bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of clonal integration, nutrients and cadmium on growth of the aquatic macrophytePistia stratiotes
Authors: Adomako Michael Opoku , Alpert Peter , Du Dao-Lin , Yu Fei-Hai 
Published: October 2020

AbstractAimsMany wetlands are polluted with both nutrients and toxic metals and vegetated largely by clonal plants. We hypothesized that eutrophication and clonal integration can increase phytoremediation of toxic metal pollution by increasing plant growth, even under the stress imposed by toxicity.MethodsTo test this hypothesis, single ramets of the common, widespread, floating, stoloniferous plant Pistia stratiotes L., were grown for 42 days at two levels of nutrient availability with and without 0.6 mg L−1 cadmium. Ramets were either severed from their vegetative offspring to prevent clonal integration or left connected, and severed offspring were either removed to eliminate intraclonal competition or left in place.Important FindingsPlants subjected to cadmium addition accumulated almost twice as much dry mass if given the higher nutrient level, due mainly to a doubling of the number of clonal offspring. Severance had little effect on the final mass of the parent plus offspring ramets. Removing offspring following severance had no effect on the final mass of the parental ramet in the presence of added cadmium, but it did increase the final mass of the parent in the absence of cadmium. These results support the hypothesis that eutrophication can increase remediation of toxic metal pollution by aquatic macrophytes but provided no evidence that clonal integration can affect remediation. Species such as P. stratiotes may help remediate co-pollution of wetlands with toxic metals and nutrients, and fragmentation of clones may not affect their remediation capacity.
Post-awakening Cortisol in Explosive Ordnance Disposal Technicians: A Replication Study in a Novel Population
Authors: Hernández Lisa M , Padilla Genieleah A , Koehn Blake W , Taylor Marcus K 
Published: October 2020

ABSTRACTIntroductionAmassing evidence suggests that post-awakening salivary cortisol rhythms (changes in cortisol throughout the day) may indicate health status. We previously established summary parameters for salivary cortisol in U.S. Navy Sea, Air, and Land and reported excellent parameter stability across 2 days of repeated sampling. To confirm the generalizability of our original findings to other military populations, we replicated the procedures of our prior report in another specialized military group. The purpose of this study was to (1) establish summary parameters of daily salivary cortisol rhythms, (2) evaluate summary parameter stability, and (3) assess the impact of sampling compliance in U.S. Navy Explosive Ordnance Disposal (EOD) technicians.Materials and MethodsSeventy active duty, male Explosive Ordnance Disposal technicians (mean ± SD age; 34.9 ± 6.5 years) self-collected saliva samples in a nondeployed setting on two consecutive weekdays at WAKE, WAKE + 30 min, WAKE + 60 min, 4 p.m., and 9 p.m. For salivary cortisol, we computed summary parameters, i.e., measures of magnitude and measures of pattern, and then evaluated their stabilities via correlational analyses and Cronbach’s alpha (α). Compliance was objectively and subjectively evaluated using actigraphy and self-reported data, respectively. This research was conducted under a Naval Health Research Center Institutional Review Board approved study (NHRC.2015.0013).ResultsAverage salivary cortisol concentrations increased at WAKE + 30 (mean ± SE reactivity; 48.9 + 6.8%) from WAKE, followed by a swift recovery at WAKE + 60. Approximately 10.9% of the group were classified as negative-responders (i.e., &lt; 0% change from WAKE to WAKE + 30). The measures of magnitude demonstrated fair stability across two days (r value range: 0.37-0.45, ps &lt; 0.01; α range: 0.54-0.62). Fifty-five percent of the sample was classified as compliant (defined as &lt;15 min deviation from target sampling times) across both days. Compliance decreased to 31% when compliance criteria were refined to &lt;5 min deviation; however, controlling for compliance did not overwhelmingly influence the more stable summary parameters of magnitude.ConclusionsThese findings demonstrate a thorough replication, with some additional refinement, of our prior study, implying generalizability across diverse military populations. Study limitations include unsupervised saliva collection in a free-living setting, which is counterbalanced by ecological validity. The noninvasive salivary sampling protocol used in this study yields stable estimations of daily cortisol rhythms in specialized military men and is recommended as an operational health surveillance tool by which to monitor chronically stressed military members.
Once in the Door, Grit May Matter More: An Evaluation of Grit in Medical Students
Authors: Ursua Francesca , Altholz Jacob , Durning Steven , Torre Dario , Dong Ting 
Published: October 2020

ABSTRACT

Introduction
Health professions educators seek understanding of the process of learner performance and achievement. Grit, defined as passion and perseverance for long-term goals, has been implicated in this process. Research suggests that effort counts twice in achievement: skill times effort equals skill and, subsequently, skill times effort equals achievement. Research also suggests that an individual’s interest influences job performance and satisfaction. Grit, composed of Perseverance of Effort and Consistency of Interest, has been shown to positively correlate with performance and achievement in various disciplines. Limited research reveals Grit negatively correlates with resident attrition and physician burnout. This study evaluates relationships between Grit and medical student performance measures.
We gather validity evidence for Grit scale use among medical students and, subsequently, use this data to evaluate for differences in Grit score by gender and assess whether there is a relationship between Grit and standardized exam scores. We hypothesize that Grit will not vary with gender and that it will be positively associated with standardized examination scores.

Methods
Enrolled students receive the 12-item Grit survey. An exploratory factor analysis evaluates validity evidence of Grit. Descriptive statistical analysis, Pearson correlation, and moderation analysis evaluate if Grit score differs by gender and if there are relationships with standardized exams.

Results
The survey response rate is 59% (412/698) and exploratory factor analysis replicates the two-factor structure of Grit found in other fields—Perseverance of Effort and Consistency of Interest. Average Grit scores do not significantly differ by gender. Grit weakly correlates with United States Medical Licensing Exam Step 1 (r = 0.10,  = 0.36) and United States Medical Licensing Exam Step 2 Clinical Knowledge (r = 0.12, P=0.29). Grit weakly and negatively correlates with Medical College Admission Test score (r = − 0.18, P&lt;0.05). Grit is not a significant moderator of the relationship between Medical College Admission score and Step exams scores.

Conclusion
Exploratory factor analysis results provide preliminary validity evidence for Grit scale use in medical students. Grit does not significantly moderate the Medical College Admission Test-Step score relationship. Grit correlates negatively with Medical College Admission Test scores. Though the correlations in this study were not significant, the results showed that Grit may tend to positively correlate with Step 1 and Step 2 Clinical Knowledge examinations. Given that these three exams are taken at different levels of training, the stepwise progression towards positive correlation may suggest that the theory “effort counts twice” applies to medical training.
Incidental Finding of Tuberculosis During Evaluation for Delayed Wound Healing
Authors: Kunciw Sabrina E , de la Cruz Eric C 
Published: October 2020

ABSTRACT
Cutaneous tuberculosis (TB) is an uncommon form of extrapulmonary TB that can be difficult to diagnose. The following case is about a 14-year-old female who was experiencing delayed wound healing after an incision and drainage of a chest wall abscess. A computed tomography scan of her chest obtained 2 months after the procedure revealed pulmonary findings consistent with TB. An acid-fast bacilli culture was obtained from the wound after the computed tomography scan was performed and was positive for Mycobacterium tuberculosis 8 weeks later. Although TB is relatively uncommon in the United States, it is more prevalent in the Republic of Korea where the patient lives and was evaluated. This case serves to illustrate the long history of challenges the military medical community has faced with TB and to remind providers to be cognizant about local common diseases when serving overseas and include these diagnoses in their differentials.
Detailed studies of IPHAS sources - III. The highly extinguished bipolar planetary nebula IPHASX J191104.8+060845
Authors: Rodríguez-González J B , Sabin L , Toalá J A , Zavala S , Ramos-Larios G , Guerrero M A , Parker Q A , Guillén P F , Ritter A 
Published: October 2020

Abstract
We present the first detailed study of the bipolar planetary nebula (PN) IPHASX J191104.8+060845 (PN G 040.6−01.5) discovered as part of the Isaac Newton Telescope Photometric Hα Survey of the Northern Galactic plane (IPHAS). We present Nordic Optical Telescope (NOT) narrow-band images to unveil its true morphology. This PN consists of a main cavity with two newly uncovered extended low-surface brightness lobes located towards the NW and SE directions. Using near-IR WISE images we unveiled the presence of a barrel like structure, which surrounds the main cavity, which would explain the dark lane towards the equatorial regions. We also use Gran Telescopio de Canarias (GTC) spectra to study the physical properties of this PN. We emphasise the potential of old PNe detected in IPHAS to study the final stages of the evolution of the circumstellar medium around solar-like stars.
A combinatorial method to isolate short ribozymes from complex ribozyme libraries
Authors: Arriola Joshua T , Müller Ulrich F 
Published: October 2020

Abstract
In vitro selections are the only known methods to generate catalytic RNAs (ribozymes) that do not exist in nature. Such new ribozymes are used as biochemical tools, or to address questions on early stages of life. In both cases, it is helpful to identify the shortest possible ribozymes since they are easier to deploy as a tool, and because they are more likely to have emerged in a prebiotic environment. One of our previous selection experiments led to a library containing hundreds of different ribozyme clusters that catalyze the triphosphorylation of their 5′-terminus. This selection showed that RNA systems can use the prebiotically plausible molecule cyclic trimetaphosphate as an energy source. From this selected ribozyme library, the shortest ribozyme that was previously identified had a length of 67 nucleotides. Here we describe a combinatorial method to identify short ribozymes from libraries containing many ribozymes. Using this protocol on the library of triphosphorylation ribozymes, we identified a 17-nucleotide sequence motif embedded in a 44-nucleotide pseudoknot structure. The described combinatorial approach can be used to analyze libraries obtained by different in vitro selection experiments.
SC2disease: a manually curated database of single-cell transcriptome for human diseases
Authors: Zhao Tianyi , Lyu Shuxuan , Lu Guilin , Juan Liran , Zeng Xi , Wei Zhongyu , Hao Jianye , Peng Jiajie 
Published: October 2020

Abstract
SC2disease (http://easybioai.com/sc2disease/) is a manually curated database that aims to provide a comprehensive and accurate resource of gene expression profiles in various cell types for different diseases. With the development of single-cell RNA sequencing (scRNA-seq) technologies, uncovering cellular heterogeneity of different tissues for different diseases has become feasible by profiling transcriptomes across cell types at the cellular level. In particular, comparing gene expression profiles between different cell types and identifying cell-type-specific genes in various diseases offers new possibilities to address biological and medical questions. However, systematic, hierarchical and vast databases of gene expression profiles in human diseases at the cellular level are lacking. Thus, we reviewed the literature prior to March 2020 for studies which used scRNA-seq to study diseases with human samples, and developed the SC2disease database to summarize all the data by different diseases, tissues and cell types. SC2disease documents 946 481 entries, corresponding to 341 cell types, 29 tissues and 25 diseases. Each entry in the SC2disease database contains comparisons of differentially expressed genes between different cell types, tissues and disease-related health status. Furthermore, we reanalyzed gene expression matrix by unified pipeline to improve the comparability between different studies. For each disease, we also compare cell-type-specific genes with the corresponding genes of lead single nucleotide polymorphisms (SNPs) identified in genome-wide association studies (GWAS) to implicate cell type specificity of the traits.
Is Foreign Policy Special?
Authors: Smith Ewan 
Published: October 2020

Abstract
People say foreign policy is a special sort of public policy. This article challenges that claim. It argues that judges should treat foreign policy in the same way they treat other sorts of policy. The article responds to four related lines of argument: that foreign policy is special on account of the constitutional separation of powers; that it demands a special sort of democratic legitimacy; that it is especially complex, secret and prophetic; and that it is simply more important than other aspects of public policy. These might be good reasons to defer to the government in general, but they are not good reasons to grant special deference to foreign policy.
LAZY1 Controls Tiller Angle and Shoot Gravitropism by Regulating the Expression of Auxin Transporters and Signaling Factors in Rice
Authors: Zhu Mo , Hu Yanjuan , Tong Aizi , Yan Bowen , Lv Yanpeng , Wang Shiyu , Ma Wenhong , Cui Zhibo , Wang Xiaoxue 
Published: October 2020

Abstract
Tiller angle is a key factor determining rice plant architecture, planting density, light interception, photosynthetic efficiency, disease resistance and grain yield. However, the mechanisms underlying tiller angle control are far from clear. In this study, we identified a mutant, termed bta1-1, with an enlarged tiller angle throughout its life cycle. A detailed analysis reveals that BTA1 has multiple functions because tiller angle, shoot gravitropism and tolerance to drought stress are changed in bta1-1 plants. Moreover, BTA1 is a positive regulator of shoot gravitropism in rice. Shoot responses to gravistimulation are disrupted in bta1-1 under both light and dark conditions. Gene cloning reveals that bta1-1 is a novel mutant allele of LA1 renamed la1-SN. LA1 is able to rescue the tiller angle and shoot gravitropism defects observed in la1-SN. The nuclear localization signal of LA1 is disrupted by la1-SN, causing changes in its subcellular localization. LA1 is required to regulate the expression of auxin transporters and signaling factors that control shoot gravitropism and tiller angle. High-throughput mRNA sequencing is performed to elucidate the molecular and cellular functions of LA1. The results show that LA1 may be involved in the nucleosome and chromatin assembly, and protein–DNA interactions to control gene expression, shoot gravitropism and tiller angle. Our results provide new insight into the mechanisms whereby LA1 controls shoot gravitropism and tiller angle in rice.
Effect of spontaneous breathing on atelectasis during induction of general anaesthesia in infants
Authors: Ji Sang-Hwan , Jang Hwan Suk , Jang Young-Eun , Kim Eun-Hee , Lee Ji-Hyun , Kim Jin-Tae , Kim Hee-Soo 
Published: October 2020

BACKGROUNDAtelectasis occurs commonly during induction of general anaesthesia in children, particularly infants.OBJECTIVESWe hypothesised that maintaining spontaneous ventilation can reduce atelectasis formation during anaesthetic induction in infants. We compared spontaneous ventilation and manual positive-pressure ventilation in terms of atelectasis formation in infants.DESIGNRandomised controlled study.SETTINGSingle tertiary hospital in Seoul, Republic of Korea, from November 2018 to December 2019.PATIENTSWe enrolled 60 children younger than 1 year of age undergoing general anaesthesia, of whom 56 completed the study. Exclusion criteria were history of hypoxaemia during previous general anaesthesia, development of a respiratory tract infection within 1 month, current intubation or tracheostomy cannulation, need for rapid sequence intubation, preterm birth, age within 60 weeks of the postconceptional age and the presence of contraindications for rocuronium or sodium thiopental.INTERVENTIONPatients were allocated randomly to either the ‘spontaneous’ group or ‘controlled’ group. During preoxygenation, spontaneous ventilation was maintained in the ‘spontaneous’ group while conventional bag-mask ventilation was provided in the ‘controlled’ group. After 5 min of preoxygenation, a lung ultrasound examination was performed to compare atelectasis formation in the two groups.RESULTSAtelectasis after preoxygenation was seen in seven (26.9%) of 26 patients in the ‘spontaneous’ group and 22 (73.3%) of 30 patients in the ‘controlled’ group (P = 0.001). The relative risk of atelectasis in the ‘spontaneous’ group was 0.39 (95% CI 0.211 to 0.723). Regarding ultrasound pictures of consolidation, the total score and sum of scores in the dependent regions were significantly lower in the ‘spontaneous’ group than in the ‘controlled’ group (P = 0.007 and 0.001, respectively).CONCLUSIONMaintaining spontaneous ventilation during induction of general anaesthesia has a preventive effect against atelectasis in infants younger than 1 year of age, particularly in the dependent portions of the lungs.TRIAL REGISTRATIONClinicaltrials.gov (identifier: NCT03739697).
The synergistic effect of dexmedetomidine on propofol for paediatric deep sedation
Authors: Mason Keira P. , Park Raymond Seungjoon , Sullivan Cornelius A. , Lukovits Karina , Halpin Erin M. , Imbrescia Samantha T. , Cavanaugh David , Prescilla Randy , Fox Victor L. 
Published: October 2020

BACKGROUND
Propofol and dexmedetomidine are used separately, and sometimes together, for paediatric deep sedation. Although their combination has been described in adults, the effect of dexmedetomidine as a potential synergist in children has not been studied before.

OBJECTIVES
The primary objective was to compare the propofol requirements of children who receive propofol alone with those who receive it in combination with dexmedetomidine for deep sedation for upper and lower endoscopic gastrointestinal procedures.

DESIGN
This was a prospective, open-label, randomised study comparing patients who received propofol alone (group P) with those who received dexmedetomidine and propofol (group DP). The depth of sedation was titrated to a target bispectral (BIS) index.

SETTING
A Gastroenterology Procedure Unit at a single, tertiary care academic medical centre from April 2018 until December 2019.

PATIENTS
Eligible patients were scheduled for upper endoscopy, lower endoscopy or both. A total of 39 patients were enrolled (20 DP) and (19 P).

INTERVENTIONS
Patients in Group DP received dexmedetomidine 0.5 μg kg−1 administered over 1 min followed by an infusion of 0.15 μg kg−1 h−1. In both groups, intravenous propofol was given in bolus increments titrated to a BIS index of 40 to 50 and then a continuous infusion of propofol to maintain BIS at 40 to 50.

MAIN OUTCOME MEASURES
The primary outcome measure was propofol requirement in each group. Secondary outcome measures were time to achieve the targeted sedation depth, time to achieve an Aldrete recovery score of 9, duration of sedation, mean BIS values, adverse events, ‘PAED’ scores and time to discharge from the postanaesthesia care unit (PACU).

RESULTS
The median (range) total dose of propofol was 0.23 (0.10 to 0.50) mg kg−1 min−1 in group DP and 0.40 (0.20 to 0.50) mg kg−1 min−1 in group P (P = 0.0004). Time of discharge from the PACU was 60 (20 to 121) min in group DP and 63 (46 to 91) min in group P (P = 0.0409).

CONCLUSION
The combination of dexmedetomidine and propofol for paediatric procedural sedation achieved a significant reduction in median propofol dose and a slightly shorter median time to discharge from PACU. Large-scale studies may determine whether this reduction decreases the risk of significant adverse events.

TRIAL REGISTRATION
ClinicalTrials.gov identifier NCT02952222
Unusual Fatigue and Failure to Utilize EMS Are Associated With Prolonged Prehospital Delay for Suspected Acute Coronary Syndrome
Authors: DeVon Holli A. , Daya Mohamud R. , Knight Elizabeth , Brecht Mary-Lynn , Su Erica , Zègre-Hemsey Jessica , Mirzaei Sahereh , Frisch Stephanie , Rosenfeld Anne G. 
Published: October 2020

Background:
Rapid reperfusion reduces infarct size and mortality for acute coronary syndrome (ACS), but efficacy is time dependent. The aim of this study was to determine if transportation factors and clinical presentation predicted prehospital delay for suspected ACS, stratified by final diagnosis (ACS vs. no ACS).

Methods:
A heterogeneous sample of emergency department (ED) patients with symptoms suggestive of ACS was enrolled at 5 US sites. Accelerated failure time models were used to specify a direct relationship between delay time and variables to predict prehospital delay by final diagnosis.

Results:
Enrolled were 609 (62.5%) men and 366 (37.5%) women, predominantly white (69.1%), with a mean age of 60.32 (±14.07) years. Median delay time was 6.68 (confidence interval 1.91, 24.94) hours; only 26.2% had a prehospital delay of 2 hours or less. Patients presenting with unusual fatigue [time ratio (TR) = 1.71, P = 0.002; TR = 1.54, P = 0.003, respectively) or self-transporting to the ED experienced significantly longer prehospital delay (TR = 1.93, P < 0.001; TR = 1.71, P < 0.001, respectively). Predictors of shorter delay in patients with ACS were shoulder pain and lightheadedness (TR = 0.65, P = 0.013 and TR = 0.67, P = 0.022, respectively). Predictors of shorter delay for patients ruled out for ACS were chest pain and sweating (TR = 0.071, P = 0.025 and TR = 0.073, P = 0.032, respectively).

Conclusion:
Patients self-transporting to the ED had prolonged prehospital delays. Encouraging the use of EMS is important for patients with possible ACS symptoms. Calling 911 can be positively framed to at-risk patients and the community as having advanced care come to them because EMS capabilities include 12-lead ECG acquisition and possibly high-sensitivity troponin assays.