bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genome-wide analysis of the AREB/ABF gene lineage in land plants and functional analysis of TaABF3 in Arabidopsis
Authors: Li Fangfang , Mei Fangming , Zhang Yifang , Li Shumin , Kang Zhensheng , Mao Hude 
Published: December 2020

Abstract
Background: Previous studies have shown that ABFs (abscisic acid-responsive transcription factors) are important ABA-signaling components that participate in abiotic stress response. However, little is known about the function of ABFs in Triticum aestivum. In addition, although various ABFs have been identified in other species, the phylogenetic relationship between ABF transcription factors has not been systemically investigated in land plants. Results: In this study, we systemically collected ABFs from land plants and analyzed the phylogenetic relationship of these ABF genes. The ABF genes are present in all the land plants we investigated, including moss, lycophyte, monocots, and eudicots. Furthermore, these ABF genes are phylogenetically divided into seven subgroups, differentiations that are supported by variation in the gene structure, protein properties, and motif patterns. We further demonstrated that the expression of ABF genes varies among different tissues and developmental stages, and are induced by one or more environmental stresses. Furthermore, we found that three wheat ABFs (TaABF1, TaABF2, and TaABF3) were significantly induced by drought stress. Compared with wild-type (WT) plants, transgenic Arabidopsis plants overexpressing TaABF3 displayed enhanced drought tolerance. Conclusions: These results provide important ground work for understanding the phylogenetic relationships between plant ABF genes. Our results also indicate that TaABFs may participate in regulating plant response to abiotic stresses.
Situational judgment test validity: An exploratory model of the participant response process using cognitive and think-aloud interviews.
Authors: Wolcott Michael D. , Lobczowski Nikki G. , Zeeman Jacqueline M. , McLaughlin Jacqueline E. 
Published: December 2020

Abstract
Background: Situational judgment tests (SJTs) are used in health sciences education to measure examinee knowledge using case-based scenarios. Despite their popularity, there is a significant gap in the validity research on the response process that demonstrates how SJTs measure their intended constructs. A model of SJT response processes has been proposed in the literature by Robert Ployhart; however, few studies have explored and expanded the factors. The purpose of this study was to describe the factors involved in cognitive processes that examinees use as they respond to SJT items in a health professions education context.Methods: Thirty participants—15 student pharmacists and 15 practicing pharmacists—completed a 12-item SJT designed to measure empathy. Each participant engaged in a think-aloud interview while completing the SJT, followed by a cognitive interview probing their decision-making processes. Interviews were transcribed and independently coded by three researchers to identify salient factors that contributed to response processes.Results: The findings suggest SJT response processes include all four stages (comprehension, retrieval, judgment, and response selection) as initially proposed by Ployhart. The study showed factors from other published research were present, including job-specific knowledge and experiences, emotional intelligence, and test-taking. The study also identified new factors not yet described, including identifying a task objective in the scenario, assumptions about the scenario, perceptions about the scenario, and the setting of the item.Conclusions: This study provides additional SJT validity evidence by exploring participants’ response processes through cognitive and think-aloud interviews. It also confirmed the four-stage model previously described by Ployhart and identified new factors that may influence SJT response processes. This study contributes to the literature with an expanded SJT response process model in a health professions education context and offers an approach to evaluate SJT response processes in the future.
Effects on applying Micro-Film Case-Based Learning model in pediatrics education
Authors: Pan Yuan , Chen Xiuqi , Wei Qiuwen , Zhao Jinmin , Chen Xun 
Published: December 2020

Abstract
Background: In view of the harsh reality Chinese paediatricians face, the challenge of paediatric education is about instilling not only knowledge and clinical skills but also resilience and beliefs. The aim of the study is to explore a more effective method than the traditional lecture-based learning (LBL) model for optimizing educational outcomes by establishing an innovative, comprehensive, case-based learning (CBL) model combined with the micro-film technique (MF+CBL). This approach has four important components: interests (attraction), knowledge application, competency, and scenario coping skills.Methods: Experimental research was conducted via a controlled parallel group study. The total sample of 104 senior-year students (Chinese) majoring in clinical medicine was randomly divided into two groups. The experimental group was exposed to the MF+CBL model and the control group to the LBL model. Overall, the results were assessed after an 8-week course via a student self-assessment questionnaire, a satisfaction survey and the final examination.Results: The experimental group generally performed better than the control group on the student self-assessment (P＜0.05), satisfaction survey (P＜0.05), and final examination (80.02±3.77 vs 73.65±3.69, P = 0.000). The open question at the end of the questionnaire revealed that a small number of students did not favour the MF+CBL model due to its time- and energy-consuming features.Conclusions: Compared with LBL, the MF+CBL model was an innovative teaching method that promoted more comprehensive quality development. It represents an alternative model for optimizing the capacity of future paediatric doctors.
Risk-adapted treatment reduced chemotherapy exposure for clinical stage 1 pediatric testicular cancer
Authors: ye yunlin , Chen Zhuang-fei , Bian Jun , Liang Hai-tao , Qin Zi-ke 
Published: December 2020

Abstract
Background: Different from adult clinical stage I (CS1) testicular cancer, surveillance has been recommended for CS1 pediatric testicular cancer. However, among high-risk children, more than 50% suffer a relapse and progression during surveillance, and adjuvant chemotherapy needs to be administered. Risk-adapted treatment might reduce chemotherapy exposure among these children.Methods: A decision model was designed and calculated using TreeAge Pro 2011 software. Clinical utilities such as the relapse rates of different groups during surveillance or after chemotherapy were collected from the literature. A survey of urologists was conducted to evaluate the toxicity of first-line and second-line chemotherapy. Using the decision analysis model, chemotherapy exposure of the risk-adapted treatment and surveillance strategies were compared based on this series of clinical utilities. One-way and two-way tests were applied to check the feasibility.Results: In the base case decision analysis of CS1 pediatric testicular cancer, risk-adapted treatment resulted in a lower exposure to chemotherapy than surveillance (average: 0.7965 cycles verse 1.3419 cycles). The sensitivity analysis demonstrated that when the relapse rate after primary chemotherapy was ≤0.10 and the relapse rate of the high-risk group was ≥0.40, risk-adapted treatment would result in a lower exposure to chemotherapy, without any association with the proportion of low-risk patients, the relapse rate of the low-risk group, the relapse rate after salvage chemotherapy or the toxicity utility of second-line chemotherapy compared to first-line chemotherapy.Conclusions: Based on the decision analysis, risk-adapted treatment might decrease chemotherapy exposure for these high-risk patients, and an evaluation after orchiectomy was critical to this process. Additional clinical studies are needed to validate this statement.
Frailty Indexed Classification of Bangladeshi Older Adults’ Physio-psychosocial Health and Associated Risk Factors- A Cross-sectional Survey Study
Authors: Rahman Mohammad Meshbahur , Hamiduzzaman Mohammad , Akter Saleha , Farhana Zaki , Hossain Mohammad Kamal , Hasan Mohammad Nayeem , Islam Md. Nazrul 
Published: December 2020

Abstract
Background: Frailty is associated with healthy ageing, and it has been identified as a means of measuring older adults’ physio-psychosocial health. We know about the ageing trends and common diseases of older adults living in South Asia, but literature to date does not widely feature their health status based on frailty, especially in Bangladesh. This study aims to understand the prevalence of frailty in Bangladeshi older adults; classify their health status; and investigate associated risk factors.Methods: A cross-sectional study was conducted in the north-eastern region (i.e. Sylhet City Corporation) of Bangladesh. Four hundred participants aged 55 years and above were randomly selected, attended a health assessment session and completed a multi-indicator survey questionnaire. We developed a 30-indicator Frailty Index (FI30) to assess the participant’s health status and categorized: good health (no-frailty/Fit); slightly poor health (mild frailty); poor health (moderate frailty); and very poor health (severe frailty). Pearson chi-square test and binary logistic regression analysis were conducted.Results: The participants’ mean age was 63.6 years, and 61.6% of them were assessed in poor to very poor health (moderate frailty/36.3% - severe frailty/25.3%). The eldest, female and participants from lower family income were found more frailty than their counterparts. Participants aged 70 years and above were more likely (adjusted OR: 4.23, 95 % CI: 2.26–7.92, p < 0.0001) to experience frailty (medical conditions) than the pre-elderly age group (55-59 years). Female participants were more vulnerable (adjusted OR=1.487, 95% CI: 0.84-2.64, p < 0.0174) to frailty (medical conditions) than male. Also, older adults who had higher family income (Income>$473.3) found a lower risk (adjusted OR: 0.294, 95% CI: 0.11-0.76, p<0.011) of frailty (poor health).Conclusion: Our study results confirm the prevalence of frailty-related disorders in Bangladeshi older adults and highlight the importance of targeted clinical and community-led preventive care programs.
The need for additional mental health support for women in the postpartum period in the times of epidemic crisis
Authors: Chrzan-Dętkoś Magdalena , Walczak-Kozłowska Tamara Zofia , Lipowska Małgorzata 
Published: December 2020

Abstract
Background: This retrospective study aimed to identify possible intensification of mental health difficulties among women seeking support in the postpartum period during the epidemic state in Poland. We assumed that the epidemic crisis, social isolation, and restrictions in hospitals which affect pregnant and postpartum women - lack of family labors, lack of the possibility to be with the newborn when he/she is hospitalized, may increase fear and reduce psychosocial resources of women, hinder their normal process of transition to motherhood and thus contribute to the intensified severity of depressive symptoms.Methods: The study participants were women seeking support at the on-line platform of the project ‘Next Stop: Mum’, which is a part of the postpartum depression prevention’s program implemented by the Ministry of Health in Poland, and enables remote self-screening for the severity of the postpartum depression symptoms with the Edinburgh Postpartum Depression Scale developed by Cox and collaborators. The analyzed data in this study were obtained from 139 women: 61 filled forms from October 1 - November 10, 2019 (non-epidemic period), and 78 filled forms from February 20 - March 30 (beginning of the COVID-19 epidemic), 2020.Results: A statistically significant difference in the severity of postpartum depression symptoms were observed among women making a self-assessment with EPDS scale at the beginning of the COVID-19 epidemic in Poland (M = 15.71; SD = 6.23), compared to the pre-epidemic neutral period (M = 13.56; SD = 6.46).Conclusions: The results of this study indicate that the epidemic crisis may be associated with an increased need for additional caution and support of women's mental health in the postpartum period. We believe that recommendations for medical staff, policy, and families of women struggling with postpartum depression symptoms during crisis should be widespread as the second wave of COVID-19 disease may develop in the autumn-winter 2020 and spring 2021.
Will Virtual Multidisciplinary Team Meetings Become the Norm for Musculoskeletal Oncology Care following the COVID-19 Pandemic? - Experience from a tertiary sarcoma centre
Authors: Rajasekaran Raja Bhaskara , Whitwell Duncan , Cosker Thomas D.A. , Gibbons Christopher L.M.H , Carr Andrew 
Published: December 2020

Abstract
Background: Like with all cancers, multidisciplinary team (MDT) meetings are the norm in bone and soft tissue tumour (BST) management too. Problem in attendance of specialists due to geographical location is the one of the key barriers to effective functioning of MDTs. To overcome this problem, virtual MDTs involving videoconferencing or telemedicine have been proposed, but however this has been seldom used and tested. The COVID-19 pandemic forced the implementation of virtual MDTs in the Oxford sarcoma service in order to maintain normal service provision. We conducted a survey among the participants to evaluate its efficacy.Methods: An online questionnaire comprising of 24 questions organised into 4 sections was circulated among all participants of the MDT after completion of 8 virtual MDTs. Opinions were sought comparing virtual MDTs to the conventional face-to-face MDTs on various aspects. A total of 36 responses were received and were evaluated.Results: 72.8% were satisfied with the depth of discussion in virtual MDTs and 83.3% felt that the decision-making in diagnosis had not changed following the switch from face-to-face MDTs. About 86% reported to have all essential patient data was available to make decisions and 88.9% were satisfied with the time for discussion of patient issues over virtual platform. Three-fourths of the participants were satisfied (36.1% - highly satisfied; 38.9% - moderately satisfied) with virtual MDTs and 55.6% of them were happy to attend MDTs only by the virtual platform in the future. Regarding future, 77.8% of the participants opined that virtual MDTs would be the future of cancer care and an overwhelming majority (91.7%) felt that the present exercise would serve as a precursor to global MDTs involving specialists from abroad in the future.Conclusion: Our study shows that the forced switch to virtual MDTs in sarcoma care following the unprecedented COVID-19 pandemic to be a viable and effective alternative to conventional face-to-face MDTs. With effective and efficient software in place, virtual MDTs would also facilitate in forming extended MDTs in seeking opinions on complex cases from specialists abroad and can expand cancer care globally.
Vagus nerve stimulation ameliorates L-NAME-induced preeclampsia-like symptoms in rats through inhibition of the inflammatory response
Authors: Zheng Linmei , Tang Rong , Shi Lei , Zhong Mei , Zhou Zhongyi 
Published: December 2020

Abstract
Background Preeclampsia is characterized by an excessive inflammatory response. Recent studies have shown that vagus nerve stimulation (VNS) has anti-inflammatory properties in vivo. This study aims to investigate whether VNS is safe for use during pregnancy and to explore the therapeutic potential and underlying mechanisms of VNS in PE. Methods Pregnant Sprague-Dawley rats were randomly chosen to receive N-nitro-L-arginine methyl ester (L-NAME)-containing water (preeclampsia-like mouse model) or saline (normal pregnancy control) daily at gestational days 14.5-20.5. VNS and the α7nAChR antagonist methyllycaconitine citrate (MLA, 1 mg/kg/d) were given daily at the same time. Results VNS decreased the high systolic blood pressure and urinary protein observed in the PE rats. In addition, VNS mitigated abnormal pregnancy outcomes. Moreover, VNS alleviated the inflammatory response by decreasing the levels of inflammatory cytokines. VNS significantly increased the expression of α7nAChR and attenuated the activation of NF-κB p65 in the placenta. Discussion Our findings indicate that maternal VNS treatment is safe during pregnancy and has a protective effect in a pregnant rat model of preeclampsia induced by L-NAME.
Severity-associated markers and assessment model for predicting the severity of COVID-19: a retrospective study in Hangzhou, China
Authors: Qi Jianjiang , He Di , Yang Dagan , Wang Mengyan , Ma Wenjun , Cui Huaizhong , Ye Fei , Wang Fei , Xu Jinjian , Li Zhijian , Liu Chuntao , Wu Jing , Qi Kexin , Wu Rui , Huang Jinsong , Liu Shourong , Zhu Yimin 
Published: December 2020

Abstract
Background: The severity of COVID-19 associates with the clinical decision making and the prognosis of COVID-19 patients, therefore, early identification of patients who are likely to develop severe or critical COVID-19 is critical in clinical practice. The aim of this study was to screen severity-associated markers and construct an assessment model for predicting the severity of COVID-19.Methods: 172 confirmed COVID-19 patients were enrolled from two designated hospitals in Hangzhou, China. Ordinal logistic regression was used to screen severity-associated markers. Least Absolute Shrinkage and Selection Operator (LASSO) regression was performed for further feature selection. Assessment models were constructed using logistic regression, ridge regression, support vector machine and random forest. The area under the receiver operator characteristic curve (AUROC) was used to evaluate the performance of different models. Internal validation was performed by using bootstrap with 500 re-sampling in the training set, and external validation was performed in the validation set for the four models, respectively.Results: Age, comorbidity, fever, and 18 laboratory markers were associated with the severity of COVID-19 (all P values <0.05). By LASSO regression, eight markers were included for the assessment model construction. The ridge regression model had the best performance with AUROCs of 0.930 (95% CI, 0.914-0.943) and 0.827 (95% CI, 0.716-0.921) in the internal and external validations, respectively. A risk score, established based on the ridge regression model, had good discrimination in all patients with an AUROC of 0.897 (95% CI 0.845-0.940), and a well-fitted calibration curve. Using the optimal cutoff value of 71, the sensitivity and specificity were 87.1% and 78.1%, respectively. A web-based assessment system was developed based on the risk score.Conclusions: Eight clinical markers of lactate dehydrogenase, C-reactive protein, albumin, comorbidity, electrolyte disturbance, coagulation function, eosinophil and lymphocyte counts were associated with the severity of COVID-19. An assessment model constructed with these eight markers would help the clinician to evaluate the likelihood of developing severity of COVID-19 at admission and early take measures on clinical treatment.
Effects of trees, gardens, and nature trails on heat index and child health: Design and methods of the Green Schoolyards Project
Authors: Lanza Kevin , Alcazar Melody , Hoelscher Deanna M. , Kohl III Harold W. 
Published: December 2020

Abstract
Background: Latinx children in the United States are at high risk for nature-deficit disorder, heat-related illness, and physical inactivity. We developed the Green Schoolyards Project to investigate how green features—trees, gardens, and nature trails—in school parks impact heat index (i.e., air temperature and relative humidity) within parks, and physical activity levels and socioemotional well-being of these children. Herein, we present novel methods for a) observing children’s interaction with green features and b) measuring heat index and children’s behaviors in a natural setting, and a selection of baseline results.Methods: During two September weeks (high temperature) and one November week (moderate temperature) in 2019, we examined three joint-use elementary school parks in Central Texas, United States, serving predominantly low-income Latinx families. To develop thermal profiles for each park, we installed 10 air temperature/relative humidity sensors per park, selecting sites based on land cover, land use, and even spatial coverage. We measured green features within a geographic information system. In a cross-sectional study, we used an adapted version of System for Observing Play and Recreation in Communities (SOPARC) to assess children’s physical activity levels and interactions with green features. In a cohort study, we equipped 30 3rd and 30 4th grade students per school during recess with accelerometers and Global Positioning System devices, and surveyed these students regarding their connection to nature. Baseline analyses included inverse distance weighting for thermal profiles and summing observed counts of children interacting with trees.Results: In September 2019, average daily heat index ranged 2.0°F among park sites, and maximum daily heat index ranged from 103.4°F (air temperature = 33.8°C; relative humidity = 55.2%) under tree canopy to 114.1°F (air temperature = 37.9°C; relative humidity = 45.2%) on an unshaded playground. 10.8% more girls and 25.4% more boys interacted with trees in September than in November.Conclusions: We found extreme heat conditions at select sites within parks, and children positioning themselves under trees during periods of high heat index. These methods can be used by public health researchers and practitioners to inform the redesign of greenspaces in the face of climate change and health inequities.
Measuring Adoption of Patient Priorities–Aligned Care Using Natural Language Processing of Electronic Health Records: Development and Validation of the Model
Authors: Razjouyan Javad , Freytag Jennifer , Dindo Lilian , Kiefer Lea , Odom Edward , Halaszynski Jaime , Silva Jennifer W , Naik Aanand D 
Published: December 2020

Background
Patient Priorities Care (PPC) is a model of care that aligns health care recommendations with priorities of older adults who have multiple chronic conditions. Following identification of patient priorities, this information is documented in the patient’s electronic health record (EHR).

Objective
Our goal is to develop and validate a natural language processing (NLP) model that reliably documents when clinicians identify patient priorities (ie, values, outcome goals, and care preferences) within the EHR as a measure of PPC adoption.

Methods
This is a retrospective analysis of unstructured National Veteran Health Administration EHR free-text notes using an NLP model. The data were sourced from 778 patient notes of 658 patients from encounters with 144 social workers in the primary care setting. Each patient’s free-text clinical note was reviewed by 2 independent reviewers for the presence of PPC language such as priorities, values, and goals. We developed an NLP model that utilized statistical machine learning approaches. The performance of the NLP model in training and validation with 10-fold cross-validation is reported via accuracy, recall, and precision in comparison to the chart review.

Results
Of 778 notes, 589 (75.7%) were identified as containing PPC language (kappa=0.82, P<.001). The NLP model in the training stage had an accuracy of 0.98 (95% CI 0.98-0.99), a recall of 0.98 (95% CI 0.98-0.99), and precision of 0.98 (95% CI 0.97-1.00). The NLP model in the validation stage had an accuracy of 0.92 (95% CI 0.90-0.94), recall of 0.84 (95% CI 0.79-0.89), and precision of 0.84 (95% CI 0.77-0.91). In contrast, an approach using simple search terms for PPC only had a precision of 0.757.

Conclusions
An automated NLP model can reliably measure with high precision, recall, and accuracy when clinicians document patient priorities as a key step in the adoption of PPC.