bluuebunny/crossref_metadata_2025_split huggingface dataset:
Natural Experiments as a Study Method in Spinal Trauma Surgery: A Systematic Review
Authors: Stadhouder Agnita , van Rossenberg Luke Xander , Kik Charlotte , Muijs S. P. J. , Öner F. C. , Houwert R. Marijn 
Published: December 2023

Study Design Systematic review. Objectives To determine if the natural experiment design is a useful research methodology concept in spinal trauma care, and to determine if this methodology can be a viable alternative when randomized controlled trials are either infeasible or unethical. Methods A Medline, Embase and Cochrane database search was performed between 2004 and 2023 for studies comparing different treatment modalities of spinal trauma. All observational studies with a natural experiment design comparing different treatment modalities of spinal trauma were included. Data extraction and quality assessment with the MINORS criteria was performed. Results Four studies with a natural experiment design regarding patients with traumatic spinal fractures were included. All studies were retrospective, one study collected follow-up data prospectively. Three studies compared different operative treatment modalities, whereas one study compared different antibiotic treatment strategies. Two studies compared preferred treatment modalities between expertise centers, one study between departments (neuro- and orthopedic surgery) and one amongst surgeons. For the included retrospective studies, MINORS scores (maximum score 18) were high ranging from 12-17 and with a mean (SD) of 14.6 (1.63). Conclusions Since 2004 only four studies using a natural experiment design have been conducted in spinal trauma. In the included studies, comparability of patient groups was high emphasizing the potential of natural experiments in spinal trauma research. Natural experiments design should be considered more frequently in future research in spinal trauma as they may help to address difficult clinical problems when RCT’s are infeasible or unethical.
Evaluating the Association Between Sociodemographic and Health Variables With Baseline Concussion Testing in Young Athletes
Authors: Kreitner Liga , Crowley Eric , Weaver Amy , Wi Chung-Il , Soma David 
Published: December 2023

Background:Baseline concussion testing can be helpful to perform when providing concussion care for young athletes. To appropriately interpret these data, it is important to understand how certain factors may affect concussion testing.Purpose:To examine the relationship of sociodemographic and health variables with baseline concussion testing in young athletes.Study Design:Cross-sectional study; Level of evidence, 3.Methods:High school and middle school athletes competing in sports or positions at high risk for concussion (football, soccer, ice hockey, wrestling, lacrosse, and pitchers/catchers in baseball/softball) during the 2020-2021 or 2021-2022 academic years completed annual baseline concussion testing and were included in the study. Baseline data included self-reported demographic and medical information, a graded symptom checklist, the Standardized Assessment of Concussion, and the King-Devick test. A validated measure, HOUSES (HOUsing-based index of SocioEconomic Status), was used to determine participants’ socioeconomic status (SES) by linking personal address information to publicly available property data. Multivariable linear regression models were fit to analyze the relationship of concussion baseline testing to sociodemographic and health variables.Results:Among the eligible 2747 athletes (mean age, 15.4 ± 1.5 years; 73.6% male), the mean Standardized Assessment of Concussion score was 26.7 ± 2.0 and the mean best King-Devick test time was 50.3 ± 10.1 seconds. Higher baseline symptom severity scores were related to lower SES ( P = .002). A lower (ie, poorer) mean Standardized Assessment of Concussion score was significantly associated with the following in the multivariable model: male sex ( P < .001), younger age ( P < .001), Black/African American race ( P = .029), Hispanic ethnicity ( P = .016), previous diagnosis of learning disorder or attention-deficit hyperactivity disorder ( P < .001), and lower SES ( P = .003). A higher (ie, poorer) mean King-Devick test time was related to younger age, previous diagnosis of a learning disorder or attention-deficit hyperactivity disorder, and lower SES (all P < .001).Conclusion:Baseline concussion testing was found to be associated with certain sociodemographic variables and underlying health conditions in high school and middle school athletes.
Advances in lithographic techniques for precision nanostructure fabrication in biomedical applications
Authors: Stokes Kate , Clark Kieran , Odetade David , Hardy Mike , Goldberg Oppenheimer Pola 
Published: December 2023

AbstractNano-fabrication techniques have demonstrated their vital importance in technological innovation. However, low-throughput, high-cost and intrinsic resolution limits pose significant restrictions, it is, therefore, paramount to continue improving existing methods as well as developing new techniques to overcome these challenges. This is particularly applicable within the area of biomedical research, which focuses on sensing, increasingly at the point-of-care, as a way to improve patient outcomes. Within this context, this review focuses on the latest advances in the main emerging patterning methods including the two-photon, stereo, electrohydrodynamic, near-field electrospinning-assisted, magneto, magnetorheological drawing, nanoimprint, capillary force, nanosphere, edge, nano transfer printing and block copolymer lithographic technologies for micro- and nanofabrication. Emerging methods enabling structural and chemical nano fabrication are categorised along with prospective chemical and physical patterning techniques. Established lithographic techniques are briefly outlined and the novel lithographic technologies are compared to these, summarising the specific advantages and shortfalls alongside the current lateral resolution limits and the amenability to mass production, evaluated in terms of process scalability and cost. Particular attention is drawn to the potential breakthrough application areas, predominantly within biomedical studies, laying the platform for the tangible paths towards the adoption of alternative developing lithographic technologies or their combination with the established patterning techniques, which depends on the needs of the end-user including, for instance, tolerance of inherent limits, fidelity and reproducibility.
Unbalanced bidirectional causal association between thyroid cancer and ER-positive breast cancer: should we recommend screening for thyroid cancer in breast cancer patients?
Authors: Wang Hongtao , Li Shiwen , Shi Jinyuan , Feng Chuyao , Wang Yanan , Zhang Fan 
Published: December 2023

Abstract
Background
The association between breast cancer (BC) and thyroid cancer (TC) has been studied in several epidemiological studies. However, the underlying causal relationship between them is not yet clear.

Methods
The data from the latest large-sample genome-wide association studies (GWAS) of BC and TC were searched in the public GWAS database. The BC GWAS data included estrogen receptor (ER)-positive and negative subgroups. Two-way two-sample Mendelian Randomization (MR) was used to explore the potential causal relationship between BC and TC. Inverse variance weighting (IVW) and the MR-Egger method were used to combine the estimation of each single nucleotide variation (previous single nucleotide polymorphism). BC was taken as the result, and the effect of TC exposure was analyzed. Then, the effect of BC exposure on the result of TC was analyzed.

Results
Both IVW and MR-Egger results indicated that gene-driven thyroid cancer does not cause estrogen receptor-positive breast cancer and is a protective factor (β = -1.203, SE = 4.663*10–4, P = 0.010). However, gene-driven estrogen receptor-positive breast cancer can lead to the development of thyroid cancer (β = 0.516, SE = 0.220, P = 0.019).

Conclusion
From the perspective of gene drive, people with TC are less likely to have ER-positive BC. In contrast, people with ER-positive BC are more likely to have TC. Therefore, it is recommended that patients with BC be screened regularly for TC.
Genetic variants in myostatin and its receptors promote elite athlete status
Authors: Leońska-Duniec Agata , Borczyk Małgorzata , Korostyński Michał , Massidda Myosotis , Maculewicz Ewelina , Cięszczyk Paweł 
Published: December 2023

Abstract
Background
While product of the myostatin gene (MSTN) is an important factor influencing muscle growth, which is well confirmed in nonhuman species, it has not been clearly confirmed whether MSTN expression influences interindividual differences in skeletal muscle mass, affects posttraining changes, or plays a role in the age-related loss of muscle mass and function in humans. Although the inconclusive results are usually explained by ethnic differences and the low frequency of some alleles, it is possible that the role of receptors (ACVR2A and ACVR2B) that affect the biological activity of myostatin is crucial. Therefore, we investigated the sequences of the MSTN, ACVR2A, and ACVR2B genes and determined the interaction between allelic variants and athletic performance and competition level in the Caucasian population. One hundred-two athletes were recruited for the sequencing study, and whole-genome sequencing (WGS) was performed. Second, 330 athletes and 365 controls were included, and real-time PCR was performed.

Results
The sequence analysis revealed two polymorphisms relatively common in the athlete cohort, and the alternate allele showed overrepresentation in athletes: MSTN rs11333758 and ACVR2A rs3764955. Regarding the polymorphic site MSTN rs11333758, there was a significant overrepresentation of the –/– genotype in all high-elite and mixed-sport high-elite athletes. Carriers of the ACVR2A rs3764955 CC and GG genotypes were more likely to be elite and high-elite athletes. In addition, carriers of the CC genotype were more likely to be in the mixed-sport subelite group. The gene‒gene interaction analysis revealed that mixed-sport high elite athletes showed significant underrepresentation of the ACVR2A rs3764955 GC - MSTN rs11333758 AA genotype combination. In the same group, we observed a significant overrepresentation of the ACVR2A rs3764955 GC - MSTN rs11333758 –/– and the ACVR2A rs3764955 CC - MSTN rs11333758 –/– genotype combinations.

Conclusions
We showed that the specific genotypes of the MSTN rs11333758 and ACVR2A rs3764955, either individually or in gene‒gene combination, are significantly associated with athletes’ competition level in the Polish population, especially in the mixed-sports athlete group. Thus, although further research is required, these polymorphisms, alone or in combination with other polymorphisms, are among the numerous candidates that could explain individual variations in muscle phenotypes.
Epichloë fungal endophyte interactions in perennial ryegrass (Lolium perenne L.) modified to accumulate foliar lipids for increased energy density
Authors: Richardson Kim A. , de Bonth Anouck C. M. , Beechey-Gradwell Zac , Kadam Suhas , Cooney Luke J. , Nelson Kelly A. , Cookson Ruth , Winichayakul Somrutai , Reid Michele , Anderson Philip , Crowther Tracey , Zou Xiuying , Maher Dorothy , Xue Hong , Scott Richard W. , Allan Anne , Johnson Richard D. , Card Stuart D. , Mace Wade J. , Roberts Nicholas J. , Bryan Gregory 
Published: December 2023

Abstract
Background
Commercial cultivars of perennial ryegrass infected with selected Epichloë fungal endophytes are highly desirable in certain pastures as the resulting mutualistic association has the capacity to confer agronomic benefits (such as invertebrate pest deterrence) largely due to fungal produced secondary metabolites (e.g., alkaloids). In this study, we investigated T2 segregating populations derived from two independent transformation events expressing diacylglycerol acyltransferase (DGAT) and cysteine oleosin (CO) genes designed to increase foliar lipid and biomass accumulation. These populations were either infected with Epichloë festucae var. lolii strain AR1 or Epichloë sp. LpTG-3 strain AR37 to examine relationships between the introduced trait and the endophytic association. Here we report on experiments designed to investigate if expression of the DGAT + CO trait in foliar tissues of perennial ryegrass could negatively impact the grass-endophyte association and vice versa. Both endophyte and plant characters were measured under controlled environment and field conditions.

Results
Expected relative increases in total fatty acids of 17–58% accrued as a result of DGAT + CO expression with no significant difference between the endophyte-infected and non-infected progeny. Hyphal growth in association with DGAT + CO expression appeared normal when compared to control plants in a growth chamber. There was no significant difference in mycelial biomass for both strains AR1 and AR37, however, Epichloë-derived alkaloid concentrations were significantly lower on some occasions in the DGAT + CO plants compared to the corresponding null-segregant progenies, although these remained within the reported range for bioactivity.

Conclusions
These results suggest that the mutualistic association formed between perennial ryegrass and selected Epichloë strains does not influence expression of the host DGAT + CO technology, but that endophyte performance may be reduced under some circumstances. Further investigation will now be required to determine the preferred genetic backgrounds for introgression of the DGAT + CO trait in combination with selected endophyte strains, as grass host genetics is a major determinant to the success of the grass-endophyte association in this species.
Chitosan-GSNO nanoparticles: a positive modulator of drought stress tolerance in soybean
Authors: Methela Nusrat Jahan , Pande Anjali , Islam Mohammad Shafiqul , Rahim Waqas , Hussain Adil , Lee Da-Sol , Mun Bong-Gyu , Maria Joseph Raj Nirmal Prashanth , Kim Sang-Jae , Kim Yoonha , Yun Byung-Wook 
Published: December 2023

Abstract
Background
Chitosan biopolymer is an emerging non-toxic and biodegradable plant elicitor or bio-stimulant. Chitosan nanoparticles (CSNPs) have been used for the enhancement of plant growth and development. On the other hand, NO is an important signaling molecule that regulates several aspects of plant physiology under normal and stress conditions. Here we report the synthesis, characterization, and use of chitosan-GSNO nanoparticles for improving drought stress tolerance in soybean.

Results
The CSGSNONPs released NO gas for a significantly longer period and at a much lower rate as compared to free GSNO indicating that incorporation of GSNO in CSNPs can protect the NO-donor from rapid decomposition and ensure optimal NO release. CS-GSNONPs improved drought tolerance in soybean plants reflected by a significant increase in plant height, biomass, root length, root volume, root surface area, number of root tips, forks, and nodules. Further analyses indicated significantly lower electrolyte leakage, higher proline content, higher catalase, and ascorbate peroxidase activity, and reduction in MDA and H2O2 contents after treatment with 50 μM CS-GSNONPs under drought stress conditions. Quantitative real-time PCR analysis indicated that CS-GSNONPs protected against drought-induced stress by regulating the expression of drought stress-related marker genes such as GmDREB1a, GmP5CS, GmDEFENSIN, and NO-related genes GmGSNOR1 and GmNOX1.

Conclusions
This study highlights the potential of nano-technology-based delivery systems for nitric oxide donors to improve plant growth, and development and protect against stresses.
The effect of foliar application of Ascophyllum nodosum (L.) Le Jol. seaweed extract on biochemical traits related to abiotic stresses in pistachio (Pistacia vera L. cv. Kaleh-Ghoochi)
Authors: Nikoogoftar-Sedghi Mohammadali , Rabiei Vali , Razavi Farhang , Molaei Sanaz , Khadivi Ali 
Published: December 2023

Abstract
Background
Due to the important economic role of pistachio (Pistacia vera L.) the cultivation of this valuable crop has been extended. Various abiotic stresses harm the growth and performance of pistachio. Seaweed extract containing various substances such as pseudo-hormones that stimulate growth, nutritional elements, and anti-stress substances can cause more resistance to abiotic stresses, and increase the quantity and the quality of the fruit. The present study was conducted to evaluate the effect of foliar application of Ascophyllum nodosum (L.) Le Jol. seaweed extract on some biochemical traits related to abiotic stress in Pistacia vera L. cv. Kaleh-Ghoochi. The first factor of foliar spraying treatment included A. nodosum seaweed extract at four levels (0, 1, 2, and 3 g/L), and the second factor was the time of spraying solution which was done at three times (1- at the beginning of pistachio kernel growth period at the end of June, 2- at the stage of full kernel development at the end of August, and 3- Spraying in both late June and August).

Results
The results showed that all investigated traits were significant under the treatment of seaweed extract compared with the control. The seaweed extract concentrations had a significant effect on all traits except soluble carbohydrates, but the time of consumption of seaweed extract on soluble carbohydrates, protein, peroxidase, ascorbate peroxidase, and superoxide dismutase enzymes was significant, while had no significant effect on the rest of the traits. According to the interaction effect of time and concentration of consumption of seaweed extract, the highest values of the biochemical characters were as follows: total phenol content: 168.30 mg CAE/g DW, flavonoid content: mg CE/g DW, catalase: 12.66 µmol APX min− 1 mg− 1 protein, superoxide dismutase: 231.4 µmol APX min− 1 mg− 1 protein, and ascorbate peroxidase: 39.53 µmol APX min− 1 mg− 1 protein.

Conclusions
Based on the results of this study, it seems that it is possible to use fertilizers containing A. nodosum seaweed extract with a concentration of 3 g/L in August to increase the tolerance of the pistachio cultivar “Kaleh-Ghoochi” to abiotic stresses.
A pre-anesthetic bolus of ketamine versus dexmedetomidine for prevention of postoperative delirium in elderly patients undergoing emergency surgery: a randomized, double-blinded, placebo-controlled study
Authors: Ghazaly Huda F. , Hemaida Tarek S. , Zaher Zaher Z. , Elkhodary Omar M. , Hammad Soudy S. 
Published: December 2023

Abstract
Background
We aimed to evaluate whether a single dose of ketamine or dexmedetomidine before induction of general anesthesia could reduce the incidence of postoperative delirium (primary outcome) or cognitive dysfunction (secondary outcome) in elderly patients undergoing emergency surgery.

Patients and methods
This randomized, double-blinded, placebo-controlled trial included 60 elderly patients who were scheduled for emergency surgery. The patients were randomly assigned into one of three groups (n = 20): group I received 0.9% normal saline, group II received 1 µg/kg dexmedetomidine, and group III received 1 mg/kg ketamine right before anesthesia induction. Patients were observed for three days after surgery and tested for postoperative delirium and cognitive dysfunction using the delirium observation screening scale and the mini-mental state examination score, respectively.

Results
The dexmedetomidine group had the lowest incidence of delirium (p = 0.001) and cognitive dysfunction (p = 0.006) compared to the ketamine and placebo groups. The multivariate logistic regression model revealed that dexmedetomidine reduced the incidence of postoperative delirium by 32% compared to placebo (reference) (OR = 0.684, 95% CI: 0.240–0.971, p = 0.025), whereas ketamine increased the risk by threefold (OR = 3.012, 95% CI: 1.185–9.681, p = 0.013). Furthermore, dexmedetomidine reduced the incidence of postoperative cognitive dysfunction by 62% (OR = 0.375, 95% CI: 0.091–0.543, p = 0.012), whereas ketamine increased the risk by 4.5 times (OR = 4.501, 95% CI: 1.161–8.817, p = 0.006).

Conclusion
A single pre-anesthetic bolus of dexmedetomidine is a practical choice for preventing postoperative delirium in elderly patients undergoing emergency surgery.

Trial registration
This study was approved by the Ethics Committee of Aswan University Hospital (approval number: aswu/548/7/2021; registration date: 06/07/2021) and registered on ClinicalTrials.gov (NCT05341154) (22/04/2022).
Grandparenting and life satisfaction among Chinese elderlies: a study of possible mechanisms
Authors: Cheng Xinfeng , Ariyo Tolulope 
Published: December 2023

Abstract
Objective
This study examines the impact of caregiving on older people’s life satisfaction, focusing on the role of caring for grandchildren. The study considers individual characteristics (aging attitudes) and situational factors (intergenerational support) and aims to identify the mediating roles of aging attitudes and intergenerational support in the relationship between caregiving and life satisfaction.

Method
The study analyzed data from the 2014 China Longitudinal Aging Social Survey (CLASS), focusing on 5363 grandparents who reported providing care for their grandchildren in the 12 months before the survey. Life satisfaction was subjectively measured. The data was analyzed using multiple linear regression, propensity score matching, and mediation analysis.

Result
The study found that grandparents who cared for their grandchildren have higher levels of life satisfaction. Self-aging attitudes, general aging attitudes, intergenerational economic support, intergenerational instrumental support, and intergenerational emotional support fully mediated the relationship between grandchild care and life satisfaction.

Conclusion
This study demonstrates that caring for grandchildren is a vital activity for older people that helps them develop positive aging attitudes and strengthens intergenerational support, thereby improving their quality of life. Hence, the government, society, families, and communities should provide more social support to older adults caring for grandchildren. This would not only benefit the health of the older people themselves but also promote intergenerational harmony and family development.
Image-based AI diagnostic performance for fatty liver: a systematic review and meta-analysis
Authors: Zhao Qi , Lan Yadi , Yin Xunjun , Wang Kai 
Published: December 2023

Abstract
Background
The gold standard to diagnose fatty liver is pathology. Recently, image-based artificial intelligence (AI) has been found to have high diagnostic performance. We systematically reviewed studies of image-based AI in the diagnosis of fatty liver.

Methods
We searched the Cochrane Library, Pubmed, Embase and assessed the quality of included studies by QUADAS-AI. The pooled sensitivity, specificity, negative likelihood ratio (NLR), positive likelihood ratio (PLR), and diagnostic odds ratio (DOR) were calculated using a random effects model. Summary receiver operating characteristic curves (SROC) were generated to identify the diagnostic accuracy of AI models.

Results
15 studies were selected in our meta-analysis. Pooled sensitivity and specificity were 92% (95% CI: 90–93%) and 94% (95% CI: 93–96%), PLR and NLR were 12.67 (95% CI: 7.65–20.98) and 0.09 (95% CI: 0.06–0.13), DOR was 182.36 (95% CI: 94.85-350.61). After subgroup analysis by AI algorithm (conventional machine learning/deep learning), region, reference (US, MRI or pathology), imaging techniques (MRI or US) and transfer learning, the model also demonstrated acceptable diagnostic efficacy.

Conclusion
AI has satisfactory performance in the diagnosis of fatty liver by medical imaging. The integration of AI into imaging devices may produce effective diagnostic tools, but more high-quality studies are needed for further evaluation.