bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extensive deep vein thrombosis in a young girl with absent inferior vena cava and iliac veins: a case report
Authors: Algaly Gufran , Alsuyihili Ali , Parveen Ayesha 
Published: February 2023

ABSTRACTCongenital absence of inferior vena cava (IVC) and iliac veins is a rare anomaly that can predispose young patients to develop deep vein thrombosis (DVT). This case report highlights the importance of considering this anatomical abnormality in young patients with unprovoked DVT. We present the case of a 17-year-old girl who visited the emergency department (ED) complaining of right leg pain and swelling for 8 days. An ED ultrasound revealed extensive DVT in the right leg veins, and further investigation with abdominal computed tomography revealed that the patient’s IVC and iliac veins were absent and showed the presence of thrombosis. The patient underwent thrombectomy and angioplasty by interventional radiology and was given a lifetime prescription for oral anticoagulation. When treating young, otherwise healthy individuals with unprovoked DVT, Clinicians should include absent IVC in their differential when treating young, otherwise healthy patients with unprovoked DVT.
HDR, the last enzyme in the MEP pathway, differently regulates isoprenoid biosynthesis in two woody plants
Authors: Krause Toni , Wiesinger Piera , González-Cabanelas Diego , Lackus Nathalie , Köllner Tobias G , Klüpfel Thomas , Williams Jonathan , Rohwer Johann , Gershenzon Jonathan , Schmidt Axel 
Published: February 2023

Abstract
Dimethylallyl diphosphate (DMADP) and isopentenyl diphosphate (IDP) serves as the universal C5 precursors of isoprenoid biosynthesis in plants. These compounds are formed by the last step of the 2-C-methyl-D-erythritol 4-phosphate (MEP) pathway, catalyzed by (E)-4-hydroxy-3-methylbut-2-en-1-yl diphosphate reductase (HDR). In this study, we investigated the major HDR isoforms of two woody plant species, Norway spruce (Picea abies) and gray poplar (Populus × canescens), to determine how they regulate isoprenoid formation. Since each of these species has a distinct profile of isoprenoid compounds, they may require different proportions of DMADP and IDP with proportionally more IDP being needed to make larger isoprenoids. Norway spruce contained two major HDR isoforms differing in their occurrence and biochemical characteristics. PaHDR1 produced relatively more IDP than PaHDR2 and it encoding gene was expressed constitutively in leaves, likely serving to form substrate for production of carotenoids, chlorophylls, and other primary isoprenoids derived from a C20 precursor. On the other hand, Norway spruce PaHDR2 produced relatively more DMADP than PaHDR1 and its encoding gene was expressed in leaves, stems, and roots, both constitutively and after induction with the defense hormone methyl jasmonate. This second HDR enzyme likely forms a substrate for the specialized monoterpene (C10), sesquiterpene (C15), and diterpene (C20) metabolites of spruce oleoresin. Gray poplar contained only one dominant isoform (named PcHDR2) that produced relatively more DMADP and the gene of which was expressed in all organs. In leaves, where the requirement for IDP is high to make the major carotenoid and chlorophyll isoprenoids derived from C20 precursors, excess DMADP may accumulate, which could explain the high rate of isoprene (C5) emission. Our results provide new insights into the biosynthesis of isoprenoids in woody plants under conditions of differentially regulated biosynthesis of the precursors IDP and DMADP.
Water exchange rates measure active transport and homeostasis in neural tissue
Authors: Williamson Nathan H , Ravin Rea , Cai Teddy X , Falgairolle Melanie , O’Donovan Michael J , Basser Peter J 
Published: February 2023

AbstractFor its size, the brain is the most metabolically active organ in the body. Most of its energy demand is used to maintain stable homeostatic physiological conditions. Altered homeostasis and active states are hallmarks of many diseases and disorders. Yet there is currently no direct and reliable method to assess homeostasis and absolute basal activity of cells in the tissue noninvasively without exogenous tracers or contrast agents. We propose a novel low-field, high-gradient diffusion exchange nuclear magnetic resonance (NMR) method capable of directly measuring cellular metabolic activity via the rate constant for water exchange across cell membranes. Exchange rates are 140±16 s−1 under normal conditions in viable ex vivo neonatal mouse spinal cords. High repeatability across samples suggest that values are absolute and intrinsic to the tissue. Using temperature and drug (ouabain) perturbations, we find that the majority of water exchange is metabolically active and coupled to active transport by the sodium–potassium pump. We show that this water exchange rate is sensitive primarily to tissue homeostasis and provides distinct functional information. In contrast, the apparent diffusion coefficient (ADC) measured with submillisecond diffusion times is sensitive primarily to tissue microstructure but not activity. Water exchange appears independently regulated from microstructural and oxygenation changes reported by ADC and T1 relaxation measurements in an oxygen–glucose deprivation model of stroke; exchange rates remain stable for 30–40 min before dropping to levels similar to the effect of ouabain and never completely recovering when oxygen and glucose are restored.
Neural responses to instructed positive couple interaction: an fMRI study on compliment sharing
Authors: Eckstein Monika , Stößel Gabriela , Gerchen Martin Fungisai , Bilek Edda , Kirsch Peter , Ditzen Beate 
Published: February 2023

AbstractLove is probably the most fascinating feeling that a person ever experiences. However, little is known about what is happening in the brains of a romantic couple—the central and most salient relationship during adult age—while they are particularly tender and exchanging loving words with one another. To gain insight into nearly natural couple interaction, we collected data from N = 84 individuals (including N = 43 heterosexual couples) simultaneously in two functional magnetic resonance imaging scanners, while they sent and received compliments, i.e. short messages about what they liked about each other and their relationship. Activation patterns during compliment sharing in the individuals revealed a broad pattern of activated brain areas known to be involved in empathy and reward processing. Notably, the ventral striatum, including parts of the putamen, was activated particularly when selecting messages for the partner. This provides initial evidence that giving a verbal treat to a romantic partner seems to involve neural reward circuitry in the basal ganglia. These results can have important implications for the neurobiological mechanisms protecting and stabilizing romantic relationships, which build a highly relevant aspect of human life and health.
The Power Elite in the Welfare State 2012–2017: Stability and Change in the Key Institutional Orders of the Core of Power Networks in Denmark
Authors: Ellersgaard Christoph Houman , Larsen Anton Grau 
Published: February 2023

Abstract
C. Wright Mills’ framework of power elites did not just address the power structure of post-World War II America. We propose a methodological framework to identify this group—by locating individuals sitting at the core of elite networks—arguing that the sector composition of this group reflects the relative importance of institutional orders within the limits of a nation-state.
With two comprehensive sets of network data, composed of around 5,000 potentially powerful affiliations containing approximately 38,000 individuals, we identify a modified version of k-cores in Danish elite networks each composing around 400 individuals in 2012 and 2017.
While 55% of the individuals in the core have changed over five years, the core group exhibits remarkable institutional stability. First, sectoral affiliations remain largely the same, as just over half were employed in the corporate world with the rest split fairly evenly amongst union leaders, academics, senior civil servants, and politicians. Other sectors, such as cultural elites, army, clergy, or judiciary were all but excluded. Second, their organizational affiliation also remains stable. Four out of five in 2017 were employed in an organization having a member in 2012. Third, the social background, ethnic background, education, and residence remain largely the same.
Evolutional transition of HBV genome during the persistent infection determined by single-molecule real-time sequencing
Authors: Arasawa Soichi , Takeda Haruhiko , Takai Atsushi , Iguchi Eriko , Eso Yuji , Shimizu Takahiro , Takahashi Ken , Yamashita Taiki , Ueda Yoshihide , Marusawa Hiroyuki , Seno Hiroshi 
Published: February 2023

Background.
Although HBV infection is a serious health issue worldwide, the landscape of HBV genome dynamics in the host has not yet been clarified. This study aimed to determine the continuous genome sequence of each HBV clone using a single-molecule real-time sequencing platform, and clarify the dynamics of structural abnormalities during persistent HBV infection without antiviral therapy.

Patients and Methods.
Twenty-five serum specimens were collected from 10 untreated HBV-infected patients. Continuous whole-genome sequencing of each clone was performed using a PacBio Sequel sequencer; the relationship between genomic variations and clinical information was analyzed. The diversity and phylogeny of the viral clones with structural variations were also analyzed.

Results.
The whole-genome sequences of 797,352 HBV clones were determined. The deletion was the most common structural abnormality and concentrated in the preS/S and C regions. Hepatitis B e antibody (anti-HBe)-negative samples or samples with high alanine aminotransferase levels have significantly diverse deletions than anti-HBe-positive samples or samples with low alanine aminotransferase levels. Phylogenetic analysis demonstrated that various defective and full-length clones evolve independently and form diverse viral populations.

Conclusions.
Single-molecule real-time long-read sequencing revealed the dynamics of genomic quasispecies during the natural course of chronic HBV infections. Defective viral clones are prone to emerge under the condition of active hepatitis, and several types of defective variants can evolve independently of the viral clones with the full-length genome.
Multifocal Contact Lenses and 0.01% Atropine Eye Drops for Myopia Control Study: Research Protocol for a 1-Year, Randomized, Four-Arm, Clinical Trial in Schoolchildren
Authors: Hiraoka Takahiro , Kiuchi Gaku , Hiraoka Reia , Maruo Kazushi , Oshika Tetsuro 
Published: February 2023

Objectives:
Previous studies have shown that combined use of orthokeratology and 0.01% atropine (AT) eye drops can strongly prevent axial elongation in myopic children. However, the efficacy of combined use with multifocal contact lens (MFCL) and 0.01% AT remains unclear. The aim of this trial is to clarify the efficacy of MFCL+0.01% AT combination therapy for myopia control and safety.

Methods:
This prospective study is a randomized, double-masked, placebo-controlled trial with four arms. A total of 240 children aged 6 to 12 years with myopia is recruited and randomly assigned to one of the four groups in a ratio of 1:1:1:1 as follows: group 1: MFCL+AT combination therapy, group 2: MFCL monotherapy, group 3: AT monotherapy, and group 4: placebo. The participants will continue the assigned treatment for 1 year. The primary and secondary outcomes are the comparisons of axial elongation and myopia progression in the four groups during the 1-year study period.

Discussion:
The present trial would determine whether the MFCL+AT combination therapy is more effective in slowing axial elongation and myopia progression in schoolchildren as compared with each monotherapy or placebo, and it also confirm acceptable safety of the combination therapy.
Treatment of Stapedial Myoclonus as a Migraine-Related Phenomenon
Authors: Birkenbeuel Jack L. , Tawk Karen , Martin Elaine C. , Abouzari Mehdi , Djalilian Hamid R. 
Published: February 2023

Objective
To describe a case series of patients with stapedial myoclonus (SM) whose conditions improved after prophylactic migraine treatment.

Patients
We present seven cases of SM reported from a tertiary care neurotology clinic. All seven patients reported SM triggers similar to those of migraine headaches and suffered from concomitant headaches and/or vertigo, and were thus treated with a standard migraine protocol used at this neurotology clinic.

Intervention
Prophylactic migraine treatment.

Main Outcome Measures
Reduction or resolution of SM.

Results
In this series, seven patients with SM were included. Six of seven subjects were male (86%), with a mean age at presentation of 44 years. Four patients noted significant improvement in their symptoms, with a reduced frequency, duration, and intensity of their symptoms with the migraine regimen. Three patients experienced complete resolution of SM with their migraine treatment.

Conclusion
We report that treatment with prophylactic migraine treatment can provide long-term relief for patients with SM, which may suggest an etiological association between migraine and SM as well as a possible treatment for SM.
The ChatGPT Storm and What Faculty Can Do
Authors: Sun Grace H. , Hoelscher Stephanie H. 
Published: February 2023

Background:
ChatGPT, an artificial intelligence-driven, pretrained, deep learning language model, can generate natural language text in response to a given query. Its rapid growth has led to concerns about ethical use in academia.

Problem:
The exponential rise in the popularity of ChatGPT, and concerns of academic integrity with its use, has raised concerns among faculty for how to best address this issue.

Approach:
Faculty should understand the potential benefits and limitations of ChatGPT and create assignments that emphasize self-reflection, critical thinking, problem solving, and independent learning. Students must be taught how to critically evaluate information and how to make informed decisions.

Conclusions:
ChatGPT has the potential to revolutionize nursing education. However, it is critical for faculty to be familiar with its capabilities and limitations in order to foster effective, yet ethical and responsible utilization, while preparing students for the dynamic, rapidly advancing technological landscape in nursing and health care.
“An Anti-Fibrotic Breast Implant Surface Coating Significantly Reduces Peri-Prosthetic Capsule Formation”
Authors: Karinja Sarah J. , Bernstein Jaime L. , Mukherjee Sudip , Jin Julia , Lin Alexandra , Abadeer Andrew , Kaymakcalan Omer , Veiseh Omid , Spector Jason A. 
Published: February 2023

Background:
The body responds to prosthetic materials with an inflammatory foreign body response and deposition of a fibrous capsule, which may be deleterious to the function of the device and a cause of significant discomfort for the patient. Capsular contracture (CC) is the most common complication of aesthetic and reconstructive breast surgery. CC is the source of significant patient morbidity and can result in pain, suboptimal aesthetic outcomes, implant failure and increased costs. The underlying mechanism remains unknown. Treatment is limited to re-operation and capsule excision; however, recurrence rates remain high. Herein we altered the surface chemistry of silicone implants with a proprietary anti-inflammatory coating to reduce capsule formation.

Methods:
Silicone implants were coated with Met-Z2-Y12, a biocompatible, anti-inflammatory surface modification. Uncoated and Met-Z2-Y12-coated implants were implanted in C57BL/6 mice. After 21, 90 or 180 days, peri-prosthetic tissue was removed for histologic analysis.

Results:
We compared mean capsule thickness at three time points. At 21, 90 and 180 days, there was a statistically significant reduction in capsule thickness of Met-Z2-Y12-coated implants compared to uncoated implants (p < 0.05).

Conclusions:
Coating the surface of silicone implants with Met-Z2-Y12 significantly reduced acute and chronic capsule formation in a mouse model for implant-based breast augmentation and reconstruction. As capsule formation obligatorily precedes CC, these results suggest contracture itself may be significantly attenuated. Furthermore, as peri-prosthetic capsule formation is a complication without anatomical boundaries, this chemistry may have additional applications beyond breast implants, to a myriad of other implantable medical devices.

Clinical relevance:
Coating of the silicone implant surface with Met-Z2-Y12 alters the peri-prosthetic capsule architecture and significantly reduces capsule thickness for at least 6 months post-operatively in a murine model. This is a promising step forward in the development of a therapy to prevent capsular contracture.
The Reality of Commercial Payer-Negotiated Rates in Cleft Lip and Palate Repair
Authors: Rochlin Danielle H. , Rizk Nada M. , Flores Roberto L. , Matros Evan , Sheckter Clifford C. 
Published: February 2023

Introduction:
Commercial payer-negotiated rates for cleft lip and palate surgery have not been evaluated on a national scale. The aim of this study was to characterize commercial rates for cleft care, both in terms of nationwide variation and in relation to Medicaid rates.

Methods:
A cross-sectional analysis was performed of 2021 hospital pricing data from Turquoise Health, a data service platform that aggregates hospital price disclosures. The data were queried by CPT code to identify 20 cleft surgical services. Within- and across-hospital ratios were calculated per CPT code to quantify commercial rate variation. Generalized linear models were utilized to assess the relationship between median commercial rate and facility-level variables, and between commercial and Medicaid rates.

Results:
There were 80,710 unique commercial rates from 792 hospitals. Within-hospital ratios for commercial rates ranged from 2.0-2.9, while across-hospital ratios ranged from 5.4-13.7. Median commercial rates per facility were higher than Medicaid rates for primary cleft lip and palate repair ($5,492.2 vs. $1,739.0), secondary cleft lip and palate repair ($5,429.1 vs. $1,917.0), and cleft rhinoplasty ($6,001.0 vs. $1,917.0) (p<0.001). Lower commercial rates were associated with hospitals that were smaller (p<0.001), safety-net (p<0.001), and non-profit (p<0.001). Medicaid rate was positively associated with commercial rate (p<0.001).

Conclusions:
Commercial rates for cleft surgical care demonstrated marked variation within and across hospitals, and were lower for small, safety-net, and/or non-profit hospitals. Lower Medicaid rates were not associated with higher commercial rates, suggesting that hospitals did not utilize cost-shifting to compensate for budget shortfalls resulting from poor Medicaid reimbursement.
Secondary Corrections for Single-sutural Craniosynostosis: Perioperative Outcomes and Predisposing Factors
Authors: Kanth Aditi , Ditthakasem Kanlaya , Herbert Morley , Fearon Jeffrey A. 
Published: February 2023

Purpose:
Many single-sutural craniosynostosis corrections end up needing secondary remodeling procedures. We sought to determine if these more complicated operations carry higher complication rates, as well as to explore potential predisposing factors.

Methods:
The authors performed a retrospective chart review of all patients undergoing primary and secondary remodeling corrections at a single center, between 2010 and 2020.

Results:
Of 491 sequential single-sutural corrections, 380 were primary procedures and 111 were secondary (89.2 percent initially treated elsewhere). 10.3 percent of primary procedures received allogeneic blood versus only 1.8 percent of secondary corrections (p =0.005). Median hospital lengths of stays were similar between groups (1°: 2.0 days [IQR 2-2], 2°: 2.0 days [IQR2-2]), as were surgical infection rates (1°: 0%, 2°: 0.9%). With respect to predisposing factors, the affected suture and presence of a genetic mutation did not appear predictive; however, the median age at primary correction was significantly younger for those needing second procedures (6.0 months [IQR 4-9] versus 12.0 months [IQR 11-16]). An Odds Ratio Estimate suggests for every month increase in age the odds of undergoing a redo drops 40 percent. With respect to surgical indications, concerns for raised intracranial pressure and skull defects were more commonly cited following strip craniectomies than remodeling procedures.

Conclusions:
This single-center review was unable to identify a higher risk profile for redo procedures. Additionally, analyses suggest performing primary corrections at a younger age, and possibly performance of strip craniectomies, were associated with a higher likelihood of a subsequent secondary correction.
Predictors for Colorectal Polyps in an Asymptomatic Population Undergoing Medical Check-ups
Authors: Zhang Chenchen , Wang Yanan , Zhu Kongxi , Wang Xiaoying , Yu Weihua , Li Shuai 
Published: February 2023

Background:
Colorectal cancer primarily arises from colorectal polyps. Early screening and removal is beneficial, especially in asymptomatic populations. This research aimed to reveal the risk factors detected in medical check-ups for colorectal polyps in asymptomatic people.

Materials and Methods:
Clinical data of 933 asymptomatic people who underwent colonoscopies from May 2014 to December 2021 was analyzed retrospectively. Data included sex, age, colonoscopy findings, polyp pathology, polyp number, and blood test results. The distribution of colorectal lesions was analyzed. Participants were divided into control and polyp groups, adenomatous and non-adenomatous polyp groups, and single and multiple adenoma groups.

Results:
Participants’ age, proportion of males, carcinoembryonic antigen (CEA), uric acid and glycosylated hemoglobin levels were significantly higher (P≤0.05) in the polyp group. Age (>40 y), sex (male), and CEA level (>1.435 ng/mL) were independent risk factors for polyps. CEA, uric acid, carbohydrate antigen 19-9, triglyceride, and total cholesterol levels were significantly higher (P<0.05) in the adenoma group than in the non-adenomatous group. CEA level (>1.435 ng/mL) was an independent predictor for adenomas (P<0.05). Participants’ age, proportion of males, CEA, glycosylated hemoglobin, and fasting blood glucose levels were significantly higher (P<0.05) in the multiple adenoma group than in the single group; the high-density lipoprotein cholesterol level was lower (P<0.05). No independent risk factors were found for the number of adenomas.

Conclusions:
Serum CEA level (>1.435 ng/mL) was independent risk factor for colorectal polyps. It may be conducive to improve discriminative ability of colorectal cancer risk stratification model.