bluuebunny/crossref_metadata_2025_split huggingface dataset:
Failed Extubation in Neonates After Cardiac Surgery: A Single-Center, Retrospective Study
Authors: Wilson Hunter C. , Gunsaulus Megan E. , Owens Gabe E. , Goldstein Stephanie A. , Yu Sunkyung , Lowery Ray E. , Olive Mary K. 
Published: May 2023

OBJECTIVES:To describe factors associated with failed extubation (FE) in neonates following cardiovascular surgery, and the relationship with clinical outcomes.DESIGN:Retrospective cohort study.SETTING:Twenty-bed pediatric cardiac ICU (PCICU) in an academic tertiary care children’s hospital.PATIENTS:Neonates admitted to the PCICU following cardiac surgery between July 2015 and June 2018.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:Patients who experienced FE were compared with patients who were successfully extubated. Variables associated with FE (p< 0.05) from univariate analysis were considered for inclusion in multivariable logistic regression. Univariate associations of FE with clinical outcomes were also examined. Of 240 patients, 40 (17%) experienced FE. Univariate analyses revealed associations of FE with upper airway (UA) abnormality (25% vs 8%,p= 0.003) and delayed sternal closure (50% vs 24%,p= 0.001). There were weaker associations of FE with hypoplastic left heart syndrome (25% vs 13%,p= 0.04), postoperative ventilation greater than 7 days (33% vs 15%,p= 0.01), Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) category 5 operations (38% vs 21%,p= 0.02), and respiratory rate during spontaneous breathing trial (median 42 vs 37 breaths/min,p= 0.01). In multivariable analysis, UA abnormalities (adjusted odds ratio [AOR] 3.5; 95% CI, 1.4–9.0), postoperative ventilation greater than 7 days (AOR 2.3; 95% CI, 1.0–5.2), and STAT category 5 operations (AOR 2.4; 95% CI, 1.1–5.2) were independently associated with FE. FE was also associated with unplanned reoperation/reintervention during hospital course (38% vs 22%,p= 0.04), longer hospitalization (median 29 vs 16.5 d,p< 0.0001), and in-hospital mortality (13% vs 3%,p= 0.02).CONCLUSIONS:FE in neonates occurs relatively commonly following cardiac surgery and is associated with adverse clinical outcomes. Additional data are needed to further optimize periextubation decision-making in patients with multiple clinical factors associated with FE.
Introducing Saddle-Shaped Radix Graft, with a Second Look into the Classic
Authors: Wu Lehao , You Jianjun , Wang Huan , Tian Le , Fan Fei 
Published: May 2023

Background:
An enduringly stable tip graft is the key to achieve successful rhinoplasty cases. However, the intrinsic nature of rib graft warping renders major unpredictability for the long-term outcome. The objective of this study was to detail and validate the use of a radix graft design that is characterized by the dual curved surfaces and beveled margin, which consequently renders a shape similar to a saddle.

Methods:
Twenty-three female patients, ranging in age from 22 to 31 years, completed the study. In all cases, the saddle-shaped radix graft was applied as the essential element for enhancing radix region profile. The complications that arose were collected retrospectively. Three-dimensional stereophotogrammetric evaluations of patients were performed. Anthropometric points were analyzed in a blinded fashion. Outcome variables were tip projection, nasal length, radix height, and the radius of curvature.

Results:
Postoperative analysis suggested significant improvement on the aesthetics of the radix region over time, evidenced by the significant increase of radix height (4.33 ± 1.21 mm versus 7.08 ± 1.00 mm), and the reduction of radius of curvature at nasofrontal break over the long term (22.63 ± 2.24 mm versus 13.94 ± 0.98 mm). Other postoperative evaluations, including radix height, tip projection, and nasal length, had significant improvement.

Conclusions:
The saddle-shaped radix graft effectively augments the radix area and creates an aesthetically pleasant nasofrontal break without causing the elevated radix deformity. It has the merits of anatomical compliance and flexibility when it comes to concomitantly improving the glabella-radix profile for those East Asians with extremely low radix.
Differential Fat Grafting to Address Facial Asymmetry in Face Lifting
Authors: Rohrich Rod J. , Lisiecki Jeffrey L. , Chiodo Michael V. 
Published: May 2023

Summary:
The modern face lift is a complex operation involving the repositioning of tissues and the refilling of volume atrophy. Preoperative analysis is key to the successful diagnosis of aging changes. Facial asymmetry is universal, and must be recognized and incorporated into surgical planning. In this article, the authors address the role of fat grafting to manage facial aging in the setting of facial asymmetry.
Rib Plaster: A Versatile, Moldable Derivative from Scraping the Periphery of the Rib
Authors: Robotti Enrico , Leone Francesco , Malfussi Victor , Cottone Giuseppe 
Published: May 2023

Summary:
A simple technique is described for obtaining rib plaster by scraping the whitish peripheral portion of residual segments of rib after the perichondrium is removed and appropriate multiple laminations are derived. This putty-like substance tends to conglomerate appropriately because of its high density and has unique properties. It is readily compacted into diced cartilage inserters, smoothly injected, and easy to mold. Rib plaster works well for camouflage of irregularities of the dorsum and tip as well as in mild augmentation. It adds no further cost, and is in adequate supply once a full-thickness rib segment has been harvested for secondary rhinoplasty.
A Murine Calvarial Defect Model for the Investigation of the Osteogenic Potential of Newborn Umbilical Cord Mesenchymal Stem Cells in Bone Regeneration
Authors: Stanton Eloise , Feng Jifan , Kondra Katelyn , Sanchez Janet , Jimenez Christian , Brown Katherine S. , Skiles Matthew L. , Urata Mark M. , Chai Yang , Hammoudeh Jeffrey A. 
Published: May 2023

Background:
The standard graft material for alveolar cleft repair (ACR) is autogenous iliac crest. However, a promising alternative potential graft adjunct - newborn human umbilical cord mesenchymal stem cells (h-UCMSC) - has yet to be explored in vivo. Their capacity for self-renewal, multipotent differentiation, and proliferation allows h-UCMSC to be harnessed for regenerative medicine. Our study seeks to evaluate the efficacy of using tissue-derived h-UCMSC and their osteogenic capabilities in a murine model to improve ACR.

Methods:

Foxn1 mice were separated into three groups with the following calvarial defects: (1) no-treatment (empty defect; n=6), (2) poly (D,L-lactide-co-glycolide) (PLGA) scaffold (n=6), and (3) h-UCMSC with PLGA (n=4). Bilateral 2-mm diameter parietal bone critical-sized defects were created using a dental drill. Micro-CT imaging occurred at 1, 2, 3, and 4 weeks postoperatively. The mice were euthanized 4 weeks postoperatively for RNAscope analysis, immunohistochemistry, and histology.

Results:
No mice experienced complications during the follow-up period. Micro-CT and histology demonstrated that the no-treatment (1) and PLGA-only (2) defects remained patent without significant defect size differences across groups. In contrast, the h-UCMSC with PLGA group (3) had significantly greater bone fill on micro-CT and histology.

Conclusions:
We demonstrate a successful calvarial defect model for the investigation of h-UCMSC-mediated osteogenesis and bone repair. Furthermore, evidence reveals that PLGA alone has neither short-term effects on bone formation nor any unwanted side effects, making it an attractive scaffold. Further investigation using h-UCMSC with PLGA in larger animals is warranted to advance future translation to patients requiring ACR.

Clinical Relevance Statement:
Our results demonstrate a successful murine calvarial defect model for the investigation of h-UCMSC-mediated osteogenesis and bone repair and provide preliminary evidence for the safe and efficacious use of this graft adjunct in alveolar cleft repair.
Evaluating the Relationship between Psychological Traits and Resilience to Musculoskeletal Injuries in Combat Control Graduates by Mendelian Randomization
Authors: Chapleau Richard R. 
Published: May 2023

AbstractU.S. Air Force combat control (CCT) personnel are a group of highly trained personnel performing a wide range of aviation-related tasks in contested combat environments. Certified by the U.S. Federal Aviation Administration to conduct air traffic control operations, CCTs are required to maintain high levels of alertness and perform complex tasks in high stress, high threat environments. Those CCTs who complete training are in exceptional physical, psychological, and cognitive fitness, however nearly 70% of CCT candidates will develop some form of musculoskeletal injury (MSI) during training. Using only open-source summary statistics results of genome-wide association studies (GWAS) on civilian populations, we report our findings from two-sample Mendelian randomization (MR) estimates evaluating the causal relationships between personality and psychological strengths associated with success in the CCT training program and MSI. We used the TwoSampleMR R-package and GWAS statistics obtained from the IEU OpenGWAS project with instrumental variables extracted at GWAS-significant and suggestive thresholds (P< 5×10−8and 5×10−5, respectively). Back pain and dislocations were the most common outcomes caused by personality and psychological traits. Altogether more than 150 MSI outcomes were identified with causes related to psychological traits associated with successfully completing combat control training. The implications of our results suggest that the combat control training program, and by extension other special operations training programs, could encounter fewer injuries by encouraging utilization of embedded psychological assets.
Rural Residence, Motorcycle Access, and Contraception Use in South and Southeast Asia
Authors: Muir Jonathan A. , Sanders Scott R. , Hendricks Hannah , Cope Michael R. 
Published: May 2023

ABSTRACTAccess to contraception is critical for limiting fertility. Yet, in South and Southeast Asia, access to these resources is often limited by spatial inequalities between rural and urban areas. Access to a motorcycle may empower women living in rural areas to attenuate these spatial inequalities, increase their educational attainment and participation in labor markets, and thereby facilitate a shift in fertility preferences. Concomitantly, motorcycle access may increase access to contraception for geographically isolated women who desire to limit fertility. We employ logistic regression models to examine associations with contraception use and unmet need for contraception for women living in rural vs. urban areas and for women with vs. without access to a motorcycle. Roughly 40 percent of women reported current use of contraception while another 21 percent indicated an unmet need for contraception. After adjusting for other variables, women with a motorcycle were more likely to report current contraception use (AOR = 1.55, 95% CI [1.50, 1.61]), modern contraception use (AOR = 1.60, 95% CI [1.54, 1.66]), and traditional contraception use (AOR = 1.49, 95% CI [1.41, 1.58]) compared to women who did not own a motorcycle. Women with a motorcycle were less likely to report an unmet need for contraception (AOR = 0.65, 95% CI [0.62, 0.68]) after adjusting for other variables. Our results are consistent with the premise that motorcycles facilitate contraception use among women living in resource-limited countries in South and Southeast Asia and thereby contribute to decreases in fertility. These relationships are contextualized by whether a woman lives in an urban or rural setting, and the number of children already present in their household; they are robust to controlling for household-level wealth and other factors that may mediate associations with contraception use.
The experiences and perceptions of working with Anaesthesia Associates: a survey of UK anaesthetists in training
Authors: Evans Ben , Turkoglu Leyla M , Brooks James , Subramaniam Jeevakan , Edwardson Stuart , McCrossan Roopa , Freeman Naomi , Wong Danny J. N. 
Published: May 2023

AbstractThe future and sustainability of the anaesthetic workforce is a growing concern with a projected shortfall of 11,000 anaesthetists by 2040. The supply of anaesthetists able to provide safe anaesthesia care does not meet the rising demand of surgical waiting lists. In recent years, changes to recruitment and curricula for anaesthetic specialty training have resulted in significant bottlenecks to training progression, further compounding the deficit in the numbers of fully trained anaesthetists. A rapid expansion the Anaesthesia Associate (AA) workforce has been proposed as one of the solutions to this worsening gap. However, no robust analysis of the impact of the expansion in AA numbers on anaesthetists in training has been conducted. There remain a number of concerns regarding access to training experience, scope of supervision, out of hours workload, equity of pay and cost of training, as well as the impact on future numbers of anaesthetists in training. In order to help shape the future integration of this workforce, we surveyed current anaesthetists in training, asking about their experiences of working with AAs, and their perceptions of the future expansion and regulation of these associate professionals. Through an online survey, we collected both quantitative and qualitative data to give a thorough representation of anaesthetists in training experience. Our results confirm that the impact of AAs on training remains a polarising topic. A third of anaesthetists in training with prior experience of working with AAs reported a negative impact on their training experience. Factors mentioned included lack of case numbers, lack of access to learning and performing regional anaesthesia, and lack of clarity in lines of supervision. Of those with no prior experience working with AAs, there was a strong negative perception towards expansion of the workforce. A small proportion described a positive experience, indicating that with clear role definition, careful implementation along with co-operation, a positive experience in all departments could be achievable. Our findings suggest a need for increased consultation and communication with stakeholders in the anaesthesia workforce, including anaesthetists in training, to ensure smooth and safe integration of the AA workforce.
Extended High-Frequency Audiometry using the Wireless Automated Hearing Test System Compared to Manual Audiometry in Children and Adolescents
Authors: Blankenship Chelsea M. , Hickson Lindsey M. , Quigley Tera , Larsen Erik , Lin Li , Hunter Lisa L. 
Published: May 2023

ABSTRACTObjectivesReliable wireless automated audiometry that includes extended high frequencies (EHF) outside a sound booth would increase access to monitoring programs for individuals at risk for hearing loss, particularly those at risk for ototoxicity. The purpose of the study was to compare thresholds obtained with 1) standard manual audiometry to automated thresholds measured with the Wireless Automated Hearing Test System (WAHTS) inside a sound booth, and 2) automated audiometry in the sound booth to automated audiometry outside the sound booth in an office environment.DesignCross-sectional, repeated measures study. Twenty-eight typically developing children and adolescents (mean = 14.6 yrs; range = 10 to 18 yrs). Audiometric thresholds were measured from 0.25 to 16 kHz with manual audiometry in the sound booth, automated audiometry in the sound booth, and automated audiometry in a typical office environment in counterbalanced order. Ambient noise levels were measured inside the sound booth and the office environment were compared to thresholds at each test frequency.ResultsAutomated thresholds were overall about 5 dB better compared to manual thresholds, with greater differences in the extended high frequency range (EHF;10-16 kHz). The majority of automated thresholds measured in a quiet office were within ± 10 dB of automated thresholds measured in a sound booth (84%), while only 56% of automated thresholds in the sound booth were within ± 10 dB of manual thresholds. No relationship was found between automated thresholds measured in the office environment and the average or maximum ambient noise level.ConclusionsThese results indicate that self-administered, automated audiometry results in slightly better thresholds overall than manually administered audiometry in children, consistent with previous studies in adults. Ambient noise levels in a typical office environment did not have an adverse effect on audiometric thresholds measured using noise attenuation headphones. Thresholds measured using an automated tablet with noise attenuating headphones could improve access to hearing assessment for children with a variety of risk factors. Additional studies of extended high frequency automated audiometry in a wider age range are needed to establish normative thresholds.
Microbial Remediation of Pesticide Accumulation and its Response of Bacterial Wilt in Brinjal
Authors: Ahmed Shenaz Sultana , Bora Popy 
Published: May 2023

ABSTRACTGrowing brinjal (Solanum melongenaL.) in a soil polluted with organophosphorus pesticide (OP) residues coupled with an additional threat of wilt disease caused byRalstonia solanacearum(Rs), pose a formidable management challenge for residue free crop production. Our study aimed at identifying efficient OP-degrading bacteria (OPDB) and their compatibility with microbial bio-control agents (MBCA) for twin objective of microbial degradation of OP -residues and reduction in incidence of bacterial wilt of brinjal in OP-contaminated soil. As many, ten bacterial isolates showing OP-degrading potential were recovered through colony growth in mineral salt (MS) - medium treated with 25 ppm chlorpyriphos. Efficient isolates displaying growth up to 700ppm chlorpyriphos were further screened for OP-degradation, leading to identification of two most efficient OPDB,Acromobacter marplatensis[MW397524] (Am) andPseudomonas azotoformans[MW397525] (Pa). These two isolates havingin vitrocompatibility with each other, showed further compatibility with two most widely used MBCA, viz.,Pseudomonas flourescens[KT258013] (Pf) andTrichoderma harzianum[ON364138] (Th), facilitating the development of consortium having extended functional corridor. The response of combination of OPDB + MBCA(Am+Pa+Pf+Th) showed 80% lower percent wilt incidence (PWI), 2.8 times higher fruit yield of brinjal, and 15-25% lower OP-residues over un-inoculated control treatment. Our studies, hence, put forward a strong unified delivery mechanism of OPDB and MBCA as a part of green technology for chemical residue -free vegetable production in contaminated soils.IMPORTANCEMicrobes isolated from crop rhizospheres are known to exhibit multiple functions (plant growth promotion, antagonism against soil borne pathogens e.g.,Rs,and acaricidal properties) depending upon type of stimuli by regulating the plant defense. Considering the limited past efforts on twin objective of cleaning up the pesticide residues accumulated in the soil (microbial removal of pesticide residues) and providing an additional safeguard against soil borne pathogen causing bacterial wilt in brinjal to collectively develop a microbial consortia mediated crop production system, devoid of any chemical residues. Such an effort adds strength to organic production system on pesticide contaminated soils. In the present study, we succeeded in identifying two most effective chloropyrifos residues degrading OPDB having compatibility two MBCA for developing consortia formulation, which aided in developing pesticide residue free soil, neutralising bacterial wilt pathogen (Rs), and creating a better nutrient supply for a well deserved production system. Such efforts would pave the way for developing more robust microbial formulations (with emphasis on entomopathogenic application) having dynamic microbial functions to replace any futuristic use of agrochemcials.
Spatiotemporal Variations of “Triple-demic” Outbreaks of Respiratory Infections in the United States in the Post-COVID-19 Era
Authors: Luo Wei , Liu Qianhuang , Zhou Yuxuan , Ran Yiding , Liu Zhaoyin , Hou Weitao , Pei Sen , Lai Shengjie 
Published: May 2023

SummaryObjectivesThe United States confronted a “triple-demic” of influenza, respiratory syncytial virus, and COVID-19 in the winter of 2022, resulting in increased respiratory infections and a higher demand for medical supplies. It is urgent to analyze each epidemic and their co-occurrence in space and time to identify hotspots and provide insights for public health strategy.MethodsWe used retrospective space-time scan statistics to retrospect the situation of COVID-19, influenza, and RSV in 51 US states from October 2021 to February 2022, and then applied prospective space-time scan statistics to monitor spatiotemporal variations of each individual epidemic, respectively and collectively from October 2022 to February 2023.ResultsOur analysis indicated that compared to the winter of 2021, COVID-19 cases decreased while influenza and RSV infections increased significantly during the winter of 2022. We revealed that a twin-demic high-risk cluster of influenza and COVID-19 but no triple-demic clusters emerged during the winter of 2021. We further identified a large high-risk cluster of triple-demic in the central US from late November, with COVID-19, influenza, and RSV having relative risks of 1.14, 1.90, and 1.59, respectively. The number of states at high risk for multiple-demic increased from 15 in October 2022 to 21 in January 2023.ConclusionOur study provides a novel spatiotemporal perspective to explore and monitor the transmission patterns of the triple epidemic, which could inform public health authorities’ resource allocation to mitigate future outbreaks.
HiTE: An accurate dynamic boundary adjustment approach for full-length Transposable Elements detection and annotation in Genome Assemblies
Authors: Hu Kang , Xu Minghua , Zou You , Wang Jianxin 
Published: May 2023

AbstractRecent advancements in genome assembly have greatly improved the prospects for comprehensive annotation of Transposable Elements (TEs). However, existing methods for TE annotation using genome assemblies are less accurate and robust, requiring extensive manual editing. In addition, the currently available gold-standard TE databases are not comprehensive, even for extensively studied species, highlighting the critical need for an automated TE detection method to supplement existing repositories. In this study, we introduce HiTE, an accurate dynamic boundary adjustment approach designed to detect full-length TEs. The experimental results demonstrate that HiTE identified 932 perfect TE models with a precision of 0.971 on the rice reference genome, which are 142% and 4.42% higher than the state-of-the-art tool RepeatModeler2, respectively. Furthermore, HiTE discovers over 800 novel TIR elements with well-defined structures that are not included in known libraries, enabling the discovery of new insights. We have also implemented a Nextflow version of HiTE to enhance its parallelism reproducibility, and portability.