bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Genomic Understanding of Gram-Positive Plant Growth-Promoting Leifsonia
Authors: Nordstedt Nathan P. , Roman-Reyna Veronica , Jacobs Jonathan M. , Jones Michelle L. 
Published: April 2021

Root-associated bacteria play critical roles in shaping plant health for abiotic and biotic stress tolerance. The Leifsonia genus includes pathogenic and beneficial bacteria but limited research is available comparatively across species regarding their association with plants. We recently identified the plant growth-promoting Leifsonia sp. C5G2 isolated from the rhizosphere of Plectranthus scutellarioides (coleus) that increased stress tolerance and quality of water-stressed greenhouse ornamentals. Using this beneficial strain as a model, we performed comparative genomics with beneficial, commensal, and pathogenic Leifsonia spp. to better understand plant association and growth promotion under abiotic stress. Comparative phylogenetic analyses showed that beneficial and commensal Leifsonia spp. clustered separately from pathogenic Leifsonia xyli subsp. xyli. In addition, the beneficial or commensal strains share biosynthetic gene and orthologous protein clusters that are not shared with known phytopathogens in our analysis. The phytopathogenic Leifsonia strains also share noticeably higher percent homology with plant-associated virulence factors in closely related Clavibacter spp. than the beneficial or commensal strains. Genome analysis supplemented with in vitro assays validated the findings that our model growth-promoting Leifsonia sp. strain C5G2 was highly prolific on diverse carbon sources. This is unlike known fastidious growth behaviors of phytopathogenic Leifsonia spp. Beneficial Leifsonia sp. C5G2 imparts water stress tolerance in plants, and multiple genes were identified in the genomes of beneficial Leifsonia strains that are potentially involved in bacterial osmotic stress and the production of osmoprotectants and vitamin B9. This work sheds light on the diversity of the genus Leifsonia, with a better understanding of potential mechanisms employed by poorly understood beneficial bacteria.
Purposeful Language Exposure by Neonatal Nurses and Caregivers in the NICU
Authors: Newnam Katherine M. , Muñoz Lauren R. 
Published: April 2021

Background:
Preterm infants are at significant risk of neurocognitive deficits including language delay. Extended hospitalization in the neonatal intensive care unit (NICU) causes missed opportunities for language exposure at critical developmental periods of neural pathways for language processing. Healthcare providers (HCPs), particularly nurses, may be instrumental in providing infant-directed speech to improve neurodevelopmental outcomes.

Purpose:
To evaluate current evidence to determine what is known about the characteristics of HCP communication to infants in the NICU.

Search/Strategy:
Four databases and forward searching were used to respond to the clinical question: “What is known about the characteristics of HCP communication to infants in the NICU?” Empiric, primary research studies published in English without date restriction were included.

Findings:
Eight studies, primarily descriptive, were reviewed. Overall, infant-directed speech was rarely provided by HCPs. Language was more often directed to sicker infants, occurred in contexts of procedural pain, and was sometimes combined with touch. Perceptions of language by nurses, infants, and parents as well as inhibitors and benefits of infant-directed speech were reported.

Implications for Practice:
As frontline neonatal providers, nurses can serve as role models of infant-directed speech for parents, helping them gain comfort and understand the importance of speaking to their preterm infants. Nurses can also provide much-needed language nutrition to preterm infants when parents cannot be present.

Implications for Research:
Methods to reduce barriers and support infant-directed speech in the NICU require testing. Predictive modeling using measures of language exposure in the NICU may support differences in neurodevelopmental outcomes.
A Measure of Long-Term Hearing Aid Use Persistence Based on Battery Reordering Data
Authors: Zobay Oliver , Dillard Lauren K. , Naylor Graham , Saunders Gabrielle H. 
Published: April 2021

Objective:
We describe the construction of a hearing aid long-term use persistence measure based on battery reorder data. The measure is derived from the notion that hearing aid users keep using their devices for some time after placing a battery order.

Design:
A hearing aid user is defined as persistent at time T if they placed a battery order within a time span W preceding T. We characterize and validate this measure using electronic health records from a large sample of US Veterans.

Results:
We describe how to choose parameters T and W for calculating persistence rates in the patient sample. For validation, the associations of persistence with: (1) the duration over which users received outpatient hearing aid care; (2) self-reported hearing aid use shortly after fitting; and (3) patient age and hearing loss are investigated. In all cases, plausible dependencies are observed.

Conclusions:
We conclude that our persistence measure is viable and hope this will motivate its use in similar studies.
The Demographics and Epidemiology of Infantile, Juvenile, and Adolescent Idiopathic Scoliosis in a Southern California Integrated Health Care System
Authors: Bondar Kevin , Nguyen Annie , Vatani Jasmine , Kessler Jeffrey 
Published: April 2021

Study Design.
Prognostic study, Level III.

Objectives.
The aim of this study was to determine the incidence and demographics of idiopathic scoliosis (IS) in a large cohort of children in a Southern California integrated healthcare system, and to identify the demographic or clinical factors associated with the greatest risk of IS.

Summary of Background Data.
Although many authors have reported on the incidence and prevalence of IS in children, there have been few incidence studies in the United States on large, self-contained populations.

Methods.
A retrospective chart analysis was done on diagnosed cases of IS within our integrated health care system in patients under age 18 years during the entire 2013 calendar year. Patient demographics were recorded and the incidence of IS was determined. Odds ratios (ORs) for having IS and for having more severe initial curve magnitudes based on demographics were determined using logistic regression models.

Results.
IS Incidence was 3.9, 28.6, and 393 per 100,000, respectively, for the infantile, juvenile, and adolescent group. The female incidence was more than twice that of males in all age groups. Multivariate logistic regression analysis showed Asians and non-Hispanic Whites had the highest OR of IS (OR 1.54 and 1.32 with 95% confidence interval [CI] 1.33–1.79 and 1.19–1.47). Whites, Blacks, and mixed-race patients had a significantly higher initial curve magnitude than Hispanics; females also had a significantly greater initial curve magnitude than boys (18.1° vs. 16.7°). Underweight patients had a 50% increased OR of IS versus normal weight (95% CI 1.16–1.94) with a progressively decreased OR of IS as weight increased.

Conclusion.
Our study of a large integrated healthcare system sheds light on the incidence of IS and the ORs based on weight, sex, and ethnicity/race. The overall incidence was lower overall than previously thought.

Level of Evidence: 3
Revision Surgery of Total Lumbar Disk Replacement
Authors: Schmitz Arthur , Collinet Arnaud , Ntilikina Yves , Tigan Leonardo , Charles Yann P. , Steib Jean-Paul 
Published: April 2021

Study Design:
This was a retrospective clinical review.

Objective:
The objective of this study was to analyze failure mechanisms after total lumbar disk replacement (TDR) and surgical revision strategies in patients with recurrent low back pain (LBP).

Summary and Background Data:
Several reports indicate that TDR revision surgery carries a major risk and that it should not be recommended. The clinical results of posterior instrumented fusion using the prosthesis like an interbody cage have not been well analyzed.

Materials and Methods:
From 2003 to 2018, 48 patients with recurrent LBP after TDR underwent revision surgery. The average age was 39 years (24–61 y). The mean follow-up was 100.4 months (24.6–207.7 mo). Clinical data, self-assessment of patient satisfaction, and Oswestry Disability Index collected at each clinical control or by phone call for the older files and radiologic assessments were reviewed. The surgical revision strategy included posterior fusion in 41 patients (group A) and TDR removal and anterior fusion in 7 patients (group B), of which 6 patients had an additional posterior fixation.

Results:
Facet joint osteoarthritis was associated with TDR failure in 85%. In 68% the position of the prosthesis was suboptimal. Range of motion was preserved in 25%, limited in extension in 65%, and limited in flexion in 40%. Limited range of motion and facet joint osteoarthritis were significantly related (P=0.0008). The complication rate in group B was 43% including iliac vein laceration. Preoperative and 2-year follow-up Oswestry Disability Index were 25.5 and 22.0, respectively, in group A versus 27.9 and 21.3 in group B.

Conclusions:
Posterior osteoarthritis was the principal cause of recurrent LBP in failed TDR. The anterior approach for revision carried a major vascular risk, whereas a simple posterior instrumented fusion leads to the same clinical results.

Level of Evidence:
Level IV.
Short Term Prediction of Preeclampsia
Authors: Sroka Dorota , Verlohren Stefan 
Published: April 2021

Abstract
Preeclampsia (PE), a multisystem disorder in pregnancy, is a main cause of perinatal mortality and is associated with long-term maternal complications. For a long time, PE was defined as the new onset hypertension and proteinuria after 20 weeks’ gestation. It had been shown that this “gold standard definition” is not able to provide a sufficient prediction of PE-related fetal and/or maternal complications. In 2018 the International Society for the Study of Hypertension in Pregnancy recommended a broader definition of the disease. The new definition of the International Society for the Study of Hypertension in Pregnancy ruled out proteinuria as mandatory for the diagnosis of PE. This new definition increases the number of patients diagnosed as preeclamptic by nearly 21%, which is not accompanied by an increased severity of maternal outcomes. Including angiogenic biomarkers, however, has been shown to increase detection of adverse outcomes.
The pathophysiology of PE is complex and not yet completely explained. Advances in prediction and diagnosis have been achieved by discovery and clinical evaluation of biomarkers, especially of placental origin. A broad spectrum of biomarkers has been tested, a few of them have been introduced into the clinical practice as of today. Especially angiogenic biomarkers that are rooted in the pathophysiology of PE have been demonstrated to be important in the prediction and diagnosis of adverse outcomes. At a cut-off value of the soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF)-ratio of 85, early-onset PE <34+0  weeks of gestation can accurately be diagnosed with a sensitivity of 89% and a specificity of 97%. The Prediction of short-term outcome in pregnant women with suspected preeclampsia (PROGNOSIS) study has shown that the high negative predictive value (99.3%) of the sFlt-1/PlGF-ratio below 38 in patients with suspected PE rules out the onset of the disease within one week. PROGNOSIS Asia, evaluating the sFlt-1/PlGF-ratio cut-off of 38 in an Asian population, confirmed the excellent accuracy in prediction.
Recently, the angiogenic biomarkers have been integrated in multi-marker prediction models. Digital approaches, integrating algorithm-based decision support tools paired with home monitoring devices may be the next step in enhancing predictive accuracy and thus bear the potential to reduce maternal and/or fetal morbidity and mortality and save costs for the payer in parallel. The objective of this review is to provide an overview of current methods for predicting and diagnosing PE.
First Trimester Screening for Preeclampsia: An Asian Perspective
Authors: Moungmaithong Sakita , Wang Xueqin , Tai Angela S.T. , Feng Qiaoli , Sahota Daljit , Leung Tak Yeung , Poon Liona C. 
Published: April 2021

Abstract
Preeclampsia (PE) is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. This disorder has profound short-term and long-term impacts on both the affected woman's and her child's health. Early-onset PE requiring preterm delivery (preterm PE) is of particular importance because it is associated with a higher risk of adverse pregnancy outcomes than term PE. First trimester screening model developed by the Fetal Medicine Foundation (FMF), which uses Bayes-theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, has been proven to be effective and have superior screening performance to that of traditional risk factor-based approach for the prediction of PE. Identification of high risk pregnant women for preterm PE and giving aspirin prophylaxis before 16th week of gestation would reduce the incidence of preterm PE. In Asia, although the prevalence of PE is slightly lower than the global estimation, early screening and prevention of this life-threatening condition is still crucial. The FMF Bayes-theorem based screening method has been validated in a large-scale prospective Asia-wide study and revealed that the first trimester triple test achieves the highest detection rate, compared with the traditional risk factor-based approaches, and that the screening performance is comparable to the published data from the FMF in East Asian women. However, in order to achieve optimal screening performance, the key is to establish standardized methods for biomarker measurements and regular biomarker quality assessment, as each biomarker is susceptible to inaccurate measurement, thus affecting performance of screening. Furthermore, it is of great importance to emphasize that the optimal preventive effect of aspirin on preterm PE is clearly associated with good compliance to treatment. In conclusion, global implementation of an effective first trimester “screen and prevent” program for preterm PE would provide the opportunity to reduce the risk of both short-term maternal and perinatal morbidity and mortality, with the possibility of intergenerational prevention of future chronic diseases for both the mother and her offspring.
Cardiac Rehabilitation Following Percutaneous Coronary Intervention Is Associated With Superior Psychological Health and Quality of Life in Males but Not in Females
Authors: Terada Tasuku , Vidal-Almela Sol , Tulloch Heather E. , Pipe Andrew L. , Reed Jennifer L. 
Published: April 2021

Purpose:
Cardiac rehabilitation (CR) improves psychological health and health-related quality of life (HR-QoL). Yet, available evidence suggests that their degree of improvements following CR may depend on patient sex and the mode of revascularization. We examined the interplay between sex and mode of revascularization on the psychological health and HR-QoL of patients completing CR.

Methods:
We analyzed the longitudinal records of patients who completed a 3-mo outpatient CR program following coronary revascularization. Levels of anxiety and depression were measured by the Hospital Anxiety and Depression Scale and HR-QoL was measured by the Medical Outcomes Study Short Form-36 before and after CR. A two-by-two analysis of covariance (females vs males by coronary artery bypass graft surgery [CABG] vs percutaneous coronary intervention [PCI]) was used to examine the sex-by-revascularization procedure interaction effect on changes in psychological health and HR-QoL.

Results:
Of the 278 participants (age: 65 ± 9 yr) included in the analysis, 191 (69%) underwent PCI and 55 (20%) were females. Following CR, there was a significant sex-by-revascularization procedure interaction effect on anxiety (P = .033) and mental HR-QoL (mental component summary [MCS]; P = .040). Following CABG, females and males showed similar improvements in anxiety (−1.3 ± 3.4 vs −1.1 ± 3.6 points, P = .460) and MCS scores (5.4 ± 8.9 vs 4.5 ± 8.7 points, P = .887); following PCI, females experienced worse anxiety levels and mental component summary scores while males showed improvements (anxiety: +1.0 ± 3.8 vs −1.3 ± 3.8 points, P = .002; MCS: −1.6 ± 9.3 vs + 4.4 ± 8.9 points, P = .008, respectively). There was no interaction effect on depression.

Conclusions:
Continued efforts are required to improve anxiety and mental HR-QoL in females treated with PCI participating in CR.
Long-Term Treatment of Bipolar Disorder with Valproate: Updated Systematic Review and Meta-analyses
Authors: Yee Caitlin S. , Vázquez Gustavo H. , Hawken Emily R. , Biorac Aleksandar , Tondo Leonardo , Baldessarini Ross J. 
Published: April 2021

Abstract

Learning objective
After participating in this activity, learners should be better able to:
• Evaluate the evidence regarding the effectiveness of long-term treatment of bipolar disorder with valproate

Background
Prophylactic treatment is critical for bipolar disorder (BD) patients. Valproate is commonly used for this purpose but lacks regulatory approval and carries appreciable risks.

Methods
Systematic literature searching through June 2020 sought prospective trials lasting ≥12 months with adults diagnosed with BD to support comparisons of risk of new illness episodes with valproate versus placebo or other agents.

Results
Included were 13 reports involving 9240 subjects treated for an average of 29.1 months (range, 12–124) in 21 trials: 9 were blinded, randomized trials (RCTs) of valproate versus placebo (n = 3), lithium (5), or olanzapine (1); 2 were unblinded RCTs versus lithium (1) or quetiapine (1); and 10 were open-label trials versus lithium (5), quetiapine (2), carbamazepine (1), lamotrigine (1), or olanzapine (1). Random-effects meta-analysis found valproate superior to placebo in 3 trials (odds ratio [OR] = 0.42 [95% confidence level (CI), 0.30–0.60]; p < .0001). In 11 trials, protective effects with valproate and lithium were similar (OR = 1.20 [CI, 0.81–1.79]; p = .36), as well in 5 comparisons versus antipsychotics quetiapine and olanzapine (OR = 0.96 [CI, 0.66–1.40]; p = .84), and 2 versus other mood-stabilizing anticonvulsants (carbamazepine and lamotrigine) (OR = 1.30 [CI, 0.75–2.26]; p = .34). Valproate was nonsignificantly more effective versus new mania than depression (χ2 = 3.03; p = .08).

Conclusions
Valproate was more effective than placebo in preventing new BD episodes of mania or depression, and not significantly different from lithium, second-generation antipsychotics, or other anticonvulsants. Overall benefits were nonsignificantly greater versus mania than bipolar depression.
Developmental Cysts of the Orbit With Mixed Conjunctival and Cutaneous Epithelial Phenotypes
Authors: Vahdani Kaveh , Thaung Caroline , Tay Eugene , Rose Geoffrey E. 
Published: April 2021

Aim:
To describe the characteristics of patients presenting with congenital orbital cysts containing epithelia of both cutaneous phenotype—that is, epidermis with or without keratin, and at least one dermal structure (sweat gland or pilosebaceous unit)—and conjunctival phenotype (with goblet cells); these cysts with mixed lining are termed “dermo-conjunctival” cysts.

Patients and methods:
Review of clinical records for patients having dermo-conjunctival cysts that were treated between 1997 and 2017; patients with cysts of solely conjunctival or solely cutaneous origin were omitted. Data recorded included gender, age at presentation, laterality, orbital location, ophthalmic features, surgical and radiological data, and light microscopic findings.

Results:
Of 241 patients with congenital orbital cysts, 22 (9%) contained both cutaneous and conjunctival epithelium; unlike the relatively common congenital cysts lined with solely cutaneous epithelia, these dermo-conjunctival cysts typically occupied the superonasal or nasal quadrants of the orbit (p < 0.000001). Fifteen (68%) of the 22 patients were male, and the group presented at a median age of 22 years (range 8–51 years), with symptoms for a median duration of 5 years (range 1 month–33 years). Fourteen (64%) had noted an orbital mass, 3 (14%) had inflammatory pain, and 1/22 (4%) had reduced acuity. Globe displacement was axial in 7 patients (32%) and nonaxial in 13 (59%), and ocular motility was restricted in 4/22 (18%). Of 17 patients with imaging, 9 (53%) had bone expansion, and the cyst was intimately related to the trochlea in 10 (59%). By definition, all cysts contained conjunctival epithelium with goblet cells: hair shafts were present in 13/22 (59%) specimens, sebaceous units in 18 (82%), sweat glands in 6 (27%), and keratinized epithelium was present in 8 (36%). Fourteen (63%) of cysts had mild chronic inflammation within the cyst wall, and granulomas were present in 8 (36%).

Conclusion:
Congenital dermo-conjunctival orbital cysts are rare and favor a medial location—this suggesting an origin from sequestered caruncular tissues, the only postseptal source of both dermal and conjunctival structures. Unlike pure cutaneous cysts that typically present as superficial masses in childhood, dermo-conjunctival cysts are often postseptal and present in adults.
Efficacy of toric intraocular lens and prevention of axis misalignment by optic capture in pediatric cataract surgery
Authors: Tachibana Kuniko , Maeda Naoyuki , Abe Kosuke , Kusaka Shunji 
Published: April 2021

Purpose:
To compare the outcomes of intraocular lens (IOL) implantation using toric (T)-IOL and nontoric (N)-IOL in pediatric cataract patients with astigmatism and to examine the effect of optic capture (OC) on the axis misalignment (AM) of the T-IOLs.

Setting:
Department of Ophthalmology, Kindai University Hospital, Osaka, Japan.

Design:
Interventional, comparative case study.

Methods:
Consecutive pediatric patients implanted with T-IOLs or N-IOLs were retrospectively reviewed. In the T-IOL group, the preoperative and postoperative corrected distance visual acuity (CDVA) and AM were compared in patients with and without OC.

Results:
The T-IOL group included 14 eyes of 11 patients, whereas the N-IOL group included 22 eyes of 15 patients. One year postoperatively, the mean ocular cylinder (1.38 ± 0.80 diopters [D]) was significantly smaller than the mean corneal cylinder (3.33 ± 1.24 D) in the T-IOL group (P = .00012, Wilcoxon signed-rank test). The mean preoperative and 1-year postoperative CDVA (logMAR) were 0.57 and 0.003 (T-IOL) and 0.71 and 0.09 (N-IOL), respectively. The AM at 1 week and 1 year postoperatively was 2.6 ± 3.7 degrees and 4.4 ± 3.1 degrees for the OC group, and 13.3 ± 8.8 degrees and 18.5 ± 14.8 degrees, for the non-OC group, respectively. The AM was significantly smaller in the OC group than that in the non-OC group (P = .009, Mann-Whitney U test) at postoperative 1 week.

Conclusions:
T-IOL implantation is effective in correcting astigmatism in pediatric cataract patients with astigmatism, and the OC technique is likely to achieve lower AM of the T-IOL.