bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical management of severe mitral annular calcification
Authors: Elde Stefan , Zhu Yuanjia , MacArthur John W. , Woo Y. Joseph 
Published: December 2022

Background Surgical management of severe mitral annular calcification (MAC) presents a challenging problem for even the most experienced surgeons. Preoperative planning is the most effective strategy to mitigate risk in these scenarios. MAC alone should not disqualify a patient from consideration for mitral valve repair, although the presence of concurrent greater than moderate stenosis warrants consideration of mitral valve replacement. Methods While repair and replacement techniques for mitral regurgitation in the setting of MAC overlap with those used to repair a non-calcified mitral apparatus, there are unique considerations to the surgical conduct of these procedures. Specifically, this article describes techniques that may be employed when the severity of MAC precludes typical repair or replacement strategies. Results Between 2014 and 2021, 77 patients were operated on by a single surgeon for mitral valve disease complicated by severe MAC. Using the systematic approach described herein, 1-year mortality was 7.8% and overall mortality over a follow-up period extending 1 to 8 years was 9.1%. Conclusions Despite the inherent challenges of mitral valve repair or replacement in the setting of severe MAC, a systematic approach beginning with preoperative planning, modification of annular suture placement, and techniques to mitigate severe complications have, in our experience, resulting in a reliable methodology for managing severe MAC with excellent outcomes.
Improving thromboprophylaxis in the medical inpatients: The role of the resident in an academic hospital
Authors: Torres-Quintanilla Francisco J , Azpiri-López José R , Romero-Ibarguengoitia Maria E , Ponce-Sierra Tadeo H , Martínez-Gallegos Eunice P 
Published: December 2022

Introduction Venous thromboembolism (VTE) is one of the main causes of preventable in-hospital death. It is recommended for hospitals to have an appropriate thromboprophylaxis (TP) protocol to avoid VTE complications. Objective To determine the effect of the resident physician feedback to the staff physician in TP appropriateness after the Caprini RAM score implementation. Methods Caprini RAM was implemented by the residents in medical patients. Patients were divided in low, moderate, high, and highest-risk groups, with TP recommendation accordingly. In cases with inadequate TP, the resident provided feedback to the staff physician for adjustment. Change to appropriate TP was assessed retrospectively. Results A total of 265 records were included. Before intervention, 193 (72.8%) patients had appropriate TP and post-intervention, 207 (78.1%) patients received adequate TP ( p < .001). Conclusions Feedback from the internal medicine resident to staff physician improves appropriate TP in medical inpatients as a quality of care strategy.
Analysis of adverse events leading to dose reduction/interruption of lenvatinib treatment in patients with Child-Pugh B unresectable hepatocellular carcinoma
Authors: Kimura Michio , Asano Hiroki , Usami Eiseki , Teramachi Hitomi , Yoshimura Tomoaki 
Published: December 2022

Introduction We aimed to compare the safety of lenvatinib as first-line treatment for unresectable hepatocellular carcinoma (HCC) in patients with Child-Pugh A (CP-A) and Child-Pugh B (CP-B) and to determine the adverse events (AEs) that cause dose reduction/interruption of treatment in patients with CP-B. Methods Sixty-six patients with lenvatinib as a first-line treatment for HCC at Ogaki Municipal Hospital (Ogaki, Japan) between April 2018 and January 2022 were retrospectively evaluated. We analyzed the treatment duration, AEs, and reasons for dose reduction/interruption associated with lenvatinib treatment in patients with CP-A and CP-B HCC. Results The CP-B group had significantly more cases of grade ≥ 2 fatigue and anorexia than the CP-A group ( p  =  0.045 and p  =  0.042, respectively). Regarding AEs that caused dose reduction/interruption of treatment, the CP-A group had significantly more cases of proteinuria than the CP-B group ( p  =  0.015), whereas the CP-B group had significantly more cases of hand-foot syndrome (HFS) than the CP-A group ( p  =  0.013). Conclusion Patients with CP-B have greater difficulty than patients with CP-A in continuing treatment with repeated dose reductions/interruption of treatment due to intolerable grade ≥ 2 AEs (fatigue and anorexia). HFS is more likely to cause dose reduction/interruption of treatment in CP-B than in CP-A unresectable HCC.
Gendered play behaviours in autistic and non-autistic children: A population-based cohort study
Authors: Hull Laura , Heuvelman Hein , Golding Jean , Mandy William , Rai Dheeraj 
Published: December 2022

Gender-typical play is observed throughout childhood for non-autistic children. However, there has been limited research into the gender typicality of autistic children’s play compared to that of non-autistic children. In a longitudinal population-based cohort, we compared gendered play behaviours in autistic and non-autistic children using standardised parent-report (30, 42 and 57 months) and child-report (8 years) data ( N = 11,251). We observed no difference in gendered play behaviours between girls with or without autism at any time point. Autistic and non-autistic boys did not differ in the gender typicality of their play when aged 30 months, but the play of autistic boys appeared less masculine than that of non-autistic boys (β = −1.1, 95% confidence interval = −2.1 to −0.2; and β = −2.6, 95% confidence interval = −4.7 to −0.5) at 42 and 57 months. Autistic boys also self-reported less masculine play behaviours than non-autistic boys at 8 years of age (β = −3.4, 95% confidence interval = −6.6 to −0.2). We found that autistic boys’ play was less gender typical than that of non-autistic boys in middle and later childhood. Our findings highlight the importance of examining gendered play behaviours in a developmental context and have relevance for understanding the development of gender identity in autism. Lay abstract Non-autistic children tend to show gendered patterns of play behaviours – boys are more likely to play with ‘masculine’ toys, and girls are more likely to play with ‘feminine’ toys. However, little is known about whether autistic children follow these patterns as well. We looked at the masculinity and femininity of autistic and non-autistic children’s play behaviours at multiple time points. Parents reported their children’s play behaviours at ages 30, 42 and 57 months, and children reported their own play behaviours at 8 years old. We found no difference between autistic and non-autistic girls, who both showed more feminine play behaviours as they got older. Autistic boys’ play behaviours were reported as less masculine than non-autistic boys at 42 and 57 months, and at 8 years old. We also found that non-autistic boys’ play tended to become more masculine as they got older, but this was not the case for autistic boys. Our findings suggest that differences in autistic and non-autistic boys’ play behaviours may develop at around 42 months old.
Calcaneal reconstruction using a femoral head allograft and biologic adjuncts: A case report
Authors: Weiss Matthew B , Konopka Jaclyn A , Azam Mohammad T , Ubillus Hugo A , Mercer Nathaniel P , Kennedy John G 
Published: December 2022

We present a case of calcaneal reconstruction after both an improvised explosive device injury and subsequent salvage procedures left the patient with a large calcaneal defect and damaged hindfoot soft tissue. A subtalar arthrodesis was performed with a femoral head allograft, where it was fused to the remaining calcaneus and superiorly through the talus, to successfully reconstruct this defect. Demineralized bone matrix, bone morphogenetic protein, and concentrated bone marrow aspirate were also added as adjuncts to promote bone remodeling. At final follow-up, the patient denied pain, was fully weight-bearing, and had resumed an active lifestyle. Level of Evidence: Level V, Case Report
Immunogenicity of SARS-CoV-2 vaccines in patients with multiple myeloma: a systematic review and meta-analysis
Authors: Chuleerarux Nipat , Manothummetha Kasama , Moonla Chatphatai , Sanguankeo Anawin , Kates Olivia S. , Hirankarn Nattiya , Phongkhun Kasidis , Thanakitcharu Jaedvara , Leksuwankun Surachai , Meejun Tanaporn , Thongkam Achitpol , Mongkolkaew Thanuthong , Dioverti M. Veronica , Torvorapanit Pattama , Langsiri Nattapong , Worasilchai Navaporn , Plongla Rongpong , Chindamporn Ariya , Gopinath Shilpa , Nissaisorakarn Pitchaphon , Thaniyavarn Tany , Nematollahi Saman , Permpalung Nitipong 
Published: December 2022

Abstract
Patients with multiple myeloma (MM) have a diminished immune response to coronavirus disease 2019 (COVID-19) vaccines. Risk factors for an impaired immune response are yet to be determined. We aimed to summarize the COVID-19 vaccine immunogenicity and to identify factors that influence the humoral immune response in patients with MM. Two reviewers independently conducted a literature search in MEDLINE, Embase, ISI Web of Science, Cochrane library, and Clinicaltrials.gov from existence until 24 May 24 2022. (PROSPERO: CRD42021277005). A total of 15 studies were included in the systematic review and 5 were included in the meta-analysis. The average rate (range) of positive functional T-lymphocyte response was 44.2% (34.2%-48.5%) after 2 doses of messenger RNA (mRNA) COVID-19 vaccines. The average antispike antibody response rates (range) were 42.7% (20.8%-88.5%) and 78.2% (55.8%-94.2%) after 1 and 2 doses of mRNA COVID-19 vaccines, respectively. The average neutralizing antibody response rates (range) were 25% (1 study) and 62.7% (53.3%-68.6%) after 1 and 2 doses of mRNA COVID-19 vaccines, respectively. Patients with high-risk cytogenetics or receiving anti-CD38 therapy were less likely to have a humoral immune response with pooled odds ratios of 0.36 (95% confidence interval [95% CI], 0.18, 0.69), I2 = 0% and 0.42 (95% CI, 0.22, 0.79), I2 = 14%, respectively. Patients who were not on active MM treatment were more likely to respond with pooled odds ratio of 2.42 (95% CI, 1.10, 5.33), I2 = 7%. Patients with MM had low rates of humoral and cellular immune responses to the mRNA COVID-19 vaccines. Further studies are needed to determine the optimal doses of vaccines and evaluate the use of monoclonal antibodies for pre-exposure prophylaxis in this population.
Identification of a Saltol-Independent Salinity Tolerance Polymorphism in Rice Mekong Delta Landraces and Characterization of a Promising Line, Doc Phung
Authors: Nguyen Tam Thanh , Dwiyanti Maria Stefanie , Sakaguchi Shuntaro , Koide Yohei , Le Dung Viet , Watanabe Toshihiro , Kishima Yuji 
Published: December 2022

AbstractThe Mekong Delta River in Vietnam is facing salinity intrusion caused by climate change and sea-level rise that is severely affecting rice cultivation. Here, we evaluated salinity responses of 97 rice accessions (79 landraces and 18 improved accessions) from the Mekong Delta population by adding 100 mM NaCl to the nutrient solution for up to 20 days. We observed a wide distribution in salinity tolerance/sensitivity, with two major peaks across the 97 accessions when using the standard evaluation system (SES) developed by the International Rice Research Institute. SES scores revealed strong negative correlations (ranging from − 0.68 to − 0.83) with other phenotypic indices, such as shoot elongation length, root elongation length, shoot dry weight, and root dry weight. Mineral concentrations of Na+ in roots, stems, and leaves and Ca2+ in roots and stems were positively correlated with SES scores, suggesting that tolerant accessions lower their cation exchange capacity in the root cell wall. The salinity tolerance of Mekong Delta accessions was independent from the previously described salinity tolerance–related locus Saltol, which encodes an HKT1-type transporter in the salinity-tolerant cultivars Nona Bokra and Pokkali. Indeed, genome-wide association studies using SES scores and shoot dry weight ratios of the 79 accessions as traits identified a single common peak located on chromosome 1. This SNP did not form a linkage group with other nearby SNPs and mapped to the 3′ untranslated region of gene LOC_Os01g32830, over 6.5 Mb away from the Saltol locus. LOC_Os01g32830 encodes chloroplast glycolate/glycerate translocator 1 (OsPLGG1), which is responsible for photorespiration and growth. SES and shoot dry weight ratios differed significantly between the two possible haplotypes at the causal SNP. Through these analyses, we characterize Doc Phung, one of the most salinity-tolerant varieties in the Mekong Delta population and a promising new genetic resource.
Ocular symptoms in COVID-19 infection: a survey study
Authors: McHarg Matthew , Wang Yujuan , Yakin Mehmet , Zeleny Alex , Caplash Sonny , Sen H Nida , Kodati Shilpa 
Published: December 2022

Abstract
Background
Coronavirus disease 2019 (COVID-19) systemic symptoms and sequelae have been studied extensively, but less is known about the characterization, duration, and long-term sequelae of ocular symptoms associated with COVID-19 infection. The purpose of this study was to analyze the frequency, spectrum, and duration of ocular symptoms in participants with COVID-19 infection treated in inpatient and outpatient settings.

Methods
A retrospective electronic survey was distributed to NIH employees and the public who reported testing positive for SARS-CoV-2. The anonymous survey collected information on demographics, past ocular history, systemic COVID-19 symptoms, and ocular symptoms.

Results
A total of 229 (21.9% male and 78.1% female, mean age 42.5 ± 13.9) survey responses were included. Ocular symptoms were reported by 165 participants with a mean of 2.31 ± 2.42 symptoms. The most commonly reported ocular symptoms were light sensitivity (31.0%), itchy eyes (24.9%), tearing (24.9%), eye redness (24.5%), and eye pain (24.5%). Participants with ocular symptoms had a higher number of systemic symptoms compared to participants without ocular symptoms (mean 9.17 ± 4.19 vs 6.22 ± 3.63; OR: 1.21; 95% CI: 1.11 – 1.32; p < 0.001). Ocular symptoms were more common in those who reported a past ocular history compared to those who did not (81.8% vs 67.1%; OR: 2.17; 95% CI: 1.08 – 4.37; p = 0.03). Additionally, the onset of ocular symptoms occurred most frequently at the same time as systemic symptoms (47.5%), and 21.8% reported symptoms lasting ≥ 14 days.

Conclusions
Ocular surface-related symptoms are the most frequent ocular manifestations, and systemic disease severity is associated with the presence of ocular symptoms. Additionally, our results show that ocular symptoms can persist post-COVID-19 infection. Further work is needed to better understand ocular symptoms in COVID-19 and long-term sequelae.
Clinical Prognostic Factors and Integrated Multi-Omics Studies Identify Potential Novel Therapeutic Targets for Pediatric Desmoid Tumor
Authors: Ning Bo , Huang Peng , Zhu Lining , Ma Zhijie , Chen Xiaoli , Xu Haojun , Ma Ruixue , Yao Chengyun , Zheng Pengfei , Xia Tian , Xia Hongping 
Published: December 2022

Abstract
Background
Desmoid tumor (DT), also known as desmoid-type fibromatosis (DTF) or aggressive fibromatosis (AF) is a rare mesenchymal tumor affecting both children and adults. It is non-metastasis but infiltrative, growing with a high recurrence rate to even cause serious health problems. This study investigates the biology of desmoid tumors through integrated multi-omics studies.

Methods
We systematically investigated the clinical data of 98 extra-abdominal cases in our pediatric institute and identified some critical clinical prognostic factors. Moreover, our integrated multi-omics studies (Whole Exome Sequencing, RNA sequencing, and untargeted metabolomics profiling) in the paired PDT tumor/matched normal tissues identified more novel mutations, and potential prognostic markers and therapeutic targets for PDTs.

Results
The top mutation genes, such as CTNNB1 (p.T41A and p.S45F) and MUC4 (p.T3775T, p.S3450S, etc.), were observed with a mutation in more than 40% of PDT patients. We also identified a panel of genes that are classed as the FDA-approved drug targets or Wnt/β-catenin signaling pathway-related genes. The integrated analysis identified pathways and key genes/metabolites that may be important for developing potential treatment of PDTs. We also successfully established six primary PDT cell lines for future studies.

Conclusions
These studies may promote the development of novel drugs and therapeutic strategies for PDTs.
Protocatechuic acid, ferulic acid and relevant defense enzymes correlate closely with walnut resistance to Xanthomonas arboricola pv. juglandis
Authors: Zhang Qian , Li Meixuan , Yang Guiyan , Liu Xiaoqiang , Yu Zhongdong , Peng Shaobing 
Published: December 2022

Abstract
Background
Juglans regia L. is an important nut tree that has a wide range of distribution in temperate regions of the world. In some walnut orchards, walnut blight can become a problematic disease that affects the growth of walnut trees. To explore the correlation between biochemical response and walnut resistance, we inoculated four walnut cultivars with Xanthomonas arboricola pv. juglandis (Xaj). The walnut cultivars were, namely, ‘Xiangling’, ‘Xiluo 2’, ‘Yuanfeng’ and ‘Xifu 2’. Total phenol content (TPC) and total flavonoid content (TFC) were measured, whereby nine major phenolic compounds and several relevant enzymes were identified.

Results
The results showed that the most resistant and susceptible walnut varieties were ‘Xiluo 2’ and ‘Xifu 2’ respectively. The reaction of walnut to Xaj was characterized by the early accumulation of phenolic compounds in the infected site. After inoculation with Xaj, we found that the resistant variety ‘Xiluo 2’ show the significant differences with other varieties at different time points through the determination of related antioxidant enzymes such as catalase (CAT) and peroxidase (POD). Meanwhile, the phenylalanine ammonia lyase (PAL) of ‘Xiluo 2’ increased significantly at 8 day post infection (dpi) and made differences from the control samples, while other varieties changed little. And the polyphenol oxidase (PPO) was significantly higher than in the control at 16 dpi, maintaining the highest and the lowest activity in ‘Xiluo 2’ and ‘Xifu 2’ respectively. It was also found that the content of protocatechuic acid in all cultivars increased significantly at 4 dpi, and ‘Xiluo 2’ was significantly higher than that of the control. In the early stage of the disease, ferulic acid content increased significantly in ‘Xiluo 2’.

Conclusion
Our findings confirmed that the metabolism of phenolic compounds and related defense enzymes are of great significance in the response of walnut to Xaj.
GhAAO2 was observed responding to NaHCO3 stress in cotton compared to AAO family genes
Authors: Liu Xiaoyu , Cui Yupeng , Kang Ruiqin , Zhang Hong , Huang Hui , Lei Yuqian , Fan Yapeng , Zhang Yuexin , Wang Jing , Xu Nan , Han Mingge , Feng Xixian , Ni Kesong , Jiang Tiantian , Rui Cun , Sun Liangqing , Chen Xiugui , Lu Xuke , Wang Delong , Wang Junjuan , Wang Shuai , Zhao Lanjie , Guo Lixue , Chen Chao , Chen Quanjia , Ye Wuwei 
Published: December 2022

Abstract
Background
Abscisic acid (ABA) is an important stress hormone, the changes of abscisic acid content can alter plant tolerance to stress, abscisic acid is crucial for studying plant responses to abiotic stress. The abscisic acid aldehyde oxidase (AAO) plays a vital role in the final step in the synthesis of abscisic acid, therefore, understanding the function of AAO gene family is of great significance for plants to response to abiotic stresses.

Result
In this study, 6, 8, 4 and 4 AAO genes were identified in four cotton species. According to the structural characteristics of genes and the traits of phylogenetic tree, we divided the AAO gene family into 4 clades. Gene structure analysis showed that the AAO gene family was relatively conservative. The analysis of cis-elements showed that most AAO genes contained cis-elements related to light response and plant hormones. Tissue specificity analysis under NaHCO3 stress showed that GhAAO2 gene was differentially expressed in both roots and leaves. After GhAAO2 gene silencing, the degree of wilting of seedlings was lighter than that of the control group, indicating that GhAAO2 could respond to NaHCO3 stress.

Conclusions
In this study, the AAO gene family was analyzed by bioinformatics, the response of GhAAO gene to various abiotic stresses was preliminarily verified, and the function of the specifically expressed gene GhAAO2 was further verified. These findings provide valuable information for the study of potential candidate genes related to plant growth and stress.
Readiness of health facilities to provide safe childbirth in Liberia: a cross-sectional analysis of population surveys, facility censuses and facility birth records
Authors: King Jessica , Tarway-Twalla Alfred K. , Dennis Mardieh , Twalla Musu Pusah , Konwloh Patrick K. , Wesseh Chea Sanford , Tehoungue Bentoe Zoogley , Saydee Geetor S. , Campbell Oona , Ronsmans Carine 
Published: December 2022

Abstract
Background
The provision of quality obstetric care in health facilities is central to reducing maternal mortality, but simply increasing childbirth in facilities not enough, with evidence that many facilities in sub-Saharan Africa do not fulfil even basic requirements for safe childbirth care. There is ongoing debate on whether to recommend a policy of birth in hospitals, where staffing and capacity may be better, over lower level facilities, which are closer to women’s homes and more accessible. Little is known about the quality of childbirth care in Liberia, where facility births have increased in recent decades, but maternal mortality remains among the highest in the world. We will analyse quality in terms of readiness for emergency care and referral, staffing, and volume of births.

Methods
We assessed the readiness of the Liberian health system to provide safe care during childbirth use using three data sources: Demographic and Health Surveys (DHS), Service Availability and Readiness Assessments (SARA), and the Health Management Information System (HMIS). We estimated trends in the percentage of births by location and population caesarean-section coverage from 3 DHS surveys (2007, 2013 and 2019–20). We examined readiness for safe childbirth care among all Liberian health facilities by analysing reported emergency obstetric and neonatal care signal functions (EmONC) and staffing from SARA 2018, and linking with volume of births reported in HMIS 2019.

Results
The percentage of births in facilities increased from 37 to 80% between 2004 and 2017, while the caesarean section rate increased from 3.3 to 5.0%. 18% of facilities could carry out basic EmONC signal functions, and 8% could provide blood transfusion and caesarean section. Overall, 63% of facility births were in places without full basic emergency readiness. 60% of facilities could not make emergency referrals, and 54% had fewer than one birth every two days.

Conclusions
The increase in proportions of facility births over time occurred because women gave birth in lower-level facilities. However, most facilities are very low volume, and cannot provide safe EmONC, even at the basic level. This presents the health system with a serious challenge for assuring safe, good-quality childbirth services.