bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Large Cohort Analysis of Epiglottic Phenotypes and Pharyngeal Residue
Authors: Kravietz Adam , Crosby Tyler , Yang Jackie , Balou Stamatela , Dion Gregory R. , Logan Ashley , Amin Milan R. 
Published: January 2024

Objective: To describe the phenotypic characteristics of the epiglottis at rest and their impact on vallecular residue. Methods: Videofluoroscopic studies (VFSS) were pooled from 2 Laryngology practices, and Image J was used to measure epiglottic anatomic features at rest. Studies were rated by the MBSImp and presence of vallecular residue following swallow of thin and puree boluses. A conditional inference tree analysis was performed to isolate which epiglottic parameters were risk factors for presence of vallecular reside followed by logistic regression. Results: The majority of patients had a normal shaped epiglottis, followed by omega shape. The mean angle of the epiglottis from the hyoid was approximately 90°. Only abnormal epiglottic movement was associated with increased risk of residue for thin boluses (OR 35.09, CI 10.93-158.66, P < .001). However, in those with normal epiglottic movement, age >70 years old was associated with increased risk of residue (OR 3.98, CI 1.73-9.23, P = .001). For puree boluses, a normal or omega shaped epiglottis was associated with residue (OR 5.19, CI 2.41-11.51, P < .001), and this relationship was further modulated by increased distance of the epiglottic tip from the posterior pharyngeal wall. No other anatomic features of the resting epiglottis were associated with residue. Comorbidities potentially affecting swallow were infrequent in the cohort and were not associated with residue. Conclusion: Abnormal epiglottic movement is associated with aspiration, and in this study we find that abnormal epiglottic movement increases the risk of vallecular residue and that older age is a risk factor for residue. The resting properties of the epiglottis do not appear to be associated with abnormal epiglottic movement or residue.
Improving Early Initiation of Breastfeeding in Healthy Late Preterm Neonates Through Reformed Lactation Support Program: A Before and After Study
Authors: Singh Ishita , Chandran Rabindran , B Umamaheswari , Amboiram Prakash 
Published: January 2024

Background Early Initiation of Breastfeeding (EIBF) reduces neonatal mortality up to three times, particularly in preterm and low-birth weight infants. Existing Lactation Support Program (LSP) of the institute tackles breastfeeding-related issues to achieve EIBF as early as possible for all delivered healthy infants. LSP was reformed by introducing new policy in February 2021 to achieve EIBF <1 hour in all healthy delivered neonates. Aim The aim of the study was to study the efficacy of new lactation policy of LSP on rates of EIBF and time to attain the first breastfeeding in late preterm neonates of gestational age 35+0 weeks -36+6 weeks. Method A ‘before-and-after’ design was used to study the effect of the new policy on EIBF at a tertiary care institute in India from January 2018 to March 2023. Impact was assessed by comparing baseline data in pre-policy (group A) with that of new policy (group B). Result Among 417 babies included, 336 and 81 belonged to group A and B, respectively. EIBF rates were 42% and 99% in group A and group B, respectively ( p < .0001). Median time to initiate EIBF was 100 min IQR [85–117] in group A compared to 26 minutes IQR [19–37] in group B ( p < .0001). Conclusion Lactation support program is an invaluable key practice for attainment of EIBF. Through simple measures, significant improvement in EIBF was possible in healthy late preterm population. This LSP can be considered as ideal model to be adapted at national level to improvise EIBF.
Diagnostic Utility of the CAN Score and Proportionality Indices and Variations in Neutrophil—and Platelet—Lymphocyte Ratios in Fetal Malnutrition
Authors: Priyanka Olety , Sindgikar Seema Pavaman 
Published: January 2024

Background Nutritional status of neonates is best assessed using clinical assessment of nutrition (CAN) score and proportionality indices. The onset of malnutrition that begins in utero, termed fetal malnutrition (FM), can induce a state of inflammation. This study is aimed at estimating the prevalence of FM in different classes of births along with analysis of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in cord blood as markers of inflammation. Materials and Methods It was a cross-sectional, descriptive study. The proportionality indices—body mass index (BMI), ponderal index (PI), and CAN score—were calculated. PI <2.2, BMI<11.2 kg/m2, and CAN score <25 were indicators of FM. The Chi-square test was used to test the sensitivity and specificity of CAN score against PI and BMI. Results A total of 100 term neonates were included, divided into 3 groups: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Fetal malnutrition was present in 16% of total neonates. The sensitivity and specificity of the CAN score was more than 85% with significant p-value {χ 2 = 33 (PI), χ 2 = 58.8 (BMI)}. Median NLR in FM was 1.63 ± 0.65, significantly ( P < .001) higher than well-nourished neonates. Platelet lymphocyte ratio did not have a significant difference. Clinical assessment of nutrition score showed a positive correlation with maternal ( r = 0.806, P < .001) and neonatal BMI ( r = 0.368, P < .001). Conclusion Proportionality indices and CAN score can be interchangeably used to diagnose FM. The presence of higher NLR values in neonates with FM suggesting an underlying inflammatory process requires closer follow-up.
Comparison of procedural time with two different ultrasound-guided approaches for dorsalis pedis artery cannulation in adult patients: A randomized trial
Authors: Karan Priyabrat , Sharma Ankur , Mukesh Arun , Goyal Shilpa , Rathod Darshna , Kumari Kamlesh , Meshram Tanvi , Kothari Nikhil , Bhatia Pradeep 
Published: January 2024

Background: In adult patients, there has never been an evaluation of short-axis out-of-plane versus long-axis in-plane approaches of ultrasound-guided dorsalis pedis artery cannulation. This research was conducted to compare these two techniques to cannulate the dorsal pedis artery. Methods: In this trial, 128 adult patients undergoing surgery and necessitating arterial cannulation were examined. Dorsalis pedis artery cannulation was performed utilizing an ultrasound by long-axis in-plane approach (group L) or short-axis out-of-plane (group S) techniques. Results: Group S had a higher first attempt success rate than group L (46.9% vs 28.6%, p = 0.039). The S group had a lower assessment time than the L group (11.48 ± 3.07 vs 19.68 ± 2.79 s; p = 0.000). Cannulation time was higher in the S group (18.91 ± 1.92 s) compared to the L group (12.48 ± 1.61 s; p = 0.000). Nevertheless, the total procedure time was comparable between the L group and the S group (32.16 ± 2.95 vs 30.42 ± 4.07 s; p = 0.107). Conclusions: In adults, both views of ultrasonography can be used to guide DPA cannulation. The cannulation time for the DPA in L group was less than the S group, whereas the assessment time was less in S group. The total procedure time, however, was similar between both the groups.
Endovascular Strategies and Outcomes for Aberrant Splenic Artery Aneurysms
Authors: Fang Gang , Lu Yige , Zou Lingwei , Wang Yuning , Fu Weiguo , Dong Zhihui 
Published: January 2024

Objectives: Aberrant splenic artery aneurysms (ASAAs) located at the splenomesenteric trunk (SMT) and the celiacomesenteric trunk have a close anatomical relationship with the superior mesenteric artery (SMA). The aim of this study was to review our institutional experience of endovascular treatment for ASAAs and evaluate the long-term outcomes. Methods: A retrospective review of patients with ASAAs who underwent endovascular treatment between December 2006 and December 2022 was performed. The demographics of the patients, aneurysm characteristics, treatment strategies, perioperative and long-term outcomes, and complications were analyzed. Results: A total of 29 patients with ASAAs were endovascularly treated at our institution. The SMT variant occurred in the majority of the patients. All ASAAs were characterized by eccentric growth and extremely short inflow arteries. Only 1 patient’s inflow artery of the aneurysm exceeded 1 cm in length. Thirteen patients were treated by coil embolization alone. Four patients received bare stent-assisted coil embolization. A combination of coil embolization and covered stent placement across the orifice of the aberrant splenic artery was performed in the remaining 12 cases. Coil migration into the SMA occurred in 2 patients during the operation. Technical success was achieved in all patients. With a median duration of 63 (34–101) months of follow-up, no intestinal ischemia, aneurysm-related death, aneurysm rupture, or sac enlargement occurred. Three cases of aneurysm sac reperfusion were observed, and 1 patient underwent reintervention with secondary embolization. Asymptomatic occlusion of the covered stent was detected in 1 patient at 2 years. Conclusions: Endovascular treatment is a safe, effective, and durable option for ASAAs. Inflow embolization might be difficult to achieve in ASAAs and poses a high risk of coil migration into the SMA. Long-term observation indicates that reasonable use of the covered stent could achieve reliable inflow artery exclusion in ASAAs without intestinal complications. Clinical impact Aberrant splenic artery aneurysm (ASAA) is an extremely rare entity. This study reported a large sample size of ASAAs treated by endovascular techniques with long-term follow-up. The ASAA was characterized by an extremely short inflow artery and a close anatomical relationship with the superior mesenteric artery (SMA). Endovascular treatment is a safe, effective, and durable option for ASAAs. Inflow embolization might be difficult to achieve in ASAAs and pose a high risk of coil migration into the SMA. Long-term observation indicates that reasonable use of the covered stent could achieve reliable inflow artery exclusion in ASAAs without intestinal complications.
Proxy use of patient portals on behalf of children: Federally Qualified Health Centers as a case study
Authors: Dang Patrick , Chavez Arlette , Pham Cecilia , Tipton Mary , Woodard LeChauncy D , Adepoju Omolola E 
Published: January 2024

Objective This study examined the proxy use of patient portals for children in a large Federally Qualified Health Centers (FQHC) network in Texas. Methods We used de-identified individual-level data of patients, 0–18 years, who had 1+ visits between December 2018 and November 2020. Logistic regression was used to examine patient-, clinic-, and geographic-level factors associated with portal usage by an assumed proxy (i.e. parent or guardian). Results The proxy portal usage rate increased from 28% in the pre-pandemic months (November 2018–February 2020) to 34% in the pandemic months (March–Nov 2020). Compared to patients 0–5 years, patients aged 6 to 18 years had lower odds of portal usage (6–10 OR: 0.77, p < 0.001; 11–14 OR: 0.62, p < 0.001; 15–18 OR: 0.51, p < 0.001). Minoritized groups had significantly lower odds of portal usage when compared to their non-Hispanic White counterparts (non-Hispanic Black OR: 0.78, p < 0.001; Hispanic OR 0.63, p < 0.001; Asian OR: 0.69, p < 0.001). Having one chronic condition was associated with portal usage (OR: 1.57, p < 0.001); however, there were no significant differences in portal usage between those with none or multiple chronic conditions. Portal usage also varied by service lines, with obstetrics and gynecology (OR: 1.84, p < 0.001) and behavioral health (OR 1.82, p < 0.001) having the highest odds of usage when compared to pediatrics. Having a telemedicine visit was the strongest predictor of portal usage (OR: 2.30, p < 0.001), while residence in zip codes with poor broadband internet access was associated with lower odds of portal usage (OR: 0.97, p < 0.001). Conclusion While others have reported portal usage rates as high as 64% in pediatric settings, our analysis suggests proxy portal usage rates of 30% in pediatric FQHC settings, with race/ethnicity, age group, and chronic disease status being significant drivers of portal non-usage. These findings highlight the need for appropriate and responsive health information technology approaches for vulnerable populations receiving care in low-resource settings.
Burden of Caregiving for Young Stroke Survivors in the Community: A Cross-sectional Study
Authors: Aghoram Rajeswari , Priya Done Indira , Narayan Sunil K. 
Published: January 2024

Introduction Caring for young stroke survivors presents challenges for carers. Little is known about the burden experienced by them. Aim In this study, we estimated the caregiving burden among carers of young stroke survivors and explored its patterns and determinants. Methods One hundred and fifty young stroke survivors (aged <45 years at index stroke) and their caregivers were recruited in this hospital-based cross-sectional study, three or more months from the stroke. We estimated the burden of caregiving using Burden Assessment Schedule-20 (BAS). Cognitive status, physical disability, and neuropsychiatric symptoms were evaluated using standard instruments. We used descriptive statistics and performed multivariate analysis for factors associated with high burden. We used STATA ver. 14.2, Stata Corp, TX, USA. Results The median age of caregivers was 37.5 years (IQR 12) and 98 (65.3%) were women. The carers were most often spouses (101; 67.3%). The median total BAS score was 28 (IQR 12). Most carers (127; 84.7%) experienced some burden while 15 (10%; 95%CI: 5.2%–14.8%) reported high burden. The most common domain of burden was relationships with others (105; 70%) and marital relationships (66; 65%). Dementia (OR: 2.55; 95%CI: 1.07–6.07) and the presence of neuropsychiatric symptoms (OR: 7.62 95%CI: 2.94–19.81) were associated with an increased burden of caregiving. Conclusion Most caregivers of young stroke survivors experience some burden, with interpersonal relationships being the most common domain. Dementia and neuropsychiatric symptoms are associated with increased burden.
Percutaneous Transcatheter Closure of a Post-device Residual Aorta-pulmonary Window
Authors: R Jyothi Prakash , Murtaza Kamal , V Vasudev 
Published: January 2024

Introduction The aortopulmonary window (APW) is a rare congenital cardiac anomaly in which there is incomplete separation of the pulmonary artery and aorta. Percutaneous transcatheter closure is possible in a specific subset of APWs only, and surgery remains the mainstay of therapy. Clinical summary We report a rare case of percutaneous device closure of post-device residual APW in a 32-month-old baby who had residual shunt post the device closure at two months of age. Discussion Transcatheter closure of an aortopulmonary window is an effective and safe procedure for specific anatomic defects.
Valuable elements in sludge from eight municipal wastewater treatment plants in relation to their recovery potential
Authors: Valchev Dobril , Ribarova Irina , Borisov Boyan , Radovanov Viden , Lyubomirova Valentina , Kostova Irina , Dimova Galina , Karpuzova Orhideya , Lazarova Svetlana 
Published: January 2024

Abstract
Background
The management of sludge from municipal wastewater treatment plants (WWTPs) is a global issue, but also an opportunity for circular reuse. Recent data show that sludge reuse in agriculture has the highest share of all utilization routes in the EU. Council Directive 86/278/EEC on the spreading of sludge in agriculture, adopted more than 35 years ago, is still relevant, notwithstanding the discussion on the need to update it. Extracting critical, strategic, and precious metals and metalloids from sludge is an alternative for sludge reuse, which offers several benefits, such as avoiding the high environmental and health risks associated with using sludge directly in agriculture. Additionally, it allows for the recovery of metals, including those listed as Critical Raw Materials by the European Commission. To implement this alternative, it is necessary to first assess the metal content in the sludge and then develop economically and technically viable technologies. In this study, the content of chemical elements in the sludge of eight full-scale WWTPs in Bulgaria is analysed with focus on: (1) assessing the suitability for agricultural application by evaluating the content of macro- and micronutrients and hazardous metals; (2) assessing the possibility of using the sludge as a source of critical and precious metals.

Results
For the main nutrients, the following contents as a percentage of the sludge dry weight (DW) were recorded—2.06% to 6% for N, 1.52% to 2.67% for P and 0.47% to 0.81% for K, which are in line with case studies of successful sludge application in agriculture. Only sludge samples from two WWTPs exceeded the permitted limit for hazardous metals and metalloids. On the other hand, of the 21 metal and metalloid constituents listed in the EU Critical and Strategic Material (CRM) list, at least one of the examined samples has a content above 10 mg/kg for 15 elements. The average contents in mg/kgDW of Au (1.1), Al (19,272.9), Mg (6677.6), Ti (1730.9), Ga (20.9) and As (16.6) measured in the investigated WWTPs are among the highest or second highest reported in other countries.

Conclusions
The results of the study show prospects for optimising and improving the reuse of sewage sludge in Bulgaria. Sewage sludge from most WWTPs has potential for agricultural application due to its high nutrient content. Large amounts of accumulated critical and strategic metals, gold and silver are trapped in Bulgarian sewage sludge, indicating that sewage sludge could be considered an alternative source with high potential for these valuable elements.
Advances in understanding the genetic architecture of antibody response to paratuberculosis in sheep by heritability estimate and LDLA mapping analyses and investigation of candidate regions using sequence-based data
Authors: Usai Mario Graziano , Casu Sara , Sechi Tiziana , Salaris Sotero L. , Miari Sabrina , Mulas Giuliana , Cancedda Maria Giovanna , Ligios Ciriaco , Carta Antonello 
Published: January 2024

Abstract
Background
Paratuberculosis is a contagious and incurable disease that is caused by Mycobacterium avium subsp. paratuberculosis (MAP) with significant negative effects on animal welfare and farm profitability. Based on a large naturally infected flock over 12 years, we analyzed repeated enzyme-linked immunosorbent assay tests (ELISA), OvineSNP50 BeadChip genotypes and whole-genome sequences imputed from 56 influential animals. The main goals were to estimate the genetic parameters of proxy traits for resistance to MAP, identify genomic regions associated with the host’s immune response against MAP and search for candidate genes and causative mutations through association and functional annotation analyses of polymorphisms identified by sequencing.

Results
Two variables were derived from ELISA tests. The first, a binary variable, assessed the infection status of each animal over the entire productive life, while the second considered the level of antibody recorded over time. Very similar results were obtained for both variables. Heritability estimates of about 0.20 were found and a significant region capturing 18% and 13% of the genetic variance was detected on ovine chromosome 20 by linkage disequilibrium and linkage analysis on OvineSNP50 positions. Functional annotation and association analyses on the imputed sequence polymorphisms that were identified in this region were carried out. No significant variants showed a functional effect on the genes that mapped to this region, most of which belong to the major histocompatibility complex class II (MHC II). However, the conditional analysis led to the identification of two significant polymorphisms that can explain the genetic variance associated with the investigated genomic region.

Conclusions
Our results confirm the involvement of the host’s genetics in susceptibility to MAP in sheep and suggest that selective breeding may be an option to limit the infection. The estimated heritability is moderate with a relevant portion being due to a highly significant region on ovine chromosome 20. The results of the combined use of sequence-based data and functional analyses suggest several genes belonging to the MHC II as the most likely candidates, although no mutations in their coding regions showed a significant association. Nevertheless, information from genotypes of two highly significant polymorphisms in the region can enhance the efficiency of selective breeding programs.
Essential genes identification model based on sequence feature map and graph convolutional neural network
Authors: Hu Wenxing , Li Mengshan , Xiao Haiyang , Guan Lixin 
Published: January 2024

Abstract
Background
Essential genes encode functions that play a vital role in the life activities of organisms, encompassing growth, development, immune system functioning, and cell structure maintenance. Conventional experimental techniques for identifying essential genes are resource-intensive and time-consuming, and the accuracy of current machine learning models needs further enhancement. Therefore, it is crucial to develop a robust computational model to accurately predict essential genes.

Results
In this study, we introduce GCNN-SFM, a computational model for identifying essential genes in organisms, based on graph convolutional neural networks (GCNN). GCNN-SFM integrates a graph convolutional layer, a convolutional layer, and a fully connected layer to model and extract features from gene sequences of essential genes. Initially, the gene sequence is transformed into a feature map using coding techniques. Subsequently, a multi-layer GCN is employed to perform graph convolution operations, effectively capturing both local and global features of the gene sequence. Further feature extraction is performed, followed by integrating convolution and fully-connected layers to generate prediction results for essential genes. The gradient descent algorithm is utilized to iteratively update the cross-entropy loss function, thereby enhancing the accuracy of the prediction results. Meanwhile, model parameters are tuned to determine the optimal parameter combination that yields the best prediction performance during training.

Conclusions
Experimental evaluation demonstrates that GCNN-SFM surpasses various advanced essential gene prediction models and achieves an average accuracy of 94.53%. This study presents a novel and effective approach for identifying essential genes, which has significant implications for biology and genomics research.