bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti-obesity medication prescriptions by race/ethnicity and use of an interpreter in a pediatric weight management clinic
Authors: Bomberg Eric M. , Palzer Elise F. , Rudser Kyle D. , Kelly Aaron S. , Bramante Carolyn T. , Seligman Hilary K. , Noni Favour , Fox Claudia K. 
Published: April 2022

Background: Race/ethnicity and low English proficiency healthcare disparities are well established in the United States. We sought to determine if there are race/ethnicity differences in anti-obesity medication (AOM) prescription rates among youth with severe obesity treated in a pediatric weight management clinic and if, among youth from non-primary English speaking families, there are differences in prescriptions between those using interpreters during visits versus not. Methods: We reviewed electronic health records of 2- to 18-year-olds with severe obesity seen from 2012 to 2021. Race/ethnicity was self-report, and AOMs included topiramate, stimulants (e.g. phentermine, lisdexamfetamine), naltrexone (±bupropion), glucagon-like peptide-1 agonists, and orlistat. We used general linear regression models with log-link to compare incidence rate ratios (IRRs) within the first 1 and 3 years of being followed, controlling for age, percent of the 95th BMI percentile (%BMIp95), number of obesity-related comorbidities (e.g. insulin resistance, hypertension), median household income, and interpreter use. We repeated similar analyses among youth from non-primary English speaking families, comparing those using interpreters versus not. Results: 1,725 youth (mean age 11.5 years; %BMIp95 142%; 53% non-Hispanic White, 20% Hispanic/Latino, 16% non-Hispanic black; 6% used interpreters) were seen, of which 15% were prescribed AOMs within 1 year. The IRR for prescriptions was lower among Hispanic/Latino compared to non-Hispanic White youth at one (IRR 0.70; CI: 0.49–1.00; p = 0.047) but not 3 years. No other statistically significant differences by race/ethnicity were found. Among non-primary English speaking families, the IRR for prescriptions was higher at 1 year (IRR 2.49; CI: 1.32–4.70; p = 0.005) in those using interpreters versus not. Conclusions: Among youth seen in a pediatric weight management clinic, AOM prescription incidence rates were lower in Hispanics/Latinos compared to non-Hispanic Whites. Interpreter use was associated with higher prescription incidence rates among non-primary English speakers. Interventions to achieve equity in AOM prescriptions may help mitigate disparities in pediatric obesity.
Proton Pump Inhibitors and the Risk of Early Aseptic Loosening in Hip and Knee Arthroplasty
Authors: Tamimi Iskandar , Carnero Pablo , Bautista David , Gonzalez David , Rodrigo Pablo , Bravo María Jose. , Gómez Abel , Tamimi Faleh , Garcia de Quevedo David 
Published: April 2022

Introduction The use of proton pump inhibitors (PPIs) has been associated with a higher risk of osteoporotic fractures and non-unions rates. However, the relation between the use of PPIs and the development of aseptic loosening in arthroplasty procedures has not been studied. The objective of this study is to analyze the relation between the use of PPIs, and the risk of early aseptic loosening in total knee arthroplasty (TKA) and total hip arthroplasty (THA). Materials and methods A nested case-control study was conducted on patients who were subjected THA or TKA in our center between 2010 and 2014. Cases were patients subjected to revision surgery due to early aseptic loosening during the study period. Cases were matched with controls who did not require any type of revision surgery by type of joint replacement (THA/TKA), gender, age (+/− 2 years), and follow-up time (±6 months). Odds Ratios were adjusted to potential confounders. Results The crude and adjusted ORs (95% CI) of undergoing revision surgery for aseptic loosening following primary total knee arthroplasty or total hip arthroplasty, were 6.25 (2.04–19.23) and 6.10 (1.71–21.73), respectively, for any use PPIs compared with non-users. Crude and adjusted ORs, were 11.6 (2.93–45.88) and 17.1 (2.41–121.66), respectively, for patients with a Proportion of Days Covered (PDC) for PPIs <.5 (Table 2). In addition, the crude and adjusted ORs of undergoing revision surgery, were 5.05 (1.59–16.02) and 5.01 (1.36–18.44), respectively, for patients with a PDC for PPIs ≥.5. Discussion These results suggest that PPIs should be used with caution in patients with TKA and THA, and that the use of these drugs should not be prolonged unless there was a justifiable indication. Conclusions The use of PPIs and was associated with a higher risk of early aseptic loosening in patients subjected to THA and TKA.
Longitudinal observational study on health literacy and clinical outcomes in older adults with total knee arthroplasty in the context of inpatient and outpatient rehabilitation
Authors: Rohringer Matthias , Fink Christian , Kellerer Jan Daniel , Schulc Eva 
Published: April 2022

Purpose To assess health literacy (HL) of patients with total knee arthroplasty (TKA) and evaluate its impact on patient reported outcome measures (PROMs) as well as investigating outcome differences in inpatient and outpatient rehabilitation. Methods In this study, HL and PROMs of older patients were assessed preoperatively (T0) and after 3 (T1), 6 (T2), and 12 (T3) months. HL was assessed with the short form of the European HL Questionnaire; pain scores, functional restrictions, and activity levels with standardized PROMs. Results Limited HL was observed in 70.6% of patients at T0. HL improved from baseline to follow-ups (p < 0.001). There was no impact of HL on PROMs. Pain scores were higher in patients undergoing outpatient rehabilitation (p = 0.022). No differences were found between the rehabilitation settings for the other outcomes. Conclusion The study shows that limited HL is prevalent in patients with scheduled TKA. Rehabilitation seems to have a positive effect on increasing HL.
Toe flexion movement with tendon excursion based on anatomical variation: A cadaver study
Authors: Hirota Kento , Watanabe Kota , Saito Yuki , Miyamoto Hiroki , Negishi Keisuke , Teramoto Atsushi , Katayose Masaki 
Published: April 2022

Background/Purpose To investigate the relationship between anatomical variation of the toe flexor muscles and the resulting variation of toe flexion angle from tendon excursion. Methods Six cadaveric lower extremities preserved by Thiel’s embalming method were evaluated. The toe flexor muscles were distracted individually and toe flexion angles measured. The anatomic variation were observed by gross anatomical dissection. Results The toes with tendinous slips of flexor hallucis longus (FHL) showed similar flexion angles between the FHL and flexor digitorum longus. However, there were differences observed regarding toe flexion and tendon excursion of the flexor digitorum muscle and quadratus plantae due to the anatomic variations. Conclusion The anatomical variation of the toe flexor muscles should be taken into account when evaluating toe function and applying exercise therapy for foot disorders.
Lived Experiences of Older Adults in the COVID-19 Pandemic in a Teaching Hospital in Ghana
Authors: Aboh Irene K. , Arthur Andrew L. , Woolley Philomina 
Published: April 2022

Aim The study sought to assess the impact or lived experiences of COVID-19 pandemic on older adults in the midst of the COVID-19 pandemic in a Teaching Hospital in Ghana. Methods The study employed an explorative qualitative research design where older adults were purposively identified and recruited to partake in in-depth interviews from April to June 2021. They were located in the hospital environment where they came for review or physician attention. 10 out of 20 of these population were successfully used as saturation was reached and data was analyzed thematically. Result The results of the study showed that a considerable number of older adults who receive care from the Hospital were knowledgeable of COVID-19 and demonstrated a positive attitude towards it by being sensitive to the appropriate preventive measures. Almost all the participants had heard of COVID-19, knew what it was, its mode of transmission and knew of the fact that asymptomatic persons could spread or transmit the disease and its prevention. They also believed that following proper handwashing with soap under running water, maintaining social distance, wearing of nose masks, using of hand sanitizers, avoiding crowded places, and consuming balanced diets as well as Vitamin C to boost the immune system are helpful. And, most of them received help from their partners, family, children, friends, healthcare professionals, and the media. Conclusion COVID 19 has brought a new dimension to how people relate and interact with each other. Literature documents that older adults were at risk of the disease and fatality rate of the disease was high. This created anxiety and it was evident that this anxiety was handled differently.
A gain-of-function variant in the Wiskott-Aldrich syndrome gene is associated with a MYH9-related disease-like syndrome
Authors: Marx David , Dupuis Arnaud , Eckly Anita , Molitor Anne , Olagne Jérôme , Touchard Guy , Kaaki Sihem , Ory Cécile , Faller Anne-Laure , Gérard Bénédicte , Cotter Melanie , Westerberg Lisa , Keszei Marton , Moulin Bruno , Gachet Christian , Caillard Sophie , Bahram Seiamak , Carapito Raphaël 
Published: April 2022

Abstract
While loss-of-function variants in the WAS gene are associated with Wiskott-Aldrich syndrome and lead to microthrombocytopenia, gain-of-function variants of WAS are associated with X-linked neutropenia (XLN) and the absence of microthrombocytopenia. Only a few XLN families have been reported so far, and their platelet phenotype was not described in detail. To date, no renal involvement was described in XLN. In the present study, we report exome sequencing of individuals from 3 generations of a family with a dominant disease combining neutropenia, macrothrombocytopenia, and renal failure. We identified a heterozygous missense gain-of-function variant in the WAS gene (c.881T&gt;C, p.I294T) that segregates with the disease and is already known to cause XLN. There was no pathogenic variant in MYH9, TUBB1, or ACTN1. This is the first report of a WAS gain-of-function variant associated with both the hematological phenotype of XLN (neutropenia, macrothrombocytopenia) and renal disease (proteinuria, renal failure) with glomerular tip lesion hyalinosis and actin condensations in effaced podocytes foot processes.
Heat Transfer Performance and Structural Optimization of a Novel Micro-channel Heat Sink
Authors: Xiang Jianhua , Deng Liangming , Zhou Chao , Zhao Hongliang , Huang Jiale , Tao Sulian 
Published: April 2022

AbstractWith the advent of the 5G era, the design of electronic equipment is developing towards thinness, intelligence and multi-function, which requires higher cooling performance of the equipment. Micro-channel heat sink is promising for the heat dissipation of super-thin electronic equipment. In this study, thermal resistance theoretical model of the micro-channel heat sink was first established. Then, fabrication process of the micro-channel heat sink was introduced. Subsequently, heat transfer performance of the fabricated micro-channel heat sink was tested through the developed testing platform. Results show that the developed micro-channel heat sink has more superior heat dissipation performance over conventional metal solid heat sink and it is well suited for high power LEDs application. Moreover, the micro-channel structures in the heat sink were optimized by orthogonal test. Based on the orthogonal optimization, heat dissipation performance of the micro-channel radiator was further improved.
High-quality chromosome-scale de novo assembly of the Paspalum notatum ‘Flugge’ genome
Authors: Yan Zhenfei , Liu Huancheng , Chen Yu , Sun Juan , Ma Lichao , Wang Aihua , Miao Fuhong , Cong Lili , Song Hui , Yin Xue , Wang Qi , Gong Yayun , Yang Guofeng , Wang Zengyu 
Published: April 2022

Abstract
Background
Paspalum notatum ‘Flugge’ is a diploid with 20 chromosomes (2n = 20) multi-purpose subtropical herb native to South America and has a high ecological significance. It is currently widely planted in tropical and subtropical regions. Despite the gene pool of P. notatum ‘Flugge’ being unearthed to a large extent in the past decade, no details about the genomic information of relevant species in Paspalum have been reported. In this study, the complete genome information of P. notatum was established and annotated through sequencing and de novo assembly of its genome.

Results
The latest PacBio third-generation HiFi assembly and sequencing revealed that the genome size of P. notatum ‘Flugge’ is 541 M. The assembly result is the higher index among the genomes of the gramineous family published so far, with a contig N50 = 52Mbp, scaffold N50 = 49Mbp, and BUSCOs = 98.1%, accounting for 98.5% of the estimated genome. Genome annotation revealed 36,511 high-confidence gene models, thus providing an important resource for future molecular breeding and evolutionary research. A comparison of the genome annotation results of P. notatum ‘Flugge’ with other closely related species revealed that it had a close relationship with Zea mays but not close compared to Brachypodium distachyon, Setaria viridis, Oryza sativa, Puccinellia tenuiflora, Echinochloa crusgalli. An analysis of the expansion and contraction of gene families suggested that P. notatum ‘Flugge’ contains gene families associated with environmental resistance, increased reproductive ability, and molecular evolution, which explained its excellent agronomic traits.

Conclusion
This study is the first to report the high-quality chromosome-scale-based genome of P. notatum ‘Flugge’ assembled using the latest PacBio third-generation HiFi sequencing reads. The study provides an excellent genetic resource bank for gramineous crops and invaluable perspectives regarding the evolution of gramineous plants.
Genome-wide analysis of the VQ motif-containing gene family and expression profiles during phytohormones and abiotic stresses in wheat (Triticum aestivum L.)
Authors: Zhang Lili , Wang Keke , Han Yuxuan , Yan Luyu , Zheng Yan , Bi Zhenzhen , Zhang Xin , Zhang Xiaohong , Min Donghong 
Published: April 2022

Abstract
Background
VQ motif-containing (VQ) proteins are cofactors of transcriptional regulation that are widely involved in plant growth and development and respond to various stresses. The VQ gene family has been identified and characterized for many plants, but there is little research on VQ gene family proteins in wheat (Triticum aestivum L.).

Results
In this study, 113 TaVQ genes (40 homoeologous groups) were identified in the wheat genome. TaVQ proteins all contain the conserved motif FxxhVQxhTG, and most of the TaVQ genes do not contain introns. Phylogenetic analysis demonstrated that TaVQ proteins can be divided into 8 subgroups (I-VIII). The chromosomal location mapping analysis indicated that TaVQ genes are disproportionally distributed on 21 wheat chromosomes. Gene duplication analysis revealed that segmental duplication significantly contributes to the expansion of the TaVQ gene family. Gene expression analysis demonstrated that the expression pattern of TaVQ genes varies in different tissues. The results of quantitative real-time PCR (qRT-PCR) found that TaVQ genes displayed different expression levels under different phytohormones and abiotic stresses. The cis-elements analysis of the promoter region demonstrated that stress responses, hormone responses, growth and development, and WRKY binding elements are all widely distributed. Additionally, a potential regulatory network between TaVQ proteins and WRKY transcription factors was visualized.

Conclusion
This study systematically analyzed the wheat TaVQ gene family, providing a reference for further functional characterization of TaVQ genes in wheat.
Improved outcomes and reduced medical costs through multidisciplinary co-management protocol for geriatric proximal femur fractures: a one-year retrospective study
Authors: Li Yang , Tung Kuan-Kai , Cho Yi-Cheng , Lin Shih-Yi , Lee Cheng-Hung , Chen Chih-Hui 
Published: April 2022

Abstract
Background
To manage the rapidly growing incidence of, and related medical burden resulting from hip fractures in older adults in an aging society, studies involving orthogeriatric co-management treatment models have reported improved outcomes, including reduced medical costs. The treatment gap for osteoporosis was however seldom emphasized in the published treatment protocols. Aiming to improve the existing orthogeriatric protocol, we have established a patient-centered protocol for elderly patient hip fractures, which simultaneously focuses on fracture care and anti-osteoporosis agent prescription in regarding to healthcare quality and medical expense.

Methods
This was a retrospective study comparing patients who enrolled in the multidisciplinary co-managed protocol for geriatric hip fractures and those who did not. The inclusion criteria for this study were: (a) single-sided hip fractures treated from 1 to 2018 to 30 June 2020, (b) patients who were 60-years or older (c) trauma treated within 3 days from time of injury, and (d) minimal follow-up period of 12 months after surgery.

Results
From 1 to 2018 to 30 June 2020, 578 patients were included (267 patients in the protocol group vs. 331 patients in the conventional group). The protocol group was associated with significantly reduced lengths of hospital stay (p = 0.041), medical expenditures (p = 0.006), and mortality (p = 0.029) during their acute in-hospital admission period. Early osteoporosis diagnosis and anti-osteoporosis agent prescription were achieved in the protocol group, with a significantly wider coverage for BMD assessment (p < 0.001) and prescriptions for anti-osteoporosis medication (p < 0.001). Yet, there was no significant decline in the one-year refracture rate in the protocol group.

Conclusions
The implementation of a multidisciplinary co-managed care protocol for geriatric proximal femur fractures successfully improved patient outcomes with significantly reduced lengths of stay, medical expenditures, and mortality during the acute in-hospital admission period. The high prescription rate of anti-osteoporosis medication after hip fractures in the protocol group was not associated with a significantly lower re-fracture rate in the 12-month follow-up. However, the association between early anti-osteoporosis agent prescription and reduced long-term medical expenses in this group of patients has provided a direction for future research.
Molecular characterisation of second-line drug resistance among drug resistant tuberculosis patients tested in Uganda: a two and a half-year’s review
Authors: Mujuni Dennis , Kasemire Dianah Linda , Ibanda Ivan , Kabugo Joel , Nsawotebba Andrew , Phelan Jody E. , Majwala Robert Kaos , Tugumisirize Didas , Nyombi Abdunoor , Orena Beatrice , Turyahabwe Irene , Byabajungu Henry , Nadunga Diana , Musisi Kenneth , Joloba Moses Lutakoome , Ssengooba Willy 
Published: April 2022

Abstract
Background
Second-line drug resistance (SLD) among tuberculosis (TB) patients is a serious emerging challenge towards global control of the disease. We characterized SLD-resistance conferring-mutations among TB patients with rifampicin and/or isoniazid (RIF and/or INH) drug-resistance tested at the Uganda National TB Reference Laboratory (NTRL) between June 2017 and December 2019.

Methods
This was a descriptive cross-sectional secondary data analysis of 20,508 M. tuberculosis isolates of new and previously treated patients’ resistant to RIF and/or INH. DNA strips with valid results to characterise the SLD resistance using the commercial Line Probe Assay Genotype MTBDRsl Version 2.0 Assay (Hain Life Science, Nehren, Germany) were reviewed. Data were analysed with STATAv15 using cross-tabulation for frequency and proportions of known resistance-conferring mutations to injectable agents (IA) and fluoroquinolones (FQ).

Results
Among the eligible participants, 12,993/20,508 (63.4%) were male and median (IQR) age 32 (24–43). A total of 576/20,508 (2.8%) of the M. tuberculosis isolates from participants had resistance to RIF and/or INH. These included; 102/576 (17.7%) single drug-resistant and 474/576 (82.3%) multidrug-resistant (MDR) strains. Only 102 patients had test results for FQ of whom 70/102 (68.6%) and 01/102 (0.98%) had resistance-conferring mutations in the gyrA locus and gyrB locus respectively. Among patients with FQ resistance, gyrAD94G 42.6% (30.0–55.9) and gyrA A90V 41.1% (28.6–54.3) mutations were most observed. Only one mutation, E540D was detected in the gyrB locus. A total of 26 patients had resistance-conferring mutations to IA in whom, 20/26 77.0% (56.4–91.0) had A1401G mutation in the rrs gene locus.

Conclusions
Our study reveals a high proportion of mutations known to confer high-level fluoroquinolone drug-resistance among patients with rifampicin and/or isoniazid drug resistance. Utilizing routinely generated laboratory data from existing molecular diagnostic methods may aid real-time surveillance of emerging tuberculosis drug-resistance in resource-limited settings.
Pulse pressure is associated with cognitive performance in Japanese non-demented population: a cross-sectional study
Authors: Mizuhara Ryo , Mitaki Shingo , Takamura Masahiro , Abe Satoshi , Onoda Keiichi , Yamaguchi Shuhei , Nagai Atsushi 
Published: April 2022

Abstract
Background
Growing evidence suggests that vascular risk factors, especially hypertension, relate not only to cardiovascular disease but also to cognitive impairment. However, the impact of pulse pressure on cognitive function remains controversial. In this study, we evaluated the associations between pulse pressure and cognitive function in a Japanese health examination cohort using propensity matching analysis.

Methods
We examined 2,546 individuals with a mean age of 60.8 ± 10.3 years who voluntarily participated in health examination. Clinical variables included pulse pressure, and brain magnetic resonance imaging (MRI). We divided the participants into the high and low pulse pressure groups with a pre-defined cut-off value of 65 mmHg and evaluated their physical examination data, cognitive functions including Okabe’s test, Kohs’ test, and silent brain lesions using propensity matching. To clarify whether pulse pressure and blood pressure have different implications for cognitive function, a mediating analysis was also conducted.

Results
From the 2,546 subjects, 439 (17.2%) were in the high PP group. The propensity matching algorithm produced 433 pairs of patients with similar propensities. Higher pulse pressure corresponded to lower Okabe and Kohs’ scores (44.3 ± 7.1 vs 42.7 ± 7.5; p = 0.002, 97.9 ± 18.0 vs 95.0 ± 18.1 p = 0.019, respectively). The relationship between pulse pressure and cognitive impairment was not significantly mediated by systolic blood pressure. We observed no significant associations between silent brain lesions and pulse pressure.

Conclusion
High pulse pressure was associated with lower cognitive performance without systolic blood pressure mediation in Japanese subjects without dementia.