bluuebunny/crossref_metadata_2025_split huggingface dataset:
Key hydraulic traits control the dynamics of plant dehydration in four contrasting tree species during drought
Authors: Blackman Chris J , Billon Lise-Marie , Cartailler Julien , Torres-Ruiz José M , Cochard Hervé 
Published: June 2023

Abstract
Trees are at risk of mortality during extreme drought, yet our understanding of the traits that govern the timing of drought-induced hydraulic failure remains limited. To address this, we tested SurEau, a trait-based soil–plant–atmosphere model designed to predict the dynamics of plant dehydration as represented by the changes in water potential against those observed in potted trees of four contrasting species (Pinus halepensis Mill., Populus nigra L., Quercus ilex L. and Cedrus atlantica (Endl.) Manetti ex Carriére) exposed to drought. SurEau was parameterized with a range of plant hydraulic and allometric traits, soil and climatic variables. We found a close correspondence between the predicted and observed plant water potential (in MPa) dynamics during the early phase drought, leading to stomatal closure, as well as during the latter phase of drought, leading to hydraulic failure in all four species. A global model’s sensitivity analysis revealed that, for a common plant size (leaf area) and soil volume, dehydration time from full hydration to stomatal closure (Tclose) was most strongly controlled by the leaf osmotic potential (Pi0) and its influence on stomatal closure, in all four species, while the maximum stomatal conductance (gsmax) also contributed to Tclose in Q. ilex and C. atlantica. Dehydration times from stomatal closure to hydraulic failure (Tcav) was most strongly controlled by Pi0, the branch residual conductance (gres) and Q10a sensitivity of gres in the three evergreen species, while xylem embolism resistance (P50) was most influential in the deciduous species P. nigra. Our findings point to SurEau as a highly useful model for predicting changes in plant water status during drought and suggest that adjustments made in key hydraulic traits are potentially beneficial to delaying the onset of drought-induced hydraulic failure in trees.
Direct oral anticoagulants and their antagonists in perioperative practice
Authors: Levy Jerrold H. , Mamoun Negmeldeen 
Published: June 2023

Purpose of review
Review management strategies for patients receiving nonvitamin K direct-acting oral anticoagulants (DOACs).

Recent findings
Updated clinical trials and guidelines continue to further define optimal management for patients on DOACs requiring emergency surgery or procedural interventions. In addition, specific bleeding management strategies that include either specific or nonspecific antagonists are becoming available.

Summary
Most currently used DOACs are factor Xa inhibitors and should be stopped for 24–48 h for elective surgical procedures in patients at risk for bleeding and potentially longer for dabigatran, depending on renal function. Idarucizumab, a specific dabigatran reversal agent, has been studied in surgical patients and is currently approved for use. For Xa inhibitors apixaban and rivaroxaban, although andexanet alfa is approved for medical bleeds, it is not approved for surgical patients, has a short duration of effect, and costs $12 500 per gram. When managing DOAC-treated patients requiring emergency surgery, when stopping the DOAC and delaying surgery is not feasible, standard approaches should include hemostatic, hemodynamic, and transfusional support. Due to higher risk associated with therapeutic agents used to manage DOAC-related bleeding, increasing data supports the potential off-label use of prothrombin complex concentrate (PCC).
Electroconvulsive therapy: recent advances and anesthetic considerations
Authors: Ninke Tobias , Groene Philipp 
Published: June 2023

Purpose of review
This review summarizes the current indications and principles of ECT. Contemporary anesthetic considerations are described with a focus on the optimal use of hypnotic agents and providing ECT in pregnant patients.

Recent findings
ECT is useful in treatment-resistant major depression, bipolar disorders, and treatment-resistant schizophrenia. It is a well tolerated treatment in pregnant patients with treatment-resistant depression. Cognitive side effects may be attenuated by using unilateral placement of scalp electrodes, fewer treatment sessions, and the use of ultrabrief pulse width of the electrical charge. All modern hypnotics can be used for induction of anesthesia for ECT but should be titrated to effect. Etomidate is superior to Propofol in regarding seizure quality. The use of Ketamine shows good seizure quality and may alleviate cognitive impairment. Providing ECT for pregnant patients may prove challenging because of logistic difficulties and the physiologic changes during pregnancy. Although representing an effective treatment option in severely ill patients, ECT is underutilized because of stigmatization and ethnic and financial disparities.

Summary
ECT is effective in treating treatment-resistant psychiatric illnesses. Symptoms of cognitive impairment are the most common side effects but can be treated by modifying the technique of ECT. All modern hypnotics can be used for the induction of general anesthesia. Etomidate and Ketamine may be of special interest in patients with insufficient seizure duration. Treating pregnant patients with ECT requires a multidisciplinary approach, in order to provide a safe therapy for mother and unborn child. Stigmatization and social disparities are hindering the widespread use of ECT as an effective treatment for severely ill psychiatric patients.
Half-pin Breakage in Multiplanar External Fixators Used for Pediatric Deformity Correction
Authors: Bridges Callie S. , Taylor Tristen N. , Lee Tiffany , Moore Kevin , Shenava Vinitha R. , Hill Jaclyn F. 
Published: June 2023

Background:
Pediatric patients with leg length discrepancies and complex deformities may require multiplanar external fixators for correction. We have encountered 4 cases of half-pin breakage with the Orthex hexapod frame. The purpose of this study is to report factors associated with half-pin breakage and compare various deformity correction characteristics between 2 hexapod frames – Taylor Spatial Frame (TSF) and Orthex.

Methods:
Pediatric patients with lower extremity deformities treated with an Orthex or TSF at a single tertiary children’s hospital between 2012 and 2022 were included for retrospective review. Variables compared between frame groups include frame configuration, half-pin/wire fixation, length achieved, angular correction, and frame time.

Results:
There were 23 Orthex frames (23 patients) and 36 TSF (33 patients) included. Four Orthex and zero TSF had proximal half-pin breakage. The Orthex group was younger on average (10 vs. 12 y, P=.04*) at the time of frame placement. The majority (52%) of Orthex frames were used for simultaneous lengthening and angular correction, while the majority (61%) of TSF was used for only angular correction. Orthex had more half-pins used for proximal fixation (median 3 vs. 2, P<0.0001*) and more frames with nonstandard configuration (7 (30%) vs. 1 (3%), P=0.004*). Orthex group had a longer total frame time (median 189 vs. 146 days, P=0.012*) and longer time required for regenerate healing (117 vs. 89 d, P=0.02*). There were no significant differences in length gained, angular correction, or healing index between Orthex and TSF. Nonstandard configuration, increased number of proximal half-pins, younger age at index surgery, and increased lengthening were associated with pin breakage.

Conclusions:
This is the first study to report half-pin breakage while using multiplanar frames in pediatric lower extremity deformity correction. The Orthex and TSF groups consisted of significantly different patients and frame configurations, making it difficult to identify any specific cause for pin breakage. This study shows that pin breakage is likely caused by multiple factors and is associated with the increased complexity of deformity correction.

Level of Evidence:
Level III—Retrospective Comparison Study.
Quality of Life of Sepsis Survivors*
Authors: Kurematsu Kumiko , Ikematsu Yuko 
Published: June 2023

OBJECTIVE:
To determine the differences between the quality of life for sepsis and nonsepsis survivors, factors affecting the quality of life for sepsis survivors, and their changes over time.

DESIGN:
A prospective longitudinal study with a quantitative comparative design.

SETTING:
A university hospital in the greater Tokyo area of Japan.

PATIENTS:
The study included 41 and 40 patients in the sepsis and nonsepsis groups, respectively.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Health-related quality of life (HRQOL), independence in activities of daily living (ADL), stress levels, and spirituality were compared between the sepsis and nonsepsis groups at ICU discharge, hospital discharge, and 1 month after discharge. Comparison of HRQOL between the sepsis and nonsepsis groups showed significantly low HRQOL in the sepsis group compared with the nonsepsis group at ICU discharge and hospital discharge. Factors such as stress levels and spirituality affected the HRQOL in the nonsepsis group at ICU discharge. At discharge, stress and spirituality affected HRQOL in both the sepsis and nonsepsis groups. One month after discharge, ADL, stress, and spirituality affected HRQOL in both the sepsis and nonsepsis groups. In terms of changes over time, HRQOL at ICU discharge in the sepsis group was significantly lower than at discharge and 1 month after discharge. The two-way analyses of variance showed no interactions between the groups and time regarding HRQOL.

CONCLUSIONS:
HRQOL of sepsis survivors was significantly lower than that of nonsepsis survivors. ADL and stress influenced HRQOL. The study suggests the importance of ADL training and stress alleviation during the ICU stay.
A gut bacterial signature in blood and liver tissue characterizes cirrhosis and hepatocellular carcinoma
Authors: Effenberger Maria , Waschina Silvio , Bronowski Christina , Sturm Gregor , Tassiello Oronzo , Sommer Felix , Zollner Andreas , Watschinger Christina , Grabherr Felix , Gstir Ronald , Grander Christoph , Enrich Barbara , Bale Reto , Putzer Daniel , Djanani Angela , Moschen Alexander R. , Zoller Heinz , Rupp Jan , Schreiber Stefan , Burcelin Remy , Lass-Flörl Cornelia , Trajanoski Zlatko , Oberhuber Georg , Rosenstiel Philip , Adolph Timon E. , Aden Konrad , Tilg Herbert 
Published: June 2023

Background:
HCC is the leading cause of cancer in chronic liver disease. A growing body of experimental mouse models supports the notion that gut-resident and liver-resident microbes control hepatic immune responses and, thereby, crucially contribute to liver tumorigenesis. However, a comprehensive characterization of the intestinal microbiome in fueling the transition from chronic liver disease to HCC in humans is currently missing.

Methods:
Here, we profiled the fecal, blood, and liver tissue microbiome of patients with HCC by 16S rRNA sequencing and compared profiles to nonmalignant cirrhotic and noncirrhotic NAFLD patients.

Results:
We report a distinct bacterial profile, defined from 16S rRNA gene sequences, with reduced α-and β-diversity in the feces of patients with HCC and cirrhosis compared to NAFLD. Patients with HCC and cirrhosis exhibited an increased proportion of fecal bacterial gene signatures in the blood and liver compared to NAFLD. Differential analysis of the relative abundance of bacterial genera identified an increased abundance of Ruminococcaceae and Bacteroidaceae in blood and liver tissue from both HCC and cirrhosis patients compared to NAFLD. Fecal samples from cirrhosis and HCC patients both showed a reduced abundance for several taxa, including short-chain fatty acid–producing genera, such as Blautia and Agathobacter. Using paired 16S rRNA and transcriptome sequencing, we identified a direct association between gut bacterial genus abundance and host transcriptome response within the liver tissue.

Conclusions:
Our study indicates perturbations of the intestinal and liver-resident microbiome as a critical determinant of patients with cirrhosis and HCC.
Mycophenolate Mofetil Use in Pediatric Immune Thrombocytopenia Refractory to First-line Therapy: a Single-center Experience
Authors: Goldberg Tracie A. , Levy Carolyn Fein 
Published: June 2023

Most children treated for immune thrombocytopenia remit during the first year following diagnosis. For the ∼40% who develop persistent or chronic disease, second-line treatment options include immunomodulation and thrombomimetic agents. While immunomodulators target the underlying mechanism, prolonged immunosuppression may increase the risk of infection. We report the use of the reversible immunomodulating agent mycophenolate mofetil (MMF) in 16 pediatric patients with immune thrombocytopenia refractory to first-line treatment. Using escalating doses up to 2400 mg/m2/d, MMF treatment resulted in a 73% response rate. Adverse events were mostly mild and tolerable. Complete responders have been successfully tapered off MMF with sustained responses.
Early Postoperative Magnetic Resonance Imaging Findings Related to Electrocauterization for Cerebellar Reduction During Chiari Decompression Surgery
Authors: Ginat Daniel T. , Hooper Grayson W. 
Published: June 2023

Background
Cerebellar tonsillar reduction or resection can be performed as part of the surgical management of Chiari type 1 malformation when it is accompanied by symptomatic brainstem compression or syringomyelia. The purpose of this study is to characterize the early postoperative magnetic resonance imaging (MRI) findings in patients with Chiari type 1 malformations who undergo cerebellar tonsillar reduction via electrocautery.

Methods
The extent of cytotoxic edema and microhemorrhages demonstrated on MRI scans obtained within 9 days following surgery was assessed and correlated with neurological symptoms.

Results
Cytotoxic edema was found on all postoperative MRI examinations included in this series, with superimposed hemorrhage in 12 of 16 patients (75%) and was primarily located along the margins of the cauterized inferior cerebellum. Cytotoxic edema was present beyond the margins of the cauterized cerebellar tonsils in 5 of 16 patients (31%) and was associated with new focal neurological deficits in 4 of 5 patients (80%).

Conclusion
Cytotoxic edema and hemorrhages along the cerebellar tonsil cautery margins can be expected findings in early postoperative MRI in patients who undergo Chiari decompression accompanied by tonsillar reduction. However, the presence of cytotoxic edema beyond these regions can be associated with new focal neurological symptoms.
Using Ultrahigh b-Value Diffusion-Weighted Imaging to Noninvasively Assess Renal Fibrosis in a Rabbit Model of Renal Artery Stenosis
Authors: Zhang Zhiping , Zha Tingting , Jiang Zhenxing , Pan Liang , Liu Yang , Dong Congsong , Chen Jie , Xing Wei 
Published: June 2023

Objective
This study aimed to investigate the feasibility of diffusion-weighted imaging with ultrahigh b values (ubDWI) for the evaluation of renal fibrosis (RF) induced by renal artery stenosis (RAS) in a rabbit model.

Methods
Thirty-two rabbits underwent left RAS operation, whereas 8 rabbits received sham surgery. All rabbits underwent ubDWI (b = 0–4500 s/mm2). The standard apparent diffusion coefficient (ADCst), molecular diffusion coefficient (D), perfusion fraction (f), perfusion-related diffusion coefficient (D*) and ultrahigh apparent diffusion coefficient (ADCuh) were longitudinally assessed before operation and at weeks 2, 4, and 6 after operation. The degree of interstitial fibrosis and the expression of aquaporin (AQP) 1 and AQP2 were determined through pathological examination.

Results
In the stenotic kidney, the ADCst, D, f, and ADCuh values of the renal parenchyma significantly decreased compared with those at baseline (all P < 0.05), whereas the D* values significantly increased after RAS induction (P < 0.05). The ADCst, D, D*, and f were weakly to moderately correlated with interstitial fibrosis as well as with the expression of AQP1 and AQP2. Furthermore, the ADCuh negatively correlated with interstitial fibrosis (ρ = −0.782, P < 0.001) and positively correlated with AQP1 and AQP2 expression (ρ = 0.794, P < 0.001, and ρ = 0.789, P < 0.001, respectively).

Conclusions
Diffusion-weighted imaging with ultrahigh b values shows the potential for noninvasive assessment of the progression of RF in rabbits with unilateral RAS. The ADCuh derived from ubDWI could reflect the expression of AQPs in RF.
Effect of Deep Learning Reconstruction on Evaluating Cervical Spinal Canal Stenosis With Computed Tomography
Authors: Ohtake Yuta , Yasaka Koichiro , Hamada Akiyoshi , Fujita Nana , Abe Osamu 
Published: June 2023

Objective
Magnetic resonance imaging (MRI) is commonly used to evaluate cervical spinal canal stenosis; however, some patients are ineligible for MRI. We aimed to assess the effect of deep learning reconstruction (DLR) in evaluating cervical spinal canal stenosis using computed tomography (CT) compared with hybrid iterative reconstruction (hybrid IR).

Methods
This retrospective study included 33 patients (16 male patients; mean age, 57.7 ± 18.4 years) who underwent cervical spine CT. Images were reconstructed using DLR and hybrid IR. In the quantitative analyses, noise was recorded by placing the regions of interest on the trapezius muscle. In the qualitative analyses, 2 radiologists evaluated the depiction of structures, image noise, overall image quality, and degree of cervical canal stenosis. We additionally evaluated the agreement between MRI and CT in 15 patients for whom preoperative cervical MRI was available.

Results
Image noise was less with DLR than hybrid IR in the quantitative (P ≤ 0.0395) and subjective analyses (P ≤ 0.0023), and the depiction of most structures was improved (P ≤ 0.0052), which resulted in better overall quality (P ≤ 0.0118). Interobserver agreement in the assessment of spinal canal stenosis with DLR (0.7390; 95% confidence interval [CI], 0.7189–0.7592) was superior to that with hybrid IR (0.7038; 96% CI, 0.6846–0.7229). As for the agreement between MRI and CT, significant improvement was observed for 1 reader with DLR (0.7910; 96% CI, 0.7762–0.8057) than hybrid IR (0.7536; 96% CI, 0.7383–0.7688).

Conclusions
Deep learning reconstruction provided better quality cervical spine CT images in the evaluation of cervical spinal stenosis than hybrid IR.
Imaging Features of Primary Intraosseous Meningiomas
Authors: Gao Lu , Chen Peiyao , Yang Lin , Li Yang , Han Fang , Liu Heng , Zhang Jiawen 
Published: June 2023

Objective
To describe the imaging features of primary intraosseous meningiomas (PIMs) to aid an accurate diagnosis.

Methods
Clinical materials and radiological data for 9 patients with pathologically confirmed PIMs were reviewed comprehensively.

Results
Most lesions involved inner and outer plates of the calvaria and all were relatively well circumscribed. Upon computed tomography, portions of the solid neoplasm were hyperattenuated or isoattenuated. Hyperostosis was found in many lesions, but calcification was seen rarely. On magnetic resonance imaging, most neoplasms were hypointense on T1-weighted images, hyperintense on T2-weighted images, and heterogeneous on fluid-attenuated inversion recovery images. In most cases, the soft tissue of neoplasms showed hyperintense on diffusion-weighted imaging and hypointense on apparent diffusion coefficient. All lesions were obviously enhanced after gadolinium administration. Each patient accepted surgical treatment and recurrence was not observed during follow-up.

Conclusions
Primary intraosseous meningiomas are very rare tumors that occur usually in later life. They are well-defined and tend to involve the inner and outer plates of the calvaria, with a classic appearance of hyperostosis on computed tomography. Primary intraosseous meningiomas display hypointense on T1-weighted images, hyperintense on T2-weighted images, and hyperattenuated or isoattenuated on computed tomography. Hyperintense on diffusion-weighted imaging, hypointense on apparent diffusion coefficient can also be found. Obvious enhancement supplied additional information for an accurate diagnosis. A neoplasm with these features should raise the suspicion of a PIM.
Lymphoscintigraphy of the Lower Extremities
Authors: Mrhac Lubomir , Havel Martin , Kolacek Michal , Kraft Otakar , Bukovansky Kamil 
Published: June 2023

Abstract
We describe a 57-year-old man with prostate cancer. A radical prostatectomy with a pelvic lymphadenectomy was performed. After 2 years, a mild swelling of the lower extremities appeared, and the patient was referred for lower-limb lymphoscintigraphy. A lymphoscintigraphy of the superficial lymphatic system in the limbs showed prominent, dermal backflow in the area of the right hypogastrium. Lymphoscintigraphy of the deep lymphatic system showed reflux in the left hypogastrium. This discrepancy between the findings in the superficial and deep lower-limb lymphatic systems was explained by asymmetric sampling of the lymph nodes during the lymphadenectomy.
SUPPLEMENTATION WITH NICOTINAMIDE RIBOSIDE ATTENUATES T CELL EXHAUSTION AND IMPROVES SURVIVAL IN SEPSIS
Authors: Zhao Guang-ju , Yang Xi-yu , Zhang Chen , Dong Wei , Dong Fu-bo , Zhang Jie , Chen Xiao-Yan , Yao Ren-qi , Xiao Zhong , Chen Long-wang , Yao Yong-ming , Lu Zhong-qiu 
Published: June 2023

ABSTRACT
T cell exhaustion is the main cause of sepsis-induced immunosuppression and is associated with the poor prognosis. Nicotinamide adenine dinucleotide (NAD+
) is well known for its anti-aging effect, but its role in sepsis-induced T cell exhaustion remains to be elucidated. In the present study, using a classic septic animal model, we found that the levels of NAD+ and its downstream molecule, which is sirtuins 1 (SIRT1), in T cells in sepsis were decreased. Supplementation with nicotinamide ribose (NR), the precursor of NAD+, right after cecal ligation and puncture significantly increased the levels of NAD+ and SIRT1. Supplementation with NR alleviated the depletion of mononuclear cells and T lymphocytes in spleen in sepsis and increased the levels of CD3+ CD4+ and CD3+ CD8+ T cells. Interestingly, both Th1 and Th2 cells were expanded after NR treatment, but the balance of Th1/Th2 was partly restored. Nicotinamide ribose also inhibited the regulatory T cells expansion and programmed cell death 1 expression in CD4+ T cells in sepsis. In addition, the bacteria load, organ damage (lung, heart, liver, and kidney), and the mortality of septic mice were reduced after NR supplementation. In summary, these results demonstrate the beneficial effect of NR on sepsis and T cell exhaustion, which is associated with NAD+/SIRT1 pathway.