bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overexpression of a carrot BCH gene, DcBCH1, improves tolerance to drought in Arabidopsis thaliana
Authors: Li Tong , Liu Jie-Xia , Deng Yuan-Jie , Xu Zhi-Sheng , Xiong Ai-Sheng 
Published: October 2021

AbstractBackgroundCarrot (Daucus carotaL.), an important root vegetable, is very popular among consumers as its taproot is rich in various nutrients. Abiotic stresses, such as drought, salt, and low temperature, are the main factors that restrict the growth and development of carrots. Non-heme carotene hydroxylase (BCH) is a key regulatory enzyme in the β-branch of the carotenoid biosynthesis pathway, upstream of the abscisic acid (ABA) synthesis pathway.ResultsIn this study, we characterized a carrot BCH encoding gene,DcBCH1. The expression ofDcBCH1was induced by drought treatment. The overexpression ofDcBCH1inArabidopsis thalianaresulted in enhanced tolerance to drought, as demonstrated by higher antioxidant capacity and lower malondialdehyde content after drought treatment. Under drought stress, the endogenous ABA level in transgenicA. thalianawas higher than that in wild-type (WT) plants. Additionally, the contents of lutein and β-carotene in transgenicA. thalianawere lower than those in WT, whereas the expression levels of most endogenous carotenogenic genes were significantly increased after drought treatment.ConclusionsDcBCH1can increase the antioxidant capacity and promote endogenous ABA levels of plants by regulating the synthesis rate of carotenoids, thereby regulating the drought resistance of plants. These results will help to provide potential candidate genes for plant drought tolerance breeding.
Rheumatic heart disease in The Gambia: clinical and valvular aspects at presentation and evolution under penicillin prophylaxis
Authors: Jaiteh Lamin E. S. , Drammeh Lamin , Anderson Suzanne T. , Mendy John , Ceesay Samba , D’Alessandro Umberto , Carapetis Jonathan , Mirabel Mariana , Erhart Annette 
Published: October 2021

Abstract
Background
Rheumatic heart disease (RHD) remains the leading cause of cardiac-related deaths and disability in children and young adults worldwide. In The Gambia, the RHD burden is thought to be high although no data are available and no control programme is yet implemented. We conducted a pilot study to generate baseline data on the clinical and valvular characteristics of RHD patients at first presentation, adherence to penicillin prophylaxis and the evolution of lesions over time.

Methods
All patients registered with acute rheumatic fever (ARF) or RHD at two Gambian referral hospitals were invited for a clinical review that included echocardiography. In addition, patients were interviewed about potential risk factors, disease history, and treatment adherence. All clinical and echocardiography information at first presentation and during follow-up was retrieved from medical records.

Results
Among 255 registered RHD patients, 35 had died, 127 were examined, and 111 confirmed RHD patients were enrolled, 64% of them females. The case fatality rate in 2017 was estimated at 19.6%. At first presentation, median age was 13 years (IQR [9; 18]), 57% patients had late stage heart failure, and 84.1% a pathological heart murmur. Although 53.2% of them reported history of recurrent sore throat, only 32.2% of them had sought medical treatment. A history suggestive of ARF was reported by 48.7% patients out of whom only 15.8% were adequately treated. Two third of the patients (65.5%) to whom it was prescribed were fully adherent to penicillin prophylaxis. Progressive worsening and repeated hospitalisation was experienced by 46.8% of the patients. 17 patients had cardiac surgery, but they represented only 18.1% of the 94 patients estimated eligible for cardiac surgery.

Conclusion
This study highlights for the first time in The Gambia the devastating consequences of RHD on the health of adolescents and young adults. Our findings suggest a high burden of disease that remains largely undetected and without appropriate secondary prophylaxis. There is a need for the urgent implementation of an effective national RHD control programto decrease the unacceptably high mortality rate, improve case detection and management, and increase community awareness of this disease.
Convalescent plasma treatment for patients of 80 years and older with COVID-19 pneumonia
Authors: Romon Iñigo , Dominguez-Garcia Juan J. , Arroyo Jose L. , Suberviola Borja , Cabezón Itxasne , Abascal Beatriz , Baldeón Cristina , Cuesta Amalia , Portilla Raquel , Casuso Elena , Ocio Enrique , Briz Montserrat 
Published: October 2021

Abstract
Background
Older patients, frequently with multiple comorbidities, have a high mortality from COVID-19 infection. Convalescent plasma (CP) is a therapeutic option for these patients. Our objective is to retrospectively evaluate the efficacy and adverse events of CP treatment in this population group.

Methods
Forty one patients over 80 years old with COVID-19 pneumonia received CP added to standard treatment, 51.2% with high anti-SARS-CoV-2 IgG titers and 48.8% with low titers. Median time between the onset of symptoms and the infusion of plasma was 7 days (IQR 4–10). A similar group of 82 patients who received only standard treatment, during a period in which CP was not available, were selected as a control group.

Results
In-hospital mortality was 26.8% for controls and 14.6% for CP patients (P = 0.131) and ICU admission was 8.5% for controls and 4.9% for CP patients (P = 0.467). Mortality tended to be lower in the high-titer group (9.5%) than in the low-titer group (20%), and in patients transfused within the first 7 days of symptom onset (10%) than in patients transfused later (19.1%), although the differences were not statistically significant (P = 0.307 and P = 0.355 respectively). There was no difference in the length of hospitalization. No significant adverse events were associated with CP treatment.

Conclusions
Convalescent plasma treatment in patients over 80 years old with COVID-19 pneumonia was well tolerated but did not present a statistically significant difference in hospital mortality, ICU admission, or length of hospitalization. The results should be interpreted with caution as only half the patients received high-titer CP and the small number of patients included in the study limits the statistical power to detect significant differences.

Trial registration
CEIm Cantabria # 2020.127.
Patients with Parkinson’s disease predict a lower incidence of colorectal cancer
Authors: Fang Hongsheng , Du Yunlan , Pan Shuting , Zhong Ming , Tang Jiayin 
Published: October 2021

Abstract
Background
Recent theory on the “gut-brain axis” suggests a close relationship between the dysfunction of the gut and the disorders of the brain.

Methods
We performed a systemic literature search followed by a multi-step inclusion selection for all studies on the risk of Colorectal cancer (CRC) in Parkinson’s disease (PD) patients using the following databases: PubMed, EMBASE and WOS. Relative risk (RR) and the 95% confidence intervals (CI) were calculated using either the random-effects model or the fixed-effects meta-analysis model, based on the assessment of heterogeneity.

Results
Seventeen studies involving a total of 375,964 PD patients and 879,307 cancer patients were included. Independent meta-analyses for cohort studies and case-control studies showed that the overall pooled RR of the cohort studies was 0.78 (0.66–0.91), and that of the case-control studies was 0.78 (0.65–0.94), indicating that patients with PD have a significantly decreased risk for CRC. The significant lower risk is present in both the colon and the rectum subgroups classified by tumor location. Moreover, the risk for CRC is significantly lower in America (RR = 0.58), Europe (RR = 0.82) and Asia (RR = 0.83) compared to the control population.

Conclusion
The occurrence of CRC was significantly lower in patients with diagnosis of PD.
Urban-rural differences in the association between social activities and depressive symptoms among older adults in China: a cross-sectional study
Authors: Wang Yanan , Li Zhen , Fu Chang 
Published: October 2021

Abstract
Background
Participation in social activities has positive health effects among older adults; however, few studies have investigated the association between social activity and depressive symptoms among Chinese older adults. This study aimed to examine the association between social activities and depressive symptoms among older adults in China regarding urban-rural differences.

Methods
Data were collected from 8255 respondents from the 2015 China Health and Retirement Longitudinal Study. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale. Type and frequency of social activities were collected via a questionnaire. Multivariate logistic regression analysis was used to explore the relationship between social activities and depressive symptoms.

Results
In our study, the prevalence of depressive symptoms was lower in urban older adults compared with rural older adults (25.2% vs. 40.7%). After adjustment for all covariates, our results indicated that interacting with friends almost weekly or almost daily (almost weekly: OR = 0.568, 95%CI: 0.337–0.955; almost daily: OR = 0.664, 95%CI: 0.453–0.973) and participating in community organizations almost daily were inversely associated with depressive symptoms among urban older adults (OR = 0.107, 95%CI: 0.012–0.952). Interacting with friends almost daily (OR = 0.847, 95% CI: 0.720–0.996) and participation in hobby groups either almost every week or almost daily were both inversely associated with depressive symptoms among rural older adults (almost weekly: OR = 0.683, 95%CI: 0.518–0.902; almost daily: OR = 0.567, 95%CI: 0.440–0.731). Participating in sports groups almost daily was inversely associated with depressive symptoms among both urban and rural older adults (urban: OR = 0.664, 95%CI: 0.445–0.991; rural: OR = 0.506, 95%CI: 0.366–0.700).

Conclusions
Our findings indicated that there is a cross-sectional association between participation in social activities and depressive symptoms among Chinese older adults, and the association differed between urban and rural older adults. This implies that participation in social activities may be significant for alleviating depressive symptoms of older adults. When encouraging older adults to participate in social activities, the government should consider urban-rural differences and take effective measures accordingly. Longitudinal studies are needed to examine the causal relationships between social activities and depressive symptoms among older adults.
Diagnosis pitfall of interstitial pregnancy: a case report of a term pregnancy with abnormal placentation
Authors: Najib Fatemeh Sadat , Vafaei Homeira , Foroughi Amin Abolhasan , Namazi Niloofar 
Published: October 2021

AbstractBackgroundInterstitial Pregnancy (IP) is a lethal condition due to high risk of sudden onset massive hemorrhage. Such conditions are managed as soon as diagnosed almost in the first trimester. There are a few case reports of IP conditions terminated after the second trimester. Herein, we introduce a term interstitial pregnancy complicated by abnormal placentation.Case presentationIn this case report, we introduce a 32-year-old lady, primigravida, with an undiagnosed IP that was in her 38 weeks of gestational with placenta increta. She developed with perforated IP presenting with acute abdomen and internal bleeding at 26 weeks of gestational age. However, with a misdiagnosis impression, she got stable in operation room. Then, the pregnancy continued till 36 weeks of gestational age that was misdiagnosed with cervical cancer in prenatal work-ups. Finally, during elective cesarean section at 38 weeks, an IP with placenta increta (placenta evading from the serosa to the myometrium of the uterus) was observed. The baby was healthy with no obvious anomaly or morbidity.ConclusionsPhysicians should be aware to detect IP in all trimesters and pay attention to the coexisting complications such as placenta accreta to manage them more accurately.
A very preterm infant born to mother of mirror syndrome secondary to fetomaternal hemorrhage: a case report
Authors: Song Sijie , Zhu Yefang , Jorch Gerhard , Zhang Xiaoting , Wu Yan , Chen Wen , Gong Hua , Zhou Ligang , Wang Xueyan , Zhong Xiaoyun 
Published: October 2021

Abstract
Background
Mirror syndrome (MS) is defined as maternal edema with fetal hydrops and placental edema with different etiologies, such as rhesus isoimmunization and twin-twin transfusion syndrome. Herein, we showcased a unique MS case secondary to fetomaternal hemorrhage (FMH).

Case presentation
A 32-year-old gravida 2 para 0 woman diagnosed with fetal hydrops was admitted to our hospital. Maternal laboratory tests revealed anemia, slightly increased creatinine and uric acid levels, hypoproteinemia, and significantly increased alpha-fetoprotein and hemoglobin-F levels. Therefore, FMH was diagnosed initially. Two days after admission, the woman had unexpectedly progressive anasarca and started to feel chest distress, palpitations, lethargy, and oliguria, and MS was suspected. An emergency cesarean section was performed to terminate the pregnancy. The maternal clinical symptoms and laboratory tests rapidly improved after delivery. A very preterm infant with a 2080-g birthweight at 31 weeks gestation survived after emergency cesarean section, active resuscitation, emergency blood transfusion, abdominocentesis, and advanced life support.

Conclusions
FMH could develop into MS, providing new insights into the etiology of MS. Once MS is diagnosed, emergency cesarean section might be an alternative treatment. The very preterm infant survived with a favorable long-term outcome, and a well-trained perinatal work team is needed for such cases.
The PROCEM study protocol: Added value of preoperative contrast-enhanced mammography in staging of malignant breast lesions - a prospective randomized multicenter study
Authors: Åhsberg Kristina , Gardfjell Anna , Nimeus Emma , Ryden Lisa , Zackrisson Sophia 
Published: October 2021

Abstract
Background
Correct preoperative estimation of the malignant extent is crucial for optimal planning of breast cancer surgery. The sensitivity of mammography is lower in dense breasts, and additional imaging techniques are sometimes warranted. Contrast-enhanced mammography (CEM) has shown similar sensitivity and in some cases better specificity, than magnetic resonance imaging (MRI) in small, observational studies. CEM may be more cost-effective than MRI, and may provide better identification of the tumor extent, however, no randomized trials have been performed to date to investigate the added value of CEM.
In a feasibility study, we found that the treatment was changed in 10/47 (21%) cases after additional CEM. The purpose of the present study is to evaluate the added value of CEM in preoperative staging of breast cancer in a randomized study.

Method
This prospective randomized study will include 440 patients with strongly suspected or established diagnosis of breast malignancy, based on assessment with mammography, ultrasound and core biopsy/cytology, and for whom primary surgery is planned. Patients will be randomized 1:1 using a web-based randomization tool to additional investigation with CEM or no further imaging. The CEM findings will be taken into consideration, which may lead to changes in primary treatment, which is the primary endpoint of this study. Secondary endpoints include rate of reoperation and number of avoidable mastectomies, as well as a cost-benefit analysis of additional CEM. Patient-reported health-related quality of life will be investigated at 1 year with the validated Breast-Q™ questionnaire. The rate of local recurrence or new cancer ipsi- or contralaterally within 5 years will be assessed from medical records and pathology reports.

Discussion
The aim of this trial is to explore the added value of CEM in preoperative staging of breast cancer. The results obtained from this study will contribute to our knowledge on CEM as an additional imaging method to standard investigation with digital mammography and ultrasound. The findings may also provide additional information on which patient groups would benefit from CEM, and on the economic aspects of CEM in standard preoperative practice.

Trial registration
This trial is registered at clinicaltrials.gov, registration no: NCT04437602, date of registration: June 18, 2020.
Comparison of anterior knee laxity, stiffness, genu recurvatum, and general joint laxity in the late follicular phase and the ovulatory phase of the menstrual cycle
Authors: Shagawa Mayuu , Maruyama Sae , Sekine Chie , Yokota Hirotake , Hirabayashi Ryo , Hirata Arisa , Yokoyama Mizuki , Edama Mutsuaki 
Published: October 2021

Abstract
Background
One risk factor for anterior cruciate ligament (ACL) injury may be fluctuations in female hormones. This study examined variability in joint laxity, as a risk factor for ACL injury, during the menstrual cycle.

Methods
Subjects were 15 female university students with regular menstrual cycles. We measured estradiol (E2) concentration, anterior knee laxity (AKL), stiffness, genu recurvatum (GR), and general joint laxity (GJL) during the late follicular and ovulatory phases. AKL was measured as anterior tibial displacement of the femur after application of 44-, 89-, and 133-N loads on the tibia. Stiffness was calculated as Δforce/Δdisplacement at loads of 44–89 N and between 89 and 133 N. GR was measured prone, with the base of the patella distal to the edge of the bed. The University of Tokyo joint laxity test was used to evaluate GJL.

Results
E2 concentration was significantly higher in the ovulatory phase than in the late follicular phase (p = 0.018), AKL and stiffness did not differ significantly between phases, and GR and GJL were significantly higher in the ovulatory phase than in the late follicular phase (p = 0.011, 0.031).

Conclusion
These findings suggest that E2 concentrations may affect GR and GJL during the menstrual cycle.
The relationship between vitamin D status and islet function in patients with type 2 diabetes mellitus
Authors: Zhao Hang , Zheng Chong , Zhang Miaomiao , Chen Shuchun 
Published: October 2021

Abstract
Background
The aim of the study was to explore the relationship between vitamin D status and islet function in patients with type 2 diabetes mellitus.

Methods
The participants were recruited from Hebei General Hospital. Basic characteristics and blood indicators were collected after fasting overnight. The data were analyzed statistically using SPSS 22.0. Analysis of variance, a nonparametric test, or a trend Chi-square test was used for the comparisons. The association between 25-hydroxy vitamin D and modified homeostasis model assessment-β was assessed using multivariate ordinal logistic regression.

Results
One hundred seventy-four patients aged 26 to 79 years with type 2 diabetes mellitus were included in this study. Patients with vitamin D deficiency had a lower modified homeostasis model assessment-β level compared with those without vitamin D deficiency. There were differences in body mass index, diabetes course, glycosylated hemoglobin, fasting blood glucose, fasting blood C-peptide, triglyceride, and 25-hydroxy vitamin D among different modified homeostasis model assessment-β groups based upon the tertiles. 25-hydroxy vitamin D, as continuous or categorical variables, was positively related to modified homeostasis model assessment-β whether or not cofounding factors were adjusted.

Conclusion
There is an association between increased 25-hydroxy vitamin D levels and improvement in modified homeostasis model assessment-β function in patients with type 2 diabetes mellitus.

Trial registration
Cross-sectional trails ChiCTR2000029391, Registration Date: 29/01/2020.
Medical decisions concerning the end of life for cancer patients in three Colombian hospitals – a survey study
Authors: de Vries Esther , Leal Arenas Fabián Alexander , van der Heide Agnes , Gempeler Rueda Fritz E. , Murillo Raul , Morales Olga , Diaz-Amado Eduardo , Rodríguez Nelcy , Gonzalez Beatriz Juliana , Castilblanco Delgado Danny Steven , Calvache Jose A. 
Published: October 2021

AbstractBackgroundCancer patients’ end-of-life care may involve complex decision-making processes. Colombia has legislation regarding provision of and access to palliative care and is the only Latin American country with regulation regarding euthanasia. We describe medical end-of-life decision-making practices among cancer patients in three Colombian hospitals.MethodsCancer patients who were at the end-of-life and attended in participating hospitals were identified. When these patients deceased, their attending physician was invited to participate. Attending physicians of 261 cancer patients (out of 348 identified) accepted the invitation and answered a questionnaire regarding end-of-life decisions: a.) decisions regarding the withdrawal or withholding of potentially life-prolonging medical treatments, b.) intensifying measures to alleviate pain or other symptoms with hastening of death as a potential side effect, and c.) the administration, supply or prescription of drugs with an explicit intention to hasten death. For each question addressing the first two decision types, we asked if the decision was fully or partially made with the intention or consideration that it may hasten the patient’s death.ResultsDecisions to withdraw potentially life-prolonging treatment were made for 112 (43%) patients, 16 of them (14%) with an intention to hasten death. For 198 patients (76%) there had been some decision to not initiate potentially life-prolonging treatment. Twenty-three percent of patients received palliative sedation, 97% of all patients received opioids.Six patients (2%) explicitly requested to actively hasten their death, for two of them their wish was fulfilled. In another six patients, medications were used with the explicit intention to hasten death without their explicit request. In 44% (n = 114) of all cases, physicians did not know if their patient had any advance care directives, 26% (n = 38) of physicians had spoken to the patient regarding the possibility of certain treatment decisions to hasten death where this applied.ConclusionsDecisions concerning the end of life were common for patients with cancer in three Colombian hospitals, including euthanasia and palliative sedation. Physicians and patients often fail to communicate about advance care directives and potentially life-shortening effects of treatment decisions. Specific end-of-life procedures, patients’ wishes, and availability of palliative care should be further investigated.