bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma alkaline phosphatase is associated with mortality risk in patients with aortic valve stenosis
Authors: Nunes José Pedro L. 
Published: November 2022

Abstract

Background: Aortic valve stenosis is an important clinical condition, with a significant mortality rate in the elderly. Plasma values of alkaline phosphatase (ALP) have been shown to act as a marker of prognosis in different clinical conditions and in the general population.

Methods: Plasma levels of ALP were studied in a cohort of patients with aortic valve stenosis, and a 5-year survival evaluation was performed.

Results: Twenty-four patients were under study, of whom 12 were dead at the 5-year follow-up. The median age at baseline evaluation was 79 years (interquartile range, 72–85 years), and 11 patients were female (13 were male). The median value of ALP, of 83 IU/L, was used to separate patients into two groups: 2 patients who died in the group with low ALP values versus 10 patients who died in the group with high ALP values. Using ALP with the same cutoff level, the Kaplan–Meier study with log-rank analysis showed a significance level <0.01. Cox regression analysis showed an overall significant result, with a significant level for plasma ALP (significance level 0.03), but not for age, sex, or transvalvular gradient (assessed by echocardiography).

Conclusions: Elevated plasma ALP is associated with increased mortality risk in patients with aortic valve stenosis. This finding may merit evaluation in studies with a larger number of patients.
Evaluation of the quality of life and associated factors of a group of children and adolescents with cystic fibrosis in the northern region of Portugal: a cross-sectional pilot study
Authors: Pita Olívia , Teixeira Beatriz , Dias Cláudia Camila , Almeida Paulo , Azevedo Inês , e Silva Diana 
Published: November 2022

Abstract

Introduction:
Children/adolescents with cystic fibrosis (CF) have psychological and physical difficulties that have a severe impact on their health-related quality of life (HRQoL).

Aim:
To evaluate the impact of CF on HRQoL in a pediatric age sample by identifying major determinants and comparing the HRQoL reports of children and their parents.

Methods:
A sample of 27 children/adolescents was included in a cross-sectional observational study. Inclusion criteria were age between 4 and 18 years, diagnosis of CF, and the attendance of a caregiver in patients younger than 14 years. A questionnaire was applied to assess sociodemographic data and nutritional status. HRQoL was evaluated using the Portuguese revised version of the CF questionnaire (CFQ-R). Spearman correlations were calculated to analyze the agreement between children's and parents' reports. Spearman correlations and Mann–Whitney U tests were performed to identify associations between HRQoL domains and determinants.

Results:
The scores of CFQ-R domains were high, with the lowest median value being 66.67. It was found positive moderate associations between children's and parents' reports in 3 domains (P < .05): eating disturbances, body image, and respiratory symptoms. The median scores were similar in the eating disturbances (approximately 80.00) and in the respiratory symptoms (83.33). However, there is a consistent difference of 14.07 in the body image domain. Current age, physical activity, and iron were positively associated with HRQoL, whereas age at diagnosis was negatively associated.

Conclusion:
These findings reinforce the importance to evaluate HRQoL during childhood and adolescence and to invest in this public health theme.
Physician Assistants’ Training and Self-Perceived Competencies to Work with Survivors of Intimate Partner Violence
Authors: Smith Noël E. , Thompson Katherine M. , McCall Timothy C. 
Published: November 2022

Introduction
The purpose of this research was to assess physician assistant (PA) education and training on the diagnosis, management, and treatment of survivors of intimate partner violence (IPV), as well as perceived current vs. desired skills in tasks related to the management and treatment of IPV.

Methods
Participants in 2 studies included a convenience sample of attendees at an annual PA conference (study 1) and PAs in the United States who were randomly selected to be administered an online survey related to their PA practice (study 2).

Results
In 2 studies, PAs reported low perceived competence to treat and manage patients who are survivors of IPV. More than half of the respondents (51.2%) had received training to work with survivors of IPV. Almost 3 in 5 indicated that they felt adequately prepared, and almost 3 in 10 regularly asked patients about IPV. Gaps between current and desired perceived skills to treat and manage survivors of IPV were larger among PAs who had previous training related to IPV compared with PAs with no prior training.

Discussion
Guidance for PA educators may improve PA education and increase competencies among new PAs. Without more substantial guidance from an accrediting body, PA programs are left responsible for implementing IPV curriculum. Professional associations as well as constituent and specialty organizations that provide continuing medical education have an equally important role in strengthening skills and abilities among PAs.
An Examination of Predictors of Attrition in Physician Assistant Programs
Authors: Quincy Brenda , Snyder Jennifer , Brown Darwin 
Published: November 2022

IntroductionThe purpose of this study was to explore the relationship between program characteristics and attrition rates.MethodsProgram graduation rates, attrition rates, and Physician Assistant National Certifying Examination (PANCE) pass rates were extracted from program websites from February-March 2021 and summarized for 2018, 2019, and 2020. Means were compared across categories of independent variables. Attrition rates and PANCE pass rates were correlated. Prerequisites and attrition rate were evaluated with multiple regression.ResultsMean attrition rates varied little across years. Significant differences in mean attrition were limited to a few US Census Bureau regions or divisions. No significant correlation between the total number of prerequisite courses or total prerequisite credits and attrition existed. In 2020, mean attrition rate was statistically significantly greater when biochemistry was required (M = 6.89, SD = 7.04) than when not required (M = 4.91, SD = 4.75) and was statistically significantly lower when an additional chemistry course was required (M = 3.65, SD = 4.00) than when not required (M = 5.93, SD = 5.82). No significant predictors of attrition were found with regression.DiscussionThe mean attrition rates have been relatively stable from 2018–2020, suggesting that the presence of prerequisite coursework has no significant impact on attrition rates. This suggests that specific prerequisites may not predict success in a program, supporting the idea of decreasing or eliminating prerequisites. Additional studies are needed to understand the factors, including specific combinations of prerequisites, that predict completion of a physician assistant program.
A Qualitative Evaluation of Medical Students' Perspectives Regarding Collaboration with Physician Assistants
Authors: Shachar Ben , Rubin Serena , Kazevman Gill , Leung Fok-Han 
Published: November 2022

Introduction
Physician assistant (PA) is a burgeoning profession in Canada, with several accredited training programs. Because the scope of practice for PAs in Ontario, as delineated by the province, stipulates that all tasks they perform must be delegated by a supervising physician, it is expected that medical students will increasingly encounter and work alongside PAs in clinical environments. There has been a paucity of research to date investigating how medical students experience this professional relationship. This current study aimed to investigate the attitudes and perspectives that medical students have about working with PAs.

Methods
Medical students from the University of Toronto (n = 11) in various stages of training participated in 3 focus groups. The focus groups used a semi-structured interview guide to explore medical students’ general opinions of the profession, their understanding of the interprofessional relationship, and their experiences working with PAs. Qualitative methods with a phenomenological underpinning were used to analyze the focus groups.

Results
The findings show that medical students have observed or collaborated with PAs in clinical environments but are generally unaware of the profession’s scope of practice and responsibilities. Medical students also viewed PAs as beneficial to patient care and expressed a desire to discover more about the profession through formal education.

Discussion
This call for interprofessional education should be heeded by medical faculty to better prepare medical students for future collaboration with PAs.
Primary cleft rhinoplasty: A systematic review of results, growth restriction, and avoiding secondary rhinoplasty
Authors: Zelko Ian , Zielinski Eric , Santiago Chiara N , Alkureishi Lee WT , Purnell Chad A 
Published: November 2022

Background:
Primary rhinoplasty (PR) during correction of unilateral cleft lip continues to be a topic of debate due to concerns that early nasal intervention affects nasal and maxillary development long-term. This study aims to determine the volume and quality of evidence for and against primary unilateral cleft rhinoplasty.

Methods:
A systematic review was performed adhering to the PRISMA Guidelines. Articles were pulled from PubMed and EMBASE and screened by title and abstract. Studies with human subjects undergoing rhinoplasty at the time of unilateral cleft lip repair and some evaluation of the nasal outcome were included. Studies with a large proportion of syndromic patients, case reports, editorials, letters, reviews, studies exclusive to bilateral clefts, and studies not available in English were excluded. Those that met criteria were then systematically reviewed.

Results:
Twenty-five articles were included. Ten articles that assessed the results of PR subjectively all supported cleft lip repair with PR. Sixteen articles assessed the results of PR objectively, with fifteen supporting PR during cleft lip repair. Eight of nine studies that evaluated nasal growth and development over time found no restriction in nasal development. Five studies with a follow-up period of at least six years found the percentage of patients that avoided revision rhinoplasty ranged from 43% to 100%. There were significant risks of bias in a majority of studies.

Conclusion:
The vast majority studies reviewed support that primary rhinoplasty during unilateral cleft lip repair results in good outcomes with limited or no effect on nasal growth.
Peripheral visual field loss and activities of daily living
Authors: Okrent Smolar Avital Lily , Gagrani Meghal , Ghate Deepta 
Published: November 2022

Purpose of review
Peripheral visual field (VF) loss affects 13% of the population over 65. Its effect on activities of daily living and higher order visual processing is as important as it is inadequately understood. The purpose of this review is to summarize available literature on the impact of peripheral vision loss on driving, reading, face recognition, scene recognition and scene navigation.

Recent findings
In this review, glaucoma and retrochiasmal cortical damage are utilized as examples of peripheral field loss which typically spare central vision and have patterns respecting the horizontal and vertical meridians, respectively. In both glaucoma and retrochiasmal damage, peripheral field loss causes driving difficulty – especially with lane maintenance – leading to driving cessation, loss of independence, and depression. Likewise, peripheral field loss can lead to slower reading speeds and decreased enjoyment from reading, and anxiety. In glaucoma and retrochiasmal field loss, face processing is impaired which impacts social functioning. Finally, scene recognition and navigation are also adversely affected, impacting wayfinding and hazard detection leading to decreased independence as well as more frequent injury.

Summary
Peripheral VF loss is an under-recognized cause of patient distress and disability. All peripheral field loss is not the same, differential patterns of loss affect parameters of activities of daily living (ADL) and visual processing in particular ways. Future research should aim to further characterize patterns of deranged ADL and visual processing, their correlation with types of field loss, and associated mechanisms.
Strain development of A/H1N1pdm09 candidate vaccine viruses for the 2021–22 northern hemisphere influenza season
Authors: Dempsey Rachael , Ritter Lydia , Parker Lauren 
Published: November 2022

The vaccine effectiveness (VE) of the A/H1N1pdm09 component of the 2017–18 quadrivalent live attenuated influenza vaccine (QLAIV) was improved by performing rational haemagglutinin (HA) mutagenesis. Introducing N125D, D127E, D222G and R223Q substitutions into the HA protein of A/Slovenia/2903/2015 (A/SLOV15) enhanced replicative fitness in primary human nasal epithelial cells (hNECs). This allowed A/SLOV15 to overcome inter-strain competition in QLAIV, resulting in improved VE.
During strain development for the 2021–22 QLAIV formulation, A/H1N1pdm09 LAIV viruses containing wild-type (WT) HA and neuraminidase (NA) sequences were found to replicate poorly in embryonated eggs and hNECs. We aimed to enhance replicative fitness via the HA mutagenesis approach that was performed previously for A/SLOV15. Therefore, combinations of these four mutations were introduced into the HA protein of representative 6B.1A-5a.2 viruses, A/Victoria/2570/2019 and A/Victoria/1/2020 (A/VIC1). Replicative fitness of A/VIC1 V7 was improved ~30-fold in eggs and ~300-fold in hNECs relative to its parent, without compromising other critical LAIV characteristics.
Kinetic model derivation for design, building and operation of solid waste treatment unit based on system dynamics and computer simulation
Authors: Hu Dawei , Li Shuaishuai , Liu Xiaolei , Liu Hong , Liu Guanghui 
Published: November 2022

AbstractSolid waste disposal is significantly important to maintain normal operation of both natural and artificial ecosystems. In this study, a kinetic model of solid waste treatment unit (SWTU) was upfront developed based on microbial ecology, system dynamics, cybernetics and digital simulation, which accurately described the relationships and interactions between solid waste decomposition (SWD) processes and biotic/abiotic factors. Then a specific SWTU prototype was designed and built from this kinetic model. A 370-day experiment demonstrated that SWTU maintained normal operation with robust stability and desired dynamic behaviors, and effectively disposed the solid waste. Therefore, this kinetic model was highly valid due to its high structural and behavioral similarity with the prototype. This research could lay a strong theoretical foundation for further closed-loop control and optimization of SWTU, and provide scientific guidance to environmental management and sustainable development.
Computational structure prediction methods enable the systematic identification of oncogenic mutations
Authors: Fu Xi , Reglero Clara , Swamy Vinay , Loh Jui Wan , Khiabanian Hossein , Albero Robert , Forouhar Farhad , AlQuraishi Mohammed , Ferrando Adolfo A. , Rabadan Raul 
Published: November 2022

AbstractOncogenic mutations are associated with the activation of key pathways necessary for the initiation, progression and treatment-evasion of tumors. While large genomic studies provide the opportunity of identifying these mutations, the vast majority of variants have unclear functional roles presenting a challenge for the use of genomic studies in the clinical/therapeutic setting. Recent developments in predicting protein structures enable the systematic large-scale characterization of structures providing a link from genomic data to functional impact. Here, we observed that most oncogenic mutations tend to occur in protein regions that undergo conformation changes in the presence of the activating mutation or when interacting with a protein partner. By combining evolutionary information and protein structure prediction, we introduce the Evolutionary and Structure (ES) score, a computational approach that enables the systematic identification of hotspot somatic mutations in cancer. The predicted sites tend to occur in Short Linear Motifs and protein-protein interfaces. We test the use of ES-scores in genomic studies in pediatric leukemias that easily recapitulates the main mechanisms of resistance to targeted and chemotherapy drugs. To experimentally test the functional role of the predictions, we performed saturated mutagenesis in NT5C2, a protein commonly mutated in relapsed pediatric lymphocytic leukemias. The approach was able to capture both commonly mutated sites and identify previously uncharacterized functionally relevant regions that are not frequently mutated in these cancers. This work shows that the characterization of protein structures provides a link between large genomic studies, with mostly variants of unknown significance, to functional systematic characterization, prioritizing variants of interest in the therapeutic setting and informing on their possible mechanisms of action.
Protected area planning to conserve biodiversity in an uncertain future
Authors: Schuster Richard , Buxton Rachel , Hanson Jeffrey O. , Binley Allison D. , Pittman Jeremy , Tulloch Vivitskaia , La Sorte Frank A. , Roehrdanz Patrick R. , Verburg Peter H. , Rodewald Amanda D. , Wilson Scott , Possingham Hugh P. , Bennett Joseph R. 
Published: November 2022

AbstractProtected areas are a key instrument for conservation. Despite this, they are vulnerable to risks associated with weak governance, land use intensification, and climate change. Using a novel hierarchical optimization approach, we identified priority areas for expanding the global protected area system to explicitly account for such risks whilst maximizing protection of all known terrestrial vertebrate species. We illustrate how reducing exposure to these risks requires expanding the area of the global protected area system by 1.6% while still meeting conservation targets. Incorporating risks from weak governance drove the greatest changes in spatial priorities for protection, while incorporating risks from climate change required the largest increase in global protected area. Conserving wide-ranging species required countries with relatively strong governance to protect more land when bordering nations with comparatively weak governance. Our results underscore the need for cross-jurisdictional coordination and demonstrate how risk can be efficiently incorporated into conservation planning.Article Impact StatementAccounting for governance, land use and climate risks will result in more resilient and effective conservation effort for biodiversity.
A novel method revealing animal evolutionary relationships based on milk Mid-infrared
Authors: Fan Yikai , Han Jiazheng , Wang Haitong , Nan Liangkang , Luo Xuelu , Chu Chu , Wang Liang , Liu Li , Li Yongqing , Li Chunfang , Ren Xiaoli , Ding Lei , Liu Wenju , Hao Xingjie , Chen Yansen , Liu George E. , Zhou Yang , Zhang Shujun 
Published: November 2022

AbstractMid-infrared spectra (MIRS) can effectively reflect the chemical bonds in milk, which has been widely used in dairy herd improvement. However, the relationship between MIRS and animal evolution remains largely unclear. This study firstly found great differences in MIRS and the components of milk by analyzing MIRS information of 12 different mammal species. A five-level discriminant model of evolutionary level based on MIRS was established with a test set kappa coefficient >0.97. In addition, a regression model of genetic distance was also established to estimate the genetic distance of different animal species with a correlation coefficient of R >0.94. These results showed that this method could be used for accurate mammalian evolutionary relationship assessment. We further clarified the potential relationship between MIRS and genes, such as PPP3CA and SCD that could change MIRS by regulating specific milk components. In conclusion, we expand the application of MIRS in animal species identification and evolution research and provide new perspectives for the research on the formation mechanism of different animal milk special components.
Evolution, Expansion and Characterization of Cannabinoid Synthase Gene Family inCannabis Sativa
Authors: Allen Keith D , Torres Anthony , De Cesare Kymron , Gaudino Reginald 
Published: November 2022

AbstractWe are working toward a complete functional and genomic characterization of the cannabinoid synthase family inCannabis(itself part of the larger Berberine Bridge Enzyme family). This clade, which is unique toCannabis, includes four main subclades that appear to have arisen by a series of gene duplications. We have functionally characterized three cannabinoid synthases, in addition to the three already characterized, so that now all four subclades contain at least one characterized enzyme. The previously uncharacterized Clade C enzymes have relatively low activity and produce CBCA as their primary product. In addition, we report genomic characterization to better understand the structure and high level of copy number variation in this family. We report a pattern of shared regions immediately upstream of the cannabinoid synthase genes that suggests a specific sequence of breakpoints, and hence gene duplication events. We present a model of gene family expansion to account for the observed data, along with evidence that this expansion occurred under selective pressure. This work adds to our understanding of both the high level of variability in this family and the origin of THCA in type III plants lacking a functional THCAS gene.
Characterisation and automated quantification of induced seizure-related behaviours inXenopus laevistadpoles
Authors: Panthi Sandesh , Chapman Phoebe A. , Szyszka Paul , Beck Caroline W. 
Published: November 2022

AbstractEpilepsy, a clinical diagnosis characterized by paroxysmal episodes known as seizures, affects 1% of people worldwide. Safe and patient-specific treatment is vital and can be achieved by the development of rapid pre-clinical models of for identified epilepsy genes. Epilepsy can result from either brain injury or gene mutations, and can also be induced chemically.Xenopus laevistadpoles could be a useful model for confirmation of variants of unknown significance found in epilepsy patients, and for drug re-purposing screens that could eventually lead to benefits for patients. Here, we characterise and quantify seizure-related behaviours inX. laevistadpoles arrayed in 24-well plates. To provoke acute seizure behaviours, tadpoles were chemically induced with either pentylenetetrazole (PTZ) or 4-aminopyridine (4-AP). To test the capacity to adapt this method for drug testing, we also exposed induced tadpoles to the anti-seizure drug valproate (VPA). Four induced seizure-like behaviours were described and manually quantified, and two of these (darting, circling) could be accurately detected automatically, using the video analysis software TopScan. Additionally, we recorded swimming trajectories and mean swimming velocity. Automatic detection showed that either PTZ or 4-AP induced darting behaviour and increased mean swimming velocity compared to untreated controls. Both parameters were significantly reduced in the presence of VPA. In particular, darting behaviour was a shown to be a sensitive measure of epileptic seizure activity. While we could not automatically detect the full range of seizure behaviours, this method shows promise for future studies, sinceX. laevisis a well-characterised and genetically tractable model organism.