bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends and outcomes of heart transplantation in adults with congenital heart disease
Authors: Alsoufi Bahaaldin , Kozik Deborah , Perrotta Melissa , Wilkens Sarah , Lambert Andrea Nicole , Deshpande Shriprasad , Slaughter Mark , Trivedi Jaimin 
Published: March 2024

Abstract

OBJECTIVES
Heart transplantation for adult congenital heart disease is complicated and associated with challenging pretransplant support, long waiting and high early post-transplant mortality. We explored if surgical and medical advances and allocation system changes have affected outcomes.

METHODS
From United Network for Organ Sharing database, adults with congenital heart disease listed for heart transplantation were queried. To explore practice and outcome trends, patients were divided into 4 eras (eras 1–3: nearly 3 equal periods from 1992 to 2018, era 4: after 2018, corresponding with new allocation system). Univariate and multivariable analysis was performed to evaluate outcomes.

RESULTS
A total of 2737 patients were listed. There was gradual increase in listed and transplanted patients, along with significant increase in use of mechanical support, simultaneous kidney and liver transplantation. While proportion of transplanted remained constant, there was decrease in proportion delisted/died after listing (P = 0.01) and waiting list duration (P = 0.01), especially in era 4. Thirty-day post-transplant mortality remains high; however, it has significantly improved starting era 3 (P = 0.01). Current survival at 1-year and 5-years is 85% and 65%, with improvement mainly related to decreased early death. On multivariable analysis, factors associated with survival were lower glomerular filtration rate (hazard ratio = 0.99, P = 0.042), bilirubin (hazard ratio = 1.17, P&lt;0.001) and mechanical ventilation (hazard ratio = 2.3, P=0.004)

CONCLUSIONS
Heart transplantation in adults with congenital heart disease is increasing, along with added complexity, higher usage of pretransplant mechanical support and simultaneous organ transplantation. Despite that, more complex patients do not experience worse outcomes. Early mortality improved but remains high. New donor allocation system allowed shorter waiting time and higher proportion transplanted without altering early mortality.
An insight into healthcare professionals’ perspectives on discussing implantable cardioverter defibrillator deactivation
Authors: Hill Loreena , Cassidy Lorna , Dixon Lana , Fitzsimons Donna , Thylen Ingela , Jaarsma Tiny 
Published: March 2024

Abstract

Aims
International studies have examined patients’ views concerning the discussion of deactivating an implantable cardioverter defibrillator (ICD). Findings reported that many patients were either not informed about the subject or were informed late in their illness trajectory. This study aimed to explore healthcare professionals’ perspectives on discussing ICD deactivation and identify priorities for clinical practice and future research.

Methods and results
Eleven interviews were conducted, involving heart failure nurses, physicians, and an allied professional. All were responsible for the care of patients with an ICD, from the UK or Sweden. A semi-structured guide was used. All interviews were audio-recorded, transcribed, translated (as applicable), and analysed independently by experienced researchers, using framework analysis. Findings were presented, along with published work at a stakeholder meeting, and a consensus agreement was reached on priorities for clinical practice and future research. Four themes emerged from the exploratory interviews. Healthcare professionals described the discussion about deactivation as challenging, requiring compassion and involvement of family members. They agreed that the topic should be initiated prior to, or shortly after, device implantation. This was reflected in the priorities to improve communication, through the increased availability and implementation of prompts and tools, as well as the provision of tailored information to patients and family members. Stakeholders recognized the future potential of digital technology in device education.

Conclusion
Discussing deactivation remains challenging. Healthcare professionals recognized the need to initiate the discussion early, with compassion and involvement of family members. Priorities were agreed by stakeholders, which require clinical implementation and further research.
Exceptions to the rule: When does resistance evolution not undermine antibiotic therapy in human bacterial infections?
Authors: Bhattacharya Amrita , Aluquin Anton , Kennedy David A 
Published: March 2024

Abstract
The use of antibiotics to treat bacterial infections often imposes strong selection for antibiotic resistance. However, the prevalence of antibiotic resistance varies greatly across different combinations of pathogens and drugs. What underlies this variation? Systematic reviews, meta-analyses, and literature surveys capable of integrating data across many studies have tried to answer this question, but the vast majority of these studies have focused only on cases where resistance is common or problematic. Yet much could presumably be learned from the cases where resistance is infrequent or absent. Here we conducted a literature survey and a systematic review to study the evolution of antibiotic resistance across a wide range of pathogen-by-drug combinations (57 pathogens and 53 antibiotics from 15 drug classes). Using Akaike information criterion-based model selection and model-averaged parameter estimation we explored 14 different factors posited to be associated with resistance evolution. We find that the most robust predictors of high resistance are nosocomial transmission (i.e., hospital-acquired pathogens) and indirect transmission (e.g., vector-, water-, air-, or vehicle-borne pathogens). While the former was to be expected based on prior studies, the positive correlation between high resistance frequencies and indirect transmission is, to our knowledge, a novel insight. The most robust predictor of low resistance is zoonosis from wild animal reservoirs. We also found partial support that resistance was associated with pathogen type, horizontal gene transfer, commensalism, and human-to-human transmission. We did not find support for correlations between resistance and environmental reservoirs, mechanisms of drug action, and global drug use. This work explores the relative explanatory power of various pathogen and drug factors on resistance evolution, which is necessary to identify priority targets of stewardship efforts to slow the spread of drug-resistant pathogens.
Mining the microbiome of Lake Afdera to gain insights into microbial diversity and biosynthetic potential
Authors: Balcha Ermias Sissay , Macey Michael C , Gemeda Mesfin Tafesse , Cavalazzi Barbara , Woldesemayat Adugna Abdi 
Published: March 2024

Abstract
Microorganisms inhabiting hypersaline environments have received significant attention due to their ability to thrive under poly-extreme conditions, including high salinity, elevated temperatures and heavy metal stress. They are believed to possess biosynthetic gene clusters (BGCs) that encode secondary metabolites as survival strategy and offer potential biotechnological applications. In this study, we mined BGCs in shotgun metagenomic sequences generated from Lake Afdera, a hypersaline lake in the Afar Depression, Ethiopia. The microbiome of Lake Afdera is predominantly bacterial, with Acinetobacter (18.6%) and Pseudomonas (11.8%) being ubiquitously detected. A total of 94 distinct BGCs were identified in the metagenomic data. These BGCs are found to encode secondary metabolites with two main categories of functions: (i) potential pharmaceutical applications (nonribosomal peptide synthase NRPs, polyketide synthase, others) and (ii) miscellaneous roles conferring adaptation to extreme environment (bacteriocins, ectoine, others). Notably, NRPs (20.6%) and bacteriocins (10.6%) were the most abundant. Furthermore, our metagenomic analysis predicted gene clusters that enable microbes to defend against a wide range of toxic metals, oxidative stress and osmotic stress. These findings suggest that Lake Afdera is a rich biological reservoir, with the predicted BGCs playing critical role in the survival and adaptation of extremophiles.
Informing Producers in a Nontraditional Maple Syrup Region: Red Maple and Sugar Maple Production Parameters in Kentucky
Authors: Hackworth Zachary J , Lhotka John M , Ochuodho Thomas O , Thomas William R 
Published: March 2024

Abstract
Maple syrup is an important nontimber forest product in the northern latitudes of North America but has regained popularity in more southerly regions, including Kentucky. We provide the first formal investigation of the relationships between tree attributes and sap production parameters for red maple (Acer rubrum) and sugar maple (Acer saccharum) in Kentucky. During the 2020 and 2021 maple syrup seasons, we monitored per-tap sap volume production and sugar content of seventy-five red maples and seventy-five sugar maples to understand regional trends in maple production. Positive interannual correlations (r = 0.69–0.71) for sap volume and sugar content indicated that individual-tree production was relatively consistent between years. Moderate to strong positive relationships between diameter at breast height (DBH) and both annual sap volume production and sugar content were identified for both species. Predictive equations for sap volume and sugar content based on dbh demonstrated satisfactory predictive power and probable generalizability to new data sets. Trends in sap volume production and sugar content during Kentucky’s maple syrup season indicated that maple syrup production is closely related to weather patterns and site and tree characteristics, and the tools developed in this study will aid regional practitioners with feasibility analyses, operational implementation, long-term planning, and sugarbush management.
Study Implications: Maple syrup production has become more popular in southern states in recent decades. Our study tracked yearly sap volume production and sugar content (the measures that control syrup yield) for red and sugar maples across two seasons in Kentucky. We found that both sap volume and sugar content increased with DBH and can be satisfactorily predicted by DBH. Trees in dominant and codominant crown classes yielded higher syrup volumes than intermediate and overtopped trees. The tools developed by this study will aid landowners and foresters in estimating the potential maple syrup yield of southern sugarbushes.
Ancient Loss of Catalytic Selenocysteine Spurred Convergent Adaptation in a Mammalian Oxidoreductase
Authors: Rees Jasmin , Sarangi Gaurab , Cheng Qing , Floor Martin , Andrés Aida M , Oliva Miguel Baldomero , Villà-Freixa Jordi , Arnér Elias S J , Castellano Sergi 
Published: March 2024

Abstract
Selenocysteine, the 21st amino acid specified by the genetic code, is a rare selenium-containing residue found in the catalytic site of selenoprotein oxidoreductases. Selenocysteine is analogous to the common cysteine amino acid, but its selenium atom offers physical–chemical properties not provided by the corresponding sulfur atom in cysteine. Catalytic sites with selenocysteine in selenoproteins of vertebrates are under strong purifying selection, but one enzyme, glutathione peroxidase 6 (GPX6), independently exchanged selenocysteine for cysteine &lt;100 million years ago in several mammalian lineages. We reconstructed and assayed these ancient enzymes before and after selenocysteine was lost and up to today and found them to have lost their classic ability to reduce hydroperoxides using glutathione. This loss of function, however, was accompanied by additional amino acid changes in the catalytic domain, with protein sites concertedly changing under positive selection across distant lineages abandoning selenocysteine in glutathione peroxidase 6. This demonstrates a narrow evolutionary range in maintaining fitness when sulfur in cysteine impairs the catalytic activity of this protein, with pleiotropy and epistasis likely driving the observed convergent evolution. We propose that the mutations shared across distinct lineages may trigger enzymatic properties beyond those in classic glutathione peroxidases, rather than simply recovering catalytic rate. These findings are an unusual example of adaptive convergence across mammalian selenoproteins, with the evolutionary signatures possibly representing the evolution of novel oxidoreductase functions.
Age Differences in Experiences of Pandemic-Related Health and Economic Challenges Among Adults Aged 55 and Older
Authors: Wiemers Emily E , Lin I-Fen , Wiersma Strauss Anna , Chin Janecca , Hotz V Joseph , Seltzer Judith A 
Published: March 2024

Abstract

Background and Objectives
The oldest adults faced the highest risk of death and hospitalization from coronavirus disease 2019 (COVID-19), but less is known about whether they also were the most likely to experience pandemic-related economic, healthcare, and mental health challenges. Guided by prior research on vulnerability versus resilience among older adults, the current study investigated age differences in economic hardship, delays in medical care, and mental health outcomes among adults aged 55 and older.

Research Design and Methods
Data were from the COVID-19 module and Leave Behind Questionnaire in the 2020 Health and Retirement Study (HRS). We estimated linear probability models to examine differences in experiences of pandemic-related economic and health challenges by age group (55–64, 65–74, 75+) with and without controls for preexisting sociodemographic, social program, health, and economic characteristics from the 2018 HRS. Models accounting for differential mortality also were estimated.

Results
Adults aged 65–74 and 75+ experienced fewer economic and mental health challenges and those aged 75+ were less likely to delay medical care than adults aged 55–64. Age gradients were consistent across a broad range of measures and were robust to including controls. For all age groups, economic challenges were less common than delays in medical care or experiences of loneliness, stress, or being emotionally overwhelmed.

Discussion and Implications
Even though the oldest adults were at the greatest risk of death and hospitalization from COVID-19, they experienced fewer secondary pandemic-related challenges. Future research should continue to explore the sources of this resilience for older adults.
TolDC Restores the Balance of Th17/Treg via Aryl Hydrocarbon Receptor to Attenuate Colitis
Authors: Wang Shu , Xu Ying , Wang Lu , Lin Junjie , Xu Chenjing , Zhao Xiaojing , Zhang Hongjie 
Published: March 2024

Abstract

Background
Tolerogenic dendritic cells (TolDCs) have been evidenced to trigger regulatory T cell’s (Treg’s) differentiation and be involved in the pathogenesis of Crohn’s disease (CD). Aryl hydrocarbon receptor (AhR) plays a crucial role in the differentiation of TolDCs, although the mechanism remains vague. This study aimed to evaluate the role of AhR in TolDCs formation, which may affect Th17/Treg balance in CD.

Methods
Colon biopsy specimens were obtained from healthy controls and patients with CD. Wild type (WT) and AhR-/- mice were induced colitis by drinking dextran sulphate sodium (DSS) with or without 6-formylindolo 3,2-b carbazole (FICZ) treatment. Wild type and AhR-/- bone marrow-derived cells (BMDCs) were cultured under TolDCs polarization condition. Ratios of DCs surface markers were determined by flow cytometry. Enzyme-linked immunosorbent assay (ELISA) was performed to quantify the levels of interleukin (IL)-1β, transforming growth factor (TGF)-β and IL-10. Tolerogenic dendritic cells differentiated from BMDCs of WT or AhR-/- mice were adoptively transferred to DSS-induced WT colitis mice.

Results
Patients with CD showed less AhR expression and activation in their inflamed colon regions. Compared with WT mice, AhR-/- mice experienced more severe colitis. Tolerogenic dendritic cells and Tregs were both decreased in the colon of AhR-/- colitis mice, while Th17 cells were upregulated. In vitro, compared with WT DCs, AhR-deficient DCs led to less TolDC formation. Furthermore, intestinal inflammation in WT colitis mice, which transferred with AhR-/- TolDCs, showed no obvious improvement compared with those transferred with WT TolDCs, as evidenced by no rescues of Th17/Treg balance.

Conclusions
Activation of AhR attenuates experimental colitis by modulating the balance of TolDCs and Th17/Treg. The AhR modulation of TolDCs may be a viable therapeutic approach for CD.
Gender and the legal academy
Authors: de Búrca Gráinne , Dixon Rosalind , Prieto Rudolphy Marcela 
Published: March 2024

Abstract
This Foreword examines what we describe as a “gender gap” in the legal academy. The gap can be seen most clearly in the significantly lower proportion of tenured women faculty members than of men faculty members in most parts of the world, but it is evident in many other aspects too, including the fact that women in academia are often clustered in a “pink ghetto” with lower pay, status, and job security. We begin by outlining the nature of the academic gender gap and some of the obstacles to its removal or reduction, before considering the reasons this gap should be a matter for concern. Two kinds of reasons for such concern are offered: consequences-based and justice-based. The Foreword concludes by suggesting a number of ways in which the gender gap might be addressed, arguing for attention to be paid to the risk of pursuing apparent solutions which may have the effect of entrenching or exacerbating aspects of the problem. Ultimately, we argue that what is needed is not just a larger proportion of women in law schools, but a more just and feminist legal academy along multiple intersecting dimensions.
Long-term outcome and cardiac function after anatomic repair of congenitally corrected transposition
Authors: Yokohama Fumi , Toh Norihisa , Kotani Yasuhiro , Takaya Yoichi , Kuroko Yosuke , Baba Kenji , Akagi Teiji , Kasahara Shingo , Ito Hiroshi 
Published: March 2024

Abstract

OBJECTIVES
There is limited information on long-term outcomes and trajectories of ventricular and valvular functions in patients with congenitally corrected transposition of the great arteries after anatomic repair according to the operative strategy with a median follow-up period of more than 10 years.

METHODS
Twenty-nine patients who underwent anatomic repair in Okayama University Hospital between January 1994 and December 2020 were reviewed. Outcomes were compared between patients who underwent a double switch operation (DS group) and patients with an atrial switch with a Rastelli operation (Rastelli–Senning/Mustard group).

RESULTS
Fifteen (52%) were in the DS group and 14 (48%) were in the Rastelli–Senning/Mustard group. The median follow-up period after anatomic repair was 12.7 (interquartile range 4.2–18.8) years. There were 3 (10%) early deaths and 3 (10%) late deaths. Survival rates for the entire cohort at 10 and 20 years were 86% and 71%, respectively, and were not different between the 2 groups. Using competing risk analysis, risks of heart failure, cardiac rhythm device implantation and atrial arrhythmia showed no significant differences between the 2 groups, whereas risk of reoperation was higher in the Rastelli–Senning/Mustard group than that in the DS group. Four patients after a DS operation and 1 patient after a Rastelli technique developed more than moderate aortic regurgitation.

CONCLUSIONS
During a median follow-up period of more than 10 years, mortality rate and ventricular and valvular functions after anatomic repair were acceptable, though the incidences of late complications were relatively high, especially in the Rastelli–Senning/Mustard group.
Mitral valve replacement in children: balancing durability and risk with mechanical and bioprosthetic valves
Authors: Van Puyvelde Joeri , Meyns Bart , Rega Filip , Gewillig Marc , Eyskens Benedicte , Heying Ruth , Cools Bjorn , Salaets Thomas , Hellings Peter-William , Meuris Bart 
Published: March 2024

Abstract

OBJECTIVES
To investigate if there is still a place for bioprosthetic mitral valve replacement in children by comparing the prosthetic durability and transplant-free survival after bioprosthetic and mechanical mitral valve replacement.

METHODS
We reviewed all mitral valve replacements in children between 1981 and 2020. Bioprosthetic mitral valve replacement cases were individually matched to mechanical mitral valve replacement cases. The incidence rate of a 2nd replacement was calculated using the cumulative incidence function that considered death or transplantation as a competing risk.

RESULTS
The median age at implantation was 3.6 years (interquartile range 0.8–7.9) for the bioprosthetic valve cohort (n = 28) and 3 years (interquartile range 1.3–7.8) for the mechanical valve cohort (n = 28). Seven years after bioprosthetic mitral valve replacement, the cumulative incidence of death or transplantation was 17.9% [95% confidence interval (CI) 6.3–34.1] and the cumulative incidence of a 2nd replacement was 63.6% (95% CI 39.9–80.1). Seven years after mechanical mitral valve replacement, the cumulative incidence of death or transplantation was 28.6% (95% CI 13.3–46) and the cumulative incidence of a 2nd replacement was 10.7% (95% CI 2.6–25.5). Fifteen years after mechanical mitral valve replacement, the cumulative incidence of death or transplantation was 33.6% (95% CI 16.2–52.1) and the cumulative incidence of a 2nd replacement was 41.1% (95% CI 18.4–62.7). The cumulative incidence curves for bioprosthetic and mechanical mitral valve replacement were statistically different for a 2nd valve replacement (P &lt; 0.001) but not for death or transplantation (P = 0.33).

CONCLUSIONS
There is no difference in transplant-free survival after bioprosthetic and mechanical mitral valve replacement in children. The lifespan of bioprosthetic mitral valves remains limited in children because of structural valve failure due to calcification. After 15 years, 40% of mechanical valves were replaced, primarily because of patient–prosthesis mismatch related to somatic growth.
Research and application of safety monitoring technology of distribution automation based on SOM neural network
Authors: Han Yinfeng , Li Peng , Xu Chongyou , Ye Xiaming , Xie Yuzhe 
Published: March 2024

Abstract
For automatic situation monitoring in power distribution safety monitoring, data features are mainly extracted by single hidden layer neural network, which makes the standard error of monitoring results larger. Therefore, the research and application of power distribution automation safety monitoring technology based on SOM neural network are proposed. Preprocess the power grid, collect distribution operation data, set multi-dimensional monitoring nodes according to the collected data, build a distribution operation status monitoring model and analyze the data fusion technology of distribution automation safety monitoring according to the model. On this basis, the distribution automation safety monitoring system is defined, the output node correction weight and the reverse output node correction weight are calculated, the SOM neural network identification model is constructed and the research and application of the distribution automation safety monitoring technology are completed under the action of the gravitational function between individuals within the target time. The experimental results show that the change curve of the number of vulnerabilities and the actual number of false positives is consistent, the number of vulnerabilities is small and the monitoring results are more accurate; The state of the safety monitoring equipment of distribution automation is normal. After applying the method in this paper, the change curve is consistent with the actual value, and the delay time is less than 15 ms.