bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Changing Procedural Characteristics Versus Changing Risk Profile in Age‐Based Trends of Outcomes in Patients With Transfemoral Transcatheter Aortic Valve Replacement From 2012 to 2018: A Nationwide Analysis
Authors: Ashraf Muddasir , Carnahan Ryan M. 
Published: November 2022

Background
The trends in outcomes in patients who undergo transcatheter aortic valve replacement are well described in the literature. Some of these trends are driven by the decreasing risk profile of patients because of changing indications for transcatheter aortic valve replacement. We aimed to evaluate these trends in different age groups and quantify how much of these trends are driven by changes in procedural characteristics.

Methods and Results

Using the National Inpatient Sample from 2012 to 2018, we identified 204 230 adult patients who underwent transfemoral aortic valve replacement. The study's primary objective was to evaluate the changes in age‐based trends in in‐hospital mortality driven by changes in procedural characteristics over time. The secondary objectives were to evaluate similar trends in cardiac and noncardiac complications and resource use. Univariate and multivariate linear and logistic regression were used to obtain effect sizes. From 2012 to 2018, in‐hospital mortality decreased from 1.8% to 0.79% in the age group 18 to 64 years, from 3.8% to 1.6% in the age group 65 to 80 years, and from 5.3% to 1.5% in the age group >80 years (
P
trend<0.01 for all age groups); these trends remained statistically significant on adjusted analysis except in patients aged 18 to 64 years. The other outcomes also showed variable trends over time. Length of stay, cost, and early discharge rates improved even after adjusting for comorbidities, which is likely attributable to improvement in procedural characteristics.

Conclusions
The changes in outcomes related to transcatheter aortic valve replacement are partly driven by changing patient risk profiles over time, but procedural characteristics have likely contributed to these trends in all age groups.
A Closer Look at the Sixteenth-century Ambraser Heldenbuch
Authors: Classen Albrecht 
Published: November 2022

Abstract
This study concerns a late medieval manuscript, the Ambraser Heldenbuch, created by Hans Ried for Emperor Maximilian I between 1504 and 1516. The recent facsimile edition makes it much easier to probe the critical question why this volume was not printed and what makes it stand out so much in the context of the early modern book market. The inclusion of the anonymous verse narrative Mauritius von Craûn (ca. 1220–1240) allows for more trenchant analyses concerning the patron and his interest in these literary works. The study takes into view the emperor’s strong concern with his afterlife, the paradoxical aspects determining that novella, and the contrast of this text copied here, very oddly, for the first time with the more popular literary works offered on the early modern book market. At a time when the printing press was increasingly conquering the book business, luxury bibliophile items continued to be produced as manuscripts. It might well be that the current book market finds a parallel in this phenomenon, with the electronic book pushing traditionally printed books aside. In fact, until today, we still resort to the manuscript in special cases, such as deeds, wills, licenses, and other documents.
“Truly a Distant and Dark Land”: the Rinan-Linyi Borderland in the Shuijing zhu
Authors: Felt D. Jonathan 
Published: November 2022

Abstract
This paper is about the depictions of the southern borderland of the Sinitic ecumene in the Shuijing zhu (written by Li Daoyuan in c. 515–524 ce) and the geographical concepts that frame this account. This borderland, in what is now central Vietnam, had been part of the classical Han empire (202 bce–220 ce) but began at the end of the second century to separate and form an independent state called Linyi (Lâm Ấp). In contrast to the stark boundaries depicted in Han imperial geographies, the Shuijing zhu describes the complexities of gradated frontiers and fluid borderlands. It explores the concept of environmental determinism in this exotic southern climate, and it reveals the challenges inherent in trying to expand geographical knowledge into new frontiers.
Using the Masora for Interpreting the Vocalisation and Accentuation of the Biblical Text
Authors: Martín-Contreras Elvira 
Published: November 2022

The marginal annotations that appear with the biblical text in most medieval biblical manuscripts—called by the technical term Masora—are hardly taken into account when interpreting the biblical text. Their idiosyncratic characteristics (they are formulated briefly, concisely, and, on many occasions, elliptically) make it nearly impossible to appreciate the content of the annotation and its possible interpretive relevance on a first reading. All these difficulties can be resolved, however, by establishing implicit information and formulating a clear methodology as to how to analyse the Masoretic annotations. This allows us to study
them and apply them to the interpretation of the biblical text. This article shows the benefits of using the Masora for the interpretation of the biblical text through some selected examples, all
of them related to vocalisation and stress. The content of these Masora annotations is explained and applied to textual interpretation.
Outcome of transurethral resection of bladder tumour under spinal anaesthesia combined with obturator nerve block in Sri Lanka
Authors: Ambegoda Madura , Shiyanth Selvantharajah , Vidanapathirana Sanjeewa , Kumara Sagara , Gunaratne Asoka , Abeygunasekera Anuruddha 
Published: November 2022

Purpose: Transurethral resection of bladder tumour (TURBT) is done under general anaesthesia (GA) with muscle relaxation to prevent obturator jerk and bladder perforation. TURBT under spinal anaesthesia (SA) with obturator nerve block (ONB) may prevent the obturator jerk while eliminating the disadvantages of GA. Objectives: To assess the outcome of TURBT under SA and ONB. Methods: Patients undergoing TURBT for lateral wall tumours from 01.11.2017 to 30.10.2020 were prospectively studied. Anterior branch of obturator nerve with plain Bupivacaine was blocked with the guidance of an ultrasound scan and a nerve stimulator. Significant obturator jerk which necessitated conversion to GA was defined as failed ONB. Results: Out of 72 patients with mean age of 66.7 years underwent ONB, 61 (84.7%) were men. Fifty two (72.2%) had unilateral and 20 (27.8%) had bilateral blocks. Sixty one (84.7%) patients had no obturator jerk whereas 5 (7%) had a mild jerk which did not preclude safe resection. Six patients (8.3%) had a failed ONB requiring conversion to GA. None had a bladder perforation requiring laparotomy, developed neurovascular injury or anaesthetic toxicity and only one patient required intensive care monitoring. Conclusion: SA with anterior branch of ONB is an effective and safe alternative to GA with muscle relaxation for TURBT although a randomized trial is necessary to determine the true efficacy and safety over the other.
Variety-Specific Transcriptional and Alternative Splicing Regulations Modulate Salt Tolerance in Rice from Early Stage of Stress
Authors: Jian Guihua , Mo Yujian , Hu Yan , Huang Yongxiang , Ren Lei , Zhang Yueqin , Hu Hanqiao , Zhou Shuangxi , Liu Gang , Guo Jianfu , Ling Yu 
Published: November 2022

AbstractSalt stress poses physiological drought, ionic toxicity and oxidative stress to plants, which causes premature senescence and death of the leaves if the stress sustained. Salt tolerance varied between different rice varieties, but how different rice varieties respond at the early stage of salt stress has been seldom studied comprehensively. By employing third generation sequencing technology, we compared gene expressional changes in leaves of three rice varieties that varied in their level of tolerance after salt stress treatment for 6 h. Commonly up-regulated genes in all rice varieties were related to water shortage response and carbon and amino acids metabolism at the early stage of salt stress, while reactive oxygen species cleavage genes were induced more in salt-tolerant rice. Unexpectedly, genes involved in chloroplast development and photosynthesis were more significantly down-regulated in the two salt tolerant rice varieties ‘C34’ and ‘Nona Bokra’. At the same time, genes coding ribosomal protein were suppressed to a more severe extent in the salt-sensitive rice variety ‘IR29’. Interestingly, not only variety-specific gene transcriptional regulation, but also variety-specific mRNA alternative splicing, on both coding and long-noncoding genes, were found at the early stage of salt stress. In summary, differential regulation in gene expression at both transcriptional and post-transcriptional levels, determine and fine-tune the observed response in level of damage in leaves of specific rice genotypes at early stage of salt stress.
Trade-off between conservation of biological variation and batch effect removal in deep generative modeling for single-cell transcriptomics
Authors: Li Hui , McCarthy Davis J. , Shim Heejung , Wei Susan 
Published: November 2022

Abstract
Background
Single-cell RNA sequencing (scRNA-seq) technology has contributed significantly to diverse research areas in biology, from cancer to development. Since scRNA-seq data is high-dimensional, a common strategy is to learn low-dimensional latent representations better to understand overall structure in the data. In this work, we build upon scVI, a powerful deep generative model which can learn biologically meaningful latent representations, but which has limited explicit control of batch effects. Rather than prioritizing batch effect removal over conservation of biological variation, or vice versa, our goal is to provide a bird’s eye view of the trade-offs between these two conflicting objectives. Specifically, using the well established concept of Pareto front from economics and engineering, we seek to learn the entire trade-off curve between conservation of biological variation and removal of batch effects.

Results
A multi-objective optimisation technique known as Pareto multi-task learning (Pareto MTL) is used to obtain the Pareto front between conservation of biological variation and batch effect removal. Our results indicate Pareto MTL can obtain a better Pareto front than the naive scalarization approach typically encountered in the literature. In addition, we propose to measure batch effect by applying a neural-network based estimator called Mutual Information Neural Estimation (MINE) and show benefits over the more standard maximum mean discrepancy measure.

Conclusion
The Pareto front between conservation of biological variation and batch effect removal is a valuable tool for researchers in computational biology. Our results demonstrate the efficacy of applying Pareto MTL to estimate the Pareto front in conjunction with applying MINE to measure the batch effect.
Evolution of the CBL and CIPK gene families in Medicago: genome-wide characterization, pervasive duplication, and expression pattern under salt and drought stress
Authors: Zhang Xiao-Xia , Ren Xiao-Long , Qi Xiao-Tong , Yang Zhi-Min , Feng Xiao-Lei , Zhang Tian , Wang Hui-Jie , Liang Peng , Jiang Qi-Ying , Yang Wen-Jun , Fu Yuan , Chen Min , Fu Zhi-Xi , Xu Bo 
Published: November 2022

AbstractBackgroundCalcineurin B-like proteins (CBLs) are ubiquitous Ca2+sensors that mediate plant responses to various stress and developmental processes by interacting with CBL-interacting protein kinases (CIPKs). CBLs and CIPKs play essential roles in acclimatization of crop plants. However, evolution of these two gene families in the genusMedicagois poorly understood.ResultsA total of 68CBLand 135CIPKgenes have been identified in five genomes fromMedicago. Among these genomes, the gene number ofCBLs andCIPKs shows no significant difference at the haploid genome level. Phylogenetic and comprehensive characteristic analyses reveal thatCBLs andCIPKs are classified into four clades respectively, which is validated by distribution of conserved motifs. The synteny analysis indicates that the whole genome duplication events (WGDs) have contributed to the expansion of both families. Expression analysis demonstrates that twoMsCBLs and threeMsCIPKs are specifically expressed in roots, mature leaves, developing flowers and nitrogen fixing nodules ofMedicago sativaspp.sativa, the widely grown tetraploid species. In particular, the expression of these five genes was highly up-regulated in roots when exposed to salt and drought stress, indicating crucial roles in stress responses.ConclusionsOur study leads to a comprehensive understanding of evolution ofCBLandCIPKgene families inMedicago, but also provides a rich resource to further address the functions of CBL-CIPK complexes in cultivated species and their closely related wild relatives.
Optical coherence tomography angiography analysis of microvascular abnormalities and vessel density in treatment-naïve eyes with diabetic macular edema
Authors: Braham Imène Zhioua , Kaouel Hela , Boukari Mejdi , Ammous Imen , Errais Khalil , Boussen Ilhem Mili , Zhioua Raja 
Published: November 2022

Abstract
Background
The aim of this study was to evaluate the structural retinal vascular integrity using optical coherence tomography angiography (OCTA) in treatment-naïve eyes with diabetic macular edema (DME) and to compare it with findings in diabetic eyes without DME.

Methods
In this prospective study, 70 eyes with diabetic retinopathy were included (37 eyes with DME and 33 eyes without DME). The medical records, including swept-source optical coherence tomography and 9 × 9 mm swept-source OCTA images were reviewed and compared between DME and non-DME groups. Microaneurysms, intraretinal microvascular abnormalities (IRMA), areas of capillary non perfusion, foveal avascular zone (FAZ), and capillary vascular density (CVD) were analyzed in the superficial capillary plexus (SCP) and the deep capillary plexus (DCP).

Results
Compared to the non-DME eyes, DME eyes had more microaneurysms in the SCP and the DCP (p = 0,039 and p = 0,024 respectively), more IRMA in the SCP (p = 0,005), larger areas of capillary non perfusion in the SCP and the DCP (p = 0,026 and p = 0,02 respectively) and larger FAZ in both plexuses (p = 0,048 in the SCP and p = 0,012 in the DCP). The CVD in the DCP was lower in DME eyes compared to non-DME eyes (p = 0,007). The severity of DME was significantly correlated to the number of microaneurysms and to the FAZ surface. Central macular thickness was significantly correlated with the number of microaneurysms in the DCP, the surface of capillary non perfusion areas and the FAZ area in both plexuses.

Conclusions
OCTA with a 9 × 9 mm field of view showed that the retinal vascular integrity regarding the number of microaneurysms, the number of IRMA, the surface of capillary non perfusion areas, the FAZ area and the CVD, was significantly more impaired in DME eyes compared to diabetic eyes without DME. The DCP seemed to be more affected in diabetic eyes with and without DME than the SCP.
Novel GRIA2 variant in a patient with atypical autism spectrum disorder and psychiatric symptoms: a case report
Authors: Cai Qianyun , Zhou Zhongjie , Luo Rong , Yu Tao , Li Dengfeng , Yang Fan , Yang Zuozhen 
Published: November 2022

Abstract
Background
As sequencing technology has advanced in recent years, a series of synapse-related gene variants have been reported to be associated with autism spectrum disorders (ASDs). The α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor is a subtype of the ionotropic glutamate receptor, whose number or composition changes can regulate the strength and plasticity of synapses.

Case presentation
Here, we report a de novo GRIA2 variant (NM_001083619.3: c.2308G > A, p.Ala770Thr) in a patient with obvious behavior regression and psychiatric symptoms. It encodes GluA2, which is the crucial subunit of the AMPA receptor, and the missense variation is predicted to result in instability of the protein structure.

Conclusions
The association between GRIA2 variants and onset of ASD symptoms is rare, and our study expands the spectrum of phenotypic variations. For patients with an unexplained etiology of ASD accompanied by psychiatric symptoms, genetic causes should be considered, and a complete genetic evaluation should be performed.
Global, regional, and national burden of disease study of atrial fibrillation/flutter, 1990–2019: results from a global burden of disease study, 2019
Authors: Li Hong , Song Xuejing , Liang Yi , Bai Xue , Liu-Huo Wu-Sha , Tang Chao , Chen Wen , Zhao Lizhi 
Published: November 2022

Abstract
Background
Data from the Global Burden of Disease, Injury, and Risk Factor Study 2019 (GBD 2019) was used to assess the burden and change in prevalence, incidence, deaths, disability-adjusted life years, and risk factors for atrial fibrillation/flutter in 204 countries and territories between 1990 and 2019.

Methods
Incidence, prevalence, deaths, disability-adjusted life years (DALYs), and their age-standardized rates of AF/AFL were analyzed by age, sex, socio-demographic index (SDI), and human development index (HDI) using the Global Burden of Disease study 2019 (GBD2019) results，and risk factors for AF/AFL (mainly high systolic blood pressure, high body-mass index, alcohol use, smoking and diet high in sodium) were differentially analyzed.

Results
There are 59.70 million (95% uncertainty interval (UI) 45.73–75.29 million) AF/AFL patients worldwide in 2019, with 4.72 million (95% uncertainty interval (UI) 3.64–5.96 million) new cases and 0.315 million deaths (95% uncertainty interval (UI) 0.268–0.361 million) and 8.39 million disability-adjusted years (95% uncertainty interval (UI) 6.69–10.54 million). The highest risk factor for deaths, DALYs attributable to AF/AFL in 2019 was high systolic blood pressure, high body-mass index, alcohol use, smoking, and diet high in sodium. It is estimated that between 2030 and 2034, the total incidence of male AF/ AFL will be 16.08 million, and the total number of deaths will be 1.01 million. For females, the total number of incidence is 16.85 million, and the total number of deaths is 1.49 million.

Conclusions
AF/AFL remains a major global public health problem, although the ASR of prevalence, incidence, and DALY at the worldwide level showed a decreasing trend from 1990 to 2019(the ASR of deaths increased slightly). However, the unfavorable trend observed in this study in countries with lower SDI suggests that current prevention and treatment strategies should be reoriented. Some countries should develop more targeted and specific strategies to prevent the increase of AF/AFL.
Knowledge, attitudes, and practices of university students regarding COVID-19: a cross-sectional study in Vietnam
Authors: Doan Dung Anh , Ho Huong Hien , Tran Long Duc , Nguyen Phuong Lan , Le Anh Thi Lan , Dinh Dai Xuan 
Published: November 2022

AbstractObjectiveThis cross-sectional study investigated the knowledge, attitudes, and practices (KAP) of Vietnamese university students regarding COVID-19.MethodsA validated questionnaire (Cronbach's alpha = 0.71) was used to survey 1,025 students. A convenience sampling method was used for recruiting students from April to May 2022. The Wilcoxon rank-sum test and the Kruskal–Wallis rank-sum test/Dunn test for multiple comparisons were employed to compare students' KAP scores between two groups and among three groups or more, respectively. Factors associated with students' COVID-19 KAP scores were determined via univariate and multivariate linear regression models. Variables in the multivariate linear regression models were chosen using the Bayesian Model Averaging method in R software version 4.2.0.ResultsA majority of students had good knowledge (75.61%), positive attitudes (98.24%), and good practices toward COVID-19 (94.93%). Regarding the COVID-19 knowledge, the proportions of students who knew that mosquito bites and exposure to/eating wild animals would not lead to COVID-19 infection were not high (47.22 and 34.34%, respectively). More importantly, 70.34% of students thought that vitamins and minerals could help prevent or cure COVID-19. Antibiotics were the first choice for COVID-19 treatment of 438 students (42.73%). Nearly half of students (48.0%) bought antibiotics to keep at home in case of COVID-19 infection. The average KAP scores of medical students (19.97 ± 3.99, 45.10 ± 3.94, 9.72 ± 1.78) and females (18.67 ± 4.44, 44.79 ± 3.79, 9.36 ± 1.84) were significantly higher than those of non-medical students (16.48 ± 4.37, 43.33 ± 4.03, 8.68 ± 1.87) and males (17.01 ± 4.55, 42.79 ± 4.39, 8.77 ± 1.97), respectively (p < 0.001). Older students were more likely to have good knowledge and practices than the younger ones (p < 0.001). In addition, students using websites of the World Health Organization/the Ministry of Health and scientific articles to seek COVID-19 information were significantly associated with higher KAP scores when compared with those not using these sources (p < 0.001,p < 0.001, andp = 0.00139, respectively).ConclusionStudents' KAP scores significantly varied by age, sex, major, and sources of COVID-19 information. Although many students had sufficient knowledge, positive attitudes, and good preventive practices toward COVID-19, additional education and training strategies are paramount, especially for non-medical students and males.
Tranexamic acid in pertrochanteric fractures: a retrospective analysis of perioperative outcomes after fixation with a proximal femoral nail
Authors: Hanke John , Mendel Thomas , Wingert Matthias , Schenk Philipp , Heinecke Markus , Wilharm Arne 
Published: November 2022

Abstract
Background
Treatment of pertrochanteric femoral fractures is often associated with significant blood loss. It has already been demonstrated that the administration of tranexamic acid (TXA) for endoprosthetic procedures reduces blood losses and leads to a decreased frequency of postoperative complications. The aim of this study is to demonstrate whether the administration of TXA as part of osteosynthesis treatment for pertrochanteric fractures using a proximal femoral nail reduces perioperative blood losses and haemorrhage-related complications.

Methods
In a two-centre retrospective cohort study, 1 g TXA i.v. was administered preoperatively to 294 patients who had suffered from pertrochanteric femoral fractures. The subjects were compared clinically to a historical control group who did not receive TXA (nonTXA). Outcomes were evaluated on the basis of perioperative blood loss, transfusion requirement, and occurrence of complications.

Results
The TXA group showed evidence of a reduction in blood loss (TXA = 0.97 ± 0.47 l; nonTXA = 1.06 ± 0.47 l; p = 0.004) and a lower frequency of transfusion (TXA = 20%; nonTXA = 31%; p = 0.032) as compared to the nonTXA group. However, evidence of this therapeutic effect could only be demonstrated at one of the centres on subgroup comparison between the two centres. At the second centre, the data did not show a significant difference. A trend could be seen towards a reduction in postoperative renal failure. No complications occurred resulting from the administration of tranexamic acid.

Conclusion
Preoperative administration of TXA does not lead to an increased rate of thromboembolic complications when applied for treatment of pertrochanteric femoral fractures. Evidence of a positive effect could be seen in principle in relation to the reduction in perioperative blood loss and the frequency of transfusion. The difference in effect between the two centres remains to be clarified: for this reason, it is possible to assume that further factors influencing the efficacy of TXA administration are at play which were not taken into account in this study.