bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARISON OF PAIN EXPERIENCE IN PATIENTS UNDERGOING SUB-TENON'S ANESTHESIA VERSUS PERIBULBAR ANESTHESIA DURING ELECTIVE VITREORETINAL SURGERY
Authors: Ripa Matteo , Schipa Chiara , Kopsacheilis Nikolaos , Nomikarios Mikes , De Rosa Carlo , De Rosa Pasquale , Motta Lorenzo 
Published: July 2022

Purpose:
To assess and compare the patients' discomfort and pain experienced during anesthesia, pars plana vitrectomy, and 24 hours postoperatively after sub-Tenon's injection (STI) versus peribulbar block (PB) in elective vitreoretinal surgery.

Methods:
Retrospective study involving 80 patients who underwent elective vitreoretinal surgery receiving either PB (Group 1, n = 40) or STI (Group 2, n= 40) between January 2021 and March 2022. Patients' pain experienced during the procedure and 24 hours postoperatively were assessed using a pain scale and a two-section questionnaire. One hour postoperatively, patients were asked to rate the level of pain they felt during the entire procedure by pointing at a 0 to 100 Visual Analog Scale. Subsequently, patients answered a two-section questionnaire regarding pain and discomfort felt 24 hours postoperatively.

Results:
According to Visual Analog Scale measurements, patients experienced significantly more pain during PB than during STI 1 hour after surgery. Patients undergoing PB experienced more pain than those who underwent STI, experiencing burning and discharge feeling. Patients undergoing STI had a lower pain level score 24 hours postoperatively despite similar discomfort.

Conclusion:
Sub-Tenon's injection has a lower pain score than PB during the procedure and 24 hours postoperatively, representing a valuable procedure to deliver analgesia in vitreoretinal surgery.
Assessing Harmful Bias and Celebrating Strength Through the Narratives of Black/African American Physician Assistant Students
Authors: Bester Vanessa S. , Bradley-Guidry Carolyn 
Published: July 2022

Introduction
Two national crises, the COVID-19 pandemic and systemic racism, have drawn nationwide attention to the disparities that exist in our society today. The American healthcare system, including physician assistant (PA) education, is not exempt from the impact of harmful bias and discrimination. The purpose of this study was to explore narratives recounting the experiences of Black/African Americans who have successfully completed their PA education in an attempt to understand how PA educators can better support students of color.

Methods
Qualitative, semi-structured interviews, guided by a critical race theory framework, were conducted with 6 Black/African American PAs who had graduated within the last 5 years. Trustworthiness was ensured through member checking, triangulation, peer debriefing during the coding and analysis process, and autoethnographic reflection.

Results
Themes of mentorship and cultural capital, including aspirations, family, social support, and resistance to an oppressive system, highlight the strengths present in Black/African American students. Additional themes surrounding stress related to race, including a pressure to prove, isolation and anxiety, and imposter phenomenon, all pointed toward the need for honest and safe dialogue among individuals with racial differences.

Discussion
This research article presents key findings and opportunities for PA educators to emphasize cultural capital to enable Black/African American PA students to thrive. Communicating across racial differences and intentional engagement are imperative for PA educators to successfully support Black/African American students.
The Role of Interpersonal Toxicity on Healthcare Students’ Well-Being
Authors: Sierra Talia , McCall Timothy C. , Brown Heidi , Smith Noël E. 
Published: July 2022

Introduction
Nearly half of all medical students suffer from burnout, which not only has detrimental effects on the students themselves but can transfer into the clinical realm. Yet, studies exploring burnout and interpersonal toxicity in physician assistant (PA) students are rare. This study examined the role that interpersonal toxicity and abuse play in PA student burnout.

Methods
Nearly 2500 PA students in the United States responded to a survey about well-being, stress, and experiences with interpersonal toxicity in PA school as part of a larger cross-sectional study on PA student experiences in their didactic and clinical years. The present research focuses on overall measures among all PA students, as well as differences between didactic and clinical students, including the extent to which experiences of interpersonal toxicity predict symptoms associated with burnout.

Results
Overall, PA students reported high levels of satisfaction and happiness in school and life, but enthusiasm for school decreased for clinical students. More than two-thirds of students reported moderate to high levels of life stress, and more than 9 in 10 reported moderate to high levels of school stress. Symptoms of burnout were reported by many students, with clinical students reporting interpersonal toxicity exposure more often than didactic students. Experiencing interpersonal toxicity or abuse predicted symptoms of burnout.

Discussion
While PA students report high levels of life and school satisfaction, given the high levels of stress also reported, burnout metrics and well-being programs are needed. PA programs should work to create a supportive and engaging educational environment to ensure students’ long-term career success.
Prognostic value of GRACE risk score in patients hospitalized for coronavirus disease 2019
Authors: Dönmez Esra , Özcan Sevgi , Tuğrul Sevil , Ziyrek Murat , İnce Orhan , Nar Sagir Gurur , Baran Yavuz Mustafa , Gungor Baris , Okuyan Ertugrul , Sahin Irfan 
Published: July 2022

Objective
COVID-19 pandemic continues to threaten human health as novel mutant variants emerge and disease severity ranges from asymptomatic to fatal. Thus, studies are needed to identify the patients with ICU need as well as those who have subsequent mortality. Global Registry of Acute Coronary Events (GRACE) risk score is a validated score in acute coronary syndrome. We aimed to evaluate if GRACE score can indicate adverse outcomes and major ischemic events in hospitalized COVID-19 patients.

Methods
All hospitalized patients due to COVID-19 at our institution between March 2020 and September 2020 were included in this retrospective study. Patients were grouped according to GRACE risk scores: low risk 0–108 points, intermediate risk 109–140 and high risk ≥141.

Results
A total of 787 patients were enrolled; 434 patients formed group 1. One-hundred forty-one patients in group 2 and 212 patients formed group 3. We found that inhospital mortality, length of hospital stay, ICU and advanced ventilatory support need were associated with increasing GRACE risk score. In addition, major ischemic events were more frequently observed in higher risk groups and strong positive correlations between GRACE risk score and pro-BNP, procalcitonin and moderate positive correlation with D-dimer, CRP, NLR was found. Regression analysis showed that only GRACE risk score was an independent risk factor associated with inhospital mortality, major ischemic events, advanced ventilatory support and ICU need.

Conclusion
The GRACE risk score is easy to apply on hospital admission and useful for classifying those in medium-high-intensity care units and to raise the assignments of sources.
Progression to Anti-TNF Treatment in Very Early Onset Inflammatory Bowel Disease Patients
Authors: Eindor-Abarbanel Adi , Meleady Laura , Lawrence Sally , Hamilton Zachary , Krikler Gena , Lakhani Alam , Zhang Qian , Jacobson Kevan 
Published: July 2022

Objectives:
Limited data are currently available regarding anti-tumor necrosis factor (TNF) use and outcomes in very early onset inflammatory bowel disease (VEOIBD) patients. We aimed to assess the long-term outcomes and time to progression to anti-TNF treatment in VEOIBD patients.

Methods:
We retrospectively reviewed IBD patients diagnosed under 6 years of age, between January 2005 and December 2019, from the British-Columbia (BC) Pediatric IBD database. Demographic data, disease characteristics, disease location and severity were documented. Data on anti-TNF treatment at initiation and during follow up including type of biologic, dosing, and response were collected. Kaplan-Meier curves were used to assess the number of years to progression to anti-TNF treatment and the parameters influencing commencement.

Results:
Eighty-nine patients with VEOIBD were diagnosed during the study period. Median age at diagnosis was 3.8 years [interquartile range (IQR) 2.6–5.1], 45.3% had Crohn disease (CD) and 62.8% were males. Median duration of follow up was 6.39 years (IQR 3.71–10.55). Anti-TNF treatment was started on 39.5% of patients and 7.0% underwent surgery. Rapid progression to biologic treatment was associated with Perianal fistulizing disease or stricturing disease in CD patients (P = 0.026, P = 0.033, respectively), and disease severity (P = 0.017) in ulcerative colitis
(UC) patients. The median dose of infliximab at 1 year was 10 mg/kg (IQR 7.5–11) and a median dose interval of 4.5 weeks (IQR 4–6). Clinical remission was reported in 61.8% of patients on their first biologic agent.

Conclusions:
The response rate was higher than previously reported and might be due to higher infliximab dosing with shorter infusion intervals than standard dosing.
How Long Can a Dead Body Remain Infectious?
Authors: Ventura Francesco , Drommi Martina , Barranco Rosario , Balbo Arianna , Errico Stefano , Mangioni Manuela , Molinari Giulia , Di Biagio Antonio , De Pace Vanessa , Lai Alessia , Bruzzone Bianca 
Published: July 2022

Abstract
The SARS-CoV-2 pandemic involved several changes and difficulties in the work of forensic pathologists. Postmortem nasopharyngeal swabs for the diagnosis of the SARS-CoV-2 infection are recommended before an autopsy examination by the Centers for Disease Control and Prevention.
Autopsy examinations must not be performed for SARS-CoV-2 infection cases when airborne infection isolation rooms or other suitable spaces are unavailable. However, it has not yet been reported whether the presence of SARS-CoV-2 at a low viral load may be enough to infect and disseminate the contagion.
Here, we report the case of a 67-year-old man found dead at home on November 9, 2020, and transferred immediately after to the Genova District Mortuary. As the first postmortem molecular nasopharyngeal swab resulted positive, a weekly sampling was carried until February 4, 2021. All the molecular tests were positive for SARS-CoV-2, including the last swab performed 87 days after the arrival of the corpse at the morgue. Virus isolation conducted on VERO E6 cells revealed no cytopathic effect indicating no viral replication as early as 18 days after the corpse's arrival at the morgue and until January 2021.
Our findings suggest that the presence of the genome of SARS-CoV-2 at low viral load should not be considered a sign of an active infection but a trace of a remaining viral genome from a previous infection. Then, if the virus shows no replication activity, its molecular detection should not constitute a threat to public health. Further studies are required to establish the infection's potential and its correlation with viral load.
Risk factors and the epidemiology of surgical-site infections at a tertiary care medical center in Mexico, the experience at the National Institute of Medical Sciences and Nutrition Salvador Zubirán: A 6-month-prospective cohort study; carried out during the first decade of the XXI century. Untitled Item
Authors: Delgado-Hachmeister Jorge , Mercado-Joffre Irene , Jimenez Martha Huertas , Ponce de Leon Rosales Samuel , Rangel-Frausto Sigfrido 
Published: July 2022

<p>In the data isq, means surgical site infection. We also provide the name of the surgeons for surgeons to check their personal infection rates to improve outcomes. Stata 8.2 version is used, College Station, TX, USA. Most are categorical variables, or converted to categorical variables, or need to be converted to categorical variables, for example to set up a cut of value for albumin < 3g/dl. The same as the body mass index >= 27. </p>
A Systematic Review of Operative Team Familiarity on Metrics of Efficiency, Patient Outcomes, Cost, and Team Satisfaction
Authors: Witmer Hunter D.D. , Dhiman Ankit , Jones Alonzo D. , Laffan Alison M. , Adelman Dan , Turaga Kiran K. 
Published: July 2022

Objective:
This study seeks to systematically review the current literature on how surgical team familiarity relates to metrics of operative efficiency.

Background:
The operating room (OR) is a complex environment involving numerous multidisciplinary interactions that must interface precisely to achieve a successful outcome.

Methods:
A systematic search of the PubMed database was prospectively registered in the National Institute for Health Research PROSPERO database (CRD 42020181046) and performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Exposure variable was team familiarity and outcome measures included operative efficiency, patient outcomes, costs, and/or team satisfaction.

Results:
Of 1123 articles screened, 15 studies involving 24,340 operations met inclusion criteria. All studies were limited to an individual specialty, procedure, or both. The effects of more familiar teams were most pronounced in decreasing operative times [standardized mean difference of −0.51 (95% confidence interval: −1.00, −0.02), P=0.04], whereas the reported impacts on patient clinical outcomes, material waste, and team satisfaction were much more heterogenous.

Conclusions:
Improving OR team familiarity is associated with superior operative efficiency and may be associated with other favorable measures. Further inferences are limited by literature heterogeneity, yet could be a novel focus for improving OR performance.
Interplay between the oxytocin and opioid systems in regulating social behaviour
Authors: Putnam Philip T. , Chang Steve W. C. 
Published: July 2022

The influence of neuromodulators on brain activity and behaviour is undeniably profound, yet our knowledge of the underlying mechanisms, or ability to reliably reproduce effects across varying conditions, is still lacking. Oxytocin, a hormone that acts as a neuromodulator in the brain, is an example of this quandary; it powerfully shapes behaviours across nearly all mammalian species, yet when manipulated exogenously can produce unreliable or sometimes unexpected behavioural results across varying contexts. While current research is rapidly expanding our understanding of oxytocin, interactions between oxytocin and other neuromodulatory systems remain underappreciated in the current literature. This review highlights interactions between oxytocin and the opioid system that serve to influence social behaviour and proposes a parallel-mechanism hypothesis to explain the supralinear effects of combinatorial neuropharmacological approaches.This article is part of the theme issue ‘Interplays between oxytocin and other neuromodulators in shaping complex social behaviours’.
Oxytocin—a social peptide? Deconstructing the evidence
Authors: Leng Gareth , Leng Rhodri I. , Ludwig Mike 
Published: July 2022

In this paper, we analyse the claim that oxytocin is a ‘social neuropeptide’. This claim originated from evidence that oxytocin was instrumental in the initiation of maternal behaviour and it was extended to become the claim that oxytocin has a key role in promoting social interactions between individuals. We begin by considering the structure of the scientific literature on this topic, identifying closely interconnected clusters of papers on particular themes. We then analyse this claim by considering evidence of four types as generated by these clusters: (i) mechanistic studies in animal models, designed to understand the pathways involved in the behavioural effects of centrally administered oxytocin; (ii) evidence from observational studies indicating an association between oxytocin signalling pathways and social behaviour; (iii) evidence from intervention studies, mainly involving intranasal oxytocin administration; and (iv) evidence from translational studies of patients with disorders of social behaviour. We then critically analyse the most highly cited papers in each segment of the evidence; we conclude that, if these represent the best evidence, then the evidence for the claim is weak.This article is part of the theme issue ‘Interplays between oxytocin and other neuromodulators in shaping complex social behaviours’.
The role of oxytocin in shaping complex social behaviours: possible interactions with other neuromodulators
Authors: Paletta Pietro , Bass Noah , Kavaliers Martin , Choleris Elena 
Published: July 2022

This review explores the role of oxytocin in the mediation of select social behaviours, with particular emphasis on female rodents. These behaviours include social recognition, social learning, pathogen detection and avoidance, and maternal care. Specific brain regions where oxytocin has been shown to directly mediate various aspects of these social behaviours, as well as other proposed regions, are discussed. Possible interactions between oxytocin and other regulatory systems, in particular that of oestrogens and dopamine, in the modulation of social behaviour are considered. Similarities and differences between males and females are highlighted.This article is part of the theme issue ‘Interplays between oxytocin and other neuromodulators in shaping complex social behaviours’.
Single Cell RNA Sequencing Driven Characterization of Pediatric Mixed Phenotype Acute Leukemia
Authors: Mumme Hope L. , Raikar Sunil S. , Bhasin Swati S. , Thomas Beena E. , DeRyckere Deborah , Wechsler Daniel S. , Porter Christopher C. , Castellino Sharon M. , Graham Douglas K. , Bhasin Manoj K. 
Published: July 2022

AbstractBackgroundMixed phenotype acute leukemia (MPAL) is a rare subgroup of leukemia characterized by blast cells that display both myeloid and lymphoid lineage features, making this cancer difficult to diagnose and treat. A deeper characterization of MPAL at the molecular level is essential to better understand similarities/differences to the more common and better-studied leukemias, acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Therefore, we performed single-cell RNA sequencing (scRNAseq) on MPAL bone marrow (BM) samples in an attempt to develop a more granular map of the MPAL microenvironment landscape.MethodsWe analyzed ∼16,000 cells from five pediatric MPAL BM samples collected at diagnosis to generate a single-cell transcriptomic landscape of B/Myeloid (B/My) and T/Myeloid (T/My) MPAL blasts and associated microenvironment cells. Cell clusters were identified using principal component analysis and uniform manifold approximation and projection (UMAP). Unsupervised analysis was performed to determine the overall relationship among B/My MPAL, T/My MPAL, and other acute leukemias – B-ALL, T-ALL, and AML. Supervised differentially expressed gene (DEG) analysis was performed to identify B/My and T/My MPAL blast-specific signatures. MPAL sample transcriptome profiles were compared with normal BM stem and immune cells to identify MPAL-specific dysregulation. Gene set enrichment analysis (GSEA) was performed, and significantly enriched pathways were compared in MPAL subtypes. Comparative analysis was performed on diagnostic samples based on their future minimal residual disease (MRD) and relapse status.ResultsB/My MPAL and T/My MPAL blasts displayed distinct subtype-specific blast signatures. UMAP analysis revealed that B/My MPAL samples had greater overlap with B-ALL samples, while T/My MPAL samples clustered separately from other acute leukemia subtypes. Genes overexpressed in both MPAL subtypes’ blasts compared to other leukemias and healthy controls includedPLIN2, CD81, andUBE2S. B/My MPAL blast-specific genes includedIRS2, SMIM3, andHBEGF, whereas T/My MPAL blast-overexpressed genes includedIER5, BOD1L1, andHPGD. Sirtuin signaling, p38 MPAK signaling, and PI3K signaling pathways were upregulated in B/My MPAL blasts while oxidative phosphorylation and Rho family GTPases signaling pathways were upregulated in T/My MPAL blasts. Transcriptomic, pathways, and cell communication level differences were observed in the MPAL samples based on future MRD and clinical outcome status.ConclusionsWe have for the first time described the single-cell landscape of pediatric MPAL and demonstrate that B/My and T/My MPAL have unique scRNAseq profiles distinct from each other as well as from ALL and AML.
TGFB1 rs8179181 polymorphism is reproducibly associated with Parkinson’s disease in a Spanish population
Authors: Comino Alicia , Antolín-Vallespín Mónica , López-Benito Azahara , Muñoz Gloria , del Castillo Francisco Javier , Vela Lydia , Martínez-Castrillo Juan Carlos , Sánchez-Capelo Amelia 
Published: July 2022

ABSTRACTThere is evidence that transforming growth factor (TGF)-β signaling participates in the pathology of Parkinson’s disease (PD). Dampened TGF-β signaling in Smad3- or TβRII-deficient mice leads to the appearance of α-synuclein inclusions in the brain, as well as dopaminergic, motor, and cognitive deficits. Accordingly, we hypothesized that genetic variants of TGFB/SMAD could be risk factors for PD in humans. Here, we present two independent case-control studies aimed at evaluating the association between genetic variants of six genes related to TGF-β signaling (TGFB1, TGFB2, TGFBRI, TGFBRII, SMAD3 and SMAD2) and the development of sporadic PD. A total of 275 unrelated Spanish Caucasian individuals were included in the study (141 cases and 134 controls), with 132 individuals in the discovery phase and 143 individuals in the replication phase. Next-generation sequencing identified a total of 409 variants in the coding, splicing, and untranslated regions of these genes. Analysis of common variants in the discovery phase revealed an association between PD and the TGFB1 rs8179181 variant, which was further confirmed in the replication phase [odds ratio (OR) 0.48, 95% confidence interval (CI) 0.32–0.73, p = 0.00057). A weak association of the SMAD3 rs11556089 polymorphism with PD was also detected (OR 0.49, 95% CI 0.26–0.93, p = 0.0375). Seven haplotypes were identified; however, there were no significant differences in their frequencies between patients with PD and controls. In conclusion, both the discovery and replication phases of this study suggest that the rs8179181 variant of TGFB1 represents a novel susceptibility locus for PD.HIGHLIGHTSDeficient TGF-β signalling via Smad3 induces the formation of α-synuclein aggregates and a parkinsonian pathology in mice.TGFB1, TGFB2, TGFBRI, TGFBRII, SMAD3 and SMAD2 genes were sequenced to search for associations of their allelic variants with idiopathic PD.Two independent case-control studies of Spanish Caucasian individuals identified 409 genetic variants in their coding, splicing and UTR regions.The rs8179181 SNP in TGFB1 was reproducibly associated with idiopathic PD, representing a novel PD susceptibility locus.