bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Blood Loss of Isolated Acetabular Fractures
Authors: McGee Andrew , Obinwa Chibuike , White Parker , Cichos Kyle , McGwin Gerald , Bergin Patrick , Spitler Clay 
Published: September 2022

Objective:
To quantify preoperative blood loss in isolated acetabular fractures and identify any fracture or patient characteristics associated with increased blood loss or blood transfusion.

Design:
Retrospective cohort study.

Setting:
Two level 1 trauma centers.

Patients/Participants:
All patients with operative, isolated acetabular fractures from January 2010 to December 2018.

Intervention:
Operative management of an acetabular fracture.

Main Outcome Measurements:
Volume of preoperative blood loss and transfusion rates associated with isolated acetabular fracture patterns.

Results:
A total of 598 patients were included. The mean preoperative blood loss of all fractures was 1172.6 mL. The 3 fracture patterns with the greatest average preoperative blood loss were associated both column (1454.9 mL), T-type (1374.8 mL), and anterior column posterior hemitransverse fractures (1317.7 mL). The acetabular fracture pattern had a significant association with preoperative blood loss and preoperative transfusion. The timing from injury to surgery and body mass index were significantly associated with preoperative blood loss.

Conclusions:
In conclusion, operatively treated isolated acetabular fractures surprisingly lose an average of greater than 1 liter of blood in the preoperative setting. Surgeons must carefully assess patient's physiology, ensuring they are adequately resuscitated before surgery and remain aware that increasing body mass index is associated with increased preoperative blood loss. However, as patients await surgery, unreduced acetabular fractures continue to contribute to ongoing blood loss beyond the first 24 hours from injury. We believe the best hemostasis after initial resuscitation is provided by surgical reduction and fixation, and we recommend a continued early surgical intervention to prevent continued bleeding from fracture surfaces.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Consensus and inconsistency between different consensus documents on renal denervation worldwide: the way forward
Authors: Wang Tzung-Dau 
Published: September 2022

Abstract
Given the unsatisfactory hypertension control rates and high rates of non-adherence to antihypertensive medications worldwide, device therapy which can safely provide durable blood pressure-lowering effects can fulfill the unmet need. A series of second-generation randomized sham-controlled renal denervation (RDN) trials have demonstrated the efficacy and safety of RDN in a wide range of hypertensive patients. The four representative consensus documents on RDN (from the Taiwan Hypertension Society and Taiwan Society of Cardiology [THS/TSOC 2019], Asia Renal Denervation Consortium 2019, European Society of Hypertension [ESH 2021], and Society for Cardiovascular Angiography & Intervention and National Kidney Foundation [SCAI/NKF 2021]) consistently recommend RDN as an alternative or complementary treatment strategy for patients with uncontrolled hypertension. In addition, both documents from Asia further recommend that RDN can be considered as an initial treatment strategy for drug-naïve hypertensive patients. There is still inconsistency regarding whether ambulatory blood pressure monitoring should be used routinely both before and after RDN, and whether patients with a secondary cause of hypertension could be treated with RDN if their blood pressure remains uncontrolled after definitive treatment (treatment-resistant secondary hypertension). The THS/TSOC consensus provides acronyms to summarize key aspects of patient selection (RDNi2) and pre-RDN assessments (RAS). The ESH and SCAI/NKF documents recommend establishing structured pathways for clinical practice and issues regarding reimbursement. All documents identify knowledge gaps in RDN, from identifying predictors of super-responders to demonstrating effects on cardiovascular events. These gaps should be urgently filled to facilitate the wider application of this device therapy for patients with hypertension.
Efficacy of different doses of intranasal dexmedetomidine in preventing emergence agitation in children with inhalational anaesthesia
Authors: Lei Dong-Xu , Wu Chun-Ju , Wu Ze-Yan , Wang Ling-Yu , Zhao Qing , She Ying-Jun 
Published: September 2022

BACKGROUND
Emergence agitation is a common paediatric complication after inhalational anaesthesia. Intranasal dexmedetomidine can prevent emergence agitation effectively, but the optimal dose is uncertain.

OBJECTIVE
The aim of our study was to investigate the 95% effective dose (ED95) of intranasal dexmedetomidine for the prevention of emergence agitation after inhalational anaesthesia for paediatric ambulatory surgery.

DESIGN
A prospective, randomised, placebo-controlled, double-blind, clinical trial.

SETTING
The study was conducted in Guangzhou Women and Children's Medical Center in China from August 2017 to December 2018.

PATIENTS
Three hundred and eighteen children scheduled for ambulatory surgery were enrolled into two age groups of less than 3 years and at least 3 years.

INTERVENTIONS
The children in each age group were randomised into five equal subgroups to receive either intranasal dexmedetomidine 0.5, 1.0, 1.5 or 2.0 μg kg−1 (Groups D0.5, D1.0, D1.5 and D2.0), or intranasal isotonic saline (group C) after induction.

MAIN OUTCOME MEASURES
The primary outcome was the ED95 dose of intranasal dexmedetomidine for preventing emergence agitation after inhalational anaesthesia for paediatric ambulatory surgery.

RESULTS
The incidences of emergence agitation for Groups C, D0.5, D1.0, D1.5 and D2.0 were 63, 40, 23, 13 and 3% in children less than 3 years, and 43, 27, 17, 7 and 3% in children at least 3 years. The ED95 of intranasal dexmedetomidine for preventing emergence agitation was 1.99 μg kg−1 [95% confidence interval (CI), 1.83 to 3.80 μg kg−1] in children less than 3 years, and 1.78  μg kg−1 (95% CI, 0.93 to 4.29 μg kg−1) in children at least 3 years. LMA removal time for groups D1.5 and D2.0 was 9.6 ± 2.2 and 9.7 ± 2.5 min, respectively, for children less than 3 years, and 9.4 ± 2.0 and 9.9 ± 2.7 min in children at least 3 years, respectively. Length of stay in the postanaesthesia care unit for Groups D1.5 and D2.0 was 34.3 ± 9.6 and 37.1 ± 11.2 min, respectively, in children less than 3 years, and 34.7 ± 10.2 and 37.3 ± 8.3 min in children at least 3 years, respectively. These times were longer in the D1.5 and D2.0 subgroups than in the control subgroup in the two age groups of less than 3 years and at least 3 years, respectively: 7.2 ± 1.9 min in children less than 3 years and 7.3 ± 2.5 min in children at least 3 years for LMA removal time, 22.2 ± 7.9 min in children less than 3 years and 22.0 ± 7.7 min in children at least 3 years for PACU stay time in control subgroup, respectively; P < 0.05).

CONCLUSION
Intranasal dexmedetomidine prevented emergence agitation after paediatric surgery in a dose-dependent manner. The optimal dose of intranasal dexmedetomidine for preventing emergence agitation was higher in younger children.

TRIAL REGISTRY
chictr.org.cn: ChiCTR-IOR-17012415.
Comparative visual outcomes of EDOF intraocular lens with FLACS vs conventional phacoemulsification
Authors: Xu Jia , Li Wenbo , Xu Zhe , Zhao Binsong , Zhong Yueyang , Wang Kai , Liu Xin , Song Xiaohui , Yu Yinhui , Zhu Yanan , Tang Qiaomei , Yao Ke 
Published: September 2022

Purpose:
To investigate the visual quality after femtosecond laser–assisted cataract surgery (FLACS) and conventional phacoemulsification surgery (CPS) with the implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL) TECNIS Symfony.

Setting:
Eye Center, the Second Affiliated Hospital of Zhejiang University, Zhejiang, China.

Design:
Prospective cohort study.

Methods:
Patients were given the option to choose FLACS or CPS and were implanted with a TECNIS Symfony. Main outcome measures were postoperative examinations that included defocus curves, contrast sensitivity (CS), optic path difference aberrometry scan, anterior segment photography, and questionnaires.

Results:
261 patients (261 eyes) were enrolled. The circularity index of FLACS was more precise than that of CPS (P = .001). FLACS demonstrated a significantly lower IOL decentration (P = .011) and IOL tilt (P = .009). FLACS presented a significantly lower total aberration (P < .001), higher-order aberrations (HOAs) (P = .001), coma (P = .001), and spherical aberration (P < .001). With IOL decentration of more than 0.40 mm, total internal aberration (P = .023) and HOAs (P = .045) were significantly deteriorated. As for defocus curve, FLACS was better at −1.00 diopter (P < .01). The FLACS group achieved higher CS at 6 to 18 cycles per degree under glare condition (P < .05). With regard to photic phenomena, the FLACS group received better outcomes (P < .05).

Conclusions:
With the implantation of an EDOF IOL, FLACS could precisely control the shape and size of the capsulotomy and induce a significantly better-centered IOL, leading to higher visual performance compared with CPS.
Stigma Toward Mental Illness Among Saudi Medical Students
Authors: Almadani Ahmad H. , AbuDujain Nasser M. , Aljebreen Shahad M. , AlJaffer Mohammed A. 
Published: September 2022

Abstract
This cross-sectional study aims to compare pre- versus post-psychiatry course stigma levels toward mental illnesses among King Saud University medical students and identify which factors could affect stigma degree. The sample included 384 randomly chosen students. The overall scores of the used scale, the 15-item Opening Minds Scale for Healthcare Providers (OMS-HC-15), indicated no statistically significant difference between the before- and the after-psychiatry-course groups. The univariate analysis for differences in OMS-HC-15 score according to the sociodemographic characteristics of the pre psychiatry course group indicated that the factors associated with the total OMS-HC-15 score were sex (p < 0.001), being diagnosed with mental illness (p < 0.001), and having a relative diagnosed with mental illness (p = 0.005). Among the post psychiatry course group, the univariate analysis indicated that the same factors, namely, sex (p = 0.001), being diagnosed with mental illness (p = 0.006), and having a relative diagnosed with mental illness (p = 0.007), were associated with the total OMS-HC-15 score. Further studies at a larger scale to confirm generalizability of the results are warranted.
Single-cell profiling identifies a CD8brightCD244brightNatural Killer cell subset that reflects disease activity in HLA-A29-positivebirdshot chorioretinopathy
Authors: Nath Pulak R. , Maclean Mary , Nagarajan Vijay , Lee Jung Wha , Yakin Mehmet , Kumar Aman , Nadali Hadi , Schmidt Brian , Kaya Koray D. , Kodati Shilpa , Young Alice , Caspi Rachel R. , Kuiper Jonas J. W. , Sen H. Nida 
Published: September 2022

ABSTRACTBirdshot chorioretinopathy uveitis (BCR-UV) is strongly associated with HLA-A29 which implicates MHC-I pathway mediated perturbation of natural killer (NK) cells as a potential disease mechanism. We profiled blood NK cells at single-cell resolution in a cohort of patients and healthy controls and investigated the links between NK cell subpopulations and disease activity. Flow cytometry analysis of major immune cell lineages revealed substantial expansion of the CD56dimCD16+ NK cells in BCR-UV compared to healthy controls and to other types of non-infectious uveitis.Ex vivorestimulation showed that NK cells from BCR-UV patients exhibit increased secretion of TNF-alpha, a cytokine considered central to the pathogenesis of BCR-UV. Unbiased transcriptomic characterization at single-cell resolution established that the expanded CD16+ (i.e.,FCGR3A+) NK cells also co-express high levels ofCD8AandCD244, indicating expansion of a subset of CD56dimCD16+ CD8+ NK cells in patients. Confirmation of these results by high-dimensional flow cytometry further showed that the BCR-UV-associated CD8brightCD244brightNK cells displayed activation receptors including CD314 (NKG2D), and cytotoxicity receptor CD337 (NKp30). Finally, longitudinal monitoring of patients showed that clinical remission after systemic immunomodulatory treatment correlated with a significant decrease in CD8brightCD244brightNK cells. In conclusion, there is an expansion of CD8brightCD244brightNK cells during active disease in BCR-UV patients which decrease upon successful systemic immunomodulatory treatment, suggesting that CD8bright/CD244brightNK cells may be a pro-inflammatory NK subset involved in the underlying disease mechanism.
Debiasing and Educational Interventions in Medical Diagnosis: A Systematic Review
Authors: Tung Arthur , Melchiorre Michael 
Published: September 2022

AbstractBackgroundThe prevalence of cognitive bias and its contribution to diagnostic errors has been documented in recent research. Debiasing interventions or educational initiatives are key in reducing the effects and prevalence of cognitive biases, contributing to the prevention of diagnostic errors. The objectives of this review were to 1) characterize common debiasing strategies implemented to reduce diagnosis-related cognitive biases, 2) report the cognitive biases targeted, and 3) determine the effectiveness of these interventions on diagnostic accuracy.MethodsSearches were conducted on April 25, 2022, in MEDLINE, Embase, Healthstar, and PsycInfo. Studies were included if they presented a debiasing intervention which aimed to improve diagnostic accuracy. The Rayyan review software was used for screening. Quality assessments were conducted using the JBI Critical Appraisal Tools. Extraction, quality assessment, and analysis were recorded in Excel.ResultsSearches resulted in 2232 studies. 17 studies were included in the final analysis. Three major debiasing interventions were identified: tool use, education of biases, and education of debiasing strategies. All intervention types reported mixed results. Common biases targeted include confirmation, availability, and search satisfying bias.ConclusionWhile all three major debiasing interventions identified demonstrate some effectiveness in improving diagnostic accuracy, included studies reported mixed results when implemented. Furthermore, no studies examined decision-making in a clinical setting, and no studies reported long-term follow-up. Future research should look to identify why some interventions demonstrate low effectiveness, the conditions which enable high effectiveness, and effectiveness in environments beyond vignettes and among attending physicians.PROSPERO registration numberCRD42022331128
Targeting caveolae to pump bispecific antibody to TGF-β into diseased lungs enables ultra-low dose therapeutic efficacy
Authors: Kadam Anil H. , Kandasamy Kathirvel , Buss Tim , Cederstrom Brittany , Yang Chun , Narayanapillai Sreekanth , Rodriguez Juan , Levin Michael D. , Koziol Jim , Olenyuk Bogdan , Borok Zea , Chrastina Adrian , Schnitzer Jan E. 
Published: September 2022

AbstractThe long-sought-after “magic bullet” in systemic therapy remains unrealized for disease targets existing inside most tissues, theoretically because vascular endothelium impedes passive tissue entry and full target engagement. We engineered the first “dual precision” bispecific antibody with one arm pair to precisely bind to lung endothelium and drive active delivery and the other to precisely block TGF-β effector function inside lung tissue. Targeting caveolae for transendothelial pumping proved essential for delivering most of the injected intravenous dose precisely into lungs within one hour and for enhancing therapeutic potency by >1000-fold in a rat pneumonitis model. Ultra-low doses (μg/kg) inhibited inflammatory cell infiltration, edema, lung tissue damage, disease biomarker expression and TGF-β signaling. The prodigious benefit of active vs passive transvascular delivery of a precision therapeutic unveils a new promising drug design, delivery and therapy paradigm ripe for expansion and clinical testing.
Impact of adverse event reporting system on burnout and job satisfaction of nurses in China: a nationwide cross-sectional study using a multilevel modeling approach
Authors: Chen Yanhua , He Yanrong , Wang Peicheng , Jiang Feng , Du Yanrong , Cheung Ming Yen , Liu Huanzhong , Liu Yuanli , Liu Tingfang , Tang Yi-lang , Zhu Jiming 
Published: September 2022

AbstractIMPORTANCEMany organizational and personal factors may contribute to burnout and poor job satisfaction experienced by nurses. Adverse Event Reporting System (AERS) is a key component of organizational-level quality improvement system which impacts workplace wellness for nurses. However, little is known about the underlying influence and mechanism that AERS have on nurse’ well-being.OBJECTIVETo explore the relationship between the implementation of AERS, burnout, and job satisfaction among psychiatric nurses in China. To uncover the mechanism through which AERS influences burnout and job satisfaction, while examining the mediating effect of workplace violence from patients.DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study used the multilevel linear regression analyses with a national sample of 9,744 psychiatric nurses from 41 psychiatric hospitals across 29 provinces in China. Data collection was performed in March 2019, and the analyses were conducted from May to July 2022.MAIN OUTCOMES AND MEASURESThe main outcomes were self-reported burnout and job satisfaction. Burnout was measured by the Maslach Burnout Inventory and job satisfaction was measured using Minnesota Satisfaction Questionnaire.RESULTSAmong 9,744 nurses (mean [SD] age, 34.7 [8.8] years) interviewed, 8064 (82.8%) were female. AERS was positively associated with job satisfaction (β=3.70; p<0.05), but negatively with burnout (β=-3.42; p<0.01) and workplace violence (β=-0.55; p<0.1). Workplace violence was positively associated with burnout (β=2.27; p< 0.01), while negatively associated with job satisfaction (β=-0.81; p<0.01). Mediation analysis indicated that the association between AERS, burnout, and job satisfaction was mediated by workplace violence.CONCLUSIONS AND RELEVANCEThis study highlights that the implementation of AERS is associated with less workplace violence in hospitals, and it may also contribute to lower levels of burnout and higher levels of job satisfaction among psychiatric nurses.Key pointsQuestionHow does hospital’s Adverse Event Reporting System (AERS) impact nurses’ well-being? What are the underlying mechanisms?FindingsIn this cross-sectional study of 9744 psychiatric nurses, nurses in hospitals with AERS reported significantly lower burnout and job dissatisfaction than those in hospitals without AERS. AERS seems to impact well-being by reducing workplace violence.MeaningAlthough Chinese authorities recently stipulated AERS, not all healthcare organizations have fully implemented it. Reporting and consequent quality improvement actions seem to alleviate workplace violence, especially in patient-provider relationship. This will inform hospital management to further leverage AERS for workplace well-being and satisfaction.
Visual evidence for the recruitment of four enzymes with RNase activity to the Bacillus subtilis replication forks
Authors: Hinrichs Rebecca , Graumann Peter L. 
Published: September 2022

AbstractRemoval of RNA/DNA hybrids for the maturation of Okazaki fragments on the lagging strand, or due to misincorporation of ribonucleotides by DNA polymerases, is essential for all types of cells. In prokaryotic cells such as Escherichia coli, DNA polymerase 1 and RNase HI are supposed to remove RNA from Okazaki fragments, but many bacteria lack HI-type RNases, such as Bacillus subtilis. Here, four proteins have been shown to be able to remove RNA from RNA/DNA hybrids in vitro, but their actual contribution to DNA replication is unclear. We have studied the dynamics of DNA polymerase A (similar to Pol 1), 5’->3’ exonuclease ExoR, and the two endoribonucleases RNase HII and HIII in B. subtilis using single molecule tracking. We found that all four enzymes show a localization pattern similar to that of replicative DNA helicase. By scoring the distance of tracks to replication forks, we found that all four enzymes are enriched at DNA replication centers. After inducing UV damage, RNase HIII was even more strongly recruited to the replication forks, and PolA showed a more static behavior, indicative of longer binding events, whereas RNase HII and ExoR showed no response. Inhibition of replication by HPUra clearly demonstrated that both RNase HII and RNase HIII are directly involved in replication, with RNase HIII playing a major role. We found that the absence of ExoR increases the likelihood of RNase HIII at the forks, indicating that substrate availability rather than direct protein interactions may be a major driver for the recruitment of RNases to the lagging strands. Thus, B. subtilis replication forks appear to be an intermediate between E. coli type and eukaryotic replication forks and employ a multitude of RNases, rather than any dedicated enzyme for RNA/DNA hybrid removal.
Simple, rapid, and sensitive quantification of dolichyl phosphates using phosphate methylation and reverse-phase liquid chromatography-high resolution mass spectrometry
Authors: Kale Dipali , Kikul Frauke , Phapale Prasad , Beedgen Lars , Thiel Christian , Brügger Britta 
Published: September 2022

AbstractDolichyl monophosphates (DolPs) are essential lipids in glycosylation pathways that are highly conserved across almost all domains of life. The availability of DolP is crucial for all glycosylation processes, as these lipids serve as membrane-anchored building blocks that various types of glycosyltransferases use to generate complex post-translational modifications of proteins and lipids. Analysis of DolP species by reverse-phase liquid chromatography-mass spectrometry (RPLC-MS) has remained challenging due to their very low abundance and wide range of lipophilicities. Until now, a method for the simultaneous qualitative and quantitative assessment of DolP species from biological membranes has been lacking. Here we describe a novel approach based on simple sample preparation, rapid and efficient trimethylsilyl diazomethane (TMSD)-dependent phosphate methylation and RPLC-MS analysis for quantification of DolP species with different isoprene chain lengths. We used this workflow to selectively quantify DolP species from lipid extracts derived ofSaccharomyces cerevisiae, HeLa and human skin fibroblasts from steroid 5-α-reductase 3-congenital disorders of glycosylation (SRD5A3-CDG) patients and healthy controls. Integration of this workflow with global lipidomics analyses will be a powerful tool to further our understanding of the role of DolPs in pathophysiological alterations of metabolic pathways downstream of HMG-CoA reductase, associated with CDGs, hypercholesterolemia, neurodegeneration, and cancer.
On the Aging and Reproductive Consequences of Biological Complexity
Authors: Sarkar Tapash Jay 
Published: September 2022

AbstractModeling the dynamics of aging often involves attempting to identify a handful of causal factors and correlating it to some ordered and/or disordered evolution. However, this approach may completely overlook the reality of aging as a distributed and complex evolution. Additionally, the theory driving aging should not just be about the how, but also the why, in that there should be motivated objectives and principles behind growth, decay and alternative routes like reproduction. All of these features are incorporated into a new, theoretical model for the aging process proposed herein. It incorporates a number of techniques from other fields that regularly characterize and predict complex systems dynamics.