bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brief windows with more favorable atmospheric conditions explain patterns of Polylepis reticulata tree water use in a high-altitude Andean forest
Authors: Carabajo-Hidalgo Aldemar , Sabaté Santiago , Crespo Patricio , Asbjornsen Heidi 
Published: September 2023

Abstract
Polylepis trees occur throughout the Andean mountain region, and it is the tree genus that grows at the highest elevation worldwide. In the humid Andes where moisture is rarely limiting, Polylepis trees must adapt to extreme environmental conditions, especially rapid fluctuations in temperature, ultraviolet radiation and vapor pressure deficit (VPD). However, Polylepis’ water-use patterns remain largely unknown despite the importance of understanding their response to microclimate variation to determine their capacity to maintain resilience under future environmental change. We conducted a study in a Polylepis reticulata Kunth forest in the Ecuadorian Andes to evaluate its tree water-use dynamics and to identify the main environmental drivers of transpiration. Tree sap flow was monitored simultaneously with soil volumetric water content (VWC) and microclimate during 2 years for trees growing in forest edge and interior locations. We found that sap flow was primarily controlled by VPD and that VWC exerted a secondary role in driving sap flow dynamics. The highest values for sap flow rates were found when VPD &gt; 0.15 kPa and VCW &lt; 0.73 cm3 cm−3, but these threshold conditions only occurred during brief periods of time and were only found in 11% of our measurements. Moreover, these brief windows of more favorable conditions occurred more frequently in forest edge compared with forest interior locations, resulting in edge trees maintaining 46% higher sap flow compared with interior trees. Our results also suggest that P. reticulata has a low stomatal control of transpiration, as the sap flow did not decline with increasing VPD. This research provides valuable information about the potential impacts of projected future increases in VPD due to climate change on P. reticulata water-use dynamics, which include higher sap flow rates leading to greater transpirational water loss due to this species’ poor stomatal control.
Head morphology reflects the introduction history in a globally invasive carnivore—the small Indian mongoose
Authors: Louppe Vivien , Fabre Anne-Claire , Lorvelec Olivier , Veron Géraldine 
Published: September 2023

Abstract
Species displaced outside their native range may face new pressures resulting from both environmental gradients and important differences in ecosystem structure. We investigated how this may impact the morphological variation of a globally introduced carnivoran, the small Indian mongoose. Previous research showed size variations in several introduced populations, suggesting that these differences resulted from character release in response to the absence of competition from native species. Here, we contrasted the morphological evolution of indigenous and introduced populations using geometric morphometric approaches on the head system of a large sample of specimens belonging to several regions. Our analyses revealed that differences in size and shape between introduced and native populations do not support hypothesis of character release. These results suggest that morphological variations in introduced populations may reflect the introduction history of the species, rather than evolutionary processes resulting from changes in ecosystem composition.
Upregulation of SOX9 promotes the self‐renewal and tumorigenicity of cervical cancer through activating the Wnt/β‐catenin signaling pathway
Authors: Feng Qian , Cui Nan , Li Shan , Cao Jing , Chen Qian , Wang Haiyan 
Published: September 2023

AbstractSry‐box9 (SOX9) maintains stem cell properties and plays crucial roles in many cancers. However, whether SOX9 is correlated with cervical cancer cell stemness and its detailed mechanism remains obscure. We studied the relationship between SOX9 and prognosis of cervical cancer through public database, and SOX9 was related to poor prognosis of cervical cancer. Elevated SOX9 expression enhanced the self‐renewal properties and promotes tumorigenicity in cervical cancer. Overexpression of SOX9 could promote the expression of stem cell‐related factors in cervical cancer cells and xenografts. Meanwhile, overexpression of SOX9 could also enhance the expressions of FZD10, β‐catenin, and c‐Myc in cervical cancer cells and xenografts, while inhibiting the expression of DDK1. The activation of Wnt pathway by chir‐99 021 raised the tumor spheroid ability of SOX9 knockdown HeLa cells. In addition, SOX9 could transcriptional inhibit DKK1 and activate FZD10 and MYC by binding to their promoters to affect the Wnt/β‐catenin pathway. These results demonstrated SOX9 regulated the self‐renewal and tumorigenicity of cervical cancer through Wnt/β‐catenin pathway by directly transcriptional activation of FZD10, MYC and transcriptional inhibition of DKK1.
Improving access to care for underserved communities through telemedicine
Authors: Guthrie Jennifer D. , Snyder Jennifer A. 
Published: September 2023

ABSTRACT
Telemedicine use expanded rapidly during the COVID-19 pandemic, giving patients access to quality care while reducing the spread of infection. Although beneficial changes were made to reimbursement and privacy guidelines to increase the ease of telemedicine for clinicians, the lack of digital devices, Internet, digital knowledge, and trust in this method of delivery are potential barriers to telemedicine for healthcare visits, and may have widened the care gap for underserved patients. To ensure that patients of all socioeconomic levels have access to telemedicine requires education, expanding broadband Internet access across the United States, and offering free or reduced Internet services to patients in need.
Should urinary catheters be avoided in patients with total joint arthroplasty?
Authors: Baldwin Michael 
Published: September 2023

ABSTRACT
Patients undergoing total joint arthroplasty typically have indwelling urinary catheters placed preoperatively to decompress the bladder, assess urinary output, and prevent postoperative urinary retention. However, catheterization is associated with several complications and increased hospital length of stay, and research supports eliminating routine placement of urinary catheters in most patients undergoing elective joint arthroplasty and certain general surgeries lasting no more than 2 hours.
Ropivacaine Promotes Axon Regeneration by Regulating Nav1.8-mediated Macrophage Signaling after Sciatic Nerve Injury in Rats
Authors: Cui Yongchen , Wang Xiaofeng , Xu Yang , Cao Yue , Luo Gang , Zhao Zhe , Zhang Junfeng 
Published: September 2023

Background
Continuous nerve block with ropivacaine is commonly performed after repair surgery for traumatic peripheral nerve injuries. After peripheral nerve injury, tetrodotoxin-resistant voltage-gated sodium channel Nav1.8 is upregulated and contributes to macrophage inflammation. This study investigated whether ropivacaine promotes peripheral nerve regeneration through Nav1.8-mediated macrophage signaling.

Methods
A sciatic nerve transection-repair (SNT) model was established in adult Sprague–Dawley rats of both sexes. The rats received 0.2% ropivacaine or 10 μM Nav1.8-selective inhibitor A-803467 around the injured site or near the sacrum for 3 days. Nerve regeneration was evaluated using behavioral, electrophysiologic, and morphological examinations. Moreover, myelin debris removal, macrophage phenotype, Nav1.8 expression, and neuropeptide expression were assessed using immunostaining, enzyme-linked immunosorbent assay, and Western blotting.

Results
Compared to the SNT-plus-vehicle group, the sensory, motor, and sensory–motor coordination functions of the two ropivacaine groups were significantly improved. Electrophysiologic (mean ± SD: recovery index of amplitude, vehicle 0.43 ± 0.17 vs. ropivacaine 0.83 ± 0.25, n = 11, P < 0.001) and histological analysis collectively indicated that ropivacaine significantly promoted axonal regrowth (percentage of neurofilament 200 [NF-200]–positive area: vehicle 19.88 ± 2.81 vs. ropivacaine 31.07 ± 2.62, n = 6, P < 0.001). The authors also found that, compared to the SNT-plus-vehicle group, the SNT-plus-ropivacaine group showed faster clearance of myelin debris, accompanied by significantly increased macrophage infiltration and transition from the M1 to M2 phenotype. Moreover, ropivacaine significantly attenuated Nav1.8 upregulation at 9 days after sciatic nerve transection (vehicle 4.12 ± 0.30-fold vs. ropivacaine 2.75 ± 0.36-fold, n = 5, P < 0.001), which coincided with the increased expression of chemokine ligand 2 and substance P. Similar changes were observed when using the selective Nav1.8 channel inhibitor A-803467.

Conclusions
Continuous nerve block with ropivacaine promotes the structural and functional recovery of injured sciatic nerves, possibly by regulating Nav1.8-mediated macrophage signaling.

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Functional gastrointestinal disorders, mental health, genetic susceptibility, and incident chronic kidney disease
Authors: Liu Mengyi , He Panpan , Ye Ziliang , Yang Sisi , Zhang Yanjun , Wu Qimeng , Zhou Chun , Zhang Yuanyuan , Hou Fan Fan , Qin Xianhui 
Published: September 2023

Abstract

Background:
Whether functional gastrointestinal disorders (FGIDs) are associated with the long-term risk of chronic kidney disease (CKD) remains unclear. We aimed to investigate the prospective association of FGIDs with CKD and examine whether mental health mediated the association.

Methods:
About 416,258 participants without a prior CKD diagnosis enrolled in the UK Biobank between 2006 and 2010 were included. Participants with FGIDs (including irritable bowel syndrome [IBS], dyspepsia, and other functional intestinal disorders [FIDs; mainly composed of constipation]) were the exposure group, and non-FGID participants were the non-exposure group. The primary outcome was incident CKD, ascertained from hospital admission and death registry records. A Cox proportional hazard regression model was used to investigate the association between FGIDs and CKD, and the mediation analysis was performed to investigate the mediation proportions of mental health.

Results:
At baseline, 33,156 (8.0%) participants were diagnosed with FGIDs, including 21,060 (5.1%), 8262 (2.0%), and 6437 (1.6%) cases of IBS, dyspepsia, and other FIDs, respectively. During a mean follow-up period of 12.1 years, 11,001 (2.6%) participants developed CKD. FGIDs were significantly associated with a higher risk of incident CKD compared to the absence of FGIDs (hazard ratio [HR], 1.36; 95% confidence interval [CI], 1.28–1.44). Similar results were observed for IBS (HR, 1.27; 95% CI, 1.17–1.38), dyspepsia (HR, 1.30; 95% CI, 1.17–1.44), and other FIDs (HR, 1.60; 95% CI, 1.43–1.79). Mediation analyses suggested that the mental health score significantly mediated 9.05% of the association of FGIDs with incident CKD and 5.63–13.97% of the associations of FGID subtypes with CKD. Specifically, the positive associations of FGIDs and FGID subtypes with CKD were more pronounced in participants with a high genetic risk of CKD.

Conclusion:
Participants with FGIDs had a higher risk of incident CKD, which was partly explained by mental health scores and was more pronounced in those with high genetic susceptibility to CKD.
LIM domain only 7 negatively controls nonalcoholic steatohepatitis in the setting of hyperlipidemia
Authors: Wu Tiangen , Chen Xi , Xu Kequan , Dai Caixia , Li Xiaomian , Zhang Yang-Wen-Qing , Li Jinghua , Gao Meng , Liu Yingyi , Liu Fusheng , Zhang Xutao , Wang Bicheng , Xia Peng , Li Zhen , Ma Weijie , Yuan Yufeng 
Published: September 2023

Background and Aims:
Hyperlipidemia has been extensively recognized as a high-risk factor for NASH; however, clinical susceptibility to NASH is highly heterogeneous. The key controller(s) of NASH susceptibility in patients with hyperlipidemia has not yet been elucidated. Here, we aimed to reveal the key regulators of NASH in patients with hyperlipidemia and to explore its role and underlying mechanisms.

Approach and Results:
To identify the predominant suppressors of NASH in the setting of hyperlipidemia, we collected liver biopsy samples from patients with hyperlipidemia, with or without NASH, and performed RNA-sequencing analysis. Notably, decreased Lineage specific Interacting Motif domain only 7 (LMO7) expression robustly correlated with the occurrence and severity of NASH. Although overexpression of LMO7 effectively blocked hepatic lipid accumulation and inflammation, LMO7 deficiency in hepatocytes greatly exacerbated diet–induced NASH progression. Mechanistically, lysine 48 (K48)-linked ubiquitin-mediated proteasomal degradation of tripartite motif-containing 47 (TRIM47) and subsequent inactivation of the c-Jun N-terminal kinase (JNK)/p38 mitogen-activated protein kinase (MAPK) cascade are required for the protective function of LMO7 in NASH.

Conclusions:
These findings provide proof-of-concept evidence supporting LMO7 as a robust suppressor of NASH in the context of hyperlipidemia, indicating that targeting the LMO7-TRIM47 axis is a promising therapeutic strategy for NASH.
Open-Source Automated Segmentation of Neuronal Structures in Corneal Confocal Microscopy Images of the Subbasal Nerve Plexus With Accuracy on Par With Human Segmentation
Authors: Zemborain Zane Zenon , Soifer Matias , Azar Nadim S. , Murillo Sofia , Mousa Hazem M. , Perez Victor L. , Farsiu Sina 
Published: September 2023

Purpose:
The aim of this study was to perform automated segmentation of corneal nerves and other structures in corneal confocal microscopy (CCM) images of the subbasal nerve plexus (SNP) in eyes with ocular surface diseases (OSDs).

Methods:
A deep learning–based 2-stage algorithm was designed to perform segmentation of SNP features. In the first stage, to address applanation artifacts, a generative adversarial network–enabled deep network was constructed to identify 3 neighboring corneal layers on each CCM image: epithelium, SNP, and stroma. This network was trained/validated on 470 images of each layer from 73 individuals. The segmented SNP regions were further classified in the second stage by another deep network as follows: background, nerve, neuroma, and immune cells. Twenty-one-fold cross-validation was used to assess the performance of the overall algorithm on a separate data set of 207 manually segmented SNP images from 43 patients with OSD.

Results:
For the background, nerve, neuroma, and immune cell classes, the Dice similarity coefficients of the proposed automatic method were 0.992, 0.814, 0.748, and 0.736, respectively. The performance metrics for automatic segmentations were statistically better or equal as compared to human segmentation. In addition, the resulting clinical metrics had good to excellent intraclass correlation coefficients between automatic and human segmentations.

Conclusions:
The proposed automatic method can reliably segment potential CCM biomarkers of OSD onset and progression with accuracy on par with human gradings in real clinical data, which frequently exhibited image acquisition artifacts. To facilitate future studies on OSD, we made our data set and algorithms freely available online as an open-source software package.
Relationship Between Intraocular Pressure and Age: A Population-Based Study in Nepal
Authors: Bhandari Gopal , Bhandari Sadhan , Byanju Raghunandan , Pradhan Sangita , Sah Ranjeet Kumar , Kandel Ram Prasad , Thompson Isabel J. , Rotchford Alan P. , West Sheila K. , Muñoz Beatriz , Stevens Valerie M. , Oatts Julius T. , Ou Yvonne , Lietman Thomas M. , O’Brien Kieran S. , Keenan Jeremy D. 
Published: September 2023

Précis:
Intraocular pressure (IOP) decreased with age in a population-based study in Nepal, from a mean of 14.1 mm Hg among those 60–64 years old to 13.0 mm Hg among those 80 years old or older.

Purpose:
Few studies have assessed the distribution of IOP from the Indian subcontinent, despite its large population and high burden of glaucoma. The objective of this study was to assess the distribution of IOP measurements from adults living in a lowland region of Nepal.

Methods:
In a population-based cross-sectional study, all individuals aged 60 years and older from an area of lowland Nepal were invited for an IOP assessment with a rebound tonometer.

Results:
Of 160 communities (28,672 people aged ≥60 y) enrolled, 79 (13,808 people aged ≥60 y) were randomly selected for IOP testing. Of those eligible, 10,017 (72.5%) individuals underwent tonometry. Mean IOP decreased monotonically over 5-year age groups, from 14.1 mm Hg (SD: 3.6) among those aged 60–64 years to 13.0 mm Hg (SD: 4.2) among those 80 years or older. The 97.5th percentile IOP measurement was 21.0 mm Hg for all age groups. In adjusted analyses, younger age, self-reported diabetes, and higher population density were each associated with higher IOP, and self-reported cataract surgery was associated with lower IOP.

Conclusions:
Mean IOP was lower among older individuals in Nepal, consistent with many studies from East Asia and in contrast to many studies from western populations. These results suggest that ethnic background might be a consideration when diagnosing ocular hypertension.
Glaucoma Surgery Shifts Among Medicare Beneficiaries After 2022 Reimbursement Changes in the United States
Authors: Williams Parker J. , Hussain Zain , Paauw Mark , Kim Chaesik , Juzych Mark S. , Hughes Bret A. , Ridha Faisal 
Published: September 2023

Précis:
This study revealed the best-estimated surgical procedural counts for 2021 and 2022 and suggests a direct influence of coding and reimbursement changes on surgical device selection.

Purpose:
To analyze utilization rates of glaucoma surgeries and minimally invasive (microinvasive) glaucoma surgery among US Medicare beneficiaries between 2021 and 2022.

Design:
Retrospective comparative analysis of 68,118 unique patients.

Methods:
National claims data from a 5% sample of all Medicare beneficiaries were utilized to compare glaucoma procedure counts between the first quarter of 2021 and the first quarter of 2022. Duplicate claims were excluded, and 50 modifiers were counted as 2 distinct procedures. A multiplier was applied to estimate annual utilization for the entire Medicare population. χ2 analysis was employed to compare categorical data from the 2 time periods.

Results:
Current Procedural Terminology codes for angle-based stenting decreased by an estimated 20,960 procedures between 2021 and 2022 (28.60%). Goniotomy increased by an estimated 11,680 procedures (66.97%) and canaloplasty increased by an estimated 6640 procedures (47.43%). Glaucoma surgeries decreased by an estimated 5760 procedures (4.25%) despite an increase of cataract surgery by 234,960 procedures (15.63%), an increase in YAG capsulotomy by 19,280 procedures (3.31%), and an increase in intravitreal injections by 146,320 procedures (3.86%).

Conclusion:
Despite overall surgical volume increases among the ophthalmology procedures, angle-based stenting utilization decreased significantly with an accompanying trend change following the coding and reimbursement changes implemented in January 2022. Of the minimally invasive (microinvasive) glaucoma surgery procedures, goniotomy and canaloplasty counts increased the most between these periods. Trabeculectomy and glaucoma drainage device procedures continued to decrease, following well-established trends. Future studies are warranted to examine how these shifts in utilization may impact patient care outcomes.
Incidence of and Risk Factors for Fellow-Eye Involvement in Sturge-Weber Syndrome Children With Unilateral Glaucoma
Authors: Shin Young In , Ha Ahnul , Jeong Yoon , Huh Min Gu , Jeoung Jin Wook , Park Ki Ho , Kim Young Kook 
Published: September 2023

Précis:
Among children with unilateral glaucoma associated with Sturge-Weber syndrome (SWS), 7 of 47 demonstrated involvement in the fellow eye, and that group had had earlier first-eye surgery relative to the noninvolvement group.

Purpose:
The aim of this study was to determine the incidence of and risk factors for fellow-eye involvement in children with unilateral SWS-associated glaucoma.

Materials and Methods:
Children diagnosed with a unilateral facial port-wine stain and ipsilateral glaucoma before the age of 5 and followed up for at least 5 years were enrolled. The incidence rates of fellow-eye glaucoma involvement were estimated per 100 person-years, and factors associated with a higher incidence of fellow-eye involvement were investigated.

Results:
A total of 47 children [24 (51.1%) girls] with unilateral SWS-associated glaucoma were included. All of them had facial port-wine stain involving ophthalmic division of the trigeminal nerve, and 18 (38.3%) had neurological comorbidities. The mean age at glaucoma diagnosis was 0.8±1.2 years [range, 0.08 (1 mo)–4.0 y]. Over a median follow-up of 8.4 years, glaucoma was diagnosed in the fellow eye of 7 of the children (14.9%; incidence rate of 1.8 per 100 person-years), 6 of whom were girls (P=0.097) and 5 of whom were diagnosed before the age of 4 years (P=0.508). The fellow-eye–involvement group showed significantly higher mean follow-up intraocular pressure in the fellow eye, older age at first-eye surgery (both P<0.005), and higher frequency of choroidal hemangioma both at first onset and in fellow eyes (P=0.026 and 0.019, respectively).

Conclusions:
In this cohort of SWS children diagnosed with unilateral glaucoma, the risk of fellow-eye involvement was higher in girls, within the first 4 years, and in cases with choroidal hemangioma. The fellow-eye–involved children underwent surgery on the first eye earlier than those without fellow-eye involvement.
Assessment of the iCare HOME2, a New Intraocular Pressure Self-Measurement Tonometer
Authors: Kratz Assaf , Zbidat Rabia , Kishner Rina , Cohen Michal , Shalata Walid , Goldberg Ivan 
Published: September 2023

Précis:
The iCare HOME2 tonometer generally can be considered reliable for most eyes and clinical settings, although it may produce slightly overestimated or underestimated intraocular pressure (IOP) readings in thicker and thinner corneas, respectively.

Purpose:
To evaluate the accuracy, correlation, and analysis of differences in IOP measurements between the gold standard Goldmann applanation tonometer (GAT) and the new, self-measurement iCare HOME2 tonometer (icare).

Patients and Methods:
In this retrospective study, patients were randomly selected from those who attended a routine examination in our clinic. After a complete ocular examination, each patient’s IOP was measured and recorded with GAT and iCare HOME2. Central corneal thickness was measured. Eyes with any corneal morbidity were excluded. Pearson correlation coefficient was used to determine the correlation between paired IOP measurements. Bland-Altman plots were graphed for the analysis of differences in IOP between the instruments.

Results:
One hundred thirty-five eyes of 70 patients were included in the study. The mean IOP measured with GAT was 16.3 ± 6.5 mm Hg (range: 3–56). The mean IOP measured with iCare HOME2 was 16.5 ± 7.3 mm Hg (range: 3–55), (P = 0.47). A strong, significant positive correlation was found for paired IOP measurements by the 2 instruments (r = 0.94; P < 0.0001). A small systematic proportional bias was seen for the paired IOP measurements, meaning that with higher IOPs the iCare HOME2 yielded higher IOP readings than GAT, but this difference was clinically insignificant. The instrument underestimated IOPs with corneas thinner than 522 µm, whereas it overestimated IOPs when corneas were thicker than this.

Conclusion:
The iCare HOME2 could be a reliable tonometer for most eyes and clinical settings. Central corneal thickness measurement is recommended in patients who use the instrument.