bluuebunny/crossref_metadata_2025_split huggingface dataset:
Childbirth after perioperative systemic therapy in patients with breast cancer: a retrospective single institutional study in Japan
Authors: Takeda Misuzu , Kataoka Akemi , Abe Tomomi , Inoue Yuka , Uehiro Natsue , Takahashi Yoko , Nakashima Eri , Ogiya Akiko , Sakai Takehiko , Morizono Hidetomo , Miyagi Yumi , Ohno Shinji , Ueno Takayuki 
Published: March 2023

Abstract

Background
The number of breast cancer patients of childbearing age has been increasing. Therefore, we investigated the characteristics and the childbearing status of the patients who received systemic therapy for breast cancer during their childbearing age to better understand the clinical impact of childbirth.

Methods
Female patients with breast cancer younger than 40 years old who underwent surgery and received perioperative systemic therapy from 2007 to 2014 were included in this study. We compared the characteristics of patients with and without childbirth after treatment.

Result
Of 590 patients, 26 delivered a child, and 355 did not bear a child during the median observation period of 8.1 years, whilst 209 had unknown childbirth data. The childbirth group had a lower mean age at surgery (32.2 vs. 35.1, P &lt; 0.001). The proportion of patients who desired childbirth and used assisted reproductive technology was significantly higher in the childbirth group (65.4 vs. 23.9% and 45.2 vs. 5.1%, respectively, P &lt; 0.001). The patients in the childbirth group had significantly less advanced disease (P = 0.002). In the childbirth group, the age at childbirth was significantly older in patients who received combined endocrine therapy and chemotherapy (40.8 years) than in patients who received either alone (endocrine therapy: 36.9 years, chemotherapy: 36.7 years, P = 0.04). However, survival was not different between those with and without childbirth.

Conclusion
It is critical to recognize the desire for childbirth in patients with breast cancer who are receiving systemic therapy and to provide them with necessary fertility information before treatment to support their decision-making.
Are magnetic fields universal in O-type multiple systems?
Authors: Hubrig S , Järvinen S P , Ilyin I , Schöller M , Jayaraman R 
Published: March 2023

ABSTRACTAlthough significant progress has been achieved in recent surveys of the magnetism in massive stars, the origin of the detected magnetic fields remains to be the least understood topic in their studies. We present an analysis of 61 high-resolution spectropolarimetric observations of 36 systems with O-type primaries, among them 10 known particle-accelerating colliding-wind binaries exhibiting synchrotron radio emission. Our sample consists of multiple systems with components at different evolutionary stages with wide and tight orbits and different types of interactions. For the treatment of the complex composite spectra of the multiple systems, we used a special procedure involving different line masks populated for each element separately. Out of the 36 systems, 22 exhibit in their least-squares deconvolution Stokes V profiles definitely detected Zeeman features, among them 7 systems with colliding winds. For 14 systems, the detected Zeeman features are most likely associated with O-type components, whereas for 3 systems we suggest an association with an early B-type component. For the remaining five systems, the source of the field is unclear. Marginal evidence for the detection of a Zeeman feature is reported for 11 systems and non-detection for 3 systems. The large number of systems with definitely detected Zeeman features presents a mystery, but probably indicates that multiplicity plays a definite role in the generation of magnetic fields in massive stars. The newly found magnetic systems are supreme candidates for spectropolarimetric monitoring over their orbital and rotation periods to obtain trustworthy statistics on the magnetic field geometry and the distribution of field strength.
Goldilocks and RNA: where Mg2+ concentration is just right
Authors: Guth-Metzler Rebecca , Mohamed Ahmad Mohyeldin , Cowan Elizabeth T , Henning Ashleigh , Ito Chieri , Frenkel-Pinter Moran , Wartell Roger M , Glass Jennifer B , Williams Loren Dean 
Published: March 2023

Abstract
Magnesium, the most abundant divalent cation in cells, catalyzes RNA cleavage but also promotes RNA folding. Because folding can protect RNA from cleavage, we predicted a ‘Goldilocks landscape’, with local maximum in RNA lifetime at Mg2+ concentrations required for folding. Here, we use simulation and experiment to discover an innate and sophisticated mechanism of control of RNA lifetime. By simulation we characterized RNA Goldilocks landscapes and their dependence on cleavage and folding parameters. Experiments with yeast tRNAPhe and the Tetrahymena ribozyme P4–P6 domain show that structured RNAs can inhabit Goldilocks peaks. The Goldilocks peaks are tunable by differences in folded and unfolded cleavage rate constants, Mg2+ binding cooperativity, and Mg2+ affinity. Different folding and cleavage parameters produce Goldilocks landscapes with a variety of features. Goldilocks behavior allows ultrafine control of RNA chemical lifetime, whereas non-folding RNAs do not display Goldilocks peaks of protection. In sum, the effects of Mg2+ on RNA persistence are expected to be pleomorphic, both protecting and degrading RNA. In evolutionary context, Goldilocks behavior may have been a selectable trait of RNA in an early Earth environment containing Mg2+ and other metals.
XAP5 CIRCADIAN TIMEKEEPER regulates RNA splicing and the circadian clock by genetically separable pathways
Authors: Zhang Hongtao , Kumimoto Roderick W , Anver Shajahan , Harmer Stacey L 
Published: March 2023

Abstract
The circadian oscillator allows organisms to synchronize their cellular and physiological activities with diurnal environmental changes. In plants, the circadian clock is primarily composed of multiple transcriptional–translational feedback loops. Regulators of post-transcriptional events, such as precursor messenger RNAs (pre-mRNA) splicing factors, are also involved in controlling the pace of the clock. However, in most cases the underlying mechanisms remain unclear. We have previously identified XAP5 CIRCADIAN TIMEKEEPER (XCT) as an Arabidopsis thaliana circadian clock regulator with uncharacterized molecular functions. Here, we report that XCT physically interacts with components of the spliceosome, including members of the Nineteen Complex (NTC). PacBio Iso-Seq data show that xct mutants have transcriptome-wide pre-mRNA splicing defects, predominantly aberrant 3′ splice site selection. Expression of a genomic copy of XCT fully rescues those splicing defects, demonstrating that functional XCT is important for splicing. Dawn-expressed genes are significantly enriched among those aberrantly spliced in xct mutants, suggesting that the splicing activity of XCT may be circadian regulated. Furthermore, we show that loss-of-function mutations in PRP19A or PRP19B, 2 homologous core NTC components, suppress the short circadian period phenotype of xct-2. However, we do not see rescue of the splicing defects of core clock genes in prp19 xct mutants. Therefore, our results suggest that XCT may regulate splicing and the clock function through genetically separable pathways.
CAPER: patient preferences to inform nonsurgical treatment of chronic low back pain: a discrete-choice experiment
Authors: Wilson Leslie , Zheng Patricia , Ionova Yelena , Denham Alina , Yoo Connie , Ma Yanlei , Greco Carol M , Hanmer Janel , Williams David A , Hassett Afton L , Scheffler Aaron Wolfe , Valone Frank , Mehling Wolf , Berven Sigurd , Lotz Jeffrey , O’Neill Conor 
Published: March 2023

Abstract

Objective
We developed and used a discrete-choice measure to study patient preferences with regard to the risks and benefits of nonsurgical treatments when they are making treatment selections for chronic low back pain.

Methods
“CAPER TREATMENT” (Leslie Wilson) was developed with standard choice-based conjoint procedures (discrete-choice methodology that mimics an individual’s decision-making process). After expert input and pilot testing, our final measure had 7 attributes (chance of pain relief, duration of relief, physical activity changes, treatment method, treatment type, treatment time burden, and risks of treatment) with 3–4 levels each. Using Sawtooth software (Sawtooth Software, Inc., Provo, UT, USA), we created a random, full-profile, balanced-overlap experimental design. Respondents (n = 211) were recruited via an emailed online link and completed 14 choice-based conjoint choice pairs; 2 fixed questions; and demographic, clinical, and quality-of-life questions. Analysis was performed with random-parameters multinomial logit with 1000 Halton draws.

Results
Patients cared most about the chance of pain relief, followed closely by improving physical activity, even more than duration of pain relief. There was comparatively less concern about time commitment and risks. Gender and socioeconomic status influenced preferences, especially with relation to strength of expectations for outcomes. Patients experiencing a low level of pain (Pain, Enjoyment, and General Activity Scale [PEG], question 1, numeric rating scale score&lt;4) had a stronger desire for maximally improved physical activity, whereas those in a high level of pain (PEG, question 1, numeric rating scale score&gt;6) preferred both maximum and more limited activity. Highly disabled patients (Oswestry Disability Index score&gt;40) demonstrated distinctly different preferences, placing more weight on achieving pain control and less on improving physical activity.

Conclusions
Individuals with chronic low back pain were willing to trade risks and inconveniences for better pain control and physical activity. Additionally, different preference phenotypes exist, which suggests a need for clinicians to target treatments to particular patients.
Feasibility of ice sheet conservation using seabed anchored curtains
Authors: Keefer Bowie , Wolovick Michael , Moore John C 
Published: March 2023

AbstractSea level rise is expected to be rapid and extremely damaging to coastal communities and infrastructure, with unavoidable losses and coastal protection costs in the tens of billions per year. Retreat of the Thwaites and Pine Island Glaciers is likely already in an unstable regime as their oceanic fronts are ablated by deep intruding layers of relatively warm seawater. Warm water can be blocked from reaching the grounding line by thin flexible buoyant curtains anchored to the seabed. The consequent reduction in ice shelf melting could result in increased ice sheet buttressing as the shelf makes contact with seabed highs. Flexible curtains are less costly than solid artificial barriers, more robust against iceberg collisions, and easier to repair or remove in the event of unforeseen side effects. We illustrate the technical viability of this approach by considering curtain design concepts that should withstand oceanographic forces, and feasible methods of installation. Suitable materials are commonly available. Installation of a seabed curtain in temperate ocean waters would be entirely within the capabilities of existing offshore and deep ocean construction techniques. Installing in polar waters presents severe challenges from icebergs, harsh weather, and brief working seasons, which can however, be overcome with present-day technology. An 80 km long curtain installed in 600 m deep waters on alluvial sediments could help stabilize Pine Island and Thwaites glaciers over the next few centuries at much lower cost ($40–80 billion + $1–2 billion/yr maintenance) than the global coastline protection (∼$40 billion/yr) needed due to their collapse.
Large Bets and Stock Market Crashes
Authors: Kyle Albert S , Obizhaeva Anna A 
Published: March 2023

Abstract
Some market crashes occur because of significant imbalances in demand and supply. Conventional models fail to explain the large magnitudes of price declines. We propose a unified structural framework for explaining crashes, based on the insights of market microstructure invariance. A proper adjustment for differences in business time across markets leads to predictions which are different from conventional wisdom and consistent with observed price changes during the 1987 market crash and the 2008 sales by Société Générale. Somewhat larger-than-predicted price drops during 1987 and 2010 flash crashes may have been exacerbated by too rapid selling. Somewhat smaller-than-predicted price decline during the 1929 crash may be due to slower selling and perhaps better resiliency of less integrated markets.
Precision oncology comes of age
Authors: Sorscher Steven 
Published: March 2023

ABSTRACT
Each cancer has a unique fingerprint, and precision oncology can be used to more effectively fight malignancies. The identified genes, expressed RNA, and proteins expressed in patients' cancers are now used routinely to predict prognosis and inform treatment recommendations. This article describes how malignancies develop and some of the targeted drugs that can be used against them.
Individualized diet conversation in primary care
Authors: Croskey Olivia , Clark M. Kathleen 
Published: March 2023

Abstract

Background:
Most primary care providers do not routinely discuss nutrition and diet with their patients, largely due to lack of time, inadequate resources, and perceived complexity of the topic. This article describes development and implementation of a brief protocol for systematically assessing and discussing diet during routine primary care visits to increase the frequency of these conversations and improve patient health outcomes.

Methods:
The authors developed a protocol for assessing both nutrition and stage of change as well as a guide for engaging in patient-led conversations about nutrition. The protocol was modeled after Screening, Brief Intervention, and Referral to Treatment and informed by the Dietary Guidelines for Americans, the Transtheoretical Model of Behavior Change, and principles of motivational interviewing. It was implemented over three months at a rural health clinic staffed by one NP.

Results:
The protocol and conversation guide were easy to use with minimal training and seamlessly incorporated into clinic workflow. The likelihood of making diet changes increased significantly following the diet conversation, with persons who initially scored lower in readiness to change ultimately reporting significantly greater increases.

Conclusion:
A protocol for assessing diet and engaging patients in a stage of change–appropriate diet conversation can be efficiently integrated into a single primary care visit and increase patients' intent to change their diet. Further investigation is needed to evaluate the protocol more completely and in multiple clinics.
Health Disparities in Extracorporeal Membrane Oxygenation Utilization and Outcomes: A Scoping Review and Methodologic Critique of the Literature*
Authors: Moynihan Katie M. , Dorste Anna , Alizadeh Faraz , Phelps Kayla , Barreto Jessica A. , Kolwaite Amy R. , Merlocco Anthony , Barbaro Ryan P. , Chan Titus , Thiagarajan Ravi R. 
Published: March 2023

Objectives:
To map the scope, methodological rigor, quality, and direction of associations between social determinants of health (SDoH) and extracorporeal membrane oxygenation (ECMO) utilization or outcomes.

Data Sources:
PubMed, Web of Science, Embase, and Cochrane Library databases were systematically searched for citations from January 2000 to January 2023, examining socioeconomic status (SES), race, ethnicity, hospital and ECMO program characteristics, transport, and geographic location (context) with utilization and outcomes (concept) in ECMO patients (population).

Study Selection:
Methodology followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses scoping review extension. Two reviewers independently evaluated abstracts and full text of identified publications. Exclusion criteria included non-English, unavailable, less than 40 patients, and periprocedural or mixed mechanical support.

Data Extraction:
Content analysis used a standardized data extraction tool and inductive thematic analysis for author-proposed mediators of disparities. Risk of bias was assessed using the Quality in Prognosis Studies tool.

Data Synthesis:
Of 8,214 citations screened, 219 studies were identified. Primary analysis focuses on 148 (68%) including race/ethnicity/SES/payer variables including investigation of ECMO outcomes 114 (77%) and utilization 43 (29%). SDoH were the primary predictor in 15 (10%). Overall quality and methodologic rigor was poor with advanced statistics in 7%. Direction of associations between ECMO outcomes or utilization according to race, ethnicity, SES, or payer varied. In 38% adverse outcomes or lower use was reported in underrepresented, under-resourced or diverse populations, while improved outcomes or greater use were observed in these populations in 7%, and 55% had no statistically significant result. Only 26 studies (18%) discussed mechanistic drivers of disparities, primarily focusing on individual- and hospital-level rather than systemic/structural factors.

Conclusions:
Associations between ECMO utilization and outcomes with SDoH are inconsistent, complicated by population heterogeneity and analytic shortcomings with limited consideration of systemic contributors. Findings and research gaps have implications for measuring, analyzing, and interpreting SDoH in ECMO research and healthcare.
Predictors of Abnormal Sleep Duration in Older Adults With Hip Fracture and Diabetes
Authors: KUO Wen-Yu , CHEN Min-Chi , SHYU Yea-Ing Lotus 
Published: March 2023

ABSTRACT

Background
Abnormal sleep duration affects recovery in older adults with hip fracture and diabetes mellitus (DM) negatively. However, the predictors of abnormal sleep duration in this population remain unknown.

Purpose
This study was designed to explore the predictors of abnormal sleep duration among older adults with hip fracture and DM within 6 months of hospital discharge.

Methods
A longitudinal study using secondary data from a randomized controlled trial was implemented. Data on fracture-related factors (diagnosis, surgical methods) were collected from medical charts. Information on the duration of DM, methods of DM control, and diabetes-related peripheral vascular disease was collected by asking simple questions. Diabetic peripheral neuropathy was assessed using the Michigan Neuropathy Screening Instrument. Sleep duration outcomes were determined using data collected from a SenseWear armband.

Results
Having more comorbidities (OR = 3.14, p = .04), having undergone open reduction (OR = 2.65, p = .005), having undergone closed reduction with internal fixation (OR = 1.39, p = .04), and having DM (OR = 1.18, p = .01), diabetic peripheral neuropathy (OR = 9.60, p = .02), or diabetic peripheral vascular disease for a longer duration (OR = 15.62, p = .006) were all associated with a higher risk of abnormal sleep duration.

Conclusions
The findings indicate that patients with more comorbidities or who had undergone internal fixation, had a long DM history, or had complications are more likely to have abnormal sleep duration. Thus, greater attention should be focused on the sleep duration of diabetic older adults with hip fracture who are affected by these factors to achieve better postoperative recovery.
Indications for surgical resection of complicated infantile hemangiomas in the β-blocker’s era: a single-institution experience from a retrospective cohort study
Authors: Beqo Besiana P. , Gasparella Paolo , Flucher Christina , Spendel Stephan , Quehenberger Franz , Haxhija Emir Q. 
Published: March 2023

Background and Objectives:This study aims to review how the introduction of propranolol as the primary treatment option for children with infantile hemangiomas (IHs) has affected the use of other treatment options at our institution and to determine the indications for surgical treatment of children with IHs in the propranolol era.Patients and Methods:The authors conducted a single-center, noncompeting, historical/retrospective cohort study to review all cases referred to the institution for IH evaluation from 2005 to 2020. The authors analyzed the complete charts of patients who received surgery from 2011 to 2020 and evaluated the reasons for each surgical intervention. Detailed descriptive statistics are provided. Logistic regression analysis and Pearson’sχ2-test were applied.Results:During the study period, 592 children received treatment. From 2011, oral propranolol (n=268; 74%) and surgery (n=95; 26%) were the only treatments of choice for complicated IH cases. A significant decrease in the frequency of surgical treatment was observed (P=0.01). The authors identified four main indications for surgical treatment: (1) patients with ulceration and IH size appropriate for surgical resection (15%); (2) patients whose parents preferred surgical treatment (19%); (3) patients who presented late and underwent surgery before the age of three (29%); and (4) patients with sequelae after IH involution and excision after the third year of life (37%).Conclusions:Despite the significant decrease in the need for surgical treatment of children with IHs since the introduction of propranolol, there are still several clear indications for treating IH cases where surgery plays a crucial role.
Current evidence for dietary therapies in irritable bowel syndrome
Authors: Rej Anupam , Penny Hugo A. 
Published: March 2023

Purpose of review
Diet appears to trigger symptoms in the majority of individuals with irritable bowel syndrome (IBS) and is associated with a reduced quality of life. There has been a recent focus on the role of dietary therapies to manage individuals with IBS. The aim of this review is to discuss the utility of traditional dietary advice (TDA), low-FODMAP diet (LFD) and gluten-free diet (GFD) in IBS.

Recent findings
Several recent randomized controlled trials (RCTs) have been published demonstrating the efficacy of the LFD and GFD in IBS, with the evidence base for TDA being predominantly based on clinical experience, with emerging RCTs evaluating TDA. Only one RCT has been published to date comparing TDA, LFD and GFD head to head, with no difference noted between diets in terms of efficacy. However, TDA has been noted to be more patient-friendly and is commonly implemented as a first-line dietary therapy.

Summary
Dietary therapies have been demonstrated to improve symptoms in patients with IBS. In view of insufficient evidence to recommend one diet over another currently, specialist dietetic input in conjunction with patient preference is required to determine implementation of dietary therapies. Novel methods of dietetic delivery are required in view of the lack of dietetic provision to deliver these therapies.
Consideration of Factitious Disorder in Management of Patients With Autoinflammatory Disease
Authors: Reinfeld Samuel , Sfreddo Hannah J. , Yao Qingping , Chacko Mason 
Published: March 2023

Abstract
Factitious disorder, a disorder characterized by the falsification of symptoms to obtain primary gain, continues to be one of the more challenging cases that psychiatrists encounter. We describe a case of a woman we treated on the medical unit who falsified several of her symptoms but also was diagnosed with Yao syndrome, a disease that can also cause unexplained symptoms such as abdominal pain and fever. We navigate the difficulties in managing this type of patient and comanaging her with medicine and rheumatology. Although the prevalence of factitious disorder is anywhere from 1% to 2% of patients on the medical floor, they typically utilize a disproportionate number of resources. Despite this, the literature is still inconclusive when it comes to the management and treatment approaches. More study is warranted on this complex and burdensome illness.