bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mechanisms of phase-separation-mediated cGAS activation revealed by dcFCCS
Authors: Yao Yirong , Wang Wenjuan , Chen Chunlai 
Published: July 2022

Abstract
Cyclic GMP–AMP synthase (cGAS), as a DNA sensor, plays an important role in cGAS–STING pathway, which further induces expression of type I interferon as the innate immune response. Previous studies reported that liquid–liquid phase separation (LLPS) driven by cGAS and long DNA is essential to promote catalytic activity of cGAS to produce a second messenger, cyclic GMP–AMP (cGAMP). However, the molecular mechanism of LLPS promoting cGAS activity is still unclear. Here, we applied dual-color fluorescence cross-correlation spectroscopy (dcFCCS), a highly sensitive and quantitative method, to characterize phase separation driven by cGAS and DNA from miscible individual molecule to micronscale. Thus, we captured nanoscale condensates formed by cGAS at close-to-physiological concentration and quantified their sizes, molecular compositions and binding affinities within condensates. Our results pinpointed that interactions between DNA and cGAS at DNA binding sites A, B, and C and the dimerization of cGAS are the fundamental molecular basis to fully activate cGAS in vitro. Due to weak binding constants of these sites, endogenous cGAS cannot form stable interactions at these sites, leading to no activity in the absence of LLPS. Phase separation of cGAS and DNA enriches cGAS and DNA by 2 to 3 orders of magnitude to facilitate these interactions among cGAS and DNA and to promote cGAS activity as an on/off switch. Our discoveries not only shed lights on the molecular mechanisms of phase-separation-mediated cGAS activation, but also guided us to engineer a cGAS fusion, which can be activated by 15 bp short DNA without LLPS.
Impact of Ghost Introgression on Coalescent-Based Species Tree Inference and Estimation of Divergence Time
Authors: Pang Xiao-Xu , Zhang Da-Yong 
Published: July 2022

Abstract
The species studied in any evolutionary investigation generally constitute a small proportion of all the species currently existing or that have gone extinct. It is therefore likely that introgression, which is widespread across the tree of life, involves “ghosts,” that is, unsampled, unknown, or extinct lineages. However, the impact of ghost introgression on estimations of species trees has rarely been studied and is poorly understood. Here, we use mathematical analysis and simulations to examine the robustness of species tree methods based on the multispecies coalescent model to introgression from a ghost or extant lineage. We found that many results originally obtained for introgression between extant species can easily be extended to ghost introgression, such as the strongly interactive effects of incomplete lineage sorting (ILS) and introgression on the occurrence of anomalous gene trees. The relative performance of the summary species tree method (ASTRAL) and the full-likelihood method (*BEAST) varies under different introgression scenarios, with the former being more robust to gene flow between nonsister species, whereas the latter performing better under certain conditions of ghost introgression. When an outgroup ghost (defined as a lineage that diverged before the most basal species under investigation) acts as the donor of the introgressed genes, the time of root divergence among the investigated species generally was overestimated, whereas ingroup introgression, as commonly perceived, can only lead to underestimation. In many cases of ingroup introgression that may or may not involve ghost lineages, the stronger the ILS, the higher the accuracy achieved in estimating the time of root divergence, although the topology of the species tree is more prone to be biased by the effect of introgression. [Anomalous gene trees; divergence time; ghost introgression; multispecies coalescent; simulation; species tree.]
Maternal Outcomes in Subsequent Pregnancies After Classical Cesarean Delivery
Authors: Thompson Beatrix B. , Reddy Uma M. , Burn Martina , Abdel-Razeq Sonya , Xu Xiao 
Published: July 2022

OBJECTIVE:
To compare maternal outcomes in subsequent pregnancies of patients who had a prior classical cesarean delivery with those with a prior low transverse cesarean delivery.

METHODS:
We conducted a cross-sectional analysis of patients with live singleton births at or after 24 weeks of gestation who had a prior classical cesarean delivery or a low transverse cesarean delivery in the 2016–2019 National Inpatient Sample database. Outcome measures included mode of delivery, uterine rupture, and severe maternal morbidity (SMM), as defined by the Centers for Disease Control and Prevention. Maternal outcomes were compared using the χ2 test and the propensity score method, accounting for differences in patients' clinical risk factors. Multivariable regressions further assessed how patients' sociodemographic and hospital characteristics might influence the differences in maternal outcomes between the two groups.

RESULTS:
The sample included 1,671,249 patients: 25,540 with prior classical cesarean delivery and 1,645,709 with prior low transverse cesarean delivery. Cesarean delivery occurred in 95.5% of patients with prior classical cesarean compared with 91.3% of those with prior low transverse delivery (P<.001; propensity score method: odds ratio [OR] 0.99, 95% CI 0.85–1.16) and uterine rupture occurred in 1.1% and 0.3%, respectively (P<.001; propensity score method: OR 2.17, 95% CI 1.40–3.36). Among patients with prior classical cesarean delivery, uterine rupture occurred in 10.6% of those who underwent labor compared with 0.3% of those who did not (P<.001). Rates of SMM were 5.9% and 2.0% in the two groups, respectively (P<.001; propensity score method: OR 1.87, 95% CI 1.53–2.29). After adjustment of maternal sociodemographic and hospital characteristics, differences in the risk of uterine rupture and SMM between the two groups were attenuated but remained significant.

CONCLUSION:
Prior classical cesarean delivery was associated with a higher risk of uterine rupture and SMM in subsequent pregnancies, compared with prior low transverse cesarean delivery, even after accounting for patients' clinical, sociodemographic, and hospital characteristics.
Severe Obesity Worsens 30-Day Surgical Outcomes and Projected Costs in Operative Femoral Shaft and Tibial Shaft Fractures
Authors: Pean Christian A. , Rivero Steven M. , Suneja Nishant , Weaver Michael J. 
Published: July 2022

Objective:
To assess the impact of severe obesity on 30-day adverse event rates, hospital length of stay (LOS), readmissions, and projected costs after operative fixation of tibia and femur fractures.

Methods:
An analysis of the American College of Surgeons National Surgical Quality Improvement Project database from 2012 to 2019 of isolated femoral shaft and tibial shaft fracture fixation cases was conducted. Adverse events, LOS, readmission rates, and operative time were queried for severe obesity, defined as body mass index greater than 40, compared with other patients. Student t tests were used to assess continuous variables. Fisher exact test and odds ratios were used for categorical variables. A cost-analysis was also performed to quantify the effect of severe obesity on projected health care expenditures.

Results:
A total of 10,436 patients were included with 7.0% of patients categorized as severely obese. Severely obese patients had higher infectious complication rates (9.0% vs. 6.7%, P = 0.013, OR 1.36, 95% CI 1.04–1.78), readmission rates (7.9% vs. 5.6%, P-value = 0.008, OR 1.44, 95% CI 1.08–1.91), longer LOS (5.8 days SD ±10.2 vs. 5.0 days SD ±7.9 days, P-value = 0.008), and longer operative times (mean 115 minutes ± 56 minutes SD vs. 103 minutes SD ±54 minutes, P-value = <0.001). Severe obesity resulted in an estimated $4258.07 additional health care expenditures per patient compared with nonobese patients. This amounted to a projected added total expenditure of $3.09 million USD in the overall cohort.

Conclusion:
Severe obesity is associated with significantly worse 30-day outcomes and higher readmission rates for patients undergoing operative fixation of tibial shaft and femoral shaft fractures. Health policy considerations should be made to incentivize care for this patient population, particularly in trauma where modification of risk factors before surgery is often not feasible.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Nature products of traditional Chinese medicine provide new ideas in γδT cell for tumor immunotherapy
Authors: Duya Paulina Atieno , Chen Yinxiao , Bai Liding , Li Zhaodong , Li Jiaying , Chai Rundong , Bian Yuhong , Zhao Shuwu 
Published: July 2022

Abstract
Due to the unique features of innate immune cells, the role of γδT cells in tumor immunity has gradually attracted more and more attention. Previous studies have found that γδT cells play a dual role in tumor immunology: tumor-promoting and tumor-controlling. The anti-tumor therapy of γδT cell has made remarkable success in clinical application. Especially in recent years, researchers have provided some novel effective ways such as γδT cell exosomes and adoptive chimeric antigen receptor-γδT cell immunotherapy. However, some problems remain to be solved, such as low expansion rate, poor targeting, and tumor microenvironment limiting the effectiveness of γδT immunotherapy. Traditional Chinese medicine is expected to play a positive role in the body immune-enhancing function, promoting the proliferation and activation of γδT cells, and inducing the differentiation of γδT cells. In this review, we summarize the recent research progress and urgent problems of γδT cell in anti-tumor immunotherapy. Moreover, some new strategies of γδT cell for tumor immunotherapy were proposed.
Anti-fatigue effect from Ginseng Radix et Rhizoma: a suggestive and promising treatment for long COVID
Authors: Zhou Xiangda , Zhang Keying , Liu Lanbo , Zhao Qianru , Huang Ming , Shao Rui , Wang Yanyan , Qu Bin , Wang Yu 
Published: July 2022

Abstract
Two years after the coronavirus disease 2019 (COVID-19) outbreak, an increasing number of patients continue to suffer from long COVID (LC), persistent symptoms, and/or delayed or long-term complications beyond the initial 4 weeks from the onset of symptoms. Constant fatigue is one of the most common LC symptoms, leading to severely reduced quality of life among patients. Ginseng Radix et Rhizoma—known as the King of Herbs in traditional Chinese medicine—has shown clinical anti-fatigue effects. In this review, we summarize the underlying anti-fatigue mechanisms of Ginseng Radix et Rhizoma extracts and their bioactive compounds, with a special focus on anti-viral, immune remodeling, endocrine system regulation, and metabolism, suggesting that Ginseng Radix et Rhizoma is a potentially promising treatment for LC, especially in regard to targeting fatigue.
Development and validation of global prediction models for monitoring the manufacturing process of herbal medicine by ultraviolet spectroscopy
Authors: Zhao Jie , Zhou Zimei , Zhao Fang , Yan Xu , Pan Jianyang , Qu Haibin 
Published: July 2022

Abstract

Objective:
Process monitoring for traditional Chinese medicine (TCM) preparations is necessary to ensure quality of the product. A typical pharmaceutical process of TCM preparations consists of multiple manufacturing units, such as ethanol precipitation, concentration, and water precipitation, among others. Compared with the traditional practice of one prediction model for one unit, the global model covers the variation from samples with different backgrounds or processes and can be used to monitor intermediates from substeps.

Methods:
We used ultraviolet (UV) spectroscopy to establish global models for a typical TCM preparation—Danhong injection. The concentrations of danshensu, protocatechualdehyde, rosmarinic acid, salvianolic acid A, salvianolic acid B, and hydroxyl safflor yellow A and the total phenolic and total sugar contents were quantified for every intermediate from operation units of Danhong injection. New samples prepared by mixing different intermediates were introduced for the calibration set to cover more variations. An accuracy profile was employed to validate the developed method from the aspects of specificity, trueness, precision, accuracy, linearity, and robustness.

Results:
The developed models showed a high determination coefficient (R
2) value up to 0.97 and a low root-mean-square error of the prediction set. Five components of the models passed all validation tests, whereas the total sugar was not suitable for modeling with UV and was not applicable to the whole process.

Conclusions:
This study indicates that the global models of UV spectroscopy for the quantitative determination of phenolic acids are feasible and reliable with a simple, rapid, and non-destructive method.
Anesthesia techniques and the risk of complications as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO).
Authors: Segers Maartje HM , Rosen Paul , van den Biggelaar Frank JHM , Brocato Lucia , Henry Ype P , Nuijts Rudy , Tassignon Marie-José , Young David , Stenevi Ulf , Behndig Anders , Lundström Mats , Dickman Mor M 
Published: July 2022

ABSTRACT

PURPOSE:
To determine the trends in anesthesia techniques for cataract surgery over the past decade and their relationship to surgical complications.

SETTING:
Clinics affiliated with the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO)

DESIGN:
Retrospective cross-sectional register-based study

METHODS:
Variables include patient demographics, visual acuity, ocular comorbidities, surgery characteristics, intraoperative complications, and postoperative complications for the study period from January, 2008, to December, 2018. The anesthesia methods registered in the EUREQUO and included in the study are topical, combined topical and intracameral, sub-Tenon’s, regional, and general anesthesia. Multivariate logistic regression models for each complication were constructed to estimate the adjusted odds ratio (OR) and 95% confidence intervals (CIs).

RESULTS:
Complete data were available of 1,354,036 cataract surgeries. Topical anesthesia increased significantly over time (from 30% to 76%, P<.001). Sub-Tenon’s and regional anesthesia decreased (from 27% and 38% to 16% and 6%, respectively, P<.001), and general and combined topical and intracameral anesthesia remained stable (around 2%). Sub-Tenon’s (OR 0.80 95%CI 0.71-0.91, P<.001), regional (0.74 95%CI 0.71-0.78, P<.001), general (0.53 95%CI 0.50-0.56, P<.001), and intracameral anesthesia (0.76 95%CI 0.64-0.90, P=0.001) carried a significantly decreased risk of posterior capsule rupture (PCR), with and without dropped nucleus, compared with topical anesthesia. The risk of endophthalmitis was significantly lower with regional anesthesia compared with topical anesthesia (OR 0.60 95%CI 0.44-0.82, P=.001).

CONCLUSION:
The use of topical anesthesia for cataract surgery increased over time. Topical anesthesia is associated with an increased risk of PCR with and without dropped nucleus, and endophthalmitis.
Results From the Perceived Value of Certification Tool-12 Survey: Analysis of the Perceived Value of Certification Among Stroke and Neuroscience Nurses
Authors: Walter Suzy Mascaro , McNair Norma D. , Banat Rebecca , Anderson Tracey , Dai Zheng , Wang Kesheng 
Published: July 2022

ABSTRACT

AIM: The purpose of this study was to explore the perceived value of certification among those with a neuroscience or stroke nursing certification. METHODS: The Perceived Value of Certification Tool-12 (PVCT-12) consists of 12 value statements related to the benefits of certification, using a 4-point Likert scale ranging from strongly disagree to strongly agree. Descriptive statistics were used to determine the percentage of agreement among respondents with each of the PVCT-12 items. A generalized linear model approach was then used to estimate the associations between age, sex, race, experience, certification, highest degree earned, primary responsibility, and primary work setting with intrinsic and extrinsic values. An exploratory factor analysis was performed to identify factors on which related variables were found. RESULTS: The 632 certificants were predominantly female (90%) with a mean age of 54 years. Approximately 80% were White, followed by Asian (11%), Hispanic (4%), and Black (3%). Certification included certified neuroscience registered nurse (34%), stroke certified registered nurse (47%), or both (20%). Approximately 57% of the certificants work in critical care/medical-surgical units. Work setting included academic (46%) and community (42%). Responses indicated lower levels of agreement with the value statements regarding certification challenges, professional autonomy, being listened to, and monetary gain. Those in administration had statistically significant higher intrinsic and extrinsic value scores (P = .005) as compared with those in nonadministrative roles. There was no significant difference on perceived intrinsic or extrinsic values for those who work in an academic environment versus those who work in a community environment (P = .25). After factor analysis, the PVCT-12 was found to have 3 factors that accounted for 53.4% of the total variation in the data: recognition of specialization, personal achievement, and professional accomplishment. CONCLUSION: The PVCT-12 incorporated a Likert-type scale to provide levels of agreement for intrinsic and extrinsic values among stroke certified registered nurses and certified neuroscience registered nurses. To complement these findings, further research using open-ended questions is needed to improve our understanding of participant responses regarding complex values such as “autonomy” and the “extent of being listened to.”
A Comparative Survey Study of In-Person Versus Virtual Trauma Peer Review Meetings
Authors: Zebley James A. , Chang Parker , Sarani Babak , Boese Stephanie , Messing Jonathan 
Published: July 2022

Background:
The American College of Surgeons Committee on Trauma mandates regular peer review meetings for verified trauma centers. The COVID-19 pandemic forced in-person meetings to transition to an online platform.

Objective:
The objective of this study was to assess the opinions of participants regarding the benefits and negative aspects of the virtual peer review process. We hypothesize that physicians and nurses would prefer a virtual meeting format.

Methods:
An anonymous online survey of members of the American Association for the Surgery of Trauma and the Society of Trauma Nurses was distributed in May and June of 2021. Demographic data and Likert scale-based responses were collected using the Research Electronic Data Capture platform.

Results:
Invitations were sent to 1,726 physicians and 2,912 nurses. In total, 137 (8%) physicians and 141 (5%) nurses completed the survey. Both groups felt that either platform was effective in addressing opportunities for improvement in care. Physicians disagreed with the statement that anonymous online voting improved their ability to more accurately address opportunities for improvement. In total, 108 (79%) physicians and 100 (71%) nurses preferred a hybrid meeting. Only 18 (13%) physicians and 23 (16%) nurses wanted virtual meetings, whereas only 29 (21%) physicians and 36 (26%) nurses wanted in-person meetings going forward.

Conclusions:
Virtual and in-person trauma peer review meetings are equally effective in terms of case discussion and identifying opportunities for improvement in care. Given that most people preferred a hybrid meeting, future studies evaluating how best to incorporate and implement this format are needed.
Health Care Providers' Lived Experience Caring for Victims of Youth Violence Separated From Family During Trauma Resuscitation
Authors: Kittle Jolene 
Published: July 2022

Background:
Family presence during trauma resuscitation is increasingly emphasized; yet it is inconsistently applied and has not been studied in victims of youth violence from the perspective of the health care provider.

Objective:
The purpose of this study is to explore the lived experience of health care providers involved in the care of children who are separated from their family during trauma resuscitation for injuries sustained from youth violence.

Methods:
A qualitative, transcendental phenomenological study was conducted to examine health care providers' experiences. Data were collected from March 2021 to April 2021 using open-ended, semistructured interviews conducted via Zoom or telephone. Data were transcribed and analyzed following the transcendental phenomenological reduction approach.

Results:
Seven health care providers were interviewed. Ages of the participants ranged from 31 to 60 years (mean: 52.1 years). Years of practice ranged from 9.5 to 36 years (mean: 26 years). The participants' professions included surgeon, registered nurse, violence interventionalist, and social worker. From the data collected, 6 major themes emerged: current landscape, decision making, safety and security, law enforcement presence, characteristics of families of victims of youth violence, and staff reflections.

Conclusions:
This study demonstrates the value of incorporating health care providers' experiences to inform the barriers, facilitators, and nuances of implementing family presence during trauma resuscitation for pediatric victims of violence.
Acute Traumatic Spinal Cord Injury: Implementation of a Multidisciplinary Care Pathway
Authors: Portelli Tremont Jaclyn N. , Cook Nicole , Murray Laura Helen , Udekwu Pascal Osi , Motameni Amirreza T. 
Published: July 2022

BACKGROUND:
Management of acute traumatic spinal cord injuries is complex, and patients are at risk for severe complications while inpatient. Performance review revealed opportunities for improvement in the care of patients with acute traumatic spinal cord injury at our institution.

OBJECTIVE:
To compare mortality, failure-to-rescue, and health care utilization of patients with acute traumatic spinal cord injury after implementation of a revised multidisciplinary care pathway.

METHODS:
Using a pre- and post-between-subjects study design, a retrospective cross-sectional analysis of consecutive patients admitted to our Level I trauma center with acute traumatic spinal cord injury was performed. An updated care pathway for all patients who presented with acute traumatic spinal cord injury was implemented in July 2020. This pathway includes a revised order set in the electronic medical record, distribution of a “best practice” guide to inpatient providers, a formal twice-daily respiratory evaluation, and weekly clinical nurse specialist-led patient rounds.

RESULTS:
One hundred and eight patients were included in analysis (prepathway: n = 52, postpathway: n = 56). Total mean hospital length of stay was 15.2 (14.0) and 21.5 (24.8) days for the pre- and postpathway groups. Eleven patients (21%) compared with six patients (11%) died, and failure-to-rescue occurred in six patients (60%) compared with zero patient in the pre- and postpathway groups, respectively. In addition, 10 (20%) postpathway patients were discharged to home compared with one (2%) in the prepathway group.

DISCUSSION:
Following implementation of the updated acute traumatic spinal cord injury pathway, overall inpatient mortality decreased, and fewer patients died after experiencing a complication. Results highlight the need for continued review of care practices and multidisciplinary review in quality improvement initiatives.