bluuebunny/crossref_metadata_2025_split huggingface dataset:
Returning Home: A Comparative Analysis of the Experiences of Sri Lankan First- and Second-Generation Refugee Returnees from India
Authors: Ekanayake Anoji , Amirthalingam Kopalapillai 
Published: March 2023

Abstract
Since the end of the civil war in 2009, Sri Lankan refugees in India have begun to return home slowly. This article examines the reintegration experiences of first-generation returnees vis-à-vis second-generation returnees who were either born in India or were small children at the time of migration and thus have limited memory of their lives in Sri Lanka before migration. Particular attention is given to challenges encountered, coping mechanisms adapted to overcome these challenges and returnees’ perceptions of their own return decision in hindsight. Using 13 in-depth case studies in the Northern Province of Sri Lanka, we found that while the reintegration of first-generation returnees has been relatively uneventful, second-generation returnees, particularly those with Indian higher educational qualifications, faced a cluster of challenges upon their return involving financial, social, and bureaucratic aspects. Their coping mechanisms include accepting jobs beneath their qualifications, remigration to India, and maintaining strong bonds with fellow returnees and friends still in India. While challenges faced upon returning to Sri Lanka have led some returnees, particularly the young, to doubt their decision to return, others are content with their decision as they feel they have better rights in Sri Lanka.
Too “Full of Gender” How Activists Conceptualize the Promises and Pitfalls of Gender-Neutral Identity Documents
Authors: Saguy Abigail C , Williams Juliet A 
Published: March 2023

Abstract
The social movements literature identifies a dilemma that activists face between principles of affirming and deconstructing identity. Drawing on in-depth interviews with 85 activists from diverse political perspectives, this article shows that, in discussing identity documents (IDs), progressive activists took a practical approach that recognized both the advantages and drawbacks of recognition. They expressed support both for initiatives that would provide additional sex/gender marker options—beyond M or F—on IDs and those that would remove sex/gender markers from IDs altogether. This article argues that progressives readily perceived the drawbacks of recognition in the case of IDs because this context—more than others—cues concerns about state regulation and surveillance. Conservatives, who advocate for limiting government power in other contexts, were less likely than progressives to support the idea of removing sex/gender markers from government IDs, appealing to other priorities to justify this stance. Together, these findings underscore the extent to which expediency motivates social activists. They also show how both political orientation and social context shape preferences for emphasizing versus de-emphasizing sex/gender.
A scoping review of ejaculatory dysfunction due to surgical treatments for benign prostatic hyperplasia: limitations of available tools for assessment and reporting
Authors: Khooblall Prajit , Bole Raevti , Leelani Navid , Lundy Scott , Bajic Petar 
Published: March 2023

AbstractIntroductionClinicians primarily focus on the presence or absence of anterograde ejaculation following surgery for benign prostatic hyperplasia (BPH). Failing to assess dysfunctional ejaculation and associated bother in a granular fashion can underestimate the prevalence and significance of ejaculatory dysfunction in this population.ObjectivesThis scoping review provides critical appraisal of existing tools assessing ejaculatory function and associated bother, emphasizing the importance of adequate history-taking, preoperative counseling, and supplemental questions that should be used prior to and after treatment.MethodsA literature review was conducted using pertinent keywords from 1946 to June 2022. Eligibility criteria included men developing ejaculatory dysfunction following BPH surgery. Measured outcomes included the assessment of patient bother related to ejaculatory function, pre- and postoperative scores from the Male Sexual Health Questionnaire (MSHQ). and Danish Prostate Symptom sexual function domain (DAN-PSSsex).ResultsResults of this study included only 10 documented patients’ bother due to ejaculatory dysfunction following treatment. Pre- and postoperative MSHQ were used as the diagnostic tool in 43/49 studies, one study documented “preservation of anterograde ejaculation”, and one used DAN-PSSsex. Q1–4 of the MSHQ were used in 33/43 studies, 3/43 used Q1, 3, 5–7, 1/43 used solely Q4, 1/43 used Q1–3 + Q6 and Q7, and 5/43 used the entire MSHQ. No studies used post-ejaculation urinalysis to diagnose retrograde ejaculation. Only four studies explicitly documented bother and found 25–35% of patients were bothered with a “lack of ejaculate” or “other ejaculation difficulties” during sexual activity after BPH surgery.ConclusionsThere are currently no studies stratifying patient bother by various components of ejaculation (force, volume, consistency, sensation of seminal expulsion, painful ejaculation, etc.) after BPH surgery. Opportunities for improvement exist in reporting ejaculatory dysfunction related to BPH treatment. A comprehensive sexual health history is needed. Further investigation into effects of BPH surgical treatments on specific characteristics of the patient’s experience of ejaculation is required.
Variability in genome-engineering source materials: consider your starting point
Authors: Patange Simona , D. Miller Sierra , D. Maragh Samantha 
Published: March 2023

AbstractThe presence and impact of variability in cells as the source material for genome engineering are important to consider for the design, execution and interpretation of outcomes of a genome-engineering process. Variability may be present at the genotype and phenotype level, yet the impact of these sources of variability on a genome-engineering experiment may not be regularly considered by researchers. In this perspective, we use clustered regularly interspaced short palindromic repeat (CRISPR)/CRISPR-associated protein (Cas) genome editing of mammalian cells to provide examples of how variation within or across cell samples may mislead a researcher in their expectations about the cells they are engineering. Furthermore, we highlight the need for understanding the baseline cell genotype and phenotype to appropriately understand the starting cell material and interpret and attribute the impact of engineering on cells. We emphasize that heterogeneity within a cell pool and the inherent variability in the cellular materials used for genome engineering are complex, but of high value to characterize and account for where possible, to move toward the potential of generating desired and predictable engineered products. Provided is a framework cause-and-effect diagram for CRISPR/Cas9 genome editing toward identifying and mitigating potential sources of variability. We encourage researchers to consider the variability of source materials and undertake strategies, which may include those described here, for detecting, attributing and minimizing additional sources of variability where possible toward the aim of fostering greater reliability, confidence and reproducibility in genome-engineering studies.Graphical Abstract
Reproduction alternation in trees: testing the resource depletion hypothesis using experimental fruit removal inQuercus ilex
Authors: Le Roncé Iris , Dardevet Elia , Venner Samuel , Schönbeck Leonie , Gessler Arthur , Chuine Isabelle , Limousin Jean-Marc 
Published: March 2023

AbstractThe keystones of resource budget models to explain mast seeding are that fruit production depletes tree stored resources, which become subsequently limiting to flower production the following year. These two hypotheses have, however, rarely been tested in forest trees. Using a fruit removal experiment, we tested whether preventing fruit development would increase nutrient and carbohydrates storage and modify allocation to reproduction and vegetative growth the following year. We removed all the fruits from nine adult Quercus ilex L. trees shortly after fruit set and compared, with nine control trees, the concentrations of nitrogen (N), phosphorus (P), zinc (Zn), potassium (K) and starch in leaves, twigs and trunk before, during and after the development of female flowers and fruits. The following year, we measured the production of vegetative and reproductive organs as well as their location on the new spring shoots. Fruit removal prevented the depletion of N and Zn in leaves during fruit growth. It also modified the seasonal dynamics in Zn, K and starch in twigs, but had no effect on reserves stored in the trunk. Fruit removal increased the production of female flowers and leaves the following year, and decreased the production of male flowers. Our results show that resource depletion operates differently for male and female flowering, because the timing of organ formation and the positioning of flowers in shoot architecture differ between male and female flowers. Our results suggest that N and Zn availability constrain flower production in Q. ilex, but also that other regulatory pathways might be involved. They strongly encourage further experiments manipulating fruit development over multiple years to describe the causal relationships between variations in resource storage and/or uptake, and male and female flower production in masting species.
Wheat Pore-Forming Toxin-Like Protein Confers Broad-Spectrum Resistance to Fungal Pathogens in Arabidopsis
Authors: Singh Lovepreet , Sinha Arunima , Gupta Megha , Xiao Shunyuan , Hammond Rosemarie , Rawat Nidhi 
Published: March 2023

Fusarium head blight (FHB), caused by the hemibiotrophic fungus Fusarium graminearum, is one of the major threats to global wheat productivity. A wheat pore-forming toxin-like (PFT) protein was previously reported to underlie Fhb1, the most widely used quantitative trait locus in FHB breeding programs worldwide. In the present work, wheat PFT was ectopically expressed in the model dicot plant Arabidopsis. Heterologous expression of wheat PFT in Arabidopsis provided a broad-spectrum quantitative resistance to fungal pathogens including F. graminearum, Colletotrichum higginsianum, Sclerotinia sclerotiorum, and Botrytis cinerea. However, there was no resistance to bacterial or oomycete pathogens Pseudomonas syringae and Phytophthora capsici, respectively in the transgenic Arabidopsis plants. To explore the reason for the resistance response to, exclusively, the fungal pathogens, purified PFT protein was hybridized to a glycan microarray having 300 different types of carbohydrate monomers and oligomers. It was found that PFT specifically hybridized with chitin monomer, N-acetyl glucosamine (GlcNAc), which is present in fungal cell walls but not in bacteria or oomycete species. This exclusive recognition of chitin may be responsible for the specificity of PFT-mediated resistance to fungal pathogens. Transfer of the atypical quantitative resistance of wheat PFT to a dicot system highlights its potential utility in designing broad-spectrum resistance in diverse host plants. [Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Deep Isoflurane Anesthesia Is Associated with Alterations in Ion Homeostasis and Specific Na+/K+-ATPase Impairment in the Rat Brain
Authors: Reiffurth Clemens , Berndt Nikolaus , Gonzalez Lopez Adrian , Schoknecht Karl , Kovács Richard , Maechler Mathilde , grote Lambers Mirja , Dreier Jens P. , Friedman Alon , Spies Claudia , Liotta Agustin 
Published: March 2023

Background
Maintenance of ion homeostasis is essential for normal brain function. Inhalational anesthetics are known to act on various receptors, but their effects on ion homeostatic systems, such as sodium/potassium-adenosine triphosphatase (Na+/K+-ATPase), remain largely unexplored. Based on reports demonstrating global network activity and wakefulness modulation by interstitial ions, the hypothesis was that deep isoflurane anesthesia affects ion homeostasis and the key mechanism for clearing extracellular potassium, Na+/K+-ATPase.

Methods
Using ion-selective microelectrodes, this study assessed isoflurane-induced extracellular ion dynamics in cortical slices of male and female Wistar rats in the absence of synaptic activity, in the presence of two-pore-domain potassium channel antagonists, during seizures, and during spreading depolarizations. The specific isoflurane effects on Na+/K+-ATPase function were measured using a coupled enzyme assay and studied the relevance of the findings in vivo and in silico.

Results
Isoflurane concentrations clinically relevant for burst suppression anesthesia increased baseline extracellular potassium (mean ± SD, 3.0 ± 0.0 vs. 3.9 ± 0.5 mM; P < 0.001; n = 39) and lowered extracellular sodium (153.4 ± 0.8 vs. 145.2 ± 6.0 mM; P < 0.001; n = 28). Similar changes in extracellular potassium and extracellular sodium and a substantial drop in extracellular calcium (1.5 ± 0.0 vs. 1.2 ± 0.1 mM; P = 0.001; n = 16) during inhibition of synaptic activity and two-pore-domain potassium suggested a different underlying mechanism. After seizure-like events and spreading depolarization, isoflurane greatly slowed extracellular potassium clearance (63.4 ± 18.2 vs. 196.2 ± 82.4 s; P < 0.001; n = 14). Na+/K+-ATPase activity was markedly reduced after isoflurane exposure (greater than 25%), affecting specifically the α2/3 activity fraction. In vivo, isoflurane-induced burst suppression resulted in impaired extracellular potassium clearance and interstitial potassium accumulation. A computational biophysical model reproduced the observed effects on extracellular potassium and displayed intensified bursting when Na+/K+-ATPase activity was reduced by 35%. Finally, Na+/K+-ATPase inhibition with ouabain induced burst-like activity during light anesthesia in vivo.

Conclusions
The results demonstrate cortical ion homeostasis perturbation and specific Na+/K+-ATPase impairment during deep isoflurane anesthesia. Slowed potassium clearance and extracellular accumulation might modulate cortical excitability during burst suppression generation, while prolonged Na+/K+-ATPase impairment could contribute to neuronal dysfunction after deep anesthesia.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
The impact of COVID-19 nationwide control measures on trauma workload at a regional trauma center
Authors: Fun Joan R. S. , Balasubramaniam Sunder , Teo Li Tserng 
Published: March 2023

Abstract

Background
The coronavirus disease 2019 (COVID-19) pandemic has led to the control of movement and diversion of medical resources in many countries. This affects the provision of care to critically injured patients.

Methods
We analyzed data from the trauma registry of a regional trauma center in Singapore, looking at patient volume and the pattern of injuries over a 3-month period. This was compared with the same period in the preceding 2 years.

Results
A total of 93 patients were admitted during this period, compared with 111 in 2019 and 118 in 2018, a drop of 15% to 20%. The proportion of severely injured patients and the mechanism of injury were largely unchanged.

Conclusion
Although there was a minor decrease in the absolute number of patients, the severity and pattern of injuries remained unchanged. Planners should consider this when planning for the diversion of medical and nursing resources.
Acute pulmonary embolism immediately after cesarean section despite dilatation of the left ventricle: a case report and literature review
Authors: Song Bin , Sun Yue , Liu Dandan , Li Guanggang 
Published: March 2023

Abstract

Introduction
Pulmonary embolism is a lethal complication during pregnancy and the puerperium. Compared with vaginal delivery, the risk of pulmonary disease is almost twice as high with cesarean section. However, diagnosing a pulmonary embolism can be challenging.

Case presentation
A 31-year-old nulliparous woman underwent cesarean section. Postoperatively, the patient suddenly developed dyspnea and dull pain in the left back region and cardiopulmonary function deteriorated rapidly. Venous ultrasonography confirmed thrombosis of the left common iliac vein. Transthoracic echocardiography revealed a normal right heart and a dilated left ventricle with a patent foramen ovale. An acute pulmonary embolism was confirmed by pulmonary angiography. Catheter-directed thrombus fragmentation and thrombolysis were then performed.

Conclusion
Dilated left ventricular echocardiography does not exclude postpartum acute pulmonary embolism. In extreme emergencies, when acute pulmonary embolism is the most likely diagnosis and life-threatening, catheter-directed angiography may be preferred over other approaches.
Cholelithiasis, cholecystitis, cholecystectomy and the associated risk of colorectal cancer
Authors: Tsai Po-Li , Lin Yu-Wen , Chen Jian-Syun , Wu Shu-I , Chiang Mei-Feng , Chen Ming-Jen 
Published: March 2023

Abstract

Background
Many studies have suggested that cholelithiasis or cholecystectomy may be associated with risk of colorectal cancer [CRC]. This study aimed to verify CRC risk among cholelithiasis patients who experienced cholecystitis or cholecystectomy or both.

Methods
Data of a cholelithiasis cohort (n = 28,267) and a noncholelithiasis cohort (n = 112,948) were retrieved (1:4 ratio) from the Longitudinal Health Insurance Database for comparison of CRC risk. Confounding factors were adjusted in multivariate analysis. A hospital-based cancer registry containing 8156 CRC patients was also examined. Data were statistically analyzed using χ2 test, t test, and Cox proportional-hazards model.

Results
Univariate and multivariate analysis showed that having cholelithiasis was associated with increased risk of CRC (crude hazard ratio: 1.533 [95% confidence interval {CI}: 1.423–1.652); adjusted HR: 1.481 [95% CI: 1.375–1.597], respectively, p < 0.001) relative to not having cholelithiasis. Increased CRC incidence among patients with cholelithiasis was higher in the right-sided colon (adjusted HR: 1.452 [95% CI: 1.234–1.709], p < 0.001), and higher in female patients. The trend of higher incidence of right-sided colon cancer was also seen in the hospital-based cancer registry. Of note, cholecystitis or cholecystectomy was associated with mildly increased CRC risk among cholelithiasis patients. Cholecystitis was associated with increased risk of left-sided CRC. Cholecystitis plus cholecystectomy was associated with increased risk of rectal cancer.

Conclusions
These results support that cholelithiasis is associated with increased risk of CRC especially in the right-sided colon and among female patients. Cholecystitis and cholecystectomy may shift cancer to the distal part of the large bowel.
OUTCOMES OF SWITCHING FROM PROACTIVE TO REACTIVE TREATMENT AFTER DEVELOPING ADVANCED CENTRAL NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Cornish Elisa E. , Nguyen Vuong , Puzo Martin , O'Toole Louise , Gemmy Cheung Chui M. , Vincent Andrea , Guillaumie Tremeur , Oei Sioe Lan , Morros Helena Brosa , Barthelmes Daniel , Gillies Mark C. 
Published: March 2023

Purpose:
We assessed outcomes of eyes with neovascular age-related macular degeneration (nAMD) that switched from proactive (treat-and-extend) to reactive (pro re nata) treatment regimen after developing macular atrophy (MA) or submacular fibrosis (SMFi).

Methods:
Data were collected from a retrospective analysis of a prospectively designed, multinational registry of “real-world” nAMD treatment outcomes. Eyes without MA or SMFi when starting treatment with a vascular endothelial growth factor inhibitor regimen that subsequently developed MA or SMFi were included.

Results:
Macular atrophy developed in 821 eyes and SMFi in 1,166 eyes. Seven percent of eyes that developed MA and 9% of those that developed SMFi were switched to reactive treatment. Vision was stable at 12 months for all eyes with MA and inactive SMFi. Active SMFi eyes that switched to reactive treatment had significant vision loss. No eyes that continued proactive treatment developed ≥15 letter loss, but 8% of all eyes that switched to a reactive regimen and 15% of active SMFi eyes did.

Conclusion:
Eyes that switch from proactive to reactive treatment after developing MA and inactive SMFi can have stable visual outcomes. Physicians should be aware of the risk of a significant loss of vision in eyes with active SMFi that switch to reactive treatment.
RHOMBUS DEFORMATION OF RETINAL LATERAL DISPLACEMENT AFTER EPIRETINAL MEMBRANE REMOVAL REVEALED BY DIFFEOMORPHIC IMAGE REGISTRATION
Authors: Honzawa Koki , Horiguchi Hiroshi , Terauchi Ryo , Iida Yuka , Katagiri Satoshi , Gunji Hisato , Nakano Tadashi 
Published: March 2023

Purpose:
To establish an analysis method using diffeomorphic image registration and evaluate microvascular displacement through epiretinal membrane (ERM) removal.

Methods:
Medical records of eyes that underwent vitreous surgery for ERM were reviewed. Postoperative optical coherence tomography angiography (OCTA) images were converted to the corresponding preoperative images according to a configured algorithm using diffeomorphism.

Results:
Thirty-seven eyes with ERM were examined. Measured changes in the foveal avascular zone (FAZ) area showed a significant negative correlation with central foveal thickness (CFT). The average amplitude of microvascular displacement calculated for each pixel was 69 ± 27 µm in the nasal area, which was relatively smaller than that in other areas. The vector map, which included both the amplitude and the vector of microvasculature displacement, showed a unique vector flow pattern called the rhombus deformation sign in 17 eyes. Eyes with this deformation sign showed less surgery-induced changes in the FAZ area and CFT and a milder ERM stage than those without this sign.

Conclusion:
The authors calculated and visualized microvascular displacement using diffeomorphism. The authors found a unique pattern (rhombus deformation) of retinal lateral displacement through ERM removal, which was significantly associated with the severity of ERM.
PRIMARY MULTIPLE EVANESCENT WHITE DOT SYNDROME AND MULTIPLE EVANESCENT WHITE DOT SYNDROME SECONDARY TO MULTIFOCAL CHOROIDITIS/PUNCTATE INNER CHOROIDOPATHY
Authors: Meng Yang , Zhang Qi , Li Lu , Yi Zuohuizi , Xu Yishuang , Su Yu , Liang Congbi , Xiao Di , Zhang Lu , Chen Changzheng 
Published: March 2023

Purpose:
To present and compare the clinical features and multimodal imaging (MMI) findings of the primary form of multiple evanescent white dot syndrome (MEWDS) and MEWDS secondary to multifocal choroiditis/punctate inner choroidopathy (MFC/PIC).

Methods:
A prospective case series. Thirty eyes of 30 MEWDS patients were included and divided into the primary MEWDS group and MEWDS secondary to MFC/PIC group. Demographic, epidemiologic, and clinical characteristics and MEWDS-related MMI findings of the two groups were compared.

Results:
Seventeen eyes from 17 patients with primary MEWDS and 13 eyes from 13 patients with MEWDS secondary to MFC/PIC were evaluated. Patients with MEWDS secondary to MFC/PIC tended to have a higher degree of myopia than those with primary MEWDS. No other significant differences in demographic, epidemiologic, and clinical characteristics and MMI findings were found between the two groups.

Conclusion:
“MEWDS-like reaction” hypothesis seems to be correct for MEWDS secondary to MFC/PIC, and the authors highlight the importance of MMI examinations in MEWDS. Further research is needed to confirm whether the hypothesis is applicable to other forms of secondary MEWDS.