bluuebunny/crossref_metadata_2025_split huggingface dataset:
Production of constitutive and induced secondary metabolites is coordinated with growth and storage in Norway spruce saplings
Authors: Huang Jianbei , Rücker Alexander , Schmidt Axel , Gleixner Gerd , Gershenzon Jonathan , Trumbore Susan , Hartmann Henrik 
Published: March 2020

AbstractA mechanistic understanding of how trees balance the trade-offs between growth, storage and defense is limited but crucial for predicting tree responses to abiotic and biotic stresses. Here we investigated how trees allocate storage of non-structural carbohydrates (NSC) to growth and constitutive and induced secondary metabolites (SM). We exposed Norway spruce (Picea abies) saplings to 5 weeks of complete darkness to induce light and/or carbon limitation and then applied methyl jasmonate (MeJA) to simulate biotic attack. We measured changes in biomass, NSC (sum of soluble sugars and starches), and constitutive and induced SM (sum of phenolic compounds and terpenoids) in current-year developing and previous-year mature needles and branches, as well as volatiles emitted from the canopy. Under darkness, NSC storage was preferentially used for constitutive biosynthesis of monoterpenes rather than biosynthesis of stilbenes and growth of developing organs, while SM stored in mature organs cannot be remobilized and recycled. Furthermore, MeJA-induced production of SM was constrained by low NSC availability in developing organs but not in mature organs grown in the dark. Emissions of volatiles were suppressed in the dark but after 1 h of re-illumination, emissions of both constitutive and induced monoterpene hydrocarbons recovered rapidly, whereas emissions of linalool and sesquiterpene produced via de novo synthesis did not recover. Our results highlight that light and/or carbon limitation may constrain constitutive and JA-induced biosynthesis of SM in coordination with growth, NSC storage and mobilization.
“The COVID-19 Generation”: A Cautionary Note
Authors: Rudolph Cort W , Zacher Hannes 
Published: March 2020

Abstract
With COVID-19 presenting as a global pandemic, we have noticed an emerging rhetoric concerning “the COVID-19 Generation,” both anecdotally and across various media outlets. The narratives advanced to support such rhetoric have distinct implications for the study of work, aging, and retirement. In this commentary, we review this emerging issue and present evidence against attempts to define “the COVID-19 Generation” as a new construct along conceptual, methodological, as well as practical lines, with a specific focus on identifying real dangers associated with investigating and potentially managing a new generation associated with this pandemic. We strongly caution against the adoption of “the COVID-19 Generation” as a concept of study and instead offer several suggestions to researchers, organizations, and practitioners seeking answers to complicated questions about links between COVID-19 and various processes relevant to work, aging, and retirement during this time of uncertainty.
Comprehensive analysis of long non-coding RNA and mRNA expression profile in rectal cancer
Authors: Wang De-Zhong , Chen Guan-Yang , Li Yi-Feng , Zhang Neng-Wei 
Published: March 2020

Abstract

Background:
Rectal cancer (RC) is a malignant tumor that seriously threatens human health. Long non-coding RNAs (lncRNAs) play a vital role in tumor regulation. Nevertheless, their exact expression features and functions remain obscure, and therefore was the aim of the current study.

Methods:
We utilized the Affymetrix human GeneChip to screen differentially expressed profiles of lncRNAs and mRNAs from the cancer tissues and matched paracancer tissues of 6 RC patients. Gene Ontology (GO) and pathway enrichment analyses identified crucial functions and pathways of the aberrantly expressed mRNAs. We used quantitative real-time polymerase chain reaction to verify the significant expression differences of 11 candidate lncRNAs between the cancer and paracancer tissues. LncRNA-mRNA coexpression networks were built by calculating the Pearson correlation value to identify significant correlation pairs. Online bioinformatics tools GEPIA2, ONCOMINE, and PROGgeneV2 were used to mine the expression and prognosis of three crucial mRNAs and six verified lncRNAs. Competing endogenous RNA networks were constructed by predicting microRNA response elements and calculating free energy.

Results:
We found 1658 differentially expressed lncRNAs (778 up-regulated and 880 down-regulated) and 1783 aberrantly expressed mRNAs (909 up-regulated and 874 down-regulated). GO and pathway enrichment analyses revealed the vital functions of the differentially expressed mRNAs, including cell proliferation, cell migration, angiogenesis, and cellular response to zinc ion. The canonical signaling pathways mainly included the interleukin-17, cell cycle, Wnt, and mineral absorption signaling pathways. Six lncRNAs including AC017002.2 (P = 0.039), cancer susceptibility 19 (CASC19) (P = 0.021), LINC00152 (P = 0.013), NONHSAT058834 (P = 0.007), NONHSAT007692 (P = 0.045), and ENST00000415991.1 (P = 0.045) showed significant differences in expression levels between the cancer tissue and paracancer tissue groups. AC017002.2, NONHSAT058834, NONHSAT007692, and ENST00000415991.1 have not yet been reported in RC. The crucial mRNAs myelocytomatosis viral oncogene (MYC), transforming growth factor beta induced (TGFBI), and solute carrier family 7 member 5 (SLC7A5) were selected. AC017002.2 and LINC00152 were positively correlated with MYC, TGFBI, and cytochrome P450 family 2 sub-family B member 6 (All r > 0.900, P < 0.050). NONHSAT058834 was positively associated with MYC (r = 0.930, P < 0.001), and CASC19 was positively correlated with SLC7A5 (r = 0.922, P < 0.001).

Conclusion:
This study offers convincing evidence of differentially expressed lncRNAs and mRNAs as potential biomarkers in RC.
Rapid sequence induction
Authors: Klucka Jozef , Kosinova Martina , Zacharowski Kai , De Hert Stefan , Kratochvil Milan , Toukalkova Michaela , Stoudek Roman , Zelinkova Hana , Stourac Petr 
Published: March 2020

BACKGROUNDRapid sequence induction (RSI) is a standard procedure, which should be implemented in all patients with a risk of aspiration/regurgitation during anaesthesia induction.OBJECTIVEThe primary aim was to evaluate clinical practice in RSI, both in adult and paediatric populations.DESIGNOnline survey.SETTINGSA total of 56 countries.PARTICIPANTSMembers of the European Society of Anaesthesiology.MAIN OUTCOME MEASURESThe aim was to identify and describe the actual clinical practice of RSI related to general anaesthesia.RESULTSFrom the 1921 respondents, 76.5% (n=1469) were qualified anaesthesiologists. When anaesthetising adults, the majority (61.7%,n=1081) of the respondents preoxygenated patients with 100% O2for 3 min and 65.9% (n=1155) administered opioids during RSI. The Sellick manoeuvre was used by 38.5% (n=675) and was not used by 37.4% (n=656) of respondents. First-line medications for a haemodynamically stable adult patient were propofol (90.6%,n=1571) and suxamethonium (56.0%,n=932). Manual ventilation (inspiratory pressure <12 cmH2O) was used in 35.5% (n=622) of respondents. In the majority of paediatric patients, 3 min of preoxygenation (56.6%,n=817) and opioids (54.9%,n=797) were administered. The Sellick manoeuvre and manual ventilation (inspiratory pressure <12 cmH2O) in children were used by 23.5% (n=340) and 35.9% (n=517) of respondents, respectively. First-line induction drugs for a haemodynamically stable child were propofol (82.8%,n=1153) and rocuronium (54.7%,n=741).CONCLUSIONWe found significant heterogeneity in the daily clinical practice of RSI. For patient safety, our findings emphasise the need for international RSI guidelines.TRIAL REGISTRATIONClinicalTrials.gov identifier: NCT03694860
Epidemiology, Clinical and Microbiologic Profile and Risk Factors for Inpatient Mortality in Pediatric Severe Sepsis in the United States From 2003 to 2014: A Large Population Analysis
Authors: Thavamani Aravind , Umapathi Krishna Kishore , Dhanpalreddy Harshitha , Khatana Jasmine , Chotikanatis Kobkul , Allareddy Veerajalandhar , Roy Aparna 
Published: March 2020

Objective:
To evaluate the national trends in pediatric severe sepsis in the United States from 2003 to 2014.

Study design:
For this study, we included nonoverlapping years of Kids Inpatient database and National Inpatient Sample database while including hospitalizations of children between 1 and 20 years of age from more than 4200 hospitals across the United States. We identified patient hospitalizations with severe sepsis using specific ICD codes and modified Angus Criteria. Trend analysis of various factors associated with severe sepsis was calculated using the Cochrane–Armitage test. Associated foci of infection and comorbid conditions were identified using specific ICD codes, and a multivariate regression analysis with death as outcome variable was done to evaluate for in hospital predictors of mortality.

Results:
Totally, 109,026 episodes of severe sepsis were identified during the study period between 2003 and 2014. Incidence of severe sepsis hospitalizations increased by 2.5 times (0.64–1.57 per 10,000 population) over the study period with notable concurrent significant decrease in mortality by more than 50%. Lower age, African American, Hispanic ethnicity, complex neurologic conditions, infective endocarditis, immunodeficient states including primary immunodeficiency disorder, HIV, burns, malignancy and transplant status are associated with mortality. There is a significant increase in use of healthcare resources (P < 0.001) with mean charges of 94,966$ despite a notable decrease in mean length of stay (22 vs. 16 days, P < 0.001) over the study period.

Conclusion:
Incidence of pediatric severe sepsis is high leading to a significant use of healthcare resources. This study provides a detailed analysis of associated inpatient factors and comorbidities associated with mortality.
Safety and efficacy data supporting U.S. FDA approval of intracameral phenylephrine and ketorolac 1.0%/0.3% for pediatric cataract surgery: clinical safety and pupil and pain management
Authors: Wilson M. Edward , Trivedi Rupal H. , Plager David A. 
Published: March 2020

Purpose:
To assess the safety of phenylephrine and ketorolac (PE/K) 1.0%/0.3% compared with phenylephrine (PE) 1.0% in children aged 0 to 3 years undergoing cataract surgery. The effect of PE/K to PE on intraoperative pupil diameter and postoperative pain were also compared.

Setting:
Multicenter study in the United States.

Design:
Randomized double-masked phase 3 clinical trial.

Methods:
This study was powered to assess safety only. Depending on randomization, 4 mL of PE/K 1.0%/0.3% or PE 1.0% was injected into the surgical irrigation solution. Safety endpoints were assessed up to 90 days postoperatively. From surgical videos, a masked central reader measured the change in pupil diameter from immediately prior to incision to wound closure. Postoperative pain was measured using Alder Hey Triage Pain Score at 3 hours, 6 hours, 9 hours, and 24 hours following wound closure and recorded by parent/caregiver.

Results:
Seventy-two patients received masked intervention. There were no notable changes in vital signs or ophthalmological complications in either group. Mean change in pupil diameter was similar between PE/K 1.0%/0.3% and PE 1.0% (mean difference in area under the curve −0.071; P = .599). Postoperative ocular pain scores and overall mean scores were lower in PE/K group at all individual time points, and differences in overall mean scores were statistically significant at 6 and 24 hours (P = .029 and 0.021, respectively).

Conclusions:
PE/K 1.0%/0.3% was safe for use in children and maintained mydriasis during cataract surgery. Postoperative pain levels were lower in the PE/K 1.0%/0.3% group.
Energy Balance-Related Behaviors and Body Mass Index in Asian School-Aged Children With Congenital Heart Disease
Authors: Yang Fu-Ling , Gau Bih-Shya , Yang Hsiao-Ling , Lin Ming-Tai , Moons Philip 
Published: March 2020

Background
Overweight/obesity is a substantial global public health concern, which can be caused by genetic factors and energy balance-related behaviors (EBRBs). If it occurs in children with congenital heart disease (CCHD), it can yield an extra burden on their health. Most studies on CCHD have taken place in Western societies, leaving Asian populations understudied, especially children.

Objective
We sought (1) to determine body mass index distribution among school-aged CCHD in Taiwan, (2) to ascertain whether the body mass index of CCHD differs from that of the general population, (3) to describe EBRBs in CCHD, and (4) to identify factors associated with underweight and overweight/obesity among CCHD.

Methods
In this cross-sectional study, 97 child-parent dyads (53.6% boys; mean age, 9.73 years; 25.8% moderate-to-severe heart conditions) were enrolled. Self-administered questionnaires were used to collect demographics, medical factors, food frequency, physical activity, and sedentary behaviors. Anthropometric measurements were taken in the hospital. Independent predictors of EBRBs and health conditions were calculated through logistic regression analysis.

Results
Among Taiwanese CCHD, 19.6% were underweight and 14.4% were overweight/obese. Children with moderate-to-severe heart defects were more often underweight. Body mass index did not differ between CCHD and children in the general population. More complex heart defects and asthma were associated with being underweight, whereas sedentary behaviors, cardiomegaly, and the New York Heart Association classification II to IV were associated with being overweight/obese.

Conclusions
Sedentary lifestyle is seemingly the only EBRB correlated with being overweight. Physical activity programs for children may help prevent and treat overweight or obesity in Asian CCHD, similar to Western countries.
Reflections on Nursing Ingenuity During the COVID-19 Pandemic
Authors: Newby Jamison C. , Mabry Madison C. , Carlisle Byron A. , Olson DaiWai M. , Lane Blair E. 
Published: March 2020

ABSTRACT

INTRODUCTION: This reflections article provides insight toward nursing innovations to reduce the overuse of personal protective equipment while maintaining a safe environment for staff taking care of COVID-19 patients. The secondary aim of this article to capitalize on recent advances in mass electronic communication through social media to encourage nurses across the globe to share their knowledge and expertise during this pandemic. INNOVATIONS: The many innovations that have been implemented fall into 3 categories of reducing unnecessary use of personal protective equipment, promoting staff safety and readiness, and reducing foot traffic. SUMMARY: These strategies are being shared to promote dissemination of innovative nursing interventions that will save lives during the COVID-19 pandemic.
Serum Metabolites in Hand-Arm Vibration Exposed Workers
Authors: Vihlborg Per , Graff Pål , Hagenbjörk Annika , Hadrévi Jenny , Bryngelsson Ing-Liss , Eriksson Kåre 
Published: March 2020

Objective:
To investigate whether low molecular organic biomarkers could be identified in blood samples from vibration exposed workers using a metabolomics.

Methods:
The study population consisted of 38 metalworkers. All participants underwent a standardized medical examination. Blood samples were collected before and after work shift and analyzed with gas chromatography time-of-flight mass spectrometry. Multivariate modeling (orthogonal partial least-squares analysis with discriminant analysis [OPLS-DA]) were used to verify differences in metabolic profiles.

Results:
Twenty-two study participants reported vascular symptoms judged as vibration-related. The metabolic profile from participants with vibration-induced white fingers (VWF) was distinctly separated from participants without VWF, both before and after vibration exposure.

Conclusion:
Metabolites that differed between the groups were identified both before and after exposure. Some of these metabolites might be indicators of health effects from exposure to vibrations. This is the first time that a metabolomic approach has been used in workers exposed to vibrations.
Multicenter Study Investigating Foreign Language Acquisition at School in Children, Adolescents, and Young Adults With Uni- or Bilateral Cochlear Implants in the Swiss German Population
Authors: Beeres-Scheenstra Renske J. , Azar Alireza Rahimi , Heinzmann Sybille , Stieger Christof , Kompis Martin , Caversaccio Marco , Bodmer Daniel , Huber Alexander , Lehnick Dirk , Candreia Claudia , Linder Thomas E. 
Published: March 2020

Objectives:
Evaluation of foreign language acquisition at school in cochlear implant patients.

Study Design:
Multicenter cohort study.

Setting:
CI centers.

Patients:
One hundred twenty-five CI users (10–18 yr) in the German-speaking part of Switzerland were enrolled. Demographic data were obtained by means of written questionnaires. German-speaking children with mainstream foreign language tuition (English and/or French) were enrolled for further testing. The control group of normal-hearing individuals was matched on age, class, and number of foreign language lessons attended.

Results:
Overall, 100 questionnaires were returned. The 12 CI users without foreign language learning attended special schools. CI users who attended foreign language classes had better German speech comprehension compared with those without foreign language tuition (89 versus 51%; p < 0.05). Thirty-one CI users of different grades were further tested. All (10/10) CI 6th graders attained the school objectives for both English reading and listening skills. French performance at 6th grade for reading was 3/7 and for listening only 1/7. There were 13 matched normal-hearing pairs for English and 10 for French. The total scores were on average 7% higher, with a statistical significance for English reading (p < 0.05).

Conclusions:
Almost 90% of CI children in Switzerland learn foreign language(s) at school. All the tested patients reached the current school objectives for English reading. The success rate for French was lower, especially regarding listening tasks. The 13 matched pairs with normal-hearing did not score substantially better.
Optimization of Cervical and Ocular Vestibular Evoked Myogenic Potential Testing Using an Impulse Hammer in Adults, Adolescents, and Children
Authors: Rodriguez Amanda I. , Marler Elizabeth , Fitzpatrick Denis , Creutz Thomas , Cannon Shauntelle A. , Thomas Megan L. A. , Janky Kristen L. 
Published: March 2020

Objective:
To characterize cervical and ocular vestibular evoked myogenic potential (c- and oVEMP) responses using an impulse hammer (IH) in adults and pediatrics at standardized force levels and evaluate: the relationship of force level on VEMP amplitude, sternocleidomastoid (SCM) contraction on cVEMP amplitude, required number of tap stimuli, and subject comfort. Using these data, optimal testing parameters were selected.

Study Design:
Prospective study.

Setting:
Tertiary referral center.

Patients:
Seventy-eight healthy adults, adolescents, and children with no hearing or vestibular deficits.

Interventions:
All subjects received c- and oVEMP testing using IH and 500 Hz tone burst air conduction stimuli. Adults received hard, medium, and soft force levels. Adolescents and children received medium and soft force levels. A comfort questionnaire was administered pre- and post-testing.

Main Outcome Measures:
IH VEMP response parameters (response rates, latency, cVEMP pre-stimulus SCM Electromyography [EMG], and peak-to-peak amplitude) were assessed per force level. Subjective reporting for patient comfort was also assessed.

Results:
VEMP response rates ranged from 92 to 100%. Force had a linear relationship with VEMP amplitude. SCM contraction had a linear relationship with raw cVEMP amplitude; however, dissipated with amplitude normalization. Force level did not impact the number of taps needed. A minimum peak force of 15 to 20 N, accounting for SCM contraction, and using a lower EMG monitoring limit for cVEMP is recommended to elicit reliable responses.

Conclusions:
Overall, IH VEMP is appropriate and comfortable to use in adults and pediatrics and can be useful when an air conduction stimulus is contraindicated or not preferred.
Allograft hemorrhage as a manifestation of carbapenem-resistant Klebsiella pneumonia infection in kidney transplant recipients
Authors: Wang Zhen , Qian Yeyong , Bai Hongwei , Yang Jintao , Li Xiang 
Published: March 2020

Abstract

Rationale:
Carbapenem-resistant Klebsiella pneumonia (CRKP) infections have been a concerning threat, especially in organ transplant patients with very high mortality. Allograft hemorrhage associated with CRKP infection has never been described.

Patient concerns:
A total of 6 recipients tested positive for CRKP were identified in 297 adult kidney transplant recipients who received kidney from donors according to Chinese type donation after cardiac death (DCD) at our center between January 2006 and December 2017.

Diagnoses:
CRKP identification was performed via Vitek 2 system, and the susceptibility was tested by broth microdilution and disk diffusion. Based on the signs of infection and the positive culture, the diagnosis of CRKP infection was established.

Interventions:
Therapy with antibiotic such as including ceftazidime-avibactam or tigecycline and surgical control of primary infection source including allograft nephrectomy and/or thorough debridement was administrated.

Outcomes:
The most striking aspect was that spontaneous recurrent hemorrhage occurred in all the 6 patients. The mortality of CRKP infection in our study was 50%.

Lessons:
CRKP infection possibly due to donor-to-recipient transmission in DCD kidney transplants was essentially a necrotic hemorrhagic inflammation and characterized by recurrent hemorrhage and high mortality. The pre-donation screening for CRKP colonization should be mandatory and, if positive, donation should be contraindicated. And, the effective infection source control such as allograft nephrectomy and/or thorough debridement was important to improve outcomes. Further investigation will be required to further characterize the clinical efficacy of new pharmacotherapeutic schemes including ceftazidime-avibactam.
Cardiac arrhythmia caused by a novel type of atrial conduction block
Authors: Cai Weixun , Xu Siyi , Li Xiaodong 
Published: March 2020

Abstract

Introduction:
We report an extremely rare case of atrial conduction block with unusual electrocardiogram (ECG) results, which has never been reported before. There are 2 types of atrial conduction block that result in atrial irregularities or complete atrial conduction block. The former is similar to other types of cardiac blocks such as sinus node to atrial block, atrial to ventricular block, or bundle branch blocks, which are characterized by 2 P waves at a specific frequency. This is due to the complete inner atrial block that results in the atrial muscle being divided into 2 parts without conduction between them so that each part has its rhythm generator. The objective of this report is to examine the cause of inner atrial conduction block and to promote awareness of this disorder.

Patient concerns:
An 81-year-old Chinese male patient was examined after complaining about chest discomfort, and it was found that he had atrial tachycardia; ECG results revealed a P wave loss at specific intervals (or P wave separation).

Diagnosis:
A diagnosis of P wave loss at specific intervals (or P wave separation) was made based on ECG results.

Interventions:
An ECG was performed on the patient

Outcomes:
It was unclear whether this patient has atrial separation or a new type of atrial conduction block, but our results revealed that this case presents a novel type of atrial conduction block, which we named ‘P wave block.’

Conclusion:
The type of EKG shown in this case has never been reported. This EKG shows a new type of conduction block in the atrium, temporarily named as a new type of P wave block.