bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medicago PHYA promotes flowering, primary stem elongation and expression of flowering time genes in long days
Authors: Jaudal Mauren , Wen Jiangqi , Mysore Kirankumar S. , Putterill Joanna 
Published: July 2020

Abstract
Background
Flowering time is an important trait for productivity in legumes, which include many food and fodder plants. Medicago truncatula (Medicago) is a model temperate legume used to study flowering time pathways. Like Arabidopsis thaliana (Arabidopsis), its flowering is promoted by extended periods of cold (vernalization, V), followed by warm long day (LD) photoperiods. However, Arabidopsis flowering-time genes such as the FLOWERING LOCUS C (FLC)/ MADS AFFECTING FLOWERING (MAF) clade are missing and CONSTANS-LIKE (CO-LIKE) genes do not appear to have a role in Medicago or Pisum sativum (pea). Another photoperiodic regulator, the red/far red photoreceptor PHYTOCHROME A (PHYA), promotes Arabidopsis flowering by stabilizing the CO protein in LD. Interestingly, despite the absence of CO-LIKE function in pea, PsPHYA plays a key role in promoting LD photoperiodic flowering and plant architecture. Medicago has one homolog of PHYA, MtPHYA, but its function is not known.

Results
Genetic analysis of two MtPHYA Tnt1 insertion mutant alleles indicates that MtPHYA has an important role in promoting Medicago flowering and primary stem elongation in VLD and LD and in perception of far-red wavelengths in seedlings. MtPHYA positively regulates the expression of MtE1-like (MtE1L), a homologue of an important legume-specific flowering time gene, E1 in soybean and other Medicago LD-regulated flowering-time gene homologues, including the three FLOWERING LOCUS T-LIKE (FT-LIKE) genes, MtFTa1, MtFTb1 and MtFTb2 and the two FRUITFULL-LIKE (FUL-LIKE) genes MtFULa and MtFULb. MtPHYA also modulates the expression of the circadian clock genes, GIGANTEA (GI) and TIMING OF CAB EXPRESSION 1a (TOC1a). Genetic analyses indicate that Mtphya-1 Mte1l double mutants flowered at the same time as the single mutants. However, Mtphya-1 Mtfta1 double mutants had a weak additive effect in delaying flowering and in reduction of primary axis lengths beyond what was conferred by either of the single mutants.

Conclusion
MtPHYA has an important role in LD photoperiodic control of flowering, plant architecture and seedling de-etiolation under far-red wavelengths in Medicago. It promotes the expression of LD-induced flowering time genes and modulates clock-related genes. In addition to MtFTa1, MtPHYA likely regulates other targets during LD floral induction in Medicago.
Effect of student-led health interventions on patient outcomes for those with cardiovascular disease or cardiovascular disease risk factors: a systematic review
Authors: Suen Jenni , Attrill Stacie , Thomas Jolene M. , Smale Matilda , Delaney Christopher L. , Miller Michelle D. 
Published: July 2020

Abstract
Background
As the need for health care services rise, alternative service delivery models such as student-led health interventions become attractive alternatives to alleviate the burden on healthcare. Predominantly, student-led health interventions were free clinics servicing socially disadvantaged communities in the USA. A 2015 systematic review identified that students value these student-run clinics and reported skill and knowledge attainment from participating. Previous research has reported on patient satisfaction outcomes, but less frequently about the clinical outcomes patients accrue from these student-delivered services. As cardiovascular disease is the leading cause of death worldwide, this review aimed to explore the effectiveness of student-led health interventions through examining their impact on objective clinical outcomes, using the case of patients at risk of, or with, cardiovascular disease.

Methods
A systematic literature search was conducted in eight electronic databases to identify student-led health interventions conducted on adults with a cardiovascular disease risk factor or established cardiovascular disease, and a clinical outcome of interest. Through double-blinded screening and data extraction, sixteen studies were identified for synthesis.

Results
The majority of student-led health interventions for patients at risk of cardiovascular disease demonstrated a positive impact on patient health. Statistically significant changes amongst patients at risk of cardiovascular disease appeared to be associated with student-led individualised intervention or group-based interventions amongst patients with diabetes or those who are overweight or obese. The evidence was of moderate quality, as included studies lacked a control group for comparison and detail to enable the intervention to be replicated.

Conclusions
Future research applying a student-led health intervention through a randomised control trial, with rigorous reporting of both student and patient interventions and outcomes, are required to further understand the effectiveness of this alternative service delivery model.
Heart rate variability and pulmonary dysfunction in rats subjected to hemorrhagic shock
Authors: Khodadadi Fateme , Bahaoddini Aminollah , Tavassoli Alireza , Ketabchi Farzaneh 
Published: July 2020

Abstract
Background
The activity of autonomic nervous system and its association with organ damage have not been entirely elucidated in hemorrhagic shock. The aim of this study was to investigate heart rate variability (HRV) and pulmonary gas exchange in hemorrhagic shock during unilateral subdiaphragmatic vagotomy.

Methods
Male Sprague Dawley rats were randomly assigned into groups of Sham, vagotomized (Vag), hemorrhagic shock (HS) and Vag + HS. HS was induced in conscious animals by blood withdrawal until reaching to mean arterial blood pressure (MAP) of 40 ± 5 mmHg. Then, it was allowed to MAP returning toward the basal values. MAP and heart rate (HR) were recorded throughout the experiments, HRV components of low (LF, sympathetic index), high (LH, parasympathetic index), and very low (VLF, injury index) frequencies and the LF/HF ratio calculated, and the lung histological and blood gas parameters assessed.

Results
In the initial phases of HS, the increase in HR with no change in MAP were observed in both HS and Vag + HS groups, while LF increased only in the HS group. In the second phase, HR and MAP decreased sharply in the HS group, whereas, only MAP decreased in the Vag + HS group. Meanwhile, LF and HF increased relative to their baselines in the HS and Vag + HS groups, even though the values were much pronounced in the HS group. In the third phase, HR, MAP, LF, HF, and the LF/HF ratio were returned back to their baselines in both HS and Vag + HS groups. In the Vag + HS group, the VLF was lower and HR was higher than those in the other groups. Furthermore, blood gas parameters and lung histology indicated the impairment of gas exchange in the Vag + HS group.

Conclusions
The sympathetic activity is predominant in the first phase, whereas the parasympathetic activity is dominant in the second and third phases of hemorrhagic shock. There is an inverse relationship between the level of VLF and lung injury in vagotomized animals subjected to hemorrhagic shock.
The risk factors for calcification vary among the different sections of the lower extremity artery in patients with symptomatic peripheral arterial disease
Authors: Yan Hankun , Chang Zhihui , Liu Zhaoyu 
Published: July 2020

Abstract
Background
Peripheral arterial disease (PAD) is associated with considerable mortality and morbidity worldwide. The present study explored the risk factors for arterial calcification among the different sections of the lower extremity in patients with PAD and analyzed their correlations with the extent of arterial stenosis at the corresponding section.

Methods
This study enrolled symptomatic PAD patients from our hospital from March 2017 to March 2018. The lower extremity arterial calcification score (LEACS) and lower extremity arterial stenosis index (LEASI), representing the extent of arterial stenosis, were measured on computed tomography (CT) and the correlations between them were analyzed using Spearman’s correlation analysis. The relationships between risk factors and calcification were analyzed among the different sections of the lower extremity artery.

Results
In total, 209 patients were included. The LEACSs of the total lower extremity, aortoiliac artery, and femoropopliteal and infrapopliteal arteries were correlated with the LEASI (all P < 0.05), but their correlation was relatively weak in the aortoiliac artery. Univariate analysis showed that hypertension was associated with the total (P = 0.019) and aortoiliac (P = 0.012) LEACSs. Diabetes was related to both femoropopliteal (P = 0.001) and infrapopliteal (P = 0.002) LEACSs. The infrapopliteal LEACS was higher in male patients (P = 0.011). After adjustment for age, the above relationships were maintained among the different sections, but not in the total lower extremity artery.

Conclusions
The LEACS is associated with the LEASI in all arterial sections, but that of the aortoiliac artery was relatively weak. Different factors have different effects on calcification among the various sections of the lower extremity artery.
Cross-cultural validation and psychometrics’ evaluation of women’s experience of maternity care scale in French: the ESEM
Authors: Floris L. , de Labrusse C. 
Published: July 2020

Abstract
Background
Evaluating women’s satisfaction should reflect the entire maternity care experience (antenatal, intrapartum and postnatal). The Women’s Experience Maternity Care Scale (WEMCS) questionnaire enables this assessment. The purpose of this study was to translate in French, adapt and explore the psychometric properties of the WEMCS and to determine the best cut-off on the optimal satisfaction for the three scales.

Methods
Backward, forward translation and cross-cultural adaptation were processed to validate the French version of WEMCS: Échelle de Satisfaction de l’Experience des soins en Maternité (ESEM). Psychometric tests assessed the questionnaire, which includes three scales, such as construct validity, internal consistency, Cronbach’s alpha coefficients and ceiling and floor effects. A receiver operating characteristic (ROC) curve was used to determine the best cut-off values for optimal satisfaction. Reproducibility was verified by test–retest reliability.

Results
Primiparas with uncomplicated pregnancies were recruited antenatally at the University Hospital of Geneva. Of the 229 patients who agreed to participate, 202 women (88.2%) returned the test and retest questionnaires. Principal component analysis for the antenatal, intrapartum and postnatal scales suggested the unidimensional character of the three scales; Cronbach’s alpha coefficients were high for the three scales with values of > 0.85. Construct validity based on the five-point Likert scale values showed a Spearman’s rho correlation of r = 0.56 for the antenatal scale (p < 0.001) and r = 0.62 for the intrapartum scale (p < 0.001), as well as a strong correlation with the postnatal scale, with r = 0.78 (p < 0.001). Optimum cut-off scores for the ROC curve of the antenatal, intrapartum and postnatal scores were equal to or higher than 48, 50 and 70, respectively. The three scales showed good sensitivity and good specificity. The stability of the ESEM questionnaire was confirmed by intra-class correlation coefficients of > 0.80. However, the three scales revealed ceiling effects.

Conclusion
The psychometric proprieties of the ESEM demonstrate it’s ability to evaluate the quality of perinatal health care. The ESEM should be tested in the context of different models of women’s care and with women with different degrees of pregnancy complications to explore the validity of this scale.
A case report of gastric amyloidosis due to multiple myeloma mimicking gastric cancer
Authors: Xiao Huini , Qing Duxin , Li Chenjie , Zhou Hejun 
Published: July 2020

Abstract
Background
Gastrointestinal (GI) amyloidosis is a rare complication of multiple myeloma (MM). Due to its nonspecific clinical presentation and endoscopic appearance, an early and accurate diagnosis of GI amyloidosis is difficult. Here, we report a case of GI amyloidosis due to MM, which initially presented as GI manifestations mimicking gastric cancer.

Case presentation
A 68-year-old woman presented to the hospital with a 6-month history of anemia, coupled with a recent onset of poor appetite and vomiting for 10 days. Esophagogastroduodenoscopy revealed a gastric antrum mucosal bulge that appeared on visual inspection to be a tumor. As a result, gastric cancer was suspected. However, gastric antrum biopsies demonstrated mild chronic superficial gastritis and esophageal biopsies demonstrated moderate-to-severe atypical hyperplasia of the squamous epithelium. A second endoscopy revealed massive gastric retention and a gastric antrum mucosal bulge with surface erosion. Ultimately, an upper GI tract biopsy demonstrating positive Congo red staining and a bone marrow biopsy indicating plasmacytosis confirmed the diagnosis of gastric amyloidosis due to MM.

Conclusion
This case demonstrates that MM should be considered in patients with nonspecific GI manifestations, and in such cases, a biopsy with Congo red staining should be considered to confirm GI amyloidosis. Early detection of GI amyloidosis will ultimately improve outcomes for these rare patients.
Pancreatic undifferentiated carcinoma with osteoclast-like giant cells curatively resected after pembrolizumab therapy for lung metastases: a case report
Authors: Obayashi Miku , Shibasaki Yasushi , Koakutsu Toru , Hayashi Yoshiro , Shoji Tsuyoshi , Hirayama Kazuhisa , Yamazaki Masanori , Takayanagi Yasuhiro , Shibata Hiroshi , Nakamura Masato , Maruo Hirotoshi 
Published: July 2020

Abstract
Background
Therapy targeting programmed death-1 or programmed death-1 ligand-1 (PD-1/PD-L1) has been developed for various solid malignant tumors, such as melanoma and non-small-cell lung cancer (NSCLC), but this approach has little effect in the treatment of pancreatic cancer. Pancreatic undifferentiated carcinoma with osteoclast-like giant cells (UCOGC) is a rare pancreatic malignancy having unique morphology and is considered a variant of pancreatic ductal adenocarcinoma (PDAC). Although UCOGC has been reported to have better prognosis than conventional PDAC, the optimal treatment for UCOGC with distant metastases has not been determined.

Case presentation
A 66-year-old man was initially diagnosed with NSCLC with multiple intrapulmonary metastases and abdominal lymph node metastasis in the tail of the pancreas, and bronchial biopsy and diagnostic imaging were performed. Pathologic examination of the lung showed poorly differentiated adenocarcinoma cells expressing epithelial marker and PD-L1. Therefore, pembrolizumab monotherapy for NSCLC was given. The pulmonary lesions shrank markedly and were in complete remission after 8 months of anti-PD-1 therapy, though no therapeutic effect was observed in the pancreatic site. Distal pancreatectomy was then performed, and histopathological examination showed that the tumor was UCOGC originating from the pancreas. The histologic findings of the resected specimen mimicked those of the lung biopsy specimen, leading to the final assessment that the lung tumors were metastatic foci that migrated from the UCOGC, and only the metastatic lesions benefited from pembrolizumab therapy.

Conclusion
Immune checkpoint inhibitors have limited therapeutic effects on primary lesions of pancreatic cancer, but they may exert antitumor effects on pulmonary metastases of UCOGC.
Fruit and vegetable consumption is associated with lower prevalence of asymptomatic diverticulosis: a cross-sectional colonoscopy-based study
Authors: Maxner Benjamin , McGoldrick Jessica , Bellavance Danielle , Liu Po-Hong , Xavier Ramnik J. , Yarze Joseph C. , Ricciardi Rocco , Staller Kyle , Chung Daniel C. , Khalili Hamed 
Published: July 2020

Abstract
Background
Previous studies of the relationship between dietary factors and risk of diverticulosis have yielded inconsistent results. We therefore sought to investigate the association between consumption of fruit and vegetables and prevalent diverticulosis.

Methods
Our study population included participants in the Gastrointestinal Disease and Endoscopy Registry (GIDER), a colonoscopy-based longitudinal cohort at the Massachusetts General Hospital, who provided comprehensive information on dietary intake and lifestyle factors using validated questionnaires prior to colonoscopy. Information on presence and location of diverticula was obtained from the endoscopist at the end of each procedure. We used Poisson regression modeling to calculate the prevalence ratios (PRs) and 95% confidence intervals (CIs).

Results
Among 549 participants with a mean age of 61 years enrolled in GIDER, we confirmed diverticulosis in 245 (44.6%). The prevalence of diverticulosis appeared to decrease with higher consumption of fruit and vegetables (Ptrend = 0.007 for fruit and 0.008 for vegetables, respectively). Compared to participants with less than five servings of vegetables per week, the multivariable-adjusted PRs of diverticulosis were 0.84 (95% CI, 0.60–1.17) with five to seven servings per week and 0.62 (95% CI, 0.44–0.89) with greater than one serving per day. Similarly, compared to participants with less than five servings per week of fruit, the multivariable-adjusted PR of diverticulosis was 0.60 (95% CI, 0.41–0.87) with greater than one serving per day. These associations were not modified by age, BMI, smoking, or red meat intake (All Pinteraction > 0.055).

Conclusion
In a colonoscopy-based longitudinal cohort study, we show that higher consumption of fruit and vegetables is associated with lower risk of prevalent diverticulosis.
Socio-demographic characteristics and cognitive performance in oldest old subjects asking for driving license renewal
Authors: Bernardelli Giuseppina , Caruso Palmina , Travaini Guido , Merzagora Isabella , Gualdi Francesca , Sartori Raffaela D. G. , Mari Daniela , Cesari Matteo , Edefonti Valeria 
Published: July 2020

Abstract
Background
No papers have examined the relationship between socio-demographic characteristics and cognitive performance in oldest old subjects (i.e, > = 80 years old) asking for driving license renewal. We hypothesize that, even in this highly functioning population, age, sex, and education influence cognitive performance, expressed as total or single domain (raw) test scores. This research question allows to describe, identify, and preserve independence of subjects still able to drive safely.

Methods
We examined cross-sectionally a cohort of > = 80 years old subjects (at enrollment) asking for driving license renewal in the Milan area, Italy, 2011–2017. The analysis was restricted to 3378 first and 863 second visits where individual’s cognitive performance was evaluated. According to the study protocol, the Mini Mental State Examination (MMSE) test was administered at the first visit for driving license renewal and the Montreal Cognitive Assessment (MoCA) test at the second visit, following an additional renewal request. Ordinary least squares regression models were fitted at either time points. In each model, we included age, sex, and education as independent variables, whereas the dependent variable was total or single domain score for either test. In total, we fitted 15 regression models to assess our research hypothesis.

Results
The median subject in our sample reached the maximum scores on domains targeting operational and tactical abilities implied in safe driving, but had sub-optimal scores in the long-term memory domain included among the strategic abilities. In multiple models, being > = 87 (versus 80- < 86 years old) significantly decreased the mean total and memory scores of MMSE, but not those of the MoCA. Females (versus males) had significantly higher mean total and long-term memory scores of either tests, but not other domains. Mean total and single domain scores increased for increasing education levels for either tests, with increments for high school graduates being ~ 2 of those with (at most) a junior high school diploma.

Conclusions
Sex and education, as well as age to a lesser extent, predict cognitive functioning in our oldest old population, thus confirming that concepts like cognitive reserve and successful ageing are valuable constructs in the identification of older subjects still able to drive.
Estimating the nationwide transmission risk of measles in US schools and impacts of vaccination and supplemental infection control strategies
Authors: Azimi Parham , Keshavarz Zahra , Cedeno Laurent Jose Guillermo , Allen Joseph G. 
Published: July 2020

AbstractBackgroundThe spread of airborne infectious diseases such as measles is a critical public health concern. The U.S. was certified measles-free in 2000, but the number of measles cases has increased in recent years breaking the record of the nationwide annual number of cases since 1992. Although the characteristics of schools have made them one of the most vulnerable environments during infection outbreaks, the transmission risk of measles among students is not completely understood. We aimed to evaluate how three factors influence measles transmission in schools: personal (vaccination), social (compartmentalizing), and building systems (ventilation, purification, and filtration).MethodsWe used a combination of a newly developed multi-zone transient Wells-Riley approach, a nationwide representative School Building Archetype (SBA) model, and a Monte-Carlo simulation to estimate measles risk among U.S. students. We compared our risk results with the range of reported transmission rates of measles in school outbreaks to validate the risk model. We also investigated the effectiveness of vaccination and ten supplemental infection control scenarios for reducing the risk of measles transmission among students.ResultsOur best nationwide estimate of measles transmission risk in U.S. schools were 3.5 and 32% among all (both unvaccinated and immunized) and unvaccinated students, respectively. The results showed the transmission risk of measles among unvaccinated students is > 70 times higher than properly immunized ones. We also demonstrated that the transmission risk of measles in primary schools (assuming teacher self-contained classrooms) is less than secondary schools (assuming departmentalized systems). For building-level interventions, schools with ductless-with-air-filter and ductless-without-air-filter systems have the lowest and highest transmission risks of measles, respectively. Finally, our simulation showed that infection control strategies could cut the average number of infected cases among all students in half when a combination of advanced air filtration, ventilation, and purification was adopted in the modeled schools.ConclusionsOur results highlight the primary importance of vaccination for reducing the risk of measles transmission among students. Yet, additional and significant risk reduction can be achieved through compartmentalizing students and enhancing building ventilation and filtration systems.