bluuebunny/crossref_metadata_2025_split huggingface dataset:
cifB-transcript levels largely explain cytoplasmic incompatibility variation across divergentWolbachia
Authors: Shropshire J Dylan , Hamant Emily , Conner William R , Cooper Brandon S 
Published: June 2022

AbstractDivergent hosts often associate with intracellular microbes that influence their fitness. Maternally transmitted Wolbachia bacteria are the most common of these endosymbionts, due largely to cytoplasmic incompatibility (CI) that kills uninfected embryos fertilized by Wolbachia-infected males. Closely related infections in females rescue CI, providing a relative fitness advantage that drives Wolbachia to high frequencies. One prophage-associated gene (cifA) governs rescue, and two contribute to CI (cifA and cifB), but CI strength ranges from very strong to very weak for unknown reasons. Here, we investigate CI-strength variation and its mechanistic underpinnings in a phylogenetic context across 20 million years (MY) of Wolbachia evolution in Drosophila hosts diverged up to 50 MY. These Wolbachia encode diverse Cif proteins (100% to 7.4% pairwise similarity), and AlphaFold structural analyses suggest that CifB sequence similarities do not predict structural similarities. We demonstrate that cifB-transcript levels in testes explain CI strength across all but two focal systems. Despite phylogenetic discordance among cifs and the bulk of the Wolbachia genome, closely related Wolbachia tend to cause similar CI strengths and transcribe cifB at similar levels. This indicates that other non-cif regions of the Wolbachia genome modulate cif-transcript levels. CI strength also increases with the length of the host’s larval life stage, presumably due to prolonged cif action. Our findings reveal that cifB-transcript levels largely explain CI strength, while highlighting other covariates. Elucidating CI’s mechanism contributes to our understanding of Wolbachia spread in natural systems and to improving the efficacy of CI-based biocontrol of arboviruses and agricultural pests globally.
Point-of-care ultrasound leads to a rare incidental diagnosis in a patient with acute kidney injury
Authors: Quinn Jesse H. , Sviggum Erik B. , La Nou Abigail T. , Burkhamer Kyle J. 
Published: June 2022

ABSTRACT
Cardiac amyloidosis is a rare disorder with a poor long-term prognosis. Presenting features often mirror those of more commonly encountered diseases, making diagnosis challenging. Clinicians should suspect amyloidosis in patients presenting with symptoms of heart failure and preserved ejection fraction. Diagnostic testing assesses for characteristic ECG, echocardiogram, and cardiovascular MRI findings. Confirmatory testing traditionally is performed with endomyocardial biopsy, but safer, less-invasive options exist. Although overall prognosis is unfavorable, contemporary advances in treatment options have improved short-term patient survival.
Glenohumeral joint effusion assessment with point-of-care ultrasound
Authors: Ahern Brian J. , Falconi Audrey E. 
Published: June 2022

ABSTRACT
Ultrasound has favorable diagnostic accuracy for detecting glenohumeral joint effusions. This article describes an easy-to-learn and interpret limited glenohumeral joint ultrasound examination that can help guide further evaluation and treatment. We report on a patient ultimately diagnosed with septic arthritis of the glenohumeral joint, the associated joint effusion having been detected on bedside ultrasound. This ultrasound examination is applicable to generalist PAs and those working in orthopedics and acute care settings.
Prevalence and associated factors of obstructive sleep apnea in refractory hypertension
Authors: Chedier Bernardo , Roderjan Christian N. , Cavalcanti Aline H. , de Souza Fabio , Muxfeldt Elizabeth S. 
Published: June 2022

Background:
Refractory hypertension (RfHT) and obstructive sleep apnea (OSA) share common pathophysiological mechanisms and probably are intrinsically associated, but their prevalence, clinical profile, and polysomnography (PSG) pattern remain misunderstood.

Objective:
To describe OSA prevalence and PSG pattern of patients with RfHT in a large cohort of resistant hypertension (RHT).

Methods:
This is a cross-sectional study involving 418 RHT patients (30.9% male; mean age of 62.5 ± 9.9 years) who were submitted to full-night PSG. RfHT was defined as uncontrolled ambulatory blood pressure monitoring using five or more antihypertensive drugs, including spironolactone. Bivariate analysis compared RHT and RfHT and multivariate analysis was performed to assess the independent correlates of OSA.

Results:
A total of 90 patients (21.5%) were diagnosed with RfHT (26.7% male; mean age of 58.5 ± 8.3 years). In comparison with resistant ones, RfHT patients were younger, with higher smoking and previous cardiovascular diseases prevalence, especially stroke. There was no difference regarding anthropometric measures. OSA prevalence (80.0 vs. 82.9%) and moderate/severe OSA (51.1 vs. 57.0%) were similar in both groups as well as apnea–hypopnea index. In its turn, refractory hypertensive patients presented better sleep efficiency (78 vs. 71%), with higher total sleep time (315 vs. 281 min) and lower sleep latency (11 vs. 17 min). There was no difference regarding rapid eye movement sleep, oxygen saturation, microarousals index, and periodic limb movement.

Conclusion:
In this large RHT cohort, resistant and refractory hypertensive patients have similar OSA prevalence, although refractory ones, which by definition use spironolactone, are younger and apparently have a better sleep pattern.
Effects of grade, academic performance, and sex on spatial working memory and attention in primary school children: a cross-sectional observational study
Authors: Zhan Nengpeng , Fan Xuelian , Shen Fengtao , Song Lulu , Zhou Chenhuan , Xiao Jiayi , Wu Xun , Li Leonardo Jiahao , Xi Jiayao , Jiayi Li Sophia , Zeng Suhua , Li Can , Wang Lihui , Li Weidong 
Published: June 2022

Objective:
Only a few studies have investigated the development trends in spatial working memory and attention among a large sample of primary school students over a wide range of ages, while the efficiency of learning and memory processes is fundamental to academic performance, particularly for children, who are in a key developmental stage when their life opportunities can be altered. We aimed to explore how the spatial working memory and attention of primary school children are affected by grade, academic performance, and sex.

Methods:
In this cross-sectional observational study, students (144 boys, 139 girls, 6-13 years old) were recruited from Experimental Primary School Affiliated to Shanghai Jiao Tong University in Shanghai, China in 2018. The study protocol was reviewed and approved by the Bio-Ethics Board of the Bio-X Institutes, Shanghai Jiao Tong University. Based on a simple Spatial Working Memory and Attention Test on Paired Symbols test, we evaluate 283 participants’ working memory and attention ability.

Results:
Attention and working memory performance were enhanced as a positive function of grade in primary school children, and students who showed better academic achievement also performed better on the working memory task. However, attention and working memory performance were not affected by sex.

Conclusion:
Attention and working memory performance of primary school students develop with grade and corresponds to Better academic performance. Attention and working memory ability do not differ significantly between boys and girls.
Factors Associated With Poor Response to Clozapine in Schizophrenia
Authors: Grover Sandeep , Naskar Chandrima , Chakrabarti Subho 
Published: June 2022

Abstract

Purpose/Background
Limited numbers of studies have assessed the predictors of clozapine nonresponse. This study aimed to assess the demographic and clinical factors associated with an inadequate response to clozapine in patients with treatment-resistant schizophrenia (TRS).

Methods/Procedures
Two hundred eighty-seven outpatients with TRS receiving clozapine for more than 1 year were divided into 2 groups based on the need for a second antipsychotic medication and/or electroconvulsive therapy after receiving clozapine in the maximum tolerable dose for at least 3 months.

Results/Findings
One hundred two patients (35.4%) were considered to be clozapine nonresponders. Compared with responders, clozapine nonresponders were more often unemployed at the time of starting clozapine (P = 0.04), had a longer duration of untreated psychosis (P = 0.007), had received significantly higher number of adequate antipsychotic trials in the past (P = 0.02), had received antipsychotic polypharmacy in the past (P = 0.01), had experienced adverse effects with first- (P < 0.001) and second-generation antipsychotics (P = 0.01), and had more medical comorbidities (P = 0.03). The nonresponders more frequently had visual hallucinations (P = 0.001), and feelings/acts or impulses attributed to some external source (P = 0.03) in the lifetime, and had a significantly higher Clinical Global Impression severity score at the time of starting of clozapine (P < 0.001). While on clozapine, nonresponders received significantly higher dose of clozapine (P = 0.001) and higher proportion of them experienced constipation (P = 0.04), hypersalivation (P = 0.002), and obsessive-compulsive symptoms (P = 0.05) as adverse effects of clozapine.

Conclusions/Implications
The present study shows that approximately one-third of patients with TRS do not respond to clozapine. However, clozapine nonresponders, although broadly similar in sociodemographic profile to clozapine responders, differ from clozapine responders on past treatment profile.
Topographic Anatomy of the Medial Labyrinthine Wall: Implications for the Transcanal Endoscopic Approach to the Internal Auditory Canal
Authors: Yacoub Abraam , Molinari Giulia , Mostafa Badr Eldin , El Fiky Lobna , Mansour Ossama , Presutti Livio , Caversaccio Marco , Anschuetz Lukas 
Published: June 2022

Hypothesis
To characterize transcanal endoscopic landmarks of the medial labyrinthine wall and correlate these with anatomical features of the fundus of the internal auditory canal (IAC).

Background
The transcanal transpromontorial approach (TTA) enables minimally invasive access to the IAC. The establishment of a landmark-based dissection technique for the approach is crucial to avoid injury to the facial nerve.

Methods
Twenty temporal bones were dissected endoscopically through the TTA. Furthermore, high-resolution computed tomography (CT) scans from ten adult normal temporal bones were analyzed and three-dimensionally reconstructed.

Results
A stepwise dissection technique for the TTA was demonstrated depending on a newly described landmark used in the identification of the facial nerve. The proposed landmark, which was named the intervestibulocochlear crest (IVCC), is an integrated part of the otic capsule. It can be differentiated after the excision of the lateral labyrinthine wall as a laterally based bony pyramid between the cochlea and the vestibule. Its medially directed apex blends with the central part of the falcifrom crest and points to the distal part of the meatal facial nerve. The IVCC is best detected on axial CT images at the level of the tympanic facial nerve. The union between the IVCC and the falciform crest appears radiologically as a short stem or mini-martini glass.

Conclusion
The proposed IVCC is a novel landmark with a consistent relationship to the IAC fundus and the facial nerve. It may be utilized in conjunction with the falciform crest to identify the facial nerve during minimally invasive transcanal surgeries.
Computed-Tomography Estimates of Interaural Mismatch in Insertion Depth and Scalar Location in Bilateral Cochlear-Implant Users
Authors: Goupell Matthew J. , Noble Jack H. , Phatak Sandeep A. , Kolberg Elizabeth , Cleary Miranda , Stakhovskaya Olga A. , Jensen Kenneth K. , Hoa Michael , Kim Hung Jeffrey , Bernstein Joshua G. W. 
Published: June 2022

Hypothesis
Bilateral cochlear-implant (BI-CI) users will have a range of interaural insertion-depth mismatch because of different array placement or characteristics. Mismatch will be larger for electrodes located near the apex or outside scala tympani, or for arrays that are a mix of precurved and straight types.

Background
Brainstem superior olivary-complex neurons are exquisitely sensitive to interaural-difference cues for sound localization. Because these neurons rely on interaurally place-of-stimulation-matched inputs, interaural insertion-depth or scalar-location differences for BI-CI users could cause interaural place-of-stimulation mismatch that impairs binaural abilities.

Methods
Insertion depths and scalar locations were calculated from temporal-bone computed-tomography scans for 107 BI-CI users (27 Advanced Bionics, 62 Cochlear, 18 MED-EL).

Results
Median interaural insertion-depth mismatch was 23.4 degrees or 1.3 mm. Mismatch in the estimated clinically relevant range expected to impair binaural processing (>75 degrees or 3 mm) occurred for 13 to 19% of electrode pairs overall, and for at least three electrode pairs for 23 to 37% of subjects. There was a significant three-way interaction between insertion depth, scalar location, and array type. Interaural insertion-depth mismatch was largest for apical electrodes, for electrode pairs in two different scala, and for arrays that were both-precurved.

Conclusion
Average BI-CI interaural insertion-depth mismatch was small; however, large interaural insertion-depth mismatch—with the potential to degrade spatial hearing—occurred frequently enough to warrant attention. For new BICI users, improved surgical techniques to avoid interaural insertion-depth and scalar mismatch are recommended. For existing BI-CI users with interaural insertion-depth mismatch, interaural alignment of clinical frequency tables might reduce negative spatial-hearing consequences.
Long-Term Outcomes of Round Window Reinforcement for Superior Semicircular Canal Dehiscence Syndrome
Authors: Bunne Marie , Andersson Helene , Myhrum Marte 
Published: June 2022

Objective
To report long-term patient reported outcome measures (PROMs) after standardized round window rein-forcement (RWR) with thin cartilage and perichondrium for superior semicircular canal dehiscence syndrome (SSCDS).

Methods
Cross-sectional survey in 2020 and retrospective longitudinal study of outcomes at 3 months, 1 year, and last follow-up after 28 consecutive RWRs. Endpoints were the last follow-up for PROMs and 1 year postoperatively for audiometry and cVEMP.

Results
At the last follow-up (mean 2.4 years postoperatively), improvement was reported for 19/28 ears (68%) in symptoms overall; for 17/27 ears (63%) in auditory symptoms, and for 12/24 (50%) in vestibular symptoms. Nine ears (32%) required further surgery. No major complications occurred. On the group level, postoperative improvement at 3 months declined significantly for auditory and vestibular symptoms over time, and stayed stable beyond 1 year. Improved ears had on average 2.9 years follow-up. Improvement correlated significantly with SSCD length, and was associated with contralateral dehiscence. Thirteen ears (46%) had another potential cause of vestibular symptoms. This group showed significantly less improvement. Audiometric test results did not predict PROMs.

Conclusions
Since long-term outcomes do not compare with those reported for plugging and repair, RWR is not suggested as a first line intervention for SSCDS. Considering the stable rates of improvement on average 2.9 years postoperatively and the absence of major complications, RWR may be an alternative to plugging or repair in fragile patients who do not accept the risk of complications with more invasive surgery, and who accept that results may deteriorate over time.
Progression of Hearing Loss in Observed Non-Growing Vestibular Schwannoma
Authors: Luryi Alexander L. , Babu Seilesh , Bojrab Dennis I. , Kveton John F. , Schutt Christopher A. 
Published: June 2022

Objective
To assess hearing outcomes in observed vestibular schwannoma (VS) with focus on non-growing tumors.

Study Design
Retrospective review.

Setting
Two tertiary neurotology centers.

Patients and Interventions
Patients with sporadic VS undergoing at least 3 years’ observation.

Main Outcome Measures
Changes in pure tone averages (PTA) and word recognition scores (WRS) normalized to the contralateral ear.

Results
During the study period, 39 of 105 included patients (37.1%) had tumor growth. Patients with tumor growth had a mean normalized increase in PTA of 8.0 dB HL (p = 0.008) corresponding to a normalized average worsening of their PTA of 1.8 dB per year. Patients with non-growing tumors less than 5 mm in maximal dimension did not have significant ongoing normalized hearing loss (p > 0.05). Patients with non-growing tumors more than or equal to 5 mm had a mean normalized increase in PTA of 7.4 dB HL (p = 0.001) corresponding to an average of 2.0 dB HL per year, which was similar to the loss observed in growing tumors regardless of size (p > 0.05). Normalized decline in PTA of at least 5 dB HL was seen in 72% of patients with growing tumors, 53% of patients with nongrowing tumors more than or equal to 5 mm, and 38% of patients with non-growing tumors less than 5 mm.

Conclusions
A long-term analysis of hearing outcomes in observed vestibular schwannoma is presented. With observation, VS more than or equal to 5 mm is associated with continued hearing loss even without tumor growth, while non-growing tumors less than 5 mm are not associated with continuing hearing loss. These data inform expectations for observed VS for providers and patients.
A Systematic Review of Cases with Bezold’s Abscess
Authors: Young Kurtis , Ilustre Joshua , Tang Dennis M. , Wu Arthur W. , Wong Yu-Tung 
Published: June 2022

Objective
The objective for this systematic review is to characterize clinical presentations of Bezold’s abscesses to improve awareness and promote earlier diagnoses and prompt intervention in this increasingly rare otologic infection.

Data sources
Pubmed/Medline, CINAHL (EBSCOhost), and Web of Science articles in all languages were searched.

Study selection
Inclusion criteria were that the article was either a case report, case series, or retrospective review with individual case data available. Non-English articles were excluded if they lacked an English language abstract and if that abstract lacked information on baseline demographics, clinical presentation, and management.

Data extraction
Included studies were evaluated using fulltext review and demographics, etiology, microbiology, antibiotic usage, and surgical variables were collected.

Data synthesis
Data were qualitatively synthesized, with means and averages obtained for all continuous variables.

Conclusions
Bezold’s abscess remains a rare otologic infection, but they are relatively commonly associated with serious neurologic and systemic complications. Delay in diagnosis was a frequent commonality and diagnostic vigilance is tantamount in avoiding this sequelae. Aggressive surgical extirpation and long-term antibiotic treatment is recommended.
Omega-3 fatty acids and metabolic partitioning of fatty acids within the liver in the context of nonalcoholic fatty liver disease
Authors: Calder Philip C. 
Published: June 2022

Purpose of review
Nonalcoholic fatty liver disease (NAFLD) is now the most prevalent form of liver disease globally, affecting about 25% of the world's adult population. It is more common in those living with obesity, where it may affect as many as 80% of individuals. The aim of this article is to describe recent human studies evaluating the influence of omega-3 fatty acids on de novo lipogenesis (DNL) and hepatic fatty acid partitioning between incorporation into triacylglycerols (TAGs) and β-oxidation, to discuss the relevance of these effects in the context of NAFLD, and to provide an overview of the mechanisms that might be involved.

Recent findings
The omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) decrease hepatic DNL and partition fatty acids away from TAG synthesis and toward β-oxidation. EPA and DHA affect multiple hepatic transcription factors resulting in down-regulation of the DNL pathway and upregulation of β-oxidation. The net result is decreased accumulation of hepatic TAG and lowering of circulating TAG concentrations. Human trials demonstrate that EPA and DHA can decrease liver fat in patients with NAFLD.

Summary
Increased intake of EPA and DHA may reduce the likelihood of hepatic TAG accumulation and could be used to reduce liver fat in patients with NAFLD.
Neoadjuvant treatment combined with planned endoscopic surgery in locally advanced sphenoid sinus basaloid squamous cell carcinoma
Authors: Zhang Yinghong , Tian Suqing , Du Yali , Zuo Qiang , Zhu Li , Ma Furong 
Published: June 2022

Introduction:
Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive variant of SCC. It often diagnosed at a late clinical stage and is associated with a poor survival rate, and the optimal sequence of treatment modalities remains unclear.

Patient concerns:
A 45-years-old male patient presented with 3 months history of left side nasal obstruction without rhinorrhea, olfaction loss, epistaxis, loss of visual acuity, and negative for family history of sinonasal carcinoma.

Diagnosis:
A transnasal biopsy was performed under general anesthesia. The Hematoxylin-eosin staining of the pathological slice and immunohistochemistry findings were consistent with the diagnosis of BSCC.

Interventions:
The patient was treated with planned endoscopic surgery after preoperative neoadjuvant cisplatin with concurrent radiation therapy. After neoadjuvant therapy, the tumor volume was reduced, facilitating transnasal radical resection. The endoscopic surgery was followed by radiation therapy.

Outcome:
Follow-up at 24 months post-surgery did not reveal any recurrence of the tumor.

Conclusion:
Neoadjuvant therapy consisting of radiation and cisplatin is a potentially effective therapeutic option in the treatment of locally advanced BSCC prior to surgical resection. This treatment and concurrent radiation followed by planned surgical resection results in significantly improved survival of the patients.
How provocative tests in addition to wet swallows during high-resolution manometry can direct clinical management
Authors: Sanagapalli Santosh , Sweis Rami , Fox Mark 
Published: June 2022

Purpose of review
Provocative tests have been advocated to address limitations of high-resolution manometry (HRM) with wet swallows. We describe the commonly used provocative manometric manoeuvres [rapid drink challenge (RDC), multiple rapid swallows (MRS), solid swallows and the solid test meal (STM)], compare their diagnostic yield and accuracy to wet swallows, and outline their role in directing clinical management.

Recent findings
Provocative testing with RDC and STM identifies a proportion of achalasia cases missed by standard testing, and RDC can play a similar role to radiology in the evaluation of treatment response. In EGJOO, provocative testing with RDC and STM not only increase the diagnostic yield, but can also help differentiate between spurious cases and those representing true outflow obstruction likely to respond to achalasia-type therapies. MRS and STM can help determine the clinical relevance (or otherwise) of ineffective oesophageal motility, and in this setting, MRS may predict the likelihood of postfundoplication dysphagia. RDC and STM can help identify cases of postfundoplication dysphagia more likely to respond to dilatation.

Summary
Provocative testing has been shown to increase diagnostic yield of HRM, clarify inconclusive diagnoses, allows corroboration of dysmotility with patient symptoms and helps direct clinical management.