bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Factors for Clinical Outcomes After Arthroscopic Rotator Cuff Repair
Authors: Malavolta Eduardo Angeli , Assunção Jorge Henrique , Andrade-Silva Fernando Brandão , Gracitelli Mauro Emilio Conforto , Kiyomoto Henry Dan , Ferreira Neto Arnaldo Amado 
Published: April 2023

Background: Limited knowledge exists regarding prognostic factors after rotator cuff repair. Purpose: To identify pre- and perioperative predictors for functional outcomes after arthroscopic rotator cuff repair. Study Design: Case-control study; Level of evidence, 3. Methods: This study included patients who underwent arthroscopic rotator cuff repair between January 2013 and April 2019 and who had preoperative magnetic resonance imaging scans. The procedures were performed by 4 shoulder surgeons at a single institution. Excluded were patients who had previous surgeries, those who underwent open surgery, and those without 12- and 24-month follow-up clinical data. Patient-reported outcomes (American Shoulder and Elbow Surgeons [ASES] Standardized Shoulder Assessment Form and University of California, Los Angeles [UCLA] Shoulder Rating Scale scores) were assessed preoperatively and at 6, 12, and 24 months postoperatively. Using multiple linear regression analysis, the authors evaluated the influence of 29 variables relating to patient, lesion, and procedure characteristics on postoperative outcomes, with the 24-month ASES score as the dependent variable. Results: The study sample consisted of 474 patients (500 shoulders). The median ASES score increased from 41.6 preoperatively to 88.3 at 24 months ( P < .001), and the median UCLA score increased from 14 preoperatively to 32 in the same period ( P < .001). The following variables were found to be independent predictors for higher 24-month postoperative ASES score: male sex, absence of rheumatologic disease, older age, lower degree of supraspinatus muscle fatty degeneration, acromioplasty, and a higher preoperative ASES score. Conclusion: The prognostic factors for better clinical results at 24 months after arthroscopic rotator cuff repair were male sex, absence of rheumatologic disease, older age, lower degree of fatty degeneration of the supraspinatus muscle, concomitant acromioplasty, and higher preoperative ASES score.
Loss of p53 enhances the tumor-initiating potential and drug resistance of clonogenic multiple myeloma cells
Authors: Chang Yu-Tai , Chiu Ian , Wang Qiuju , Bustamante Jorge , Jiang Wenxuan , Rycaj Kiera , Yi Song , Li Joey , Kowalski-Muegge Jeanne , Matsui William 
Published: April 2023

Abstract
Tumor relapse and drug resistance are major factors that limit the curability of multiple myeloma (MM). New regimens have improved overall MM survival rates, but patients with high-risk features continue to have inferior outcomes. Chromosome 17p13 deletion (del17p) that includes the loss of the TP53 gene is a high-risk cytogenetic abnormality and is associated with poor clinical outcomes owing to relatively short remissions and the development of pan-drug resistant disease. Increased relapse rates suggest that del17p enhances clonogenic growth, and we found that the loss of p53 increased both the frequency and drug resistance of tumor-initiating MM cells (TICs). Subsequent RNA sequencing (RNA-seq) studies demonstrated significant activation of the Notch signaling pathway and upregulation of inhibitor of DNA binding (ID1/ID2) genes in p53–knock out (p53-KO) cells. We found that the loss of ID1 or HES-1 expression or treatment with a gamma-secretase inhibitor (GSI) significantly decreased the clonogenic growth of p53-KO but not p53 wild-type cells. GSI treatment in a small set of MM specimens also reduced the clonogenic growth in del17p samples but not in non-del17p samples. This effect was specific as overexpression of the Notch intracellular domain (NICD) rescued the effects of GSI treatment. Our study demonstrates that the Notch signaling and ID1 expression are required for TIC expansion in p53-KO MM cells. These findings also suggest that GSI may be specifically active in patients with p53 mutant MM.
Serum from half of patients with immune thrombocytopenia triggers macrophage phagocytosis of platelets
Authors: Norris Peter A. A. , Tawhidi Zoya , Sachs Ulrich J. , Cserti-Gazdewich Christine M. , Lin Yulia , Callum Jeannie , Gil Gonzalez Lazaro , Shan Yuexin , Branch Donald R. , Lazarus Alan H. 
Published: April 2023

Abstract
Humoral antiplatelet factors, such as autoantibodies, are thought to primarily clear platelets by triggering macrophage phagocytosis in immune thrombocytopenia (ITP). However, there are few studies characterizing the capacity and mechanisms of humoral factor–triggered macrophage phagocytosis of platelets using specimens from patients with ITP. Here, we assessed sera from a cohort of 24 patients with ITP for the capacity to trigger macrophage phagocytosis of normal donor platelets and characterized the contribution of humoral factors to phagocytosis. Sera that produced a phagocytosis magnitude greater than a normal human serum mean + 2 standard deviations were considered phagocytosis-positive. Overall, 42% (8/19) of MHC I alloantibody-negative ITP sera were phagocytosis-positive. The indirect monoclonal antibody immobilization of platelet antigens assay was used to detect immunoglobulin G (IgG) autoantibodies to glycoproteins (GP)IIb/IIIa, GPIb/IX, and GPIa/IIa. Autoantibody-positive sera triggered a higher mean magnitude of phagocytosis than autoantibody-negative sera. Phagocytosis correlated inversely with platelet counts among autoantibody-positive patients but not among autoantibody-negative patients. Select phagocytosis-positive sera were separated into IgG-purified and -depleted fractions via protein G and reassessed for phagocytosis. Phagocytosis was largely retained in the purified IgG fractions. In addition, we assessed serum concentrations of C-reactive protein, serum amyloid P, and pentraxin 3 as potential phagocytosis modulators. Pentraxin 3 concentrations correlated inversely with platelet counts among patients positive for autoantibodies. Taken together, sera from approximately half of the patients with ITP studied triggered macrophage phagocytosis of platelets beyond a normal level. An important role for antiplatelet autoantibodies in phagocytosis is supported; a role for pentraxins such as pentraxin 3 may be suggested.
Deciphering the genetic basis of immune thrombocytopenia: current evidence for genetic predisposition in adult ITP
Authors: Georgi Julia-Annabell , Middeke Jan Moritz , Bornhäuser Martin , Matzdorff Axel , Trautmann-Grill Karolin 
Published: April 2023

AbstractImmune thrombocytopenia (ITP) is the consequence of a complex, still incompletely understood immunological dysregulation. Proposed mechanisms include autoantibody-induced platelet destruction, impaired platelet production as well as abnormalities in T-cell immunity, such as T helper cells (Th1) polarization, a high proportion of Th17 cells, and a reduced number of regulatory T cells. Although the etiology of ITP is incompletely understood and considered multifactorial in most cases, genetic variants are thought to play a key role in susceptibility to ITP, especially in persistent or chronic ITP. Efforts are currently underway to uncover possible predisposing genetic factors for the development of ITP. Single-nucleotide polymorphisms and copy number variations have been identified in several immune-related genes, such as cytokine genes, Fcγ receptor genes or T-cell costimulation genes, and have been associated with patients’ susceptibility to ITP. However, because of the clinical heterogeneity and low incidence of ITP it remains challenging to perform genetic analyses with sufficiently large sample size within informative patient populations, highlighting the need for collection of well-annotated biomaterials in clinical trials or registry projects. Another significant challenge is to go beyond performing association studies alone and to establish genotype-phenotype associations, thus proving causality between a genetic alteration and ITP pathogenesis. This review summarizes our current knowledge on genetic alterations identified as potential predisposing factors for the development of ITP in adults, thereby addressing signaling pathways considered critical for ITP pathogenesis.
Semicircular canal shape diversity among modern lepidosaurs: life habit, size, allometry
Authors: Latimer Ashley E. , Sherratt Emma , Bonnet Timothée , Scheyer Torsten M. 
Published: April 2023

Abstract
Background
The shape of the semicircular canals of the inner ear of living squamate reptiles has been used to infer phylogenetic relationships, body size, and life habits. Often these inferences are made without controlling for the effects of the other ones. Here we examine the semicircular canals of 94 species of extant limbed lepidosaurs using three-dimensional landmark-based geometric morphometrics, and analyze them in phylogenetic context to evaluate the relative contributions of life habit, size, and phylogeny on canal shape.

Results
Life habit is not a strong predictor of semicircular canal shape across this broad sample. Instead, phylogeny plays a major role in predicting shape, with strong phylogenetic signal in shape as well as size. Allometry has a limited role in canal shape, but inner ear size and body mass are strongly correlated.

Conclusions
Our wide sampling across limbed squamates suggests that semicircular canal shape and size are predominantly a factor of phylogenetic relatedness. Given the small proportion of variance in semicircular canal shape explained by life habit, it is unlikely that unknown life habit could be deduced from semicircular canal shape alone. Overall, semicircular canal size is a good estimator of body length and even better for body mass in limbed squamates. Semiaquatic taxa tend to be larger and heavier than non-aquatic taxa, but once body size and phylogeny are accounted for, they are hard to distinguish from their non-aquatic relatives based on bony labyrinth shape and morphology.
Splicing complexity as a pivotal feature of alternative exons in mammalian species
Authors: Zhao Feiyang , Yan Yubin , Wang Yaxi , Liu Yuan , Yang Ruolin 
Published: April 2023

Abstract
Background
As a significant process of post-transcriptional gene expression regulation in eukaryotic cells, alternative splicing (AS) of exons greatly contributes to the complexity of the transcriptome and indirectly enriches the protein repertoires. A large number of studies have focused on the splicing inclusion of alternative exons and have revealed the roles of AS in organ development and maturation. Notably, AS takes place through a change in the relative abundance of the transcript isoforms produced by a single gene, meaning that exons can have complex splicing patterns. However, the commonly used percent spliced-in (Ψ) values only define the usage rate of exons, but lose information about the complexity of exons’ linkage pattern. To date, the extent and functional consequence of splicing complexity of alternative exons in development and evolution is poorly understood.

Results
By comparing splicing complexity of exons in six tissues (brain, cerebellum, heart, liver, kidney, and testis) from six mammalian species (human, chimpanzee, gorilla, macaque, mouse, opossum) and an outgroup species (chicken), we revealed that exons with high splicing complexity are prevalent in mammals and are closely related to features of genes. Using traditional machine learning and deep learning methods, we found that the splicing complexity of exons can be moderately predicted with features derived from exons, among which length of flanking exons and splicing strength of downstream/upstream splice sites are top predictors. Comparative analysis among human, chimpanzee, gorilla, macaque, and mouse revealed that, alternative exons tend to evolve to an increased level of splicing complexity and higher tissue specificity in splicing complexity. During organ development, not only developmentally regulated exons, but also 10–15% of non-developmentally regulated exons show dynamic splicing complexity.

Conclusions
Our analysis revealed that splicing complexity is an important metric to characterize the splicing dynamics of alternative exons during the development and evolution of mammals.
Metabolomics and transcriptomics strategies to reveal the mechanism of diversity of maize kernel color and quality
Authors: Jiang Yufeng , Yang Li , Xie Hexia , Qin Lanqiu , Wang Lingqiang , Xie Xiaodong , Zhou Haiyu , Tan Xianjie , Zhou Jinguo , Cheng Weidong 
Published: April 2023

Abstract
Background
Maize has many kernel colors, from white to dark black. However, research on the color and nutritional quality of the different varieties is limited. The color of the maize grain is an important characteristic. Colored maize is rich in nutrients, which have received attention for their role in diet-related chronic diseases and have different degrees of anti-stress protection for animal and human health.

Methods
A comprehensive metabolome (LC-MS/MS) and transcriptome analysis was performed in this study to compare different colored maize varieties from the perspective of multiple recombination in order to study the nutritional value of maize with different colors and the molecular mechanism of color formation.

Results
Maize kernels with diverse colors contain different types of health-promoting compounds, highlighting that different maize varieties can be used as functional foods according to human needs. Among them, red-purple and purple-black maize contain more flavonoids than white and yellow kernels. Purple-black kernels have a high content of amino acids and nucleotides, while red-purple kernels significantly accumulate sugar alcohols and lipids.

Conclusion
Our study can provide insights for improving people’s diets and provide a theoretical basis for the study of food structure for chronic diseases.
Changes in ventilation distribution during general anesthesia measured with EIT in mechanically ventilated small children
Authors: Clasen Dorothea , Winter Isabel , Rietzler Stephan , Wolf Gerhard K. 
Published: April 2023

Abstract
Background
Atelectasis during general anesthesia is a risk for perioperative complications. EIT measurements were performed in mechanically ventilated healthy children during elective surgery to demonstrate the changes in ventilation distribution during general anesthesia. The ventilation distribution was quantified by calculating the Global Inhomogeneity index (GI).

Methods
EIT measurements were performed in 23 children (9 weeks—10 years) without lung disease to detect changes in regional ventilation during elective surgery. Three previously defined time points were marked during the measurement: after intubation and start of pressure-controlled ventilation (PCV), change to pressure support ventilation (PSV), and after extubation (spontaneous breathing—SB). Ventilation distribution based on regions of interest (ROI) and changes in end-expiratory volume (∆EELV) were collected at these time points and compared. The Global Inhomogeneity index was calculated at the beginning of pressure-controlled ventilation (PCV).

Results
With increasing spontaneous breathing, dorsal recruitment of atelectasis occurred. The dorsal ventilation fraction increased over the time of general anesthesia with increasing spontaneous breathing, whereas the ventral fraction decreased relatively (Difference ± 5.5 percentage points respectively; 95% CI; 3.5—7.4; p < 0.001). With the onset of spontaneous breathing, there was a significant reduction in end-expiratory volume (Difference: 105 ml; 95% CI, 75–135; p < 0.001). The GI of the lung-healthy ventilated children is 47% (SD ± 4%).

Conclusion
Controlled ventilation of healthy children resulted in increased ventilation of the ventral and collapse of the dorsal lung areas. Restart of spontaneous breathing after cessation of surgery resulted in an increase in ventilation in the dorsal with decrease in the ventral lung areas. By calculating the GI, representing the ratio of more to less ventilated lung areas, revealed the presumed homogeneous distribution of ventilation.

Trial registration
ClinicalTrials.gov Registration ID: NCT04873999. First registration: 05/05/2021.
Influencing factors and predictive model of postoperative infection in patients with primary hepatic carcinoma
Authors: Ma Yanan , Tan Bing , Wang Sumei , Ren Chaoyi , Zhang Jiandong , Gao Yingtang 
Published: April 2023

Abstract
Background
The purpose of this study was to explore the risk factors for postoperative infection in patients with primary hepatic carcinoma (PHC), build a nomogram prediction model, and verify the model to provide a better reference for disease prevention, diagnosis and treatment.

Methods
This single-center study included 555 patients who underwent hepatobiliary surgery in the Department of Hepatobiliary Surgery of Tianjin Third Central Hospital from January 2014 to December 2021, and 32 clinical indicators were selected for statistical analysis. In this study, Lasso logistic regression was used to determine the risk factors for infection after liver cancer resection, establish a predictive model, and construct a visual nomogram. The consistency index (C-index), calibration curve, and receiver operating characteristic (ROC) curve were used for internal validation, and decision curve analysis (DCA) was used to analyze the clinical applicability of the predictive model. The bootstrap method was used for intramodel validation, and the C-index was calculated to assess the model discrimination.

Results
Among the 555 patients, 279 patients met the inclusion criteria, of whom 48 had a postoperative infection, with an incidence rate of 17.2%. Body mass index (BMI) (P = 0.022), alpha-fetoprotein (P = 0.023), total bilirubin (P = 0.016), intraoperative blood loss (P < 0.001), and bile leakage (P < 0.001) were independent risk factors for infection after liver cancer surgery. The nomogram was constructed and verified to have good discriminative and predictive ability. DCA showed that the model had good clinical applicability. The C-index value verified internally by the bootstrap method results was 0.818.

Conclusion
Postoperative infection in patients undergoing hepatectomy may be related to risk factors such as BMI, preoperative AFP level, TBIL level, intraoperative blood loss and bile leakage. The prediction model of the postoperative infection nomogram established in this study can better predict and estimate the risk of postoperative infection in patients undergoing hepatectomy.
Disrespect during childbirth and postpartum mental health: a French cohort study
Authors: Leavy Emma , Cortet Marion , Huissoud Cyril , Desplanches Thomas , Sormani Jessica , Viaux-Savelon Sylvie , Dupont Corinne , Pichon Swann , Gaucher Laurent 
Published: April 2023

Abstract
Background
While the World Health Organisation (WHO) warned about mistreatment, disrespect and/or abuse during childbirth as early as 2014. This same year a social media movement with #payetonuterus brought to light the problematic of obstetrical violence in French speaking countries, and more specifically on issues of disrespect. The experience of care is an integral part of the quality of care, and perception on inadequate support during labour and loss of control in labour are some of the most frequently reported risk factors for childbirth-related post-traumatic stress disorder (CB-PTSD). Therefore, it seems crucial to study the associations between disrespect during childbirth and the mental well-being of mothers.

Methods
We performed a multicentered cohort study using auto-questionnaires within a French perinatal network. The main outcome was women’s report of disrespect during childbirth measured by the Behavior of the Mother’s Caregivers – Satisfaction Questionnaire (BMC-SQ) 3 days and 2 months after childbirth. CB-PTSD and Postpartum Depression (PPD) were assessed 2 months after childbirth using respectively the Post-Traumatic Checklist Scale (PCLS) and the Edinburgh Postnatal Depression Scale (EPDS).

Results
This study followed 123 mothers from childbirth to 2 months postpartum. Among them, 8.13% (n = 10/123) reported disrespect during childbirth at 3 days after childbirth. With retrospect, 10.56% (n = 13/123) reported disrespect during childbirth at 2 months postpartum, i.e. an increase of 31%. Some 10.56% (n = 13/123) of mothers suffered from postpartum depression, and 4.06% (n = 5/123) were considered to have CB-PTSD at 2 months after childbirth. Reported disrespect during childbirth 3 days after birth was significantly associated with higher CB-PTSD 2 months after birth (R2 = 0.11, F(1,117) = 15.14, p < 0.001 and β = 9.11, p = 0.006), PPD at 2 months after childbirth was positively associated to reported disrespect in the birth room, 3 days after birth (R2 = 0.04, F(1, 117) = 6.28, p = 0.01 and β = 3.36, p = 0.096). Meanwhile, PPD and CB-PTSD were significantly associated 2 months after childbirth (R2 = 0.41, F=(1,117) = 82.39, p < 0.01 and β = 11.41, p < 0.001).

Conclusions
Disrespect during childbirth was associated with poorer mental health during the postpartum period. Given the high prevalence of mental health problems and the increased susceptibility to depression during the postpartum period, these correlational results highlight the importance of gaining a deeper awareness of healthcare professionals about behaviours or attitudes which might be experienced as disrespectful during childbirth.
Robson classification of caesarean births: implications for reducing caesarean section rate in a private tertiary hospital in Nigeria
Authors: Akadri Adebayo Adekunle , Imaralu John Osaigbovo , Salami Omotayo Felicia , Nwankpa Chimaobi Chukwuemeka , Adepoju Akinmade Adekunle 
Published: April 2023

Abstract
Background
Caesarean section (CS) is a potentially lifesaving obstetric procedure. However, there are concerns about the rising CS rate in many countries of the world including Nigeria. The Ten-Group Robson classification system is presently recommended as an effective monitoring tool for comparing CS rates and identifying target groups for intervention aimed at reducing the rates. The aim of this study was to evaluate the cesarean section rate and the groups with the highest risk of CS at the obstetric unit of Babcock University Teaching Hospital (BUTH), using the Robson classification system.

Methods
A cross-sectional study involving 447 women who gave birth at the obstetric unit of BUTH between August 2020 and February 2022. Relevant information was retrieved from the delivery records of the study participants. Data were analyzed using the IBM-SPSS Statistics for Windows version 23.0 (IBM Corp., Armonk, NY, USA).

Results
The overall CS rate was 51.2%. Multiparous women with previous CS, single, cephalic, term (group 5); nulliparous women, single cephalic, term, with induced labour or pre-labour CS (group 2); women with preterm single cephalic, term (group 10); and single cephalic term multiparous women in spontaneous labour (group 3) were the largest contributors to CS rate accounting for 34.5%, 14.0%, 12.6%, and 10.0% respectively. The commonest indication for CS was previous CS (87; 38.0%), followed by poor progress in labour (24; 10.5%).

Conclusions
The CS rate in BUTH is high and Robson groups 5, 2 10 and 3 were the major contributors to this high rate. Interventions directed at reducing the first CS by improving management of spontaneous and induced labours; and strengthening clinical practice around encouraging vaginal birth after CS will have the most significant effect on reducing CS rate.