bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of the benzoxazinoid pathway with boron homeostasis in maize
Authors: Chu Liuyang , Shrestha Vivek , Schäfer Cay Christin , Niedens Jan , Meyer George W , Darnell Zoe , Kling Tyler , Dürr-Mayer Tobias , Abramov Aleksej , Frey Monika , Jessen Henning , Schaaf Gabriel , Hochholdinger Frank , Nowak-Król Agnieszka , McSteen Paula , Angelovici Ruthie , Matthes Michaela S 
Published: November 2024

Abstract
Both deficiency and toxicity of the micronutrient boron lead to severe reductions in crop yield. Despite this agricultural importance, the molecular basis underlying boron homeostasis in plants remains unclear. To identify molecular players involved in boron homeostasis in maize (Zea mays L.), we measured boron levels in the Goodman-Buckler association panel and performed genome-wide association studies. These analyses identified a benzoxazinless (bx) gene, bx3, involved in the biosynthesis of benzoxazinoids, such as 2,4-dihydroxy-7-methoxy-1,4-benzoxazin-3-one (DIMBOA), which are major defense compounds in maize. Genes involved in DIMBOA biosynthesis are all located in close proximity in the genome, and benzoxazinoid biosynthesis mutants, including bx3, are all DIMBOA deficient. We determined that leaves of the bx3 mutant have a greater boron concentration than those of B73 control plants, which corresponded with enhanced leaf tip necrosis, a phenotype associated with boron toxicity. By contrast, other DIMBOA-deficient maize mutants did not show altered boron levels or the leaf tip necrosis phenotype, suggesting that boron is not associated with DIMBOA. Instead, our analyses suggest that the accumulation of boron is linked to the benzoxazinoid intermediates indolin-2-one (ION) and 3-hydroxy-ION. Therefore, our results connect boron homeostasis to the benzoxazinoid plant defense pathway through bx3 and specific intermediates, rendering the benzoxazinoid biosynthesis pathway a potential target for crop improvement under inadequate boron conditions.
Original Research: Improving Pain Assessment After Inpatient Orthopedic Surgery: A Comparison of Two Scales
Authors: Boggs Lauryn , Fleming Jennifer , Geamanu Andreea , Vaidya Rahul 
Published: November 2024

ABSTRACT

Purpose:
In pain assessment, the commonly used Numeric Rating Scale (NRS) offers an incremental 0-to-10 range of response options. But this broad range often leads to discordant evaluations between nurses and their patients. This study aimed to compare the NRS to the three-category Interventional Pain Assessment (IPA) scale, validate the IPA scale in an inpatient setting, and determine RN and patient scale preferences.

Methods:
This prospective study enrolled 122 postoperative orthopedic patients and their designated 104 RNs at a level 1 trauma center in the midwestern United States. Patients were asked to verbally rate their pain from 0 to 10 using the NRS and from 0 to 2 on the IPA scale. Patients were also asked which scale best conveyed their pain. The RNs were asked which scale best informed them of their patient's pain situation and which scale they preferred. To establish a correlation between the two scales, we considered NRS values of 0 to 7 (signifying no pain to moderate pain) to correspond to IPA scale values of 0 to 1 (signifying no pain to tolerable pain). NRS values of 8 to 10 (signifying severe pain) were considered to correspond to IPA scale values of 2 (signifying intolerable pain). Responses in which patients reported IPA scores indicating no pain to tolerable pain but NRS scores above 7 or IPA scale scores indicating intolerable pain but NRS scores of 7 or below were defined as discordant answers.

Results:
Data analysis revealed a strong significant correlation between the NRS and IPA scale (τ = 0.597), with an 82.7% concordance rate. Once an NRS score rose above 7, more discordance between the two scales became increasingly prevalent, as evidenced by the 45% of patients who also reported tolerable pain on the IPA scale. Significantly more patients (89.3%) preferred the IPA scale to communicate their pain level than the NRS (10.7%). Significantly more RNs (76%) felt the IPA scale best informed them of their patient's pain and was a better guide for treatment than felt the NRS did so (24%).

Conclusions:
The IPA scale asks about pain tolerability and thus has a direct role in the management of pain medications. Both patients and nurses felt they were better able to convey and understand pain when using the IPA scale than when using the NRS. There was consensus regarding pain scale preference among patients and their RNs, with both groups preferring the IPA scale due to its simplicity and, among the RNs, its usefulness in guiding treatment. The IPA scale may be a much better tool for accurately assessing a patient's pain experience and needs, with the potential to change practice and improve pain management.
Buprenorphine Administration and Prescribing at Emergency Departments: A National Analysis from 2014–2021
Authors: Ramdin Christine , McGowan Tanner , Perrone Jeanmarie , Mazer-Amirshahi Maryann , Nelson Lewis S. 
Published: November 2024

Background
Emergency department (ED)–initiated buprenorphine provides a low barrier access point and safety net to mitigate opioid overdose risk and increase treatment engagement. We sought to describe trends and patterns of buprenorphine utilization from the ED using national data.

Methods
This is a retrospective review of the National Hospital Ambulatory Medical Care Survey between 2014 and 2021. Our primary outcomes were trends in ED buprenorphine utilization. We described patient demographics, visit characteristics, and conducted trend analyses. We utilized logistic regression to determine predictors of buprenorphine prescribing.

Results
Between 2014 and 2021, there were 341,875 ED visits in which buprenorphine was administered, with no change over time (P = 0.08). There were 392,031 visits where buprenorphine was prescribed at ED discharge, with an increase over time (P = 0.01). The largest rise in rate for discharge prescriptions occurred between 2019 and 2020 (37,737 [0.03%] visits vs 126,041 [0.10%]) (233% increase in rate, P < 0.0001).

Conclusions
Although there was an increase in buprenorphine prescribing at ED discharge, there was no increase in administration. The acceleration in prescribing between 2019 and 2020 suggests that the ED may have been a safety net for patients who lost access to addiction care during COVID-19. Future studies should explore reasons for disparities and barriers to buprenorphine utilization.
Anomalous origin of right coronary artery from left anterior descending coronary artery presenting with syncope – a case report
Authors: Hanif Kiran , Ali Tooba , Akhtar Parveen , Haque Md Ariful 
Published: November 2024

Introduction and importance:
Non-dominant right coronary artery (RCA) is supposed to be benign as it does not result in large myocardial infarction. Still, in this case, non-dominant RCA from left anterior descending (LAD) artery not only produces ischemia but also results in incessant ventricular tachycardia, which is a life-threatening arrhythmia because of compromised blood flow. However, RCA is free of atherosclerotic plaque, which is the main cause of ischemia/infarction and subsequent arrhythmia.

Case presentation:
A 21-year-old male was admitted to the emergency cardiology ward of the National Institute of Cardiology following an episode of syncope. The patient reported a sudden loss of consciousness without preceding symptoms.

Clinical discussion:
The present case highlights the importance of a comprehensive evaluation and diagnosis in the management of syncope in young patients. The case presented here revealed a rare finding of a single coronary artery with a left main origin and an anomalous RCA emerging from the LAD artery. This is a very unusual presentation, with less than 50 occurrences recorded in the medical literature. This abnormality is classified as a single coronary artery anomaly (CAA), which means that the coronary arteries arise from a single coronary ostium within the aorta.

Conclusion:
In conclusion, CAA is an uncommon cause of SCA that can easily be overlooked without a systematic approach. In this report, we discuss the case of a patient who was discovered to have an anomalous RCA that branched off from the LAD artery.
PLASMA RICH IN GROWTH FACTORS MEMBRANE IN THE TREATMENT OF MACULAR HOLES ASSOCIATED WITH MACTEL TYPE 2
Authors: Arias Juan D. , Córdoba-Ortega Carlos M. , Martinez-Pulgarín Dayron F. , Viteri Eduardo J. , Parra Maria M. , Rangel Carlos M. 
Published: November 2024

Purpose:
To demonstrate the regenerative effects of Plasma membrane rich in growth factors (PRGFm) as an adjuvant in the surgical treatment of Full-thickness macular holes (FTMH) associated with MacTel type 2 (MacTel).

Methods:
Observational study of a consecutive case series. Type 2 MacTel patients with FTMH. Best-corrected visual acuity, optical coherence tomography (OCT) data, anatomic closure rates, and duration of follow-up were documented.

Results:
3 patients who met the inclusion criteria were enrolled, 2 are naïve and one is already operated with silicon oil in situ. Median follow-up was 6 months (range 6-18 months), anatomic closure rate was 100%, and median visual acuity change was 20/60 (range 20/40 - 20/100). No complications related to PRGFm were found.

Conclusion:
PRGFm is a valuable option for the treatment of FTMH associated with MacTel type 2. Its application promotes tissue regeneration and facilitates anatomical closure. The technique is reproducible and does not require manipulation of the internal limiting membrane.
Clinical Effectiveness of Multimodal Exercise Combined With Supportive Music and Imagery in the Management of Poststroke Mood Disorders
Authors: Mao Yu-Cui , Li Hui-Hua , Tao Sheng , Zhang Wei-Wei , Zhang Liu-Hong , Geng De-Qin , Ren Neng , Gao Li-Yan 
Published: November 2024

ABSTRACT

BACKGROUND: The objective of this study is to investigate the clinical effectiveness of the combination of multimodal exercise (MME) with supportive music and imagery in the management of poststroke mood disorders (PSMD). METHODS: A total of 200 PSMD patients treated in the neurology department of a tertiary hospital in Jiangsu Province were enrolled. They were assigned to either a control group or the observation group using a random number table at a 1:1 ratio, with 100 patients in each group. The control group received conventional nursing care, and the observation group received both MME and music and imagery in addition to the conventional nursing interventions. The scores of the 10-item Kessler Psychological Distress Scale (K10), Hospital Anxiety and Depression Scale (HADS), and Well-being Index Scale (WBIS) were recorded before and 3, 6, and 9 months after the interventions and compared between the 2 groups. RESULTS: Changes in K10, HADS, and WBIS scores significantly differed between the 2 groups after interventions (all P < .05) and among different time points (all P < .05). There were interactions between the time points of the K10, HADS, and WBIS assessments and the intervention methods in both groups (P < .05). The improvements in anxiety or depression and psychological distress in the observation group were significantly superior to those in the control group. CONCLUSION: MME combined with music and imagery can effectively improve anxiety and depression, reduce symptoms of psychological distress, and improve well-being in PSMD patients.
When Things Go South, It Does Affect You
Authors: Gould Caitlin A. , Frattaroli Shannon , Williams D’Ann L. , Bulzacchelli Maria T. , Barnett Daniel J. , Davis Meghan F. 
Published: November 2024

Abstract
Commercial fishing is a dangerous profession with known hazards for musculoskeletal injuries, yet minimal examination of microbiological or attendant psychosocial hazards from water- and food-borne pathogens like Vibrio vulnificus and V. parahaemolyticus exists. Improving knowledge of Vibrio-related hazards addresses Total Worker Health® concerns for commercial fisheries workers.

Methods
Following a grounded theory approach, we conducted semistructured interviews with watermen and related workers who fish and harvest shellfish in the Chesapeake Bay, USA, to investigate risk perceptions and understanding, and compliance with regulations intended to reduce worker and consumer illnesses and injuries from pathogen exposures.

Results
Worker and consumer illnesses and injuries, and threat of fishery closures—with regulatory and organizational factors—influence this workforce.

Conclusions
Our findings support interventions that promote monitoring, surveillance, and awareness of Vibrio-related risk among watermen, regulatory officials, medical professionals, and the public.
Robotic-Assisted Adrenalectomy of a Giant Dopamine-Only Secreting Pure Adrenal Ganglioneuroma: A Case Report and Operative Video
Authors: Khalil Ibrahim A. , Alhyari Abdelkareem , Younes Nagy , Badawi Alaeddin , Mansour Abdulhamed , Taha Noheir M. , Al Rumaihi Khalid 
Published: November 2024

Introduction:
Ganglioneuromas (GNs) are rare, differentiated tumors that originate from neural crest cells and can occasionally develop in the adrenal medulla. Adrenal GNs (AGNs) are typically hormonally silent and asymptomatic. Hormone-secreting pure AGNs in adults are uncommon; however, dopamine-secreting pure AGNs are extremely rare, with only a few cases reported in the literature. Giant AGNs are usually managed with open surgical intervention.

Case Presentation:
We present a case of a giant dopamine-secreting pure AGN in a 19-year-old woman who complained of mild left flank pain with no other symptoms. On physical examination, a mass was felt in left upper abdomen. MRI showed a left retroperitoneal mass extending from the left suprarenal region inferiorly, anterior to and compressing the left kidney, measuring 9 × 7.5 × 14 cm. Hormonal investigations ruled out Cushing syndrome, and catecholamine studies were negative for metanephrines, normetanephrines, adrenaline, and noradrenaline but were positive for dopamine levels more than 3 times the upper normal level. The patient underwent robotic-assisted adrenalectomy with minimal morbidity.

Conclusion:
Robotic-assisted adrenalectomy is a feasible and effective treatment option for rare dopamine-secreting pure AGNs. Careful patient selection and thorough preoperative preparation are essential to minimize risks and ensure favorable outcomes.
Comparing Cochlear Implant Outcomes in 100 Patients With Sporadic Vestibular Schwannoma Managed With Observation, Radiosurgery, or Microsurgery: A Multi-Institutional Review
Authors: Dornhoffer James R. , Marinelli John P. , Lohse Christine M. , Cottrell Justin , McMenomey Sean O. , Roland J. Thomas , Thompson Nicholas J. , Brown Kevin D. , Lucas Jacob C. , Babu Seilesh C. , Lindquist Nathan R. , Perkins Elizabeth L. , Rahne Torsten , Plontke Stefan K. , Tan Donald , Hunter Jacob B. , Harvey Erin , Deep Nicholas L. , Cerasiello Samantha Y. , Kircher Matthew L. , Espahbodi Mana , Tooker Evan L. , Lloyd Simon K.W. , Carlson Matthew L. 
Published: November 2024

Objective
To compare cochlear implant (CI) speech perception outcomes in patients with sporadic vestibular schwannoma (VS) managed with observation, radiosurgery, or microsurgery.

Study Design
Retrospective review.

Setting
Eleven tertiary academic medical centers.

Patients
One hundred patients with sporadic VS who received an ipsilateral CI.

Interventions
Ipsilateral cochlear implantation.

Main Outcome Measures
Pure-tone thresholds, monosyllabic speech perception testing scores, and rates of open-set speech acquisition.

Results
Of the 100 patients studied, 54 underwent microsurgery, 26 underwent radiosurgery, 19 continued observation, and 1 underwent multimodal therapy. Among all patients, the median post-implantation pure-tone average was 31 dB (interquartile range [IQR] 25–39 dB) and the median monosyllabic speech perception score was 30% (IQR 0–60%) at a median of 12 months (IQR 5–25 months) post-implantation. Patients who were managed with microsurgery (median speech perception score 11%, IQR 0–52%) exhibited poorer implant outcomes overall compared with those managed with observation (median speech perception score 52%, IQR 40–72%) or radiosurgery (median speech perception score 30%, IQR 16–60%). Open-set speech perception was achieved in 61% of patients managed with microsurgery, 100% with observation, and 80% with radiosurgery. In a multivariable setting, those managed with observation (p = 0.02) or who underwent radiosurgery (p = 0.04) were significantly more likely to achieve open-set speech perception compared with patients who underwent microsurgery.

Conclusions
Cochlear implants offer benefit in selected patients with sporadic VS. Although achieved in over half of people after microsurgery, open-set speech perception is more reliably attained in patients who are treated with observation or radiosurgery compared with microsurgical resection. These data may inform patient counseling and VS tumor management in people who may benefit from implantation.
The Relationship Between eSRTs and Upper Stimulation Levels in a Large Cohort of Adult Cochlear Implant Recipients
Authors: Holder Jourdan T. , Hoffman Jennifer , Williams Haley , Gifford René H. 
Published: November 2024

Objective
To compare electrically evoked stapedial reflex thresholds (eSRTs) measured at 1 month post-activation to upper stimulation levels used for programming adult cochlear implant (CI) recipients over time in a large clinical population.

Study Design
Review of prospectively collected clinical database.

Setting
Large CI program at an academic medical center.

Patients
Postlingually deafened adult CI recipients (n = 439).

Main Outcome Measure(s)
eSRTs recorded in the medical record and upper stimulation levels derived from the programming software at 1 and 6 months post-activation.

Results
The correlation between eSRTs and upper stimulation levels was strong for all three manufacturers (r = 0.80–0.86). On average, upper stimulation levels were set 15.4 clinical levels below eSRT for Cochlear using a pulse width of 25 microseconds, 13.4 clinical levels below eSRT for Cochlear using a pulse width of 37 microseconds, 11.3 clinical units below eSRT for Advanced Bionics, and 0.1 charge unit above eSRT for MED-EL. eSRTs were found to be elicited at similar levels for different electrodes/frequencies across the array. After upper stimulation levels were set based on eSRT at 1 month post-activation, there was no significant change in upper stimulation levels between 1 and 6 months post-activation.

Conclusions
eSRTs and upper stimulation levels are highly correlated. Average differences between eSRTs and upper stimulation levels reported herein can be used to guide programming in the clinic. Further, when eSRTs are used to program upper stimulation levels, upper stimulation levels should be relatively similar across channels and stable over time.
Automatic Final-Product Assessment of Virtual Reality Mastoidectomy Performance: A Validity and Reliability Study
Authors: Mikkelsen Peter Trier , Sørensen Mads Sølvsten , Senn Pascal , Frithioff Andreas , Andersen Steven Arild Wuyts 
Published: November 2024

Objective
Assessment is key in modern surgical education to monitor progress and document sufficient skills. Virtual reality (VR) temporal bone simulators allow automated tracking of basic metrics such as time, volume removed, and collisions. However, adequate performance assessment further includes compound rating of the stepwise bony excavation, and exposure and preservation of soft tissue structures. Such complex assessment requires further development of automated assessment routines in the VR simulation environment. In this study, we present the integration of automated mastoidectomy final-product assessment with validation against manual rating.

Methods
At two international temporal bone courses, 33 ORL trainees performed anatomical mastoidectomies in the Visible Ear (VR) Simulator with automatic performance assessment using a newly implemented rating routine based on the modified Welling Scale. Automated assessment was compared with manual ratings by experts using absolute agreement, intraclass correlation, and generalizability analysis to establish validity and reliability.

Results
The overall average agreement between manual and automatic assessment was 83.9% compared with the inter-rater agreement of 88.9%. A majority of items (15 out of 26) showed high agreement between automated and manual rating (>85%). Intraclass correlation coefficients were found to be high. Generalizability analysis with D-studies found that five repetitions per participant are needed for a G coefficient >0.8, which is considered necessary for high-stakes assessments.

Conclusion
We have demonstrated the feasibility, validity, and reliability of an automatic assessment system integrated into a VR temporal bone simulator. This can prove to be an important tool for future self-directed training with skills certification.
Safety Outcomes of Balloon Dilation Eustachian Tuboplasty in Pediatric Patients: A Follow-Up Study
Authors: Ahluwalia Jatin , Babu Seilesh , Haupert Michael , Thottam Prasad 
Published: November 2024

Objectives
Balloon dilation eustachian tuboplasty (BDET) has gained popularity as a treatment modality for chronic eustachian tube dysfunction (ETD) in both adults and children. Although its safety and efficacy in the adult population have been well described, very few large-sample studies assessing its safety profile have been performed in the pediatric population. This study serves as a follow-up to a previously published analysis assessing the safety of BDET in the pediatric population.

Methods
Retrospective chart review of 71 pediatric patients (139 ears) aged 11 ± 7 years who underwent BDET from 2019 to 2023. Medical records were reviewed from the extended postoperative period. A standardized grading scale that assesses severity of surgical complications was used.

Results
A total of five minor complications (7%) were noted. These included transient postoperative tinnitus, hyperacusis, otalgia, nausea, and epistaxis. There were no major complications requiring repeat intervention or need for imaging or hospital admission. In all cases, these symptoms had resolved in the postoperative time frame, with majority of them demonstrating complete resolution before the first postoperative visit.
When combining these findings with the previously published paper by the same institution, the overall complication rate is 6.1% with 114 total patients. All complications between both papers are considered minor with no long-term effects

Conclusions
In this retrospective analysis, BDET is shown to be a relatively safe procedure when performed in the pediatric population. Upon review of the literature, this is the largest safety analysis of exclusively pediatric patients who underwent BDET.

Level of evidence
4.