionally, 137 of included articles (63%) were research/evaluation, 48 (22%) were descriptive, and 32 (15%) were opinion. Of the 137 research/evaluation studies, 115 (84%) were quantitative, 10 (7%) were qualitative, 8 (6%) were mixed methods, and 4 (3%) were Reviews. Among these research/evaluation studies, the most commonly used data collection method was surveys (n = 120), followed by academic tests (n = 14). Other methods included interviews (n = 6), focus groups (n = 4), written reflections (n = 3), user data (n = 1), and blood tests (n = 1).ConclusionsImportant questions remain regarding the safety and inclusiveness of online learning spaces and approaches, particularly for members of historically excluded groups and learners in low-resource settings. More rigorous, theoretically informed research in online medical education is required to better understand the social implications of online medical education, including more in-depth, qualitative investigations about well-being and inclusion and more strategies for ensuring online spaces are safe, inclusive, and supportive.
ASCCP Committee Opinion: Adjuvant Human Papillomavirus Vaccine for Patients Undergoing Treatment for Cervical Intraepithelial Neoplasia
Authors: Sharpless Kathryn E. , Marcus Jenna Z. , Kuroki Lindsay M. , Wiser Amy L. , Flowers Lisa 
Published: December 2022

Objectives
Individuals treated for cervical intraepithelial neoplasia grade 2 or worse (CIN2+) are at long-term risk of persistent or recurrent disease despite treatment. This committee opinion aims to summarize and provide evidence-based recommendations for adjuvant human papillomavirus (HPV) vaccination based on available, published literature.

Methods
A task force from the ASCCP Practice Committee reviewed current Centers for Disease Control and Prevention (CDC) guidelines and previously published literature about the role of adjuvant HPV vaccination in previously unvaccinated individuals undergoing treatment for CIN2+ and other HPV-related diseases.

Results
Current CDC guidelines recommend routine or catch-up HPV vaccination for individuals aged 9 to 26 years, and shared decision making regarding vaccination for individuals aged 27 to 45 years. Multiple published studies suggest a possible benefit for adjuvant HPV vaccination in previously unvaccinated individuals undergoing treatment for CIN2+.

Conclusions
The American Society for Colposcopy and Cervical Pathology recommends adherence to current CDC recommendations for vaccination of individuals aged 9 to 26 years and consideration of the possible benefit of adjuvant HPV vaccination during shared decision making for previously unvaccinated individuals aged 27 to 45 years who are undergoing treatment for CIN2+.
Assessing the national representativeness of estimates of antimicrobial resistant urogenital Neisseria gonorrhoeae in US men, Gonococcal Isolate Surveillance Project, 2008–2018
Authors: Nielsen Karen E. , St. Cyr Sancta B. , Pham Cau D. , Kreisel Kristen M. 
Published: December 2022

Abstract

Background
The percentage of Neisseria gonorrhoeae (GC) isolates with resistance or elevated minimum inhibitory concentrations (MICs) to antimicrobials has steadily increased. Current estimates are based on the Gonococcal Isolate Surveillance Project (GISP), a sentinel surveillance study of male GC in the United States. This analysis seeks to assess for adjustment prior to treating aggregated GISP estimates as nationally representative of all reported male urogenital infections.

Methods
We used multilevel regression with poststratification (MRP) to compute national estimates of the proportion of antimicrobial resistance (AMR – defined as exceeding MIC thresholds) in male GC using data from 2008-2018 GISP and case reports. Sensitivity analyses investigated the impact of analysis assumptions and unmeasured variables. We additionally produced estimates of 2018 AMR GC cases among US males.

Results
National estimates were consistent with unweighted estimates. The estimated proportion of incident AMR GC infections in men with urogenital GC in 2018 was 51.5% (95% CI: 50.1% - 52.9%), equating to an estimated 366,300 incident AMR GC infections in US men aged 15-39 years. Estimates of AMR for tested antimicrobials in male GC infections in 2018 ranged from 0.16% (95% CI: 0.08% - 0.24%) for ceftriaxone to 29.9% (95% CI: 28.6% - 31.1%) for ciprofloxacin. Sensitivity analyses revealed that unmeasured data on sex of sex partners could substantially impact weighted estimates.

Conclusions
AMR among reported incident male urogenital GC infections remains rare for ceftriaxone, the current standard of care. Aggregated GISP data are generally representative of men in the US who are reported with urogenital gonorrhea.
Impact of Pulmonary Complications on Outcomes and Resource Use After Elective Cardiac Surgery
Authors: Hadaya Joseph , Verma Arjun , Marzban Mehrab , Sanaiha Yas , Shemin Richard J. , Benharash Peyman 
Published: December 2022

Objective:
To characterize the impact of pulmonary complications (PCs) on mortality, costs, and readmissions after elective cardiac operations in a national cohort and to test for hospital-level variation in PC.

Background:
PC after cardiac surgery are targets for quality improvement efforts. Contemporary studies evaluating the impact of PC on outcomes are lacking, as is data regarding hospital-level variation in the incidence of PC.

Methods:
Adults undergoing elective coronary artery bypass grafting and/or valve operations were identified in the 2016-2019 Nationwide Readmissions Database. PC was defined as a composite of reintubation, prolonged (>24 hours) ventilation, tracheostomy, or pneumonia. Generalized linear models were fit to evaluate associations between PC and outcomes. Institutional variation in PC was studied using observed-to-expected ratios.

Results:
Of 588,480 patients meeting study criteria, 6.7% developed PC. After risk adjustment, PC was associated with increased odds of mortality (14.6, 95% CI, 12.6–14.8), as well as a 7.9-day (95% CI, 7.6–8.2) increase in length of stay and $41,300 (95% CI, 39,600–42,900) in attributable costs. PC was associated with 1.3-fold greater hazard of readmission and greater incident mortality at readmission (6.7% vs 1.9%, P<0.001). Significant hospital-level variation in PC was present, with observed-to-expected ratios ranging from 0.1 to 7.7.

Conclusions:
Pulmonary complications remain common after cardiac surgery and are associated with substantially increased mortality and expenditures. Significant hospital-level variation in PC exists in the United States, suggesting the need for systematic quality improvement efforts to reduce PC and their impact on outcomes.
Negative Prognostic Impact of Tumor Deposits in Rectal Cancer
Authors: Agger Erik , Jörgren Fredrik , Jöud Anna , Lydrup Marie-Louise , Buchwald Pamela 
Published: December 2022

Objective:
To investigate whether tumor deposits (TDs) in rectal cancer are associated with increased recurrence risk and decreased survival.

Background:
Tumor deposits (TDs) are considered a risk factor for recurrence after colon cancer resection, and the presence of TDs prompts adjuvant chemotherapy. The prognostic relevance of TDs in rectal cancer requires further exploration.

Methods:
All patients treated with abdominal resection surgery for rectal cancer in Sweden between 2011 and 2014 were eligible for inclusion in this retrospective cohort study based on prospectively collected data from the Swedish Colorectal Cancer Registry. The primary endpoint was local recurrence or distant metastasis. Secondary outcomes were overall and relative survival.

Results:
Five thousand four hundred fifty-five patients were identified of which 3769 patients were analyzed after exclusion. TDs were found in 404 (10.7%) patients, including 140 (3.7%) patients with N1c-status. In TD-positive patients, local recurrence and distant metastasis rates at 5 years were 6.3% [95% CI 3.8–8.8%] and 38.9% [95% CI, 33.6–43.5%] compared with 2.7% [95% CI, 2.1–3.3%] and 14.3% [95% CI, 13.1–15.5%] in TD-negative patients. In multivariable regression analysis, the risk of local recurrence and distant metastasis were increased; HR 1.86 [95% CI, 1.09–3.19; P=0.024] and 1.87 [95% CI, 1.52–2.31; P=<0.001], respectively. Overall survival at 5 years was 68.8% [95% CI, 64.4–73.4%] in TD-positive patients and 80.7% [95% CI, 79.4–82.1%] in TD-negative patients. pN1c-patients had similar outcomes regarding local recurrence, distant metastasis, and survival as pN1a-b stage patients. TD-positive pN1a-b patients had significantly worse outcomes whereas TDs did not affect outcomes in pN2a-b patients.

Conclusion:
This study suggests that TDs have a negative impact on the prognosis in rectal cancer. Thus, efforts should be made to diagnose TD-positive rectal cancer patients preoperatively.
Neoadjuvant Chemotherapy With CAPOX Versus Chemoradiation for Locally Advanced Rectal Cancer With Uninvolved Mesorectal Fascia (CONVERT): Initial Results of a Phase III Trial
Authors: Mei Wei-Jian , Wang Xiao-Zhong , Li Yun-Feng , Sun Yue-Ming , Yang Chun-Kang , Lin Jun-Zhong , Wu Zu-Guang , Zhang Rui , Wang Wei , Li Yong , Zhuang Ye-Zhong , Lei Jian , Wan Xiang-Bin , Ren Ying-Kun , Cheng Yong , Li Wen-Liang , Wang Zi-Qiang , Xu Dong-Bo , Mo Xian-Wei , Ju Hai-Xing , Ye Sheng-Wei , Zhao Jing-Lin , Zhang Hong , Gao Yuan-Hong , Zeng Zhi-Fan , Xiao Wei-Wei , Zhang Xiao-Peng , Zhang Xuan , Xie E , Feng Yi-Fei , Tang Jing-Hua , Wu Xiao-Jun , Chen Gong , Li Li-Ren , Lu Zhen-Hai , Wan De-Sen , Bei Jin-Xin , Pan Zhi-Zhong , Ding Pei-Rong 
Published: December 2022

Objective:
To compare neoadjuvant chemotherapy (nCT) with CAPOX alone versus neoadjuvant chemoradiotherapy (nCRT) with capecitabine in locally advanced rectal cancer (LARC) with uninvolved mesorectal fascia (MRF).

Background Data:
nCRT is associated with higher surgical complications, worse long-term functional outcomes, and questionable survival benefits. Comparatively, nCT alone seems a promising alternative treatment in lower-risk LARC patients with uninvolved MRF.

Methods:
Patients between June 2014 and October 2020 with LARC within 12 cm from the anal verge and uninvolved MRF were randomly assigned to nCT group with 4 cycles of CAPOX (Oxaliplatin 130 mg/m2 IV day 1 and Capecitabine 1000 mg/m2 twice daily for 14 d. Repeat every 3 wk) or nCRT group with Capecitabine 825 mg/m² twice daily administered orally and concurrently with radiation therapy (50 Gy/25 fractions) for 5 days per week. The primary end point is local-regional recurrence-free survival. Here we reported the results of secondary end points: histopathologic response, surgical events, and toxicity.

Results:
Of the 663 initially enrolled patients, 589 received the allocated treatment (nCT, n=300; nCRT, n=289). Pathologic complete response rate was 11.0% (95% CI, 7.8-15.3%) in the nCT arm and 13.8% (95% CI, 10.1-18.5%) in the nCRT arm (P=0.33). The downstaging (ypStage 0 to 1) rate was 40.8% (95% CI, 35.1-46.7%) in the nCT arm and 45.6% (95% CI, 39.7-51.7%) in the nCRT arm (P=0.27). nCT was associated with lower perioperative distant metastases rate (0.7% vs. 3.1%, P=0.03) and preventive ileostomy rate (52.2% vs. 63.6%, P=0.008) compared with nCRT. Four patients in the nCT arm received salvage nCRT because of local disease progression after nCT. Two patients in the nCT arm and 5 in the nCRT arm achieved complete clinical response and were treated with a nonsurgical approach. Similar results were observed in subgroup analysis.

Conclusions:
nCT achieved similar pCR and downstaging rates with lower incidence of perioperative distant metastasis and preventive ileostomy compared with nCRT. CAPOX could be an effective alternative to neoadjuvant therapy in LARC with uninvolved MRF. Long-term follow-up is needed to confirm these results.
Associations between Traditional Chinese Medicine Body Constitution and Cardiovascular Disease Risk in a White population
Authors: Shu Lihua , Yin Xiaolin , Zhu Xiangzhu , Zhao Jing , Deng Xinqing , Shubin Yevheniy Eugene , Murff Harvey J. , Ness Reid M. , Yu Chang , Shrubsole Martha J. , Dai Qi 
Published: December 2022

AbstractIntroductionTraditional Chinese medicine (TCM) has guided generations of practice on disease treatment and health maintenance. The TCM principles include the framework of body constitution (BC). In essence, it represents one of the first attempts at applying the principle of personalized, precision medicine. Major limitations to broad implementation of the body constitution (BC) framework, and perhaps TCM as a whole, include not only a lack of empirical study about its relation to other models of health maintenance but also a poor understanding of its applicability outside of Chinese population.MethodsWe conducted a study using baseline data from the Personalized Prevention of Colorectal Cancer Trial. 191 participants from an almost entirely White population were evaluated for BC type.ResultsFifty-seven (29.8%) were identified as neutral BC, while Blood-stasis (17.3%), Qi-deficient (13.6%), and Special diathesis (10.5%) were the pre-eminent pathologic subtypes. We also found there are substantial differences in proportions of TCM BC types in our study of white Americans conducted in US from previous studies conducted in Chinese populations. Additional analyses investigated the relationship between cardiovascular disease (CVD) risk and BC subtypes. Among them, Yang-deficiency, Yin-deficiency, and Blood stasis carried a lower risk of CVD.ConclusionsIt is important to understand the underlying mechanisms contributing to these differences, which may not only help to understand the underlying mechanism for TCM, but also help to identify novel factors or mechanisms for CVD risk, prevention and treatment.
Disentangling the spread dynamics of insect invasions using spatial networks
Authors: Estay Sergio A. , Silva Carmen P. , López Daniela N. , Labra Fabio A. 
Published: December 2022

AbstractDescribing and understanding spatiotemporal spread patterns in invasive species remains a longstanding interdisciplinary research goal. Here we show how a network-based top-down approach allows the efficient description of the ongoing invasion byDrosophila suzukiiin Chile. To do so, we apply theoretical graph methods to calculate the minimum cost arborescence graph (MCA) to reconstruct and understand the invasion dynamics ofD. suzukiisince the first detection in 2017. This method estimates a directed rooted weighted graph by minimizing the total length of the resulting graph. To describe the temporal pattern of spread, we estimate three metrics of spread: the median dispersal rate, the median coefficient of diffusion, and the median dispersal acceleration. The estimated MCA shows that over four years,D. suzukiicolonized a ~1,000 km long strip in the central valley of Chile, with an initial phase with long paths and connections and no clear direction pattern, folowed by a clearer north-east propagation pattern. The median dispersal rate for the entire period was 8.8 [7.4 – 10.6,95% CI], while the median diffusion coefficient was 19.6 meters2/day [13.6 – 27.9, 95% CI]. The observed spread dynamics and the log-normal distribution of accelerations are consistent with longdistance dispersal events. The complexities of real landscapes cannot be summarized in any model, but this study shows how an alternative top-down approach based on graph theory can facilitate the ecological analysis of the spread of an invasive species in a new territory.
Injury and a program of fetal wound healing in the fetal and neonatal extrahepatic bile duct
Authors: de Jong Iris E.M. , Hunt Mallory L. , Chen Dongning , Du Yu , Llewellyn Jessica , Gupta Kapish , Erxleben Dorothea , Rivas Felipe , Hall Adam R. , Furth Emma E. , Naji Ali , Liu Chengyang , Dhand Abhishek , Burdick Jason , Davey Marcus G. , Flake Alan W. , Porte Robert J. , Russo Pierre A. , Gaynor J. William , Wells Rebecca G. 
Published: December 2022

ABSTRACTIntroductionBiliary atresia (BA) is an obstructive cholangiopathy that initially affects the extrahepatic bile ducts (EHBDs) of neonates. The etiology is uncertain, but evidence points to a prenatal cause; however, the response of the fetal EHBD to injury remains unknown. The objective of this study was to define the fetal response to EHBD injury and to determine whether it follows a fetal wound healing paradigm.MethodsMouse, rat, sheep, and human EHBD samples were studied at different developmental time points. Models included a fetal sheep model of prenatal hypoxia, human BA EHBD remnants and liver samples taken at the time of the Kasai procedure, EHBDs isolated from neonatal rats and mice, and spheroids and other models generated from primary neonatal mouse cholangiocytes.ResultsA wide layer of high molecular weight HA encircling the lumen was characteristic of the normal perinatal but not adult EHBD. This layer, which was surrounded by collagen, expanded in injured ducts in parallel with extensive peribiliary gland (PBG) hyperplasia, increased mucus production and elevated serum bilirubin levels. BA EHBD remnants similarly showed increased HA centered around ductular structures compared with age-appropriate controls. High molecular weight HA typical of the fetal/neonatal ducts caused increased cholangiocyte spheroid growth, whereas low molecular weight HA induced abnormal epithelial morphology; low molecular weight HA caused matrix swelling in a bile duct-on-a-chip device.ConclusionThe fetal/neonatal EHBD, including in human EHBD remnants from Kasai surgeries, demonstrated an injury response with high levels of HA typical of the regenerative, scarless program termed fetal wound healing. Although generally beneficial, the expanded peri-luminal HA layer may swell and lead to elevated bilirubin levels and obstruction of the EHBD.
Open-3DSIM: an Open-source three-dimensional structured illumination microscopy reconstruction platform
Authors: Cao Ruijie , Li Yaning , Chen Xin , Ge Xichuan , Li Meiqi , Guan Meiling , Hou Yiwei , Fu Yunzhe , Jiang Shan , Gao Baoxiang , Xi Peng 
Published: December 2022

AbstractWith optical section and defocus removal effect, three-dimensional structured illumination microscopy (3DSIM) can get a whole sight of intracellular organelle. Here, Open-3DSIM is reported as an open-source reconstruction platform with double improvement on lateral and axial resolution. MATLAB code, ImageJ version and Exe application are provided for biologists and engineers to maximize its user-friendliness and prompt its further development. Through adaptive parameter estimation and spectrum filter optimization, we demonstrate its superior performance of artifact suppression and defocus elimination over other algorithms on various specimens, under gradient signal-to-noise levels. Moreover, with the capacity to extract the dipole orientation, Open-3DSIM paves a new avenue for interpreting the subcellular structures in six dimensions (xyzθλt).
A non-conserved histidine residue on KRAS drives paralog selectivity of the KRAS G12D inhibitor MRTX1133
Authors: Keats Miles A. , Han John J. W. , Lee Yeon-Hwa , Lee Chih-Shia , Luo Ji 
Published: December 2022

AbstractThe discovery of small molecule inhibitors against mutant KRAS protein was a recent breakthrough in targeted therapy. Understanding the mechanism of selectivity by KRAS inhibitors and the mechanism of resistance to them can guide the future development of KRAS inhibitors. MRTX1133 was the first non-covalent inhibitor against the KRAS G12D mutant that demonstrated specificity and potency in pre-clinical tumor models. We used isogenic cell lines expressing a single RAS allele to evaluate the selectivity of this compound. We found that in addition to KRAS G12D, MRTX1133 shows significant activity against several other KRAS mutants as well as wildtype KRAS protein. In contrast, MRTX1133 exhibits no activity against both G12D and wildtype forms of HRAS and NRAS proteins. Functional analysis revealed that the selectivity of MRTX1133 towards KRAS is associated with its binding to histidine 95 on KRAS, a residue that is not conserved in HRAS and NRAS. Reciprocal mutation of amino acid 95 among the three RAS paralogs resulted in reciprocal change in their sensitivity towards MRTX1133. Thus, histidine 95 is an essential selectivity handle for MRTX1133 towards KRAS. This knowledge could aid the development of future KRAS-selective inhibitors.
Research and Diagnostic Algorithmic Rules (RADAR) and RADAR plots for the first episode of major depressive disorder: effects of childhood and recent adverse experiences on suicidal behaviors, neurocognition and phenome features
Authors: Maes Michael , Almulla Abbas F 
Published: December 2022

AbstractThis study was performed to ascertain whether a) a valid precision model and valid Research and Diagnostic Algorithmic Rules (RADAR) scores can be computed in patients experiencing first-episode depression; and b) adverse childhood experiences (ACEs) and negative life events (NLEs) are associated with suicidal behavior (SBs), cognitive impairment, and phenome RADAR scores.This study recruited 90 patients with major depressive disorder (MDD) in an acute phase, of whom 71 showed a first-episode MDD (FEM), and 40 controls. We constructed RADAR scores for ACEs, NLEs encountered the last year, SBs and severity of depression, anxiety, chronic fatigue and physiosomatic symptoms using the Hamilton Depression and Anxiety Rating scales and the Fibro-Fatigue scale.Partial least squares analysis showed that in FEM, one latent vector (labelled the phenome of FEM) could be extracted from depressive, anxiety, fatigue, physiosomatic, melancholia, and insomnia symptoms, SBs, and cognitive impairments. The latter were conceptualized as a latent vector extracted from the Verbal Fluency Test, Mini Mental State Examination, and ratings of memory and judgment, indicating a generalized cognitive decline (G-CoDe). We found that 60.8% of the variance in the FEM phenome was explained by the cumulative effects of NLEs and ACEs, in particular emotional neglect and, to a lesser extent, physical abuse, and by the interaction between ACEs and physical abuse, whereby the latter attenuates the effects of NLEs.In conclusion, not the binary diagnosis of MDD (DSM/ICD) should be used in research and clinical settings but the RADAR scores and plots constructed here.