bluuebunny/crossref_metadata_2025_split huggingface dataset:
AefR, a TetR Family Transcriptional Repressor, Regulates Several Auxin Responses in Pseudomonas syringae Strain PtoDC3000
Authors: Johnson Joshua M. B. , Kunkel Barbara N. 
Published: December 2023

The plant hormone indole-3-acetic acid (IAA), also known as auxin, plays important roles in plant growth and development, as well as in several plant–microbe interactions. IAA also acts as a microbial signal and in many bacteria regulates metabolism, stress responses, and virulence. In the bacterial plant pathogen Pseudomonas syringae pv. tomato strain DC3000 ( PtoDC3000), exposure to IAA results in large-scale transcriptional reprogramming, including the differential expression of several known virulence genes. However, how PtoDC3000 senses and responds to IAA and what aspects of its biology are regulated by IAA is not understood. To investigate the mechanisms involved in perceiving and responding to IAA, we carried out a genetic screen for mutants with altered responses to IAA. One group of mutants of particular interest carried disruptions in the aefR gene encoding a TetR family transcriptional regulator. Gene expression analysis confirmed that the aefR mutants have altered responses to IAA. Thus, AefR is the first demonstrated auxin response regulator in PtoDC3000. We also investigated several aspects of PtoDC3000 biology that are regulated by both AefR and IAA, including antibiotic resistance, motility, and virulence. The observation that the aefR mutant has altered virulence on Arabidopsis, suggests that the sector of the IAA response regulated by aefR is important during pathogenesis. Our findings also provide evidence that AefR plays a role in coordinating changes in gene expression during the transition from early to late stages of infection. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Characterization of Ralstonia pseudosolanacearum Diversity and Screening Tomato, Pepper, and Eggplant Resistance to Manage Bacterial Wilt in South Asia
Authors: Subedi Nagendra , Cowell Tabitha , Cope-Arguello Matthew , Paul Pierce , Cellier Gilles , Bkayrat Hashem , Bonagura Nicolas , Cadatal Angela , Chen Rachel , Enriquez Ariana , Parasar Rama , Repetto Lisa , Rivas Aracely Hernandez , Shahbaz Mahnoor , White Kaitlin , Lowe-Power Tiffany M. , Miller Sally A. 
Published: December 2023

In South Asia, bacterial wilt pathogens in the Ralstonia solanacearum species complex (RSSC) impose major constraints on eggplant, tomato, and pepper production. To improve the efficacy of bacterial wilt management, the goals of this study were to (i) conduct a survey of RSSC pathogens in Bangladesh and Nepal, (ii) characterize the genetic diversity of these isolates, and (iii) screen 37 tomato, eggplant, and pepper accessions for resistance to six representative isolates from South Asia. We isolated 99 isolates from Bangladesh and 20 isolates from Nepal and determined that all are phylotype I isolates of the Ralstonia pseudosolanacearum species. We sequenced and assembled draft genomes for 25 isolates. Phylogenomic analyses suggest that there is a wide diversity of endemic phylotype I isolates in South Asia and possible introductions of two clonal phylotype I lineages into Bangladesh and Nepal. We contextualize our newly described isolates based on prior reports of RSSC diversity in South Asia and global reports of RSSC pathogens on eggplant and pepper. Greenhouse trials revealed multiple tomato, eggplant, and pepper accessions that exhibit promising levels of resistance to six phylotype I isolates from South Asia. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Differences in Hearing Devices and Speech Therapy Utilization Between Children With Permanent Unilateral Versus Bilateral Hearing Loss
Authors: Brodie Kara D. , Florentine Michelle M. , Taketa Emily , Ho Melissa , Chan Dylan K. 
Published: December 2023

Objectives:
In this study, we aimed to describe differences in diagnosis and both auditory and speech/language intervention utilization between children with permanent unilateral hearing loss as compared with bilateral hearing loss.

Design:
A retrospective cohort study was performed of children evaluated in a multidisciplinary hearing loss clinic at a tertiary care pediatric hospital. Children aged 0 to 18 years with either permanent unilateral or bilateral hearing loss were included.

Results:
One hundred fourteen children with unilateral hearing loss and 268 children with bilateral hearing loss were studied for a total of 382 children. There were no demographic differences between children with permanent unilateral versus bilateral hearing loss. Rates of newborn hearing screening and referred screening results were similar between those with unilateral and bilateral hearing loss. Despite similar rates of referred newborn hearing screening, those with bilateral hearing loss were diagnosed at a younger age (mean 3.6 years, SD 3.8 years) as compared with those with unilateral hearing loss (mean 5.0 years, SD 4.2 years). Children with unilateral hearing loss had similar severity of hearing loss in their poorer hearing ear as compared with children with bilateral hearing loss, yet they were significantly less likely to be fitted with hearing devices (53% versus 78%) or receive speech/language therapy (36% versus 54%) as compared with children with bilateral hearing loss. Multivariate analysis found that bilateral hearing loss and earlier age of hearing loss diagnosis were associated with hearing device use.

Conclusions:
Early diagnosis and intervention for childhood hearing loss have a significant impact on a child’s educational success and social relationships. However, little is known about differences in diagnosis and resource utilization between children with permanent unilateral hearing loss versus bilateral hearing loss. Children with unilateral hearing loss were diagnosed at a later age and were less likely to utilize hearing devices or speech/language therapy compared with those with bilateral hearing loss, despite having similar severity of hearing loss in the poorer hearing ear. There is a strong body of evidence that children with unilateral hearing loss have improved hearing outcomes with hearing devices, which suggests there is room for improvement in identifying unilateral hearing loss and providing adequate services to optimize educational success. However, speech therapy is generally implemented in response to language delays. Therefore, children with unilateral loss may have lower rates of language delays as compared with those with bilateral hearing loss, thereby explaining differences in speech therapy utilization.
Practical Methods of Assessing Coronal Alignment and Outcomes in Adult Spinal Deformity Surgery
Authors: Shen Yong , Sardar Zeeshan M. , Greisberg Gabriella , Katiyar Prerana , Malka Matan , Hassan Fthimnir , Reyes Justin , Zuckerman Scott L. , Marciano Gerard , Lombardi Joseph M. , Lehman Ronald A. , Lenke Lawrence G. ,   Multi-Ethnic Normative Alignment Study (MEANS) Group
Published: December 2023

Study Design.
Asymptomatic cohort: prospective, cross-sectional, multicenter. Symptomatic: retrospective, multisurgeon, single-center.

Objective.
To assess the association between cranial coronal alignment and adult spinal deformity (ASD) surgical risk and outcomes.

Summary of Background Data.
ASD leads to decreased quality of life. Studies have shown that coronal malignment (CM) is associated with worse surgical outcomes.

Materials and Methods.
A total of 468 adult participants were prospectively enrolled in the asymptomatic cohort. Totally, 172 symptomatic ASD patients with 2-year follow-ups were retrospectively enrolled in the symptomatic cohort. Three cranial plumb line parameters: the positions of the plumb lines from the midpoint between the medial orbital rims (ORB-L5), the odontoid (OD-L5), and the C7 centroid (C7-L5) relative to the L5 pedicle, were measured. Each subject had plumb line medial (M), touching (T), or lateral (L) to either pedicle. The association between each group of patients and radiographic parameters, intraoperative variables, patient-reported outcomes, and clinical outcomes were analyzed.

Results.
In the asymptomatic cohort, OD-L5 was medial to or touching the L5 pedicle in 98.3% of volunteers. In the symptomatic patients, preoperative OD-L5-L exhibited higher mean age (56.2±14.0), odontoid-coronal vertical axis (OD-CVA) (5.5±3.3 cm), Oswestry disability index (ODI) score (40.6±18.4), pelvic fixation rate (56/62, 90.3%), OR time (528.4±144.6 min), median estimated blood loss (1300 ml), and durotomy rate (24/62, 38.7%). A similar pattern of higher CVA, preoperative ODI, intraoperative pelvic fixation rate, OR time, estimated blood loss, and durotomy rate was observed in ORB-L5-L and C7-L5-L patients. Final follow-up postoperative OD-L5-L was associated with higher rates of proximal junctional kyphosis (13.0%) and pseudarthrosis (17.4%).

Conclusion.
Preoperative OD-L5, ORB-L5, and C7-L5 lateral to pedicles were associated with worse preoperative ODI and higher intraoperative complexity. Postoperative OD-L5-L was associated with higher rates of proximal junctional kyphosis and pseudarthrosis. Postoperative CM, approximated by the cranial plumb line lateral to the L5 pedicles, was associated with sagittal plane complications.
Inborn errors of type I interferon immunity in patients with symptomatic acute hepatitis E
Authors: Saadat Ali , Gouttenoire Jérôme , Ripellino Paolo , Semela David , Amar Soraya , Frey Beat M. , Fontana Stefano ,   HEV Human Genetics Collaborators, Mdawar-Bailly Elise , Moradpour Darius , Fellay Jacques , Fraga Montserrat 
Published: December 2023

Background and Aims:
The clinical spectrum of human infection by HEV ranges from asymptomatic to severe acute hepatitis. Furthermore, HEV can cause diverse neurological manifestations, especially Parsonage-Turner syndrome. Here, we used a large-scale human genomic approach to search for genetic determinants of severe clinical presentations of HEV infection.

Approach and Results:
We performed whole genome sequencing in 3 groups of study participants with PCR-proven acute HEV infection: (1) 24 patients with symptomatic acute hepatitis E; (2) 12 patients with HEV-associated Parsonage-Turner syndrome; and (3) 16 asymptomatic blood donors (controls). For variant calling and annotation, we used GATK4 best practices followed by Variant Effect Predictor (VEP) and Annovar. For variant classification, we implemented the American College of Medical Genetics and Genomics/Association for Molecular Pathology Bayesian classification framework in R. Variants with a probability of pathogenicity >0.9 were considered damaging. We used all genes with at least 1 damaging variant as input for pathway enrichment analyses.
We observed a significant enrichment of type I interferon response pathways in the symptomatic hepatitis group: 10 out of 24 patients carried a damaging variant in one of 9 genes encoding either intracellular viral sensors (IFIH1, DDX58, TLR3, POLR3B, POLR3C) or other molecules involved in type I interferon response [interferon regulatory factor 7 (IRF7), MYD88, OAS3, GAPDH]. We did not find any enriched pathway in the Parsonage-Turner syndrome group or in the controls.

Conclusions:
Our results highlight the essential role of type I interferon in preventing symptomatic acute hepatitis E.
Insufficiency of plasmatic arginine/homoarginine during the initial postoperative phase among patients with tumors affecting the medulla oblongata heightens the likelihood of neurogenic pulmonary oedema following surgery
Authors: Wang Liang , Zhang Qing , Zhang Yuan , Zheng Guanghui , Wang Ke , Wu Zhen , Zhang Junting , Jia Wang , Zhang Guojun 
Published: December 2023

Background:
This prospective clinical study aims to investigate the fluctuations of neurotransmitters in peripheral venous blood during the perioperative period and to identify independent predictors for postoperative neurogenic pulmonary oedema (NPE) in patients with medulla oblongata-involved tumours.

Materials and methods:
Peripheral venous blood samples of the enroled patients at seven perioperative time points, as well as their medical records and radiologic data were collected. High-performance liquid chromatography-tandem mass spectrometry was utilized to detect the concentrations of 39 neurotransmitters in these samples. The study applied univariate and multivariate generalized estimating equation (GEE) logistic regression analyses to explore independent predictors of postoperative NPE, and one-way repeated-measures ANOVA to compare the concentrations of the same neurotransmitter at different perioperative time points.

Results:
The study included 36 patients with medulla oblongata-involved tumours from January to December 2019, and found that 13.9% of them experienced postoperative NPE. The absence of intraoperative use of sevoflurane (P=0.008), decreased concentrations of arginine (P=0.026) and homoarginine (P=0.030), and prolonged postoperative tracheal extubation (P<0.001) were identified as independent risk factors for postoperative NPE in medulla oblongata-involved tumour patients. Pairwise comparison analysis revealed that the perioperative decreases in arginine and homoarginine concentrations mainly occurred within the postoperative 8 h.

Conclusion:
This study demonstrates that NPE is not uncommon in patients with medulla oblongata-involved tumours. The absence of intraoperative use of sevoflurane, decreased concentrations of plasmatic arginine and homoarginine, and prolonged postoperative tracheal extubation are independent predictors of postoperative NPE. These two neurotransmitters’ concentrations dropped mainly within the early postoperative hours and could serve as potential early warning indicators of postoperative NPE in clinical practice.
Decoding surgical skill: an objective and efficient algorithm for surgical skill classification based on surgical gesture features –experimental studies
Authors: Chen Zixin , Yang Dewei , Li Ang , Sun Louzong , Zhao Jifan , Liu Jie , Liu Linxun , Zhou Xiaobo , Chen Yonghua , Cai Yunqiang , Wu Zhong , Cheng Ke , Cai He , Tang Ming , Peng Bing , Wang Xin 
Published: December 2023

Background:
Various surgical skills lead to differences in patient outcomes and identifying poorly skilled surgeons with constructive feedback contributes to surgical quality improvement. The aim of the study was to develop an algorithm for evaluating surgical skills in laparoscopic cholecystectomy based on the features of elementary functional surgical gestures (Surgestures).

Materials and methods:
Seventy-five laparoscopic cholecystectomy videos were collected from 33 surgeons in five hospitals. The phase of mobilization hepatocystic triangle and gallbladder dissection from the liver bed of each video were annotated with 14 Surgestures. The videos were grouped into competent and incompetent based on the quantiles of modified global operative assessment of laparoscopic skills (mGOALS). Surgeon-related information, clinical data, and intraoperative events were analyzed. Sixty-three Surgesture features were extracted to develop the surgical skill classification algorithm. The area under the receiver operating characteristic curve of the classification and the top features were evaluated.

Results:
Correlation analysis revealed that most perioperative factors had no significant correlation with mGOALS scores. The incompetent group has a higher probability of cholecystic vascular injury compared to the competent group (30.8 vs 6.1%, P=0.004). The competent group demonstrated fewer inefficient Surgestures, lower shift frequency, and a larger dissection-exposure ratio of Surgestures during the procedure. The area under the receiver operating characteristic curve of the classification algorithm achieved 0.866. Different Surgesture features contributed variably to overall performance and specific skill items.

Conclusion:
The computer algorithm accurately classified surgeons with different skill levels using objective Surgesture features, adding insight into designing automatic laparoscopic surgical skill assessment tools with technical feedback.
Intraoperative strategies in identification and functional protection of parathyroid glands for patients with thyroidectomy: a systematic review and network meta-analysis
Authors: Lu Dengwei , Pan Bin , Tang Enjie , Yin Supeng , Sun Yiceng , Yuan Yuquan , Yin Tingjie , Yang Zeyu , Zhang Fan 
Published: December 2023

Background:
This study aimed to assess the benefits and limitations of four intraoperative visualization of parathyroid gland (IVPG) strategies in the identification and functional protection of parathyroid glands (PGs).

Methods:
We searched PubMed, the Cochrane Central Register of Controlled Trials, CNKI, EMBASE, Web of Science and Google Scholar databases until 30 June 2023. Four IVPG strategies were composed of the naked eyes (NE) and three imaging strategies: autofluorescence (AF), indocyanine green fluorescence (ICGF), and carbon nanoparticles (CN). We performed a pairwise meta-analysis (PMA) for direct comparisons and a Bayesian network meta-analysis (NMA) for indirect comparisons.

Results:
A total of 29 eligible studies were included. According to NMA and PMA, AF had significantly lower rates of postoperative hypocalcemia and hypoparathyroidism, PG inadvertent resection, and PG auto-transplantation compared to NE, while had significantly higher rate of PG identification. CN showed significantly lower rates of postoperative hypocalcemia and hypoparathyroidism, and PG inadvertent resection compared to NE in PMA and NMA. ICGF showed a significantly higher rate of PG auto-transplantation compared to NE in PMA and AF in NMA. According to SUCRA values, AF showed the best advantage in reducing the rate of postoperative hypocalcemia (0.85) and PG inadvertent resection (0.89), and increasing the rate of PG identification (0.80). CN had the greatest advantage in reducing the rate of postoperative hypoparathyroidism (0.95). ICGF ranked the highest in the rate of PG auto-transplantation (0.98).

Conclusions:
Three imaging strategies demonstrate significant superiority over NE in the intraoperative PG identification and functional protection. AF is the best strategy in reducing the incidence of postoperative hypocalcemia, increasing the rate of PG identification, and reducing the rate of PG inadvertent resection and auto-transplantation. ICGF has great value in assessing PG viability, leading to the trend towards PG auto-transplantation. CN is the best strategy in reducing the incidence of postoperative hypoparathyroidism.
Combining the Hospital Frailty Risk Score With the Charlson and Elixhauser Multimorbidity Indices to Identify Older Patients at Risk of Poor Outcomes in Acute Care
Authors: Gilbert Thomas , Cordier Quentin , Polazzi Stéphanie , Street Andrew , Conroy Simon , Duclos Antoine 
Published: December 2023

Objective:
The Hospital Frailty Risk Score (HFRS) can be applied to medico-administrative datasets to determine the risks of 30-day mortality and long length of stay (LOS) in hospitalized older patients. The objective of this study was to compare the HFRS with Charlson and Elixhauser comorbidity indices, used separately or combined.

Design:
A retrospective analysis of the French medical information database. The HFRS, Charlson index, and Elixhauser index were calculated for each patient based on the index stay and hospitalizations over the preceding 2 years. Different constructions of the HFRS were considered based on overlapping diagnostic codes with either Charlson or Elixhauser indices. We used mixed logistic regression models to investigate the association between outcomes, different constructions of HFRS, and associations with comorbidity indices.

Setting:
743 hospitals in France.

Participants:
All patients aged 75 years or older hospitalized as an emergency in 2017 (n=1,042,234).
Main outcome measures: 30-day inpatient mortality and LOS >10 days.

Results:
The HFRS, Charlson, and Elixhauser indices were comparably associated with an increased risk of 30-day inpatient mortality and long LOS. The combined model with the highest c-statistic was obtained when associating the HFRS with standard adjustment and Charlson for 30-day inpatient mortality (adjusted c-statistics: HFRS=0.654; HFRS + Charlson = 0.676) and with Elixhauser for long LOS (adjusted c-statistics: HFRS= 0.672; HFRS + Elixhauser =0.698).

Conclusions:
Combining comorbidity indices and HFRS may improve discrimination for predicting long LOS in hospitalized older people, but adds little to Charlson’s 30-day inpatient mortality risk.
Factors associated with postoperative quality of life in patients with intertrochanteric fracture
Authors: Ramezani Akam , Babagoli Mazyar , Ghaseminejad-Raeini Amirhossein , Golbakhsh Mohammadreza , Shafiei Seyyed Hossein 
Published: December 2023

Introduction:
Intertrochanteric fractures, which make up the majority of hip fractures, are a common and serious injury that can greatly impact quality of life. Treatment of such fractures comprises nearly half of the costs contributed to hip fractures. Identifying the factors affecting the functional outcomes of patients after intertrochanteric fracture can help to reduce burden of disease for the patient and healthcare system. The present study investigated the factors underlying the worsening of short form-36 score (SF-36) scores for intertrochanteric fracture patients.

Materials and methods:
This retrospective cohort study was designed based on data from our clinic. All consecutive patients with intertrochanteric fractures from November 2016 to September 2020 were reviewed. The exclusion criteria included patients having a second injury or having had previous surgery related to the hip and those with incomplete data. Baseline characteristics of patients were extracted from annotated records. The lab data were acquired from the electronic hospital system. The outcomes were SF-36 scores obtained by phone contact with patients or their families. Statistical analysis was conducted in SPSS.

Results:
A total of 310 patients were included in the current study. The female gender, advanced age, history of diabetes, thyroid malfunction, cancer, osteoporosis, anticoagulant use and blood transfusion were identified as risk factors for lower SF-36 scores. Low levels of haemoglobin before surgery, blood urea nitrogen (BUN), BUN/Creatinine, and white blood count values correlated with lower SF-36 scores.

Conclusion:
Numerous contextual variables affected the functional outcomes of the patients. Consideration of these factors could be helpful in reducing costs and improving the quality of life for intertrochanteric fracture patients.