bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vein hierarchy mediates the 2D relationship between leaf size and drought tolerance across subtropical forest tree species
Authors: He Pengcheng , Ye Qing , Hua Lei , Zhu Shidan , Liu Hui , Ning Qiurui , Hu Qin , Li Qiang , Qin Xinsheng 
Published: December 2023

Abstract
Previous studies have observed a 2D relationship (i.e. decoupled correlation) between leaf size (LS) and leaf economics as well as a tight correlation between leaf economics and drought tolerance. However, the underlying mechanism maintaining the relationship between LS and drought tolerance remains largely unknown. Here, we measured LS, water potential at 50% loss of hydraulic conductance, hydraulic safety margin and different orders of vein traits across 28 tree species in a subtropical forest in Southern China. We found that LS and drought tolerance were in two independent dimensions (R2 = 0.00, P &gt; 0.05). Primary and secondary vein traits (i.e. vein diameter and density) explained the variation of LS, with R2 ranging from 0.37 to 0.70 (all Ps &lt; 0.01), while minor vein traits accounted for the variation of leaf drought tolerance, with R2 ranging from 0.30 to 0.43 (all Ps &lt; 0.01). Our results provide insight into the 2D relationship between LS and drought tolerance and highlight the importance of vein hierarchy in plant leaf functioning.
Lived Experiences of Hospitalized Patients With Coronavirus Disease at Tibebe Ghion Comprehensive Specialized Hospital, Bahir Dar, North West Ethiopia, A Phenomenological Study
Authors: Yihun Abebe , Ambaw Fentie , Yigzaw Zeamanuel Anteneh 
Published: December 2023

Background
Hospitalized patients with coronavirus disease experienced different challenges at treatment centers; however, there is no evidence in Ethiopia on patients’ experiences at COVID-19 treatment centers. Therefore, the aim of this study was to explore the lived experiences of hospitalized patients with coronavirus disease at Tibebe Ghion Comprehensive Specialized Hospital, Bahir Dar, Ethiopia, in 2021.

Methods
A qualitative phenomenological study design with a heterogeneous purposive sampling technique was used. Fifteen hospitalized patients participated from March 15 to April 1, 2021. The information was gathered through an in-depth interview technique with an audio recorder. Thematic analysis was used to analyze the data using Atlas Ti version 7.09 software.

Result
Hospitalized patients with the coronavirus disease had a variety of experiences with various phenomena. Lived experiences were identified with 2 major themes: the psychoemotional theme has 2 subthemes (psychological and emotional experience), and the context-related experience has 5 subthemes (socioeconomic, patient–health care provider, health facility–related, exposure prevention, and governmental-related factors).

Conclusion
The study identified 2 major themes: 7 subthemes and 10 categories. Study participants faced different challenges, mainly hopelessness, anxiety, a lack of caregiver, isolation, a shortage of medications, poor communication between the patient and health care provider, and a lack of health insurance. Therefore, we recommend giving psychological support, improving communication between patients and health care professionals, and ensuring health insurance.
Gender Differences in Plastic Surgery Trainee Confidence: A Pilot Analysis During Cleft Lip Simulation
Authors: Stanek Krystof , Phillips Nicole , Staffa Steven J. , Saldanha Francesca Y. L. , Rogers-Vizena Carolyn R. 
Published: December 2023

Background:
Underrepresentation of women in plastic surgery remains a concern. This study investigates gender-related differences in self-confidence and surgical ability among plastic surgery trainees in an effort to work toward gender parity.

Methods:
Residents and fellows were recorded performing up to three cleft lip repairs on a high-fidelity simulator. Demographic information was collected, and two questionnaires were completed to assess self-confidence after each simulation. Videos were rated blindly using the objective structured assessment of technical skills and unilateral cleft lip repair competency assessment tool. Differences between participants were estimated using generalized estimating equations modeling, and correlation between overall self-confidence and performance was examined using Pearson correlation (r).

Results:
Twenty-six participants (six self-identified women and 20 self-identified men) completed 73 simulated procedures. There was no gender-related difference in training level, volume of prior experience, speed with which participants completed each simulated procedure, or objective performance. However, a significant difference was found in overall procedural self-confidence, with women rating their confidence lower (mean = 16.9, SD = 4.3) than men (mean = 19.4, SD = 3.8); P = 0.021. Further analysis revealed that confidence scores correlated more strongly with objective performance for women (r = 0.83) than for men (r = 0.45).

Conclusions:
Women plastic surgery trainees overall reported lower self-confidence than their male counterparts, despite demonstrating at least as much skill. Confidence and skill were more closely related for women, suggesting that mentorship focused on concrete skill building may help close the confidence gap.
High Number of Plasma Exchanges Increases the Risk of Bacterial Infection in ABO-incompatible Living Donor Liver Transplantation
Authors: Choi Mun Chae , Min Eun-Ki , Yim Seung Hyuk , Kim Deok-Gie , Lee Jae Geun , Joo Dong Jin , Kim Myoung Soo 
Published: December 2023

Background.
Bacterial infections are major complications that cause significant mortality and morbidity in living donor liver transplantation (LDLT). The risk of bacterial infection has not been studied in ABO-incompatible (ABOi) recipients with a desensitization protocol in relation to the number of plasma exchanges (PEs). Therefore, we aimed to analyze the risk of bacterial infection in ABOi LDLT recipients with a high number of PEs compared with recipients with a low number of PEs.

Methods.
A retrospective study was performed with 681 adult LDLT recipients, of whom 171 ABOi LDLT recipients were categorized into the high (n = 52) or low (n = 119) PE groups based on a cutoff value of 6 PE sessions. We compared bacterial infections and postoperative bacteremia within 6 mo after liver transplantation with the ABO-compatible (ABOc) LDLT group (n = 510) as a control group.

Results.
The high PE group showed a bacterial infection rate of 49.9% and a postoperative bacteremia rate of 28.8%, which were significantly higher than those of the low PE group (31.1%, 17.8%) and the ABOc group (26.7%, 18.0%). In multivariate analysis, the high PE group was found to have a 2.4-fold higher risk of bacterial infection (P = 0.008). This group presented a lower 5-y survival rate of 58.6% compared with the other 2 groups (81.5% and 78.5%; P = 0.030 and 0.001).

Conclusions.
A high number of preoperative PEs increases bacterial infection rate and postoperative bacteremia in ABOi LDLT.
Benchmarking Pediatric Trauma Care in Mixed Trauma Centers: Adult Risk-Adjusted Mortality Is Not a Reliable Indicator of Pediatric Outcomes
Authors: Melhado Caroline , Evans Lauren L , Miskovic Amy , Subacius Haris , Nathens Avery B , Stein Deborah M , Burd Randall S , Jensen Aaron R 
Published: December 2023

BACKGROUND:
Trauma center benchmarking has become standard practice for assessing quality. The American College of Surgeons adult trauma center verification standards do not specifically require participation in a pediatric-specific benchmarking program. Centers that treat adults and children may therefore rely solely on adult benchmarking metrics as a surrogate for pediatric quality. This study assessed discordance between adult and pediatric mortality within mixed trauma centers to determine the need to independently report pediatric-specific quality metrics.

STUDY DESIGN:
A cohort of trauma centers (n = 493, including 347 adult-only, 44 pediatric-only, and 102 mixed) that participated in the American College of Surgeons TQIP in 2017 to 2018 was analyzed. Center-specific observed-to-expected mortality estimates were calculated using TQIP adult inclusion criteria for 449 centers treating adults (16 to 65 years) and using TQIP pediatric inclusion criteria for 146 centers treating children (0 to 15 years). We then correlated risk-adjusted mortality estimates for pediatric and adult patients within mixed centers and evaluated concordance of their outlier status between adults and children.

RESULTS:
The cohort included 394,075 adults and 97,698 children. Unadjusted mortality was 6.1% in adults and 1.2% in children. Mortality estimates had only moderate correlation (r = 0.41) between adult and pediatric cohorts within individual mixed centers. Mortality outlier status for adult and pediatric cohorts was discordant in 31% (32 of 102) of mixed centers (weighted Kappa statistic 0.06 [−0.11 to 0.22]), with 78% (23 of 32) of discordant centers having higher odds of mortality for children than for adults (6 centers with average adult mortality and high pediatric mortality and 17 centers with low adult mortality and average pediatric mortality, p < 0.01).

CONCLUSIONS:
Adult mortality is not a reliable surrogate for pediatric mortality in mixed trauma centers. Incorporation of pediatric-specific benchmarks should be required for centers that admit children.
Do You Know Your Daily Antibiotic Intake through Residues in Your Diet?
Authors: Seo Jegak , Kloprogge Frank , Smith Andrew M. , Karu Kersti , Ciric Lena 
Published: December 2023

AbstractWhile the use of a wide range of antibiotics has been reported as extensive in the rearing of agricultural animals, extremely limited information is available on the antibiotic residues in animal products and the adverse impact consistent low-level exposure to antibiotics might have on the human body as well as its microbiome. The aim of this study was to estimate the possible antibiotic concentrations humans are exposed to via their diet using the concentration of antibiotics in animal food products and water, and an online survey on dietary habits. A total of 131 participants completed the dietary habits survey, the majority belonging to the omnivorous diet habit. Distinct dietary trends were observed into omnivorous and unknown groups eating food-producing animal products, with specific food types dominating each meal: pork (e.g. ham) and dairy products (e.g. milk, yoghurt) during breakfast, beef (e.g. burger) and chicken (e.g. chicken breast) products during lunch, and fish (e.g. salmon fillet) during dinner. 34 different animal-based food and drink products were tested for the presence of ten different antibiotics. Low levels of nine of the ten antibiotics were detected across the samples tested with amoxicillin and trimethoprim being the most frequently detected antibiotics from all samples with concentrations ranging from 216.7-6866.9 μg/kg and 55.2-461.7 μg/kg, respectively. Of all products tested, over 35% exceeded the acceptable daily intake antibiotic concentration for amoxicillin, ampicillin, and enrofloxacin.
ERG1A K+Channel Increases Intracellular Calcium Concentration through Modulation of Calsequestrin1 in C2C12Myotubes
Authors: Hockerman Gregory H. , Pratt Evan , Guha Shalini , LaVigne Emily , Whitmore Clayton , Khader Omar , McClure Natalie , Zampieri Sandra , Koran Jennifer , Wang W-H , Pond Amber L. 
Published: December 2023

ABSTRACTThe ERG1A K+channel modulates the protein degradation that contributes to skeletal muscle atrophy by increasing intracellular calcium concentration ([Ca2+]i) and enhancing calpain activity, but the mechanism by which the channel regulates the [Ca2+]i is not known. Here, we have investigated the effect of human ERG1A (HERG) on [Ca2+]i in C2C12myotubes, using Fura-2 calcium assays, immunoblot, RT-qPCR, and electrophysiology. We hypothesized that HERG would modulate L-type calcium channel activity, specifically the Cav1.1 channel known to carry signal from the sarcoplasmic membrane of skeletal muscle to the sarcomeres of the myofibrils. However, we find that HERG has no effect on the amplitude of L-type channel current nor does it affect the mRNA levels nor protein abundance of the Cav1.1 channel. Instead we find that, although the rise in [Ca2+]i (induced by depolarization) is greater in myotubes over-expressing HERG relative to controls, the difference between the KCl-stimulated Ca2+increase in control and HERG over-expressing cells cannot be accounted for by L-type channel mediated Ca2+influx, which suggests that HERG could modulate excitation coupled calcium entry (ECCE). Indeed, the HERG-enhanced increase in [Ca2+]i induced by depolarization is blocked by 2-APB, an inhibitor of ECCE (and SOCE). Further, we show data suggesting that HERG also modulates the activity of ryanodine receptors, a component of ECCE, as well as store operated calcium entry (SOCE). Therefore, we investigated the effect of HERG on calsequestrin1, a calcium buffering/binding protein known to modulate ryanodine receptor 1 and store operated Ca2+entry activities. Indeed, we find that calsequestrin1 mRNA levels are decreased 0.83-fold (p<0.05) and the total protein abundance is lowered 77% (p<0.05) in myotubes over-expressing HERG relative to controls. In summary, the data show that ERG1A overexpression modulates [Ca2+]i in skeletal muscle cells by lowering the abundance of the calcium buffering/binding protein calsequestrin1.
TSpred: a robust prediction framework for TCR-epitope interactions based on an ensemble deep learning approach using paired chain TCR sequence data
Authors: Kim Ha Young , Kim Sungsik , Park Woong-Yang , Kim Dongsup 
Published: December 2023

ABSTRACTPrediction of T-cell receptor (TCR)-epitope interactions is important for many applications such as cancer immunotherapy. However, due to the scarcity of available data, it is known to be a challenging task particularly for novel epitopes. Here, we propose TSpred, a new ensemble deep learning approach for the pan-specific prediction of TCR binding specificity based on paired chain TCR data. This method combines the predictive power of CNN and the attention mechanism to capture the patterns underlying TCR-epitope interactions. In particular, we design a reciprocal attention mechanism which contributes to higher model generalizability to unseen epitopes. We perform a comprehensive evaluation of our model and observe that TSpred achieves state-of-the-art performances in both seen and unseen epitope specificity prediction tasks. Our model performs consistently well across both of the two widely used negative sampling strategies, while avoiding the potential bias associated with each strategy. Also, compared to other predictors, it is more robust to bias related to peptide imbalance in the dataset. In addition, the reciprocal attention component of our model allows for model interpretability by capturing structurally important binding regions. Results indicate that TSpred is a robust and reliable method for the task of TCR-epitope binding prediction.
Mitochondrial DNA Copy Number Variation in Asthma Risk, Severity, and Exacerbations
Authors: Xu Weiling , Hong Yun Soo , Hu Bo , Comhair Suzy A. A. , Janocha Allison J. , Zein Joe G. , Chen Ruoying , Meyers Deborah A. , Mauger David T. , Ortega Victor E. , Bleecker Eugene R. , Castro Mario , Denlinger Loren C. , Fahy John V. , Israel Elliot , Levy Bruce D. , Jarjour Nizar N. , Moore Wendy C. , Wenzel Sally E. , Gaston Benjamin , Liu Chunyu , Arking Dan E. , Erzurum Serpil C. ,   the National Heart, Lung, and Blood Institute (NHLBI) Severe Asthma Research Program (SARP),   TOPMed mtDNA Working Group in NHLBI Trans-Omics for Precision Medicine (TOPMed) Consortium
Published: December 2023

AbstractRationaleAlthough airway oxidative stress and inflammation are central to asthma pathogenesis, there is limited knowledge of the relationship of asthma risk, severity, or exacerbations to mitochondrial dysfunction, which is pivotal to oxidant generation and inflammation.ObjectivesWe investigated whether mitochondrial DNA copy number (mtDNA-CN) as a measure of mitochondrial function is associated with asthma diagnosis, severity, oxidative stress, and exacerbations.MethodsWe measured mtDNA-CN in blood in two cohorts. In the UK Biobank (UKB), we compared mtDNA-CN in mild and moderate-severe asthmatics to non-asthmatics. In the Severe Asthma Research Program (SARP), we evaluated mtDNA-CN in relation to asthma severity, biomarkers of oxidative stress and inflammation, and exacerbations.Measures and Main ResultsIn UK Biobank, asthmatics (n= 29,768) have lower mtDNA-CN compared to non-asthmatics (n= 239,158) (beta, -0.026 [95% CI, -0.038 to -0.014],P= 2.46×10-5). While lower mtDNA-CN is associated with asthma, mtDNA-CN did not differ by asthma severity in either UKB or SARP. Biomarkers of inflammation show that asthmatics have higher white blood cells (WBC), neutrophils, eosinophils, fraction exhaled nitric oxide (FENO), and lower superoxide dismutase (SOD) than non-asthmatics, confirming greater oxidative stress in asthma. In one year follow-up in SARP, higher mtDNA-CN is associated with reduced risk of three or more exacerbations in the subsequent year (OR 0.352 [95% CI, 0.164 to 0.753],P= 0.007).ConclusionsAsthma is characterized by mitochondrial dysfunction. Higher mtDNA-CN identifies an exacerbation-resistant asthma phenotype, suggesting mitochondrial function is important in exacerbation risk.
Fluctuations in serum adrenocorticotropic hormone concentration may predict the onset of immune checkpoint inhibitor-related hypophysitis
Authors: Bando Hironori , Yamamoto Masaaki , Urai Shin , Motomura Yuma , Sasaki Yuriko , Ohmachi Yuka , Kobatake Masaki , Tsujimoto Yasutaka , Oi-Yo Yuka , Suzuki Masaki , Yamamoto Naoki , Takahashi Michiko , Fukuoka Hidenori , Iguchi Genzo , Ogawa Wataru 
Published: December 2023

AbstractBackgroundImmune checkpoint inhibitor (ICI)-related hypophysitis (RH) is a common immune-related adverse event. The early detection of ICI-RH prevents life-threatening adrenal insufficiency. However, good predictors of secondary adrenal insufficiency in ICI-RH have not yet been reported. We hypothesized that fluctuations in serum adrenocorticotropic hormone (ACTH) and cortisol levels occur similarly to those in thyroid-stimulating hormone and thyroid hormones (thyroxine and triiodothyronine) in ICI-related thyroiditis. Here, we sought to test this hypothesis.MethodsPatients who used ICI and had a history of measurement of serum ACTH and cortisol concentrations were retrieved from electronic medical records, and those with a history of glucocorticoid use were excluded from the analysis. We evaluated fluctuations in serum ACTH and cortisol concentrations and the development of ICI-RH. For patients with ICI-RH, data at three points (before ICI administration [pre], maximum ACTH concentration [peak], and onset of ICI-RH) were analyzed to evaluate hormone fluctuations.ResultsA total of 202 patients were retrieved from the medical record. Forty-three patients were diagnosed with ICI-RH. Twenty-six out of 43 patients had sufficient data to evaluate fluctuations in serum ACTH and cortisol concentrations and no history of glucocorticoid use. ACTH concentrations changed from 37.4 [29.9–48.3] (pre) to 64.4 [46.5–106.2] pg/mL (peak) (1.72–fold increase,p= 0.0026) in the patients with ICI-RH before the onset. There were no differences in cortisol concentrations between the pre and peak values in patients with ICI-RH. We also evaluated the fluctuations in serum ACTH and cortisol levels in patients who did not receive ICI-RH (62 cases). However, elevation of serum ACTH levels was not observed in patients without ICI-RH, suggesting that transient elevation of serum ACTH is a unique phenomenon in patients with ICI-RH.ConclusionsSerum ACTH levels were transiently elevated in some patients with ICI-RH before the onset of secondary adrenal insufficiency. Monitoring the ACTH levels and their fluctuations can help predict the onset of ICI-RH.
Cost minimization analysis of treatments for metastatic HER2-positive breast cancer: Fixed-Dose combination of pertuzumab and trastuzumab for subcutaneous injections
Authors: Figallo Miguel , Delgado María F. , Gonzalez Mauricio , Arenas Adrián 
Published: December 2023

AbstractThe main objective of this study is to determine whether the employment of fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection (or Phesgo) to treat metastatic HER2-positive breast cancer patients would minimize costs compared to the traditional treatment of separate intravenous doses of pertuzumab and trastuzumab in Peru. To achieve this, we used EsSalud (the social security health insurance) data and assessed it through a mixed strategy, which consisted of a quantitative and a qualitative approach. The first one aimed to calculate the direct (non-drug consumables, drugs, and healthcare professionals) and indirect costs of both treatments to develop a comparison, whilst the second aimed to validate information and internalize the procedure in an EsSalud context.Overall, we found that the usage of Phesgo would be cost saving in EsSalud’s context. Specifically, we found three main insights. Firstly, the savings produced from switching from the traditional intravenous treatment to the subcutaneous one would allow EsSalud to afford full annual costs of 2 additional treatments, but without increasing their budget. This would cover 7% of the gap of 29 patients who do not have access to full treatment. Secondly, the result of a univariate sensitivity analysis in this work indicates that the price of Phesgo would have to increase by 16% so that both treatments cost the same. Thirdly, to increase the number of patients, the intravenous treatment would have to be totally replace by the Phesgo treatment, since the use of the latter requires less personnel and infrastructure.
Heart size disparity drives sex-specific response to cardiac resynchronization therapy: a post-hoc analysis of the MORE-MPP CRT trial
Authors: Wijesuriya Nadeev , Mehta Vishal , De Vere Felicity , Howell Sandra , Niederer Steven A , Burri Haran , Sperzel Johannes , Calo Leonardo , Thibault Bernard , Lin Wenjiao , Lee Kwangdeok , Grammatico Andrea , Varma Niraj , Gwechenberger Marianne , Leclercq Christophe , Rinaldi Christopher A 
Published: December 2023

AbstractBackgroundStudies have reported that female sex predicts superior cardiac resynchronization therapy (CRT) response. One theory is that this association is related to smaller female heart size, thus increased “relative dyssynchrony” at given QRS durations (QRSd).ObjectiveTo investigate the mechanisms of sex-specific CRT response relating to heart size, relative dyssynchrony, cardiomyopathy type, QRS morphology, and other patient characteristics.MethodsA post-hoc analysis of the MORE-CRT MPP trial (n=3739, 28% female), with a sub-group analysis of patients with non-ischaemic cardiomyopathy (NICM) and left bundle branch block (LBBB) (n=1308, 41% female) to control for confounding characteristics. A multivariable analysis examined predictors of response to 6 months of conventional CRT, including sex and relative dyssynchrony, measured by QRSd/LVEDV (left ventricular end-diastolic volume).ResultsFemales had a higher CRT response rate than males (70.1% vs. 56.8%, p<0.0001).Subgroup analysis:Regression analysis of the NICM LBBB subgroup identified QRSd/LVEDV, but not sex, as a modifier of CRT response (p<0.0039). QRSd/LVEDV was significantly higher in females (0.919) versus males (0.708, p<0.001). CRT response was 78% for female patients with QRSd/LVEDV>median value, compared to 68% < median value (p=0.012). Association between CRT response and QRSd/LVEDV was strongest at QRSd<150ms.ConclusionsIn the NICM LBBB population, increased relative dyssynchrony in females, who have smaller heart sizes than their male counterparts, is a driver of sex-specific CRT response, particularly at QRSd <150ms. Females may benefit from CRT at a QRSd <130ms, opening the debate on whether sex-specific QRSd cut-offs or QRS/LVEDV measurement should be incorporated into clinical guidelines.