bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cannabis Glandular Trichome Cell Walls Undergo Remodeling to Store Specialized Metabolites
Authors: Livingston Samuel J , Bae Eun Jeong , Unda Faride , Hahn Michael G , Mansfield Shawn D , Page Jonathan E , Samuels A Lacey 
Published: August 2021

Abstract
The valuable cannabinoid and terpenoid metabolites of Cannabis sativa L. are produced by floral glandular trichomes. The trichomes consist of secretory disk cells, which produce the abundant lipidic metabolites, and an extracellular storage cavity. The mechanisms of apoplastic cavity formation to accumulate and store metabolites in cannabis glandular trichomes remain wholly unexplored. Here, we identify key wall components and how they change during cannabis trichome development. While glycome and monosaccharide analyses revealed that glandular trichomes have loosely bound xyloglucans and pectic polysaccharides, quantitative immunolabeling with wall-directed antibodies revealed precise spatiotemporal distributions of cell wall epitopes. An epidermal-like identity of early trichome walls matured into specialized wall domains over development. Cavity biogenesis was marked by separation of the subcuticular wall from the underlying surface wall in a homogalacturonan and α-1,5 arabinan epitope-rich zone and was associated with a reduction in fucosylated xyloglucan epitopes. As the cavity filled, a matrix with arabinogalactan and α-1,5 arabinan epitopes enclosed the metabolite droplets. At maturity, the disk cells’ apical wall facing the storage cavity accumulated rhamnogalacturonan-I epitopes near the plasma membrane. Together, these data indicate that cannabis glandular trichomes undergo spatiotemporal remodeling at specific wall subdomains to facilitate storage cavity formation and metabolite storage.
Digital assets and property rights in insolvency
Authors: Cone Geoffrey , Bjorklund Nicholas S , Dyekman Gregory C 
Published: August 2021

Abstract
What happens to your Bitcoin or other cryptoassets if the custodian becomes insolvent? In the rush to investment in these alternative currencies, little attention has been paid to this consequence, not least by the custodians and exchanges themselves, as amply demonstrated by the case considered in this article. At the same time, we consider the solution to the problems presented in a number of insolvency cases around the world, by the comprehensive cryptoasset legislation introduced by the State of Wyoming, USA.
The Effect of Facilitated Tucking on the Pain Intensity Induced by Chest Tube Removal in Infants
Authors: Pouraboli Batool , Mirlashari Jila , Fakhr Aida Safaiee , Ranjbar Hadi , Ashtari Somayeh 
Published: August 2021

Background:
Removal of a chest tube is a painful procedure for infants. Medications, including narcotics, are used to control pain, but nonpharmacologic interventions are also effective in reducing pain during this procedure and are not associated with adverse effects.

Purpose:
To evaluate the additive effect of facilitated tucking to the use of morphine on infant pain associated at the time of chest tube removal.

Methods:
This was a prospective, randomized control study. Sixty infants were randomized into 2 equal groups utilizing a coin flip. All infants received 0.05-mg/kg morphine 20 minutes before chest tube removal. The intervention group received facilitated tucking and the control group received standard care. Infant pain was measured using the Neonatal Infant Pain Scale. Pain was assessed at 3 time points by 2 independent evaluators: 5 minutes before, during, and 5 minutes after removal of the chest tube. Mann-Whitney and Fisher's exact (Chi-square) tests were used to compare the intervention and control groups.

Results:
Pain scores were increased during chest tube removal for both the intervention and the control groups. Compared with the control group, pain scores for infants in the intervention group were less before, during, and after chest tube removal.

Implications for Practice:
Facilitated tucking combined with morphine administration can be an effective additive intervention for pain control in infants during chest tube removal.

Implications for Research:
Evaluate the effect of the facilitated tucking on pain induced by chest tube removal in preterm infants. Preterm infants may respond differently to pain.
Preserving Wideband Tympanometry Information With Artifact Mitigation
Authors: Eberhard Kristine Elisabeth , Ravicz Michael E. , Merchant Gabrielle R. , Masud Salwa F. , Maison Stéphane F. , Neely Stephen T. , Nakajima Hideko Heidi 
Published: August 2021

Objective:
Absorbance measured using wideband tympanometry (WBT) has been shown to be sensitive to changes in middle and inner ear mechanics, with potential to diagnose various mechanical ear pathologies. However, artifacts in absorbance due to measurement noise can obscure information related to pathologies and increase intermeasurement variability. Published reports frequently present absorbance that has undergone smoothing to minimize artifact; however, smoothing changes the true absorbance and can destroy important narrow-band characteristics such as peaks and notches at different frequencies. Because these characteristics can be unique to specific pathologies, preserving them is important for diagnostic purposes. Here, we identify the cause of artifacts in absorbance and develop a technique to mitigate artifacts while preserving the underlying WBT information.

Design:
A newly developed Research Platform for the Interacoustics Titan device allowed us to study raw microphone recordings and corresponding absorbances obtained by WBT measurements. We investigated WBT measurements from normal hearing ears and ears with middle and inner ear pathologies for the presence of artifact and noise. Furthermore, it was used to develop an artifact mitigation procedure and to evaluate its effectiveness in mitigating artifacts without distorting the true WBT information.

Results:
We observed various types of noise that can plague WBT measurements and that contribute to artifacts in computed absorbances, particularly intermittent low-frequency noise. We developed an artifact mitigation procedure that incorporates a high-pass filter and a Tukey window. This artifact mitigation resolved the artifacts from low-frequency noise while preserving characteristics in absorbance in both normal hearing ears and ears with pathology. Furthermore, the artifact mitigation reduced intermeasurement variability.

Conclusions:
Unlike smoothing algorithms used in the past, our artifact mitigation specifically removes artifacts caused by noise. It does not change frequency response characteristics, such as narrow-band peaks and notches in absorbance at different frequencies that can be important for diagnosis. Also, by reducing intermeasurement variability, the artifact mitigation can improve the test–retest reliability of these measurements.
Utility and Associated Charge of Anteroposterior Radiographs in Rotational Ankle Fractures During Postoperative Follow-Up: The Results of an Orthopaedic Trauma Association Survey
Authors: Garner Matthew R. , Ptasinski Anna , Aynardi Michael C. , Mosher Timothy J. , Firoozabadi Reza 
Published: August 2021

Objectives:
To evaluate the perceived utility and associated charges of the anteroposterior (AP) radiograph during rotational ankle fracture postoperative follow-up.

Design:
Survey study with charge analysis using published data at 50 orthopaedic hospitals in the United States.

Setting:
Not Applicable.

Participants:
Orthopaedic Trauma Association Members with an active email address who were invited and interested in answering a survey.

Results:
Ninety-four percent of respondents stated that they did routinely obtain an AP radiograph during rotational ankle fracture follow-up. However, 57% thought that the AP view should be eliminated from standard follow-up and only 51% found this view useful after initial treatment.

Charge Analysis:
The mean difference between a 2-view and 3-view ankle radiograph series was $102.00. Using this value and the assumption that each patient with a rotational ankle fracture gets 3 follow-up radiographs, there is the potential for a charge reduction of $306 per patient. Assuming over 134,000 rotational ankle fractures, a charge reduction of 41 million US dollars (USD) per year is possible if the AP image is routinely removed. Actual savings are likely to be less based on agreed on payer rates. Although less easy to quantify, there is also a potential reduction of radiation exposure, radiologists' interpretation time, and data storage.

Conclusions:
Routine AP radiographs should potentially be eliminated from routine postoperative ankle x-ray protocols based on this survey of experienced orthopaedic surgeons. If this specific radiograph is ordered on a case-by-case basis, then significant savings may occur.
Postoperative Prescription of Low-dose Narcotics Yields Equivalent Pain Outcomes Compared to High-dose Narcotics in Opioid-naïve Patients Undergoing Spine Surgery
Authors: Mohanty Sarthak , Shin Max , Casper David , Saifi Comron 
Published: August 2021

Study Design.
Retrospective cohort study at a single institution. Patients undergoing specific, elective spinal procedures between 2012 and 2018.

Objective.
The aim of thi stsudy was to investigate the relationship between opioid prescriptions during the immediate, post-discharge period, and patient-reported pain outcomes.

Summary of Background Data.
Medically prescribed opiates contribute to the opioid crisis, manifesting in significant mortality and economic burden. Although opioids are a mainstay of pain amelioration following spinal surgery, prescription practices are heterogeneous.

Methods.
Inclusion criteria included: patients who underwent one of 10 spinal procedures (Table 1); patients with preoperative, postoperative day (POD 1, and POD 30 pain scores reported on the visual analog scale (VAS); patients discharged without a complicated perioperative course. Opioids were converted to morphine milligram equivalents per day (MME/day) using a standard reference table. χ
2, Kruskal-Wallis, and logistic regression were utilized to investigate associations between clinical variables and postoperative pain scores. Univariate and multivariable linear regression models with Stepwise selection (cut off: P = 0.05) were employed as appropriate on POD 30 VAS pain scores.

Results.
Smoking status and postoperative LOS were associated with opioid prescription doses. Patients prescribed opioids <40 MME/day, equivalent to five tablets of 5 mg oxycodone/day, showed no significant difference in POD 30 VAS score (β coefficient: 0.095, P
= 0.752) when compared to patients who received the highest-dose opioids (>80 MME/day—equivalent to 10 tablets of 5 mg oxycodone/day). Adjusted multivariable logistic regression analysis revealed that postoperative opioid dosage/prescription was not a significant predictor of patients reporting at least 50% pain improvement, suggesting that 40 MME/day is sufficient to maintain patient satisfaction.

Conclusion.
Patients receiving the lowest dosage of opioid prescriptions with sufficient nonopiate analgesics did not report worse pain relief at POD 30 compared to those receiving higher opioid prescriptions. In light of the opioid epidemic, this study supports initial dosing recommendations by the American Society for Addiction Medicine.

Level of Evidence: 3
A Systematic Review and Pooled Prevalence of Delirium in Critically Ill Children*
Authors: Semple Diarmaid , Howlett Moninne M. , Strawbridge Judith D. , Breatnach Cormac V. , Hayden John C. 
Published: August 2021

OBJECTIVES:
Pediatric delirium is a neuropsychiatric disorder with disrupted cerebral functioning due to underlying disease and/or critical care treatment. Pediatric delirium can be classified as hypoactive, hyperactive, and mixed. This systematic review was conducted to estimate the pooled prevalence of pediatric delirium using validated assessment tools in children (Cornell Assessment of Pediatric Delirium, Pediatric Confusion Assessment Method for the ICU, PreSchool Confusion Assessment Method for the ICU, Pediatric Confusion Assessment Method for the ICU Severity Scale, and Sophia Observation Withdrawal Symptoms Pediatric Delirium scale), identify modifiable and nonmodifiable risk factors, and explore the association of pediatric delirium with clinical outcomes.

Data Sources:
A systematic search of PubMed, EMBASE, and CINAHL databases was undertaken for full articles pertaining to pediatric delirium prevalence.

Study Selection:
No language or date barriers were set. Studies were included where the following eligibility criteria were met: study design aimed to estimate pediatric delirium prevalence arising from treatment in the intensive care setting, using a validated tool. Only randomized controlled trials, cross-sectional studies, or cohort studies allowing an estimate of the prevalence of pediatric delirium were included.

Data Extraction:
Data were extracted by the primary researcher (D.S.) and accuracy checked by coauthors.

Data Synthesis:
A narrative synthesis and pooled prevalence meta-analysis were undertaken.

CONCLUSIONS:
Pediatric delirium, as determined by the Cornell Assessment of Pediatric Delirium score, is estimated to occur in 34% of critical care admissions. Eight of 11 studies reporting on subtype identified hypoactive delirium as most prevalent (46–81%) with each of the three remaining reporting either hyperactive (44%), mixed (57%), or equal percentages of hypoactive and mixed delirium (43%) as most prevalent. The development of pediatric delirium is associated with cumulative doses of benzodiazepines, opioids, the number of sedative classes used, deep sedation, and cardiothoracic surgery. Increased time mechanically ventilated, length of stay, mortality, healthcare costs, and associations with decreased quality of life after discharge were also found. Multi-institutional and longitudinal studies are required to better determine the natural history, true prevalence, long-term outcomes, management strategies, and financial implications of pediatric delirium.
Diversity of Authors of Publications From the Canadian Critical Care Trials Group*
Authors: Mehta Sangeeta , Ahluwalia Nanki , Heybati Kiyan , Burns Karen E. A. , Owais Sawayra , Cook Deborah J. ,   for the Canadian Critical Care Trials Group
Published: August 2021

OBJECTIVES:
Diverse perspectives improve the quality of scholarly initiatives. The demographic and professional diversity of scientists who contribute to critical care research and publications has not been described for the Canadian Critical Care Trials Group. Our objective was to describe the diversity of authors of publications from the Canadian Critical Care Trials Group.

DESIGN:
We conducted a quantitative content analysis of peer-reviewed articles published on behalf of the Canadian Critical Care Trials Group.

SETTING:
All peer-reviewed articles that were published on behalf of the Canadian Critical Care Trials Group between 1994 and October 2020.

SUBJECTS:
For each publication, we recorded the study design, the number of authors, and national or international collaboration. For the lead author, the senior author, and each coauthor, we recorded the following facets of diversity: gender, professional role, medical discipline, geographic location, academic stage, and visible minority status.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We identified 354 eligible publications; 74% (263/354) reported observational cohort studies, randomized trials, and surveys. Of 4,246 authors, 1,205 were unique individuals. The mean (sd) number of authors per publication was 12 (7.1). Of all 4,246 authors, 37% were women, and 13.7% were members of a visible minority group. Of all lead or senior authors, 40% and 34% respectively were women; 15% of lead and 10% of senior authors were members of a visible minority group. Three-quarters (73%) of publications listed authors from more than one profession, and more than half (54%) listed authors from more than one medical discipline. Nearly half of publications (45%) listed authors who were early career faculty, 33% listed authors who were trainees, and 67% listed authors who were from visible minority groups. Authors from different provinces and from different countries were listed in 67% and 40% of publications, respectively.

CONCLUSIONS:
Authors of Canadian Critical Care Trials Group publications are diverse with regard to demographic and professional characteristics.
Association Between Physical Activity, Screen Time and Sleep, and School Readiness in Canadian Children Aged 4 to 6 Years
Authors: Vanderloo Leigh M. , Omand Jessica , Keown-Stoneman Charles D. G. , Janus Magdalena , Tremblay Mark S. , Maguire Jonathon L. , Borkhoff Cornelia M. , Lebovic Gerald , Parkin Patricia , Mamdani Muhammad , Simpson Janis Randall , Duku Eric , Birken Catherine S. 
Published: August 2021

Abstract:

Objective:
School readiness is strongly associated with a child's future school success and well-being. The primary objective of this study was to determine whether meeting 24-hour movement guidelines (national physical activity, sedentary behaviors, and sleep recommendations) was associated with school readiness measured with mean scores in each of the 5 developmental domains of the Early Development Instrument (EDI) in Canadian children aged 4 to 6 years. Secondary objectives include examining the following: (1) the association between meeting 24-hour movement guidelines and overall vulnerability in school readiness and (2) the association between meeting individual physical activity, screen use and sleep recommendations, and overall school readiness.

Methods:
A prospective cohort study was performed using data from children (aged 4–6 years) who participated in a large-scale primary care practice-based research network.

Results:
Of the 739 participants (aged 5.9 + 0.12 years) in this prospective cohort study, 18.2% met the 24-Hour Movement Guidelines. Linear regression models (adjusted for child/family demographic characteristics, number of siblings, immigration status, and annual household income) revealed no evidence of an association between meeting all 24-hour movement guidelines and any of the 5 domains of the EDI (p > 0.05). Adjusted linear regression models revealed evidence of an association between meeting screen use guidelines and the "language and cognitive development" (β = 0.16, p = 0.004) domain, and for the sleep guideline, there was a statistically significant association with the "physical health and well-being" (β = 0.23, p = 0.001), the "language and cognitive development" (β = 0.10, p = 0.003), and the "communication skills and general knowledge" (β = 0.18, p < 0.001) domain.

Conclusion:
Early lifestyle interventions targeting screen use and sleep may be beneficial for improving a child's readiness for school.
Risk factors predisposing to acute stroke in India: a prospective study
Authors: Ram C. Venkata S. , Kumar Sudhir , Renjen Pushpendra Nath , Kumar G. Praveen , Swaminathan Jayanthi , Reddy C. Rajesh , Kondati Sathyanarayana , Sharma Mukesh , Selvan V.L. Arul , Sundaram Meenakshi , Vasudevan Anupama , Lackland Daniel 
Published: August 2021

Background:
Stroke is an important neurological disorder with significant morbidity and mortality. In India, the risk factors for stroke (obesity, diabetes mellitus, alcoholism, hypertension, and sedentary lifestyle) are mounting with economic growth and increasing the disease burden.

Objective:
To assess the severity and risk factors of stroke in India and identify any new predisposing factors.

Methods:
A multicentric (six tertiary care hospitals across India) prospective observational study (from September 2016 to July 2017) was conducted on 526 stroke patients, presenting within the first 24 h to examine the risk factors for ischemic and hemorrhagic strokes. Severity was determined using the National Institutes of Health Stroke Scale (NIHSS).

Results:
Predominantly male (72.3%), 75% of the sample was >50 years old, with a mean body mass index (BMI) of 25.8 ± 4.3 kg/m2 and 14.6% obese patients. Hypertension and diabetes mellitus were the commonest comorbidities, followed by a history of ischemic heart disease and familial history of stroke. 20.5% of patients had mild strokes, 57.4% had moderate, 8.4% experienced moderate-severe strokes, whereas 7.2% had severe strokes. Regarding the admission diagnoses, 56.8% were ischemic, 18.6% were hemorrhagic, 1.1% had a transient ischemic attack, 6.6% suffered recurrent strokes, and 17% were other forms.

Conclusion:
The foremost risk factors for stroke in India, hypertension and diabetes, need to be controlled and treated like other global high-risk populations for stroke prevention. The NIHSS scores highlight the relationship between risk factors and stroke severity.
Socioeconomic disparities and risk of hypertension among older Americans: the Health and Retirement Study
Authors: Neufcourt Lola , Zins Marie , Berkman Lisa F. , Grimaud Olivier 
Published: August 2021

Background:
Reducing hypertension represents a critical point of intervention to lower the burden of cardiovascular disease worldwide. Although the relationship between lower socioeconomic status and higher rates of hypertension is well documented, most of the evidence comes from prevalence studies involving young adult population.

Aim:
To investigate the independent association of wealth, education and income with incident hypertension among older adults living in the United States.

Methods:
This cohort study included 16 587 individuals aged 50 years and older, free of hypertension and cardiovascular disease at baseline from the Health and Retirement Study over the period 1992–2014. We used Cox proportional hazards models to examine longitudinal associations between wealth, education, and income at baseline and self-reported diagnosis of incident hypertension.

Results:
During a median follow-up of 7.8 years, 6817 participants declared an occurrence of hypertension (incidence rate: 45.3 [95% confidence interval (CI) = 44.2–46.4] per 1000 person-years). Overall, those in low as compared with high socioeconomic status groups had a higher risk of developing hypertension in late life. In particular, adjusted hazard ratios [95% CI] across decreasing wealth quartiles were 1.0 (reference), 0.97 [0.88–1.08], 1.17 [1.05–1.30], and 1.20 [1.07–1.35] in men, and 1.0 (reference), 1.28 [1.17–1.41], 1.21 [1.09–1.33], and 1.28 [1.16–1.42] in women. In multivariate analyses, wealth remained strongly associated with incident hypertension among women after accounting for other socioeconomic, behavioral and anthropometric risk factors.

Conclusions:
Socioeconomic status, especially wealth, is a strong independent predictor of incident hypertension in older adults. Our findings support population-based interventions tailored to those in disadvantaged socioeconomic groups to reduce the risk of hypertension.
Operational Stress Control Service
Authors: Martindale Sarah L. , Shura Robert D. , Cooper Marc A. , Womack Sheila F. , Hurley Robin A. , Vair Christina L. , Rowland Jared A. 
Published: August 2021

Objective:
This manuscript details the methods, outcomes, and lessons learned from a successful multi-dimensional, interdisciplinary, institutional response to HCW well-being during the COVID-19 pandemic.

Methods:
Operational Stress Control Service (OSCS) is a model for the prevention and management of stress and trauma implemented within an occupational system. Communication, Employee Wellness, and Intervention were targeted program aspects, adapted from an established US military protocol.

Results:
Since April 2020, OSCS has received 4660 unique survey responses; reached 1007 employees in-person; informed 125 leadership-hosted videoconferences; and assisted 13 departments with grief and morale-related challenges.

Conclusions:
OSCS improved communication across the organization and allowed for rapid deployment of solutions to maintain effective operations. Results highlight the benefit of multiple avenues of frequent, bottom-up, and top-down communication. Creating such services during times of normalcy might be considered in preparation for future crisis.