bluuebunny/crossref_metadata_2025_split huggingface dataset:
HENLE FIBER LAYER MAPPING WITH DIRECTIONAL OPTICAL COHERENCE TOMOGRAPHY
Authors: Kesim Cem , Bektas Sevval Nur , Kulali Zeynep , Yildiz Erdost , Ersoz M. Giray , Sahin Afsun , Gunduz-Demir Cigdem , Hasanreisoglu Murat 
Published: May 2022

Purpose:
To perform a macular volumetric and topographic analysis of Henle fiber layer (HFL) from retinal scans acquired by directional optical coherence tomography.

Methods:
Thirty healthy eyes of 17 subjects were imaged using the Heidelberg spectral-domain optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany) with varied horizontal and vertical pupil entry. Manual segmentation of HFL was performed from retinal sections of horizontally and vertically tilted optical coherence tomography images acquired within macular 20 × 20° area. Total HFL volume, mean HFL thickness, and HFL coverage area within Early Treatment for Diabetic Retinopathy Study grid were calculated from mapped images.

Results:
Henle fiber layer of 30 eyes were imaged, segmented and mapped. The mean total HFL volume was 0.74 ± 0.08 mm3 with 0.16 ± 0.02 mm3, 0.18 ± 0.03 mm3, 0.17 ± 0.02 mm3, and 0.19 ± 0.03 mm3 for superior, temporal, inferior, and nasal quadrants, respectively. The mean HFL thickness was 26.5 ± 2.9 µm. Central 1-mm macular zone had the highest mean HFL thickness with 51.0 ± 7.6 µm. The HFL coverage that have thickness equal or above to the mean value had a mean 10.771 ± 0.574 mm2 of surface area.

Conclusion:
Henle fiber layer mapping is a promising tool for structural analysis of HFL. Identifying a normative data of HFL morphology will allow further studies to investigate HFL involvement in various ocular and systemic disorders.
Impact of Simulation on Undergraduate Student Outcomes
Authors: Thomas Christine M. , Barker Nancy 
Published: May 2022

Background:
Clinical reasoning is a cognitive and metacognitive process that is essential for positive patient outcomes. Simulation experiences provide situations and reflection where students can build clinical reasoning.

Purpose:
This study examined the impact of a higher number of simulation experiences on undergraduate student outcomes.

Methods:
A retrospective comparison study examined differences between group grade point average, Assessment Technologies Institute (ATI) predictor, and National Council Licensure Examination (NCLEX) scores (P < .05). A sample of 395 students was included in data analysis.

Results:
No differences were noted in grade point average or NCLEX pass rates. However, students who completed a simulation elective had significantly higher ATI predictor scores. Cohen's d (0.39) approached a medium effect size.

Conclusions:
Incorporating higher levels of in-person simulation through creative delivery models can improve student outcomes. Simulations may enhance students' clinical reasoning skills.
Transitioning a Graduate Nursing Physical Examination Skills Lab to an Online Learning Modality
Authors: Barnes Emily R. , Vance Billie S. 
Published: May 2022

Background:
Continued restrictions imposed on face-to-face learning related to the SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) pandemic resulted in a decision to permanently transition a graduate nursing education advanced assessment course from a hybrid to an online learning modality.

Purpose:
The purpose of this article is to describe the transition of the physical examination skills lab from face-to-face to online, compare advanced practice nursing student performance outcomes, and evaluate faculty satisfaction and student satisfaction and confidence in learning.

Methods:
A retrospective comparison design was used to evaluate student outcomes. Surveys were used to evaluate faculty satisfaction and student satisfaction and confidence.

Results:
Academic performance, including the psychomotor performance proficiency of advanced assessment skills, was comparable between the modalities. Students were satisfied with and confident in their learning of skills. Faculty support online delivery despite increased workload.

Conclusions:
Continued use of the online learning modality for teaching advanced physical examination skills is warranted.
Rotation Advancement Keystone Flap for Closure of Large Myelomeningocele Defects
Authors: Hifny Mahmoud A. , Hamdan Ali R. , Tayel Amr M. , El Khateeb Eslam El-Sayed , Yagi Shunjiro , Park Tae Hwan 
Published: May 2022

Introduction
Myelomeningocele is the most common form of neural tube anomalies. Early reliable skin coverage should be achieved to reduce central nervous system infections. The keystone flaps are gaining popularity for myelomeningocele defect reconstruction. However, the use of a traditional keystone flap is limited in very wide or transversely oriented myleomeningocele defects with inadequate lateral tissue laxity. In this study, we present our successful experience using modified rotation advancement keystone flaps for closure of the transversely oriented myelomeningocele defects.

Patients and Methods
Between April 2019 and April 2020, the modified rotation advancement keystone flap was used for reconstruction of transversely oriented myelomeningocele defect in 7 patients (5 males and 2 females) with average age of 14 days. The localization of the lesions was lumbosacral in 5 patients and thoracolumbar in 2 patient. The average myelomeningocele defect width was 6.4 cm, whereas the average defect length was 5.7 cm. The following information was evaluated: the flap dimensions, operative time, and postoperative complications.

Results
All patients had uneventful operations, except for 1 case of superficial epidermolysis over flap tip, which settled with conservative wound management. Immediate venous congestion was detected in 2 patients that completely resolved. Otherwise, all wounds healed without any evidence of complications. The mean follow-up was 4 months.

Conclusions
Although the conventional keystone flap seems to have geometric constraints to close a transversally oriented myelomeningocele defect, the modified rotation advancement keystone flap serves as a superior alternative and effective option for closure transversally oriented defect.
An Evaluation of Racial Disparities in Online Marketing of Academic Plastic Surgery Practices
Authors: Moss Whitney D. , King Brody W. , Memmott Stanley , Pires Giovanna , Rosales Megan , Kwok Alvin , Tenzel Paul 
Published: May 2022

Background
Racial disparities in plastic surgery limit health care accessibility and quality. The aim of this study is to determine if racial disparities exist within patient-targeted advertising materials on academic plastic surgery practice (APSP) Web sites and if disparities are more pronounced in specific categories within plastic surgery.

Methods
Throughout May 2021, 3 independent reviewers analyzed the Web sites for APSPs and identified all photos, videos, and graphics with visible skin. For each image, the Fitzpatrick skin tone scale was used to classify the skin tone as “White” (I–III) or “non-White” (IV–VI). The images were further categorized based on the type of procedure depicted. Comparisons were made to publish US census data using χ2 tests and linear mixed effects models.

Results
In total, 4615 images were analyzed from 100 APSP Web sites. Seven hundred eighty (16.9%) portrayed non-White skin tone, which was significantly less than expected based on US census data (23.7% non-White race) (P < 0.001). Online representation had the starkest disparity in hand surgery (8.65% non-White) and adult craniofacial (9.74% non-White). The only categories that showed no significant difference between representation and demographics included implant-based breast reconstruction (P = 0.32) and pediatric craniofacial (P = 0.93). Overall, the marketing materials demonstrated significantly lower representation of non-White skin compared with the census demographics by an absolute difference of −4.71% (P < 0.001).

Conclusions
Non-White patients are significantly underrepresented in advertising materials published by APSPs, indicating systemic racial biases. Patient-targeted advertising can be improved to promote equality in representation for patients seeking plastic and reconstructive surgery.
Outcomes of SARS-CoV-2 Infection in Unvaccinated Compared With Vaccinated Solid Organ Transplant Recipients: A Propensity Matched Cohort Study
Authors: Hall Victoria G. , Al-Alahmadi Ghadeer , Solera Javier T. , Marinelli Tina , Cardinal Heloise , Prasad G. V. Ramesh , De Serres Sacha A. , Isaac Debra , Mainra Rahul , Lamarche Caroline , Sapir-Pichhadze Ruth , Gilmour Susan , Matelski John , Humar Atul , Kumar Deepali 
Published: May 2022

Background.
Solid organ transplant (SOT) recipients are at high risk for complications from coronavirus disease 2019 (COVID-19). Vaccination may mitigate this risk; however, immunogenicity appears to be significantly impaired, with reports of increased risk of breakthrough infection. It is unknown if vaccine breakthrough infections are milder or as severe as infections in unvaccinated patients.

Methods.
We performed a multicenter matched cohort study between March 2020 and September 2021 to assess influence of COVID-19 vaccination on outcomes of COVID-19 infection. Treatment characteristics and disease severity outcomes were compared on the basis of vaccine status; breakthrough infections versus unvaccinated infections. Variable ratio propensity score matching based on age, sex, transplant type, and number of comorbidities, was used to develop the analytic cohort. Logistic regression was used to assess the influence of vaccination status on the selected outcomes.

Results.
From a cohort of 511 SOT patients with COVID-19, we matched 77 partially or fully vaccinated patients with 220 unvaccinated patients. Treatment characteristics including use of dexamethasone, remdesivir, and antibiotics did not differ. Vaccinated participants were more likely to receive tocilizumab, 15 of 77 (19.5%) versus 5 of 220 (2.3%), P < 0.001. Disease severity outcomes including oxygen requirement, mechanical ventilation, and mortality were similar among medically attended vaccine breakthroughs compared with unvaccinated patients.

Conclusions.
SOT recipients who develop medically attended COVID-19 following 1- or 2-dose vaccination seem to have similar disease severity to unvaccinated patients who develop infection. This is consistent with the requirement that SOT recipients need 3 or more vaccine doses and emphasizes the importance of alternate strategies for this population.
Supercoiling-mediated feedback rapidly couples and tunes transcription
Authors: Johnstone Christopher P. , Galloway Kate E. 
Published: May 2022

AbstractTranscription induces a wave of DNA supercoiling, altering the binding affinity of RNA polymerases and reshaping the biochemical landscape of gene regulation. As supercoiling rapidly diffuses, transcription dynamically reshapes the regulation of proximal genes, forming a complex feedback loop. The resulting intergene coupling may provide a mechanism to control transcriptional variance in engineered gene networks and explain the behavior of co-localized native circuits. However, a theoretical framework is needed for integrating both biophysical and biochemical transcriptional regulation to investigate the role of supercoiling-mediated feedback within multi-gene systems. Here, we model transcriptional regulation under the influence of supercoiling-mediated polymerase dynamics, allowing us to identify patterns of expression that result from physical intergene coupling and explore integration of this biophysical model with a set of canonical biochemical gene regulatory systems. We find that gene syntax—the relative ordering and orientation of genes—defines the expression profiles, variance, burst dynamics, and intergene correlation of two-gene systems. By applying our model to both a synthetic toggle switch and the endogenous zebrafish segmentation network, we find that supercoiling can enhance or weaken conventional biochemical regulatory strategies such as mRNA- and protein-mediated feedback loops. Together, our results suggest that supercoiling couples behavior between neighboring genes, representing a novel regulatory mechanism. Integrating biophysical regulation into the analysis and design of gene regulation provides a framework for enhanced understanding of native networks and engineering of synthetic gene circuits.
Distinct cytosolic complexes containing the type III secretion system ATPase resolved by 3D single-molecule tracking in liveYersinia enterocolitica
Authors: Prindle Joshua R , Wang Yibo , Rocha Julian , Diepold Andreas , Gahlmann Andreas 
Published: May 2022

AbstractThe membrane-embedded injectisome, the structural component of the virulence-associated type III secretion system (T3SS), is used by gram-negative bacterial pathogens to inject species-specific effector proteins into eukaryotic host cells. The cytosolic injectisome proteins are required for export of effectors and display both stationary, injectisome-bound populations as well as freely-diffusing cytosolic populations. How the cytosolic injectisome proteins interact with each other in the cytosol and associate with membrane-embedded injectisomes remains unclear. Here, we utilize 3D single-molecule tracking to resolve distinct cytosolic complexes of injectisome proteins in livingYersinia enterocoliticacells. Tracking of the eYFP-labeled ATPase,YeSctN, and its regulator,YeSctL, reveals that these proteins form a cytosolic complex with each other and then further withYeSctQ.YeSctNL andYeSctNLQ complexes can be observed both in wild type cells and in ΔsctDmutants, which cannot assemble injectisomes. In ΔsctQmutants, the relative abundance of theYeSctNL complex is considerably increased. These data indicate that distinct cytosolic complexes of injectisome proteins can form prior to injectisome binding, which has important implications for how injectisomes are functionally regulated.ImportanceInjectisomes are membrane-embedded, multiprotein assemblies used by bacterial pathogens to inject virulent effector proteins into eukaryotic host cells. Protein secretion is regulated by cytosolic proteins that dynamically bind and unbind at injectisomes. However, how these regulatory proteins interact with each other remains unknown. By measuring the diffusion rates of single molecules in living cells, we show that cytosolic injectisome proteins form distinct oligomeric complexes with each other prior to binding to injectisomes. We additionally identify the molecular compositions of these complexes and quantify their relative abundances. Quantifying to what extent cytosolic proteins exist as part of larger complexes in living cells has important implications for deciphering the complexity of biomolecular mechanisms. The results and methods reported here are thus relevant for advancing our understanding of how injectisomes, and related multiprotein assemblies, such as bacterial flagellar motors, are functionally regulated.
Promising efficacy of following a third dose of mRNA SARS-CoV-2 vaccination in patients treated with anti-CD20 antibody who failed 2-dose vaccination
Authors: Funakoshi Yohei , Yakushijin Kimikazu , Ohji Goh , Hojo Wataru , Sakai Hironori , Watanabe Marika , Kitao Akihito , Miyata Yoshiharu , Saito Yasuyuki , Kawamoto Shinichiro , Yamamoto Katsuya , Ito Mitsuhiro , Koyama Taiji , Imamura Yoshinori , Kiyota Naomi , Matsuoka Hiroshi , Mori Yasuko , Minami Hironobu 
Published: May 2022

AbstractAnti-CD20 antibodies react with CD20 expressed not only on malignant B cells but also on normal B cells. It has been reported that patients treated with anti-CD20 antibodies had an insufficient response to two-dose mRNA SARS-CoV-2 vaccination. To investigate the efficacy of a third dose in these patients, we investigated serum IgG antibody titers for S1 protein after third vaccination in 22 patients treated with anti-CD20 antibody who failed two-dose vaccination. Results showed that overall, 50% of patients seroconverted. Although no patient who received the third dose within 1 year of the last anti-CD20 antibody administration showed an increase in S1 antibody titer, 69% of patients who received the third dose more than 1 year after the last anti-CD20 antibody administration seroconverted. Our data show that a third dose of vaccination is effective in improving seroconversion rate in patients treated with anti-CD20 antibody who failed standard two-dose vaccination.
Immune responses following 3rd and 4th doses of heterologous and homologous COVID-19 vaccines in kidney transplant recipients
Authors: Thomson Tina , Prendecki Maria , Gleeson Sarah , Martin Paul , Spensley Katrina J , Cardoso De Aguiar Rute , Sandhu Bynvant , Seneschall Charlotte , Gan Jaslyn , Clarke Candice L. , Lewis Shanice , Pickard Graham , Thomas David , McAdoo Stephen P. , Lightstone Liz , Cox Alison , Kelleher Peter , Willicombe Michelle 
Published: May 2022

BackgroundSolid organ transplant recipients have attenuated immune responses to SARS-CoV-2 vaccines. In this study, we report on immune responses to 3rd- (V3) and 4th- (V4) doses of heterologous and homologous vaccines in a kidney transplant population.Methods724 kidney transplant recipients were prospectively screened for serological responses following 3 primary doses of a SARS-CoV2 vaccine. 322 patients were sampled post-V4 for anti-spike (anti-S), with 69 undergoing assessment of SARS-CoV-2 T-cell responses. All vaccine doses were received post-transplant, only mRNA vaccines were used for V3 and V4 dosing. All participants had serological testing performed post-V2 and at least once prior to their 1st dose of vaccine.Results586/724 (80.9%) patients were infection-naïve post-V3; 141/2586 (24.1%) remained seronegative at 31 (21-51) days post-V3. Timing of vaccination in relation to transplantation, OR: 0.28 (0.15-0.54), p=0.0001; immunosuppression burden, OR: 0.22 (0.13-0.37), p<0.0001, and a diagnosis of diabetes, OR: 0.49 (0.32-0.75), p=0.001, remained independent risk factors for non-seroconversion. Seropositive patients post-V3 had greater anti-S if primed with BNT162b2 compared with ChAdOx1, p=0.001.Post-V4, 45/239 (18.8%) infection-naïve patients remained seronegative. De novo seroconversion post-V4 occurred in 15/60 (25.0%) patients who were seronegative post-V3. There was no difference in anti-S post-V4 by vaccine combination, p=0.50. Anti-S post-V4 were sequentially greater in those seroconverting post V2- compared with V3-, and V3- compared with V4-, at 1561 (567-5211), 379 (101-851) and 19 (9.7-48) BAU/ml respectively.T-cell responses were poor, with only 11/54 (20.4%) infection-naive patients having detectable T-cell responses post-V4, with no difference seen by vaccine type.ConclusionA significant proportion of transplant recipients remain seronegative following 3- and 4- doses of SARS-CoV-2 vaccines, with poor T-cell responses, and are likely to have inadequate protection against infection.
PREVALENCE OF PRECONCEPTION CARE PROVISION IN KISUMU COUNTY-KENYA
Authors: Morema Everlyne N. , Senghor Morris , Ouma Collins 
Published: May 2022

ABSTRACTBackground‘Preconception care’ (PCC) is the provision of biomedical, behavioral and social health interventions to women and couples before conception occurs. The PCC, is valuable and key in preventing and controlling non-communicable diseases. There is the need for comprehensive preconception care provision in Kisumu County in order to promote healthy reproduction, improve maternal and neonatal health indicators in this and similar settings. Unfortunately, the current rate of provision for this service has not been documented in Kenya and more specifically in Kisumu County.MethodsIn a cross-sectional study, data on the provision of various services as per the recommended package for preconception care was collected in health facilities using a checklist. The targeted facilities (n=28) were selected using multistage sampling. The means for all of the services in the package was determined. The significance of the difference in the means was determined by one sample T-test at P-value ≤ 0.05ResultsLevel of implementation of PCC was quite low at 39%. It was observed to be lower in the primary level facilities (KEPH level 2 and 3) at 34% and higher in referral facilities (level 4 and above) at 45%. The service with the highest implementation level was HIV prevention and management (84%) followed by sexually transmitted diseases (80%) and vaccination services (75%). The service with lowest level of implementation was environmental risk exposure reduction at 13% for level 2 and 3 followed by management of mental health disorders.ConclusionProvision of PCC was relatively low at 39% and provision was fragmented. Provision differed across service levels and care packages.
Stomatal regulators are co-opted for seta development in the astomatous liverwortMarchantia polymorpha
Authors: Moriya Kenta C. , Shirakawa Makoto , Loue-Manifel Jeanne , Matsuda Yoriko , Lu Yen-Ting , Tamura Kentaro , Oka Yoshito , Matsushita Tomonao , Hara-Nishimura Ikuko , Ingram Gwyneth , Nishihama Ryuichi , Goodrich Justin , Kohchi Takayuki , Shimada Tomoo 
Published: May 2022

AbstractThe evolution of special types of cells requires the acquisition of new gene regulatory networks controlled by transcription factors (TFs). In stomatous plants, a TF module formed by subfamilies Ia and IIIb basic helix-loop-helix TFs (Ia-IIIb bHLH) regulates stomatal formation; however, how this module evolved during land plant diversification remains unclear. Here, we show that, in the astomatous liverwortMarchantia polymorpha, a Ia-IIIb bHLH module regulates the development of a unique sporophyte tissue, the seta, which is found in mosses and liverworts. The sole Ia bHLH gene, MpSETA, and a IIIb bHLH gene, MpICE2, regulate the cell division and/or differentiation of seta lineage cells. MpSETA can partially replace the stomatal function of Ia bHLH TFs inArabidopsis thaliana, suggesting that a common regulatory mechanism underlies the setal and stomatal formation. Our findings reveal the co-option of a Ia-IIIb bHLH TF module for regulating cell fate determination and/or cell division of distinct types of cells during land plant evolution.
Isotope-based visualization of element distribution in phloem provides functional evidence for the operation of SOS1 Na+/H+ exchangers in mature zones of Arabidopsis root
Authors: Sugita Ryohei , Ogura Takaaki , Kobayashi Natsuko I. , Gill Muhammad B. , Shabala Lana , Nakanishi Tomoko M. , Shabala Sergey , Tanoi Keitaro 
Published: May 2022

AbstractIn the phloem, various solutes such as photosynthates, mineral nutrients, or toxic elements move from the source organs to sinks. One of them is the root. While this process may mediate significant quantities of solutes delivered to the root, it is unclear how the solutes are distributed along the root axis. To elucidate the distributing pattern of solutes, we visually analyzed the movement of solutes in Arabidopsis roots using a radioisotope imaging technique. The distribution patterns fell into four different groups: (1) root tip accumulation for 14C-photosynthates, 28Mg2+, 32PO43-, and 35SO42-; (2) homogenous distribution along the root axis for 42K+ and 137Cs+; (3) no detectable accumulation in the root for 45Ca2+ and 59Fe2+; and (4) transient accumulation in the root for 22Na+. The latter phenomenon was explored in more detail using Arabidopsis knockout mutants lacking functional sodium efflux transporter SOS1 (operating as Na+/H+ exchanger). By utilizing a non-invasive microelectrode MIFE ion flux measuring technique, we found that Na+ efflux was active in the mature root zone of wild-type Arabidopsis plants but not in root apex as initially thought, and that in sos1 mutants lacking functional Na+/H+ exchangers, shoot-derived 22Na+ remained in the root. These findings challenge the notion that Na+ exclusion via SOS1 is confined to the root apex and demonstrates the power of combining the radioisotope imaging technique and the MIFE ion flux measuring technique to study the kinetics of ion transport in the root and root-to-shoot communication.