bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Pediatric Physiatric Posterior Fossa Symptoms scale: Impairments and outcome in pediatric inpatient rehabilitation for posterior fossa brain tumors
Authors: Wu Jennifer , Wishart Brian D , Cohen Stephanie E , Orme Patricia , Quinn Susan S , Nimec Donna 
Published: September 2024

Abstract

Background
Clinical recognition of the postoperative neurologic sequelae of posterior fossa tumors is inconsistent. This study aimed to characterize functional impairments and recovery trajectories in pediatric patients admitted to inpatient rehabilitation following surgical resection of posterior fossa brain tumors. This study also introduces the Pediatric Physiatric Posterior Fossa Symptom scale (3PFSs) for serial assessment of postoperative symptoms in pediatric posterior fossa brain tumors.

Methods
This retrospective cohort study included 49 patients aged 1.1 to 19.9 years admitted to a pediatric unit of a free-standing rehabilitation hospital following resection of a posterior fossa brain tumor. Functional Independence Measure for Children (WeeFIM) and 3PFSs scores at admission and discharge were the primary outcome measures.

Results
Across the group, WeeFIM score improved from 51.5 ± 23.5 points at admission to 74.2 ± 28.2 points at discharge (t = 4.34, P &lt; .001). The 3PFSs score also showed improvement from 10 [Interquartile range (IQR) = 9–12] points at admission to 8 [7–10] points at discharge (t = 9.3, P &lt; .0001). While change in both the WeeFIM and 3PFSs captured statistically significant improvement in function, there was low interrating correlation (P &gt; .7). In addition, mortality was correlated with a higher discharge 3PFSs score (P = .007) but not discharge WeeFIM score.

Conclusions
In pediatric patients with postoperative neurologic sequelae due to posterior fossa brain tumors, inpatient rehabilitation resulted in global and domain-specific functional improvements. This initial application of the 3PFSs demonstrates potential applicability for stratifying patients to appropriate levels of rehabilitation, capturing functionally relevant response to rehabilitation treatment, and prognosticating long-term outcomes. These initial results are promising but require additional validation in a larger cohort.
Infectious Diseases Fellowship Training in Caring for People Who Use Drugs: A National Assessment of an Emerging Training Need
Authors: Vasishta Shilpa , Jawa Raagini , Kurz Sarah , Nolan Nathanial S 
Published: September 2024

Abstract

Background
Infectious complications of substance use are increasingly encountered in infectious diseases (ID) clinical care. In this study, we surveyed ID fellows in the United States to assess training experiences, clinical practices, and perspectives in caring for people who use drugs (PWUD).

Methods
An 18-item survey was distributed to ID fellows via email and social media platforms. Four focus groups were conducted with a subset of participants to elucidate themes in fellowship experiences and training needs.

Results
Among 196 survey respondents (estimated 24% response rate), all reported caring for PWUD in ID fellowship. Forty-nine percent received some formal fellowship-based didactics around care of PWUD, and 64% worked with faculty seen as advocates for PWUD. Integrated care practices for PWUD were infrequently employed: 50% offered risk reduction counseling, and 33% discussed medications for opioid use disorders, naloxone, or HIV preexposure prophylaxis. Risk reduction counseling was felt to be “extremely” within scope of ID practice (69%), although comfort level with this skill was low; fellows’ likelihood of offering counseling was significantly associated with their comfort (P ≤ .0001). Common themes in caring for PWUD included an expanded role for ID consultants, a lack of formalized training, and benefits of developing dedicated opportunities in this field.

Conclusions
ID fellows frequently care for PWUD but may have gaps in knowledge or comfort that affect care practices. Increased fellowship training in the care of PWUD has potential to improve clinical practices and support growing interest in this field among current and prospective ID fellows.
Engineering a conserved immune coreceptor into a primed state enhances fungal resistance in crops without growth penalty
Authors: Li Chong , Gong Ben-Qiang , Luo Shuyi , Wang Tong , Long Ruhui , Jiang Xianya , Deng Yi Zhen , Li Jian-Feng 
Published: September 2024

Abstract
Plants must tactically balance immunity and growth when combating lethal pathogens like fungi. CHITIN ELICITOR RECEPTOR KINASE 1 (CERK1), a conserved cell-surface co-receptor for the fungal elicitor chitin, enables plants to induce chitin-triggered immunity to counteract fungal invasion. Previously, we reported that bacterial infection can prime CERK1 through juxtamembrane (JM) phosphorylation to enhance fungal resistance, which only occurs in Arabidopsis (Arabidopsis thaliana) and its close relatives in Brassicaceae. Here, we aim to transfer the priming mechanism of Arabidopsis CERK1 (AtCERK1) to crop CERK1 via JM substitution. We revealed in protoplasts that the entire AtCERK1 JM variable region (AtJM) is essential for imparting the bacterial elicitor flg22-induced primed state to the Nicotiana benthamiana CERK1 (NbCERK1). The NbCERK1 chimera containing AtJM (NbCERK1AtJM) and similarly constructed rice (Oryza sativa) OsCERK1AtJM could undergo flg22-induced JM phosphorylation and confer enhanced antifungal immunity upon bacterial coinfection. Moreover, the NbCERK1AtJM+3D derivative with AtJM phosphomimetic mutations to mimic a constant primed state and similarly constructed OsCERK1AtJM+3D were sufficient to mediate strengthened chitin responses and fungal resistance in transgenic plants independent of bacterial infection. Importantly, no growth and reproduction defects were observed in these plants. Taken together, this study demonstrates that manipulating the primed state of a cell-surface immune receptor offers an effective approach to improve disease resistance in crops without compromising growth and yield and showcases how fundamental insights in plant biology can be translated into crop breeding applications.
The multiple dimensions of resilience in agricultural trade networks
Authors: Jafari Yaghoob , Engemann Helena , Zimmermann Andrea 
Published: September 2024

Abstract
The global food and agricultural trade network is crucial for food security. Shocks such as those posed by extreme weather events, conflicts, pandemics, and economic crises can test the resilience of the trade network to the sudden interruption of trade flows. Depending on the level of connectivity in the trade network and its structure, such shocks have the potential to propagate through the entire network and can affect countries’ food availability and variety. This paper contributes to the literature on food and agricultural trade networks in two main ways: (1) understanding the global trade network as a complex system that can be affected by and responds to shocks, we define and operationalize its resilience as a multidimensional concept, which is shaped by the interdependencies in the network and their structure; and (2) applying techniques from network analysis to examine the evolution of three dimensions of resilience within the global food and agricultural trade network between 1995 and 2019. The main findings show that, between 1995 and 2007, trade connectivity among countries increased. Overall, this bolstered countries’ and the network's resilience to trade shocks. However, vulnerabilities persisted in terms of ensuring sufficient product variety and quantity. Adding to these vulnerabilities, trade integration stalled in the second half of the series, pointing to a slight tendency towards trade disintegration and potentially lower resilience of countries to trade shocks already in 2019.
VEXAS syndrome as a mimicker of ANCA-associated vasculitis
Authors: Murillo-Chavez Franco , Antiochos Brendan 
Published: September 2024

Abstract

Objectives
Differentiating VEXAS syndrome from cases of canonical forms of primary vasculitis remains a significant clinical challenge, particularly for ANCA-associated vasculitis (AAV). We reviewed the clinical features of VEXAS as an AAV mimicker, while adding three new cases to the existing literature.

Methods
We identified three cases of VEXAS with an AAV phenotype in our institution. We performed a comprehensive literature search of available similar cases and summarized and compared the findings. Inclusion criterion was a positive UBA1 mutation analysis.

Results
Patient 1 was referred for evaluation of eosinophilic granulomatosis with polyangiitis (GPA), but had no active respiratory symptoms, despite CT imaging showing widespread ground-glass opacities. Patient 2 had no history of sinus disease, despite being referred under the diagnostic construct of limited GPA. Patient 3 developed a novel inflammatory syndrome suspected to represent GPA. Six other cases were identified upon literature review. In all the cases, the most common findings were pulmonary infiltrates (67%), skin involvement (55%) and ocular manifestations (44%). Additionally, 44% of cases had renal involvement, with half of them displaying kidney lesions resembling the typical AAV pattern.

Conclusion
VEXAS can mimic different phenotypes of AAV and should be considered in atypical AAV presentations, especially when refractory to multiple treatments. Further studies are needed to explore the immunologic basis for an AAV phenotype within the spectrum of VEXAS.
The effects of heat and hydrogen peroxide treatment on the osteoinductivity of demineralized cortical bone: a potential method for preparing tendon/ligament repair scaffolds
Authors: He Shukun , Hu Ruonan , Yao Xuan , Cui Jing , Liu Huimin , Zhu Min , Ning Liangju 
Published: September 2024

Abstract
Recent studies have indicated that demineralized cortical bone (DCB) may be used to repair tendons and ligaments, such as the patellar tendon and anterior cruciate ligament (ACL). Hydrogen peroxide (H2O2) has been shown to reduce the osteoinductivity of DCB, and heat treatment may also decrease the osteoinductivity of DCB. The purpose of this study was (i) to determine whether heat treatment reduces the osteoinductivity of DCB and (ii) to compare the effectiveness of heat treatment and H2O2 treatment on BMP-2 inactivation. DCB was prepared by immersion in 0.6 N hydrochloric acid, and DCB-H and DCB-HO were prepared by heat treatment (70°C for 8 h) and H2O2 treatment (3% H2O2 for 8 h), respectively. The surface topographies, elemental distributions and histological structures of the scaffolds were observed by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR) and histological staining. The viability and osteogenic differentiation of TDSCs cultured on the scaffolds were evaluated via live/dead cell staining and Cell Counting Kit-8 (CCK-8) testing, real-time polymerase chain reaction (RT-PCR) and western bolt (WB) analysis, alkaline phosphatase activity (ALP) and alizarin red S (ARS) staining. The intramuscular implantation of the scaffolds in rats was also used to evaluate the effect of heat treatment and H2O2 treatment on the osteoinductivity of DCB. Our results demonstrated that both treatments removed BMP-2 and osteocalcin (OCN) within the DCB and that DCB-H and DCB-HO had good cytocompatibility and reduced the osteogenic differentiation of TDSCs. Moreover, the in vivo results indicated that the DCB-H and DCB-HO groups had smaller areas of osteoid formation than did the DCB group, and the DCB-HO group had the smallest area among the three groups. Our study demonstrated that heat treatment could reduce the osteoinductivity of DCB, and that H2O2 treatment was more effective than heat treatment.
Sleep state-dependent development of resting-state functional connectivity during the preterm period
Authors: Shiraki Anna , Kidokoro Hiroyuki , Watanabe Hama , Taga Gentaro , Ushida Takafumi , Narita Hajime , Mitsumatsu Takamasa , Kumai Sumire , Suzui Ryosuke , Sawamura Fumi , Ito Yuji , Yamamoto Hiroyuki , Nakata Tomohiko , Sato Yoshiaki , Hayakawa Masahiro , Takahashi Yoshiyuki , Natsume Jun 
Published: September 2024

Abstract

Study Objectives
The brains of preterm infants exhibit altered functional connectivity (FC) networks, but the potential variation in sleep states and the impact of breathing patterns on FC networks are unclear. This study explores the evolution of resting-state FC from preterm to term, focusing on breathing patterns and distinguishing between active sleep (AS) and quiet sleep (QS).

Methods
We recruited 63 preterm infants and 44 healthy-term infants and performed simultaneous electroencephalography and functional near-infrared spectroscopy. FC was calculated using oxy- and deoxyhemoglobin signals across eight channels. First, FC was compared between periodic breathing (PB) and non-PB segments. Then sleep state-dependent FC development was explored. FC was compared between AS and QS segments and between preterm infants at term and term-born infants in each sleep state. Finally, associations between FC at term, clinical characteristics, and neurodevelopmental outcomes in late infancy were assessed in preterm infants.

Results
In total, 148 records from preterm infants and 44 from term-born infants were analyzed. PB inflated FC values. After excluding PB segments, FC was found to be elevated during AS compared to QS, particularly in connections involving occipital regions. Preterm infants had significantly higher FC in both sleep states compared to term-born infants. Furthermore, stronger FC in specific connections during AS at term was associated with unfavorable neurodevelopment in preterm infants.

Conclusions
Sleep states play a critical role in FC development and preterm infants show observable changes in FC.
Integrated Management of Sclerotinia Stem Rot of Soybean Including Organically Allowed Fungicides in the Midwest United States
Authors: Debbink Kelly , da Silva Camila Rocco , Silva Erin M. , Mueller Brian D. , Telenko Darcy E. P. , Smith Damon L. 
Published: September 2024

Sclerotinia stem rot (SSR) is an economically important disease of soybean, especially in the Great Lakes region of the United States. Few studies on SSR have considered organic management practices and how integrated management techniques best apply in these systems. Trials in Wisconsin and Indiana aimed to evaluate management techniques available to organic farmers for their efficacy in SSR control while preserving yield. The practices evaluated included genetically resistant cultivars, tillage techniques, and the application of Organic Materials Review Institute (OMRI)-listed foliar fungicides. The resistant cultivar had significantly lower SSR than the susceptible cultivar in three site-years ( P < 0.01). The resistant cultivar also had significantly greater yield than the susceptible cultivar in two site-years ( P < 0.05). Using a roller-crimped rye cover crop resulted in mixed results on SSR and yield. No effect on SSR or yield by OMRI-listed foliar fungicides was observed ( P > 0.05). Overall, the results emphasize the importance of planting a resistant soybean cultivar to manage SSR in organic farming systems in the Midwestern United States. [Formula: see text] Copyright © 2025 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Lessons Learned From State-Based Efforts to Leverage Medicaid Funds for Graduate Medical Education
Authors: Fraher Erin P. , Rains Jacob A. , Bacon Thomas J. , Spero Julie , Hawes Emily 
Published: September 2024

Abstract

Purpose
Total Medicaid funds invested in graduate medical education (GME) increased from $3.78 billion in 2009 to $7.39 billion in 2022. States have flexibility in designing Medicaid GME payments to address population health needs. This study assessed states’ impetus for using Medicaid funds for GME, structure of state Medicaid payments, composition and charge of advisory bodies that guide these investments, and degree of transparency and accountability to track whether Medicaid GME investments achieved desired workforce outcomes.

Method
Structured interviews were conducted in 2015 to 2016 and 2020 to 2021 with subject matter experts representing 10 states. Interview transcripts were analyzed and coded in 6 thematic areas: impetus for using Medicaid funds, the structure of state Medicaid payments, the composition of advisory bodies, the degree of transparency of Medicaid investments, accountability of Medicaid investments, and challenges.

Results
States used Medicaid GME funding to address maldistribution of physicians by geography, setting, and specialty; respond to population growth and undergraduate medical education expansion; offset potential loss of teaching health center program funds; and launch new programs and sustain existing ones. States leveraged Medicaid funding by modifying state plan amendments and redesigning funding formulas to meet specific health workforce needs. Many states had advisory bodies to educate legislators, reach consensus on workforce needs, recommend how to disburse funds, and navigate competing stakeholder interests. States identified a need for improved data and analytic systems to understand workforce needs and monitor the outcomes of GME investments. Determining which accountability measures to use and implementing metrics were challenges.

Conclusions
States have much to learn from each other about strategies to best leverage Medicaid funds to develop and sustain residency programs to meet population health needs. Learning collaboratives should be developed to provide a forum for states to share best practices and strategies for overcoming challenges.
Addressing Low Scholarly Output in Residency With a Resident-Led Society for Innovation and Research
Authors: Raymond Caitlin , Gosnell Joseph , Zahner Christopher 
Published: September 2024

Abstract

Problem
Research in residency develops skills essential for the practice of medicine with many benefits for residents, residency programs, the community of medicine, and patients. However, resident participation in research and innovation remains limited, with barriers that are difficult to address without significant overhead or changes to curriculum.

Approach
In September 2021, the Society for Innovation and Research (SIR), a resident-led organization dedicated to promoting and supporting resident achievement in research and innovation, was founded. Using only 1 hour of protected didactic time a month, SIR workshops provide critical mentoring and feedback to make resident research a success, with education on various topics of interest to residents. In addition, SIR celebrates and publicizes resident research success and lays the groundwork for interested residents to participate in innovation.

Outcomes
The authors assessed for any increase in resident research productivity by analyzing PubMed-indexed publications for 11 semesters from fall 2018 to fall 2023. After the launch of SIR, the mean (SD) total number of publications increased from 5.3 (2.4) to 13.3 (1.6) (P = .01), the total mean (SD) number of residents publishing increased from 3.7 (1.3) to 10.0 (1.2) (P = .009), and the mean (SD) total number of coauthored articles increased from 0.1 (0.3) to 2.8 (1.3) (P = .007).

Next Steps
The skill set acquired from participation in research during residency is more critical than ever in the wake of the COVID-19 pandemic. SIR initiatives are generalizable to most residency programs in most specialties and require little overhead in terms of physical space, digital resources, and staffing. The authors are currently exploring expanding the SIR program to other residencies at U.S. institutions and have set up processes for the mantle of SIR leadership to be passed down among the pathology resident body.
The Association of Master Adaptive Learning With Less Burnout and More Resilience in Obstetrics and Gynecology Residents
Authors: Santen Sally A. , Ginzburg Samara B. , Pusic Martin V. , Richardson Judee , Banks Erika , George Karen E. , Hammoud Maya M. , Wolff Meg , Morgan Helen K. 
Published: September 2024

Abstract

Purpose
Medical education should prepare learners for complex and evolving work, and should ideally include the Master Adaptive Learner (MAL) model—meta-learning skills for continuous self-regulated learning. This study aimed to measure obstetrics and gynecology (OB/GYN) residents’ MAL attributes, assess associations with burnout and resilience, and explore learning task associations with MAL.

Method
OB/GYN residents were surveyed electronically at an in-training examination in January 2022. The survey included demographic information, the 2-item Maslach Burnout Inventory, the 2-item Connor–Davidson Resilience Scale, 4 MAL items (e.g., “I take every opportunity to learn new things”), and questions about training and learning experiences.

Results
Of 5,761 residents, 3,741 respondents (65%) were included. A total of 1,478 of 3,386 (39%) demonstrated burnout (responded positive for burnout on emotional exhaustion or depersonalization items). The mean (SD) Connor–Davidson Resilience Scale score was 6.4 (1.2) of a total possible score of 8. The mean (SD) MAL score was 16.3 (2.8) of a total possible score of 20. The MAL score was inversely associated with burnout, with lower MAL scores for residents with (mean [SD] MAL score, 16.5 [2.4]) vs without (mean [SD], 16.0 [2.3]) burnout (P < .001). Higher MAL scores were associated with higher resilience (R = 0.29, P < .001). Higher MAL scores were associated with the statement “I feel that I was well prepared for my first year of residency” (R = 0.19, P < .001) and a plan to complete subspecialty training after residency (mean [SD] of 16.6 [2.4] for “yes” and 16.2 [2.4] for “no,” P < .001).

Conclusions
Residents who scored higher on MAL showed more resilience and less burnout. Whether less resilient, burned-out residents did not have the agency to achieve MAL status or whether MAL behaviors filled the resiliency reservoir and protected against burnout is not clear.
Impact of Surveillance Imaging in Patients With HPV-Associated Oropharyngeal Carcinoma Treated With Definitive Radiation and Chemotherapy
Authors: Shang Trisha , Raab Gabriel , Chen Linda , Yu Yao , Shamseddine Achraff , Riaz Nadeem , McBride Sean M. , Gelblum Daphna , Morris Luc GT , Lee Nancy Y. , Zakeri Kaveh 
Published: September 2024

Objectives:
Surveillance imaging for HPV-associated oropharyngeal carcinomas (OPCs) differs among physicians and institutions. Surveillance imaging can detect disease progression earlier, but can also contribute to anxiety and cost, without proven survival benefits. We sought to determine practice patterns of surveillance imaging and the number of surveillance scans needed to detect one recurrence in patients with HPV-associated OPCs.

Methods:
We performed a retrospective cohort study between 2017 and 2019 (median follow-up: 39.9 mo) of consecutive patients with locally advanced HPV-associated OPC who received definitive concurrent chemoradiotherapy (CRT) with 70 Gy at a single institution. Patients were followed post-CRT and their surveillance scans were recorded. Recurrences were classified as detected by first post-treatment scans, surveillance scans, clinical exams, or incidental findings. The number of surveillance scans needed to detect 1 recurrence was determined by dividing the number of surveillance scans by the number of recurrences detected by surveillance scans.

Results:
Among 276 patients with a median follow-up of 39.9 months, there were 28 recurrences. Of all recurrences, 11 (39.3%) were detected by the first post-treatment scan, 11 (39.3%) by surveillance scan, 5 (17.9%) by clinical exam, and 1 (3.6%) was incidentally found. A total of 694 surveillance scans were taken. The number of surveillance scans needed to detect 1 recurrence was 64 overall, 45 within 2 years, and 248 beyond 2 years from treatment.

Conclusions:
First post-treatment scans and surveillance scans detected more recurrences than clinical exams. A high burden of surveillance scans is needed to detect 1 recurrence, especially beyond 2 years from treatment.