bluuebunny/crossref_metadata_2025_split huggingface dataset:
γ-H2AX and phospho-ATM enzyme-linked immunosorbent assays as biodosimetry methods for radiation exposure assessment: a pilot study
Authors: Ramadhani Dwi , Tetriana Devita , Purnami Sofiati , Suvifan Viria Agesti , Kurnia Hasan Basri Iin , Kisnanto Teja , Oktariyani Tiara Andalya , Syafira Dira , Yunus Muhamad Yasin , Miura Tomisato , Syaifudin Mukh , Widowati Retno 
Published: September 2023

Abstract
In the event of a radiological incident, a fast and accurate biological dosimetry (biodosimetry) method for evaluating people who have been potentially exposed to ionising radiation is crucial. Among the many biodosimetry methods available, the immunodetection of phosphorylated H2AX (γ-H2AX) stands as a promising method to be used in the triage of patients exposed to radiation. Currently, the most common way to measure γ-H2AX levels is through fluorescence microscopy. In this pilot study, we assessed the feasibility of using an enzyme-linked immunosorbent assay (ELISA) for quantifying γ-H2AX for biodosimetry purposes. Moreover, the usefulness of measuring phosphorylated ATM (pATM) levels through ELISA for biodosimetry was also evaluated. Blood samples were obtained from three male donors (38 y) and were irradiated with 60Co (0, 1, 2 and 6 Gy). Peripheral blood mononuclear cells (PBMCs) were isolated and lysed before measuring γ-H2AX, total H2AX protein and pATM using ELISA kits. The dicentric chromosome assay (DCA) using whole blood was also performed for comparison. Data from all donors at each dose were pooled before statistical analysis. The ratio of γ-H2AX/total H2AX and pATM levels increased in a radiation-dose-dependent manner. The average γ-H2AX/total H2AX ratios were 0.816 ± 0.219, 0.830 ± 0.685, 1.276 ± 1.151 and 1.606 ± 1.098, whereas the average levels of pATM were 59.359 ± 3.740, 63.366 ± 0.840, 66.273 ± 2.603 and 69.936 ± 4.439, in PBMCs exposed to 0, 1, 2 and 6 Gy, respectively. The linear-quadratic dose–response calibration curve for DCA was Y = 0.0017 (±0.0010) + 0.0251 (±0.0142) × D + 0.0342 (±0.0039) × D2 $\boldsymbol{Y}=\mathbf{0.0017}\left(\pm \mathbf{0.0010}\right)+\mathbf{0.0208}\left(\pm \mathbf{0.0218}\right)\times \boldsymbol{D}+\mathbf{0.0350}\left(\pm \mathbf{0.0050}\right)\times{\boldsymbol{D}}^{\mathbf{2}}$. Overall, despite a large variability in the ratio of γ-H2AX/total H2AX among donors, the present study revealed the suitability of using the ratio of γ-H2AX/total H2AX and pATM for biodosimetry. Still, more research with a larger group of subjects is necessary to construct a reliable calibration curve for the ratio of γ-H2AX/total H2AX and pATM levels for biodosimetry.
A large brush-footed trapdoor spider (Mygalomorphae: Barychelidae) from the Miocene of Australia
Authors: McCurry Matthew R , Frese Michael , Raven Robert 
Published: September 2023

Abstract
The aridification of the Australian continent led to the diversification of mygalomorph spiders in the Miocene, but a depauperate fossil record has made it difficult to investigate evolution across this epoch. Here, we describe the first fossil barychelid spider (Araneae: Barychelidae) in the world and the second fossil mygalomorph spider from Australia. It is placed as a new genus and species (Megamonodontium mccluskyi gen. et sp. nov.). Megamonodontium resembles Monodontium Kulczyński, 1908, a genus that persists in rainforests through Singapore, Indonesia and Papua New Guinea. The new specimen is the second largest spider fossil in the world and is approximately five times larger than extant Monodontium. The fossil shows that this lineage once occupied mesic rainforest habitats in Australia but has since been replaced by other spiders.
Psychological Treatment Targeting Acceptance and Compassion in Chronic Pain Patients
Authors: Buhrman Monica , Tillfors Maria , Holländare Fredrik , Lekström Emily , Håkansson Alexander , Boersma Katja 
Published: September 2023

Objectives:
Chronic pain is often associated with lower function. Self-criticism is associated with depressive symptoms. The purpose of this study was to explore if fusing acceptance and commitment therapy (ACT) and compassion focused therapy (CFT), could improve psychological wellbeing and disability in chronic pain patients with high levels of self-criticism in comparison to a wait-list control group.

Methods:
Individuals with chronic pain (n=71) were randomly assigned to an 8-week internet-based intervention focused on acceptance and compassion or a wait-list condition. Primary treatment outcomes were Chronic Pain Acceptance Questionnaire, Self-Compassion Scale, and Pain Disability Index. Secondary outcomes were Montgomery Åsberg Depression Rating Scale, Anxiety Sensitivity Index, Quality of Life Inventory, Multidimensional Pain Inventory and Perseverative Thinking Questionnaire.

Results:
Missing data at post-intervention was 22.5%. Intention to treat (ITT) analyses were conducted using linear mixed-models. Results revealed greater levels of acceptance and self-compassion for the treatment group, which were primary outcomes, with effect sizes ranging from small to large and these results were maintained at six-month follow-up. Rates of clinically significant improvements were also greater for the treatment group in comparison to the wait-list control group on acceptance and compassion. The treatment group also improved in the third primary outcome, pain disability. Significant differences were found in several of the secondary outcomes, in favour for the treatment group.

Discussion:
Internet-based ACT with CFT components shows promise as a viable treatment option in the management of chronic pain.
An Exploration of Physical Therapy Outcomes and Psychometric Properties of the Patient-Specific Functional Scale Following an Interdisciplinary Pain Management Program
Authors: Gagnon Christine M. , Yuen Maya , Palmer Kelsey 
Published: September 2023

Objectives:
The Patient-Specific Functional Scale (PSFS) has been used to assess physical functioning in various chronic pain populations. There is a lack evidence for its use with diverse pain populations who have high impact chronic pain (HICP). The primary aim of this study was to assess the psychometric properties of the PSFS with a heterogeneous sample of patients with HICP

Methods:
A retrospective observational study of prospective functional outcomes collected before and after participation an intensive pain management program (IPMP): (PSFS, Disabilities of the Arm, Shoulder, and Hand; Lower Extremity Functional Scale; Neck Disability Index; Oswestry Disability Index), Multidimensional Patient Impression of Change, pain intensity, pain limitation, and fear avoidance from the charts of 509 IPMP completers. The reliability, validity, and responsiveness of the PSFS were analyzed using Cronbach’s alpha, Pearson correlations, and receiver operating characteristic.

Results:
Significant improvements were found for all outcomes following program participation (all p’s <0.0001). Correlations of the PSFS with similar outcomes (convergent validity) were lower than expected (r’s 0.16 - 0.33). A low correlation (r=-0.12) with an unrelated measure, fear-avoidance, supported divergent validity. PSFS change score correlations with similar outcome measures ranged from 0.46 to 0.53. The area under the curve values for the PSFS ranged from 0.801 to 0.857 suggesting a moderate ability for the PSFS to detect improvement.

Discussion:
The psychometric properties of the PSFS showed mixed support for construct validity but good support for the responsiveness of the PSFS when used with a heterogeneous sample of patients with HICP.
The Effect of Genetic HLA Matching on Liver Transplantation Outcome: A Systematic Review and Meta-Analysis
Authors: Kok Gautam , Ilcken Eveline F. , Houwen Roderick H.J. , Lindemans Caroline A. , Nieuwenhuis Edward E.S. , Spierings Eric , Fuchs Sabine A. 
Published: September 2023

Objective:
We aim to investigate the effects of genetically based HLA matching on patient and graft survival, and acute and chronic rejection after liver transplantation

Background:
Liver transplantation is a common treatment for patients with end-stage liver disease. In contrast to most other solid organ transplantations, there is no conclusive evidence supporting human leukocyte antigen (HLA) matching for liver transplantations. With emerging alternatives such as transplantation of bankable (stem) cells, HLA matching becomes feasible, which may decrease the need for immunosuppressive therapy and improve transplantation outcomes.

Methods:
We systematically searched the PubMed, Embase, and Cochrane databases and performed a meta-analysis investigating the effect of genetic HLA matching on liver transplantation outcomes (acute/chronic rejection, graft failure, and mortality).

Results:
We included 14 studies with 2682 patients. HLA-C mismatching significantly increased the risk of acute rejection (full mismatching: risk ratio = 1.90, 95% confidence interval = 1.08 to 3.33, P = 0.03; partial mismatching: risk ratio = 1.33, 95% confidence interval = 1.07 to 1.66, P = 0.01). We did not discern any significant effect of HLA mismatching per locus on acute rejection for HLA-A, -B, -DR, and -DQ, nor on chronic rejection, graft failure, or mortality for HLA-DR, and -DQ.

Conclusions:
We found evidence that genetic HLA-C matching reduces the risk of acute rejection after liver transplantation while matching for other loci does not reduce the risk of acute rejection, chronic rejection, graft failure, or mortality.
The Efficacy and Cost-Effectiveness of a Simulation-Based Primary Care Procedural Skills Training Program for Advanced Practice Providers
Authors: Clemens Lisa 
Published: September 2023

Introduction:
The purpose of this program evaluation was to investigate the efficacy of simulation-based primary care procedural skills training to increase participant confidence, knowledge, and skill in performing the procedures included in the training and to evaluate the cost-effectiveness of the training.

Methods:
A retrospective, within-subjects analysis of the change in perceived confidence, skill, and knowledge in procedure performance after the simulation-based primary care procedural skills training program measured by pretraining and post-training Likert scale surveys and change in clinical procedure performance frequency for abscess incision and drainage and laceration repair up to 6 months before and 6 months after the training in the outpatient setting was performed.

Results:
Participants self-reported higher median confidence, perceived skill, and perceived knowledge of all procedures included in the training course, with statistically significant increases for all procedures. A mean increase in laceration repairs in the clinical setting of 10% after training was found. Higher median performance of abscess incision and drainage after training (median = 20.00%, n = 25) compared with before training (median = 0.00%, n = 25) and a mean increase in performance of abscess incision and drainage in the clinical setting of 6% after training was found, but increases were not statistically significant.

Discussion:
Participation in a 2-day simulation-based primary care procedural skills training program was an effective method to increase confidence, perceived skill, and knowledge of outpatient procedures among practicing providers. Further evaluation to establish return on investment is needed, because statistically significant increases in clinical procedure performance were unable to be demonstrated.
Accelerating HIV vaccine development through meaningful engagement of local scientists and communities
Authors: Chinyenze Kundai , Nduati Eunice , Muturi-Kioi Vincent 
Published: September 2023

Purpose of review
There is a need to conduct multiple experimental medicine trials in regions with significant burden of disease to ensure the global relevance of vaccines under development including the African context.

Recent findings
African scientists can support accelerated HIV vaccine development by leading EMVTs in the region in a complementary fashion to global efforts and augment evidence generated to optimize and advance relevant vaccines towards licensure. The ADVANCE program enables EMVTs, where local scientists lead trial implementation and immunogenicity endpoint analysis of promising vaccine approaches. Concerted efforts towards scientific collaboration, enhancing specific clinical and lab capacity, and improving ethical and regulatory systems to review EMVTs in Africa will be catalytic. Appropriate engagement of local communities and stakeholders will be equally important, and the field needs to refine existing research literacy approaches to effectively partner with communities around current complex scientific approaches. Review of inclusion of relevant populations in early research is also needed.

Summary
African scientists and communities can help accelerate HIV vaccine development through stronger global collaboration. Now is the time for bold investments to enable the conduct of innovative EMVTs in Africa where the eventual vaccines will have the greatest impact.
Assessing Guidelines on the Need for Colonoscopy after Initial Flexible Sigmoidoscopy in Young Patients with Outlet-Type Rectal Bleeding
Authors: Bagshaw Philip F. , Tuck Anita , Aramowicz Jaana , Cox Brian , Frizelle Francis Antony , Church James M. 
Published: September 2023

BACKGROUND:
While young age of onset colorectal cancer is increasing in incidence lack of screening leads to symptomatic presentation, often with rectal bleeding. Because most cancers in patients under 50 are left-sided, flexible sigmoidoscopy is a reasonable way of investigating bleeding in these patients.

OBJECTIVE:
To predict which patients undergoing flexible sigmoidoscopy for outlet rectal bleeding need a full colonoscopy.

DESIGN:
Findings at colonoscopy were compared with published indications for colonoscopy after flexible sigmoidoscopy. These were: (1) Any number of advanced adenomas defined as a tubular adenoma >9 mm, a tubulovillous or villous adenoma of any size, or any adenoma with high grade dysplasia. (2) Three or more tubular adenomas of any size or histology. (3) Any sessile serrated lesion. (4) Twenty or more hyperplastic polyps.

SETTING:
Charity Hospital with volunteer specialists.

PATIENTS:
Under age 57, outlet type rectal bleeding, undergoing flexible sigmoidoscopy at least to the descending colon, followed by colonoscopy with biopsy of all resected lesions.

INTERVENTIONS:
Flexible sigmoidoscopy and colonoscopy with excision of all removable lesions.

MAIN OUTCOME MEASURES:
Findings at colonoscopy.

RESULTS:
66 cases who had a colonoscopy between 5 and 811 days after sigmoidoscopy, who also had complete data. Forty-three male and 23 female with mean age of 39.5 years. Analysis of flexible sigmoidoscopy criteria for finding proximal high-risk lesions on colonoscopy showed a sensitivity of 76.9%, a specificity of 67.9%, a positive predictive value of 37%, a negative predictive value of 92.3%, and an accuracy of 69.7%.

LIMITATIONS:
Large number of exclusions for inadequate colonoscopy or inadequate data causing reduced patient number in the study.

CONCLUSION:
Our criteria for follow-up colonoscopy based on the findings at initial flexible sigmoidoscopy in young patients with outlet rectal bleeding are reliable enough to be used in routine clinical practice, provided this is audited.
Tranexamic Acid Prevention of Hemorrhagic Complications Following Interpolated Flap Repair: A Single-Center, Retrospective, Cohort Study
Authors: Freeman S. Caleb , Heath Michael S. , Neill Brett , Morris Caroline , Lucero Olivia M. , Yu Wesley , Bar Anna , Leitenberger Justin J. 
Published: September 2023

BACKGROUND
Tranexamic acid (TXA) is increasingly being used to prevent hemorrhagic complications after dermatologic surgery. Interpolated flap repairs following Mohs micrographic surgery are at risk for increased bleeding events and unplanned health care utilization, particularly among patients on antithrombotic medication.

OBJECTIVE
To assess bleeding events after interpolated flap repair in patients receiving TXA compared with those who did not.

MATERIALS AND METHODS
A retrospective review identified interpolated flap repairs in a 5-year period. Hemorrhagic complications were analyzed, defined as major bleeding events, which included all unplanned medical visits, and minor bleeding events, which included any unplanned patient phone calls or messages through electronic medical record.

RESULTS
One hundred fifteen patients had interpolated flap repair during the 5-year period, of which 21 (18.3%) received TXA postprocedure. Twenty-seven bleeding events were identified in the non-TXA group compared with 1 event in the TXA-treated group. Patients who received TXA were less likely to have had a bleeding event (28.7% vs 4.8%, p < .01).

CONCLUSION
Patients undergoing interpolation flap repair were less likely to experience a bleeding event after subcutaneous injection of TXA.
Clinical standardization for the detection of hemispheric dominance for steady-state auditory evoked fields in normal hearing
Authors: Wang Mao-Che , Chi Tai-Shih , Shiao An-Suey , Li Lieber Po-Hung , Hsieh Jen-Chuen 
Published: September 2023

Background:
Steady-state auditory evoked responses (SSAERs) are promising indicators of major auditory function. The improvement in accessibility in the clinical setting depends on the standardization and definition of the characteristics of SSAERs. There have been some insights into the changes in the interhemispheric dominance of SSAERs in some clinical entities. However, the hemispheric asymmetry of SSAERs in healthy controls remains inconclusive.

Methods:
Twelve right-handed healthy volunteers with normal hearing were recruited. Steady-state auditory evoked fields (SSAEFs) were measured binaurally using magnetoencephalography (MEG) under pure-tone auditory stimuli at 1000 Hz with an amplitude modulation frequency of 43 Hz. The laterality index, based on the ratio of SSAEF strength over the right hemisphere to that over the left hemisphere, was also analyzed.

Results:
The SSAEFs source was localized bilaterally on the superior temporal plane, with an orientation centripetal to the auditory cortex. The laterality index ranged from 1.1 to 2.3, and there were no sex differences. In all subjects, the strength of the SSAEFs was significantly weaker in the left hemisphere than in the right hemisphere (p = 0.014).

Conclusion:
Right-sided dominance of the SSAEFs was verified in subjects with normal hearing. Acoustic sources clinically available in audiometric tests were used as stimuli. Such a simplification of parameters would be helpful for the standardization of precise production and the definition of the characteristics of SSAERs. Because MEG is still not easily accessible clinically, further studies using electroencephalography with larger sample sizes are necessary to address these issues.
Surgical stabilization of rib fractures is associated with better return on investment for a health care institution than nonoperative management
Authors: Bauman Zachary M. , Khan Hason , Cavlovic Lindsey , Raposo-Hadley Ashley , Todd Sydney J. , King Tylor , Cahoy Kevin , Kamien Andrew , Cemaj Samuel , Sheppard Olabisi , Matos Miguel , Berning Bennett , Evans Charity H. , Cantrell Emily 
Published: September 2023

BACKGROUND
Surgical stabilization of rib fractures (SSRFs) continues to gain popularity due to patient benefits. However, little has been produced regarding the economic benefits of SSRF and its impact on hospital metrics such as Vizient. The aim of this study was to explore these benefits hypothesizing SSRF will demonstrate positive return on investment (ROI) for a health care institution.

METHODS
This is a retrospective review of all rib fracture patients over 5 years at our Level I trauma center. Patients were grouped into SSRF versus nonoperative management. Basic demographics were obtained including case mix index (CMI). Outcomes included narcotic requirements in morphine milliequivalents prior to discharge, mortality, and discharge disposition. Furthermore, actual hospital length of stay (ALOS) versus Vizient expected length of stay were compared between cohorts. Contribution margin (CM) was also calculated. Independent t-test, paired t-test, and linear regression analysis were performed, and significance set at p < 0.05.

RESULTS
A total of 1,639 patients were included; 230 (14%) underwent SSRF. Age, gender, and Injury Severity Score were similar. Surgical stabilization of rib fracture patients had more ribs fractured (7 vs. 4; p < 0.001) and more patients with flail chest (43.5% vs. 6.7%; p < 0.001). Surgical stabilization of rib fracture patients also had a significantly higher CMI (4.33 vs. 2.78; p = 0.001). Narcotic requirements and mortality were less in the SSRF cohort; 155 versus 246 morphine milliequivalents (p < 0.001) and 1.7% versus 7.1% (p = 0.003), respectively. Surgical stabilization of rib fracture patients were more likely to be discharged home (70.4% vs. 63.7%; p = 0.006). Surgical stabilization of rib fracture patients demonstrated shorter ALOS where nonoperative management patients demonstrated longer ALOS compared with Vizient expected length of stay. Contribution margins for SSRF patients were significantly higher and linear regression analysis showed a CM $1,128.14 higher per patient undergoing SSRF (p < 0.001).

CONCLUSION
Patients undergoing SSRF demonstrate a significant ROI for a health care organization. Despite SSRF patients having a higher CMI, they were able to be discharged sooner than expected by Vizient calculations resulting in better a CM.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level IV.
Large-scale computational modelling of the M1 and M2 synovial macrophages in Rheumatoid Arthritis
Authors: Zerrouk Naouel , Alcraft Rachel , Hall Benjamin A. , Augé Franck , Niarakis Anna 
Published: September 2023

AbstractMacrophages play an essential role in rheumatoid arthritis (RA). Depending on their phenotype (M1 or M2), they can play a role in the initiation or resolution of inflammation. The M1/M2 ratio in RA is higher than in healthy controls. Despite this, no treatment targeting specifically macrophages is currently used in clinics. Thus, devising strategies to selectively deplete proinflammatory macrophages and promote anti-inflammatory macrophages could be a promising therapeutic approach in RA.State-of-the-art molecular interaction maps of M1 and M2 macrophages in rheumatoid arthritis are available and represent a dense source of knowledge; however, these maps remain limited by their static nature. Discrete dynamic modelling can be employed to study the emergent behaviours of these systems. Nevertheless, handling such large-scale models is challenging. Due to their massive size, it is computationally demanding to identify biologically relevant states in a cell- and disease-specific context.In this work, we developed an efficient computational framework that converts molecular interaction maps into Boolean models using the CaSQ tool. Next, we use a newly developed BMA tool version deployed to a high-performance computing cluster to identify the models’ steady states. The identified attractors are then validated using gene expression datasets and prior knowledge. We successfully applied our framework to generate and calibrate the first RA M1 and M2 macrophage Boolean models. Using single and double knockout simulations, we identified NFkB, JAK1/JAK2, and ERK1/Notch1 as potential targets that could selectively suppress proinflammatory macrophages, and GSK3B as a promising target that could promote anti-inflammatory macrophages in RA.