bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcription factor NAC1 activates expression of peptidase-encoding AtCEPs in roots to limit root hair growth
Authors: Rodríguez-García Diana R , Rondón Guerrero Yossmayer del Carmen , Ferrero Lucía , Rossi Andrés Hugo , Miglietta Esteban A , Aptekmann Ariel A , Marzol Eliana , Martínez Pacheco Javier , Carignani Mariana , Berdion Gabarain Victoria , Lopez Leonel E , Díaz Dominguez Gabriela , Borassi Cecilia , Sánchez-Serrano José Juan , Xu Lin , Nadra Alejandro D , Rojo Enrique , Ariel Federico , Estevez José M 
Published: October 2023

Abstract
Plant genomes encode a unique group of papain-type Cysteine EndoPeptidases (CysEPs) containing a KDEL endoplasmic reticulum (ER) retention signal (KDEL-CysEPs or CEPs). CEPs process the cell-wall scaffolding EXTENSIN (EXT) proteins that regulate de novo cell-wall formation and cell expansion. Since CEPs cleave EXTs and EXT-related proteins, acting as cell-wall-weakening agents, they may play a role in cell elongation. The Arabidopsis (Arabidopsis thaliana) genome encodes 3 CEPs (AtCPE1-AtCEP3). Here, we report that the genes encoding these 3 Arabidopsis CEPs are highly expressed in root-hair (RH) cell files. Single mutants have no evident abnormal RH phenotype, but atcep1-3 atcep3-2 and atcep1-3 atcep2-2 double mutants have longer RHs than wild-type (Wt) plants, suggesting that expression of AtCEPs in root trichoblasts restrains polar elongation of the RH. We provide evidence that the transcription factor NAC1 (petunia NAM and Arabidopsis ATAF1, ATAF2, and CUC2) activates AtCEPs expression in roots to limit RH growth. Chromatin immunoprecipitation indicates that NAC1 binds to the promoter of AtCEP1, AtCEP2, and, to a lower extent, AtCEP3 and may directly regulate their expression. Inducible NAC1 overexpression increases AtCEP1 and AtCEP2 transcript levels in roots and leads to reduced RH growth while the loss of function nac1-2 mutation reduces AtCEP1-AtCEP3 gene expression and enhances RH growth. Likewise, expression of a dominant chimeric NAC1-SRDX repressor construct leads to increased RH length. Finally, we show that RH cell walls in the atcep1-3 atcep3-2 double mutant have reduced levels of EXT deposition, suggesting that the defects in RH elongation are linked to alterations in EXT processing and accumulation. Our results support the involvement of AtCEPs in controlling RH polar growth through EXT processing and insolubilization at the cell wall.
Linear algebra in engineering: a study of specialized knowledge of Chilean and Brazilian teachers
Authors: Bianchini Barbara Lutaif , Gomes Eloiza , González Marcela Parraguez , Lima de Gabriel Loureiro 
Published: October 2023

Abstract
The objective of this paper is to establish comparisons between the Linear Algebra (LA) approach practiced in Engineering courses offered by Chilean and Brazilian Higher Education Institutions and, for that, teachers from both countries were interviewed. From a methodological point of view, the research consists of two case studies. For the analysis of the interviews, we used the precepts of Content Analysis. The data were qualitatively analyzed considering the MTSK theoretical model. In this analysis, we sought to identify what specialized knowledge these teachers have regarding AL and about its teaching and learning. The results have shown that, in relation to the Mathematical Knowledge (MK) domain, which refers to content knowledge, the Knowledge of Topics subdomain (KoT), linked to the way that teachers know the topics they teach, is the most present among interviewees. In the Pedagogical Content Knowledge (PCK) domain, covering specific pedagogical knowledge linked to Mathematics, the Knowledge of Mathematics Teaching (KMT), regarding strategies, teaching theories, resources and materials, and Knowledge of Mathematics Learning Standards (KMLS) subdomains, concerning the curricular specifications and the moments in which the student must or can learn certain content and with what level of depth prevail.
Agreement Between Self-reports and Urine Toxicology Measures of Illicit Methamphetamine and Cocaine Use During Early Pregnancy
Authors: Sujan Ayesha C. , Alexeeff Stacey E. , Slama Natalie E. , Goler Nancy , Avalos Lyndsay A. , Adams Sara R. , Conway Amy , Ansley Deborah , Pal Anish , Gunn Rachel L. , Micalizzi Lauren , Young-Wolff Kelly C. 
Published: October 2023

Objective
This study aimed to assess agreement between self-report and urine toxicology measures assessing use of 2 illicit simulants (methamphetamine and cocaine) during early pregnancy.

Methods
This cross-sectional study of 203,053 pregnancies from 169,709 individuals receiving prenatal care at Kaiser Permanente Northern California between January 1, 2011, and December 31, 2019, assessed agreement (κ, sensitivity, and specificity) between self-reported frequency and urine toxicology measures of methamphetamine and cocaine early in pregnancy.

Results
Prenatal use of the illicit stimulants was rare according to toxicology (n = 244 [0.12%]) and self-report measures (n = 294 [0.14%]). Agreement between these measures was low (κ < 0.20). Of the 498 positive pregnancies, 40 (8.03%) screened positive on both measures, 204 (40.96%) screened positive on toxicology tests only, and 254 (51.00%) screened positive by self-report only. Relative to toxicology tests, sensitivity of any self-reported use was poor with 16.39% (95% confidence interval [CI], 11.75%–21.04%) of pregnancies with a positive toxicology test self-reporting any use in pregnancy. Relative to self-report, sensitivity of toxicology tests was also poor with 13.61% (95% CI, 9.69%–17.52%) of pregnancies who self-reported any use having positive urine toxicology tests. The sensitivity improved slightly at higher frequencies of self-reported use: daily, 17.50% (95% CI, 5.72%–29.29%); weekly, 25.00% (95% CI, 11.58%–38.42%); and monthly or less, 11.06% (95% CI, 6.89%–15.23%). Specificity was high (>99%), reflecting the high negative rate of use.

Conclusions
Findings suggest that using self-report and toxicology measures in combination likely provides the most accurate information on methamphetamine and cocaine use in early pregnancy. Findings also highlight the need to provide supportive nonstigmatizing environments in which pregnant individuals feel comfortable disclosing substance use without fear of punishment.
Comparison of Gait and Functional Outcomes Between Open and Arthroscopic Treatment of Adolescent and Young Adult Femoroacetabular Impingement
Authors: Morris William Z. , Loewen Alex , Ulman Sophia , Johnson Ben , Sucato Daniel J. , Podeszwa David A. , Ellis Henry B. 
Published: October 2023

Background:
Management of femoroacetabular impingement (FAI) through an arthroscopic or surgical hip dislocation (SHD) approach has been shown to have similar clinical success and patient-reported outcomes. However, there are limited data comparing functional outcomes. The purpose of this study was to compare gait and functional outcomes of adolescent/young adult patients with FAI treated by either an arthroscopic or open SHD approach.

Methods:
We identified prospectively enrolled adolescent/young adult patients (≤20 years old) who underwent surgical treatment for FAI through an SHD or arthroscopic approach. Participants were evaluated in a movement science lab preoperatively and postoperatively (minimum 8 months postoperatively) with barefoot walking and a 30-second single-limb balance trial on the affected side. Participants also completed the Harris Hip Score at the same timepoints. Differences from preoperative to postoperative were determined using a paired-samples t test for each surgical technique, and differences between the SHD and arthroscopic groups were determined using an independent samples t test (α=0.05).

Results:
Fifty-five participants (42F, 16.2±1.4 y) were tested and grouped by surgical intervention. The SHD and arthroscopy groups consisted of 28 and 27 participants, respectively, with no significant difference between the SHD and arthroscopic cohorts in age (16.4±1.2 vs. 15.9±1.5 y, respectively, P=0.218) or sex distribution (78.6% vs. 74.1% females, respectively, P=0.75). Each group demonstrated significant postoperative improvement in Harris Hip Score (SHD: 64.8±16.4 to 81.8±17.8; arthroscopy: 57.0±16.7 to 84.7±19.7; preoperatively to postoperatively, respectively, both P<0.001). During gait, increased maximum hip flexion was observed following surgical intervention for the SHD group (32.3±5.7 vs. 36.1±5.2, P=0.003). No other clinically significant changes were detected in the SHD or arthroscopic groups preoperatively to postoperatively in trunk, pelvis, or hip kinematics in the coronal plane. During the balance task, neither cohort demonstrated markers of clinically significant abductor dysfunction. However, post operatively, the arthroscopy group was able to balance longer than the SHD group (18.8±7.8 vs. 14.2±2.7 s, respectively, P=0.008), although no differences were detected in trunk or pelvis position in the coronal plane during balance.

Conclusions:
Both open SHD and arthroscopic treatment of FAI resulted in improved clinical outcomes with no clinically significant abductor dysfunction 1 year post operatively. However, further study is needed to determine whether more dynamic tasks can potentially elicit subtle differences between the groups.

Levels of Evidence:
Level II—prospective study.
Recovery of Gait in Children and Adolescents After Pediatric Femoral Shaft Fracture Treated With Intramedullary Nail Fixation: A Longitudinal Prospective Study
Authors: Flinck Marianne , Riad Jacques 
Published: October 2023

Background:
Femoral shaft fractures in school-aged children are commonly treated with intramedullary nail fixation. Outcomes such as time to healing, alignment and non-union, leg length discrepancy, and refractures, and other complications are often reported based on radiographic findings. There are limited reports on physical function, including objective quantitative measures. The aim was to study the progress and recovery of gait after femoral shaft fracture in children and adolescents.

Methods:
Inclusion criteria were individuals 6 to 16 years of age with a femoral shaft fracture treated with intramedullary nails. Exclusion criteria were pathologic fractures and other physical impairments or injuries that influenced gait.
At 6 and 12 weeks, assessments of mobilization and weight bearing were performed at clinical hospital follow-ups.
At 3, 6, 9, and 12 months, physical examinations of passive range of motion, stair walking, and three-dimensional gait analysis, including temporospatial, movement (kinematics), and force (kinetics) data, were performed.

Results:
Seventeen participants, with a median of 9.2 (interquartile range 6.5 to 11.3) years of age were included. At 6 weeks, 14 of 16 (88%) used walking aids and at twelve weeks, 25% did. Sixty-nine percent could walk up and down stairs at 6 weeks and 100% at 12 weeks. At 3 months, 3 participants walked with a speed below 100 cm/second and had clear deviations in gait pattern compared with the control group. Three participants had no deviations in gait patterns at 3 months. Gait patterns had normalized in most participants at 6 months. Hip and knee extension moments were decreased up to 6 months compared with the control group. Hip extensor muscle work was increased on the fractured side compared with the control group.

Conclusions:
Early recovery, between 6 and 12 weeks postoperatively, was noted in basic performance tests after femoral shaft fractures in children and adolescents. Three-dimensional gait analysis revealed normalization of gait patterns at 6 months. Information on the expected time and degree of recovery of physical function could guide the rehabilitation process.

Level of Evidence:
Level III.
Comprehensive Grading System of Inflammatory Features of the Lumbar Facet Joints on Magnetic Resonance Imaging
Authors: Acosta José I. , Ermann Joerg , Isaac Zacharia , DeFilipp Miriam , Gottreich Julia R. , Andrew Michael N. , Chang Yuchiao , Zampini Jay M. , Katz Jeffrey N. , Mandell Jacob C. 
Published: October 2023

Study design.
Retrospective.

Objective.
We aimed to describe a magnetic resonance imaging (MRI)-based grading system of inflammatory features of the lumbar facet joints using an atlas and assess its reliability.

Summary of Background Data.
Chronic low back pain is often caused by facet joint arthropathy. Inflammatory features are often evident on MRI. While several grading systems of facet arthropathy have been described, there is scant data on the reliability of these systems, and none focus exclusively on inflammatory features.

Methods.
We describe a grading system that assesses facet joint effusion, bone marrow edema, and soft tissue edema. Each feature was graded from 0-3 (facet edema) or 0-2 (bone marrow edema intensity and extent, soft tissue edema intensity and extent). Four spine experts graded MRIs of 50 subjects at the bilateral L3/4, L4/5, and L5/S1 levels. All subjects had symptomatic facet arthropathy and received therapeutic facet joint injections. We assessed the intra- and inter-reader reliability of each feature at each joint and summarized across all six joints.

Results.
The mean age of subjects was 56 years (SD = 17), and 48% were female. The injections occurred at the L3/4 level in 12% of cases, at L4/5 in 88%, and at L5/S1 in 80% of cases. The intra-reader reliability kappa’s for each feature ranged from 0.42 to 0.81. In contrast, the inter-reader reliability kappa values for each feature ranged from 0.37 to 0.54.

Conclusion.
MRI inflammatory features of the lumbar facet joints are often noted in patients with low back pain. The proposed grading system is reliable and could serve as a research tool for studies assessing the clinical relevance and prognostic value of these features.
Proptosis Regression After Teprotumumab Treatment for Thyroid Eye Disease
Authors: Rosenblatt Tatiana R. , Chiou Carolina A. , Yoon Michael K. , Wolkow Natalie , Lee Nahyoung Grace , Freitag Suzanne K. 
Published: October 2023

Purpose:
This study analyzed the degree and timing of proptosis regression after teprotumumab therapy.

Methods:
A retrospective study of all patients who completed 8 teprotumumab infusions at 1 institution from January 1, 2020 to December 31, 2022. Change in proptosis was assessed in millimeters and percentages compared with immediate post-treatment and pretreatment proptosis.

Results:
Of 119 patients with post-treatment data (mean follow-up 10.56 months, range: 3.05–25.08), 208 (87.39%) eyes of 110 patients had initial proptosis improvement. Of the 78 patients with multiple follow-up visits, 102 (65.38%) eyes of 59 patients had proptosis regression averaging 12.78% (range: 1.85–58.82%) compared with immediately post-treatment or 2.43 mm (0.5–10.0 mm). Eight (7.84%) eyes had initial documentation of regression more than 1 year after treatment, 40 (39.22%) between 6 months and 1 year, and 54 (52.94%) eyes within 6 months with 25 (46.30%) of these continuing to worsen at subsequent follow-up. Forty (25.64%) eyes of 24 patients had more proptosis at most recent follow-up than before teprotumumab, with an average regression of 1.53 mm (0.5–4.0 mm) or 7.74% (1.85–20.69%) of pretreatment proptosis. In comparison, 99 (63.46%) eyes of 54 patients maintained improvement, with reduction averaging 3.13 mm (0.5–11.0 mm) or 13.19% (1.92–41.67%) of pretreatment proptosis (p < 0.001).

Conclusions:
Two-thirds of eyes had regression despite initial teprotumumab response, typically within 1 year of treatment, with ongoing worsening over time. Most patients maintained some proptosis reduction compared with before treatment despite regression, although 25% were worse than pretreatment. The occurrence of regression was independent of the pretreatment duration of clinical thyroid eye disease. Overall, compared with preteprotumumab, there was a greater amount of improvement than regression at most recent follow-up.
Improvement of positive dysphotopsia with multifocal intraocular lenses by hormone replacement therapy
Authors: Komatsu Koji , Masuda Yoichiro , Hayashi Takaaki , Nakano Tadashi 
Published: October 2023

Introduction:
The case of a patient with positive dysphotopsia (PD) affected by hormone replacement therapy (HRT) after multifocal intraocular lens (IOL) insertion is reported.

Patient and Clinical Findings:
A 66-year-old woman underwent bilateral cataract surgery and multifocal IOL implantation. Postoperatively, the uncorrected distance and near visual acuity improved bilaterally. The patient experienced mild PD symptoms in the left eye. She had been using an estradiol patch for menopausal disorders. 6 months postoperatively, the use of an estradiol patch was discontinued because of dermatitis and she noticed a marked worsening of her PD.

Diagnosis, Intervention, and Outcomes:
With the patient's cooperation, full-field electroretinography (ERG) and contrast sensitivity tests were performed before and after estradiol discontinuation. After the discontinuation, the amplitude of both rod and cone ERGs decreased, contrast sensitivity decreased, and PD deteriorated. There were no changes in anterior-segment condition and retinal shape.

Conclusions:
PD symptoms worsened after the discontinuation of estrogen hormone therapy. ERG amplitude and contrast sensitivity decreased when HRT was discontinued, suggesting that retinal function in the presence of estrogen receptors may be related to the development of PD.
Clinical characteristics, risk factors, and outcomes of patients with polymicrobial Pseudomonas aeruginosa bloodstream infections
Authors: Zheng Cheng , Wang Guangtao , Qiu Lingling , Luo Xinhua , Zhang Xijiang , Zhong Li , Zhang Chuming , Lin Ronghai , Chen Qingqing 
Published: October 2023

Background:
Previous studies on polymicrobial Pseudomonas aeruginosa bloodstream infections (Pa-BSIs) are dated, and it is necessary to reanalyze polymicrobial Pa-BSIs. The aim of this study was to investigate clinical characteristics and risk factors for polymicrobial Pa-BSI in comparison with monomicrobial Pa-BSI.

Methods:
A double-center retrospective observational study was performed between January 1, 2013 and June 30, 2022, in two tertiary hospitals. All patients with Pa-BSI were enrolled, and their clinical data were collected by reviewing electronic medical records.

Results:
A total of 278 patients with Pa-BSI were enrolled, including 77 patients (27.7%) with polymicrobial Pa-BSI. Compared with monomicrobial Pa-BSI, the main source of polymicrobial Pa-BSI was pneumonia (49.4% vs 31.3%, p < 0.01), whereas the main source of monomicrobial Pa-BSI was primary BSIs (21.9% vs 2.6%, p = 0.04). In multivariate analysis, a history of cerebrovascular accident (CVA) (adjusted odds ratio [OR], 3.62; 95% CI, 1.46-8.92) was independently associated with polymicrobial Pa-BSI. Primary BSI was associated with monomicrobial Pa-BSI (OR, 0.08; 95% CI, 0.02-0.38). Patients with polymicrobial Pa-BSI had a longer intensive care unit (ICU) length of stay after onset of BSI than those with monomicrobial Pa-BSI (2 [2, 16] vs 13 [3.75, 29], p = 0.02).

Conclusion:
Patients with Pa-BSI and the presence of CVA need to be alert to the possibility of polymicrobial BSI occurrence. Prolonged ICU stay and pneumonia as a source of BSI warrant clinician attention for polymicrobial Pa-BSI, and primary BSIs are likely associated with monomicrobial BSIs.
Clinical Preceptor Development and the Benefit of Structured Teaching Techniques: A Scoping Review
Authors: Cushing Rachel 
Published: October 2023

Introduction
Physician assistant (PA) education in the clinical year is dependent on clinical preceptors. Recruitment of preceptors has been identified as a significant barrier for programs. As a result of the preceptor shortage, evaluation of the barriers to recruitment and retention has been considered. The lack of development and training was identified as a barrier to recruitment and retention of preceptors.
The aim of this scoping review article was to identify structured teaching strategies to reduce the development and training barrier and improve preceptor efficacy and efficiency. Structured teaching techniques, such as the One-Minute Preceptor and Summarize, Analyze, Narrow, Probe, Plan, and Select (SNAPPS), are proven to be effective and efficient ways to train learners.

Methods
Online databases were used to identify articles published from 2014 to 2022 using the following terms: “physician assistant” or “nurse practitioner,” “preceptor development,” “preceptorship,” “teaching methods,” “pedagogy,” “clinical teaching,” and “medical education.” Seventeen articles formed the basis of the scoping review of the literature. A singular author reviewed the articles.

Results
Training resources help ease student instruction burden that preceptors experience. Many preceptors rely on clinical experience to guide their teaching methods. Introducing formal, structured teaching strategies can improve preceptors' effectiveness. By implementing preceptor training using structured teaching strategies, PA programs can decrease barriers for preceptors and potentially increase preceptor effectiveness and efficiency.

Conclusions
Training preceptors on using structured teaching strategies through workshops, asynchronous learning modules, and podcasts could provide preceptors with the support needed to educate clinical phase PA students. Physician assistant programs must explore best practices in clinical teaching and the associated education and operational outcomes.
An international multi-institution real-world study of the optimal surveillance frequency for stage II/III gastric cancer: The more, the better?
Authors: Wu Dong , Lu Jun , Lin Jia , Xu Bin-bin , Xue Zhen , Zheng Hua-Long , Lin Guo-sheng , Huang Jiao-bao , Shen Li-li , Zheng Chao-Hui , Li Ping , Xie Jian-Wei , Wang Jia-Bin , Lin Jian-Xian , Chen Qi-Yue , Cao Long-Long , Ma Yu-Bin , Truty Mark J. , Huang Chang-Ming 
Published: October 2023

Background:
Due to lacking evidence on surveillance for gastric cancer (GC), this study aimed to determine the optimal postsurgical surveillance strategy for pathological stage (pStage) II/III GC patients and compare its cost-effectiveness with traditional surveillance strategies.

Methods:
Prospectively collected data from stage II/III GC patients (n=1,661) who underwent upfront surgery at a large-volume tertiary cancer center in China (FJMUUH cohort) between January 2010 and October 2015. For external validation, two independent cohorts were included, which were composed of 380 stage II/III GC patients at an tertiary cancer center in U.S.A (Mayo cohort) between July 1991 and July 2012 and 270 stage II/III GC patients at another tertiary cancer center in China (QUAH cohort) between May 2010 and Oct 2014. Random forest models were used to predict dynamic recurrence hazards and to construct individual surveillance strategies for stage II/III GC. Cost-effectiveness was assessed by Markov model.

Results:
The median follow-up period of the FJMUUH, the Mayo, and QUAH cohorts were 55, 158, and 70 months, respectively. In the FJMUUH cohort, the 5-year recurrence risk was higher in pStage III compared with pStage II GC patients (P<0.001). Our novel individual surveillance strategy achieved optimal cost-effectiveness for pStage II GC patients (ICER = $490/QALY). The most intensive NCCN surveillance guideline was more cost-effective (ICER = $983/QALY) for pStage III GC patients. The external validations confirmed our results.

Conclusion:
For patients with pStage II GC, individualized risk-based surveillance outperformed the JGCTG and NCCN surveillance guidelines. However, the NCCN surveillance guideline may be more suitable for patients with pStage III GC. Even though our results are limited by the retrospective study design, we believe that our findings should be considered when recommending postoperative surveillance for stage II/III gastric cancer with upfront surgery in the absence of a randomized clinical trial.

Trial Registration:
Clinical Trials.gov.