bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunogenicity, Safety, and Breakthrough Severe Acute Respiratory Syndrome Coronavirus 2 Infections After Coronavirus Disease 2019 Vaccination in Organ Transplant Recipients: A Prospective Multicenter Canadian Study
Authors: Kabbani Dima , Yotis Demitra M , Ferreira Victor H , Shalhoub Sarah , Belga Sara , Tyagi Varalika , Ierullo Matthew , Kulasingam Vathany , Hébert Marie-Josée , West Lori , Delisle Jean-Sébastien , Racine Normand , De Serres Sacha A , Cardinal Héloïse , Dieudé Mélanie , Humar Atul , Kumar Deepali 
Published: April 2023

Abstract

Background
Solid organ transplant (SOT) recipients are at risk for severe coronavirus disease 2019 (COVID-19), despite vaccination. Our study aimed to elucidate COVID-19 vaccine immunogenicity and evaluate adverse events such as hospitalization, rejection, and breakthrough infection in a SOT cohort.

Methods
We performed a prospective, observational study on 539 adult SOT recipients (age ≥18 years old) recruited from 7 Canadian transplant centers. Demographics including transplant characteristics, vaccine types, and immunosuppression and events such as hospitalization, infection, and rejection were recorded. Follow ups occurred every 4–6 weeks postvaccination and at 6 and 12 months from first dose. Serum was processed from whole blood to measure anti-receptor binding domain (RBD) antibodies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein to assess immunogenicity.

Results
The COVID-19 vaccines were found to be safe in SOT recipients with low rates of rejection requiring therapy (0.7%). Immunogenicity improved after the third vaccine dose, yet 21% developed no anti-RBD response. Factors such as older age, lung transplantation, chronic kidney disease, and shorter duration from transplant were associated with decreased immunogenicity. Patients with at least 3 doses were protected from hospitalization when experiencing breakthrough infections. Significantly increased anti-RBD levels were observed in patients who received 3 doses and had breakthrough infection.

Conclusions
Three or four doses of COVID-19 vaccines were safe, increased immunogenicity, and protected against severe disease requiring hospitalization. Infection paired with multiple vaccinations significantly increased anti-RBD response. However, SOT populations should continue to practice infection prevention measures, and they should be prioritized for SARS-CoV-2 pre-exposure prophylactics and early therapeutics.
Dicer-like 3a mediates intergenerational resistance against root-knot nematodes in rice via hormone responses
Authors: Meijer Anikó , Atighi Mohammad Reza , Demeestere Kristof , De Meyer Tim , Vandepoele Klaas , Kyndt Tina 
Published: April 2023

Abstract
In a continuously changing and challenging environment, passing down the memory of encountered stress factors to offspring could provide an evolutionary advantage. In this study, we demonstrate the existence of “intergenerational acquired resistance” in the progeny of rice (Oryza sativa) plants attacked by the belowground parasitic nematode Meloidogyne graminicola. Transcriptome analyses revealed that genes involved in defense pathways are generally downregulated in progeny of nematode-infected plants under uninfected conditions but show a stronger induction upon nematode infection. This phenomenon was termed “spring loading” and depends on initial downregulation by the 24-nucleotide (nt) siRNA biogenesis gene dicer-like 3a (dcl3a) involved in the RNA-directed DNA methylation pathway. Knockdown of dcl3a led to increased nematode susceptibility and abolished intergenerational acquired resistance, as well as jasmonic acid/ethylene spring loading in the offspring of infected plants. The importance of ethylene signaling in intergenerational resistance was confirmed by experiments on a knockdown line of ethylene insensitive 2 (ein2b), which lacks intergenerational acquired resistance. Taken together, these data indicate a role for DCL3a in regulating plant defense pathways during both within-generation and intergenerational resistance against nematodes in rice.
Overnight declarative memory consolidation and non-rapid eye movement sleep electroencephalographic oscillations in older adults with obstructive sleep apnea
Authors: Teh Jun Z , Grummitt Lucinda , Haroutonian Carla , Cross Nathan E , Skinner Bradley , Bartlett Delwyn J , Yee Brendon , Grunstein Ronald R , Naismith Sharon L , D’Rozario Angela L 
Published: April 2023

Abstract

Study Objectives
To compare overnight declarative memory consolidation and non-rapid eye movement (NREM) sleep electroencephalogram (EEG) oscillations in older adults with obstructive sleep apnea (OSA) to a control group and assess slow-wave activity (SWA) and sleep spindles as correlates of memory consolidation.

Methods
Forty-six older adults (24 without OSA and 22 with OSA) completed a word-pair associate's declarative memory task before and after polysomnography. Recall and recognition were expressed as a percentage of the morning relative to evening scores. Power spectral analysis was performed on EEG recorded at frontal (F3-M2, F4-M1) and central (C3-M2, C4-M1) sites. We calculated NREM absolute slow oscillation (0.25–1 Hz) and delta (0.5–4.5 Hz) EEG power, and slow (11–13 Hz) spindle density (number of events per minute of N2 sleep) and fast (13–16 Hz) spindle density.

Results
There were no significant differences in overnight recall and recognition between OSA (mean age 58.7 ± 7.1 years, apnea–hypopnea index (AHI) 41.9 ± 29.7 events/hour) and non-OSA (age 61.1 ± 10.3 years, AHI 6.6 ± 4.2 events/hour) groups. The OSA group had lower fast spindle density in the frontal region (p = 0.007). No between-group differences in SWA were observed. In the Control group, overnight recognition positively correlated with slow spindle density in frontal (rho = 0.555, p = 0.020) and central regions (rho = 0.490, p = 0.046). Overnight recall was not related to SWA or spindle measures in either group.

Conclusions
Older adults with OSA had deficits in fast sleep spindles but showed preserved overnight declarative memory consolidation. It is possible that compensatory mechanisms are being recruited by OSA patients to preserve declarative memory consolidation despite the presence of sleep spindle deficits.
Cultivating Sense of Belongingness Among Graduate Nursing Students: A Virtual Fitness Challenge
Authors: Stamm Robyn W. , Davis Lindsay , Gillespie Gordon L. , Lopez Rosado Juan O. , Rota Matthew J. 
Published: April 2023

Abstract
Sense of belongingness in the academic environment has been associated with positive student outcomes and increased student success. To cultivate belongingness, graduate nursing students were invited to participate in a virtual fitness challenge. Sense of belongingness was measured through pre- (n = 103) and post-intervention (n = 64) surveys with three subscales: other students, faculty, and the university. Students reported improved sense of belongingness following the intervention for all subscales, with statistically significant improvements related to other students (p = .007) and the university (p = .023). A virtual fitness challenge may improve sense of belongingness among graduate nursing students.
Cognitive and Noncognitive Factors Influencing Nursing Students’ Academic Success: Structural Equation Model Analysis
Authors: Hollinger-Smith Linda M. , Patterson Barbara J. , Morin Karen H. , Scott Cameron J. 
Published: April 2023

Abstract

AIM
The study aim was to identify and explore relationships among cognitive and noncognitive factors that may contribute to prelicensure baccalaureate nursing students’ academic success across their program of study.

BACKGROUND
Nurse educators are challenged to improve students’ academic success. With limited evidence, cognitive and noncognitive factors have been identified in the literature as potential factors that influence academic success and may support students’ readiness for practice as new graduate nurses.

METHOD
Data sets from 1,937 BSN students at multiple campuses were analyzed using an exploratory design and structural equation modeling.

CONCLUSION
Six factors were conceptualized as contributing equally to the initial cognitive model. The final noncognitive model, with deletion of two factors, yielded the best fit for the four-factor model. Cognitive and noncognitive factors were not significantly correlated. This study provides a beginning understanding of cognitive and noncognitive factors associated with academic success that may support readiness for practice.
Delaying the Fellowship Start Date in Obstetrics and Gynecology
Authors: Banks Erika , George Karen E. , Doulaveris George , Gressel Gregory M. , Sax Megan , Connolly AnnaMarie 
Published: April 2023

OBJECTIVE:
To evaluate residents planning fellowship, their preferences for fellowship start date, and the acceptability of resultant gaps in pay and insurance coverage.

METHODS:
A survey was conducted during the 2022 in-service training examination querying obstetrics and gynecology residents about their desire to pursue fellowship, their preferred fellowship start date (understanding the salary gap), and the acceptability of a medical insurance gap.

RESULTS:
Survey analysis of respondents planning to pursue fellowship demonstrated that, acknowledging the pay gap that would occur, 93.9% preferred a fellowship start date after July 1, with the majority (65.1%, 593/911) preferring an August 1 fellowship start date. Most respondents (87.7%, 798/910) found the potential resultant gap in medical insurance coverage acceptable. Survey data showed that racial and ethnic identity was not a determining factor in either of these issues.

CONCLUSION:
The majority of current residents planning to pursue fellowship prefer a delayed fellowship start date, even if it means a gap in salary and insurance coverage. The results of this study, requested by a specialty-wide, consensus-building workgroup, informed a statement signed by the majority (88.9%) of workgroup constituents supporting an August 1 clinical fellowship start date.
Diagnosis Accuracy for Compartment Syndrome: A Systematic Review and Meta-Analysis
Authors: Lorange Justin-Pierre , Laverdière Carl , Corban Jason , Montreuil Julien , Harvey Edward J. 
Published: April 2023

Objective:
To evaluate whether published studies support basing the diagnosis of compartment syndrome of the lower leg on clinical findings, intracompartmental pressure (ICP) monitoring, or both.

Data Sources:
A PubMed/MEDLINE, Web of Science, and Embase search of the English literature from 1966 to February 2022 was performed. This used “lower extremity” or “leg” or “tibia” and “compartment syndrome” and “pressure” as the subjects. A manual search of the bibliographies was performed and cross-referenced with those used to formulate the American Academy of Orthopaedic Surgeons clinical practice guidelines.

Study Selection and Extraction:
Inclusion criteria were traumatic tibia injuries, presence of data to calculate the sensitivity, specificity, positive and negative predictive values of clinical findings and/or pressure monitoring, and the presence or absence of compartment syndrome as the outcome. A total of 2906 full articles were found, of which 63 were deemed relevant for a detailed review. Seven studies met all eligibility criteria.

Data Synthesis:
The likelihood ratio form of Bayes theorem was used to assess the discriminatory ability of the clinical findings and ICP monitoring as tests for compartment syndrome. The predictive value for diagnosing acute compartment syndrome was 21% and 29% for the clinical signs and ICP, respectively. When combining both, the probability reached 68%.

Conclusions:
The use of ICP monitoring may be helpful when combined with a clinical assessment to increase the sensitivity and specificity of the overall diagnosis. Previously accepted individual inference values should be revisited with new prospective studies to further characterize the statistical value of each clinical finding.

Level of Evidence:
Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Risk Factors and Characteristics of Recalcitrant Osteomyelitis After Initial Surgical and Antibiotic Treatment
Authors: Shah Nihar S. , Kanhere Arun P. , Dowell Evan , Sabbagh Ramsey S. , Bonamer John , Franklin Austin , Sanders Drew T. , Sagi H Claude 
Published: April 2023

Objectives:
To evaluate the injury, patient, and microbiological characteristics that place patients at risk for recalcitrant fracture–related infection and osteomyelitis despite appropriate initial treatment.

Design:
Retrospective chart review.

Setting:
Three level I trauma centers.

Patients and Participants:
Two hundred and fifty-seven patients undergoing surgical debridement and antibiotic therapy for osteomyelitis from 2003 to 2019.

Main Outcome Measurements:
Patients were categorized as having undergone serial bone debridement if they had 2 separate procedures a minimum of 6 weeks apart with a full course of appropriate antibiotics in between. Patient records were reviewed for age, injury location, body mass index, smoking status, comorbidities, and culture results including the presence of multidrug-resistant organisms and culture-negative osteomyelitis.

Results:
A total of 257 patients were identified; 49% (n = 125) had a successful single course of treatment, and 51% (n = 132) required repeat debridement for recalcitrant osteomyelitis. At the index treatment for osteomyelitis, the most common organisms in both groups were methicillin-resistant (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA). There was no significant difference in incidence of polymicrobial infection between the 2 groups (25% vs. 20%, P = 0.49). The most common organisms cultured at the time of repeat saucerization remained MRSA and MSSA; however, the same organism was cultured from both the index and repeat procedures in only 28% (n = 37) of cases. Diabetic patients, intravenous drug use status, delay to diagnosis, and open fractures of the lower leg are independent risk factors for failure of initial treatment of posttraumatic osteomyelitis.

Conclusions:
Successful eradication of fracture-related infection and posttraumatic osteomyelitis is difficult and fails 51% of the time despite standard surgical and antimicrobial therapy. Although MRSA and MSSA remain the most common organisms cultured, patients who fail initial treatment for osteomyelitis often do not culture the same organisms as those obtained at the index procedure.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Residual coronary artery tree description and lesion EvaluaTion (CatLet) score, clinical variables, and their associations with outcome predictions in patients with acute myocardial infarction
Authors: Xu Mingxing , Wang Shu , Zhang Ying , Zhang Jie , Ma Jin , Shen Junfei , Tang Yida , Jiang Tingbo , He Yongming 
Published: April 2023

Abstract

Background:
We have recently developed a new Coronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring system. Our preliminary studies have demonstrated its superiority over the the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery (SYNTAX) score with respect to outcome predictions for acute myocardial infarction (AMI) patients. The current study hypothesized that the residual CatLet (rCatLet) score predicts clinical outcomes for AMI patients and that a combination with the three clinical variables (CVs)—age, creatinine, and ejection fraction, will enhance its predicting values.

Methods:
The rCatLet score was calculated retrospectively in 308 consecutively enrolled patients with AMI. Primary endpoint, major adverse cardiac or cerebrovascular events (MACCE) including all-cause mortality, non-fatal AMI, transient ischemic attack/stroke, and ischemia-driven repeat revascularization, was stratified according to rCatLet score terciles: rCatLet_low ≤3, rCatLet_mid 4–11, and rCatLet_top ≥12, respectively. Cross-validation confirmed a reasonably good agreement between the observed and predicted risks.

Results:
Of 308 patients analyzed, the rates of MACCE, all-cause death, and cardiac death were 20.8%, 18.2%, and 15.3%, respectively. Kaplan–Meier curves for all endpoints showed increasing outcome events with the increasing tertiles of the rCatLet score, with P values <0.001 on trend test. For MACCE, all-cause death, and cardiac death, the area under the curves (AUCs) of the rCatLet score were 0.70 (95% confidence intervals [CI]: 0.63–0.78), 0.69 (95% CI: 0.61–0.77), and 0.71 (95% CI: 0.63–0.79), respectively; the AUCs of the CVs-adjusted rCatLet score models were 0.83 (95% CI: 0.78–0.89), 0.87 (95% CI: 0.82–0.92), and 0.89 (95% CI: 0.84–0.94), respectively. The performance of CVs-adjusted rCatLet score was significantly better than the stand-alone rCatLet score in terms of outcome predictions.

Conclusion:
The rCatLet score has a predicting value for clinical outcomes for AMI patients and the incorporation of the three CVs into the rCatLet score will enhance its predicting ability.

Trial Registration:
http://www.chictr.org.cn, ChiCTR-POC-17013536.
Effect of head and neck positions on tracheal intubation using a McGRATH MAC video laryngoscope
Authors: Kim Hyerim , Chang Jee-Eun , Won Dongwook , Lee Jung-Man , Kim Tae Kyong , Kim Min Jong , Min Seong-Won , Hwang Jin-Young 
Published: April 2023

BACKGROUND
Different head and neck positions may affect video laryngoscopy in terms of laryngeal exposure, intubation difficulty, advancement of the tracheal tube into the glottis and the occurrence of palatopharyngeal mucosal injury.

OBJECTIVE
We investigated the effects of simple head extension, head elevation without head extension and the sniffing position on tracheal intubation using a McGRATH MAC video laryngoscope.

DESIGN
A randomised, prospective study.

SETTING
Medical centre governed by a university tertiary hospital.

PATIENTS
A total of 174 patients undergoing general anaesthesia.

METHODS
Patients were randomly allocated to one of three groups: simple head extension (neck extension without a pillow), head elevation only (head elevation with a pillow of 7 cm and no neck extension) and sniffing position (head elevation with a pillow of 7 cm and neck extension).

MAIN OUTCOMES
During tracheal intubation using a McGRATH MAC video laryngoscope in three different head and neck positions, we assessed intubation difficulty by several methods: a modified intubation difficulty scale score, time taken for tracheal intubation, glottic opening, number of intubation attempts, requirements for other manoeuvres (lifting force or laryngeal pressure) for laryngeal exposure and advancement of the tracheal tube into the glottis. The occurrence of palatopharyngeal mucosal injury was evaluated after tracheal intubation.

RESULTS
Tracheal intubation was significantly easier in the head elevation group than in the simple head extension (P = 0.001) and sniffing positions (P = 0.011). Intubation difficulty did not differ significantly between the simple head extension and sniffing positions (P = 0.252). The time taken for intubation in the head elevation group was significantly shorter than that in the simple head extension group (P < 0.001). A lifting force or laryngeal pressure was required less frequently for tube advancement into the glottis in the head elevation group than in the simple head extension (P = 0.002) and sniffing position groups (P = 0.012). The need for a lifting force or laryngeal pressure for tube advancement into the glottis was not significantly different between the simple head extension and sniffing positions (P = 0.498). Palatopharyngeal mucosal injury occurred less frequently in the head elevation group than in the simple head extension group (P = 0.009).

CONCLUSION
The head elevation position facilitated tracheal intubation using a McGRATH MAC video laryngoscope compared with a simple head extension or sniffing position.

TRIAL REGISTRY NUMBER
ClinicalTrials.gov (NCT05128968)
Male Pectoralis Major Muscle Augmentation with Autologous Fat Transplantation Using VASER Lipoaspirate: Evaluation with MRI
Authors: Kandulu Hüseyin , Terzibasioglu Ali Ege 
Published: April 2023

Background:
The popularity of autologous fat grafts has increased for the reshaping, contouring, and augmentation of the male breast tissue. However, long-term maintenance of tissue viability and the ways for assessment serve as hot-spot topics in the field. This study was designed to evaluate the viability of fat grafts obtained by a vibration amplification of sound energy at resonance (VASER)-assisted lipoaspiration procedure using a magnetic resonance imaging–based approach.

Methods:
This is a prospective examination of 20 male patients (40 breasts) who underwent VASER-assisted liposuction and fat grafting surgery, and long-term fat graft viability was evaluated by magnetic resonance imaging scans.

Results:
Participants had an average age of 34.85 ± 7.37 years with a mean BMI of 26.73 ± 2.63 kg/m2. The mean fat graft volume injected was 542.63 ± 144.78 mL on the right, and 548.95 ± 140.36 mL on the left side. On the magnetic resonance imaging follow-up, the mean intrapectoral adipose tissue thickness was 20.34 ± 6.31 mm on the right, and 18.94 ± 8.27 mm on the left sides and tissue viability was preserved in all cases. The mean follow-up duration was 22 ± 9.8 (range 14-44) months.

Conclusion:
VASER-assisted lipoaspiration and autologous fat grafting of the major pectoralis muscle provide a satisfactory outcome and long-term maintenance of the grafted adipose tissue.
Treatment and Management of Ectrodactyly–Ectodermal Dysplasia–Clefting Syndrome With Scleral Prosthetic Devices
Authors: Labunski Andrea , Carrasquillo Karen G. , Brocks Daniel 
Published: April 2023

Abstract:
This case report highlights the unique application and long-term benefits of customized scleral devices in a patient with ocular complications from ectrodactyly–ectodermal dysplasia–clefting (EEC) syndrome over the span of 10 years. A 13-year-old girl with a history of EEC syndrome and ocular manifestations, including severe bilateral dry eye disease, corneal neovascularization and scarring, progressive fibrous pannus, and limbal stem cell deficiency, was examined and fitted with scleral devices. The goal of treatment was to stabilize the ocular surface, enhance vision, and improve ocular comfort. Throughout the course of treatment, there was minimal progression in ocular signs, despite interruptions in scleral device wear from application and removal challenges secondary to ectrodactyly. Customized scleral devices provided an optimal environment to support the ocular surface, improve comfort, and improve visual acuity. Further studies are required to demonstrate the benefits of scleral devices in larger populations of patients with EEC syndrome.