bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing the electron transport chain to sustainably improve photosynthesis
Authors: Gu Lianhong 
Published: September 2023

AbstractGenetically improving photosynthesis is a key strategy to boosting crop production to meet the rising demand for food and fuel by a rapidly growing global population in a warming climate. Many components of the photosynthetic apparatus have been targeted for genetic modification for improving photosynthesis. Successful translation of these modifications into increased plant productivity in fluctuating environments will depend on whether the electron transport chain (ETC) can support the increased electron transport rate without risking overreduction and photodamage. At present atmospheric conditions, the ETC appears suboptimal and will likely need to be modified to support proposed photosynthetic improvements and to maintain energy balance. Here, I derive photochemical equations to quantify the transport capacity and the corresponding reduction level based on the kinetics of redox reactions along the ETC. Using these theoretical equations and measurements from diverse C3/C4 species across environments, I identify several strategies that can simultaneously increase the transport capacity and decrease the reduction level of the ETC. These strategies include increasing the abundances of reaction centers, cytochrome b6f complexes, and mobile electron carriers, improving their redox kinetics, and decreasing the fraction of secondary quinone–nonreducing photosystem II reaction centers. I also shed light on several previously unexplained experimental findings regarding the physiological impacts of the abundances of the cytochrome b6f complex and plastoquinone. The model developed, and the insights generated from it facilitate the development of sustainable photosynthetic systems for greater crop yields.
Measuring Welfare by Matching Households across Time
Authors: Baqaee David R , Burstein Ariel T , Koike-Mori Yasutaka 
Published: September 2023

AbstractThe money metric utility function is an essential tool for calculating welfare-relevant growth and inflation. We show how to recover it from repeated cross-sectional data without making parametric assumptions about preferences. We do this by solving the following recursive problem. Given compensated demand, we construct money metric utility by integration. Given money metric utility, we construct compensated demand by matching households over time whose money metric utility value is the same. We illustrate our method using household consumption survey data from the United Kingdom from 1974 to 2017 and find that real consumption calculated using official aggregate inflation statistics overstates money metric utility in 1974 pounds for the poorest households by around 0.5% a year and understates it by around a third of a percentage point per year for the richest households. We extend our method to allow for missing or mismeasured prices, assuming preferences are separable between goods with well-measured prices and the rest. We discuss how our results change if the prices of some service sectors are mismeasured.
Biologic disease-modifying anti-rheumatic drugs are equally effective in psoriatic arthritis patients with low and high joint counts
Authors: Möller Burkhard , Scholz Godehard A , Amsler Jennifer , Ciurea Adrian , Micheroli Raphael , Nissen Michael J , Papagiannoulis Eleftherios , Blapp Christoph , Scherer Almut , Yawalkar Nikhil 
Published: September 2023

Abstract

Objective
A lack of representation in pivotal trials currently limits guidance for the use of biologic DMARDs (bDMARDs) in PsA patients with a low number of actively inflamed joints. The aim of this study was to compare the effectiveness of a first bDMARD in PsA patients with a low vs high number of affected joints.

Methods
PsA patients with available 66/68 joint count assessments were divided into low joint count (LJC) patients when presenting with &lt;3 tender or &lt;3 swollen joints or high joint count (HJC) patients with ≥3 joints in both categories. We studied drug retention as a joint count independent effectiveness variable in LJC and HJC patients in univariate and multivariable adjusted Cox regression models.

Results
A total of 197 LJC patients differed not only in joint counts, but also had lower enthesitis scores, less often dactylitis, less disability and a better health-related quality of life at first bDMARD initiation than 190 HJC patients. However, LJC patients were less often on conventional synthetic DMARDs (csDMARDs). Despite these differences at baseline, bDMARD retention was not significantly different between LJC and HJC patients in both crude and adjusted analyses [hazard ratio (HR) 1.09 (95% CI 0.76, 1.58), P = 0.52]. Furthermore, bDMARD retention was significantly better [HR 0.63 (95% CI 0.47, 0.85), P &lt; 0.002] when administered with csDMARD co-therapy.

Conclusions
bDMARDs were similarly effective in terms of drug retention in patients with low and high joint counts. In the setting of absent remission and a significant disease burden, bDMARDs should not be withheld from patients because they exhibit only a low joint count.
Establishing the Role of Inflammatory Markers in the Diagnosis and Treatment of Acute Hand Infections in the Pediatric Population
Authors: Schutz John , Lalka Andy , Williams Morgan A. , Sibbel Sarah E. , Sinclair Micah K. 
Published: September 2023

Introduction:
Distinguishing the severity of the diagnosis and an appropriate treatment plan in pediatric hand infections can be complex due to the variable amount of information available at the presentation. Inflammatory blood markers, including white blood cell count, erythrocyte sedimentation rate, and C-reactive protein are reported to aid in determining the severity of infection and response to treatment in adult hand infections. The purpose of this study was to identify the relevance of inflammatory marker levels in pediatric patients with hand and wrist infections and to determine their utility in diagnosis and treatment.

Methods:
This multicenter, retrospective, cohort study included patients aged 0 to 18 who received treatment for an acute hand or wrist infection between 2009 and 2020. Data collected included demographics, time to presentation, diagnosis, inflammatory markers, culture results, antibiotic treatment, and surgical treatment. Infections were categorized as deep (osteomyelitis, tenosynovitis, abscess) and superficial (paronychia, felon, cellulitis). Exclusion criteria included: patients above 18 years of age, chronic infection, open fractures, and absence of any documented inflammatory markers. Statistically, t tests were used to compare mean differences in inflammatory markers between patients who did and did not receive pretreatment antibiotics and between patients who had superficial versus deep hand infections.

Results:
A total of 123 patients met the inclusion criteria. Pretreatment with antibiotics before definitive management was not significantly associated with differences in laboratory markers compared with patients not pretreated with antibiotics. Deep hand infections had inflammatory markers similar to superficial infections. Patients with deep hand infections required a bedside or operative procedure 78.9% of the time compared with superficial infections (21.2%) (P<0.001). Patients with an isolated methicillin-resistant Staphylococcus aureus infection had inflammatory marker values that were not significantly different from patients infected with all other microbes.

Conclusions:
Inflammatory markers were not significantly different between patients who received pretreatment with antibiotics and those who did not. While deep infections were often treated with bedside or surgical procedures, the inflammatory marker values were similar to those of superficial infections. The same held true for patients infected with culture-positive, isolated methicillin-resistant Staphylococcus aureus bacteria. Consequently, inflammatory markers may be useful to identify the presence of infection and monitor the response to treatment, they did not aid in determining the specific type of infection or selection of a treatment plan.

Level of Evidence:
Level III—retrospective comparative study.
Post-Acute Myocardial Infarction Heart Failure Core Genes and Relevant Signaling Pathways
Authors: Lin Ling , Zicheng Ling , Shaohua Gu 
Published: September 2023

Abstract:
There is increasing concern about heart failure after myocardial infarction and the current clinical treatment measures for ventricular remodeling. Herein, we present the results of differential gene analysis, pathway enrichment analysis, and characteristic gene screening. Our study identifies 4 core genes (KLRC2, SNORD105, SNORD45B, and RNU5A-1) associated with post-acute myocardial infarction (AMI) heart failure. The authors discuss the significance of the identified core genes, their potential implications in immune dysfunction and heart failure, and their relevance to disease regulatory genes. The study concludes by emphasizing the importance of clinical relevance in molecular research and suggests potential therapeutic targets for post-AMI heart failure.
A huge gastric trichobezoar presenting with Rapunzel syndrome: A case report
Authors: Lohiya Makhan Lal , Chandawat Parikshit Singh , Rangi Jay Prakash , Lal Mohan , Kulhari Apeksha 
Published: September 2023

Abstract
Trichobezoars are gastrointestinal concretions of ingested hair. These are uncommon conditions that arise in emotionally disturbed or mentally impaired young women during childhood and adolescence. Rapunzel syndrome is rare gastric trichobezoar that extends beyond the pylorus, leading to an intestinal obstruction. Gastric trichobezoars do not manifest symptoms until they are very large. Here, we report a 16-year-old girl with a 5-year history of trichophagia and trichotillomania who suffered from a huge (30 × 7.5 × 6 cm) gastric trichobezoar extending into the duodenum (Rapunzel syndrome) that was successfully addressed by laparotomy, psychiatric treatment, and follow-up.
Flap Viability Evaluation Using a Tissue Oximetry Camera as an Alternative to Indocyanine Green Fluorescence Imaging
Authors: Takaya Ayako , Tsuge Itaru , Nakano Takashi , Yamanaka Hiroki , Katsube Motoki , Sakamoto Michiharu , Morimoto Naoki 
Published: September 2023

Summary:
Indocyanine green (ICG) fluorescence imaging is useful for assessing flap viability; however, it is associated with a risk of anaphylactic shock, even in patients with no history of drug allergies. SnapshotNIR is a noncontact, camera-type handheld tissue oximeter that can measure the tissue oxygen saturation of the body surface. The device emits red and near infrared light wavelengths and then optimizes the measurement of the differential reflectance from oxygenated and deoxygenated hemoglobin, and StO2 is calculated. A 20 × 15 cm surgical field can be evaluated in less than 3 seconds by holding the camera at a distance of 30 cm. We applied this device at zone II in a deep inferior epigastric perforator (DIEP) flap, and compared the findings with the border of flap perfusion detected by ICG imaging. Left breast reconstruction using a free DIEP flap was performed for a 60-year-old woman. The DIEP flap was vascularized by a perforator vessel coursing to the right abdominis muscle. First, Diagnogreen (5 mg; Daiichi Sankyo Co., Tokyo, Japan) was intravenously injected, and the ICG fluorescence perfusion border detected by PDE-neo (Hamamatsu Photonics, Hamamatsu City, Shizuoka, Japan) was determined. The ICG border was defined by two reconstructive surgeons after fluorescence had spread out for 2 minutes. Next, zones Ⅱ and Ⅳ of the DIEP flap, contralateral to the perforator, were evaluated using photographs obtained by SnapshotNIR. There were significant StO2 value differences between the ICG-negative area and ICG-positive area. This device can be widely applied in the noninvasive evaluation of flap viability.
Hinge Strut: A New Septal Strut for Nasal Tip Projection, Definition, and Stability in Latino Noses
Authors: Pérez Willis Wilder A. , Adrianzen Nuñez Gerardo A. , Mendoza Guerra Cynthia P. , Perez Soto Wilder A. 
Published: September 2023

Background:
Obtaining ideal support to maintain the nasal tip has been investigated in several rhinoplasty studies. We aimed to describe a support technique, namely the use of a “hinge strut” (HS) for the nasal tip in Latino noses and to evaluate nasolabial angles at 6-months follow-up.

Methods:
In total, 46 Latino patients who had undergone rhinoplasty using the HS technique between June 2021 and June 2022 were recruited in Lima, Peru. All patients had nasolabial angle measurements taken preoperatively and at 1, 3, and 6 months postoperatively in active and passive positions to evaluate angle changes during this 6-month period.

Results:
We evaluated 38 women and six men aged 18–45 years (mean age, 25.74 years). In the passive position, the mean nasolabial angles were 91.5 degrees preoperatively and 106, 104, and 103 degrees at 1, 3, and 6 months, respectively, postoperatively. In the active position, the mean nasolabial angles were 85.5 degrees preoperatively and 102.6, 99.1, and 98.1 degrees at 1, 3, and 6 months, respectively, postoperatively (P < 0.0001, using Friedman chi-square test).

Conclusions:
The HS technique is safe and reproducible, with nasal tip maintenance and an adequate angle elevation trend observed at 6-months follow-up. Further studies and longer observation times are necessary to determine longer-term outcomes.
Early steroids after pediatric liver transplantation protect against T-cell–mediated rejection: Results from the ChilSFree study
Authors: Goldschmidt Imeke , Chichelnitskiy Evgeny , Götz Juliane , Rübsamen Nicole , Karch André , Jäger Veronika , Kelly Deirdre , Lloyd Carla , Debray Dominique , Girard Muriel , d’ Antiga Lorenzo , di Giorgio Angelo , Hierro Loreto , Pawlowska Joana , Klaudel-Dreszler Maja , McLin Valerie , Korff Simona , Falk Christine , Baumann Ulrich 
Published: September 2023

Steroid-free immunosuppression protocols gained popularity in pediatric liver transplantation (pLT) after the introduction of IL-2–receptor blockade for induction therapy. We analyzed the clinical and immunologic outcome data of the multicenter prospective observational ChilSFree study to compare the impact of steroid-free versus steroid-containing immunosuppressive therapy following pLT in a real-life scenario. Two hundred forty-six children [55.3% male, age at pLT median: 2.4 (range: 0.2–17.9) y] transplanted for biliary atresia (43%), metabolic liver disease (9%), acute liver failure (4%), hepatoblastoma (9%), and other chronic end-stage liver diseases (39%) underwent immune monitoring and clinical data documentation over the first year after pLT. Patient and graft survival at 1 year was 98.0% and 92.7%, respectively. Primary immunosuppression was basiliximab induction followed by tacrolimus (Tac) monotherapy (55%), Tac plus steroid tapering over 3 months (29%), or cyclosporine and steroid tapering (7%). One center used intraoperative steroids instead of basiliximab followed by Tac plus mycophenolate mofetil (7% of patients). N = 124 biopsy-proven T-cell–mediated rejections were documented in n = 82 (33.3%) patients. T-cell–mediated rejection occurred early (median: 41 d, range: 3–366 d) after pLT. Patients initially treated with Tac plus steroids experienced significantly fewer episodes of rejection than patients treated with Tac alone (chi-square p<0.01). The use of steroids was associated with earlier downregulation of proinflammatory cytokines interferon (IFN)-γ, Interleukin (IL)-6, CX motif chemokin ligand (CXCL)8, IL-7, and IL-12p70. Both primary immunosuppression with Tac plus steroids and living donor liver transplantation were independent predictors of rejection-free survival 1 year after pLT on logistic regression analysis. Adjunctive steroid therapy after pLT leads to earlier suppression of the post-pLT proinflammatory response and significantly reduced rejection rates during the first year after pLT (15.9%). Fifty-one percent of patients initially treated without steroids remain steroid-free over the first 12 months without rejection.
Cystic fibrosis liver disease in the post-modulator era
Authors: Narkewicz Michael R. 
Published: September 2023

Purpose of review
Highly effective modulators of cystic fibrosis transmembrane conductance regulator (CFTR) function have had dramatic impact on pulmonary and nutritional outcomes in persons with cystic fibrosis (pwCF). The impact on liver disease in pwCF was not the focus of the registration trials. The purpose of this review is to assess the current literature on the impact of HEMT on liver disease, progression, regression, and safety.

Recent findings
Short-term studies of HEMT in pwCF have shown that there is no significant impact on the frequency of liver enzyme abnormalities. There is no evidence for significant improvement in liver enzymes over time on HEMT therapy. There is conflicting data on improvement in liver fibrosis determined by fibrosis indices (APRI and GPR) or elastography. One study showed improvement, and another showed worsening in younger (<20 years old) pwCF. There are reports of resolution or improvement in hepatic steatosis. There are rare reports of severe acute hepatitis and one report of hepatic decompensation leading to liver transplantation due to drug-induced liver disease.

Summary
HEMT have not been shown to have a significant impact on improving liver disease or preventing fibrosis with short-term therapy. Longer studies are needed to assess the impact of HEMT on liver disease in pwCF.
Health anxiety and its association with perceived subjective workload in psychiatric nurses during the COVID-19 outbreak: a correlational study
Authors: Alipour Roghayeh , Golizadeh Leila , Arshadi Bostanabad Mohammad , Vahidi Maryam , Hosseinzadeh Mina , Namdar Areshtanab Hossein , Asadpour Hedi 
Published: September 2023

Background:Health care professionals, especially nurses, experience added workload, and psychological impact during the COVID-19 outbreak. This study aimed to investigate health anxiety and its association with perceived subjective workload in nurses working in psychiatric hospital wards.Methods:This descriptive correlational study was conducted on 206 nurses working in the psychiatric wards of Razi Psychiatry Hospital in Tabriz, Iran, in 2020–2021. Census sampling was applied and data were collected using the National Aeronautics and Space Administration Task Load Index, and the Health Anxiety Inventory. Data were analyzed using descriptive statistics,t-tests, and Pearson correlation in SPSS software version 16.Results:The mean (SD) of health anxiety and workload of nurses was 23/22(6/86) score range of 0–54 and 71.46 (12.37) score range of 0–100, respectively. The correlation between the mean of health anxiety and workload was significant only in the temporary dimension.Conclusions:Given the high workload and moderate level of health anxiety and the significant correlation between health anxiety and the temporary dimension of workload and the important role of appropriate workload in the health of nurses and the quality of nursing care, organizations and nursing managers should provide some strategies, like stuff shortage management in psychiatric wards and creating a suitable organizational culture.
Huge solitary gallstone complicated with liver cirrhosis in a middle-aged woman: case report
Authors: Chuwa Agapiti Hipoliti 
Published: September 2023

Background:
Gallstones are increasingly becoming a common diagnosis in hospitals across the continents, with predominance in women. Patients suspected of a gallstone disease require thorough evaluation including endoscopic ultrasound, magnetic resonance imaging, or magnetic resonance cholangiography. A delayed or missed diagnosis is associated with serious complications and poor prognosis.

Case presentation:
A 44-year-old female patient presented with fever, vomiting, hypochondria, and epigastric pain for 10 days. Clinical examination showed jaundice and tenderness at the right hypochondriac region. Blood analysis revealed elevated bilirubin, alkaline phosphatase, and white blood cells. The patient was sent for a computed tomography (CT) scan which showed a grossly enlarged liver about 17.2 cm in length and a hypo-attenuating mass in the gallbladder fossa that enhanced moderately and heterogeneously following intravenous contrast administration. Dilated intrahepatic biliary ducts were also appreciated. Explorative laparotomy was performed and revealed an enlarged, cirrhotic-appearing liver, a thickened gallbladder, and a whitish-yellow gallstone about 3 cm in the largest diameter situated at its neck. No isolated tumour was found.

Clinical discussion:
Although gallstone disease is very common, misdiagnosis still occurs especially in low and lower-middle-income countries. Inadequate evaluation and increased utilization of CT in emergency and surgical departments are the contributing factors for a missed diagnosis.

Conclusions:
A missed gallstone disease occurs due to various factors including inappropriate standard operating procedures, which set a CT scan as the first imaging test for all internal conditions. This case report presents the appropriate approach to achieving the diagnosis of a gallstone disease before surgical intervention.
Removing 216 sharp metal foreign objects from the digestive tract of a 30-year-old male: case report
Authors: Rezazadeh Amin , Khanghah Ali Samady , Mousazadeh Siamak , Noori Farzad 
Published: September 2023

Introduction and importance:
Foreign body (FB) ingestion and its complications are abundant in emergency departments. This potentially severe problem had a peak incidence in children aged 6 months to 6 years. Intentional adult cases are voluntary and more common in prisoners and people with psychiatric problems. However, most patients (90%) remain asymptomatic, and these pass through the body spontaneously.

Case presentation:
The authors report a case of surgically removing plenteous sharp-pointed metallic foreign bodies ingested by a young male deaf-mute bipolar schizoaffective patient from his stomach, intestine, and rectum. Furthermore, the authors have reviewed the available literature for similar cases.

Clinical discussion:
Less than 1% of patients need surgical removal, 10–20% need to be taken out endoscopically, and the remaining pass spontaneously. Plain radiography is the most available imaging modality detecting the number, material, and estimated place of the alimentary canal trapped.

Conclusion:
For the risk of perforation, migration, and peritonitis, surgery is indicated in such situations.