bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutrophils Protect Against
Staphylococcus aureus
Endocarditis Progression Independent of Extracellular Trap Release
Authors: Meyers Severien , Lox Marleen , Kraisin Sirima , Liesenborghs Laurens , Martens Caroline P. , Frederix Liesbeth , Van Bruggen Stijn , Crescente Marilena , Missiakas Dominique , Baatsen Pieter , Vanassche Thomas , Verhamme Peter , Martinod Kimberly 
Published: December 2022

Background:
Infective endocarditis (IE) is characterized by an infected thrombus at the heart valves. How bacteria bypass the immune system and cause these thrombi remains unclear. Neutrophils releasing NETs (neutrophil extracellular traps) lie at this interface between host defense and coagulation. We aimed to determine the role of NETs in IE immunothrombosis.

Methods:

We used a murine model of
Staphylococcus aureus
endocarditis in which IE is provoked on inflamed heart valves and characterized IE thrombus content by immunostaining identifying NETs. Antibody-mediated neutrophil depletion and neutrophil-selective PAD4 (peptidylarginine deiminase 4)-knockout mice were used to clarify the role of neutrophils and NETs, respectively.
S. aureus
mutants deficient in key virulence factors related to immunothrombosis (nucleases or staphylocoagulases) were investigated.

Results:

Neutrophils releasing NETs were present in infected thrombi and within cellular infiltrates in the surrounding vasculature. Neutrophil depletion increased occurrence of IE, whereas neutrophil-selective impairment of NET formation did not alter IE occurrence. Absence of
S. aureus
nuclease, which degrades NETs, did not affect endocarditis outcome. In contrast, absence of staphylocoagulases (coagulase and von Willebrand factor binding protein) led to improved survival, decreased bacteremia, smaller infiltrates, and decreased tissue destruction. Significantly more NETs were present in these vegetations, which correlated with decreased bacteria and cell death in the adjacent vascular wall.

Conclusions:

Neutrophils protect against IE independent of NET release. Absence of
S. aureus
coagulases, but not nucleases, reduced IE severity and increased NET levels. Staphylocoagulase-induced fibrin likely hampers NETs from constraining infection and the resultant tissue damage, a hallmark of valve destruction in IE.
PPARγ (Peroxisome Proliferator-Activated Receptor γ) Deacetylation Suppresses Aging-Associated Atherosclerosis and Hypercholesterolemia
Authors: Zahr Tarik , Liu Longhua , Chan Michelle , Zhou Qiuzhong , Cai Bishuang , He Ying , Aaron Nicole , Accili Domenico , Sun Lei , Qiang Li 
Published: December 2022

Background:
Atherosclerosis is a medical urgency manifesting at the onset of hypercholesterolemia and is associated with aging. Activation of PPARγ (peroxisome proliferator-activated receptor γ) counteracts metabolic dysfunction influenced by aging, and its deacetylation displays an atheroprotective property. Despite the marked increase of PPARγ acetylation during aging, it is unknown whether PPARγ acetylation is a pathogenic contributor to aging-associated atherosclerosis.

Methods:

Mice with constitutive deacetylation-mimetic PPARγ mutations on lysine residues K268 and K293 (2KR) in an LDL (low-density lipoprotein)-receptor knockout (
Ldlr
−/−
) background (
2KR:Ldlr
−/−
) were aged for 18 months on a standard laboratory diet to examine the cardiometabolic phenotype, which was confirmed in Western-type diet–fed

2KR:Ldlr
+/−

mice. Whole-liver RNA-sequencing and in vitro studies in bone marrow–derived macrophages were conducted to decipher the mechanism.

Results:

In contrast to severe atherosclerosis in
WT:Ldlr
−/−
mice, aged
2KR:Ldlr
−/−
mice developed little to no plaque, which was underlain by a significantly improved plasma lipid profile, with particular reductions in circulating LDL. The protection from hypercholesterolemia was recapitulated in Western-type diet–fed

2KR:Ldlr
+/−

mice. Liver RNA-sequencing analysis revealed suppression of liver inflammation rather than changes in cholesterol metabolism. This anti-inflammatory effect of 2KR was attributed to polarized M2 activation of macrophages. Additionally, the upregulation of core circadian component Bmal1 (brain and muscle ARNT-like 1), perceived to be involved in anti-inflammatory immunity, was observed in the liver and bone marrow–derived macrophages.

Conclusions:
PPARγ deacetylation in mice prevents the development of aging-associated atherosclerosis and hypercholesterolemia, in association with the anti-inflammatory phenotype of 2KR macrophages.
Association Between Serum Bilirubin, Lipid Levels, and Prevalence of Femoral and Carotid Atherosclerosis: A Population-Based Cross-Sectional Study
Authors: Su Qingling , Chen Hongyu , Du Shanshan , Dai Yiquan , Chen Cheng , He (何天敏) Tianmin , Feng Ruimei , Tao Tao , Hu Zhijian , Zhao Hongwei , Guo Pingfan , Ye Weimin 
Published: December 2022

Background:
Bilirubin may prevent lipid peroxidation and have important antiatherosclerotic effects. We determined associations of serum bilirubin and lipid with peripheral atherosclerosis.

Methods:
We included 4290 participants (35% men; median age, 60 years) from the southeast China who underwent B-mode ultrasound examination. Increased intima-media thickness or a focal structure encroaching into the arterial lumen by at least 0.5 mm or >50% of the surrounding intima-media thickness value was regarded as having atherosclerosis. Fasting serum bilirubin and lipid levels were measured. Cholesterol/(HDL [high-density lipoprotein] cholesterol+bilirubin), and LDL (low-density lipoprotein cholesterol)/(HDL+bilirubin) ratios were calculated. Unconditional and multinomial logistic regression models were used to examine associations of bilirubin or lipid with prevalence of peripheral atherosclerosis. Mediation analyses were performed to assess the effect of bilirubin on atherosclerosis risk mediated via lipid.

Results:
Compared with participants with the lowest levels of bilirubin, those with the highest tertile were less likely to have carotid or femoral atherosclerosis (odds ratios were 0.55–0.74). The highest levels of bilirubin significantly reduced the odds of concurrent carotid and femoral atherosclerosis by 35% to 45%. Participants with the highest levels of cholesterol, LDL, cholesterol/(HDL+bilirubin), and LDL/(HDL+bilirubin) ratios had 2.8- to 3.7-fold increased odds of concurrent carotid and femoral atherosclerosis. LDL accounted for 25.65% of the total bilirubin-atherosclerosis association. LDL and cholesterol mediated the associations between direct bilirubin and atherosclerosis (proportion: 20.40%, 9.67%, respectively).

Conclusions:
Increased serum bilirubin levels are inversely associated with the prevalence of carotid or femoral atherosclerosis. LDL and cholesterol may mediate these associations.
Into the Wild: Early Modern Protestant Missionaries and Their Views on Animals
Authors: Onnekink David 
Published: December 2022

Abstract
Christianity and the environment have a tense relationship. Although in recent years an eco-theology of stewardship has taken flight, according to theologians as well as philosophers the historical track record of Christians with regard to nature in general and animals in particular leaves much to be desired. However, this view has never been empirically tested. In this article three early modern accounts of Protestant missionaries who lived in Greenland, New Netherland (North America) and Ceylon (Sri Lanka) are analysed in order to uncover attitudes towards animals. The accounts describe local fauna, reflect upon the way in which animals are treated and discuss ‘pagan’ attitudes towards animals. The concepts of tropicality and arcticality are used to help to frame the missionaries’ views on animals in terms of othering non-European fauna. The article concludes that the critique of Christianity’s track record is essentially justified, but also that it was more nuanced and complex than has hitherto been thought. As such, the early modern missionary accounts’ focus on wildlife may well serve as a source of inspiration for present-day missionary organizations.
Utility of PET-CT in Newly Diagnosed HPV-Associated Oropharyngeal Squamous Cell Carcinoma
Authors: Lee Jaclyn , Davis Seth J. , Amin Shaunak N. , Rohde Sarah L. , Kim Young J. 
Published: December 2022

Objective: To compare the utility of positron emission tomography-computed tomography (PET-CT) versus contrasted CT neck combined with routine chest imaging for disease staging and treatment planning in human papillomavirus (HPV) associated oropharyngeal squamous cell carcinoma (OPSCC) with clinically evident sites of primary disease. Methods: All adult patients with primary HPV-associated OPSCC at a single quaternary care cancer center from 2018 to 2019 were reviewed, and those with images available for re-review were included. Primary outcomes included concordance in clinical staging between the 2 imaging modalities of interest (PET-CT vs CT), as well as independent agreement of each with pathologic staging. Analysis was performed via ordinal logistic regression. A secondary outcome was treatment selection after diagnostic imaging, analyzed via chi-squared testing. Results: In total, 100 patients were included for evaluation, of which 89% were male, 91% Caucasian, and mean age was 61.2 years (SD 9.6). Clinical disease staging agreed between imaging modalities in 95% of cases (54 of 57 patients). Pathologic staging agreed with clinical staging from CT neck in 93% of cases (25 of 27 patients; P = .004), and with PET-CT in 82% (14 of 17 patients; P =.003). No differences were observed between the 2 imaging modalities for subsequent treatment selection ( P = .39). Conclusion: In uncomplicated HPV-associated OPSCC, CT offers equivalent diagnostic accuracy to that of combined whole-body PET-CT for clinical staging, and has no appreciable impact on treatment selection. A reduced reliance on routine PET-CT during initial workup of HPV-associated OPSCC may be favorable for otherwise healthy patients with clinically evident sites of primary disease.
The Effect of Task Interruption on Working Memory Performance
Authors: Chen Yue-Yuan , Fang Wei-Ning , Bao Hai-Feng , Guo Bei-Yuan 
Published: December 2022

Objective This study used electroencephalography to explore the behavioral and electrophysiological effects of task interruption on performance. Background Task interruption is known to harm work performance, especially on working memory-related tasks. However, most studies pay little attention to cognitive processes by exploring brain activity and ignore the cumulative effect of sequential interruptions. Method Thirty-four healthy participants performed a spatial 2-back in three conditions: (1) interruptions with simple math questions, (2) suspensions with prolonged fixation cross, and (3) a pure 2-back. The measured outcomes comprise performance data, ERP amplitudes, EEG power, and subjective workload. Results Work performance decreased in the resumption trials, and cumulative interruptions had a more destructive effect on performance. EEG results showed that the P2 and P3 amplitudes induced by the 2-back task significantly increased after interruptions; theta and alpha power increased after interruptions. The P3 amplitude and alpha power induced by interruptions were significantly higher than that induced by suspensions. Conclusion Behavioral data revealed the disruptive effect of interruptions on postinterruption performance and the cumulative effect of interruptions on accuracy. Changes in ERP amplitudes and EEG power indicate the mechanisms of attention reallocation and working memory during interruptions. Larger P3 amplitudes and alpha power after interruptions than after suspensions suggested the inhibition of irrelevant information. These results may support the memory for goals model and improve the understanding of the effects of interruption on working memory. Application Focusing upon the mechanisms at play during the interruption process can support interruption management to ensure work safety and efficiency.
Drain-Less Submandibular Gland Excision With Preserved Facial Artery
Authors: Nofal Ahmed , El-Anwar Mohammad Waheed , Al shawadfy Mohamed A. , Fouad Yasser Ahmed 
Published: December 2022

Objectives To describe our experience in excision of the submandibular gland (SMG) without drain insertion and with preservation of the facial artery as a day case surgery as well as evaluation of the surgical outcomes of this procedure. Methods Prospective case series study of 42 cases of chronic calcular submandibular sialadenitis that underwent SMG excision by the same surgical team during the period from 2017 to 2021. The initial surgical plan in all cases was to excise the SMG with preservation of the facial artery and without drain insertion. Results SMG excision without drain insertion was successfully achieved in 28 patients who were discharged on the same day. In the remaining 14 patients, the surgical dissection was difficult and a suction drain was inserted at the end of the surgery; consequently, they were discharged on the next day. In all cases, facial vessels were preserved, and complete gland excision was achieved. Among the 28 patients who had no drain insertion, 1 patient had a postoperative seroma and no patient had wound related complications. Among the 14 patients who had drain insertion, 2 patients had postoperative seroma and 3 patients had wound related complications in the form of obvious scar formation. There were no other significant complications in all patients. Conclusions Submandibular gland (SMG) excision with facial artery preservation and without drain insertion as a day case surgery could be safely done in cases of chronic calcular inflammation provided that meticulous surgical dissection and complete hemostasis were achieved.
Diagnostic accuracy of lower-dose cardiac CT in evaluating young infants with non-coronary complex congenital heart disease on a 64-slice multidetector CT scanner
Authors: Sakrana Amal Abdelsattar , Alharbi Ibraheem H , Elmokadem Ali H 
Published: December 2022

Background Redoable precise and non-invasive diagnostic imaging modality with the least radiation dose is essential for infants with congenital heart disease (CHD) . Purpose To investigate the accuracy and estimate the radiation dose of our cardiac computed tomography (CCT) protocol. Material and Methods A total of 82 infants with CHD underwent non-ECG-gated CCT without contrast timing scanning techniques and were retrospectively studied. The image quality and radiation dose were estimated. The radiation dose was compared statistically to virtual retrospective ECG-gated and prospective ECG-triggering scanning modes. The diagnostic accuracy was assessed assuming the surgical results as the diagnostic gold standard. Results Most exams showed a high quality with low radiation doses compared to previous studies. The mean effective dose (ED) was 0.39 ± 1.2, significantly lower than that of the virtual retrospective ECG-gated and prospective ECG-triggering scanning and lower than in previous studies. Our CCT protocol has achieved a diagnostic accuracy of 99.52% with a sensitivity of 94.83% and specificity of 99.91%. Conclusion Non-ECG-gated CCT without contrast timing techniques can detect the non-coronary cardiovascular defects of CHD in infants with an ultralow radiation dose and a high diagnostic accuracy.
Is acute appendicitis complicated or uncomplicated? Approaching the question via computed tomography
Authors: Akçiçek Mehmet , Ilgar Mehtap , Ünlü Serkan 
Published: December 2022

Background The distinction between complicated and uncomplicated appendicitis is very important for the selection of the treatment method. Purpose To investigate the sensitivity and specificity of computed tomography (CT) in differentiating between complicated and uncomplicated appendicitis to demonstrate that false negativity in differentiating these cases can be reduced when CT findings are incorporated into the clinical evaluation of patients. Material and Methods All patients aged ≥18 years who underwent appendectomy at Malatya Training and Research Hospital in 2020 and 2021 were retrospectively screened. Of them, 283 patients were included in the study who had undergone CT before the operation. Patients with appendicitis were divided into two groups: complicated and uncomplicated, according to the results of their pathology tests. Demographic data, laboratory results, and CT images of the patients were evaluated. Results The patients with complicated appendicitis had a significantly higher mean age ( P<0.001). The most common CT findings in patients with complicated appendicitis were moderate or severe peri-appendiceal fat stranding (PFS) and appendix wall enhancement defect (AWD). The findings with the highest sensitivity were PFS (77.9%) and AWD (69.4%). Although abscess, phlegmon, and peri-appendiceal air had the highest specificity (100%), these findings were the ones with the lowest sensitivity. According to the scoring system was developed for the differential diagnosis, CT had a sensitivity of 83.3% and a specificity of 79.2%. Conclusion Based on the sensitivity and specificity values measured for CT according to the findings of our study, the scoring system may be useful for the differential diagnosis of complicated appendicitis.
Inequalities in the Evaluation of Male Versus Female Athletes in Sports Medicine Research: A Systematic Review
Authors: Paul Ryan W. , Sonnier John Hayden , Johnson Emma E. , Hall Anya T. , Osman Alim , Connors Gregory M. , Freedman Kevin B. , Bishop Meghan E. 
Published: December 2022

Background: Female sports participation continues to rise; however, inequalities between male and female athletes still exist in many areas and may extend into medical research. Purpose: The purpose of this study was to (1) compare the number of published studies evaluating male versus female athletes in various sports and (2) identify which co-ed sports currently underrepresent female athletes in the sports medicine literature. Study Design: Systematic review; Level of evidence, 4. Methods: All nonreview research studies published from 2017 to 2021 in 6 top sports medicine journals were considered for inclusion. Sports medicine studies were included that isolated athletes, reported study outcomes specific to male and/or female patients, provided study outcomes for specific sports, and evaluated ≤3 different sports. The total number of studies reporting on male and/or female athletes were compared for all sports, and odds ratios (ORs) were calculated. Comparisons of study design, level of sports participation, outcomes assessed, and study quality were also made according to participant sex. Results: Overall, 669 studies were included the systematic review. Most studies isolated male athletes (70.7%), while 8.8% isolated female athletes and 20.5% included male and female athletes. Female athletes were more frequently studied in softball and volleyball, while male athletes were more commonly researched in baseball, soccer, American football, basketball, rugby, hockey, and Australian football. Notably, male athletes were largely favored in baseball/softball (91% vs 5%; OR = 18.2), rugby (72% vs 5%; OR = 14.4), soccer (65% vs 15%; OR = 4.3), and basketball (58% vs 18%; OR = 3.2). Conclusion: Sports medicine research has favored the evaluation of male athletes in most sports, including the majority of co-ed sports. Potential reasons for this inequality of research evaluation include availability of public data and database data, financial and promotional incentives, a high percentage of male sports medicine clinicians and researchers, and sex biases in sport. While the causes of these differences are multifaceted, researchers should consider both sexes for study inclusion whenever possible, and journals should support a more balanced representation of research publications regarding male and female athletes.
Ambulatory Surgery Centers Significantly Decrease Total Health Care Expenditures in Primary Anterior Cruciate Ligament Reconstruction
Authors: Tiao Justin , Wang Kevin , Carbone Andrew D. , Herrera Michael , Zubizarreta Nicole , Gladstone James N. , Colvin Alexis C. , Anthony Shawn G. 
Published: December 2022

Background: Anterior cruciate ligament reconstruction (ACLR) is a commonly performed orthopaedic procedure. The volume and cost of ACLR procedures are increasing annually, but the drivers of these cost increases are not well described. Purpose: To analyze the modifiable drivers of total health care utilization (THU), immediate procedure reimbursement, and surgeon reimbursement for patients undergoing ACLR using a large national commercial insurance database from 2013 to 2017. Study Design: Descriptive epidemiology study. Methods: For this study, the cohort consisted of patients identified in the MarketScan Commercial Claims and Encounters database who underwent outpatient arthroscopic ACLR in the United States from 2013 to 2017. Patients with Current Procedural Terminology code 29888 were included. THU was defined as the sum of any payment related to the ACLR procedure from 90 days preoperatively to 180 days postoperatively. A multivariable model was utilized to describe the patient- and procedure-related drivers of THU, immediate procedure reimbursement, and surgeon reimbursement. Results: There were 34,862 patients identified. On multivariable analysis, the main driver of THU and immediate procedure reimbursement was an outpatient hospital as the surgical setting (US$6789 increase in THU). The main driver of surgeon reimbursement was an out-of-network surgeon (US$1337 increase). Health maintenance organization as the insurance plan type decreased THU, immediate procedure reimbursement, and surgeon reimbursement (US$955, US$108, and US$38 decrease, respectively, compared with preferred provider organization; P < .05 for all). Conclusion: Performing procedures in more cost-efficient ambulatory surgery centers had the largest effect on decreasing health care expenditures for ACLR. Health maintenance organizations aided in cost-optimization efforts as well, but had a minor effect on surgeon reimbursement. Overall, this study increases transparency into what drives reimbursement and serves as a foundation for how to decrease health care expenditures related to ACLR.