bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic ultrasound‐guided gallbladder and bile duct drainage with lumen apposing metal stent: A large multicenter cohort (with videos)
Authors: Rajadurai Anton , Zorron Cheng Tao Pu Leonardo , Cameron Rees , Tagkalidis Peter , Holt Bronte , Bassan Milan , Gupta Saurabh , Croagh Daniel , Swan Michael , Saxena Payal , Efthymiou Marios , Vaughan Rhys , Chandran Sujievvan ,   ANZEC
Published: September 2021

AbstractBackground and AimCholecystectomy and endoscopic retrograde cholangiopancreatography are the gold standard for managing acute cholecystitis and malignant biliary obstruction, respectively. Recent advances in therapeutic endoscopic ultrasound (EUS) have provided alternatives for managing patients in whom these approaches fail, namely, EUS‐guided gallbladder drainage (EUS‐GB) and EUS‐guided bile duct drainage (EUS‐BD). We aimed to assess the technical and clinical success of these techniques in the largest multicenter cohort published to date.MethodsA retrospective, multicenter, observational study involving 17 centers across Australia and New Zealand was conducted. All patients who had EUS‐GB or EUS‐BD performed in a participating center using a lumen apposing metal stent between 2016 and 2020 were included. Primary outcome was technical success, defined as intra‐procedural successful drainage. Secondary outcomes included clinical success and 30‐day mortality.ResultsOne hundred and fifteen patients underwent EUS‐GB (n = 49) or EUS‐BD (n = 66). EUS‐GB was technically successful in 47 (95.9%) while EUS‐BD was successful in 60 (90.9%). All failed cases were due to maldeployment of the distal flange outside of the targeted lumen. Clinical success of EUS‐GB was achieved in 39 (79.6%). No patients required subsequent cholecystectomy. Clinical success of EUS‐BD was achieved in 52 (78.8 %). Thirty‐day mortality was 14.3% for EUS‐GB and 12.1% for EUS‐BD.ConclusionsEUS‐guided gallbladder drainage and EUS‐BD are promising alternatives for managing nonsurgical candidates with cholecystitis and malignant biliary obstruction following failed endoscopic retrograde pancreatography. Both techniques delivered high technical success with acceptable clinical success. Further research is needed to investigate the gap between technical and clinical success.
National disparities in use of minimally invasive surgery for rectal cancer in older adults
Authors: Simon Hillary L. , Reif de Paula Thais , Spigel Zachary A. , Keller Deborah S. 
Published: September 2021

AbstractBACKGROUNDMinimally invasive surgery (MIS) is safe and improves outcomes in older persons with rectal cancer but may be underutilized. As older persons are the largest surgical population, investigation of the current use and factors impacting MIS use is warranted. Our goal is to investigate the trends and disparities that affect utilization of MIS in older persons with rectal cancer.METHODSThe National Cancer Database was reviewed for persons 65 years and older who underwent curative resection for rectal adenocarcinoma from 2010 to 2017. Cases were stratified by surgical approach (open or MIS [laparoscopic or robotic]). Univariate analysis compared patient and provider demographics across approaches. Multivariate analysis investigated variables associated with MIS use. Main outcome measures were trends and factors associated with MIS use in older persons.RESULTSOf 31,910 patients analyzed, 51.9% (n = 16,555) were open and 48.1% (n = 15,355) MIS. The MIS cohort was 66.7% (n = 10,236) laparoscopic and 33.3% (n = 5119) robotic. MIS increased from 29% in 2010 (n = 1197; 25% laparoscopic, 4% robotic) to 65% in 2017 (n = 2382; 35% laparoscopic, 30% robotic), likely from annual increases in robotics (OR 1.24/year, p < 0.0001). In the unadjusted analysis, there were significant differences in MIS use by age, race, comorbidity, socioeconomic status, and facility type. In multivariate analysis, patients with advancing age (OR 0.93, p < 0.001), major comorbidity (OR 0.75, p < 0.001), total proctectomy (OR0.78, p < 0.001), and advanced pathologic stage (OR 0.51, p < 0.001) were less likely to undergo MIS.CONCLUSIONNationwide, less than half of rectal cancer cases in older persons were performed with MIS, despite steady robotic growth. Patient and facility factors impacted MIS use. Further work on regionalizing rectal cancer care and ensuring equitable MIS access and training could improve utilization.
OsMKKK70 regulates grain size and leaf angle in rice through the OsMKK4‐OsMAPK6‐OsWRKY53 signaling pathway
Authors: Liu Zhiqi , Mei Enyang , Tian Xiaojie , He Mingliang , Tang Jiaqi , Xu Min , Liu Jiali , Song Lu , Li Xiufeng , Wang Zhenyu , Guan Qingjie , Xu Qijiang , Bu Qingyun 
Published: September 2021

AbstractGrain size and leaf angle are key agronomic traits that determine final yields in rice. However, the underlying molecular mechanisms are not well understood. Here we demonstrate that the Oryza sativa Mitogen Activated Protein Kinase Kinase Kinase OsMKKK70 regulates grain size and leaf angle in rice. Overexpressing OsMKKK70 caused plants to produce longer seeds. The osmkkk62/70 double mutant and the osmkkk55/62/70 triple mutant displayed significantly smaller seeds and a more erect leaf angle compared to the wild type, indicating that OsMKKK70 functions redundantly with its homologs OsMKKK62 and OsMKKK55. Biochemical analysis demonstrated that OsMKKK70 is an active kinase and that OsMKKK70 interacts with OsMKK4 and promotes OsMAPK6 phosphorylation. In addition, the osmkkk62/70 double mutant showed reduced sensitivity to Brassinosteroids (BRs). Finally, overexpressing constitutively active OsMKK4, OsMAPK6, and OsWRKY53 can partially complement the smaller seed size, erect leaf, and BR hyposensitivity of the osmkkk62/70 double mutant. Taken together, these findings suggest that OsMKKK70 might regulate grain size and leaf angle in rice by activating OsMAPK6 and that OsMKKK70, OsMKK4, OsMAPK6, and OsWRKY53 function in a common signaling pathway that controls grain shape and leaf angle.
Electromagnetic muscle stimulation: A retrospective study of patient experience
Authors: Moradi Amir , Fabi Sabrina , Rapaport David , Shridharani Sachin , Goldman Mitchel P. , Tsai Fu Felicia 
Published: September 2021

AbstractBackgroundElectromagnetic muscle stimulation (EMMS) is a non‐invasive body contouring technology for strengthening, firming, and toning the abdomen, buttocks, and thighs that is associated with high patient satisfaction.AimsTo gain a greater understanding of factors contributing to patient satisfaction with EMMS.MethodsThis was a retrospective, non‐comparative study of patient information and questionnaires regarding EMMS treatments to abdomen and/or buttocks collected July 1 to December 1, 2019 from clinical practices in the United States. Questionnaires collected and included for study analysis were the Subject Experience Questionnaire (SEQ), the Body Satisfaction Questionnaire (BSQ), and the Subject‐rated Global Aesthetic Improvement Scale (SGAIS).ResultsResponses from 146 treated patients were analyzed (abdomen only: n = 94; buttocks only, n = 30; abdomen and buttocks: n = 22). Patients were 79% female with mean age of 41.3 years (range: 19–73). Frequently cited reasons for seeking EMMS treatment were a desire to appear more toned (89%) or slimmer (42%), and to feel stronger (38%). BSQ and SGAIS scores were improved 4 weeks after treatment. On post‐treatment SEQ, most patients reported being “satisfied” or “very satisfied” with abdomen (83.2%; n = 89/107) or buttocks (57.4%; n = 27/47) treatment. Most patients reported feeling stronger after abdomen treatment, and across both body areas, patients were more confident, happier with their overall appearance, and motivated to work out and maintain treatment results.ConclusionThis retrospective study of patient questionnaires provides important information on aesthetic and functional factors that can contribute to high patient satisfaction following EMMS treatment of the abdomen and/or buttocks.
A prospective open‐label, multicentre study evaluating a non‐cross‐linked hyaluronic acid based soft‐tissue filler in the correction of lateral canthal and perioral lines
Authors: Sulovsky Monika , Müller Daniel , Prinz Valentina , Moellhoff Nicholas , Cajkovsky Mia , Duschek Nikolaus , Frank Konstantin 
Published: September 2021

AbstractObjectiveThe aim of this investigation was to assess the effectiveness of a non‐cross‐linked hyaluronic acid based soft‐tissue filler in the correction of lateral canthal lines and periorbital lines.Material and methodsA total of 59 female Caucasian patients with a mean age of 52.6 ± 9.0 years were enrolled in this prospective open‐label, multicentre study and received intradermal injections of a soft‐tissue filler at baseline, after 3 and 6 weeks. Aesthetic improvement and patient satisfaction, skin hydration, skin firmness and skin elasticity, as well as adverse events were assessed at 3, 6, 8, 12 and 16 weeks.ResultsAt baseline, the lateral canthal skin firmness was 0.206 ± 0.07 mm and increased after 8 weeks to 0.087 ± 0.08 mm with p < 0.001, while the perioral skin firmness was 0.205 ± 0.09 mm and increased after 8 weeks to 0.116 ± 0.08 mm with p < 0.001. Increases in skin hydration were observed after 8 weeks in both areas, however, did not reach statistical significance at any point. At week 8, 12 and 16 a majority (93.1%, 91.1% and 73.7% respectively) of the patients stated that they were ‘satisfied’ or ‘very satisfied’ with the treatment.ConclusionOverall, the skin firmness and skin visco‐elasticity showed significant increases in the lateral canthal and perioral region. Moreover, albeit not statistically significant, skin hydration increased in both areas after 8 weeks. The procedure has been shown to be safe and satisfactory for the treated patients; however, emergence of oral herpes should be added to the safety profile of intradermally applied hyaluronic acid treatments.
Revealing how language builds the identity of the advanced nurse practitioner
Authors: Thompson Wayne , McNamara Martin 
Published: September 2021

AbstractAims and objectivesTo explore how language works to enable and constrain the role of the advanced nurse practitioner (ANP) in the health system.BackgroundNurses and doctors are produced within historically established disciplinary boundaries. These boundaries are becoming more porous, offering the possibility of a more liberated identity for ANPs that will allow them to reach their full potential. Current uncertainty and confusion about ANPs’ identity result in their role being underutilised.DesignA critical discourse analysis design was used to explore participants’ language‐in‐use. Findings are reported according to the COREQ research checklist.MethodData were collected through seven in‐depth interviews and four focus groups and analysed using Gee’s (2010) Identity Building Tool. Participants included ANPs, nurses (including nurse managers), doctors and allied healthcare professionals.ResultsFour discourses were revealed. Participants’ language‐in‐use worked to privilege the ANP’s uniquely holistic identity. However, this aspect is also associated with a controlled identity, predominantly constrained by medics and restricted from advancing. The third discourse, the medicalised identity builds an identity that positions ANPs as medical replacements who are assigned trivial medical tasks. The final discourse constructs an independent powerful identity for the ANP that is influential and autonomous.ConclusionsCirculating discourses and conversations can influence and shape the construction of the ANP identity. Healthcare professionals need to identify and counter discourses and conversations that construct ANPs’ ways of knowing and knowledge as inferior and their role as subservient. Otherwise, ANPs’ identity will continue to be controlled and their advancement restricted.Relevance to clinical practiceConfusion concerning the role and identity of the ANP can limit their contribution to the healthcare system. Healthcare professionals need to be aware of how language‐in‐use can prevent the role from developing and reaching its full potential in enhancing healthcare provision and delivery. Reporting follows the COREQ criteria.
Effect of platelet‐rich plasma injection combined with individualised comprehensive physical therapy on temporomandibular joint osteoarthritis: A prospective cohort study
Authors: Liu Sha‐sha , Xu Li‐li , Fan Shuai , Lu Shen‐ji , Jin Lei , Liu Li‐kun , Yao Yuan , Cai Bin 
Published: September 2021

AbstractBackgroundThe effectiveness of platelet‐rich plasma (PRP) injection combined with physical therapy for the treatment of temporomandibular joint osteoarthritis (TMJ‐OA) has not been studied.ObjectivesTo assess the effectiveness of PRP injection combined with individualised comprehensive physical therapy for the treatment of TMJ‐OA.MethodsThis prospective cohort study included 40 patients with TMJ‐OA who received PRP injection or PRP injection combined with individualised comprehensive physical therapy. Pain intensity, maximum mouth opening, temporomandibular joint sounds, and the Jaw Functional Limitation Scale (JFLS) scores and imaging findings were compared before treatment and during follow‐up.ResultsThe pain intensity, maximum mouth opening, and temporomandibular joint sounds of the two groups significantly improved with an increase in treatment time (p < .05). The pain improvement in the combined treatment group was greater than that in the PRP injection group at 3 and 6 months (p < .05). The improvement of mouth opening was better in the combined treatment group, whereas the improvement of joint sounds was better in the PRP injection group. The improvement in JFLS scores in the combined treatment group was greater than that in the PRP injection group at 6 months (p < .05). The imaging improvement rates of the two groups were similar.ConclusionsPlatelet‐rich plasma injection can significantly improve pain, mouth opening, abnormal joint sound, and mandibular function in patients with TMJ‐OA and has good repair effect on condylar bone defects. PRP injection combined with individualised comprehensive physical therapy can effectively control the medium‐ and long‐term pain of patients.
Nonlinear association between chemosensory dysfunction and body mass index
Authors: Chen Ben , Masala Carla , Oleszkiewicz Anna , Englmaier Verena , Gunder Nadine , Menzel Susanne , Haehner Antje , Hummel Thomas 
Published: September 2021

AbstractChemosensory (gustatory and olfactory) dysfunction contributes to obesity, but the association between body mass index (BMI) and chemosensory dysfunction are inconsistently reported. The present study included 4,390 subjects at a Smell and Taste Clinic. Results suggested that both the obesity class II group (BMI ≥ 35) and underweight group (BMI < 18.5) exhibited impaired taste function compared with the normal weight group (p < .05). Comparing with the other groups, the obesity class II group exhibited a higher proportion of impaired bitter identification (8.6%), and the underweight group showed a higher proportion of impaired salty identification (7.9%). When investigating differences for individual tastes, subjects with impaired bitter identification had higher BMI (t = 2.79, p = .005) and lower olfactory scores (p < .05) compared with those with intact bitter identification. Finally, reduced taste scores are associated with an increased BMI (r = −.04, p = .022). This correlation becomes more pronounced with age (F = 1.42, p < .001).Practical ApplicationThe nonlinear association between chemosensory dysfunction and BMI suggested that maintaining the gustatory and olfactory function is of significance for normal metabolism. In obesity regulating bitter taste appears to be more important than the other tastes.
Influenza vaccination among caregivers and household contacts of children with congenital heart disease before and during COVID‐19 pandemic
Authors: Gkentzi Despoina , Mpania Lamprini , Fouzas Sotirios , Sinopidis Xenophon , Dimitriou Gabriel , Karatza Ageliki A 
Published: September 2021

AimWe aimed to investigate the influenza immunisation status of caregivers and household contacts of children with congenital heart disease (CHD) and potential barriers to vaccine uptake.MethodsProspective questionnaire‐based survey over two influenza seasons (2019–2020 and 2020–2021) on 161 children with CHD attending a tertiary paediatric cardiology clinic and their families. Logistic regression and factor analysis were performed to identify factors associated with influenza vaccine uptake.ResultsInfluenza vaccination coverage of children was 65%, whereas that of their fathers and mothers was 34% and 26%, respectively. Children with unvaccinated siblings represented 43% and those with unvaccinated adults in the household 79% of our study population. No statistically significant differences were found before and during COVID‐19 pandemic on vaccine uptake. Logistic regression analysis showed that higher education level, understanding the risk of contracting the disease and vaccination status of the child determined the vaccination status of parents, regardless of their age, age of their child, severity of CHD, beliefs about vaccine safety and efficacy and risk of transmission if not vaccinated. Factor analysis revealed distinct groups among unvaccinated parents (76.3% of the variation in the responses).ConclusionsVaccination coverage of caregivers and household contacts of children with CHD is suboptimal. Influenza vaccination campaigns should take into consideration the specific characteristics of parental groups and target interventions accordingly to increase their vaccine uptake and indirectly protect children with CHD.
Dental public health post‐graduate trainees in the US: Experiences, challenges, and opportunities—A qualitative study
Authors: Banava Sepideh , Obadan‐Udoh Enihomo , Mertz Elizabeth 
Published: September 2021

AbstractObjectivesThe goal of this study was to explore challenges and opportunities that dental public health (DPH) residents and recent graduates experienced during and after their residency training programs in the US.MethodsIn this qualitative study, to recruit participants, study invitations were distributed to 93 DPH postgraduate trainees via social media, email, and an online DPH nationwide course in 2019. Semi‐structured in‐depth interviews were conducted through Zoom audioconference. The interviews were conducted until thematic saturation was achieved. The audio‐recorded interviews were transcribed and crosschecked to ensure accuracy. The interviews were coded using grounded theory. A qualitative analysis software (ATLAS.ti 8.0) was used to facilitate coding and organizing data extraction from transcripts.ResultsEighteen DPH postgraduate trainees from 12 DPH residency programs participated and completed the interview. DPH trainees had experienced educational and financial challenges, difficulty finding DPH‐related jobs after graduation, and a complex board examination preparation process.ConclusionDPH postgraduate trainees and especially foreign‐trained dentists experienced serious challenges during and after their postgraduate residency programs. Opportunities exist to enhance the strength of DPH programs to build a competent DPH workforce.
Extracellular vesicles derived from melatonin‐preconditioned mesenchymal stem cells containing USP29 repair traumatic spinal cord injury by stabilizing NRF2
Authors: Liu Wei , Tang Pengyu , Wang Jiaxing , Ye Wu , Ge Xuhui , Rong Yuluo , Ji Chengyue , Wang Zhuanghui , Bai Jianling , Fan Jin , Yin Guoyong , Cai Weihua 
Published: September 2021

AbstractSpinal cord injury (SCI) is a devastating trauma that leads to irreversible motor and sensory dysfunction and is, so far, without effective treatment. Recently, however, nano‐sized extracellular vesicles derived from preconditioned mesenchymal stem cells (MSCs) have shown great promise in treating various diseases, including SCI. In this study, we investigated whether extracellular vesicles (MEVs) derived from MSCs pretreated with melatonin (MT), which is well recognized to be useful in treating diseases, including Alzheimer’s disease, non‐small cell lung cancer, acute ischemia‐reperfusion liver injury, chronic kidney disease, and SCI, are better able to promote functional recovery in mice after SCI than extracellular vesicles derived from MSCs without preconditioning (EVs). MEVs were found to facilitate motor behavioral recovery more than EVs and to increase microglia/macrophages polarization from M1‐like to M2‐like in mice. Experiments in BV2 microglia and RAW264.7 macrophages confirmed that MEVs facilitate M2‐like polarization and also showed that they reduce the production of reactive oxygen species (ROS) and regulate mitochondrial function. Proteomics analysis revealed that ubiquitin‐specific protease 29 (USP29) was markedly increased in MEVs, and knockdown of USP29 in MEVs (shUSP29‐MEVs) abolished MEVs‐mediated benefits in vitro and in vivo. We then showed that USP29 interacts with, deubiquitinates and therefore stabilizes nuclear factor‐like 2 (NRF2), thereby regulating microglia/macrophages polarization. In NRF2 knockout mice, MEVs failed to promote functional recovery and M2‐like microglia/macrophages polarization. We also showed that MT reduced global N6‐methyladenosine (m6A) modification and levels of the m6A “writer” methyltransferase‐like 3 (METTL3). The stability of USP29 mRNA in MSCs was enhanced by treatment with MT, but inhibited by overexpression of METTL3. This study describes a very promising extracellular vesicle‐based approach for treating SCI.
A parent’s intuition is always right: Weighing intuitions in the debate over the nature of full moral status
Authors: Graber Abraham 
Published: September 2021

AbstractThe debate over the grounds of full moral status relies heavily on the “method of cases.” In the method of cases intuitions about particular cases are taken as evidence for philosophical theories. Much in the debate over the grounds of full moral status turns on our intuitions regarding the moral status of individuals with intellectual disability. This paper argues that the intuitions of those in close personal relationships with individuals with intellectual disability are more reliable than the intuitions of those who lack such a relationship. When theorizing about full moral status, we should privilege the intuitions of those who have a close personal relationship with an individual with intellectual disability.
Are we trapped in Plato’s cave?
Authors: Weissman David 
Published: September 2021

AbstractWe often read Plato’s cave allegory for its trajectory: out of darkness into light. The back of the cave—where imagination projects fantasies onto shadows—is a place to flee. This part of the allegory reduces reality testing to thought or imagining, ignoring action and the people or things engaged. Yet thinkers prominent in our time—Immanuel Kant and W. V. O. Quine—suppose that our experience of the world is that of the cave’s prisoners: we too mistake fantasies for reality. This is an odd stance when practical life and science—beliefs informed by action and experiment—are better tests of reality than their arguments for world‐making.