bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plastic Surgeons and Equity: Are Merit-based Incentive Payment System (MIPS) Scores Impacted by Minority Patient Caseload?
Authors: Byrd Jacqueline N. , Cichocki Meghan N. , Chung Kevin C. 
Published: March 2023

Background
The Centers for Medicare and Medicaid Services introduced the Merit-Based Incentive Payment System (MIPS) in 2017 to extend value-based payment to outpatient physicians. We hypothesized that the MIPS scores for plastic surgeons are impacted by the existing measures of patient disadvantage, minority patient caseload and dual eligibility.

Methods
We conducted a retrospective cohort study of plastic surgeons participating in Medicare and MIPS using the Physicians Compare National Downloadable File and MIPS scores. Minority patient caseload was defined as non-white patient caseload. We evaluated the characteristics of participating plastic surgeons, their patient caseloads and their scores.

Results
Of 4,539 plastic surgeons participating in Medicare, 1,257 participated in MIPS in the first year of scoring. The average patient caseload is 85% White, with racial/ethnicity data available for 73% of participating surgeons. In multivariable regression, higher minority patient caseload is associated with a lower MIPS score.

Conclusions
As minority patient caseload increases, MIPS scores decrease for otherwise similar caseloads. CMS must consider existing and additional measures of patient disadvantage to ensure equitable surgeon scoring.
Emergency department thoracotomy in children: A Pediatric Trauma Society, Western Trauma Association, and Eastern Association for the Surgery of Trauma systematic review and practice management guideline
Authors: Selesner Leigh , Yorkgitis Brian , Martin Matthew , Ng Grace , Mukherjee Kaushik , Ignacio Romeo , Freeman Jennifer , Wong Lye-Yeng , Durbin Samantha , Crandall Marie , Longshore Shannon W. , Gerall Claire , Flynn-O'Brien Katherine T. , Jafri Mubeen 
Published: March 2023

BACKGROUND
The role of emergency department resuscitative thoracotomy (EDT) in traumatically injured children has not been elucidated. We aimed to perform a systematic review and create evidence-based guidelines to answer the following PICO (population, intervention, comparator, and outcome) question: should pediatric patients who present to the emergency department pulseless (with or without signs of life [SOL]) after traumatic injuries (penetrating thoracic, penetrating abdominopelvic, or blunt) undergo EDT (vs. no EDT) to improve survival and neurologically intact survival?

METHODS
Using Grading of Recommendations Assessment, Development and Evaluation methodology, a group of 12 pediatric trauma experts from the Pediatric Trauma Society, Western Trauma Association, and Eastern Association for the Surgery of Trauma assembled to perform a systematic review. A consensus conference was conducted, a database was queried, abstracts and manuscripts were reviewed, data extraction was performed, and evidence quality was determined. Evidence tables were generated, and the committee voted on guideline recommendations.

RESULTS
Three hundred three articles were identified. Eleven studies met the inclusion criteria and were used for guideline creation, providing 319 pediatric patients who underwent EDT. No data were available on patients who did not undergo EDT. For each PICO, the quality of evidence was very low based on the serious risk of bias and serious or very serious imprecision.

CONCLUSION
Based on low-quality data, we make the following recommendations. We conditionally recommend EDT when a child presents pulseless with SOL to the emergency department following penetrating thoracic injury, penetrating abdominopelvic injury and after blunt injury if emergency adjuncts point to a thoracic source. We conditionally recommend against EDT when a pediatric patient presents pulseless without SOL after penetrating thoracic and penetrating abdominopelvic injury. We strongly recommend against EDT in the patient without SOL after blunt injury.
Lower incidence of blunt cerebrovascular injury among young, properly restrained children: An ATOMAC multicenter study
Authors: Nickoles Todd A. , Lewit Ruth A. , Notrica David M. , Ryan Mark , Johnson Jeremy , Maxson Robert Todd , Naiditch Jessica A. , Lawson Karla A. , Temkit M'hamed , Padilla Benjamin , Eubanks James W. 
Published: March 2023

BACKGROUND
Motor vehicle collision (MVC) remains a leading cause of injury and death among children, but the proper use of child safety seats and restraints has lowered the risks associated with motor vehicle travel. Blunt cerebrovascular injury (BCVI) is rare but significant among children involved in MVC. This study reviewed the incidence of BCVI after MVC causing blunt injury to the head, face, or neck, comparing those that were properly restrained with those that were not.

METHODS
A prospective, multi-institutional observational study of children younger than 15 years who sustained blunt trauma to the head, face, or neck (Abbreviated Injury Scale score >0) and presented at one of six level I pediatric trauma centers from 2017 to 2020 was conducted. Diagnosis of BCVI was made either by imaging or neurological symptoms at 2-week follow-up. Restraint status among those involved in MVC was compared for each age group.

RESULTS
A total of 2,284 patients were enrolled at the 6 trauma centers. Of these, 521 (22.8%) were involved in an MVC. In this cohort, after excluding patients with missing data, 10 of 371 (2.7%) were diagnosed with a BCVI. For children younger than 12 years, none who were properly restrained suffered a BCVI (0 of 75 children), while 7 of 221 (3.2%) improperly restrained children suffered a BCVI. For children between 12 and 15 years of age, the incidence of BCVI was 2 of 36 (5.5%) for children in seat belts compared with 1 of 36 (2.8%) for unrestrained children.

CONCLUSION
In this large multicenter prospectively screened pediatric cohort, the incidence of BCVI among properly restrained children under 12 years after MVC was infrequent, while the incidence was 3.2% among those without proper restraint. This effect was not seen among children older than 12 years. Restraint status in young children may be an important factor in BCVI screening.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level IV.
Plasma thrombin generation kinetics vary by injury pattern and resuscitation characteristics in pediatric and young adult trauma patients
Authors: MacArthur Taleen A. , Goswami Julie , Howick Annelise S. , Ramachandran Dhanya , Polites Stephanie F. , Klinkner Denise B. , Park Myung S. 
Published: March 2023

BACKGROUND
Thrombin generation kinetics are not well studied in children. This study aimed to assess how thrombin generation kinetics vary in pediatric and young adult (YA) trauma patients by clinical characteristics and injury pattern.

METHODS
Prospective cohort study where plasma samples were obtained from pediatric (ages 0–17 years) and YA (ages 18–21 years) trauma patients upon emergency department arrival. Thrombin generation (calibrated automated thrombogram [CAT]) was quantified as lag time (LT, minutes), peak height (PH, nM), time to peak (ttPeak, minutes), and endogenous thrombin potential (ETP, nM × minute). Results are expressed as median and quartiles [Q1, Q3] and compared using Wilcoxon rank sum testing with p < 0.05 considered significant.

RESULTS
We enrolled 47 pediatric (median age, 15 [14, 17] years, 78% male, 87% blunt, median Injury Severity Score, 12) and 49 YA (median age 20 [18, 21] years, 67% male, 84% blunt, median Injury Severity Score, 12) patients. Pediatric and YA patients had similar rates of operative intervention (51% vs. 57%), transfusion (25% vs. 20%), and traumatic brain injury (TBI) (53% vs. 49%). Pediatric patients who required an operation had accelerated initiation of thrombin generation, with shorter LT than those who did not (2.58 [2.33, 2.67]; 2.92 [2.54, 3.00], p = 0.034). Shorter LT (2.41 [2.22, 2.67]; 2.67 [2.53, 3.00]) and ttPeak (4.50 [4.23, 4.73]; 5.22 [4.69, 5.75], both p < 0.01) were noted in pediatric patients who required transfusion as compared with those who did not. The YA patients requiring transfusion had shorter LT (2.33 [2.19, 2.74]; 2.83 [2.67, 3.27]) and ttPeak (4.48 [4.33, 5.65]; 5.33 [4.85, 6.28] both p < 0.04) than those who were not transfused. Young adults with TBI had greater ETP than those without (1509 [1356, 1671]; 1284 [1154, 1471], p = 0.032).

CONCLUSION
Thrombin generation kinetics in pediatric trauma patients prior to intervention vary with need for operation and transfusion, while thrombin generation kinetics in young adult patients are influenced by TBI and need for operation or transfusion. This is a promising tool for assessing coagulopathy in young trauma patients.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
Whole-bone toughness is linked to canal and osteocyte lacunae deficits in the ZDSD type 2 diabetic rat model
Authors: Woolley William , Obata Yoshihiro , Martin Kaitlynn , Acevedo Claire 
Published: March 2023

AbstractType 2 diabetes mellitus (T2DM) is associated with an increased fracture risk independent of bone mass. The exact origin of this increased fracture risk is still not well understood. Using a polygenic diabetic rat model, synchrotron radiation micro-computed tomography (SRμCT), andin situscanning electron microscope (SEM) fracture toughness, we related the changes at the microscale to toughness and material properties of diabetic rat femurs. The diabetic rat model (ZDSD) displayed overnight fasting hyperglycemia and an increased AGEs content. Additionally, we measured the impairment of post-yield properties and toughness in diabetic rats. The cortical geometry and porosity were also affected in this ZDSD model. We measured a decrease in osteocyte lacunar density associated with a decreased lacunar volume. Moreover, we found decreased canal density while maintaining a similar canal diameter. These results indicate that diabetes impairs bone remodeling, affecting bone microstructure. Because canals and lacunae are also linked with extrinsic toughening mechanisms, we attribute the decreased toughness largely to these microstructural changes. In conclusion, we showed that changes in lacunae and canal density, combined with AGEs accumulation, decreased toughness in T2DM rat bone.
Concussion-related disruptions to hub connectivity in the default mode network are related to symptoms and cognition
Authors: Bouchard Heather C. , Higgins Kate L. , Amadon Grace K. , Laing-Young Julia M. , Maerlender Arthur , Al-Momani Seima , Neta Maital , Savage Cary R. , Schultz Douglas H. 
Published: March 2023

AbstractConcussions present with a myriad of symptomatic and cognitive concerns; however, the relationship between these functional disruptions and the underlying changes in the brain are not yet well understood. Hubs, or brain regions that are connected to many different functional networks, may be specifically disrupted after concussion. Given the implications in concussion research, we quantified hub disruption within the default mode network (DMN) and between the DMN and other brain networks. We collected resting-state functional magnetic resonance imaging data from collegiate student-athletes (n = 44) at three timepoints: baseline (prior to beginning their athletic season), acute post-injury (approximately 48 hours after a diagnosed concussion), and recovery (after starting return-to-play progression, but prior to returning to contact). We used self-reported symptoms and computerized cognitive assessments collected across similar timepoints to link these functional connectivity changes to clinical outcomes.Concussion resulted in increased connectivity between regions within the DMN compared to baseline and recovery, and this post-injury connectivity was more positively related to symptoms and more negatively related to visual memory performance compared to baseline and recovery. Further, concussion led to decreased connectivity between DMN hubs and visual network non-hubs relative to baseline and recovery, and this post-injury connectivity was more negatively related to somatic symptoms and more positively related to visual memory performance compared to baseline and recovery. Relationships between functional connectivity, symptoms, and cognition were not significantly different at baseline versus recovery.These results highlight a unique relationship between self-reported symptoms, visual memory performance and acute functional connectivity changes involving DMN hubs after concussion in athletes. This may provide evidence for a disrupted balance of within- and between-network communication highlighting possible network inefficiencies after concussion. These results aid in our understanding of the pathophysiological disruptions after concussion and inform our understanding of the associations between disruptions in brain connectivity and specific clinical presentations acutely post-injury.
The CRL plastid outer envelope protein supports TOC75-V / OEP80 complex formation inArabidopsis
Authors: Yoshimura Ryo , Minamikawa Syun , Suzuki Takamasa , Latrasse David , Sicar Sanchari , Raynaud Cécile , Benhamed Moussa , Yoshioka Yasushi 
Published: March 2023

AbstractEmbedded β-barrel proteins in the outer envelope membrane mediate most cellular traffic between the cytoplasm and the plastids. Although TOC75-V/OEP80 has been implicated in the insertion and assembly of β-barrel proteins in the outer envelope membrane ofArabidopsis thaliana, relatively little is known about this process.CRUMPLED LEAF(CRL) encodes a protein localizing in the outer envelope membrane, and its loss of function results in pleiotropic defects, including altered plant morphogenesis, growth retardation, suppression of plastid division, and spontaneous light intensity-dependent localized cell death. A suppressor screen conducted on mutagenizedcrlmutants with ethyl methanesulfonate revealed that a missense mutation inOEP80suppressescrl’s pleiotropic defects. Furthermore, we found that the complex formation of OEP80 was compromised incrl. Furthermore, we demonstrated that CRL interacts with OEP80in vivoand that a portion of CRL is present in protein complexes with the same molecular weight as the OEP80-associated complex. Our results suggest that CRL interacts with OEP80 to regulate its complex formation. CRL has been shown to be involved in plastid protein import; therefore, pleiotropic defects incrlare likely due to the combined effects of decreased plastid protein import and altered membrane integration of β-barrel proteins in the outer envelope membrane. This study sheds light on the mechanisms that allow the integration of β-barrel proteins into the outer envelope membrane of plastids and the significance of this finding for plant cellular processes.
An Antibody-Based Molecular Switch for Continuous Biosensing
Authors: Thompson Ian A.P. , Saunders Jason , Zheng Liwei , Hariri Amani A. , Maganzini Nicolò , Cartwright Alyssa P. , Pan Jing , Eisenstein Michael , Soh Hyongsok Tom 
Published: March 2023

AbstractWe present a generalizable approach for designing biosensors that can continuously detect specific biomarkers in real time and without sample preparation. This is achieved by converting existing antibodies into target-responsive “antibody-switches” that enable continuous optical biosensing. To engineer these switches, antibodies are linked to a molecular competitor through a DNA scaffold, such that competitive target binding induces scaffold switching and fluorescent signaling of changing target concentrations. As a demonstration, we designed antibody-switches that achieve rapid, sample-preparation-free sensing of digoxigenin and cortisol in undiluted plasma. We showed that, by substituting the molecular competitor, we can further modulate the sensitivity of our cortisol switch to achieve detection at concentrations spanning 3.3 nM to 3.3 mM. Finally, we integrated this switch with a fiber-optic sensor to achieve hours-long continuous sensing of cortisol in buffer with <5-minute time resolution. We believe this modular sensor design can enable continuous biosensor development for many biomarkers.
Root-derived long-range signals activate ABA synthesis infrd3leaves to enhance drought resistance
Authors: Liu Qian-Qian , Xia Jin-Qiu , Wu Jie , Zhao Ping-Xia , Zhang Gui-Quan , Xiang Cheng-Bin 
Published: March 2023

AbstractVascular plants have evolved sophisticated mechanisms of long-distance signaling to cope with environmental stress. Reactive oxygen species (ROS) act as systemic signals in plant stress responses. However, it is not known whether ROS serve as root-to-shoot signals in the drought response. Here, we show thatferric reductase defective3(frd3) mutants exhibit enhanced drought resistance concomitant with increasedNCED3transcript levels and ABA contents in leaves. Thefrd3mutants also have an elevated hydrogen peroxide (H2O2) level in roots and leaves compared with the wild type. Grafting experiments demonstrate that drought resistance can be conferred by thefrd3rootstock, suggesting that long-distance signals derived infrd3roots trigger ABA level increases in leaves and thereby enhance drought resistance and that H2O2is a strong candidate for long-distance signals. Furthermore, comparative transcriptome and proteomics analyses revealed that many genes and proteins involved in the abiotic stress response, ROS homeostasis, and signaling pathways were affected in thefrd3mutant, supporting the drought resistance phenotype. Taken together, our findings suggest thatfrd3root-derived long-range signals activate ABA synthesis in leaves and enhance drought resistance, indicating possible root-to-shoot H2O2signaling in the plant drought response.
Acute alcohol and chronic drinking bidirectionally regulate the excitability of prefrontal cortex vasoactive intestinal peptide interneurons
Authors: Thompson Shannon M. , Ferranti Anthony S. , Joffe Max E. 
Published: March 2023

AbstractThe prefrontal cortex (PFC) regulates drinking behaviors and affective changes following chronic alcohol use. PFC activity is dynamically modulated by local inhibitory interneurons (INs), which can be divided into non-overlapping groups with distinct functional roles. Within deeper layers of neocortex, INs that express either parvalbumin or somatostatin directly inhibit pyramidal cells. By contrast, the plurality of all remaining INs express vasoactive intestinal peptide (VIP), reside within superficial layers, and preferentially target other types of INs. While recent studies have described adaptations to PFC parvalbumin-INs and somatostatin-INs in alcohol use models, whether ethanol or drinking affect the physiology of PFC VIP-INs has not been reported. To address this gap, we used genetically engineered female and male mice to target VIP-INs in layers 1-3 of prelimbic PFC for whole-cell patch-clamp electrophysiology. We found that ethanol (20 mM, ∼0.09 BEC) application to PFC brain slices enhances VIP-IN excitability. We next examined effects following chronic drinking by providing mice with 4 weeks of intermittent access (IA) ethanol two-bottle choice in the home cage. In these studies, VIP-INs from female and male IA ethanol mice displayed reduced excitability relative to cells from water-only controls. Finally, we assessed whether these effects continue into abstinence. After 7-11 days without ethanol, the hypo-excitability of VIP-INs from male IA ethanol mice persisted, whereas cells from female IA ethanol mice were not different from their controls. Together, these findings illustrate that acute ethanol enhances VIP-IN excitability and suggest these cells undergo pronounced homeostatic changes following long-term drinking.
Long-term reliable neural decoding based on flexible implantable microelectronics and machine learning for seizure prediction application
Authors: He Zicong , Zheng Jiajun , Duan Junwei , Jin Zhe , Huang Zixuan , Wu Shuaishuai , He Qian , So Kwok-Fai , Zhang Shuixing , Xiong Zhiyuan 
Published: March 2023

AbstractNeural decoding is useful for understanding brain functions and developing neural interface applications. However, neural interfaces based on rigid electronics often suffer from recording instability due to the foreign body responses caused by their mechanical mismatch with soft tissues, limiting the longitudinal accuracy of neural decoding methods. Herein, it is reported that flexible electronics can be integrated with machine learning algorithms to achieve long-term reliable neural decoding. Wet-spun conductive polymer microfibers showed mechanical robustness and flexibility, low impedance, and chronic biocompatibility, enabling intracerebral neural recordings in epileptic mice at a high signal-to-noise ratio eight weeks after implantation. When the signals recorded by the flexible electrodes were used in machine learning analyses with diverse complex algorithms, they consistently showed higher prediction accuracy for epileptic seizures than stiff metal electrode signals, particularly in the case of using long-term recordings for testing or small-sample datasets for training. A real-time warning system based on the flexible neural electrodes was built that predicted seizures eight minutes in advance with a low false alarm rate. Our work bridges flexible electronics and artificial intelligence for neural decoding applications such as long-term treatment of chronic neurological disorders.
Phenotypic plasticity in response to drought stress: Comparisons of domesticated tomato and a wild relative
Authors: Lupo Yaniv , Moshelion Menachem 
Published: March 2023

AbstractPhenotypic plasticity is the ability of an organism to undergo reversible behavioral, morphological or physiological changes in response to environmental conditions. Phenotypic plasticity enables plants to cope with uncertain environmental conditions, such as drought. A primary plastic trait is the rate of stomatal response to changes in ambient conditions, which determines the amount of water lost via transpiration, as well as levels of CO2absorption, growth and productivity. Here, we examined the differences between domesticated and wild tomato species and their responses to drought stress. We found that the domesticated tomato had a higher transpiration rate and higher stomatal conductance (gs). The domesticated tomato also had greater biomass and greater leaf area under drought conditions, as compared to the wild tomato. Despite the domesticated tomato’s higher transpiration rate and higher gs, there was no difference between the photosynthetic rates of the two lines. Moreover, the wild tomato had a higher maximum rate of rubisco activity, which might explain its greater molecular and whole canopy water-use efficiency. The domesticated tomato’s higher transpiration rate and greater leaf area led to its earlier exposure to drought stress, as compared to the wild tomato, which maintained higher levels of soil water, enabling it to maintain steady rates of whole-canopy stomatal conductance (gsc) for extended periods. The wild tomato was also more sensitive to the soil water availability and lowered its maximum transpiration rate at a higher soil-water-content level. Our results suggest that the domestication process of tomatoes favored morphological/anatomical performance traits over physiological efficiency.