bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Usefulness of Dynamic Ultrasonography in Nursemaid’s Elbow: A Prospective Case Series of 13 Patients Reconsideration of the Pathophysiology of Nursemaid’s Elbow
Authors: Tsai Chia-Che , Chiang Yi-Pin 
Published: March 2023

Background:
Nursemaid's elbow is a common musculoskeletal disorder among children under 5 years of age. However, diagnostic imaging to confirm a nursemaid’s elbow diagnosis is still unavailable. Through the use of a high-frequency ultrasound probe, we determined the etiology and possible pathophysiology of nursemaid’s elbow.

Methods:
Thirteen consecutive patients with the clinical suspicion of nursemaid’s elbows were examined. A high-frequency linear array 6 to 24 MHz hockey stick transducer was used to detect small changes (partial eclipse signs) of the radial head in the axial view before and after manipulation.

Results:
All patients in this study had a successful reduction. A partial eclipse sign was found in all patients before reduction and disappeared after successful reduction.

Conclusion:
These pathologic features detected through high-frequency ultrasonography suggest the role of the escaped posterior synovial fringe in the pathogenesis of the nursemaid’s elbow. The specific finding of a “partial eclipse sign” could be a useful additional clue leading to the correct diagnosis of the nursemaid’s elbow and may help avoid the unnecessary reduction in patients who do not have a “partial eclipse sign”.

Level of Evidence:
Level II, diagnostic studies.
Trends and Outcomes of Salvage Lobectomy for Early-stage Non–Small Cell Lung Cancer
Authors: Afshari Sam , Anker Christopher J. , Kooperkamp Hannah Z. , Sprague Brian L. , Lester-Coll Nataniel H. 
Published: March 2023

Objectives:
There is little data describing the outcomes for patients who develop local recurrences after stereotactic body radiation therapy (SBRT), a standard-of-care treatment for patients with early-stage non–small cell lung cancer. One emerging option is salvage lobectomy. We investigated trends in the use of salvage lobectomy after SBRT and described patient outcomes using a nationally representative sample.

Methods:
This is a retrospective study using the National Cancer Database of patients with non–small cell lung cancer diagnosed from 2004 to 2017. We used descriptive statistics to describe patients who underwent salvage lobectomy. Kaplan-Meier analysis was used to estimate overall survival (OS). Cox proportional modeling was used to identify factors associated with OS.

Results:
We identified 276 patients who underwent salvage lobectomy. Ninety-day mortality was 0%. The median survival time for the cohort was 50 months (95% CI, 44 to 58). Median follow-up was 65 months (Interquartile Range: 39 to 96). The factors associated with decreased OS include squamous cell histology (hazard ratio (HR)=1.72, P=0.005) and high grade (1.50, P=0.038). Increased OS was associated with lobectomy performed between 3 and 6 months after SBRT (HR=0.53, P=0.021), lobectomy performed >6 months after SBRT (HR=0.59, P=0.015), and female sex (HR=0.56, P=0.004).

Conclusions:
Salvage lobectomy after local failures of SBRT was associated with no perioperative mortality and favorable long-term outcomes. Our data suggest that lobectomy performed within 3 months of SBRT is associated with worse OS.
Effect of tenofovir-based HIV pre-exposure prophylaxis against HBV infection in men who have sex with men
Authors: Mizushima Daisuke , Takano Misao , Aoki Takahiro , Ando Naokatsu , Uemura Haruka , Yanagawa Yasuaki , Watanabe Koji , Gatanaga Hiroyuki , Kikuchi Yoshimi , Oka Shinichi 
Published: March 2023

Background and Aims:
Men who have sex with men (MSM) are vulnerable to contracting HBV as a sexually transmitted infection. We evaluated the incidence of HBV infection (HBI) and the prophylactic effect of tenofovir-based pre-exposure prophylaxis (PrEP) on HBI in an MSM cohort.

Methods and Results:
MSM who were older than 16 years were enrolled from January 2018 and followed up until June 2021 and tested for HIV, bacterial sexually transmitted infections, and HBsAg/ HBsAb and HBcAb every 3 months based on inclusion criteria, including HBsAg, HBcAb, HBsAb, and HIV negativity at enrollment. HBI was defined as seroconversion of HBsAg or HBcAb status. The log-rank test was used to evaluate the prophylactic effect of PrEP against HBI. As a substudy, individuals excluded from the main study due to HBs Ab positivity were evaluated for HBI incidence. Among 1577 MSM, 786 participants (546 PrEP nonusers, 131 daily PrEP users, and 109 event-driven PrEP users) met the criteria and were included. The annual incidence of HBV among PrEP nonusers (3.8%, 21 infections, with 559.5 person-years) was significantly higher (p = 0.018, log-rank test) than that among daily PrEP users [0.77%, 1 infection (admitted nonadherence), with 129.3 person-years] and event-driven PrEP users (no infection with 93.8 person-years). Although the incidence of HBI and HIV infection decreased with PrEP use, the incidence of other sexually transmitted infections was higher in both daily and event-driven PrEP users. The annual incidence of HBV among HBsAb-positive and HBcAb-negative PrEP nonusers was 1.8% (3 infections, with 167.5 person-years).

Conclusions:
Tenofovir-based PrEP prevented HBI among MSM in a real-world setting.
Impacts of a dispersed unit structure on allied health professionals' experiences in an Australian public hospital setting
Authors: Turato Gemma , Oprescu Florin , Whiteoak John 
Published: March 2023

Background
The limited published evidence relating to the experiences and outcomes of a unit dispersement model is generally more negative than positive from an allied health perspective.

Purpose
The perceptions of allied health managers and leaders after the transition to a unit dispersement structure were explored in this study. The objectives were to review the impacts of this type of structure and the factors for health care organizations to consider before incorporating allied health professions into a clinical matrix structure.

Methodology
A qualitative study was conducted in a large regional multisite public hospital and health service located in Australia. Semistructured interviews and focus groups were conducted with 30 allied health frontline managers and leaders.

Results
Four negative impacts on the work experience of allied health professionals in a dispersement structure were identified through data analysis as: a negative impact on service delivery to patients, a detrimental effect on professional identity, reduced ability of allied health managers and leaders to do their role effectively, and a negative impact on morale, culture, and emotional well-being. Several key factors for public hospitals to consider before embarking on an organizational structure that includes allied health professionals were identified.

Conclusion
The impacts of the unit dispersement structure on allied health professionals working within the organization under study were generally negative and did not deliver on the desired objectives. The findings reinforce the unique requirements pertaining to allied health professionals for optimal functioning.

Practice Implications
The learnings have implications for administrators in health care organizations embarking on organizational change that incorporates allied health professions in certain settings. The findings recommend that health care organizations consider several important factors before they introduce any structural change that would affect the delivery of allied health services.
Improving Empiric Antibiotic Therapy Among Cancer Patients With Acute Cholangitis
Authors: Alilio Prisca , Thakkar Keval , Tayal Aditi , Cornelius Tuhina , Greene John N. 
Published: March 2023

Abstract

Introduction
Acute cholangitis (AC) is a hepatobiliary infection that requires prompt antibiotic therapy. Providers have to rely on empiric antibiotic guidelines, before receiving culture results. These antibiotic guidelines require routine surveillance of the biliary microbial flora and resistance patterns found in cultures to increase accuracy and appropriateness of empiric therapy. This is particularly essential in cancer patients who are more likely to be exposed to various antibiotics, potentially creating unique bactobilia, and fungobilia selection pressures that are different from the general patient population and require empiric therapy to halt AC progression to septicemia, shock, or mortality. This unique population is poorly researched and primary literature is relatively scarce.

Methodology
A retrospective chart review was performed to identify all patients between the age of 18 and 85 years who met the criteria for positive biliary culture and were treated for AC using empiric antibiotic treatment at the H. Lee Moffitt Cancer Center and Research Institute from January 2012 to January 2019. The patient information and laboratory results were analyzed to identify the microbial spectrum and drug resistance in bile cultures of cancer patients.

Aim
The aim of the study is to review the microbial patterns and characteristics of AC in immunocompromised patients with cancer.

Results
Pancreatic carcinomas and cholangiocarcinoma were most prevalent malignancies among patients. Although most bile cultures were polymicrobial, further analysis indicated Enterococcus species. Streptococcus species, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Candida albicans were the most common isolates.

Conclusions
Cholangitis in cancer patients develops because of cholestasis from cancer obstructing the biliary flow mostly because of pancreatic cancer, cholangiocarcinoma, and metastatic cancer to the porta hepatis. Empiric antibiotic therapy should include broad-spectrum coverage for usual enteric flora.
Brief Report: Changes in Nocturnal Heart Rate Variability in People Living With HIV During the First Year of Antiretroviral Therapy Compared With HIV-Uninfected Community Controls
Authors: Kavishe Bazil Baltazar , PrayGod George , Brage Soren , Kitilya Brenda Wilfred , Faurholt-Jepsen Daniel , Todd Jim , Jeremiah Kidola , Filteau Suzanne , Olsen Mette Frahm , Peck Robert 
Published: March 2023

Background:
Higher nocturnal heart rate and lower nocturnal heart rate variability (HRV) is associated with increased cardiovascular disease mortality. Longitudinal studies on nocturnal HRV in people living with HIV (PLWH) are lacking.

Methods:
We conducted a 1-year prospective cohort study of adult PLWH and HIV-uninfected community controls in northwestern Tanzania. At enrollment, we collected data on cardiovascular risk factors and tested blood samples for hemoglobin, insulin, CD4 cell count, and C-reactive protein. We measured nocturnal HRV and heart rate at baseline and first-year follow-up. Mixed effect linear regression was used to determine predictors of lower HRV.

Results:
Of the 111 enrolled participants (74 PLWH and 37 HIV-uninfected adults), 57.7% were female and the median age was 40 years. Over 1 year of follow-up, the average nocturnal heart rate was 4.5 beats/minute higher in PLWH (P = 0.006). In the fully adjusted model (with age, sex, nocturnal heart rate, and diabetes), average nocturnal HRV was 10.5 milliseconds lower in PLWH compared with HIV-uninfected adults (P = 0.03). Unlike with nocturnal heart rate, nocturnal HRV did not improve after 1 year of ART in PLWH or HIV-uninfected adults (fully adjusted change = −2.5 milliseconds, P = 0.45). Lower educational attainment, lesser pancreatic β-cell function, and anemia were associated with higher HRV.

Conclusions:
Nocturnal parasympathetic nervous system function was persistently lower in PLWH compared with HIV-uninfected adults even after antiretroviral therapy initiation. Improving nocturnal autonomic nervous system function could be a target for cardiovascular disease prevention in PLWH.
Brief Report: Comparative Analysis of Pre-existing HIV Drug Resistance Mutations in Proviral DNA Using Next-Generation Sequencing and Routine HIV RNA Genotyping
Authors: Gaitan Noah C. , D'Antoni Michelle L. , Acosta Rima K. , Gianella Sara , Little Susan J. , Chaillon Antoine 
Published: March 2023

Background:We investigated whether deep sequencing of archived HIV DNA of antiretroviral-naive persons with acute/early HIV infection could identify transmitted drug resistance mutations (DRM), per the IAS drug resistance algorithm, which are not detected by routine bulk (consensus) sequencing.Methods:Deep sequencing of HIV DNA from peripheral blood mononuclear cells and consensus sequencing from concurrent blood plasma (BP) was performed from antiretroviral (ART)-naive adults with recent infection. We compared the prevalence of low-frequency (2%–20%) and high-frequency (>20%) nonnucleoside reverse transcriptase inhibitor (NNRTI), nucleoside reverse transcriptase inhibitor (NRTI), and protease inhibitor (PI) DRM.Results:Overall, 190 individuals were included, 72 (37.9%) with acute, 20 (10.5%) with very early, and 98 (51.6%) with recent HIV infection. Although all DRM detected in plasma appeared in archived proviral DNA, 9 high-frequency mutations were only detected in HIV DNA. These included 3 NRTI mutations, 4 NNRTI mutations, 1 PI mutation, and 1 H221Y (associated rilpivirine resistance) mutation. When considering DRM <20%, 11 NNRTI, 7 NRTI, 6 PI, and 3 F227L (associated doravirine resistance) mutations were found exclusively in HIV DNA. Interestingly, although 2 high-frequency M184V appeared in both DNA and RNA, low-frequency M184I were exclusive to HIV DNA (n = 6). No participants experienced virologic failure after initiating ART during the median 25.39 ± 3.13 months of follow-up on treatment.Conclusion:Although most high-frequency DRMs were consistently detected in HIV RNA and HIV DNA, the presence of low-frequency DRM in proviral DNA may be relevant for clinicians because these mutations could become dominant under drug selection pressure.
Performance of Galectin-9 for Identification of HIV Viremia in Adults Receiving Antiretroviral Therapy in a Resource-Limited Setting
Authors: Thorman Johannes , Björkman Per , Sasinovich Sviataslau , Tesfaye Fregenet , Mulleta Daba , Medstrand Patrik , Reepalu Anton 
Published: March 2023

Background:
Targeted viral load (VL) testing has been proposed for antiretroviral treatment (ART) monitoring in resource-limited settings. In this study, we have investigated the performance of the host biomarker galectin-9 (Gal-9), alone and in combination with interferon-γ–inducible protein 10 (IP-10), in identifying individuals at increased likelihood of viremia during ART.

Setting:
Cohort of HIV-positive adults receiving ART at Ethiopian health centers.

Methods:
We included participants with detectable viremia (VL ≥150 copies/mL) 12 months after starting ART and sex-matched nonviremic controls. Performance to identify individuals with VL ≥1000 copies/mL was determined for Gal-9 and the Gal-9/IP-10 combination, respectively, using receiver operating characteristic (ROC) analysis.

Results:
Among 191 participants (50.3% women), 46 (24.1%) had VL ≥1000 copies/mL, 23 (12.0%) had 150–999 copies/mL, and 122 (63.9%) had <150 copies/mL. Gal-9 and VL were positively correlated (rs = 0.451, P < 0.001). Sensitivity and specificity for Gal-9 to identify individuals with VL ≥1000 copies/mL were 91.3% (95% CI: 79.2–97.6) and 54.5% (95% CI: 46.0–62.8), respectively. The area under the ROC curve for Gal-9 was 0.810 (95% CI: 0.745–0.875), which was similar to that of the combination of Gal-9 and IP-10 [0.849 (95% CI: 0.792–0.905)]. Assuming 10% prevalence of VL ≥1000 copies/mL, using Gal-9 for targeted VL testing instead of universal VL testing would reduce the number of VL tests from 10 to 5 to identify 1 viremic individual, with misclassification of 1 in 10 viremic individuals.

Conclusions:
Gal-9 is a potential screening marker for targeted VL monitoring in ART recipients. Further studies are needed to determine optimal threshold levels.
Guidelines for Qualifications of Neurodiagnostic Personnel: A Joint Position Statement of the American Clinical Neurophysiology Society, the American Association of Neuromuscular & Electrodiagnostic Medicine, the American Society of Neurophysiological Monitoring, and ASET—The Neurodiagnostic Society
Authors: López Jaime R. , Ahn-Ewing Judy , Emerson Ron , Ford Carrie , Gale Clare , Gertsch Jeffery H. , Hewitt Lillian , Husain Aatif , Kelly Linda , Kincaid John , Kise Meledy , Kornegay Adam , Moreira Joseph J. , Nuwer Marc , Schneider Anita , Stecker Mark , Sullivan Lucy R. , Toleikis J. Richard , Wall Lois , Herman Susan 
Published: March 2023

Summary:
The Guidelines for Qualifications of Neurodiagnostic Personnel (QNP) document has been created through the collaboration of the American Clinical Neurophysiology Society (ACNS), the American Society of Neurophysiological Monitoring (ASNM), the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM), and ASET—The Neurodiagnostic Society (ASET). The quality of patient care is optimized when neurophysiological procedures are performed and interpreted by appropriately trained and qualified practitioners at every level. These societies recognize that neurodiagnostics is a large field with practitioners who have entered the field through a variety of training paths. This document suggests job titles, associated job responsibilities, and the recommended levels of education, certification, experience, and ongoing education appropriate for each job. This is important because of the growth and development of standardized training programs, board certifications, and continuing education in recent years. This document matches training, education, and credentials to the various tasks required for performing and interpreting neurodiagnostic procedures. This document does not intend to restrict the practice of those already working in neurodiagnostics. It represents recommendations of these societies with the understanding that federal, state, and local regulations, as well as individual hospital bylaws, supersede these recommendations. Because neurodiagnostics is a growing and dynamic field, the authors fully intend this document to change over time.
PRODUCTION OF XYLANASE BY Aspergillus niger GIO AND Bacillus megaterium THROUGH SOLID-STATE FERMENTATION
Authors: Fasiku Samuel Adedayo , Bello Mobolaji Akeem , Odeniyi Olubusola Ayoola 
Published: March 2023

Xylanase breaks xylan down to xylose which is used in industries such as pulp and paper, food, and feed, among others. The utilization of wastes for xylanase production is economical, hence, this work aimed at producing xylanase through solid-state fermentation and characterizing the enzyme. Xylanase-producing strains of Bacillus megaterium and Aspergillus niger GIO were inoculated separately in a 5 and 10 days solid fermentation study on maize straw, rice straw, sawdust, corn cob, sugarcane bagasse, conifer liters, alkaline-pretreated maize straw (APM), and combined-alkaline and biological-pretreated maize straw, respectively. The best substrate was selected for xylanase production. The crude enzyme was extracted from the fermentation medium and xylanase activity was characterized using parameters such as temperature, cations, pH, and surfactants. Among different substrates, the highest xylanase activity of 3.18 U/mL was recorded when Aspergillus niger GIO was grown on APM. The xylanase produced by Aspergillus niger GIO and Bacillus megaterium had their highest activities (3.67 U/mL, 3.36 U/mL) at 40 °C after 30 and 45 minutes of incubation, respectively. Optimum xylanase activities (4.58 and 3.58 U/mL) of Aspergillus niger GIO and Bacillus megaterium, respectively were observed at pH 5.0 and 6.2. All cations used enhanced xylanase activities except magnesium ion. Sodium dodecyl sulfate supported the highest xylanase activity of 6.13 and 6.90 U/mL for Aspergillus niger GIO and Bacillus megaterium, respectively. High yields of xylanase were obtained from Aspergillus niger GIO and Bacillusmegaterium cultivated on alkaline pretreated maize straw. The xylanase activities were affected by pH, temperature, surfactants, and cations.
IRES-independent, eIF2A/eIF2D-dependent translation of the enterovirus genome
Authors: Kim Hyejeong , Aponte-Diaz David , Sotoudegan Mohamad S. , Arnold Jamie J. , Cameron Craig E. 
Published: March 2023

AbstractRNA recombination in positive-strand RNA viruses is a molecular-genetic process, which permits the greatest evolution of the genome and may be essential to stabilizing the genome from the deleterious consequences of accumulated mutations. Enteroviruses represent a useful system to elucidate the details of this process. On the biochemical level, it is known that RNA recombination is catalyzed by the viral RNA-dependent RNA polymerase using a template-switching mechanism. For this mechanism to function in cells, the recombining genomes must be located in the same subcellular compartment. How a viral genome is trafficked to the site of genome replication and recombination, which is membrane associated and isolated from the cytoplasm, is not known. We hypothesized that genome translation was essential for co-localization of genomes for recombination. We show that complete inactivation of internal ribosome entry site (IRES)-mediated translation of a donor enteroviral genome enhanced recombination instead of impairing it. Recombination did not occur by a non-replicative mechanism. Rather, sufficient translation of the non-structural region of the genome occurred to support subsequent steps required for recombination. The non-canonical translation initiation factors, eIF2A and eIF2D, were required for IRES-independent translation. Our results support an eIF2A/eIF2D-dependent mechanism under conditions in which the eIF2-dependent mechanism is inactive. Detection of an IRES-independent mechanism for translation of the enterovirus genome provides an explanation for a variety of debated observations, including non-replicative recombination and persistence of enteroviral RNA lacking an IRES. The existence of an eIF2A/eIF2D-dependent mechanism in enteroviruses predicts the existence of similar mechanisms in other viruses.
Can a Simple Phenomenological Model Explain the Mechanics of Eccentric Contractions?
Authors: Yeo Sang Hoon , Herzog Walter 
Published: March 2023

SummaryNotwithstanding decades of research, predictions from the existing muscle models on eccentric contraction remain elusive. This study aimed to test the possibility that a relatively simple phenomenological muscle model, based on an adapted Hill-type muscle model with some novel assumptions, can capture the mechanics of eccentric contractions. The result of the simulations, although preliminary, support the potential of the proposed model in predicting the mechanics of eccentric contraction.