bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploiting a heterologous construction of the 3-hydroxypropionic acid carbon fixation pathway with mesaconate as an indicator in Saccharomyces cerevisiae
Authors: Xu Shijie , Qiao Weibo , Wang Zuanwen , Fu Xiaoying , Liu Zihe , Shi Shuobo 
Published: May 2023

AbstractThe 3-Hydroxypropionic acid (3-HP) pathway is one of the six known natural carbon fixation pathways, in which the carbon species used is bicarbonate. It has been considered to be the most suitable pathway for aerobic CO2 fixation among the six natural carbon fixation pathways. Mesaconate is a high value-added derivative in the 3-HP pathway and can be used as a co-monomer to produce fire-retardant materials and hydrogels. In this study, we use mesaconate as a reporting compound to evaluate the construction and optimization of the sub-part of the 3-HP pathway in Saccharomyces cerevisiae. Combined with fine-tuning of the malonyl-CoA reductase (MCR-C and MCR-N) expression level and optimization of 3-Hydroxypropionyl-CoA synthase, the 3-HP sub-pathway was optimized using glucose or ethanol as the substrate, with the productions of mesaconate reaching 90.78 and 61.2 mg/L, respectively.
Graphical Abstract
A case report of sigmoid colon cancer with the inferior mesenteric artery directly originating from the superior mesenteric artery
Authors: Mizoguchi Kiyotaka , Nagayoshi Kinuko , Mizuuchi Yusuke , Tamura Koji , Sada Masafumi , Nakata Kohei , Ouchida Kenoki , Nakamura Masafumi 
Published: May 2023

Abstract
Background
There are few reports describing the unusual origin of the inferior mesenteric artery (IMA). We report a rare case of advanced sigmoid colon cancer with the IMA arising from the superior mesenteric artery.

Case presentation
A 59-year-old man with diarrhea and abdominal distention was diagnosed with advanced sigmoid colon cancer. Colonoscopy revealed a semi-circumferential cancer lesion in the sigmoid colon. Enhanced CT scan and CT angiography showed that the IMA directly originated from the superior mesenteric artery at the level of the second lumbar vertebra. PET-CT suggested metastases in the para-intestinal lymph nodes and the liver, but not in the central lymph nodes along the IMA. Preoperative diagnosis was sigmoid colon cancer cT4aN2aM1a cStage IVA(UICC, 8th edition). We performed laparoscopic complete resection as the radical treatment of the primary region prior to resection of the liver metastases. Intraoperative findings showed that the IMA was running parallel to the abdominal aorta; meanwhile, the colonic autonomic nerve was supplied from the lumbar splanchnic nerve at the caudal side of the duodenum. Central lymph nodes around the colonic autonomic nerve were dissected en bloc with the regional lymph nodes. Pathological radical resection including the regional lymph nodes metastasis was achieved. Two months later, complete resection of the liver metastasis was performed. After the adjuvant chemotherapy, no recurrence was observed 1.5 years after the liver resection was performed.

Conclusions
Preoperative confirmation of the anatomy helped us to safely complete radical surgery in a patient with unusual bifurcation of the IMA.
A mixed-method feasibility study of the use of the Complete Vocal Technique (CVT), a pedagogic method to improve the voice and vocal function in singers and actors, in the treatment of patients with muscle tension dysphonia: a study protocol
Authors: McGlashan Julian , Aaen Mathias , White Anna , Sadolin Cathrine 
Published: May 2023

Abstract
Background
Muscle tension dysphonia (MTD) results from inefficient or ineffective voice production and is the cause of voice and throat complaints in up to 40% of patients presenting with hoarseness. Standard treatment is voice therapy (SLT-VT) delivered by specialist speech therapists in voice disorders (SLT-V). The Complete Vocal Technique (CVT) is a structured, pedagogic method which helps healthy singers and other performers optimise their vocal function enabling them to produce any sound required. The aim of this feasibility study is to investigate whether CVT administered by a trained, non-clinical CVT practitioner (CVT-P) can be applied to patients with MTD before progressing to a pilot randomised control study of CVT voice therapy (CVT-VT) versus SLT-VT.

Methods/design
In this feasibility study, we use a mixed-method, single-arm, prospective cohort design. The primary aim is to demonstrate whether CVT-VT can improve the voice and vocal function in patients with MTD in a pilot study using multidimensional assessment methods. Secondary aims are to assess whether (1) a CVT-VT study is feasible to perform; (2) is acceptable to patients, the CVT-P and SLT-VTs; and (3) whether CVT-VT differs from existing SLT-VT techniques. A minimum of 10 consecutive patients with a clinical diagnosis of primary MTD (types I–III) will be recruited over a 6-month period. Up to 6 video sessions of CVT-VT will be delivered by a CVT-P using a video link. The primary outcome will be a change in pre-/post-therapy scores of a self-reported patient questionnaire (Voice Handicap Index (VHI)). Secondary outcomes include changes in throat symptoms (Vocal Tract Discomfort Scale), acoustic/electroglottographic and auditory-perceptual measures of voice. Acceptability of the CVT-VT will be assessed prospectively, concurrently and retrospectively both quantitatively and qualitatively. Differences from SLT-VT will be assessed by performing a deductive thematic analysis of CVT-P transcripts of therapy sessions.

Conclusion
This feasibility study will provide important data to support whether to proceed with a randomised controlled pilot study focusing on the effectiveness of the intervention compared to standard SLT-VT. Progression criteria will be based on demonstrating a positive outcome in treatment, successful delivery of the pilot study protocol, acceptability to all stakeholders and satisfactory recruitment rates.

Trial registration
ClinicalTrials.gov website (NCT05365126 Unique Protocol ID: 19ET004). Registered on 06 May 2022.
Malposition of a pulmonary artery catheter in the left ventricle: a case report
Authors: Nakanishi Toshiyuki , Kato Shohei , Tamura Tetsuya , Kako Eisuke , Sobue Kazuya 
Published: May 2023

Abstract
Background
Placement of pulmonary artery catheters may be associated with a variety of complications. We present a case where a pulmonary artery catheter was accidentally advanced into the left ventricle by perforating the intraventricular septum.

Case presentation
A 73-year-old woman underwent mitral valve dysfunction. A pulmonary artery catheter could not pass the tricuspid valve under general anesthesia, which was manually advanced via the right ventricle during surgery. After valve replacement, systolic pulmonary artery pressure was higher than radial arterial blood pressure. Transesophageal echocardiography (TEE) revealed the tip of the catheter in the left ventricle. The catheter was withdrawn and then advanced to the pulmonary artery under monitoring of TEE. Transseptal shunt flow gradually decreased and finally disappeared. The surgery was completed without additional procedures.

Conclusions
Although ventricular septal perforation is rare, it should be recognized as a potential complication of pulmonary artery catheter insertion.
Framing the fallibility of Computer-Aided Detection aids cancer detection
Authors: Kunar Melina A. , Watson Derrick G. 
Published: May 2023

AbstractComputer-Aided Detection (CAD) has been proposed to help operators search for cancers in mammograms. Previous studies have found that although accurate CAD leads to an improvement in cancer detection, inaccurate CAD leads to an increase in both missed cancers and false alarms. This is known as the over-reliance effect. We investigated whether providing framing statements of CAD fallibility could keep the benefits of CAD while reducing over-reliance. In Experiment 1, participants were told about the benefits or costs of CAD, prior to the experiment. Experiment 2 was similar, except that participants were given a stronger warning and instruction set in relation to the costs of CAD. The results showed that although there was no effect of framing in Experiment 1, a stronger message in Experiment 2 led to a reduction in the over-reliance effect. A similar result was found in Experiment 3 where the target had a lower prevalence. The results show that although the presence of CAD can result in over-reliance on the technology, these effects can be mitigated by framing and instruction sets in relation to CAD fallibility.
Predictors of severe lupus flare: a prospective follow-up study
Authors: Fatemi Alimohammad , Keivani-Boroujeni Elaheh , Smiley Abbas 
Published: May 2023

Abstract
Background
Flare-up of systemic lupus erythematosus (SLE) is a common characteristic that could have deleterious effects on patients’ outcome and survival. The aim of this study was to identify the predictors of severe lupus flare.

Methods
120 patients with SLE were enrolled and followed-up for 23 months. Demographic, clinical manifestations, laboratory parameters and disease activity were recorded at each visit. In addition, presence of severe lupus flare at each visit was evaluated by using the Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLE disease activity index (SLEDAI) flare composite index. Predictors of severe lupus flare were obtained by backward logistic regression analyses. Predictors of SLEDAI were obtained by backward linear regression analyses.

Results
During the follow-up period, 47 patients had at least one episode of severe lupus flare. Mean (SD) age of patients with severe flare versus no flare was 31.7 (7.89) and 38.3 (8.24) years, respectively (P = 0.001). Ten (62.5%) out of 16 males and 37 (35.5%) out of 104 females had severe flare (P = 0.04). History of lupus nephritis (LN) was recorded in 76.5% and 44% of patients with severe flare and no severe flare, respectively (P = 0.001). Thirty-five (29.2%) patients with high anti-double-stranded DNA (anti-ds-DNA antibody) and 12 (10%) with negative anti-ds-DNA antibody had severe lupus flare (P = 0.02). By multivariable logistic regression analysis, younger age (OR = 0.87, 95% CI 0.80–0.94, P = 0.0001), history of LN (OR = 4.66, 95% CI 1.55–14.002, P = 0.006) and high SLEDAI at the first visit (OR = 1.19, 95% CI 1.026–1.38) were the main predictors of flare. When severe lupus flare after the first visit was used as the outcome variable, similar findings were observed but, SLEDAI, although left among the final predictors in the model, was not significant. SLEDAIs in future visits were mainly predicted by Anti-ds-DNA antibody, 24-h urine protein and arthritis at the first visit.

Conclusion
SLE patients with younger age, history of previous LN or high baseline SLEDAI, may need closer monitoring and follow up.
“Dancing spree” in breast: a rare case presentation
Authors: Garg Mehak , Padmanabhan Veenashankari , Ingole Sanjivanee , Gnanavel Harini , Dev Bhawna 
Published: May 2023

Abstract
Background
Filariasis is a tropical vector-borne disease seen predominantly in endemic areas, and the most common presentation is a lymphatic disorder in the form of lymphangiectasia. This case describes the breast as one of the uncommon sites of involvement by the filarial worm.

Case presentation
We report an uncommon case of breast filariasis with chief complaints of a nodular lump in the breast.

Conclusions
As symptoms of breast filariasis can mimic breast malignancy, appropriate diagnosis using real-time ultrasound plays a crucial role to reduce psychological stress on the patient and also helps in planning treatment.
Chloride ion erosion of pre-stressed concrete bridges in cold regions
Authors: Cui Hongtao , Zhuo Yi , Ke Dongyuan , Li Zhonglong , Li Shunlong 
Published: May 2023

AbstractThe erosion of chloride ions in concrete bridges will accelerate the corrosion of reinforcement, which is an important reason for the decline of bridge durability. The erosion process of chloride ion, especially deicing salt solution in cold regions, is complex and has many influencing factors. It is very important to use accurate and effective methods to analyze the chloride ion erosion process in concrete. In this study, the pre-stressed concrete bridge retired in the cold region was taken as the research object, and the specimens from the whole bridge are obtained by the method of core drilling sampling. The concentration of chloride ion was measured at different depths of the specimens. The process of chloride ion erosion was simulated in two-dimensional space through COMSOL multi-physical field simulation, and compared with the measured results. The simulation method proposed in this paper has good reliability and accuracy.
Hearing rehabilitation in patients with congenital aural atresia: an observational study in a tertiary center
Authors: Lim Rachel , Abdullah Asma , Wan Hashim Wan Fazlina , Goh Bee See 
Published: May 2023

Abstract

Background

Congenital aural atresia (CAA) and stenosis is a rare defect affecting the external auditory canal which causes varying degrees of hearing impairment. This malformation may be unilateral or bilateral. Timely hearing rehabilitation in these patients is paramount to ensure appropriate speech and language development. Thus, early detection and hearing assessment with timely intervention in the form of hearing device is crucial. There is a wide range of hearing amplification devices available for these patients, catering to individual needs and preferences. This study investigated the options and choices of hearing rehabilitation among patients with CAA in our center. This study also compared the hearing gain of different types of hearing devices and patient satisfaction levels.

Methods
This was a retrospective analysis of 55 patients with congenital aural atresia or stenosis under follow-up at the Otorhinolaryngology and Audiology Clinic of a tertiary academic institution. Data on the timing of hearing loss diagnosis and intervention, type of hearing rehabilitation, hearing gain, Jahrsdoerfer score from temporal bone computed tomography, and patient satisfaction level was collected and analyzed.

Results
Fifty-five patients were recruited with ages between 3.6 months to 58 years old. The majority of patients (63.6%) had moderate hearing loss, followed by severe hearing loss (18.2%), mild hearing loss (9.1%) and profound hearing loss (7.3%). 32.7% of patients had early hearing loss diagnosed by 3 months old, while 67.3% were diagnosed after 3 months of age. Bone anchored hearing implant (BAHA Attract/Connect) gave the highest mean hearing gain of 35.23 dB (SD ± 9.75) compared to air conduction hearing aid, bone conduction hearing aid, and canalplasty. Patients implanted with BAHA Attract/Connect reported the highest average satisfaction scores of 7.74.

Conclusion
A significant proportion of patients have delayed diagnosis and intervention. Bone-anchored hearing implants provide excellent hearing improvements in patients with CAA with good patient satisfaction.
Lactobacillus plantarum A3 attenuates ulcerative colitis by modulating gut microbiota and metabolism
Authors: Qin Songkang , Wang Yingli , Yang Mengjie , Wang Pengpeng , Iqbal Mudassar , Li Jinquan , Shen Yaoqin 
Published: May 2023

AbstractAntibiotics are widely used to treat various diseases. However, growing evidence indicates that antibiotic therapy in human life increases the incidence of inflammatory bowel disease (IBD). Therefore, we need appropriate methods to reduce the incidence or symptoms of IBD. In this study, we used lincomycin hydrochloride to construct a gut microbial dysbiosis model in mice, and then, constructed an ulcerative colitis (UC) model. Meanwhile, we used Lactobacillus plantarum A3 from equine to treat UC in mice with gut microbial dysbiosis. The results showed that lincomycin hydrochloride had little effect on the small gut microbiota in mice, but had a more destructive effect on the large intestin. Lactobacillus plantarum A3 alleviated the symptoms of UC in mice, which was reflected in its significantly reduced spleen index and disease activity index (DAI) (p < 0.05), inhibited the shortening of colon and alleviated the invasion of inflammatory cells in the colon. Moreover, we found that it played a mitigatory role by inhibiting oxidative stress and regulating inflammatory cytokines in mice. At the same time, it restored the diversity and composition of the colonic microbiota and significantly increased the abundance of beneficial bacteria such as Blautia and Akkermansia (p < 0.05); Notably, it significantly increased the concentrations of arachidonoyl ethanolamide phosphate (AEA-P) and cortisone (p < 0.05) which have analgesic and anti-inflammatory effects. In conclusion, our study found that Lactobacillus plantarum A3 has the potential to regulate UC in mice with gut microbial dysbiosis.
Digital psychological self-care for problematic alcohol use: feasibility of a new clinical concept
Authors: Kraepelien Martin , Sundström Christopher , Johansson Magnus , Ivanova Ekaterina 
Published: May 2023

Background
Digital interventions based on cognitive–behavioural therapy and relapse prevention can increase treatment access for people with problematic alcohol use, but for these interventions to be cost-effective, clinician workload needs to remain low while ensuring patient adherence and effects. Digital psychological self-care is the provision of a self-guided digital intervention within a structured care process.

Aims
To investigate the feasibility and preliminary effects of digital psychological self-care for reducing alcohol consumption.

Method
Thirty-six adults with problematic alcohol use received digital psychological self-care during 8 weeks, including telephone assessments as well as filling out self-rated questionnaires, before, directly after and 3 months after the intervention. Intervention adherence, usefulness, credibility and use of clinician time were assessed, along with preliminary effects on alcohol consumption. The study was prospectively registered as a clinical trial (NCT05037630).

Results
Most participants used the intervention daily or several times a week. The digital intervention was regarded as credible and useful, and there were no reported adverse effects. Around 1 h of clinician time per participant was spent on telephone assessments. At the 3-month follow-up, preliminary within-group effects on alcohol consumption were moderate (standardised drinks per week, Hedge's g = 0.70, 95% CI = 0.19–1.21; heavy drinking days, Hedge's g = 0.60, 95% CI = 0.09–1.11), reflecting a decrease from 23 to 13 drinks per week on average.

Conclusions
Digital psychological self-care for reducing alcohol consumption appears both feasible and preliminarily effective and should be further optimised and studied in larger trials.
Survey Validation for Measuring Perceptions of Work-Related Factors That Influence Career Paths of Men and Women in Academic Anesthesiology
Authors: Hastie Maya Jalbout , Kim Minjae , Katz Daniel , Lin Meiko , Chatterji Madhabi 
Published: May 2023

BACKGROUND:
Women’s underrepresentation in positions of leadership in medicine has been attributed to environmental, structural, motivational, and situational factors. The purpose of this study was to design and validate a survey instrument based on these constructs, using a sample of men and women anesthesiologists from 3 urban academic medical centers.

METHODS:
Following institutional review board review, survey domains were defined based on a literature review. Items were developed, and content validation was performed by external experts. Anesthesiologists at 3 academic institutions were invited to complete the anonymous survey. Validation measures were performed on the collected responses, including reliability, convergent, and discriminant validity. In addition, differences between men and women respondents were evaluated.

RESULTS:
Content validation by external experts yielded 38 items with 5-point Likert scales, defining 3 constructs: environmental (14 items), structural (13 items), and motivational (11 items) factors, with single-item measures on situational factors. Content validity indices used Cohen’s Kappa coefficients, with 0.85 as the acceptance cutoff. Two hundred seventy-four anesthesiologists in 3 academic institutions received the online survey. One hundred fifteen responses were received (42% response rate), yielding 103 complete survey responses, of which 86 cases included gender. Cronbach’s α reliability estimates for the environmental, structural, and motivational scale scores were .88, .84, and .64, respectively, after scale revision. Evidence of convergent (Pearson’s r = 0.68; P < .001) and discriminant validity (Pearson’s r = 0.017; P = .84) confirmed theoretical expectations. Gender group differences showed statistically significant differences in perceptions toward environmental but not toward structural and motivational factors.

CONCLUSIONS:
The iterative design and validation processes yielded a 3-scale survey instrument with parsimonious item sets. The preliminary evidence of construct validity and reliability fills a gap in the instrumentation literature for assessing gender issues in medicine. Findings were consistent with theoretical expectations. Women are more likely than men to experience challenges in the work environment for career advancement. No differences were found between men and women on perceived resources and overall motivation factors. Investigations should continue with larger and more diverse samples and medical specialties.