bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variation in within-host replication kinetics among virus genotypes provides evidence of specialist and generalist infection strategies across three salmonid host species
Authors: Páez David J , McKenney Douglas , Purcell Maureen K , Naish Kerry A , Kurath Gael 
Published: August 2022

Abstract
Theory of the evolution of pathogen specialization suggests that a specialist pathogen gains high fitness in one host, but this comes with fitness loss in other hosts. By contrast, a generalist pathogen does not achieve high fitness in any host, but gains ecological fitness by exploiting different hosts, and has higher fitness than specialists in nonspecialized hosts. As a result, specialist pathogens are predicted to have greater variation in fitness across hosts, and generalists would have lower fitness variation across hosts. We test these hypotheses by measuring pathogen replicative fitness as within-host viral loads from the onset of infection to the beginning of virus clearance, using the rhabdovirus infectious hematopoietic necrosis virus (IHNV) in salmonid fish. Based on field prevalence and virulence studies, the IHNV subgroups UP, MD, and L are specialists, causing infection and mortality in sockeye salmon, steelhead, and Chinook salmon juveniles, respectively. The UC subgroup evolved naturally from a UP ancestor and is a generalist infecting all three host species but without causing severe disease. We show that the specialist subgroups had the highest peak and mean viral loads in the hosts in which they are specialized, and they had low viral loads in nonspecialized hosts, resulting in large variation in viral load across hosts. Viral kinetics show that the mechanisms of specialization involve the ability to both maximize early virus replication and avoid clearance at later times, with different mechanisms of specialization evident in different host–virus combinations. Additional nuances in the data included different fitness levels for nonspecialist interactions, reflecting different trade-offs for specialist viruses in other hosts. The generalist UC subgroup reached intermediate viral loads in all hosts and showed the smallest variation in fitness across hosts. The evolution of the UC generalist from an ancestral UP sockeye specialist was associated with fitness increases in steelhead and Chinook salmon, but only slight decreases in fitness in sockeye salmon, consistent with low- or no-cost generalism. Our results support major elements of the specialist–generalist theory, providing evidence of a specialist–generalist continuum in a vertebrate pathogen. These results also quantify within-host replicative fitness trade-offs resulting from the natural evolution of specialist and generalist virus lineages in multi-host ecosystems
Breastfeeding on Injectable Opioid Agonist Therapy: A Case Report
Authors: Patricelli Charissa J. , Gouin Isabelle J. , Gordon Shanlea , Carter Nicole , Albert Arianne , Paquette Vanessa , Stewart Karly , George Shawn , Urbanoski Karen 
Published: August 2022

Background
Injectable opioid agonist therapy (iOAT) is the highest-intensity treatment currently available in Canada for individuals with severe opioid use disorder. However, there is limited data on iOAT administration in the perinatal period, with no research, practice guidelines, or known reports of breastfeeding on iOAT. This article presents the first known case of an individual breastfeeding on iOAT.

Case summary
We present a case of a pregnant 32-year-old woman from Canada with severe opioid use disorder, who stabilized with iOAT and chose to breastfeed her infant. She presented to hospital at 38 + 6 gestation in labor, unstable in her substance use disorder despite multiple interventions and was initiated on iOAT (intravenous hydromorphone) shortly after delivery. Before initiation of breastfeeding the infant was admitted to the neonatal intensive care unit for monitoring. On day 9 of life the infant received breastmilk for the first time, and was discharged from neonatal intensive care unit on day 12 of life with no clinical evidence of sedation or respiratory depression. The infant maintained mixed feeding and at 58 days of life was discharged in the mother and father’s care, a healthy infant with stable vitals.

Discussion
This case suggests positive infant and maternal health and social outcomes for breastfeeding on iOAT. Further research on perinatal iOAT use and the pharmacokinetics of high-dose hydromorphone in breastmilk is required to inform clinical practice guidelines to safely support individuals and their infants who are impacted by substance use.
High-risk Coronary Plaque Regression in Cash-based Contingency Management Intervention Among Cocaine Users With HIV-associated Subclinical Coronary Atherosclerosis
Authors: Lai Hong , Bluemke David A. , Fishman Elliot K. , Gerstenblith Gary , Celentano David D. , Treisman Glenn , Foster Parker , Mandler Raul , Khalsa Jag , Chen Shaoguang , Bhatia Sandeepan , Kolossváry Márton , Lai Shenghan 
Published: August 2022

Background
Cocaine use exacerbates human immunodeficiency virus (HIV)–associated subclinical coronary atherosclerosis. We investigated whether cocaine abstinence or reduced use achieved with contingency management (CM) intervention would retard high-risk coronary plaque progression among cocaine users with HIV and subclinical coronary atherosclerosis.

Methods
Between March 2014 and August 2017, 76 cocaine users with HIV and coronary plaques were enrolled in a study designed to decrease cocaine use and determine whether doing so impacted progression of subclinical coronary atherosclerosis as measured by coronary artery computed tomography examinations. Of the 76, 7 did not complete the study, resulting in 69 participants. A 12-month cash-based CM intervention was implemented to promote cocaine abstinence or reduced cocaine use. Generalized estimating equation approach was used to perform longitudinal data analyses.

Findings
During the 12-month CM, all 69 participants reduced cocaine use, and of these, 25 (36%; 95% confidence interval, 25%–49%) achieved cocaine abstinence. After adjusting for potential confounding factors, generalized estimating equation analyses showed that (1) endothelin-1 (ET-1) levels, a proinflammatory biomarker for endothelial dysfunction, at the 6-month and 12-month visits were significantly lower compared with baseline ET-1 (P = 0.001 and P < 0.001, respectively), and (2) low-attenuation noncalcified coronary plaque volume, a predictor for myocardial infarction, at 12-month visit was significantly lower compared with baseline low-attenuation noncalcified coronary plaque volume (P < 0.05).

Conclusions
The findings of this study have not only demonstrated that CM is effective in achieving a sustained reduction in cocaine use, but also provided compelling evidence that reduction in cocaine use leads to quantifiable cardiovascular health benefits, including concurrent decrease in high-risk plaque burden and ET-1, among cocaine users with HIV-associated coronary atherosclerosis.
Comminuted Olecranon Fractures (Mayo IIB): Is Dynamic Tension Band Wiring Enough?
Authors: Esper Garrett W. , Herbosa Christopher G. , Moses Michael J. , Egol Kenneth A. 
Published: August 2022

Objectives:
To compare the efficacy and outcomes of dynamic tension band wiring (TBW) and plate and screw (PS) fixation of comminuted (Mayo Type IIB) olecranon fractures.

Design:
Retrospective cohort.

Setting:
Academic medical center.

Patients/Participants:
Forty-one patients with Mayo type IIB (OTA/AO 2U1C) olecranon fractures were involved in the study.

Intervention:
Patients with tensile Mayo type IIB olecranon fractures between August 2012 and November 2020 treated by a single surgeon with either TBW or PS fixation were reviewed for demographics, radiographic/surgical details, and clinical/functional outcomes. Descriptive fracture data included proximal olecranon fragment size and the presence of joint impaction at surgery.

Main Outcome Measurements:
The main outcome measurements were Mayo Elbow Performance Score, elbow range of motion, patient-reported pain, and complications.

Results:
The mean follow-up was 38 months. Fractures healed for all patients in both groups. No differences in clinical outcomes, functional outcomes, elbow range of motion, or complications were seen between fixation groups. There was no difference in proximal fragment size between the 2 groups. Fractures with articular impaction requiring elevation and grafting demonstrated no difference in clinical or functional outcomes when compared with those that did not have any impaction. However, patients with impacted articular fractures treated with TBW had a higher rate of implant removal (25% vs. 0%, P = 0.05) when compared with those treated with PS.

Conclusions:
Comminuted Mayo IIB olecranon fractures are amenable to TBW or plate construct, with similar clinical and functional outcomes. The presence of articular impaction is associated with a greater need for implant removal.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Injury Pattern Recognition and Surgical Technique of Pilon Fracture Reduction With Posterior Tibial Tendon Incarceration
Authors: Labrum Joseph T. , Gallagher Bethany , Boyce Robert H. 
Published: August 2022

Summary:
Pilon fractures occur over a broad spectrum of injury severity and soft-tissue compromise. This article will review a distinct pilon injury variant characterized by posterior tibial tendon incarceration in posteromedial pilon fracture propagation. This injury pattern is vital to recognize preoperatively because failure to mobilize the entrapped posterior tibial tendon (PTT) will result in fracture malreduction and postoperative loss of PTT excursion. In addition, the authors’ preferred surgical technique for PTT mobilization and anatomic fracture reduction is described.
Deciphering diffuse glioma immune microenvironment as a key to improving immunotherapy results
Authors: Picca Alberto , Finocchiaro Gaetano 
Published: August 2022

Purpose of review
Immunotherapeutic approaches have yet to demonstrate their clinical efficacy in diffuse gliomas. Evidence is mounting that the central nervous system is subject to immune surveillance, but brain tumours manage to escape due to factors intrinsic to their tumoral immune microenvironment (TME). This review aims to discuss the recently characterized molecular bases of the glioma TME and the potentially actionable targets to improve immunotherapeutic results in these hard-to-treat cancers.

Recent findings
Single-cell studies defined the composition of the glioma immune TME and its peculiarities compared with other solid cancers. In isocitrate dehydrogenase (IDH) wildtype gliomas, the TME is enriched in myeloid cells (monocyte-derived macrophages and resident microglia) with mainly immunosuppressive functions. Lymphocytes can infiltrate the glioma TME, but are exposed to multiple immunomodulating signals that render them in a state of deep exhaustion. IDH mutant gliomas produce the oncometabolite D-2-hydroxyglutarate with negative effects on leukocyte recruitment and function, resulting in the induction of an ‘immune-desert’ TME.

Summary
Several molecular pathways have been recently identified in the induction of an ‘immune-hostile’ microenvironment in diffuse gliomas, unravelling potential vulnerabilities to targeted immunotherapies.
Age-Related Changes in Intraocular Pressure: Japan Ningen Dock Study
Authors: Terauchi Ryo , Wada Takashi , Fukai Kota , Tatemichi Masayuki , Ogawa Shumpei , Noro Takahiko , Ito Kyoko , Kato Tomohiro , Kato Kiminori , Nakano Tadashi 
Published: August 2022

Précis:
The analysis of intraocular pressure by age using a mega database showed a consistent age-related intraocular pressure decrease.

Purpose:
To clarify the association between age and intraocular pressure (IOP), the IOP value by age was assessed using a large IOP database.

Materials and Methods:
This cross-sectional study was conducted among 103 health checkup institutions registered to the Japan Society of Ningen Dock, and included participants who underwent annual health checkups between April 2014 and March 2015. The inclusion criteria were as follows: complete data for IOP in eyes, body mass index, waist circumference, blood pressure, hemoglobin A1c, and a self-administered health questionnaire. A total of 655,818 participants were enrolled. The mean age was 51.5±10.5 years (range, 20–96 y), and 40.1% were women. IOP was measured using a noncontact tonometer. Multiple linear regression analysis was conducted to explore factors associated with IOP, including age, and analyses stratified by age group: <40, 40–69, and ≥70 years.

Results:
A consistent negative association between IOP and age [β=−0.353 (95% confidence interval: −0.360–−0.346)] was observed. In the age groups of <40 and ≥70 years, the age-related IOP decline was more pronounced [β=−0.502 (95% CI: −0.566 to –0.439); β=−0.674 (95% CI: −0.753 to –0.595)], with it being 14.21±2.95 and 11.18±2.52 mm Hg in the 20–24 and 90–96 year age groups, respectively. The middle-aged (aged 40–69 y) population showed gradual decline [β=−0.313 (95% CI: −0.323 to –0.303)].

Conclusion:
Age was strongly and negatively associated with IOP. The magnitude of IOP decline across lifespans was ∼3 mmHg. Age-related decreases in IOP were nonlinear and phasic.
Addressing telehealth education in a family nurse practitioner program through simulation-based learning
Authors: Berrier Faith , Hellier Susan 
Published: August 2022

ABSTRACT
Telehealth usage increased because of the COVID-19 pandemic. Health care agencies responded by increasing existing platforms and implementing new telehealth platforms. Despite the demand, health care providers may have had little training in the telehealth care delivery model in the workplace or embedded in school. Based on educational theory, evidence, and best practice, the authors crafted a learning module that focused on telehealth medical skills followed by a summative standardized patient simulation. This article describes the development, implementation, and evaluation of the learning module and the summative simulation assessment. The learning module and the simulation provided a teaching strategy that resulted in an objective measurement of student clinical performance, which may be elusive in a traditional face-to-face practicum. Additionally, the simulation-based learning resulted in increased student satisfaction with simulation and increased self-confidence to apply the information in the clinical setting.
Radiologic Features in Cochlear Implant Candidates: A Prospective Study Comparing Candidates Carrying the p.Pro51Ser Mutation in Coagulation Factor C Homology With Noncarriers
Authors: Beerten Anneleen , Bosmans Helena , Lauwers Meindert , Vermeulen Helene , Janssens de Varebeke Sebastien Pierre 
Published: August 2022

Background
DFNA9 is a form of autosomal progressive sensorineural hearing loss, caused by more than 30 variants in the COCH gene. p.Pro51Ser (p.P51S) variant is characterized by late-onset functional deterioration toward bilateral severe hearing loss and vestibulopathy. Focal sclerosis on computed tomography (CT) and T2-weighted magnetic resonance imaging (MRI) signal loss of semicircular canals are presumably radiologic biomarkers of advanced otovestibular deterioration.

Objectives
The aim of this study was to investigate whether these biomarkers are more frequent in cochlear implant candidates carrying the p.P51S mutation versus noncarriers. Second, the correlation between the hearing and vestibular function and carrier status was studied. Finally, the relationship between the presence of these radiologic features and the degree of hearing and vestibular deterioration was investigated.

Methods
A prospective cohort study was performed on 38 candidates for cochlear implantation in a tertiary referral center. Patients underwent pure tone audiometry, videonystagmography, video head impulse tests and vestibular-evoked myogenic potentials. In addition, three dizziness questionnaires were used. All subjects were administered CT, MRI, and molecular genetic analysis.

Results
Sixteen of 38 patients were carriers of the p.P51S COCH mutation. Radiologic lesions were almost exclusively observed in carriers. MRI was more sensitive in showing lesions than CT. Furthermore, p.P51S carriers showed significantly lower function on most vestibular tests, including questionnaires, than noncarriers. Patients with imaging abnormalities showed more pronounced vestibulopathy.

Conclusion
The present study supplements previous data that endorse the hypothesis that focal sclerosis of semicircular canals are biomarkers of advanced vestibular deterioration, especially in DFNA9.
Characteristics of Pediatric Nasal Foreign Body Cases That Required Multiple Removal Procedures
Authors: Kawaguchi Risa , Matsui Satoshi , Hayashi Takuro , Takei Hirokazu , Tanizawa Naoko , Ohnishi Yasuhiro , Sameshima Tomohiro , Miyawaki Kousuke , Yoshii Takuma Henry , Tanaka Ryojiro 
Published: August 2022

Objectives
Removal of nasal foreign bodies in children should be completed as few numbers of times as possible to reduce the burden on the child. This study aimed to reveal the characteristics of pediatric nasal foreign body cases that required multiple removal procedure and to investigate the appropriate removal method for each shape of foreign body.

Methods
We retrospectively reviewed patients who visited a pediatric emergency department because of nasal foreign body from November 1, 2018, to October 31, 2020. We compared the characteristics of patients, foreign bodies, and treatment between the success and failure groups in the first removal procedure. Moreover, we described the detail of patients in the failure group. We also showed final successful removal methods according to the shape of the foreign bodies.

Results
We included 104 children in our analysis. Between the success and failure groups in the first removal procedure, there was no statistically significant difference in the characteristics of patients and foreign bodies but a significant difference in the removal method (P < 0.001). In the failure groups, the most frequent number of times required for removal is 2 and the most common methods in the first removal procedure was the parent's kiss, most of which were performed on spherical foreign bodies in younger children, Finally, only 7 cases (6.7%) failed to remove the foreign body. According to the shape of the foreign bodies, the percentage of forceps and clamps used for successful removal was high in every shape.

Conclusions
There was a significant difference in the removal method between the success and failure groups in the first removal procedure, but finally, most foreign bodies were removed by emergency physicians. Therefore, further research is needed to determine the appropriate removal method for each patient and foreign body.
Proinflammatory and cardiovascular biomarkers are associated with echocardiographic abnormalities in children with HIV taking antiretroviral therapy
Authors: Majonga Edith D. , Yindom Louis-Marie , Hameiri-Bowen Dan , Mayini Justin , Rehman Andrea M. , Kaski Juan P. , Mujuru Hilda A. , Rowland-Jones Sarah L. , Ferrand Rashida A. 
Published: August 2022

Objectives:
Children with perinatally acquired HIV (PHIV) and taking antiretroviral therapy (ART) have a high prevalence of subclinical cardiac disease. We hypothesized that cardiac disease may be a consequence of dysregulated systemic immune activation driven by HIV infection. We examined cardiovascular and proinflammatory biomarkers and their association with echocardiographic abnormalities in children with PHIV.

Design:
Cross-sectional analysis of soluble biomarkers from a prospective cohort of children aged 6–16 years with PHIV and age-matched HIV-uninfected comparison group.

Methods:
Cryopreserved plasma samples were used to measure seven soluble biomarkers using multiplex bead assay (Luminex). Multivariable logistic regression assessed how biomarker levels related to cardiac abnormalities.

Results:
A total of 406 children participated in this study (195 PHIV and 211 HIV-uninfected). Mean [standard deviation (SD)] ages of PHIV and HIV-uninfected participants were 10.7 (2.6) and 10.8 (2.8) years, respectively. Plasma levels of CRP, TNF-α, ST2, VCAM-1 and GDF-15 were significantly higher in the PHIV group compared with uninfected control (P < 0.001). Among children with PHIV, with one-unit representing one SD in biomarker level, a one-unit increase in CRP and GDF-15, was associated with increased odds of having left ventricular (LV) diastolic dysfunction [adjusted odds ratio (aOR), 1.49 (1.02–2.18; P < 0.040)] and [aOR 1.71 (1.18–2.53; P = 0.006)], respectively. Each one unit increase in GDF-15 was associated with increased odds of LV hypertrophy [aOR 1.84 (95% CI 1.10–3.10; P < 0.021)].

Conclusion:
Children with PHIV had higher levels of proinflammatory and cardiovascular biomarkers compared with HIV-uninfected children. Increased CRP and GDF-15 were associated with cardiac abnormalities in children with PHIV.
The Orbital Bones Protect the Globe From Sharp Periorbital Trauma Injuries
Authors: Nemet Arie Y. 
Published: August 2022

Background:
The bones of the orbit hold the globe and periocular structures and protect it and other periocular contents. This has been shown in blowout orbital fractures, as well as in high-energy injuries to the periorbital region. However, there is little information regarding how the orbital bones protect the globe after periorbital trauma from sharp objects.

Objectives:
This study reports 4 cases of traumatic injury from sharp objects to the periorbital area and eyelids to demonstrate the protective features of the orbital bones.

Results:
The anatomy of the periorbital bones clearly protected the globe from direct trauma in all the 4 cases.

Conclusions:
There was no harm to the orbit or visual impairment after the successful treatment with definitive surgery.
Behavioral, Learning Skills, and Visual Improvement in Crouzon Syndrome Patient Following Late Posterior Vault Distraction Osteogenesis
Authors: Raposo-Amaral Cassio E. , Menezes Priscila T. , Gil André , Raposo-Amaral Cesar A. , Ghizoni Enrico 
Published: August 2022

Background:
It is well accepted among craniofacial surgeons that surgery does not improve mental status but does prevent worsening or deterioration of cognitive and mental function. In this report, we describe significant improvement in behavioral, learning skills and visual acuity for a Crouzon patient who underwent late posteriorvault distraction osteogenesis.

Methods:
A 9-year-old Crouzon patient was referred to our hospital, presenting severe intracranial hypertension. The patient had previously undergone a strip craniectomy in early infancy at another medical institution, but there was no subsequent follow-up. Magnetic resonance imaging showed Chiari type I malformation and fundoscopy revealed papilledema. At the time of referral, the patient was not attending a regular school, had not acquired reading skills, was unable to concentrate, and could not accomplish school-related tasks that were standard for children in his age group.

Results:
The patient underwent posterior vault distraction osteogenesis and showed concentration improvement and acquisition of fluent reading skills. Chiari type I malformation resolved as well as papilledema. visual acuity improved at Snellen test preoperatively from 20/200 to 20/60 at postoperative test. Ventricle size remained unchanged subsequent to performance of the posterior cranial vault distraction. The occipital veins were less visible upon clinical examination and less pronounced when palpated, and the bruit had completely disappeared.

Conclusion:
Late posterior vault distraction osteogenesis can improve behavioral, learning skills and visual acuity as shown in this 9-year-old Crouzon patient.