bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increasing age predicts adverse pathology including intraductal carcinoma of the prostate and cribriform patterns in deferred radical prostatectomy after upfront active surveillance for Gleason grade group 1 prostate cancer: analysis of prospective observational study cohort
Authors: Tohi Yoichiro , Ishikawa Ryou , Kato Takuma , Miyakawa Jimpei , Matsumoto Ryuji , Mori Keiichiro , Mitsuzuka Koji , Inokuchi Junichi , Matsumura Masafumi , Shiga Kenichiro , Naito Hirohito , Kohjimoto Yasuo , Kawamura Norihiko , Inoue Masaharu , Akamatsu Shusuke , Terada Naoki , Miyazawa Yoshiyuki , Narita Shintaro , Haba Reiji , Sugimoto Mikio 
Published: July 2023

Abstract

Background
In men undergoing upfront active surveillance, predictors of adverse pathology in radical prostatectomy specimens, including intraductal carcinoma of the prostate and cribriform patterns, remain unknown. Therefore, we aimed to examine whether adverse pathology in radical prostatectomy specimens could be predicted using preoperative patient characteristics.

Methods
We re-reviewed available radical prostatectomy specimens from 1035 men prospectively enrolled in the PRIAS-JAPAN cohort between January 2010 and September 2020. We defined adverse pathology on radical prostatectomy specimens as Gleason grade group ≥3, pT stage ≥3, pN positivity or the presence of intraductal carcinoma of the prostate or cribriform patterns. We also examined the predictive factors associated with adverse pathology.

Results
All men analyzed had Gleason grade group 1 specimens at active surveillance enrolment. The incidence of adverse pathologies was 48.9% (with intraductal carcinoma of the prostate or cribriform patterns, 33.6%; without them, 15.3%). The addition of intraductal carcinoma of the prostate or cribriform patterns to the definition of adverse pathology increased the incidence by 10.9%. Patients showing adverse pathology with intraductal carcinoma of the prostate or cribriform patterns had lower biochemical recurrence-free survival (log-rank P = 0.0166). Increasing age at active surveillance enrolment and before radical prostatectomy was the only predictive factor for adverse pathology (odds ratio: 1.1, 95% confidence interval: 1.02–1.19, P = 0.0178; odds ratio: 1.12, 95% confidence interval: 1.02–1.22, P = 0.0126).

Conclusions
Increasing age could be a predictive factor for adverse pathology. Our findings suggest that older men could potentially derive advantages from adhering to the examination schedule in active surveillance.
Inflammatory macrophages exploited by oral streptococcus increase IL-1B release via NLRP6 inflammasome
Authors: Metcalfe Sarah , Panasiewicz Michelle , Kay Jason G 
Published: July 2023

Abstract
Chronic inflammatory periodontal disease develops in part from the infiltration of a large number of classically activated inflammatory macrophages that release inflammatory cytokines important for disease progression, including inflammasome-dependent interleukin (IL)-1β. Streptococcus gordonii is a normally commensal oral microorganism; while not causative, recent evidence indicates that commensal oral microbes are required for the full development of periodontal disease. We have recently reported that inflammatory macrophages counterintuitively allow for the increased survival of phagocytosed S. gordonii over nonactivated or alternatively activated macrophages. This survival is dependent on increased reactive oxygen species production within the phagosome of the inflammatory macrophages, and resistance by the bacterium and can result in S. gordonii damaging the phagolysosomes. Here, we show that activated macrophages infected with live S. gordonii release more IL-1β than non-activated macrophages infected with either live or dead S. gordonii, and that the survival of oral Streptococci are more dependent on macrophage activation than other Gram positive microbes, both classical pathogens and commensals. We also find that S. gordonii–dependent inflammatory macrophage inflammasome activation requires the cytoplasmic NLRP6. Overall, our results suggest S. gordonii is capable of evading immune destruction, increasing inflammatory mediators, and increasing inflammatory macrophage response, and that this ability is increased under conditions of inflammation. This work reveals additional mechanisms by which normally commensal oral streptococci-macrophage interactions can change, resulting in increased release of mature IL-1β, potentially contributing to an environment that perpetuates inflammation.
The transcription factor SPL13 mediates strigolactone suppression of shoot branching by inhibiting cytokinin synthesis in Solanum lycopersicum
Authors: Chen Shangyu , Song Xuewei , Zheng Qixiang , Liu Yuqi , Yu Jingquan , Zhou Yanhong , Xia Xiaojian 
Published: July 2023

Abstract
Plant architecture imposes a large impact on crop yield. IDEAL PLANT ARCHITECTURE 1 (IPA1), which encodes a SQUAMOSA PROMOTER BINDING PROTEIN-LIKE (SPL) transcription factor, is a target of molecular design for improving grain yield. However, the roles of SPL transcription factors in regulating tomato (Solanum lycopersicum) plant architecture are unclear. Here, we show that the expression of SPL13 is down-regulated in the lateral buds of strigolactone (SL)-deficient ccd mutants and is induced by GR24 (a synthetic analog of SL). Knockout of SPL13 by CRISPR/Cas9 resulted in higher levels of cytokinins (CKs) and transcripts of the CK synthesis gene ISOPENTENYL TRANSFERASES 1 (IPT1) in the stem nodes, and more growth of lateral buds. GR24 suppresses CK synthesis and lateral bud growth in ccd mutants, but is not effective in spl13 mutants. On the other hand, silencing of the IPT1 gene inhibited bud growth of spl13 mutants. Interestingly, SL levels in root extracts and exudates are significantly increased in spl13 mutants. Molecular studies indicated that SPL13 directly represses the transcription of IPT1 and the SL synthesis genes CAROTENOID CLEAVAGE DIOXYGENASE 7 (CCD7) and MORE AXILLARY GROWTH 1 (MAX1). The results demonstrate that SPL13 acts downstream of SL to suppress lateral bud growth by inhibiting CK synthesis in tomato. Tuning the expression of SPL13 is a potential approach for decreasing the number of lateral shoots in tomato.
Imipenem and meropenem influence the Las/Rhl quorum-sensing systems in clinical isolates of Pseudomonas aeruginosa
Authors: Deshamukhya Chandrayee , Das Bhaskar J , Paul Deepjyoti , Dhar (Chanda) Debadatta , Bhattacharjee Amitabha 
Published: July 2023

Abstract
The present study was conducted to study the influence of imipenem and meropenem at subinhibitory concentration on the transcriptional response of Las/Rhl quorum-sensing systems in isolates of Pseudomonas aeruginosa.
In the present study, six representative carbapenem nonsusceptible clinical isolates of P. aeruginosa were obtained. The agar dilution method was used to determine the minimum inhibitory concentration against imipenem and meropenem. The bacterial isolates were then cultured up to the early log phase in fresh Luria Bertani (LB) broths at 37°C with and without 2 µg mL−1 imipenem and meropenem, respectively. mRNA was then isolated from the bacterial isolates and was immediately reverse-transcribed to cDNA. The relative quantity of the expression of the lasI, lasR, rhlI, and rhlR genes was assessed by quantitative real-time Polymerase Chain Reaction (PCR) using the ΔΔCt method. The transcriptional response of the lasI and lasR genes was upregulated at subinhibitory concentration of meropenem. In contrast, the transcriptional response of the lasI, lasR, and rhlR genes was downregulated at subinhibitory concentration of imipenem as compared to the expression in untreated isolates. The data obtained in the current study showcased the ability of imipenem and meropenem to influence the response of the quorum-sensing genes at subinhibitory concentration.
Session 6: Identifying Anxiety, Depression, Trauma; Coping with Cravings
Authors: Epstein Elizabeth E. , McCrady Barbara S. 
Published: July 2023

Abstract
Session 6 provides psychoeducation on mood and anxiety symptoms and teaches skills to improve psychological health as well as to consider seeking additional help when indicated. Cognitive behavioral therapy (CBT) techniques such as cognitive restructuring, keeping a thought log, and identifying and understanding symptoms are taught and practiced in subsequent sessions. The relationship of alcohol and drugs with anxiety, depression, and other co-occurring disorders are discussed. Also, the concepts and underlying neuroscience of cravings for alcohol and drugs are discussed, and strategies for managing cravings are discussed and practiced. As in every session, abstinence plans and status are monitored and adjusted, daily drinking/craving/trigger logs are discussed, other routine interventions are delivered, and the skills learned in previous sessions are reinforced.
Session 9: Assertiveness Training and Drink/Drug refusal
Authors: Epstein Elizabeth E. , McCrady Barbara S. 
Published: July 2023

Abstract
In Session 9, , clients learn the difference between passive, passive-aggressive, aggressive, and assertive behaviors. The notion that assertive behavior promotes autonomy and well-being of women is discussed. Skills to practice assertive communication and communication in general are covered. Drink refusal as a special case of assertiveness training is also taught, with specific instructions for how and why to say “no.” These skills are practiced in session via role-play. As in every session, prior skills are carried forward, each client’s abstinence plan is monitored, routine interventions are delivered, and group support is encouraged.
Session 10: Anger Management; Relapse Prevention I: Seemingly Irrelevant Decisions
Authors: Epstein Elizabeth E. , McCrady Barbara S. 
Published: July 2023

Abstract
Session 10 teaches women anger management skills using a behavior chain to identify anger triggers, thoughts and feelings leading to aggressive behavior, and consequences.. The session also introduces a relapse prevention concept, “seemingly irrelevant decisions,” to help women identify and manage risky decisions that may seem unrelated to drinking or drug use, but that actually increase chances of using alcohol or drugs. As in every session, women-relevant vignettes and sample worksheets are provided. As in every session, prior skills are carried forward, each client’s abstinence plan is monitored, routine interventions are delivered, and group support is encouraged.
Session 2: Triggers and Behavior Chains
Authors: Epstein Elizabeth E. , McCrady Barbara S. 
Published: July 2023

Abstract
This session will help clients understand the factors supporting their drinking or drug use. They will learn about triggers, thoughts and feelings, behaviors (drinking or drug use), and consequences of use. Examples are provided and the skill is practiced during session, first by using a worksheet to list their own triggers for drinking/drug use and then by completing some behavior chains for particular triggers. Behavior chains set the stage for skills to “break the chain” and are a basic cognitive behavioral technique for behavior change. At the end of the session clients will identify upcoming high-risk situations and develop plans to cope without using alcohol or drugs. The therapist also will review homework for the upcoming week.
Session 4: Enhancing Motivation to Change and Increasing Positive Consequences of Abstinence
Authors: Epstein Elizabeth E. , McCrady Barbara S. 
Published: July 2023

Abstract
The chapter introduces the decisional matrix to help clients evaluate the pros and cons of stopping or continuing drinking or drug use and to understand the natural ambivalence people have about stopping. Clients will learn how to pay attention to the positive consequences of abstinence and keep in mind the negative consequences of use. They also will identify and plan into their weekly schedule pleasant activities to take the place of the time they used to spend using alcohol or drugs in order to make abstinence more pleasant and rewarding. Clients also will identify the functions that alcohol or drugs may have served so they will be able to replace those with healthier ways to achieve similar results. At the end of the session clients will identify upcoming high-risk situations and develop plans to cope without using alcohol or drugs. The therapist also will review homework for the upcoming week.
The SimCard Trial
Authors: Bazua Lobato Rodrigo 
Published: July 2023

Abstract
In many rural areas and low- and middle-income countries (LMICs), the noncommunicable disease (NCD) burden, such as cardiovascular disease, is increasing but primary-care infrastructure and health services are limited. This study aimed to develop and evaluate a simplified cardiovascular management program (SimCard) delivered by community health workers (CHWs) with the aid of a smartphone-based decision support system. Compared with the control group, the intervention group had a 25.5% (p &lt;0.001) higher net increase in the proportion of patient-reported antihypertensive medication use pre- and post-intervention. This study shows that properly trained CHWs can provide basic treatment at the doorstep of patients when supported by protocols to aid in the decision-making process.
Early Life Deprivation and Developmental Origins of Adult Metabolic Disease
Authors: Ghali Bassem 
Published: July 2023

Abstract
This study traces the social class and cause of death of a cohort of men born in the early 20th century in the United Kingdom over several decades to evaluate the effect of social determinants of health. The investigators traced a cohort of men who survived early childhood to ascertain cause of death. They looked at their birth weight, weight at 1 year, and feeding method and demonstrated that low birthweight and low weight at 1 year of age pose a 3-fold increased risk of death from ischemic heart disease later in life. This suggests that processes intrinsic to early growth and development impact future development of ischemic heart disease. It is possible that targeted social programs that alleviate poverty and food scarcity to address these social determinants of health of women and their infants will reduce deaths from ischemic heart disease in the future.
Can Household Contact Investigation Reduce Tuberculosis?
Authors: Seth Bhavna 
Published: July 2023

Abstract
There is a large burden of tuberculosis (TB) globally, and infection often spreads among household contacts of patients with TB. This large, cluster-randomized trial was the first to robustly demonstrate the benefits of active case finding in TB transmission. Districts in Vietnam were randomized into intervention and control arms. In the intervention districts, contacts of TB patients were actively screened for TB. The contacts of patients in the control districts were not screened, but were given educational materials. The authors found that the relative risk of screening positive for TB was 2.6 (95% CI 2.0 to 3.3) in intervention districts. The number of persons who would need to be screened to gain one additional registered case of TB was 74.6 (95% CI 64.2 to 89.2). This study demonstrates the effectiveness of active case finding for TB in high-burden countries.
Fluids in Pediatric Sepsis
Authors: Top Jessica 
Published: July 2023

Abstract
The current standard of care for treating hypovolemic shock and impaired circulation are fluid boluses. The Fluid Expansion as Supportive Therapy (FEAST) trial investigates the practice of early resuscitation with a saline bolus as compared with no bolus (control) and with an albumin bolus as compared with a saline bolus. They found that in children with febrile illness without severe hypotension, bolus resuscitation increased absolute risk of death at 48 hours by 3.3%. The results of the FEAST trial would seem to suggest that fluids should be given cautiously in children with early signs of sepsis, but should be interpreted with caution due to the limitations of the study. As a result of the FEAST trial, the WHO suggests cautious fluid administration in children with malnourishment, anemia, or malaria, and the 2012 Surviving Sepsis campaign restricts fluid resuscitation in pediatric patients to industrialized nations. Additionally, the FEAST trial is prompting investigation into how fluids are given to children in higher-resourced settings.
Does Prenatal Aspirin Prevent Preterm Preeclampsia?
Authors: Openshaw Maria 
Published: July 2023

Abstract
Hypertensive disorders of pregnancy contribute significantly to global maternal and neonatal morbidity and mortality, and an effective primary prevention strategy could save countless lives. Administration of low-dose aspirin starting in the late first trimester has shown promise in reducing the risk of preterm preeclampsia in high-risk clients. By using a combination of historical, demographic, and biometric screening factors, and randomizing high-risk women to receive low-dose aspirin or placebo, this study achieved a 62% reduction in preterm preeclampsia in high-risk women. However, the ultrasound and laboratory resources required by the screening algorithm make this approach most suitable for high-resource settings.
SPRINT Trial
Authors: Laux Timothy S. 
Published: July 2023

Abstract
Hypertension affects more than one billion worldwide. It is one of the leading risk factors for death and disability. The Systolic Blood Pressure Intervention Trial (SPRINT Trial) was done in the United States to assess the difference in cardiovascular outcomes between intensive blood pressure control (SBP &lt;120) or a more lenient goal (SBP &lt;140 mmHg) in patients with hypertension without diabetes. The trial was terminated early due to significantly lower rate of primary composite outcome in the intensive treatment group compared to the standard treatment group. The SPRINT Trial has been included in this anthology, to discuss how evidence generated in the Global North may not be translatable in resource-limited settings due to challenges at patient, clinician, and health system levels alike.
Task-Shifting for Caesarean Section
Authors: Kapira Sitalire , Openshaw Maria 
Published: July 2023

Abstract
In areas with physician shortages, nonphysician clinicians are often trained and employed to help cover this gap. Training nonphysician clinicians to perform tasks traditionally undertaken by physicians is termed “task-shifting.” This study evaluates health outcomes of patients who underwent cesarean sections by clinical officers compared with physicians and finds no increase in maternal or perinatal mortality by surgeon-type. However, clinical officers were found to have a significantly higher rate of wound infection and wound dehiscence when compared with physicians. As task-shifting is increasingly looked at as a way to help increase access to vital services, it is important not only to evaluate the health outcomes, but also to remember that task-shifting does not always occur in areas where a choice exists between nonphysician clinicians and physicians. Instead, it often occurs in areas where choices exist between nonphysician clinicians and no care at all. Importantly, this study does not evaluate the outcomes between no care, nonphysician clinicians, and physicians.
Observing the Problem
Authors: Weiner Saul J. , Schwartz Alan 
Published: July 2023

Abstract
Chapter 1, “Observing the Problem,” illustrates, through a series of case examples, what happens when clinicians overlook patient context and how care planning changes when they finally take it into account. The chapter also proposes hypotheses about why contextual errors in care planning occur—because of a tendency either to make unsupported assumptions about patients’ life circumstances and state of mind or not to consider them at all. Finally, the chapter considers how contextualizing care entails knowing what questions to ask patients and how to ask them. The authors describe how a contextualized care plan emerges out of an engaged interaction between two individuals working together to solve problems, one in the healing role and the other seeking health through health care. Interpersonal “engagement” is characterized as a particular kind of interaction between individuals, essential to contextualizing care in the clinical setting.
Better Teaching, Better Doctors
Authors: Weiner Saul J. , Schwartz Alan 
Published: July 2023

Abstract
Chapter 6, “Better Teaching, Better Doctors,” describes the development and testing of a curriculum to improve physician performance at contextualizing care. The chapter begins with an overview of American medical training, illustrating how it fosters an “efficient task completer” mindset, with a narrow biomedical focus that is often inattentive to contextual factors in patients’ lives that are essential to planning their care. A brief intensive curriculum designed to build skills at addressing contextual factors in care planning is then described. The last section provides an overview of two randomized trials of the curriculum, one comparing the performance of fourth-year medical students and another of residents to their respective control group. In the latter, subjects are also assessed in a “real-world” setting utilizing audio recordings of their clinical encounters. The findings illustrate how such a curriculum can improve skills but is not sufficient to change actual performance in practice.
A stacking survey of gamma-ray pulsars
Authors: Song Yuzhe , Paglione Timothy A D , Tan Joshua , Lee-Georgescu Charles , Herrera Danisbel 
Published: July 2023

ABSTRACT
We report on a likelihood-stacking search for γ-ray pulsars at 362 high-latitude locations that coincide with known radio pulsar positions. We observe a stacked signal conservatively 2.5σ over the background. Stacking their likelihood profiles in spectral parameter space implies a pulsar-like spectral index and a characteristic flux a factor of 2 below the Fermi Large Area Telescope point-source sensitivity, assuming isotropic/unbeamed emission from all sample pulsars. The same procedures performed on empty control fields indicate that the pulsars as a population can be distinguished from the background with a Δ(TS) = 28, where TS refers to test statistic, at the peak location (or 4.8σ), and the stacked spectra of the control fields are distinctly softer than those of the pulsars. This study also probes a unique region of parameter space populated by low $\dot{E}$ pulsars, most of which have no γ-ray ephemeris available, and is sensitive to high duty cycles. We also discuss the possible γ-ray emission mechanism from such pulsars.