bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do pretransplant C‐peptide levels predict outcomes following simultaneous pancreas‐kidney transplantation? A matched case‐control study
Authors: Gurram Venkat , Gurung Komal , Rogers Jeffrey , Farney Alan C. , Orlando Giuseppe , Jay Colleen , Reeves‐Daniel Amber , Mena‐Gutierrez Alejandra , Sakhovskaya Natalia , Doares William , Kaczmorski Scott , Sharda Berjesh , Gautreaux Michael D. , Stratta Robert J. 
Published: October 2021

AbstractFollowing simultaneous pancreas‐kidney transplantation (SPKT), survival outcomes are reported as equivalent in patients with detectable pretransplant C‐peptide levels (Cp+) and a “type 2″ diabetes mellitus (DM) phenotype compared to type 1 (Cp negative [Cp‐]) DM. We retrospectively compared 46 Cp+ patients pretransplant (≥2.0 ng/mL, mean 5.4 ng/mL) to 46 Cp‐ (level < 0.5 ng/mL) case controls matched for recipient age, gender, race, and transplant date. Early outcomes were comparable. Actual 5‐year patient survival (91% versus 94%), kidney graft survival (69% versus 86%, p = .15), and pancreas graft survival (60% versus 86%, p = .03) rates were lower in Cp+ versus Cp‐ patients, respectively. The Cp+ group had more pancreas graft failures due to insulin resistance (13% Cp+ versus 0% Cp‐, p = .026) or rejection (17% Cp+ versus 6.5% Cp‐, p = .2). Post‐transplant weight gain > 5 kg occurred in 72% of Cp+ versus 26% of Cp‐ patients (p = .0001). In patients with functioning grafts, mean one‐year post‐transplant HbA1c levels (5.0 Cp+ versus 5.2% Cp‐) were comparable, whereas Cp levels were higher in Cp+ patients (5.0 Cp+ versus 2.6 ng/mL Cp‐). In this matched case‐control study, outcomes were inferior in Cp+ compared to Cp‐ patients following SPKT, with post‐transplant weight gain, insulin resistance, and rejection as potential mitigating factors.
Biodiversity alleviates the decrease of grassland multifunctionality under grazing disturbance: A global meta‐analysis
Authors: Zhang Ruiyang , Tian Dashuan , Chen Han Y. H. , Seabloom Eric W. , Han Guodong , Wang Shaopeng , Yu Guirui , Li Zhaolei , Niu Shuli 
Published: October 2021

AbstractAimBiodiversity drives the delivery of multiple ecosystem functions related to carbon and nutrient cycling (ecosystem multifunctionality, EMF), and biodiversity and ecosystem functioning are strongly threatened by intensive grazing in grasslands. However, it remains unclear how biodiversity regulates EMF changes in response to intensive grazing.LocationGlobal.Time periodFrom 1992 to 2018.Major taxa studiedGrassland.MethodsHere, we conducted a global synthesis using 373 paired observations from 90 published studies to address the responses of plant diversity, EMF and their relationships to grazing disturbance depending on grazing intensity, livestock type, grazing duration, and climatic aridity.ResultsOur results showed that EMF significantly decreased with increasing grazing intensity, but the negative EMF response was alleviated at high levels of plant diversity. The grazing‐induced changes in EMF increased linearly with the changes in plant diversity, with the slopes increasing by 78.9% from light to heavy grazing. In addition, the grazing‐induced decrease of EMF was stronger with longer grazing duration and more arid climates. Structural equation models suggested that grazing intensity reduced EMF largely via decreasing plant diversity, whereas upsizing livestock type promoted EMF by increasing plant diversity.Main conclusionsThis study highlights the key role of biodiversity in mediating EMF in response to intensifying grazing disturbance. We call for conservation of biodiversity to maintain grassland multifunctionality and services.
Right ventricular outflow tract electroanatomical abnormalities in asymptomatic and high‐risk symptomatic patients with Brugada syndrome: Evidence for a new risk stratification tool?
Authors: Letsas Konstantinos P. , Vlachos Konstantinos , Conte Giulio , Efremidis Michael , Nakashima Takashi , Duchateau Josselin , Bazoukis George , Frontera Antonio , Mililis Panagiotis , Tse Gary , Cheniti Ghassen , Takigawa Masateru , Pambrun Thomas , Prappa Efstathia , Sacher Frederic , Derval Nicolas , Sideris Antonios , Auricchio Angelo , Jais Pierre , Haissaguerre Michel , Hocini Meleze 
Published: October 2021

AbstractIntroductionMicrostructural abnormalities at the epicardium of the right ventricular outflow tract (RVOT) may provide the arrhythmia substrate in Brugada syndrome (BrS). Endocardial unipolar electroanatomical mapping allows the identification of epicardial abnormalities. We evaluated the clinical implications of an abnormal endocardial substrate as perceived by high‐density electroanatomical mapping (HDEAM) in patients with BrS.MethodsFourteen high‐risk BrS patients with aborted sudden cardiac death (SCD) (12 males, mean age: 41.9 ± 11.8 years) underwent combined endocardial‐epicardial HDEAM of the right ventricle/RVOT, while 40 asymptomatic patients (33 males, mean age: 42 ± 10.7 years) underwent endocardial HDEAM. Based on combined endocardial‐epicardial procedures, endocardial HDEAM was considered abnormal in the presence of low voltage areas (LVAs) more than 1 cm2 with bipolar signals less than 1 mV and unipolar signals less than 5.3 mV. Programmed ventricular stimulation (PVS) was performed in all patients.ResultsThe endocardial unipolar LVAs were colocalized with epicardial bipolar LVAs (p = .0027). Patients with aborted SCD exhibited significantly wider endocardial unipolar (p < .01) and bipolar LVAs (p < .01) compared with asymptomatic individuals. A substrate size of unipolar LVAs more than 14.5 cm2 (area under the curve [AUC]: 0.92, p < .001] and bipolar LVAs more than 3.68 cm2 (AUC: 0.82, p = .001) distinguished symptomatic from asymptomatic patients. Patients with ventricular fibrillation inducibility (23/54) demonstrated broader endocardial unipolar (p < .001) and bipolar LVAs (p < .001) than noninducible patients. The presence of unipolar LVAs more than 13.5 cm2 (AUC: 0.95, p < .001) and bipolar LVAs more than 2.97 cm2 (AUC: 0.78, p < .001) predicted a positive PVS.ConclusionExtensive endocardial electroanatomical abnormalities identify high‐risk patients with BrS. Endocardial HDEAM may allow risk stratification of asymptomatic patients referred for PVS.
Safety and efficacy of microneedling technology in the treatment of acne scars
Authors: Casabona Gabriela , Alfertshofer Michael G. , Kaye Kai O , Frank Konstantin , Mercado‐Perez Arnaldo , Hargiss John B. , Green Jeremy B. , Cotofana Sebastian 
Published: October 2021

AbstractBackgroundCurrent options for the reduction of acne scarring (eg, ablative laser resurfacing) are associated with considerable side effects and limitations in terms of patient population. Percutaneous collagen induction via microneedling poses an alternative treatment method due to its low rates of reported adverse events and side effects.ObjectiveTo assess the safety and effectiveness of microneedling treatments in reducing acne scars.MethodsA total of 22 patients (18 females and 4 males) with a mean age of 38 ± 7.6 years were assessed regarding the appearance of facial acne scarring. Acne scars were assessed via the Acne Scar Assessment Scale (ASAS) and the Goodman and Baron acne scar grading scale before and after two/three treatments. Additionally, the post‐interventional development of side reactions, adverse events, and patient‐reported outcomes (eg, pain/discomfort, skin redness) was reported.ResultsCompared to baseline, the mean ASAS value was improved statistically significantly on average by 1.41 and 1.46 after the second treatment as assessed by the independent raters and the patients, respectively. In patients who received a total of three treatments, a statistically significant mean improvement in ASAS value of 1.35 and 1.66 compared to baseline was assessed by the independent raters and patients, respectively. No unexpected adverse events were reported. The severity and rate of side reactions decreased over the course of this study.ConclusionMicroneedling treatments can pose a safe and effective option in the reduction of acne scarring. In this study, microneedling helped achieving a significant reduction of acne scars while showing high patient safety.
Encountering Shakespeare in avant‐garde Kun opera
Authors: He Chengzhou 
Published: October 2021

AbstractIn commemoration of the quater‐centenary of William Shakespeare and Tang Xianzu in 2016,A Shakespearean Handan Dream, a Sino‐British theatrical co‐production, was staged in London, with Ke Jun and Leon Rubin as co‐directors. The play contains four acts of Tang’sHandan Meng(The Handan Dream), into which 12 Shakespearean episodes are inserted. Instead of merely representing cultural differences, the play is seen as an active performance event to shape the cross‐cultural aesthetic experiences of the audiences and their cosmopolitan visions. As an avant‐garde experiment, the play features a specific kind of “new interculturalism” in world theater, which challenges the existing modes of interpretation of intercultural theater. With reference to new developments in intercultural performance theory, this essay is concerned with the singularity of the intercultural performance, its social and political significance, and its contemporary relevance.
Application of Suspension Fixation with Button Plates for Patients with Distal Radioulnar Joint Dislocation: A Case Series
Authors: Liu Hongliang , Xu Shuchai , Huang Zexin , Lv Yang , Chen Bojian , Lin Xiaodong , Liu Jun , Sang Lili 
Published: October 2021

ObjectiveThe aim of the present study was to assess the effect of suspension fixation with button plates on the reconstruction of the distal radioulnar joint dislocation (DRUJ).MethodsThis was a case series of six patients (two men and four women) who underwent suspension fixation with button plates for DRUJ dislocation between January 2015 and May 2017. Physical examination, radiography, MRI, functional activity of the wrist joint, grip strength of the wrist joint, Garland–Werley wrist score, Mayo wrist score, and visual analog scale (VAS) score were used to evaluate the effect of this procedure. All patients were followed up every 3 months. The evaluation time point was 12 months after the operation. Comparisons of the functional indexes of wrist function before and after the operation were performed using paired statistical tests.ResultsThe mean range of motion of the affected limb was 70° at forearm pronation and 75° at forearm supination. The subjective assessments and tests of the motor function of the wrist showed improvement after surgery. The Garland–Werley wrist score was 13.50 ± 2.66 preoperatively, the Mayo wrist score was 56.67 ± 18.35, and the VAS score was 4.83 ± 1.17. The Garland–Werley wrist score was 2.83 ± 1.33 postoperatively at 12 months, the Mayo wrist score was 87.5 ± 6.89, and the VAS score was 0.50 ± 0.55. At 12 months, the Garland–Werley wrist score, the Mayo wrist score, and the VAS score showed significant improvements when compared with those before surgery (P = 0.000, P = 0.003, and P = 0.000, respectively). Radiographic examination revealed that the internal fixation device was in place, and no dislocation of the DRUJ could be observed. None of the patients had internal fixation device removal or re‐dislocation of the DRUJ. None of the patients had re‐dislocation of the DRUJ. No secondary ulnar or radial fractures and nerve injury were reported during and after surgery. No tumor recurrence was observed in patients with giant cell tumors of the tendon sheath. No loosening and displacement of screws were reported.ConclusionThe new method of suspension fixation with button plates for the surgical reconstruction of a DRUJ dislocation is simple, with minimal trauma, and maintains the stability of the DRUJ without the need for intra‐articular or extra‐articular reconstruction of the ligament. Furthermore, it allows early functional exercise and achieves satisfactory postoperative functional recovery.
Comparison of Arthroscopic Debridement and Repair in the Treatment of Ellman Grade II Bursal‐side Partial‐thickness Rotator Cuff Tears: A Prospective Randomized Controlled Trial
Authors: Wang Teng , Ren Zhongkai , Zhang Yi , Zhao Xia , Liu Xiaomeng , Yu Tengbo , Zhang Yingze 
Published: October 2021

ObjectiveTo compare the effects of arthroscopic debridement and repair in treating Ellman grade II bursal‐side partial‐thickness rotator cuff tears.MethodsThis is a single‐center, prospective, randomized controlled trial. From September 2017 to April 2019, 78 patients underwent arthroscopic debridement (35 patients) or repair (43 patients) due to Ellman grade II bursal‐side partial‐thickness rotator cuff tears. Twenty‐six men and 52 women were included in the study, with an average age of 56.31 years (range, 42 to 74 years). After the acromioplasty was formed, the debridement group only performed stump refreshing and surrounding soft tissue cleaning, while the repair group converted the partial tears into full‐thickness tears and then sutured them by single row or suture bridge technique. The visual analogue scale (VAS), Constant‐Murley shoulder (CMS), American Shoulder and Elbow Surgeons (ASES), and University of California, Los Angeles (UCLA) scores were used to evaluate clinical results preoperatively and at 6, 12, and 18 months postoperatively. Magnetic resonance imaging was used to assess the integrity of the rotator cuff, muscle atrophy, and fat infiltration.ResultsA total of 85 patients met the inclusion criteria and were randomly divided into the debridement group (41 patients) and the repair group (43 patients). During the 18‐month follow‐up period, a total of seven patients were lost to follow‐up. The functional scores of both groups were significantly improved: the VAS score decreased 5.06 and 4.63 in the debridement group (5.77 preoperative to 0.71 postoperative) and the repair group (5.49 to 0.86) (P < 0.05). Moreover, the CMS, ASES, UCLA scores increased 51.63, 58.24, 20.57 in debridement group (39.46 to 91.09, 34.14 to 92.38, 13.29 to 33.86), and increased 48.14, 60.53, 20.93 in repair group (43.63 to 91.77, 33.10 to 93.63, 12.58 to 33.51) (P < 0.05). No significant differences were found in functional scores between the two groups at 6, 12, and 18 months postoperatively (P > 0.05). The magnetic resonance imaging showed no re‐tears, and no difference was observed in the degree of muscle atrophy and fat infiltration between the two groups (P > 0.05). Except for four cases of shoulder stiffness, no other obvious surgery‐related complications were found.ConclusionFor Ellman grade II bursal‐side partial‐thickness rotator cuff tears, both the debridement and repair groups achieved good results during 18‐month follow‐ups, with no difference between the two groups.
Donation‐induced iron depletion is significantly associated with low hemoglobin at subsequent donations
Authors: Prinsze Femmeke J , de Groot Rosa , Timmer Tiffany C. , Zalpuri Saurabh , van den Hurk Katja 
Published: October 2021

AbstractBackgroundBlood donation is associated with a loss of hemoglobin (Hb)‐bound iron. Hb levels recover relatively fast by using stored iron. However, it takes more time to replenish iron stores, potentially resulting in iron deficiency.Study designHb and ferritin levels were measured in 5056 new, first‐time, and repeat whole blood donors. We investigated whether increasing numbers of donations are associated with lower ferritin levels. Furthermore, we tested whether low ferritin levels are associated with low‐Hb deferral at the subsequent donation attempt by performing logistic regression adjusted for age and stratified by sex.ResultsWhereas mean Hb levels are relatively stable, ferritin levels significantly decrease with increasing numbers of donations and were approximately 50% lower for donors with >50 donations compared with those with 2–10 donations. Despite the poor correlation of ferritin and Hb levels, cross‐sectional, iron‐deficient donors (ferritin <15 ng/ml) had 21.8 (8.5–55.6) higher odds in men, 10.1 (6.1–16.5) in premenopausal women, and 11.7 (5.2–26.4) in postmenopausal women for Hb deferral at a subsequent visit.DiscussionTo conclude, repeated donations may induce iron deficiency, which corresponds with an over tenfold increased risk of having insufficiently restored Hb levels at a subsequent donation attempt. Longer donation intervals and/or higher dietary or supplemental iron intake are warranted to prevent accumulated iron depletion and subsequent low‐Hb deferral in whole blood donors.
The Riddle of Atmospheric Oxygen: Photosynthesis or Photolysis?
Authors: Davankov V. A. 
Published: October 2021

AbstractThe stoichiometry of the photosynthetic reaction requires that the quantities of the end products (organic biomaterial and free oxygen) be equal. However, the correct balance of the amounts of oxygen and organic matter that could have been produced by green plants on the land and in the ocean since the emergence of unique oxygenic photosynthetic systems (no more than 2.7 billion years ago) is virtually impossible, since the vast majority of oxygen was lost in oxidizing the initially reducing matter of the planet, and the bulk of organic carbon is scattered in sedimentary rocks. In recent decades, convincing information has been obtained in favor of the large-scale photolysis of water molecules in the upper atmosphere with the scattering of light hydrogen into space and the retention of heavier oxygen by gravity. This process has been operating continuously since the formation of the Earth. It is accompanied by huge losses of water and the oxidation of salts of ferrous iron and sulfide sulfur in the oceans and methane in the atmosphere. The main stages of the evolution of the atmosphere and surface layers of the Earth’s crust are analyzed for the first time in this work by considering the parallel processes of photosynthesis and photolysis. Large-scale photolysis of water also provides consistent explanations for the main stages in the evolution of the nearest planets of our Solar System.
First contact of care for persons with spinal cord injury: a general practitioner or a spinal cord injury specialist?
Authors: Touhami Dima , Brach Mirjam , Essig Stefan , Ronca Elias , Debecker Isabelle , Eriks-Hoogland Inge , Scheel-Sailer Anke , Münzel Nadja , Gemperli Armin 
Published: October 2021

Abstract
Background
Although general practitioners (GPs) are generally considered as the first point of contact for care, this may be different for persons with complex conditions, such as those with spinal cord injury (SCI). The objective of this study is to understand the differences in long-term care provision by GPs and SCI-specialists, by examining (1) the first contact of care for SCI health problems, (2) the morbidity profile and use of health-care services in relation to first contact, and (3) the factors associated with the choice of first contact.

Methods
In this cross-sectional study based on data derived from the Swiss Spinal Cord Injury Cohort Study Community Survey 2017, the main outcome measure was the reported first contact for SCI-specific care. This information was analysed using the chi-square test and logistic regression analysis of groups based on patient characteristics, use of health-care services and secondary health conditions assessed using the Spinal Cord Injury Secondary Conditions Scale (SCI-SCS).

Results
Out of 1294 respondents, 1095 reported their first contact for SCI-specific care; 56% indicated SCI-specialists and 44% specified GPs. On average, participants who first contacted a GP reported higher number of GP consultations (5.1 ± 5.2 vs. 3.9 ± 7.2), planned visits to ambulatory clinics (3.7 ± 7.3 vs. 3.6 ± 6.7) and hospital admissions (GP, 1.9 ± 1.7 vs. 1.5 ± 1.3), but lower number of visits to SCI-specialists (1.7 ± 1.8 vs. 2.6 ± 1.7) and of hospital days (22.8 ± 43.2 vs. 31.0 ± 42.8). The likelihood to contact a GP first was significantly higher in persons ≥75 years old (OR = 4.44, 95% CI = 1.85–10.69), Italian speakers (OR = 5.06, 95% CI = 2.44–10.47), had incomplete lesions (OR = 2.39, 95% CI = 1.71–3.35), experiencing pain (OR = 1.47, 95% CI = 1.04–2.09) or diabetes mellitus (OR = 1.85, 95% CI = 1.05–3.27), but lower for those situated closer to SCI centres (OR = 0.69, 95% CI = 0.51–0.93) or had higher SCI-SCS scores (OR = 0.92, 95% CI = 0.86–0.99).

Conclusion
Age, language region, travel distance to SCI centres, lesion completeness, and occurrence of secondary conditions play a significant role in determining the choice of first contact of care, however there is still some unwarranted variation that remains unclear and requires further research.
Molecular epidemiology of hereditary ataxia in Finland
Authors: Lipponen Joonas , Helisalmi Seppo , Raivo Joose , Siitonen Ari , Doi Hiroshi , Rusanen Harri , Lehtilahti Maria , Ryytty Mervi , Laakso Markku , Tanaka Fumiaki , Majamaa Kari , Kytövuori Laura 
Published: October 2021

Abstract
Background
The genetics of cerebellar ataxia is complex. Hundreds of causative genes have been identified, but only a few cause more than single cases. The spectrum of ataxia-causing genes differs considerably between populations. The aim of the study was to investigate the molecular epidemiology of ataxia in the Finnish population.

Patients and methods
All patients in hospital database were reviewed for the diagnosis of unspecified ataxia. Acquired ataxias and nongenetic ataxias such as those related to infection, trauma or stroke were excluded. Sixty patients with sporadic ataxia with unknown etiology and 36 patients with familial ataxia of unknown etiology were recruited in the study. Repeat expansions in the SCA genes (ATXN1, 2, 3, 7, 8/OS, CACNA1A, TBP), FXN, and RFC1 were determined. Point mutations in POLG, SPG7 and in mitochondrial DNA (mtDNA) were investigated. In addition, DNA from 8 patients was exome sequenced.

Results
A genetic cause of ataxia was found in 33 patients (34.4%). Seven patients had a dominantly inherited repeat expansion in ATXN8/OS. Ten patients had mitochondrial ataxia resulting from mutations in nuclear mitochondrial genes POLG or RARS2, or from a point mutation m.8561C > G or a single deletion in mtDNA. Interestingly, five patients were biallelic for the recently identified pathogenic repeat expansion in RFC1. All the five patients presented with the phenotype of cerebellar ataxia, neuropathy, and vestibular areflexia (CANVAS). Moreover, screening of 54 patients with Charcot-Marie-Tooth neuropathy revealed four additional patients with biallelic repeat expansion in RFC1, but none of them had cerebellar symptoms.

Conclusions
Expansion in ATXN8/OS results in the majority of dominant ataxias in Finland, while mutations in RFC1 and POLG are the most common cause of recessive ataxias. Our results suggest that analysis of RFC1 should be included in the routine diagnostics of idiopathic ataxia and Charcot-Marie-Tooth polyneuropathy.