bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delphinieae flowers originated from the rewiring of interactions between duplicated and diversified floral organ identity and symmetry genes
Authors: Zhao Huiqi , Liao Hong , Li Shuixian , Zhang Rui , Dai Jing , Ma Pengrui , Wang Tianpeng , Wang Meimei , Yuan Yi , Fu Xuehao , Cheng Jie , Duan Xiaoshan , Xie Yanru , Zhang Peng , Kong Hongzhi , Shan Hongyan 
Published: December 2022

AbstractSpecies of the tribe Delphinieae (Ranunculaceae) have long been the focus of morphological, ecological, and evolutionary studies due to their highly specialized, nearly zygomorphic (bilaterally symmetrical) spiral flowers with nested petal and sepal spurs and reduced petals. The mechanisms underlying the development and evolution of Delphinieae flowers, however, remain unclear. Here, by conducting extensive phylogenetic, comparative transcriptomic, expression, and functional studies, we clarified the evolutionary histories, expression patterns, and functions of floral organ identity and symmetry genes in Delphinieae. We found that duplication and/or diversification of APETALA3-3 (AP3-3), AGAMOUS-LIKE6 (AGL6), CYCLOIDEA (CYC), and DIVARICATA (DIV) lineage genes was tightly associated with the origination of Delphinieae flowers. Specifically, an AGL6-lineage member (such as the Delphinium ajacis AGL6-1a) represses sepal spur formation and petal development in the lateral and ventral parts of the flower while determining petal identity redundantly with AGL6-1b. By contrast, two CYC2-like genes, CYC2b and CYC2a, define the dorsal and lateral-ventral identities of the flower, respectively, and form complex regulatory links with AP3-3, AGL6-1a, and DIV1. Therefore, duplication and diversification of floral symmetry genes, as well as co-option of the duplicated copies into the preexisting floral regulatory network, have been key for the origin of Delphinieae flowers.
Collaborative Architecture: Components, Relationships, and Implications for Partner Influence
Authors: Page Stephen B , Stone Melissa M 
Published: December 2022

AbstractThis article provides a detailed exploration of the collaborative architecture concept and its ability to deepen research on interorganizational collaborative arrangements. After introducing four components of collaborative architecture (goals, arenas, membership, and mechanisms), the article uses the components to compare two cases of public education reform collaborations. We investigate methodological challenges in coding and data analysis and evaluate the conceptual strengths and weaknesses of collaborative architecture, including the extent to which it lends specificity to existing frameworks for studying collaboration and collaborative governance. The article demonstrates that the collaborative architecture concept enables researchers to probe and assess important characteristics and relationships among goals, boundaries, structures, and processes of interorganizational collaboration as well as the exercise and embeddedness of partner influence.
Capital Regulations and the Management of Credit Commitments during Crisis Times
Authors: Pelzl Paul , Valderrama María Teresa 
Published: December 2022

Abstract
Borrower drawdowns on credit commitments reduce a bank’s capital buffer. Using Austrian credit register data and exploiting the 2008–09 financial crisis as an exogenous shock to bank health, we provide novel evidence that capital-constrained banks manage this risk by cutting credit commitments that are not fully used. Controlling for their capital position, we find that banks also respond to liquidity problems by cutting such commitments. However, banks manage the capital and liquidity risk posed by undrawn credit in a way that limits negative macroeconomic implications: credit cuts are targeted at financially less constrained firms, and we show that borrowers of more-affected banks can substitute lost credit with credit from other banks and do not suffer real effects. Additional findings suggest that voluntary agreements between constrained banks and strong firms to reduce spare borrowing capacity can explain why strong firms experience larger credit cuts.
Mitochondrial transplantation in cardiac surgical patients: optimism, caveats, and outstanding questions
Authors: Cherry Anne D. 
Published: December 2022

Purpose of review
Mitochondria satisfy the high metabolic demand of the heart, and also play major roles in reactive oxygen species signaling, calcium buffering, and regulation of cell death. Mitochondrial damage or dysfunction can drive diseases seen in cardiac surgical patients, including heart failure and ischemia/reperfusion injury. Exogenous transplantation of isolated mitochondria has been proposed as one way to augment mitochondrial function and mitigate a number of pathologic processes, with a heavy focus on ischemia/reperfusion injury.

Recent findings
Animal models of cardiac ischemia/reperfusion injury have shown functional benefits after mitochondrial transplantation. Many of the mechanisms underlying this therapy's effect; optimal dosing, delivery, and timing; and how it will translate to cardiac surgical patients are yet unknown.

Summary
Mitochondrial transplantation is a potential therapeutic strategy for cardiac ischemia/reperfusion injury. Effective application to selected cardiac surgical patients can be informed by further mechanistic investigations.
Cardiovascular disease, surgery and outcomes in women: are they any different
Authors: Klein Katherine M. 
Published: December 2022

Purpose of review
Cardiovascular disease is a leading cause of death for women worldwide and continues to be a major determinant of significant morbidity. Several studies have investigated the marked differences in diagnosis, treatment and etiology in cardiovascular disease and how it relates to gender. In this review, several key studies highlight the stark differences and bring light to the disparity and potential opportunities for further research.

Recent findings
One noted area of gender disparity is ischemic cardiac disease as it relates to surgical management. Women have historically had delays in diagnosis, inferior surgical revascularization techniques, and inadequate postoperative care when compared to men.

Summary
By highlighting the disparities in cardiovascular ischemic care, the hope is to bring attention and future research to a population group that is currently undertreated for their ischemic disease and suffering high mortality rates.
Is venoarterial extracorporeal membrane oxygenation an option for managing septic shock
Authors: Helwani Mohammad A. , Lim Aaron 
Published: December 2022

Purpose of review
To describe sepsis-induced cardiomyopathy. Discuss indications and current evidence of using venoarterial extracorporeal membrane oxygenation (VA-ECMO) in setting of sepsis-induced cardiomyopathy.

Recent findings
Recent data suggests a survival benefit with the use of VA-ECMO in patients with septic shock complicated by septic-induced cardiomyopathy with severe left ventricular systolic dysfunction. VA-ECMO was associated with poor outcomes in adults with septic shock without severe systolic dysfunction. The evidence is generated from retrospective and meta-analysis of observational studies.

Summary
Sepsis-induced cardiomyopathy is an increasingly recognized entity characterized by reversible ventricular dysfunction in the setting of sepsis. When hypotension persists despite standard management of septic shock (e.g. adequate fluid resuscitation, vasopressors, inotropes) and there is evidence of severe cardiac systolic dysfunction and end-organ hypoperfusion, VA-ECMO should be considered as a bridge therapy to recovery. VA-ECMO should not be used for isolated vasodilatory septic shock without significant myocardial dysfunction.
Surgical left atrial appendage occlusion with concomitant cardiac surgical procedures: exacerbating heart failure or preventing stroke
Authors: Mandell Daniel R. , Boisen Michael L. 
Published: December 2022

Purpose of review
The left atrial appendage (LAA) is a common source of thromboembolic stroke in patients with atrial fibrillation. Current guidelines recommend consideration of surgical LAA occlusion concomitant with other cardiac surgical procedures based mostly on observational data and a few small trials. Recently published results of several large retrospective studies and one prospective trial are reviewed herein.

Recent findings
Large retrospective studies using quality and administrative databases show mixed results with regard to efficacy of surgical LAA occlusion in preventing stroke, although most showed stroke reduction in patients with a history of atrial fibrillation (AF). Safety concerns have been raised based on nonrandomized data suggesting increased complications. A recent large, multicenter international randomized study with 3-year follow-up demonstrated significant reduction in stroke following LAA occlusion with no differences in death or heart failure exacerbations.

Summary
Most patients with AF undergoing another cardiac surgical procedure should be considered for concomitant LAA occlusion as part of a heart team discussion. The choice of surgical closure technique is critical. There is insufficient data to recommend LAA occlusion as an alternative to anticoagulation.
Multimodal prehabilitation program valuation for thoracic surgical patients
Authors: Solow Maxamillian , Perry Tjorvi E. 
Published: December 2022

Purpose of review
Modifiable patient-related risk factors, such as physical, emotional, and cognitive frailty, poor nutritional status, sleep hygiene, anemia, alcohol abuse, and smoking reduce a patient's ability to effectively recover from the insult of surgery. Herein, we review the value of implementing a comprehensive prehabilitation program for patients undergoing thoracic surgery.

Recent findings
Although prehabilitation is not a novel concept, recent evidence suggest that 4–6 weeks of prehabilitation prior to surgery is likely to increase a patient's preoperative functional status allowing patients to return to independence earlier after surgery. The value of a prehabilitation program can be determined using cost effectiveness analysis, cost-benefit analysis (CBA), cost-utility analysis (CUA), and cost-consequence analysis (CCA).

Summary
It stands to reason that well designed prehabilitation programs can add value by improving quality metrics at a lower cost to our healthcare system. Definitive randomized trials are needed to confirm this notion.
Current concepts in evaluation and management of preoperative anaemia in patients undergoing thoracic surgery
Authors: Lanigan Megan , Wilkey Andrew 
Published: December 2022

Purpose of review
The purpose of this review is to evaluate the current recommendations for management of perioperative anaemia in patients undergoing thoracic surgery, present the impact of anaemia on outcomes in this patient population and suggest an algorithm for evaluating and treating anaemia preoperatively.

Recent findings
Anaemia is a common medical issue noted preoperatively in patients presenting for thoracic surgery and carries significant morbidity. Preoperative anaemia increases the likelihood of receiving a perioperative transfusion, which represents a significant risk factor for morbidity and reduced disease-free survival in lung cancer patients presenting for thoracic surgery. It is also associated with longer hospital lengths of stay and increased risk for reoperation following lung transplantation. An algorithm-based approach to management of anaemia is beneficial and treatment with iron has been shown to reduce transfusions.

Summary
Patients undergoing thoracic surgery have a high incidence of preoperative anaemia that increases the risk of transfusion and postoperative morbidity. Preoperative evaluation and tailored treatment based on the underlying cause of anaemia reduces the incidence of anaemia prior to surgery and decreases transfusion rates.
Pulmonary prehabilitation and smoking cessation
Authors: Ibekwe Stephanie Opusunju , Mondal Samhati , Faloye Abimbola O. 
Published: December 2022

Purpose of review
This review aims to summarize the current literature on pulmonary prehabilitation programs, their effects on postoperative pulmonary complications, and the financial implications of implementing these programs. Additionally, this review has discussed the current trends in pulmonary prehabilitation programs, techniques for improving rates of perioperative smoking cessation, and the optimal timing of these interventions.

Recent findings
Prehabilitation is a series of personalized multimodal interventions tailored to individual needs, including lifestyle and behavioral measures. Pulmonary prehabilitation has shown to reduce postoperative pulmonary complications (PPCs).

Summary
The implications of clinical practice and research findings regarding PPCs are an increased burden of postoperative complications and financial cost to both patients and hospital systems. There is convincing evidence that pulmonary prehabilitation based on endurance training should be started 8–12 weeks prior to major surgery; however, similar rates of improved postoperative outcomes are observed with high-intensity interval training (HIIT) for 1–2 weeks. This shorter interval of prehabilitation may be more appropriate for patients awaiting thoracic surgery, especially for cancer resection. Additionally, costs associated with creating and maintaining a prehabilitation program are mitigated by shortened lengths of stay and reduced PPCs. Please see Video Abstract, http://links.lww.com/COAN/A90.
Postoperative nausea and vomiting: risk factors, prediction tools, and algorithms
Authors: Schlesinger Tobias , Meybohm Patrick , Kranke Peter 
Published: December 2022

Purpose of review
Postoperative/postdischarge nausea and vomiting (PONV/PDNV) remain relevant issues in perioperative care. Especially in ambulatory surgery, PONV can prevent discharge or lead to unplanned readmission.

Recent findings
The evidence for the management of PONV is now quite good but is still inadequately implemented. A universal, multimodal rather than risk-adapted approach for PONV prophylaxis is now recommended. The evidence on PDNV is insufficient.

Summary
PDNV management is based primarily on consequent prophylaxis and therapy of PONV.
Current status of point of care ultrasonography for the perioperative care of trauma patients
Authors: Heinz Eric R. , Keneally Ryan , d’Empaire Pablo Perez , Vincent Anita 
Published: December 2022

Purpose of review
The incorporation of point of care ultrasound into the field of anesthesiology and perioperative medicine is growing at rapid pace. The benefits of this modality align with the acuity of patient care and decision-making in anesthetic care of a trauma patient.

Recent findings
Cardiac ultrasound can be used to diagnose cardiac tamponade or investigate the inferior vena cava to assess volume status in patients who may suffer from hemorrhagic shock. Thoracic ultrasound may be used to rapidly identify pneumothorax or hemothorax in a patient suffering chest wall trauma. In addition, investigators are exploring the utility of ultrasonography in traumatic airway management and elevated intracranial pressure. In addition, the utility of gastric ultrasound on trauma patients is briefly discussed.

Summary
Incorporation of point of care ultrasound techniques into the practice of trauma anesthesiology is important for noninvasive, mobile and expeditious assessment of trauma patients. In addition, further large-scale studies are needed to investigate how point of care ultrasound impacts outcomes in trauma patients.
Liver Injury in Patients With Distal Esophageal Carcinoma After Precision Radiation Therapy
Authors: Betancourt Cuellar Sonia L. , Benveniste Marcelo F. , Truong Mylene , Nguyen Quynh-Nhu , Atiyah Afaf , Hofstetter Wayne L. , Erasmus Jeremy J. 
Published: December 2022

Objective:
To determine the incidence and various patterns of radiation-induced liver injury (RILI) and its temporal evolution on fluorodeoxiglucose-positron emission tomography/computed tomography (FDG-PET/CT) after neoadjuvant chemoradiation using precision radiation in patients with esophageal carcinoma.

Material and Methods:
We evaluated 639 patients with locally advanced esophageal carcinoma who had serial FDG-PET/CTs after neoadjuvant chemoradiation. Two readers reviewed the imaging studies in consensus and recorded the cases where new foci of increased FDG uptake were identified within the radiated liver parenchyma. RILI was confirmed by follow-up imaging or percutaneous biopsy.

Results:
FDG-avid RILI developed in 39/639 (6%) of patients. The caudate and left hepatic lobe were involved in all cases. There were various patterns of increased FDG uptake: 38% of patients had a single focus of increased FDG uptake and 62% had 2 regions of increased FDG uptake, which were focal nodular or diffuse or a combination of focal nodular and diffuse FDG uptake. On CT, 72% of patients had a poorly-marginated region of low attenuation and 28% had a well-defined region of low attenuation with sharp, well-defined linear borders in the location of the radiation, as confirmed by the treatment plan.

Conclusion:
The caudate and left hepatic lobes were involved in all cases of RILI. The various imaging patterns of RILI on FDG-PET/CT include 1 or 2 regions of increased FDG uptake with a nodular, diffuse, or combined appearance. Awareness of this potential complication of radiation therapy and knowledge of the imaging manifestations of RILI is important to avoid misinterpretation as a metastasis.
The Role of the Quality of Relationship in Couples Facing Treatment for Breast Cancer
Authors: Valente Marco , Chirico Ilaria , Girotti Chiara , Ottoboni Giovanni , Chattat Rabih 
Published: December 2022

Introduction:
Breast cancer is the leading cause of cancer death in women worldwide. Recently, the focus of research has shifted from psychiatric, psychological, and social consequences on the woman who gets sick from breast cancer to the impact on the couple. Indeed, the psychosocial perspective has developed the construct of the Quality of Relationship (QoR) that affects the quality of life of both members of the dyad.

Objective:
The aim of this study was to extend knowledge in this field by identifying and analyzing what dimensions of QoR may impact couples’ psychosocial adjustment to breast cancer and related treatments.

Patients and Methods:
Semistructured interviews explored couples’ experiences of breast cancer diagnosis and treatment. Transcripts were analyzed using inductive thematic analysis.

Results:
Twelve couples were interviewed. Results showed how the dimensions of psychosocial support, dyadic coping, communication, and intimacy are associated and define the construct of QoR, thus affecting the couples’ adjustment to breast cancer diagnosis and to the disease pathway.

Conclusion:
Assessment procedures of couple functioning since and after diagnosis could increase the appropriateness and benefits of integrating existing clinical practice in oncological settings.
Addressing Suicide Risk in Primary Care: Cost Savings Associated with Diverting Patients From Emergency Departments
Authors: Mancini Kathryn , Myers Brittany R. , Pajek Julie , Ramirez Lisa , Stancin Terry 
Published: December 2022

Abstract:

Introduction:
Integrating behavioral health into primary care ambulatory clinics can improve management of patients presenting with suicidality in medical practices. To date, financial outcomes associated with managing suicidality in integrated care have not been documented.

Objective:
This study sought to evaluate both course of treatment (e.g., the patient is discharged home and referred to emergency departments [EDs]) and financial outcomes (e.g., cost to medical center) for patients presenting with suicidality in integrated pediatric primary care.

Methods:
Medical record review was conducted across a 6-month period. Demographics, course of treatment, and financial data were collected. Financial data were extracted using EPSi software using a cost accounting model. We documented the amount in dollars billed to the patient/insurance company and the amount reimbursed to the medical center and then calculated net margins associated with each course of treatment.

Results:
Participants were 103 youth (aged 7–24 years). The results demonstrate that the integrated model of care diverted 93% of participants from the ED and that the highlighted model of care yielded cost savings for the medical center. After reimbursement, patients seen in the ED for suicide evaluations cost the medical center an average of 16 times more than patients who were managed in the primary care setting.

Conclusion:
The results document the magnitude of cost savings associated with an integrated care model for treating high-risk youth.
Improving Developmental Screening and Supporting Families with Paid Parent Partners
Authors: Badawi Debbie G. , Thomas Josie , Archuleta Pattie , Taylor Stacy , Pyle Meredith 
Published: December 2022

Abstract:

Objective:
The primary goals of the project were to improve rates of developmental screening and appropriate referral for atypical screens for children from birth to 3 years in participating practices and to integrate parent partners (PPs) into primary care.

Method:
Parents' Place of Maryland, in collaboration with the Maryland Department of Health, developed a quality improvement project to improve rates of developmental screening, referral, and follow-up. Nine practices from across the state completed the project. Participating practices received training and technical assistance for screening, referral, and data collection as well as a paid part-time PP to assist with care coordination. Families of children with atypical developmental screening results were offered a referral to receive support in following through with referrals, including needed social services to address health care barriers.

Results:
Developmental screening rates across practices increased from 65% to 95% during the 9-month project, and autism-specific screening increased from 75% to 94%. Appropriate referral rates tripled from 6% to 20% of children. After an initial learning curve, practices gradually increased referrals to PPs, and they served 292 individual families (total of 544 contacts) over 9 months. PPs helped families identify a variety of community services to meet their needs.

Conclusion:
While developmental screening rates can be improved using quality improvement processes, supporting families to connect to services requires additional resources. Integrating trained PPs into pediatric practices improves access to community-based services in a cost-efficient manner. More research is needed to identify the most efficient models for providing this service on a broader scale.