bluuebunny/crossref_metadata_2025_split huggingface dataset:
The meristem-associated endosymbiontMethylorubrum extorquensDSM13060 reprograms development and stress responses of pine seedlings
Authors: Koskimäki Janne J , Pohjanen Johanna , Kvist Jouni , Fester Thomas , Härtig Claus , Podolich Olga , Fluch Silvia , Edesi Jaanika , Häggman Hely , Pirttilä Anna Maria 
Published: July 2021

AbstractMicrobes living in plant tissues—endophytes—are mainly studied in crop plants where they typically colonize the root apoplast. Trees—a large carbon source with a high capacity for photosynthesis—provide a variety of niches for endophytic colonization. We have earlier identified a new type of plant–endophyte interaction in buds of adult Scots pine, where Methylorubrum species live inside the meristematic cells. The endosymbiont Methylorubrum extorquens DSM13060 significantly increases needle and root growth of pine seedlings without producing plant hormones, but by aggregating around host nuclei. Here, we studied gene expression and metabolites of the pine host induced by M. extorquens DSM13060 infection. Malic acid was produced by pine to potentially boost M. extorquens colonization and interaction. Based on gene expression, the endosymbiont activated the auxin- and ethylene (ET)-associated hormonal pathways through induction of CUL1 and HYL1, and suppressed salicylic and abscisic acid signaling of pine. Infection by the endosymbiont had an effect on pine meristem and leaf development through activation of GLP1-7 and ALE2, and suppressed flowering, root hair and lateral root formation by downregulation of AGL8, plantacyanin, GASA7, COW1 and RALFL34. Despite of systemic infection of pine seedlings by the endosymbiont, the pine genes CUL1, ETR2, ERF3, HYL, GLP1-7 and CYP71 were highly expressed in the shoot apical meristem, rarely in needles and not in stem or root tissues. Low expression of MERI5, CLH2, EULS3 and high quantities of ononitol suggest that endosymbiont promotes viability and protects pine seedlings against abiotic stress. Our results indicate that the endosymbiont positively affects host development and stress tolerance through mechanisms previously unknown for endophytic bacteria, manipulation of plant hormone signaling pathways, downregulation of senescence and cell death-associated genes and induction of ononitol biosynthesis.
The killer’s toolkit: remarkable adaptations in the canine teeth of mammalian carnivores
Authors: Pollock Tahlia I , Hocking David P , Evans Alistair R 
Published: July 2021

Abstract
Often the first point of contact between predator and prey, mammalian canine teeth are essential for killing, dismembering and consuming prey. Yet despite their importance, few associations among shape, function and phylogeny are established. We undertook the first comprehensive analysis of canine tooth shape across predatory mammals (Carnivora, Didelphimorphia and Dasyuromorphia), integrating shape analysis with function of this fundamental feature. Shape was quantified using three-dimensional geometric morphometrics and cross-sectional sharpness. Canines vary in three main ways (sharpness, robustness and curvature) which vary with diet, killing behaviour and phylogeny. Slender, sharp canines are associated with carnivores such as felids that target the neck of their prey and primarily consume the ‘softer’ parts of a carcass. Robust, blunt canines are found in mustelids and dasyurids that typically consume ‘harder’ materials, such as bone, or bite into skulls. Differences in the killing behaviours of felids and canids probably result in more curved canines in the latter, which act as hooks to hold prey. We find functional specialization in the upper and lower canines of individuals and across the major mammalian clades. These patterns demonstrate how canine teeth are adapted to suit diverse diets and hunting styles, enabling mammals to become some of nature's most successful predators.
Identification of Metalaxyl- and Ethaboxam-Insensitive Pythium sylvaticum Pathogenic to Pulse Crops in Montana, U.S.A.
Authors: Parikh Lipi P. , Moparthi Swarnalatha , Crutcher Frankie K. , Burrows Mary E. 
Published: July 2021

Pythium root rot and damping-off caused by Pythium spp. are important diseases of pulse crops. In a 2016 pathogen survey from dry pea growing fields in Montana, along with commonly known causal agents P. ultimum and P. irregulare, an isolate identified as P. sylvaticum (LPPY17) was isolated from the rhizosphere of a diseased pea plant collected from Valley County, MT. Root rots and damping-off caused by P. sylvaticum have not previously been reported for chickpea, pea, and lentil crops. The isolate LPPY17 was tested for fungicide resistance in vitro, and results indicated a reduced sensitivity to metalaxyl- and ethaboxam-containing fungicides. LPPY17 was also tested for pathogenicity on chickpea, pea, and lentil seedlings in the greenhouse, and the results from the study revealed LPPY17 is capable of causing both root rots and damping-off. Due to the potential pathogenicity and reduced fungicide sensitivity of this species, in the future it will be important to monitor for P. sylvaticum in pulse root rot surveys and diagnostics, because management options may be different from other common Pythium spp.
Extended L-shaped Spreader Graft for Correction of Combined Dorsal and Caudal Nasal Septal Deviations
Authors: Aboulwafa Ahmed Mabrouk 
Published: July 2021

Summary:
Although a wide range of surgical techniques have been proposed to straighten the deviated cartilaginous nasal dorsum and maximize nasal function, recurrence is common because of cartilage memory and scar contractures. An extended L-shaped spreader graft, a permanent support, was developed to correct functional and aesthetic problems, to prevent recurrence, and to maintain the correction of the septum stable and strong. This technique was utilized in 16 cases of deviated cartilaginous dorsum. All patients were subjected to a detailed history, physical examination, CT scan of the nose, and photographic documentation preoperatively. The patients were followed up during a period of 3 months to 4 years. According to physical examination, postoperative photography, and patients’ satisfaction, the final results were categorized as excellent, good, or poor. The results were as follows: 14 patients (87.5%) were classified as excellent, as their noses were completely straight, and this was consistent with physical examination and postoperative photographs. Two patients (12.5%) were classified as good because there was a minimal residual deviation according to either photographs or clinical examinations. This minimal deformity was not experienced by the patients. In conclusion, consistent, reproducible results were achieved with using the autologous extended L-shaped spreader graft for controlling and maintenance of the dorsal and caudal septal deviation after correction. It is one piece of L-shaped graft of autogenous cartilage fixed to the original septal L-strut. It is regarded as an anatomical graft that provides sustained cephalocaudal support, preserves pliability of the lobule, and maintains stability as an independent stabilizer for the native strut.
Development of a Knowledge Translation Intervention in a Student-Run Pro Bono Clinic: A Case Report
Authors: Yorke Amy M. , Smith Amy K. , Hein Emily , Woodruff Amanda , Trojanowski Suzanne 
Published: July 2021

Background and Purpose.
Although evidence-based practice (EBP) is essential to physical therapy practice, students struggle incorporating new research into patient care. Knowledge translation (KT) bridges the gap between current research and practice to ensure high-quality patient care. Student-run pro bono clinics (SRPBCs) provide students the opportunity to use KT in a practice-based environment. The purpose of this case report was to describe the development of a KT intervention to support the implementation of a clinical practice guideline (CPG) in a SRPBC.

Case Description.
Using the Knowledge to Action (KTA) framework, student leaders, with faculty guidance, developed a KT intervention to facilitate uptake of the neurological outcome measure CPG (NOM-CPG) into a SRPBC that serves patients with neurological conditions.

Outcomes.
Chart audits, surveys, and focus group interviews revealed underutilization of, yet a willingness to implement, the NOM-CPG, as well as the barriers and facilitators to EBP at the SRPBC. A multifaceted KT intervention, including education, environmental changes, and obtaining equipment, was developed to implement the NOM-CPG at the SRPBC.

Discussion and Conclusion.
Application and assessment of the KT intervention to implement the NOM-CPG is ongoing. The KTA cycle may be used to develop a KT intervention at a SRPBC to improve uptake of a CPG. Providing students the opportunity to systematically and intentionally incorporate evidence into a SRPBC promotes the development of KT strategies required to implement evidence in a clinical setting.
Identifying Patients at Risk for Fibrosis in a Primary Care NAFLD Cohort
Authors: Schreiner Andrew D. , Livingston Sherry , Zhang Jingwen , Gebregziabher Mulugeta , Marsden Justin , Koch David G. , Petz Chelsey A. , Durkalski-Mauldin Valerie L. , Mauldin Patrick D. , Moran William P. 
Published: July 2021

Goals and Background:
Using natural language processing to create a nonalcoholic fatty liver disease (NAFLD) cohort in primary care, we assessed advanced fibrosis risk with the Fibrosis-4 Index (FIB-4) and NAFLD Fibrosis Score (NFS) and evaluated risk score agreement.

Materials and Methods:
In this retrospective study of adults with radiographic evidence of hepatic steatosis, we calculated patient-level FIB-4 and NFS scores and categorized them by fibrosis risk. Risk category and risk score agreement was analyzed using weighted κ, Pearson correlation, and Bland-Altman analysis. A multinomial logistic regression model evaluated associations between clinical variables and discrepant FIB-4 and NFS results.

Results:
Of the 767 patient cohorts, 71% had a FIB-4 or NFS score in the indeterminate-risk or high-risk category for fibrosis. Risk categories disagreed in 43%, and scores would have resulted in different clinical decisions in 30% of the sample. The weighted κ statistic for risk category agreement was 0.41 [95% confidence interval (CI): 0.36-0.46] and the Pearson correlation coefficient for log FIB-4 and NFS was 0.66 (95% CI: 0.62-0.70). The multinomial logistic regression analysis identified black race (odds ratio=2.64, 95% CI: 1.84-3.78) and hemoglobin A1c (odds ratio=1.37, 95% CI: 1.23-1.52) with higher odds of having an NFS risk category exceeding FIB-4.

Conclusions:
In a primary care NAFLD cohort, many patients had elevated FIB-4 and NFS risk scores and these risk categories were often in disagreement. The choice between FIB-4 and NFS for fibrosis risk assessment can impact clinical decision-making and may contribute to disparities of care.
The Experiences of Illness in Korean Bladder Cancer Patients With Radical Cystectomy
Authors: Yi Eunhye , Yoo Yang-sook , Lee Sunhee , Park Hanjong 
Published: July 2021

Background
After radical cystectomy, many bladder cancer patients experience physical and psychological difficulties. For nurses, understanding the illness experiences should be the utmost priority.

Objective
The aim of this study was to comprehensively understand the experiences of illness among bladder cancer patients with radical cystectomy in Korea.

Methods
Purposive sampling was used in this qualitative study to recruit patients hospitalized with bladder cancer at the urology cancer center in South Korea. Data were collected through one-on-one in-depth interviews and analyzed using the thematic analysis of Braun and Clarke.

Results
Six themes were derived: “confusion with bodily changes,” “loss of daily life as it was before radical cystectomy,” “feeling daunted,” “body acceptance,” “adaptation,” and “feeling grateful for life.” These themes represent the emotional state and adaptation process after surgery.

Conclusions
This study contributes to the understanding of the experience of illness in Korean adults experiencing bladder cancer. Whereas most previous research focuses on physical aspects, including treatment methods, this study focused on understanding the life and suffering after discharge of individuals. This study can help nurses to better understand the postoperative life of the patients.

Implications for Practice
This study can be a foundation for developing informational materials or intervention programs needed to solve the difficulties encountered during urostomy or neobladder self-care. Specifically, a strategy has to be devised to alleviate the pain of loss and to help patients who feel daunted and experience a negative body image.
Decision-Making Experience Related to Mastectomy Among Women With Breast Cancer
Authors: Liu Jing , Hunter Sharyn , Zhu Jiemin , Lee Regina Lai Tong , Chan Sally Wai-Chi 
Published: July 2021

Background
Deciding to have a mastectomy can be challenging for women. An understanding of the decision-making experience related to mastectomy would contribute to improving the support of women making this decision.

Objective
The aim of this study was to understand women's decision-making experience related to mastectomy.

Methods
Studies published from 2000 to 2020 were identified by searching databases (CINAHL, MEDLINE, EMBASE, PsycINFO, PubMed, Web of Science, and China National Knowledge Infrastructure) and reference lists of previous reviews. Methodological quality of these studies was assessed using the Mixed Methods Appraisal Tool version 2018. Data were analyzed using content comparison analysis.

Results
Twenty-three quantitative and 6 qualitative studies were included in this review. Four themes emerged from the included studies: participation in decision-making, seeking information about treatment choices, postoperative perceptions of mastectomy decision-making, and factors related to mastectomy choice. Several negative experiences related to decision-making were identified. A number of clinical, sociodemographic, and psychosocial factors that influenced women to choose a mastectomy were identified.

Conclusions
This review provides in-depth information about decision-making experiences and factors that influence the choice of mastectomy. Research is required about women who have had a mastectomy using standardized instruments to investigate their decision-making experiences. Studies are also necessary in non-Western countries.

Implications for Practice
The factors and experiences identified in this review may help nurses to assist in the treatment decision-making process. Further research is required regarding breast care and other nurses' involvement in the decision-making process related to mastectomy.
Duration of Electroconvulsive Therapy Postictal Burst Suppression Is Associated With Time to Reorientation
Authors: Sartorius Alexander , Karl Sebastian , Zapp Angela , Putschögl Franziska , Bumb Jan Malte , Reinwald Jonathan , Kranaster Laura , Aksay Suna Su 
Published: July 2021

Introduction
A burst suppression pattern in the electroencephalogram represents a down-regulated brain state, which also occurs in the postictal phase of electroconvulsive therapy (ECT). Suppressive actions of the brain to terminate the seizure are thought to be necessary for the efficacy of ECT. On the other hand, recent studies showed an association of burst suppression in general anesthesia or sedation with (postprocedural) cognitive complications.

Methods
We retrospectively examined the length of postictal burst suppression and reorientation time in 49 ECT sessions of 25 consecutive patients. Burst suppression duration was determined by bispectral index monitoring and defined as the time with a bispectral index value of less than 20%. The association between duration of burst suppression and reorientation time was analyzed with multivariate logistic and linear regression analysis controlling for several covariates.

Results
The reorientation time showed a statistically significant association with the duration of burst suppression, but with no other variable. Longer phase of postictal burst suppression predicted longer reorientation time in the recovery room (P = 0.046).

Conclusions
The association between the duration of postictal burst suppression and reorientation time after ECT in this sample suggests that (not only the efficacy but also the) cognitive adverse effects of ECT might be related to the extent of postictal central inhibition after the termination of the seizure.
Surveillance of seasonal respiratory viruses among Chilean patients during the COVID-19 pandemic
Authors: Alonso-Palomares Luis A. , Joaquín Cáceres C. , Tapia Rodrigo , Aguilera-Cortés Paulina , Valenzuela Santiago , Valiente-Echeverría Fernando , Soto-Rifo Ricardo , Gaggero Aldo , Barriga Gonzalo P. 
Published: July 2021

The StudySARS-CoV-2 has generated over 122 million cases worldwide. Non-pharmaceuticals interventions such as confinements and lockdowns started in Chile on March 18th 2020. In Europe, confinements and lockdowns have been accompanied by a decrease in the circulation of other respiratory viruses such as Influenza A virus(IAV), Influenza B virus(IBV) or respiratory syncytial virus(RSV) (1). Although changes in circulation patterns of respiratory viruses have been reported, limited information regarding the southern hemisphere is available where the SARS-CoV-2 pandemic merged with the winter season. We conducted viral surveillance of respiratory viruses and we evaluated their presence and establishing whether they were co-circulating with SARS-CoV-2.
Effects of COVID-19 2021 lockdown on the sleep quality and mental health of undergraduate medical and dental students of Pakistan: A cross-sectional study
Authors: Sheikh Naveen Siddique , Anwar Aiza , Pervaiz Iqra , Arshad Zunaira , Khan Huma Saeed , Hafeez Farida 
Published: July 2021

ABSTRACTBackground and objectivesThe COVID-19 pandemic has been recognized as a cause of direct and indirect psychological consequences that impact mental health such as acute stress disorders, anxiety, irritability, poor concentration, and insomnia. This study was planned to evaluate the sleep quality and mental health of undergraduate students amidst the COVID-19 lockdown of 2021.Materials and MethodsThis observational cross-sectional study was conducted in Lahore, Pakistan, where 261 undergraduate medical and dental students enrolled at a private medical and dental school were approached from March to May 2021. The Pittsburg Sleep Quality Index (PSQI) was used to identify the sleep quality along with the Generalized Anxiety Disorder Scale (GAD-7) to establish anxiety symptoms and the Physical Health Questionnaire (PHQ-9) for depression symptoms.ResultsThe results show that 212 (81.2%) female and 49 (18.8%) male students participated in the study. Of the participants 75.1% experienced poor sleep quality, 90% had symptoms of depression, and 85.4% had symptoms of anxiety. The mean score on the PSQI scale was 8.59±4.10, on the GAD-7 scale was 11.36±5.94 and on the PHQ-9 scale was 13.70±6.81. Multiple regression analysis showed that anxiety symptoms (β = 0.315, p = 0.000) and depression symptoms (β = 0.398, p = 0.000) were significant predictors of sleep quality amongst the undergraduate medical and dental students.ConclusionA high majority of the study participants are experiencing poor sleep quality along with suffering from depression and anxiety amidst the COVID-19 lockdown. It is concluded from the analysis that anxiety and depression symptoms are significant predictors of sleep quality. Relevant authorities need to set up systems that help undergraduate medical students in alleviating and coping with these symptoms midst the COVID-19 pandemic.
Identification and validation of novel candidate risk genes in endocytic vesicular trafficking associated with esophageal atresia and tracheoesophageal fistulas
Authors: Zhong Guojie , Ahimaz Priyanka , Edwards Nicole A. , Hagen Jacob J. , Faure Christophe , Kingma Paul , Middlesworth William , Khlevner Julie , Fiky Mahmoud El , Schindel David , Fialkowski Elizabeth , Kashyap Adhish , Forlenza Sophia , Kenny Alan P. , Zorn Aaron M. , Shen Yufeng , Chung Wendy K. 
Published: July 2021

AbstractEsophageal atresias/tracheoesophageal fistulas (EA/TEF) are rare congenital anomalies caused by aberrant development of the foregut. Previous studies indicate that rare orde novogenetic variants significantly contribute to EA/TEF risk, and most individuals with EA/TEF do not have pathogenic genetic variants in established risk genes. To identify novel genetic contributions to EA/TEF, we performed whole genome sequencing of 185 trios (probands and parents) with EA/TEF, including 59 isolated and 126 complex cases with additional congenital anomalies and/or neurodevelopmental disorders. There was a significant burden of protein alteringde novocoding variants in complex cases (p=3.3e-4), especially in genes that are intolerant of loss of function variants in the population. We performed simulation analysis of pathway enrichment based on background mutation rate and identified a number of pathways related to endocytosis and intracellular trafficking that as a group have a significant burden of protein alteringde novovariants. We assessed 18 variants for disease causality using CRISPR-Cas9 mutagenesis inXenopusand confirmed 13 with tracheoesophageal phenotypes. Our results implicate disruption of endosome-mediated epithelial remodeling as a potential mechanism of foregut developmental defects. This research may have implications for the mechanisms of other rare congenital anomalies.
Sociodemographic differences in patient experience with virtual care during COVID-19
Authors: Agarwal Payal , Wang Rick , Meaney Christopher , Walji Sakina , Damji Ali , Toor Navsheer Gill , Yip Gina , Elman Debbie , Florindo Tiffiany , Fung Susanna , Witty Melissa , Pham Thuy Nga , Ramji Noor , Kiran Tara 
Published: July 2021

AbstractPurposeWe sought to understand patients’ care-seeking behaviours during the pandemic, their use and views of different virtual care modalities, and whether these differed by sociodemographic factors.MethodsWe conducted a multi-site cross-sectional patient experience survey at thirteen academic primary care teaching practices between May and June of 2020. An anonymized link to an electronic survey was sent to a subset of patients with a valid email address on file; sampling was based on birth month. For each question, the proportion of respondents who selected each response was calculated, followed by a comparison by sociodemographic characteristics using chi-squared tests.ResultsIn total, 7482 participants responded to the survey. Most received care from their primary care clinic during the pandemic (67.7%, 5068/7482), the majority via phone (82.5%, 4195/5086). Among those who received care, 30.53% (1509/4943) stated that they delayed seeking care because of the pandemic. Most participants reported a high degree of comfort with phone (92.4%, 3824/4139), video (95.2%, 238/250) and email or messaging (91.3%, 794/870). However, those reporting difficulty making ends meet, poor or fair health, and arriving in Canada in the last 10 years reported lower levels of comfort with virtual care and fewer wanted their practice to continue offering virtual options after the pandemic.ConclusionsOur study suggest that newcomers, people living with a lower income, and those reporting poor or fair health have a stronger preference and comfort for in-person primary care. Further research should explore potential barriers to virtual care and how these could be addressed.