bluuebunny/crossref_metadata_2025_split huggingface dataset:
The acute care burden of asthma in children was profoundly reduced during the COVID-19 pandemic: A multi-centre Canadian retrospective study
Authors: McConnery Jason R , Bone Jeffrey N , Goldman Ran D , Hicks Anne , Seaton Claire , Subbarao Padmaja , Moraes Theo J 
Published: June 2023

Abstract

Objectives
Asthma is a chronic lung condition that can be exacerbated when triggered by viruses. Pandemic public health restrictions aimed to reduce COVID-19 transmission indirectly effected other circulating viruses. This study assessed the impact of the pandemic and associated public health measures on acute paediatric asthma across four tertiary sites in three Canadian provinces. We queried whether pandemic-related changes would impair preventive care and delay presentation to care, increasing asthma exacerbation severity.

Methods
This retrospective study compared the frequency of acute care access and severity of presentation to emergency departments (ED) for acute asthma to four tertiary care children’s hospitals during the COVID-19 pandemic (from March 17, 2020 to June 30, 2021) to a pre-lockdown control period (July 1, 2018 to March 16, 2020). Data was subjected to interrupted time series and Chi-square analysis.

Results
Our study included 26,316 acute asthma visits to ED. Sites experienced a 63% to 89% reduction in acute asthma visits during the pandemic, compared with pre-lockdown controls, and a 17% to 85% reduction in asthma, that is out of proportion as a fraction of all-cause ED visits. For asthma, there was no difference in severity measured by rate of ward admission or rate of Paediatric Intensive Care Unit (PICU) admission.

Conclusions
Public health measures appear to have resulted in a specific protective association on acute asthma with reduced acute care utilization over and above the reduction in all-cause presentations, without an increase in severity upon presentation. Our study indicates an importance to antiviral public health and engineering strategies to reduce viral transmission and thereby asthma morbidity.
Transcription factor RcNAC091 enhances rose drought tolerance through the abscisic acid–dependent pathway
Authors: Geng Lifang , Yu Shuang , Zhang Yichang , Su Lin , Lu Wanpei , Zhu Hong , Jiang Xinqiang 
Published: June 2023

Abstract
NAC (NAM, ATAF1,2, and CUC2) transcription factors (TFs) play critical roles in controlling plant growth, development, and abiotic stress responses. However, few studies have examined NAC proteins related to drought stress tolerance in rose (Rosa chinensis). Here, we identified a drought- and abscisic acid (ABA)–induced NAC TF, RcNAC091, that localizes to the nucleus and has transcriptional activation activity. Virus-induced silencing of RcNAC091 resulted in decreased drought stress tolerance, and RcNAC091 overexpression had the opposite effect. Specifically, ABA mediated RcNAC091-regulated drought tolerance. A transcriptomic comparison showed altered expression of genes involved in ABA signaling and oxidase metabolism in RcNAC091-silenced plants. We further confirmed that RcNAC091 directly targets the promoter of RcWRKY71 in vivo and in vitro. Moreover, RcWRKY71-slienced rose plants were not sensitive to both ABA and drought stress, whereas RcWRKY71-overexpressing plants were hypersensitive to ABA, which resulted in drought-tolerant phenotypes. The expression of ABA biosynthesis– and signaling–related genes was impaired in RcWRKY71-slienced plants, suggesting that RcWRKY71 might facilitate the ABA-dependent pathway. Therefore, our results show that RcWRKY71 is transcriptionally activated by RcNAC091, which positively modulates ABA signaling and drought responses. The results of this study provide insights into the roles of TFs as functional links between RcNAC091 and RcWRKY71 in priming resistance; our findings also have implications for the approaches to enhance the drought resistance of roses.
Swift’s War and Peace
Authors: Sperrin Dan 
Published: June 2023

Abstract
This article considers some of the military and diplomatic contexts which have been neglected in the study of eighteenth-century mock-heroic literature, with a particular focus on the early satires of Swift. Typically, mock-heroic literature is seen as a skilful exercise in a particular kind of literary style, and individual mock-heroic satires are usually contextualized by setting them alongside the military epics (e.g., the Iliad or Aeneid) which they seem to parody. This article takes a slightly different approach by setting Swift’s mock-heroic satires against the background of the Grand Alliance wars against Louis XIV (1688–1714), and by taking another look at his relationship with the retired diplomat and ambassador Sir William Temple. As will be discussed, Temple’s essay ‘Of Heroic Virtue’ offered Swift a model of civil heroism which could be defended or advocated in satire, and it is the influence on Swift of the period’s diplomatic, political, and legal writings which will occupy the core of this discussion.
The immune escape mechanism of nasopharyngeal carcinoma
Authors: Li Xiaoxu , Guo Yinlin , Xiao Minmin , Zhang Wenling 
Published: June 2023

AbstractTumor cells are known for being able to evade immune system surveillance, a hallmark of malignancy. Complicated immune escape mechanisms in the tumor microenvironment (TME) provide favorable conditions for tumor invasion, metastasis, treatment resistance, and recurrence. Epstein–Barr virus (EBV) infection is closely related to the pathogenesis of nasopharyngeal carcinoma (NPC), and the co‐existence of EBV‐infected NPC cells and tumor‐infiltrating lymphocytes represents a distinctive, highly heterogeneous, and suppressive TME that supports immune escape and promotes tumorigenesis. Understanding the complex interaction between EBV and NPC host cells and focusing on the immune escape mechanism of TME may help to identify specific immunotherapy targets and to develop effective immunotherapy drugs.
Infection promotes Ser‐214 phosphorylation important for generation of cytotoxic tau variants
Authors: Balczon Ron , Choi Chung‐Sik , deWeever Althea , Zhou Chun , Gwin Meredith S. , Kolb Claire , Francis C. Michael , Lin Mike T. , Stevens Troy 
Published: June 2023

AbstractPatients who recover from hospital‐acquired pneumonia exhibit a high incidence of end‐organ dysfunction following hospital discharge, including cognitive deficits. We have previously demonstrated that pneumonia induces the production and release of cytotoxic oligomeric tau from pulmonary endothelial cells, and these tau oligomers can enter the circulation and may be a cause of long‐term morbidities. Endothelial‐derived oligomeric tau is hyperphosphorylated during infection. The purpose of these studies was to determine whether Ser‐214 phosphorylation of tau is a necessary stimulus for generation of cytotoxic tau variants. The results of these studies demonstrate that Ser‐214 phosphorylation is critical for the cytotoxic properties of infection‐induced oligomeric tau. In the lung, Ser‐214 phosphorylated tau contributes to disruption of the alveolar–capillary barrier, resulting in increased permeability. However, in the brain, both the Ser‐214 phosphorylated tau and the mutant Ser‐214‐Ala tau, which cannot be phosphorylated, disrupted hippocampal long‐term potentiation suggesting that inhibition of long‐term potentiation was relatively insensitive to the phosphorylation status of Ser‐214. Nonetheless, phosphorylation of tau is essential to its cytotoxicity since global dephosphorylation of the infection‐induced cytotoxic tau variants rescued long‐term potentiation. Collectively, these data demonstrate that multiple forms of oligomeric tau are generated during infectious pneumonia, with different forms of oligomeric tau being responsible for dysfunction of distinct end‐organs during pneumonia.
Serum tryptase and drug hypersensitivity: why, how and what? A systematic review
Authors: Klingebiel Caroline , Belhocine Wahib , Vitte Joana 
Published: June 2023

Purpose of review
Serum tryptase, a mast cell marker, provides clues for the mechanism, severity, and management of drug hypersensitivity induced by immunoglobulin E dependent or independent mast cell activation.

Recent findings
The interpretation of serum tryptase levels has been challenged during the last 2 years by major advances in tryptase genetics and their rapid incorporation into clinical practice. On the contrary, new pathophysiological insight into nonmast cell-dependent immediate hypersensitivity has been gained.

Summary
This review provides up-to-date information on the pathophysiology and recommended use and interpretation of tryptase in the context of drug hypersensitivity reactions as a function of their endotype.
New approaches in childhood asthma treatment
Authors: Castagnoli Riccardo , Brambilla Ilaria , Giovannini Mattia , Marseglia Gian Luigi , Licari Amelia 
Published: June 2023

Purpose of review
This review aims to summarize the most recent advances in asthma management, focusing on novel approaches to pediatric asthma.

Recent findings
In recent years, the therapeutic tools for pediatric asthma have expanded significantly for both the nonsevere and severe forms. The use of anti-inflammatory treatment, even for the mildest cases, and the withdrawal of symptomatic bronchodilation as monotherapy have been included in the most recent guidelines. Also, different biological therapies have revolutionized the therapeutical approach for severe uncontrolled asthma in children and adolescents.

Summary
With the expanding landscape of novel therapeutic approaches for pediatric asthma, further evidence is needed to help clinicians choose the best option for patients, particularly those with severe asthma. The identification of novel predictive biomarkers may also help pediatricians in selecting children and adolescents for innovative therapies.
The Diagnostic Process of Spinal Post-traumatic Deformity
Authors: De Gendt Erin E.A. , Benneker Lorin M. , Joaquim Andrei F. , El-Sharkawi Mohammad , Dhakal Gaurav R. , Kandziora Frank , Tee Jin , Bransford Richard J. , Vialle Emiliano N. , Vaccaro Alex R. , Popescu Eugen C. , Kanna Rishi M. , Polly David W. , Schnake Klaus J. , Berjano Pedro , Ryabykh Sergey , Neva Marko , Lamartina Claudio , Rothenfluh Dominique A. , Lewis Stephan J. , Muijs Sander P.J. , Oner F. Cumhur 
Published: June 2023

Study Design:
Survey of cases.

Objective:
To evaluate the opinion of experts in the diagnostic process of clinically relevant Spinal Post-traumatic Deformity (SPTD).

Summary of Background Data:
SPTD is a potential complication of spine trauma that can cause decreased function and quality of life impairment. The question of when SPTD becomes clinically relevant is yet to be resolved.

Methods:
The survey of 7 cases was sent to 31 experts. The case presentation was medical history, diagnostic assessment, evaluation of diagnostic assessment, diagnosis, and treatment options. Means, ranges, percentages of participants, and descriptive statistics were calculated.

Results:
Seventeen spinal surgeons reviewed the presented cases. The items’ fracture type and complaints were rated by the participants as more important, but no agreement existed on the items of medical history. In patients with possible SPTD in the cervical spine (C) area, participants requested a conventional radiograph (CR) (76%–83%), a flexion/extension CR (61%–71%), a computed tomography (CT)-scan (76%–89%), and a magnetic resonance (MR)-scan (89%–94%). In thoracolumbar spine (ThL) cases, full spine CR (89%–100%), CT scan (72%–94%), and MR scan (65%–94%) were requested most often. There was a consensus on 5 out of 7 cases with clinically relevant SPTD (82%–100%). When consensus existed on the diagnosis of SPTD, there was a consensus on the case being compensated or decompensated and being symptomatic or asymptomatic.

Conclusions:
There was strong agreement in 5 out of 7 cases on the presence of the diagnosis of clinically relevant SPTD. Among spine experts, there is a strong consensus to use CT scan and MR scan, a cervical CR for C-cases, and a full spine CR for ThL-cases. The lack of agreement on items of the medical history suggests that a Delphi study can help us reach a consensus on the essential items of clinically relevant SPTD.

Level of Evidence:
Level V
Clinical development of chimeric antigen receptor-T cell therapy for hematological malignancies
Authors: Yang Zhihuan , Wang Ying 
Published: June 2023

Abstract
Cellular therapies have revolutionized the treatment of hematological malignancies since their conception and rapid development. Chimeric antigen receptor (CAR)-T cell therapy is the most widely applied cellular therapy. Since the Food and Drug Administration approved two CD19-CAR-T products for clinical treatment of relapsed/refractory acute lymphoblastic leukemia and diffuse large B cell lymphoma in 2017, five more chimeric antigen receptor-T (CAR-T) cell products were subsequently approved for treating multiple myeloma or B cell malignancies. Moreover, clinical trials of CAR-T cell therapy for treating other hematological malignancies are ongoing. Both China and the United States have contributed significantly to the development of clinical trials. However, CAR-T cell therapy has many limitations such as a high relapse rate, adverse side effects, and restricted availability. Various methods are being implemented in clinical trials to address these issues, some of which have demonstrated promising breakthroughs. This review summarizes developments in CAR-T cell trials and advances in CAR-T cell therapy.
Breast cancer in young women: a rising threat: A 5-year follow-up comparative study
Authors: Fernandes Urânia , Guidi Gonçalo , Martins Daniela , Vieira Bruno , Leal Clara , Marques Carolina , Freitas Francisca , Dupont Margarida , Ribeiro Juliana , Gomes Carina , Marques Rita , Avelar Paulo , Esteves Ana Sofia , Pinto-de-Sousa João 
Published: June 2023

Abstract

Introduction:
Breast cancer in young women is usually considered as breast cancer occurring in women younger than 40 years and is the most frequent cancer-related cause of death in these patients. In the past few years, there seems to be an increasing trend in the prevalence of breast cancer in young women, which, associated with poorer prognosis, more aggressive histologic features, and more frequent recurrence rates, makes it a rising threat to young women. This study aimed to evaluate the biological behavior of breast cancer in young women in our institution.

Material and methods:
A retrospective, unicentric, cohort study was conducted between 2012 and 2016. All consecutive patients with breast cancer were enrolled in the study. Cases were divided into two groups: case group, those younger than 40 years, and control group, those 40 years or older. The exclusion criterion was nonoperative treatment. Several clinical and pathologic parameters were evaluated, as well as were overall survival time and disease-free survival time.

Results:
The incidence of breast cancer in young women presented a rising tendency over the study period. Significant differences were observed in the comparison of the groups according to body mass index, age at menarche, age at birth of the first child, and proliferation rate. There were no differences in overall survival and disease-free survival rates between the groups.

Conclusions:
Young women had a more symptomatic presentation, a greater tumor proliferation rate, but similar outcomes compared with older patients. Greater multicentric studies are needed to confirm or refute these results.
Self-care Level of Adults With Arterial Hypertension in Outpatient Follow-up in Brazil
Authors: de Lima Nathália Xavier , da Silva Ricardo Costa , Vieira Flaviana Vely Mendonça , Guimarães Janaína Valadares , de Matos Marcos André , Cavalcante Agueda Maria Ruiz Zimmer 
Published: June 2023

Background
Self-care is essential for minimizing the long-term progression of hypertension (HTN) and improving global health outcomes. However, little is known about the predictors of HTN self-care among adults with HTN in Brazil.

Objective
The aim of this study was to evaluate the self-care practices and the association of sociodemographic and clinical factors of adults with HTN in Brazil.

Methods
This was a cross-sectional study conducted by telephone with 120 adults with HTN monitored in a specialized outpatient clinic of a teaching hospital. Sociodemographic and clinical information was collected by a questionnaire survey. Self-care was assessed by the Self-care of Hypertension Inventory version 2. Multiple regression and Kendall's correlation analyses were performed to determine possible predictors.

Results
Low levels of self-care were observed across maintenance, management, and confidence measures. A weak correlation was observed between self-care maintenance and education (−0.13), the time of diagnosis (0.16), and the number of medications (0.15); self-care management and family income (0.13) and cognitive function (0.17); and self-care confidence and systolic (−0.15) and diastolic (−0.18) blood pressure values and time of diagnosis (0.16). In multiple regression analysis, self-care confidence was a predictor of self-care maintenance (β = 0.30; 95% confidence interval, 0.10–0.36) and management (β = 0.20; 95% confidence interval, 0.03–0.46).

Conclusion
Confidence was essential in the maintenance and management of self-care and is central to the control of HTN. Self-care interventions must consider the different aspects that may affect self-care, highlighting improving self-care confidence as a main goal.
Backheel Pass During Forward Running as a Mechanism of Severe Acute Hamstring Injury in Football: A Case Report
Authors: Markovic Goran , Karuc Ivan 
Published: June 2023

Abstract
Proximal hamstring tendon avulsions represent the most severe hamstring injury in sports and are typically sustained during stretch-related movements in closed kinetic chain: forced hip hyperflexion combined with knee extension. Here, we present the case study of the right-foot dominant professional football player with a severe proximal hamstring tendon avulsion injury and concomitant lower-grade injuries of hamstring muscle–tendon complex caused by a potentially new football-specific injury mechanism: right-foot backheel pass during forward running (ie, a kick directly backward). This mechanism involves a specific stretch-shortening cycle action of hamstring muscles in open-kinetic chain movement that has not yet been described in the scientific literature. Although further studies related to this football-specific hamstring injury mechanism are needed, clinicians and coaches working in football should be aware of it and potentially introduce additional injury mechanism-specific exercises and strategies for prevention of severe hamstring injuries which often require surgical intervention.
Gender Disparities Among Professional Team Sports Medicine Physicians
Authors: Schick Sam , Chandler Kelly , Kasprow Sarah , Sisk Morgan , Elphingstone Joseph , Wing Judson , Evely Thomas , Casp Aaron , Ponce Brent , Brabston Eugene , Momaya Amit M. 
Published: June 2023

Objective:
Although recent trends from the Accreditation Council for Graduate Medical Education (ACGME) present encouraging growth of female representation in sports medicine, the field is still lagging behind other specialties. This study investigates gender disparities among physicians providing care for professional sports teams in male and female sports leagues.

Design:
Information regarding physicians providing sports medicine care to professional teams obtained by database queries (May 2021). Chi-square analysis compared gender data of orthopaedic team physicians with American Orthopaedic Society for Sports Medicine (AOSSM) and American Academy of Orthopaedic Surgeons (AAOS) membership, residency, and fellowship census data. Primary care sports medicine physicians were compared with American Medical Society for Sports Medicine (AMSSM) and primary-care sports medicine fellowship census data.

Setting:
Professional sports health care.

Study Population:
Professional league physicians.

Interventions:
None.

Main Outcome Measures:
Gender, residency, and fellowship training of professional league physicians.

Results:
Among a total of 608 team physicians, 572 (93.5%) were male and 40 (6.5%) were female. Orthopedic surgeons comprised 64.7% of the physicians. Fourteen (3.6%) team orthopedic surgeons were female. Thirty-five percent of team physicians were primary care sports medicine physicians. Twenty-six primary care sports medicine physicians (11.6%) were female. Orthopaedic female team physician representation overall was comparable with AOSSM and AAOS membership but significantly less than orthopaedic surgery residents and sports medicine fellows (P < 0.01). Women's National Basketball Association orthopaedic team physicians were more represented than female membership among AOSSM, AAOS, and orthopaedic sports medicine fellows (P < 0.01). Except for the WNBA, Premiere Hockey Federation, National Women's Soccer League, and United States Football League, female primary care sports medicine physicians were underrepresented in professional sports compared with AMSSM membership and primary care sports fellows (P < 0.01).

Conclusion:
Overall, female representation is poor among orthopaedic surgeons and primary care physicians providing sports medicine care to professional teams. Leagues encompassing female athletes tend to have better representation of female physicians.

Level of Evidence:
IV.
Percutaneous Electrical Nerve Field Stimulation for Drug-Refractory Pediatric Cyclic Vomiting Syndrome
Authors: Karrento Katja , Venkatesan Thangam , Zhang Liyun , Pawela Louis , Simpson Pippa , Li B U.K. 
Published: June 2023

Background:
Cyclic vomiting syndrome (CVS) is a disabling condition frequently refractory to pharmacologic therapy. The aim of this study was to evaluate the effects of noninvasive, auricular percutaneous electrical nerve field stimulation (PENFS) as prophylactic therapy for pediatric CVS.

Methods:
Children 8–18 years with drug-refractory CVS were prospectively enrolled from a tertiary care CVS clinic. Subjects received 6 consecutive weeks of PENFS. CVS severity was quantified by episode frequency and duration score (range 0–25) at baseline and at extended follow-up (4–6 months after end of therapy). Response was classified as ≥50% improvement in either frequency or duration of attacks at extended follow-up. Subjects also completed validated surveys of nausea, disability, and global response.

Results:
Thirty subjects completed the study. Median (interquartile range, IQR) age was 10.5 (8.5–15.5) years; 60% were female. At follow-up, 80% met criteria for treatment response with a median (IQR) response duration of 113 (61–182) days. The frequency-duration score improved from baseline median (IQR) 12.0 (9.0–16.0) to 3.0 (1.0–6.0) at follow-up, P < 0.0001. Median (IQR) nausea and disability scores decreased from baseline to week 6: 2.1 (1.3–2.7) to 0.9 (0–1.6), P = 0.003 and 47.5 (41.0–53.0) to 38.0 (16.0–51.0), P = 0.001, respectively. At end of therapy, 66% and 55% patients reported global response of at least “moderately better” and “a good deal better,” respectively. There were no serious side effects.

Conclusions:
This study suggests long-term benefits of PENFS for children with CVS. PENFS improves several disabling aspects of CVS, including episode frequency, duration, and functional disability.
Management of aseptic nonunions and severe bone defects: let us get this thing healed!
Authors: Nauth Aaron , Crist Brett D. , Morshed Saam , Watson J. Tracy , Pape Hans-Christoph 
Published: June 2023

Summary:
Effective nonunion and bone defect management requires consideration of multiple potential contributing factors including biomechanics, biology, metabolic, and patient factors. This article reviews these factors as well as several potential nonunion or bone defect treatments including bone grafts, bone graft substitutes, the induced membrane technique, and distraction osteogenesis. A summary of these concepts and guidelines for an overall approach to management are also provided.