bluuebunny/crossref_metadata_2025_split huggingface dataset:
The irrigation efficiency trap: rational farm-scale decisions can lead to poor hydrologic outcomes at the basin scale
Authors: Morrisett Christina N. , Van Kirk Robert W. , Bernier London O. , Holt Andrea L. , Perel Chloe B. , Null Sarah E. 
Published: August 2023

Agricultural irrigation practices have changed through time as technology has enabled more efficient conveyance and application. In some agricultural regions, irrigation can contribute to incidental aquifer recharge important for groundwater return flows to streams. The Henrys Fork Snake River, Idaho (United States) overlies a portion of the Eastern Snake Plain Aquifer, where irrigated agriculture has occurred for over a century. Using irrigator interviews, aerial and satellite imagery, and statistical streamflow analysis, we document the impact of farm-scale decisions on basin-scale hydrology. Motivated to improve economic efficiency, irrigators began converting from surface to center-pivot sprinkler irrigation in the 1950s, with rapid adoption of center-pivot sprinklers through 2000. Between 1978–2000 and 2001–2022, annual surface-water diversion decreased by 311 Mm3 (23%) and annual return flow to the river decreased by 299 Mm3 over the same period. Some reaches that gained water during 1978–2000 lost water to the aquifer during the later period. We use an interdisciplinary approach to demonstrate how individual farm-scale improvements in irrigation efficiency can cumulatively affect hydrology at the landscape scale and alter groundwater-surface water relationships. Return flows are an important part of basin hydrology in irrigated landscapes and we discuss how managed and incidental aquifer recharge can be implemented to recover return flows to rivers.
Can digital technology reduce carbon emissions? Evidence from Chinese cities
Authors: Liu Hui , Wang Lili , Shen Yang 
Published: August 2023

IntroductionGlobal warming presents significant challenges to the sustainable development of human society. Accelerating the achievement of carbon peak and neutrality is the vision for creating a global ecological community with a shared future. The development of digital technology provides us with the direction of action.MethodsBased on panel data from 276 cities in China from 2011 to 2020, principal component analysis was used to measure the basic state of digital technology at the city level, and the twoway fixed effects model and instrumental variable method to verify the impact of digital technology on carbon emissions from the perspective of technology diffusion.ResultsThe results show that the deep diffusion of digital technology in the real economy sector is helpful to improve productivity and carbon efficiency, thus significantly reducing carbon emissions. The role of digital technologies in reducing carbon emissions is heterogeneous. The results of the sub-sample test show that digital technology has a stronger emission reduction effect in large-scale cities, resource-based cities, smart cities and emission trading policy pilot areas. Digital technology can reduce carbon emissions by improving energy efficiency, promoting green technology innovation, and promoting virtual agglomeration.DiscussionsThe contribution of this paper is that it not only reveals that digital technology can reduce carbon emissions but also analyzes the emission reduction path of digital technology from a new perspective. The conclusion of this paper has implications for accelerating the diffusion of digital technology in the real economy sector to accelerate the realization of green production and cope with climate change.
SARS-CoV-2 neutralizing antibody bebtelovimab – a systematic scoping review and meta-analysis
Authors: Liew Mabel Nyit Yi , Kua Kok Pim , Lee Shaun Wen Huey , Wong Kon Ken 
Published: August 2023

IntroductionThe COVID-19 pandemic is a major global public health crisis. More than 2 years into the pandemic, effective therapeutic options remain limited due to rapid viral evolution. Stemming from the emergence of multiple variants, several monoclonal antibodies are no longer suitable for clinical use. This scoping review aimed to summarize the preclinical and clinical evidence for bebtelovimab in treating newly emerging SARS-CoV-2 variants.MethodsWe systematically searched five electronic databases (PubMed, CENTRAL, Embase, Global Health, and PsycINFO) from date of inception to September 30, 2022, for studies reporting on the effect of bebtelovimab in SARS-CoV-2 infection, using a combination of search terms around ―bebtelovimab‖, ―LY-CoV1404‖, ―LY3853113‖, and ―coronavirus infection‖. All citations were screened independently by two researchers. Data were extracted and thematically analyzed based on study design by adhering to the stipulated scoping review approaches.ResultsThirty-nine studies were included, thirty-four non-clinical studies were narratively synthesized, and five clinical studies were meta-analyzed. The non-clinical studies revealed bebtelovimab not only potently neutralized wide-type SARS-CoV-2 and existing variants of concern such as B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma), and B.1.617.2 (Delta), but also retained appreciable activity against Omicron lineages, including BA.2.75, BA.4, BA.4.6, and BA.5. Unlike other monoclonal antibodies, bebtelovimab was able to bind to epitope of the SARS-CoV-2 S protein by exploiting loop mobility or by minimizing side-chain interactions. Pooled analysis from clinical studies depicted that the rates of hospitalization, ICU admission, and death were similar between bebtelovimab and other COVID-19 therapies. Bebtelovimab was associated with a low incidence of treatment-emergent adverse events.ConclusionPreclinical evidence suggests bebtelovimab be a potential treatment for COVID-19 amidst viral evolution. Bebtelovimab has comparable efficacy to other COVID-19 therapies without evident safety concerns.
Retinopathy as an initial sign of hereditary immunological diseases: report of six families and challenges in eye clinic
Authors: Wang Yingwei , Jiang Yi , Wang Junwen , Li Shiqiang , Jia Xiaoyun , Xiao Xueshan , Sun Wenmin , Wang Panfeng , Zhang Qingjiong 
Published: August 2023

IntroductionRetinal degenerative or inflammatory changes may occur with hereditary immunological disorders (HID) due to variants in approximately 20 genes. This study aimed to investigate if such retinopathy may present as an initial sign of immunological disorders in eye clinic.MethodsThe variants in the 20 genes were selected from in-house exome sequencing data from 10,530 individuals with different eye conditions. Potential pathogenic variants were assessed by multistep bioinformatic analysis. Pathogenic variants were defined according to the ACMG/AMP criteria and confirmed by Sanger sequencing, co-segregation analysis, and consistency with related phenotypes. Ocular clinical data were thoroughly reviewed, especially fundus changes.ResultsA total of seven pathogenic variants in four of the 20 genes were detected in six probands from six families, including three with hemizygous nonsense variants p.(Q308*), p.(Q416*), and p.(R550*) in MSN, one with homozygous nonsense variants p.(R257*) in AIRE, one with compound heterozygous nonsense variants p.(R176*) and p.(T902*) in LAMB2, and one with a known c.1222T&gt;C (p.W408R) heterozygous variant in CBL. Ocular presentation, as the initial signs of the diseases, was mainly retinopathy mimicking other forms of hereditary retinal degeneration, including exudative vitreoretinopathy in the three patients with MSN variants or tapetoretinal degeneration in the other three patients. Neither extraocular symptoms nor extraocular manifestations were recorded at the time of visit to our eye clinic. However, of the 19 families in the literature with retinopathy caused by variants in these four genes, only one family with an AIRE homozygous variant had retinopathy as an initial symptom, while the other 18 families had systemic abnormalities that preceded retinopathy.DiscussionThis study, for the first time, identified six unrelated patients with retinopathy as their initial and only presenting sign of HID, contrary to the previous reports where retinopathy was the accompanying sign of systemic HID. Recognizing such phenotype of HID may facilitate the clinical care of these patients. Follow-up visits to such patients and additional studies are expected to validate and confirm our findings.
Validation of the CALL score as a mortality prediction tool in a cohort of hospitalized COVID-19 patients in Chile
Authors: Sanhueza Matías , Barrera Manuel , Pedemonte Juan C. , Rojas Luis 
Published: August 2023

IntroductionThe CALL score is a predictive tool for respiratory failure progression in COVID-19. Whether the CALL score is useful to predict short- and medium-term mortality in an unvaccinated population is unknown.Materials and methodsThis is a prospective cohort study in unvaccinated inpatients with a COVID-19 pneumonia diagnosis upon hospital admission. Patients were followed up for mortality at 28 days, 3, 6, and 12 months. Associations between CALL score and mortality were analyzed using logistic regression. The prediction performance was evaluated using the area under a receiver operating characteristic curve (AUROC).ResultsA total of 592 patients were included. On average, the CALL score was 9.25 (±2). Higher CALL scores were associated with increased mortality at 28 days [univariate: odds ratio (OR) 1.58 (95% CI, 1.34–1.88), p &lt; 0.001; multivariate: OR 1.54 (95% CI, 1.26–1.87), p &lt; 0.001] and 12 months [univariate OR 1.63 (95% CI, 1.38–1.93), p &lt; 0.001; multivariate OR 1.63 (95% CI, 1.35–1.97), p &lt; 0.001]. The prediction performance was good for both univariate [AUROC 0.739 (0.687–0.791) at 28 days and 0.869 (0.828–0.91) at 12 months] and multivariate models [AUROC 0.752 (0.704–0.8) at 28 days and 0.862 (0.82–0.905) at 12 months].ConclusionThe CALL score exhibits a good predictive capacity for short- and medium-term mortality in an unvaccinated population.
Burnout and motivation to study medicine among students during the COVID-19 pandemic
Authors: Metakides Clio , Pielemeier Lena , Lytras Theodore , Mytilinaios Dimitrios G. , Themistocleous Sophia C. , Pieridi Chryso , Tsioutis Constantinos , Johnson Elizabeth O. , Ntourakis Dimitrios , Nikas Ilias P. 
Published: August 2023

AimTo investigate medical students’ burnout and motivation levels in each of the six years of their studies during the COVID-19 pandemic and identify independent predictors of burnout and motivation.MethodsAn anonymous cross-sectional survey was sent to the students of all six years within our school. Burnout was measured with the adapted Oldenburg Burnout Inventory questionnaire (OLBI-S) and motivation with the updated Strength of Motivation for Medical School (SMMS-R) questionnaire. Univariate analysis was performed with the Kruskal–Wallis test and Spearman’s correlation, while multivariable analysis with linear regression models.ResultsA total of 333 medical students (52% of student body) responded. Higher burnout levels correlated with lower motivation to study medicine (rho = −0.30, p &lt; 0.001). Burnout levels differed between the six years of medical studies, peaking in years two and four whereas being the lowest in year one (p = 0.01). Motivation levels differed significantly as well, peaking in years one and four whereas being the lowest in years five and six (p = 0.012). In the multivariable linear regression models, being a female (b = 2.22, p = 0.016), studying in the fourth year vs. first year (b = 2.54, p = 0.049), having a perceived beginner/intermediate vs. advanced/expert technology level (b = 2.05, p = 0.032) and a perceived poor school support system (b = 6.35, p &lt; 0.001) were independently associated with higher burnout levels. Furthermore, studying in the fifth year vs. first year (b = −5.17, p = 0.019) and a perceived poor school support system (b = −3.09, p = 0.01) were independently associated with a reduced motivation to study medicine.ConclusionOur study highlighted potential areas for intervention to decrease the rate of burnout and low motivation among medical students. However, further research is needed to unravel the full effect of the pandemic on medical students.
Development of an in-vitro model for extracorporeal blood pumps to study the effects of artificial pulsatility on human blood
Authors: Zieger Barbara , Schneider Denise , Brixius Sam Joé , Scherer Christian , Buchwald Armin , Trummer Georg , Czerny Martin , Beyersdorf Friedhelm , Busch Hans-Jörg , Benk Christoph , Pooth Jan-Steffen 
Published: August 2023

IntroductionThe application of extracorporeal circulation (ECC) systems is known to be associated with several implications regarding hemolysis, inflammation, and coagulation. In the last years, systems with pulsatile blood flow are increasingly used with the intention to improve hemodynamics in reperfusion. However, their implications on the aforementioned aspects remain largely unknown. To investigate the effects of pulsatility, this ex-vivo study was initiated.MethodsTest circuits (primed with human whole blood) were set up in accordance with the recommendations of international standards for in-vitro evaluation of new components and systems of ECC. Diagonal pumps were either set up with non-pulsatile (n = 5, NPG) or pulsatile (n = 5, PG) pump settings and evaluated for 6 h. All analyses were conducted with human whole blood. Blood samples were repeatedly drawn from the test circuits and analyzed regarding free hemoglobin, interleukin 8 (IL-8), platelet aggregation and acquired von Willebrand syndrome (AVWS).ResultsAfter 1 h of circulation, a significant coagulation impairment (impaired platelet function and AVWS) was observed in both groups. After 6 h of circulation, increased IL-8 concentrations were measured in both groups (NPG: 0.05 ± 0.03 pg./mL, PG: 0.03 ± 0.01 pg./mL, p = 0.48). Pulsatile pump flow resulted in significantly increased hemolysis after 6 h of circulation (NPG: 37.3 ± 12.4 mg/100 L; PG: 59.6 ± 14.5 mg/100 L; p &lt; 0.05).ConclusionOur results indicate that the coagulative impairment takes place in the early phase of ECC. Pulsatility did not affect the occurrence of AVWS ex-vivo. Prolonged durations of pulsatile pump flow led to increased hemolysis and therefore, its prolonged use should be employed cautiously in clinical practice with appropriate monitoring.
Differences in subthalamic oscillatory activity in the two hemispheres associated with severity of Parkinson’s disease
Authors: Zhao Xuemin , Zhuang Ping , Hallett Mark , Zhang Yuqing , Li Jianyu , Wen Yi , Li Jiping , Wang Yunpeng , Hu Yongsheng , Li Yongjie 
Published: August 2023

BackgroundIt is well known that motor features of Parkinson’s disease (PD) commonly begin on one side of the body and extend to the other side with disease progression. The onset side generally remains more severely affected over the course of the disease. However, the pathophysiology underlying the asymmetry of motor manifestations remains unclear. The purpose of the present study is to examine whether alterations in neuronal activity in the subthalamic nucleus (STN) associate with PD severity.MethodsMicroelectrode recording was performed in the STN during targeting for 30 patients in the treatment of deep brain stimulation. The mean spontaneous firing rate (MSFR), power density spectral analysis, and correlations were calculated. Characteristics of subthalamic oscillatory activity were compared between two hemispheres. UPDRS III scores during “Off” and “On” states were obtained for the body side of initial symptoms (BSIS) and the body side of extended symptoms (BSES).ResultsThere were significant differences of MSFR (41.3 ± 11.0 Hz vs 35.2 ± 10.0 Hz) and percentage of ß frequency oscillatory neurons (51.3% vs 34.9%) between BSIS and BSES. The percentage of ß frequency oscillatory neurons correlated with the bradykinesia/rigidity scores for both sides (p &lt; 0.05). In contrast, the percentage of tremor frequency oscillatory neurons was significantly higher in the BSES than that in the BSIS. In particular, these neurons only correlated with the tremor scores of the BSES (p &lt; 0.05).ConclusionThe results suggest that increased neuronal firing rate and ß frequency oscillatory neurons in the STN are associated with contralateral side motor severity and its progression. Tremor frequency oscillatory neurons are less observed in the STN of the BSIS suggesting that ß oscillatory activity dominates and tremor frequency oscillatory activity reciprocally declines.
Time and frequency domain analysis of physiological features during autonomic dysreflexia after spinal cord injury
Authors: Kirby Ana Karina , Pancholi Sidharth , Anderson Zada , Chesler Caroline , Everett Thomas H. , Duerstock Bradley S. 
Published: August 2023

IntroductionAutonomic dysreflexia (AD) affects about 70% of individuals with spinal cord injury (SCI) and can have severe consequences, including death if not promptly detected and managed. The current gold standard for AD detection involves continuous blood pressure monitoring, which can be inconvenient. Therefore, a non-invasive detection device would be valuable for rapid and continuous AD detection.MethodsImplanted rodent models were used to analyze autonomic dysreflexia after spinal cord injury. Skin nerve activity (SKNA) features were extracted from ECG signals recorded non-invasively, using ECG electrodes. At the same time, blood pressure and ECG data sampled was collected using an implanted telemetry device. Heart rate variability (HRV) features were extracted from these ECG signals. SKNA and HRV parameters were analyzed in both the time and frequency domain.ResultsWe found that SKNA features showed an increase approximately 18 seconds before the typical rise in systolic blood pressure, indicating the onset of AD in a rat model with upper thoracic SCI. Additionally, low-frequency components of SKNA in the frequency domain were dominant during AD, suggesting their potential inclusion in an AD detection system for improved accuracy.DiscussionUtilizing SKNA measurements could enable early alerts to individuals with SCI, allowing timely intervention and mitigation of the adverse effects of AD, thereby enhancing their overall well-being and safety.
Insights into cognitive and behavioral comorbidities of SLC6A1-related epilepsy: five new cases and literature review
Authors: Trivisano Marina , Butera Ambra , Quintavalle Chiara , De Dominicis Angela , Calabrese Costanza , Cappelletti Simona , Vigevano Federico , Novelli Antonio , Specchio Nicola 
Published: August 2023

IntroductionSLC6A1 pathogenic variants have been associated with epilepsy and neurodevelopmental disorders. The clinical phenotype includes different seizure types, intellectual disability, and psychiatric symptoms affecting mood and behavior. Few data regarding neuropsychological features have been described, and details on cognitive profiles are often missing due to the lack of standardized tests.MethodsWe retrospectively reviewed the neuropsychological assessments of five subjects carrying heterozygous missense genetic variants in SLC6A1. We also collected data on epileptic features, EEGs, and brain MRIs. Additionally, we reviewed neuropsychological data from 204 previously reported patients with SLC6A1 pathogenic variants.ResultsIn our series, at the last evaluation (median 12.6 years), three patients had borderline intellectual functioning, one patient had mild cognitive impairment, and one patient presented with a moderate cognitive disability. Three out of five patients underwent at least two neuropsychological evaluations, which revealed a worsening of cognitive functions over time. We detected attention deficits in all patients. In addition, we observed anxiety, disruptive behavior disorder, emotional instability, and hetero aggressiveness. We also performed a literature review that highlighted that most of the patients with SLC6A1 pathogenic variants have mild-to-moderate intellectual disability and that one-third of cases have autistic traits.DiscussionBased on the literature review and the detailed description of our cases, we conclude that patients with SLC6A1-related epilepsy mostly present with mild-to-moderate intellectual disability, often associated with attention disorders. Such symptoms may worsen over time. Periodic standardized neuropsychological tests may be useful tools to follow development over time, and patient-specific rehabilitation programs could be tailored consistently.
Impact of gender and mutational differences in hormone receptor expressing non-small cell lung cancer
Authors: Hsu Robert , Chen Denaly , Xia Bing , Feldman Rebecca , Cozen Wendy , Raez Luis E. , Borghaei Hossein , Kim Chul , Nagasaka Misako , Mamdani Hirva , Vanderwalde Ari M. , Lopes Gilberto , Socinski Mark A. , Wozniak Antoinette J. , Spira Alexander I. , Liu Stephen V. , Nieva Jorge J. 
Published: August 2023

BackgroundThe incidence of lung cancer in the US has been decreasing but a bigger decline has been observed in men despite similar declines in tobacco use between men and women. Multiple theories have been proposed, including exposure to exogenous estrogens. Our study seeks to understand the relationship between hormone receptors (HR), gender, and the genomic landscape of non-small lung cancer (NSCLC).Methods3,256 NSCLC tumor samples submitted for molecular profiling between 2013-2018 were retrospectively identified and assessed for HR expression. Hormone receptor (HR+) was defined as ≥ 1% nuclear staining of estrogen receptor-alpha (ER-a) or progesterone receptor (PR) by immunohistochemistry. DNA sequencing by NGS included cases sequenced by the Illumina MiSeq hot spot 47 gene panel (n=2753) and Illumina NextSeq 592 gene panel (n=503). An adjusted p-value (q-value) &lt;0.05 was determined significant.ResultsHR+ was identified in 18.3% of NSCLC. HR+ occurred more commonly in women compared to men (19.6% vs 11.4%, p &lt;0.0001, q &lt;0.0001). EGFR mutations occurred more commonly in HR+ NSCLC than HR- NSCLC (20.2% vs. 14.6%, p = 0.002, q=0.007). Overall, men with EGFR mutations were affected by HR status with a higher prevalence in HR+ NSCLC while such differences were not seen in women. However, in women ages ≤45, there was a trend towards greater prevalence HR+ NSCLC (25.25% vs. 11.32%, q= 0.0942) and 10/25 (40.0%) of HR+ cases in young women were found to be EGFR mutated. KRAS mutations and ALK+ IHC expression occurred more in HR+ NSCLC whereas TP53 mutations occurred more in HR- NSCLC.ConclusionsWomen were more likely to have HR+ NSCLC than men and EGFR and KRAS mutations occurred more commonly in HR+ NSCLC. Additional studies with more strict inclusion criteria for HR+ are warranted to see if there is benefit to targeting HR in these subgroups.