bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcriptomic analysis reveals the formation mechanism of anemone-type flower in chrysanthemum
Authors: Fan Jiawei , Huang Jialu , Pu Ya , Niu Yajing , Zhang Mengmeng , Dai Silan , Huang He 
Published: December 2022

Abstract
Background
The ray and disc florets on the chrysanthemum capitulum are morphologically diverse and have remarkably abundant variant types, resulting in a rich variety of flower types. An anemone shape with pigmented and elongated disk florets is an important trait in flower shape breeding of chrysanthemums. The regulatory mechanism of their anemone-type disc floret formation was not clear, thus limiting the directional breeding of chrysanthemum flower types. In this study, we used morphological observation, transcriptomic analysis, and gene expression to investigate the morphogenetic processes and regulatory mechanisms of anemone-type chrysanthemum.

Result
Scanning electron microscopy (SEM) observation showed that morphological differences between non-anemone-type disc florets and anemone-type disc florets occurred mainly during the petal elongation period. The anemone-type disc florets elongated rapidly in the later stages of development. Longitudinal paraffin section analysis revealed that the anemone-type disc florets were formed by a great number of cells in the middle layer of the petals with vigorous division. We investigated the differentially expressed genes (DEGs) using ray and disc florets of two chrysanthemum cultivars, 082 and 068, for RNA-Seq and their expression patterns of non-anemone-type and anemone-type disc florets. The result suggested that the CYCLOIDEA2 (CYC2s), MADS-box genes, and phytohormone signal-related genes appeared significantly different in both types of disc florets and might have important effects on the formation of anemone-type disc florets. In addition, it is noteworthy that the auxin and jasmonate signaling pathways might play a vital role in developing anemone-type disc florets.

Conclusions
Based on our findings, we propose a regulatory network for forming non-anemone-type and anemone-type disc florets. The results of this study lead the way to further clarify the mechanism of the anemone-type chrysanthemum formation and lay the foundation for the directive breeding of chrysanthemum petal types.
Efficacy and safety of intranasal midazolam versus intranasal ketamine as sedative premedication in pediatric patients: a meta-analysis of randomized controlled trials
Authors: Lang Bingchen , Wang Huiqing , Fu Yuzhi , Zeng Linan , Huang Liang , Zhang Qianqian , Chen Shouming , Jia Zhi-jun , Zhang Lingli 
Published: December 2022

AbstractBackgroundIntranasal midazolam and ketamine have been widely used as sedative premedication in children. It is difficult to determine which one yields better sedative effects for clinical practice. We conducted the present meta-analysis by summarizing the evidences to evaluate the efficacy and safety of intranasal midazolam versus intranasal ketamine as sedative premedication in pediatric patients.MethodsWe searched PubMed, Embase, and Cochrane Library from inception to April 2022. All randomized controlled trials (RCTs) used intranasal midazolam and ketamine as sedatives in children were enrolled. The risk of bias in RCTs was assessed by Cochrane risk of bias tool. Condition of parental separation, anesthesia induction or facemask acceptance, sedation level, different hemodynamic parameters and adverse events were considered as the outcomes in our study.ResultsA total of 16 studies with 1066 patients were enrolled. Compared with midazolam, administration of intranasal ketamine might be associated with severer changes in hemodynamics parameters including mean blood pressure (SMD = -0.53, with 95% CI [-0.93, -0.13]) and heart rate (HR) (SMD = -1.39, with 95% CI [-2.84, 0.06]). Meanwhile, administration of intranasal midazolam was associated with more satisfactory sedation level (61.76% vs 40.74%, RR = 1.53, with 95%CI [1.28, 1.83]), more rapid onset of sedation (SMD = -0.59, with 95%CI [-0.90, -0.28]) and more rapid recovery (SMD = -1.06, with 95%CI [-1.83, -0.28]). Current evidences also indicated that the differences of various adverse effects between two groups were not significant.ConclusionsGiven that administration of midazolam via intranasal route provides more satisfactory sedative level with less fluctuation of hemodynamics parameters and more rapid onset and recovery, it might be considered as the preferred sedative premedication for pediatric patients compared to ketamine. However, the widespread evidences with low or moderate quality indicated that superiority of intranasal midazolam in pediatric sedation needs to be confirmed by more studies with high quality and large sample size in future.Trial registrationThe protocol of present study was registered with PROSPERO (CRD42022321348).
Effectiveness and cost-effectiveness of a telemedicine programme for preventing unplanned hospitalisations of older adults living in nursing homes: the GERONTACCESS cluster randomized clinical trial
Authors: Gayot Caroline , Laubarie-Mouret Cécile , Zarca Kevin , Mimouni Maroua , Cardinaud Noelle , Luce Sandrine , Tovena Isabelle , Durand-Zaleski Isabelle , Laroche Marie-Laure , Preux Pierre-Marie , Tchalla Achille 
Published: December 2022

Abstract
Objective
The GERONTACCESS trial evaluated the utility and cost-effectiveness of a gerontological telemedicine (TLM) programme for preventing unplanned hospitalisation of residents living in nursing homes (NHs) in regions lacking medical facilities and/or qualified medical providers (“medical deserts”).

Design
GERONTACCESS was a 12-month, multicentre, prospective cluster-randomised trial conducted in NHs. The intervention group underwent TLM assessments every 3 months. The control group received the usual care. In both groups, comprehensive on-site assessments were conducted at baseline and the final visit. Care requirements were documented throughout the study.

Setting and participants
NH residents aged ≥ 60 years with multiple chronic diseases.

Methods
The study outcomes were the proportion of patients who experienced avoidable and unplanned hospitalisation, and the incremental cost savings per quality-adjusted life years from baseline to the 12-month follow-up.

Results
Of the 426 randomised participants (mean ± standard deviation age, 87.2 ± 7.6 years; 311 [73.0%] women), 23.4% in the intervention group and 32.5% in the control group experienced unplanned hospitalisation (odds ratio [OR] = 0.73, 95% confidence interval [CI] 0.43 to 0.97; p = 0.034). Each avoided hospitalisation in the intervention group saved $US 3,846.

Conclusions and implications
The results of GERONTACCESS revealed that our gerontological, preventative TLM program significantly reduced unplanned hospitalisations. This innovative intervention limited disease progression and promoted a healthy lifestyle among NH residents.

Trial registration
Clinicaltrials.gov, NCT02816177, registered June 28, 2016.
The unmet needs of older adults living in nursing homes in Mainland China: a nation-wide observational study
Authors: Huang Deqin , Zeng Tieying , Mao Jing , Zhao Meizhen , Wu Meiliyang 
Published: December 2022

Abstract
Background
The unmet needs of older adults in nursing homes could result in their poor health status physically and psychologically. The aim of this study was to understand the characteristics of unmet needs of older adults residing in nursing homes in China, and to probe into the contributing factors.

Methods
In this cross-sectional design, the demographic and health status questionnaire, Modified Barthel Index, the Numerical Rating Scale for pain assessment, Geriatric Depression Scale, Camberwell Assessment of Need for the elderly were employed to survey older adults living in 38 nursing homes in 13 cities in China from July 2017 to June 2018 through a multi-stage, stratified sampling scheme. The Short Portable Mental Status Questionnaire was adopted to exclude participants with severe cognitive impairment. Aside from descriptive analysis, a raft of hierarchical logistic regression models were run by sequentially controlling for the independent variables at 5 levels (demographic characteristics, health status, pain, ADL, and depression), aiming to identify the influencing factors of the unmet needs of the residents.

Results
The effective sample size involved 2063 older adults (63.4% female versus 36.6% male), with a response rate of 98.5%. The median and inter-quartile range of the total needs and unmet needs of the sample was 3(1, 4) and 0(0, 1) respectively, with 122 older participants having more than 3 unmet needs (high unmet need category) versus 1922 older ones having ≤ 3 unmet needs (low unmet need category). The unmet needs of older adults in nursing homes mainly fell into social domains. Gender, religion, educational background, marital status, living condition before admission, room type, incomes, staffing, number of diseases, pain, Barthel Index, and depression were contributive to unmet needs of older adults in long-term care facilities in the final model that was adjusted for all levels of variables (all p < 0.05).

Conclusion
Understanding the influencing factors of the unmet needs of older adults in long term care provides clues for healthcare professionals to offer better care for this population. System-level support to nursing homes and training of staff are highlighted. Plus, taking measures to beef up social connections for the older adults to meet their social needs was suggested.
Bacteriophages of Mycobacterium tuberculosis, their diversity, and potential therapeutic uses: a review
Authors: Zeynali kelishomi Fatemeh , Khanjani Susan , Fardsanei Fatemeh , Saghi Sarabi Hediyeh , Nikkhahi Farhad , Dehghani Behzad 
Published: December 2022

AbstractTuberculosis (TB) caused by Mycobacterium tuberculosis (M. tuberculosis) is a highly infectious disease and worldwide health problem. Based on the WHO TB report, 9 million active TB cases are emerging, leading to 2 million deaths each year. The recent emergence of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) strains emphasizes the necessity to improve novel therapeutic plans. Among the various developing antibacterial approaches, phage therapy is thought to be a precise hopeful resolution. Mycobacteriophages are viruses that infect bacteria such as Mycobacterium spp., containing the M. tuberculosis complex. Phages and phage-derived proteins can act as promising antimicrobial agents. Also, phage cocktails can broaden the spectrum of lysis activity against bacteria. Recent researches have also shown the effective combination of antibiotics and phages to defeat the infective bacteria. There are limitations and concerns about phage therapy. For example, human immune response to phage therapy, transferring antibiotic resistance genes, emerging resistance to phages, and safety issues. So, in the present study, we introduced mycobacteriophages, their use as therapeutic agents, and their advantages and limitations as therapeutic applications.
Pre-hospital and intrahospital workflow optimization for patients with suspected ischemic stroke due to large vessel occlusion - findings from a tertiary care facility
Authors: Krebs Stefan , Ferrari Julia , Schürer Alice , Chiari Astrid , Neumann Christian , Lang Wilfried , Sykora Marek 
Published: December 2022

Abstract
Background
The efficacy of recanalization treatment in patients with ischemic stroke due to large vessel occlusion (LVO) is highly time dependent. We aimed to investigate the effects of an optimization of prehospital and intrahospital pathways on time metrics and efficacy of endovascular treatment in ischemic stroke due to LVO.

Methods
Patients treated with mechanical thrombectomy (MT) at the Hospital of St. John of God Vienna, Austria, between 2013 and 2020 were extracted from the Austrian Stroke Unit Registry. Study endpoints including time metrics, early neurological improvement and functional outcome measured by modified Rankin Scale (mRS) at 3 months were compared before and after optimization of prehospital and intrahospital pathways.

Results
Two hundred ninety-nine patients were treated with MT during the study period, 94 before and 205 after the workflow optimization. Workflow optimization was significantly associated with time metrics improvement (door to groin puncture time 45 versus 31 min; p < 0.001), rates of neurological improvement (NIHSS ≥ 8: 30 (35%) vs. 70 (47%), p = 0.04) and radiological outcome (TICI ≥ 2b: 71 (75%) versus 153 (87%); p = 0.013). Functional outcome (mRS 0–2: 17 (18%) versus 57 (28%); p = 0.067) and mortality (34 (37%) versus 54 (32%); p = 0.450) at 3 months showed a non-significant trend in the later time period group.

Conclusion
The implementation of workflow optimization was associated a significant reduction of intrahospital time delays and improvement of neurological and radiological outcomes.
Dads in Distress: symptoms of depression and traumatic stress in fathers following poor fetal, neonatal, and maternal outcomes
Authors: Kothari A. , Bruxner G. , Dulhunty J. M. , Ballard E. , Callaway L. 
Published: December 2022

AbstractBackgroundThis study aims to explore the prevalence of symptoms of depression and traumatic stress in fathers in the setting of poor fetal, neonatal, and maternal outcomes.MethodsA prospective mixed-methods study was conducted at an outer metropolitan public teaching hospital in Brisbane, Australia, with quantitative results presented here. Subjects included 28 fathers whose partners had experienced pregnancy or childbirth complicated by a significant congenital abnormality or aneuploidy, termination of pregnancy, fetal death in-utero, stillbirth, admission to the neonatal intensive care unit or special care nursery or significant maternal morbidity, such as a postpartum haemorrhage or an emergency postpartum hysterectomy. These experiences were classified into two groups: anticipatory (time to prepare) and sudden (no warning). The fathers were screened using the Edinburgh Postnatal Depression Scale (EPDS) and the Impact of Events Scale-Revised (IES-R) to assess subjective distress at 2-3 weeks (timepoint 1) and 3-4 months (timepoint 2) after the event.ResultsData for both the EPDS and IES-R scales was available for 26 fathers (92.9%) at timepoint 1 and for 15 fathers (53.6%) at timepoint 2. High overall EPDS scores (≥10) were noted in 16/27 (59.3%) fathers at timepoint 1 and 6/15 fathers (40.0%) at timepoint 2. High overall IES-R scores ≥33 were noted in 12/26 (46.2%) fathers at timepoint 1 and 4/15 fathers (26.7%) at timepoint 2. A higher percentage of fathers who experienced anticipatory events had EPDS and IES-R score above these cut-offs at timepoint 1 (8/13 or 61.5%) compared to those experiencing sudden events (8/14 or 57.1%), however, percentages were similar between groups at time point 2 (2/7 or 28.6%% and 4/8 or 50.0%, respectively). More fathers who experienced anticipatory events had IES-R scores ≥33 at timepoint 1 (7/13 or 53.8%) compared to those experiencing sudden events (5/14 or 38.0%).ConclusionOur study indicates high rates of distress in fathers exposed to poor fetal, neonatal, and maternal outcomes, which can persist for months after the event. Increased support for fathers in this setting may be required to prevent poor mental health. Further research on the long-term effects of these adverse events is warranted.
Unilateral surgery for pediatric sensory exotropia: clinical characteristics and surgical results
Authors: Shafik Heba M. , Eldesouky Mohamed Ashraf , Elbakary Molham A. , Elbedewy Hazem A. 
Published: December 2022

Abstract
Background
To delineate the clinical characteristics and surgical outcomes of large angle sensory exotropia in pediatric patients.

Methods
The medical records of 54 large angle exotropia ≥40 PD patients aged from 1 to 18 years who were operated on between 2018 and 2021 and were followed up for 1 year were reviewed and contacted. Clinical characteristics and surgical outcomes were analyzed retrospectively. Patients were divided into two groups, group S patients had supermaximum recession resection and group E had augmented recession by lateral rectus muscle elongation with an autograft from the resected medial rectus muscle in the same eye. The clinical characteristics and results of both groups were compared.

Results
The mean age of the studied patients with sensory exodeviation at the time of surgery was 8.3 ± 4.2 years. Mean of the duration of exotropia was 6.9 ± 2.2 years, and the mean of postoperative follow-up was 14.3 ± 4.2 months. Surgical success was achieved in 73.07% of group S and 82.14% of group E. Recurrence was more common with anterior segment pathology. Larger post-operative distant angles were strongly related to poorer visual acuities P = 0.001 and not related to the age of onset or the duration. Narrowing of the palpebral fissure improved in both groups at the last follow up P = 0.336. The limitation of abduction in both groups improved in the last follow up P = 0.145.

Conclusion
The outcome of monocular surgery for sensory exotropia in children is satisfactory with no significant differences in results between lateral rectus muscle tendon autograft elongation technique and supermaximum recession resection. Recurrence is more common with anterior segment pathology. Larger post-operative distant angle of deviation is strongly related to poorer visual acuity.

Clinical trial registration
This study was retrospectively registered at clinicaltrials.gov (ID: NCT04286945) on 25-2-2020.
Behavioral responses for facemask use messages to prevent COVID-19 among residents of Bahir Dar City, Ethiopia: an application of extended parallel process model
Authors: Eseyneh Tenagnework , Wondiye Habtamu , Fentaw Zinabu , Eseyneh Netsanet , Bogale Eyob Ketema , Gutema Hordofa 
Published: December 2022

Abstract
Background
The coronavirus disease 2019 (COVID-19) pandemic causes major morbidity and mortality in the world. Timely behavioral response assessment of the community is important to shape the next effective interventions and risk communication strategies to adopt preventive behavior. Hence, this study aimed to assess behavioral responses for facemask-use messages to prevent COVID-19 and its predictors among residents of Bahir Dar City, Ethiopia, 2021 by using the Extended Parallel Process Model.

Methods
A community-based cross-sectional study was conducted with the guide of the Extended Parallel Process Model in Bahir Dar city from March 9 to April 9, 2021. A multistage sampling technique was used, and data was collected through a face-to-face interviewer-administered questionnaire using Epicollect5. Descriptive statistics and Binary logistic regression were computed using SPSS V.25. Variable with P < 0.25 in the bivariable analysis was a candidate for multivariable analysis to control confounding effect. In multivariable analysis, variables with P < 0.05 were considered statistically significant and the result was presented using an adjusted odd ratio (AOR) with a 95% confidence interval (CI).

Results
A total of 616 participants with a response rate of 97.1% were included. Of the total participants, 229(37.2%) were in the danger control response. The behavioral response was affected by Occupational status [AOR (95%CI) 3.53(1.67–7.46)], the number of people living together [AOR (95%CI) 2.62(1.28–5.39)], self-control [AOR (95%CI) 1.14(1.05–1.25)], a friend for the preferred source of information [AOR (95%CI) 5.18(3.22–8.33)] and printed materials for the preferred channel [AOR (95%CI) 2.14(1.35–3.43)].

Conclusion
Above one-third of the participants were in the danger control response. Occupational status, number of people living together, self-control, a friend for the preferred source of information, and printed materials for the preferred channel were independent predictors of resident behavioral response to the use of facemasks. Policymakers should consider students and people who live alone. Message developers should use a friendly person to transmit messages and should prepare printed materials. Activities and strategies should also focus on self-control and perceived efficacy without ignoring the perceived threat.
Clinical and radiologic outcomes of biportal endoscopic lumbar discectomy in obese patients: a retrospective case-control study
Authors: Park Hyun-Jin , Choi Jun-Young , You Ki-Han , Kang Min-Seok , Lee Woo-Myung , Hyun Jin-Tak , Park Sang-Min 
Published: December 2022

Abstract
Background
Obese patients have a higher risk of complications during spinal surgery than non-obese patients. To the best of our knowledge, no studies have examined the differences in clinical and radiological outcomes after biportal endoscopic lumbar discectomy (BELD) between obese and non-obese patients. The study evaluated the association between obesity and outcomes after BELD in patients with lumbar disc herniation.

Methods
This was a retrospective case-control study conducted from March 2017 to March 2021 at two hospitals with 360 patients who underwent BELD after showing no improvement with conservative treatment. Clinical and radiologic outcomes were retrospectively analyzed after BELD in the non-obese (body mass index [BMI] < 30 kg/m2) and obese (BMI ≥ 30 kg/m2) groups. Demographic data and surgery-related factors were compared between the two groups. Clinical outcomes were followed up for 12 months after surgery and analyzed for differences.

Results
A total of 211 patients were enrolled in this study, and through case-control matching, the data of 115 patients (29, obese group; 86, non-obese group) were analyzed. The two groups showed no significant differences in Oswestry Disability Index, European Quality of Life-5 Dimensions (EQ-5D), and visual analog scale scores measured immediately after BELD and 12 months after surgery. After surgery, back pain, radiating leg pain, and EQ-5D scores improved. However, there was no significant difference in improvement, residual herniated disc, hematoma, or recurrence between the groups.

Conclusions
Obese patients who underwent BELD for lumbar disc herniation showed no significant difference in clinical and radiologic outcomes compared with non-obese patients.
Transverse differences between cleft lip and palate and non-cleft palate with skeletal Class III malocclusion using buccolingual inclination: a cone-beam computed tomography retrospective study
Authors: He Jiabei , Jiang Lihua , Song Shaohua , Mo Shuixue 
Published: December 2022

Abstract
Background
The purpose of this study was to evaluate the differences between buccolingual inclination (BI) of maxillary posterior teeth in patients with cleft lip and palate (CLP) and non-cleft palate with skeletal Class III malocclusion. We propose a method of maxillary expansion which is more suitable for patients with CLP.

Methods
For this retrospective study, 40 patients with CLP and 21 patients with skeletal Class III malocclusion were selected. The CLP group was divided into the unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) groups. The BI of the maxillary first premolar (BI4), maxillary second premolar (BI5) and first molar (BI6) were measured using cone-beam computed tomography, and the differences between them were compared and analyzed by Student’s t-test.

Results
There were significant differences between cleft side BI4 and non-cleft side BI4 in the UCLP group, BI5 in the BCLP group, BI4 and BI5 in all CLP groups and the skeletal Class III malocclusion group. BI6 was similar across all three groups.

Conclusions
The premolars of patients with CLP do not exhibit the same regularity as those with Class III malocclusion; this may be related to surgical scarring of the cleft palate. Greater attention should be paid to the correction of BI in the maxillary expansion of patients with CLP.