bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genome-wide identification of heat shock factors and heat shock proteins in response to UV and high intensity light stress in lettuce
Authors: Kim Taehoon , Samraj Shafina , Jiménez Juan , Gómez Celina , Liu Tie , Begcy Kevin 
Published: April 2021

Abstract
Background
Heat shock factors (Hsfs) and Heat shock proteins (Hsps) belong to an essential group of molecular regulators involved in controlling cellular processes under normal and stress conditions. The role of Hsfs and Hsps is well known in model plant species under diverse stress conditions. While plants Hsfs are vital components of the signal transduction response to maintain cellular homeostasis, Hsps function as chaperones helping to maintain folding of damaged and newly formed proteins during stress conditions. In lettuce (Lactuca sativa), a highly consumed vegetable crop grown in the field and in hydroponic systems, the role of these gene families in response to artificial light is not well characterized.

Results
Using a genome-wide analysis approach, we identified 32 Hsfs and 22 small heat shock proteins (LsHsps) in lettuce, some of which do not have orthologs in Arabidopsis, poplar, and rice. LsHsp60s, LsHsp90s, and LsHsp100s are highly conserved among dicot and monocot species. Surprisingly, LsHsp70s have three times more members than Arabidopsis and two times more than rice. Interestingly, the lettuce genome triplication did not contribute to the increased number of LsHsp70s genes. The large number of LsHsp70s was the result of genome tandem duplication. Chromosomal distribution analysis shows larger tandem repeats of LsHsp70s genes in Chr1, Chr7, Chr8, and Chr9. At the transcriptional level, some genes of the LsHsfs, LsHsps, LsHsp60s, and LsHsp70s families were highly responsive to UV and high intensity light stress, in contrast to LsHsp90s and LsHsp100s which did not respond to a light stimulus.

Conclusions
Our genome-wide analysis provides a detailed identification of Hsfs and Hsps in lettuce. Chromosomal location and syntenic region analysis together with our transcriptional analysis under different light conditions provide candidate genes for breeding programs aiming to produce lettuce varieties able to grow healthy under hydroponic systems that use artificial light.
Utilizing machine learning dimensionality reduction for risk stratification of chest pain patients in the emergency department
Authors: Liu Nan , Chee Marcel Lucas , Koh Zhi Xiong , Leow Su Li , Ho Andrew Fu Wah , Guo Dagang , Ong Marcus Eng Hock 
Published: April 2021

AbstractBackgroundChest pain is among the most common presenting complaints in the emergency department (ED). Swift and accurate risk stratification of chest pain patients in the ED may improve patient outcomes and reduce unnecessary costs. Traditional logistic regression with stepwise variable selection has been used to build risk prediction models for ED chest pain patients. In this study, we aimed to investigate if machine learning dimensionality reduction methods can improve performance in deriving risk stratification models.MethodsA retrospective analysis was conducted on the data of patients > 20 years old who presented to the ED of Singapore General Hospital with chest pain between September 2010 and July 2015. Variables used included demographics, medical history, laboratory findings, heart rate variability (HRV), and heart rate n-variability (HRnV) parameters calculated from five to six-minute electrocardiograms (ECGs). The primary outcome was 30-day major adverse cardiac events (MACE), which included death, acute myocardial infarction, and revascularization within 30 days of ED presentation. We used eight machine learning dimensionality reduction methods and logistic regression to create different prediction models. We further excluded cardiac troponin from candidate variables and derived a separate set of models to evaluate the performance of models without using laboratory tests. Receiver operating characteristic (ROC) and calibration analysis was used to compare model performance.ResultsSeven hundred ninety-five patients were included in the analysis, of which 247 (31%) met the primary outcome of 30-day MACE. Patients with MACE were older and more likely to be male. All eight dimensionality reduction methods achieved comparable performance with the traditional stepwise variable selection; The multidimensional scaling algorithm performed the best with an area under the curve of 0.901. All prediction models generated in this study outperformed several existing clinical scores in ROC analysis.ConclusionsDimensionality reduction models showed marginal value in improving the prediction of 30-day MACE for ED chest pain patients. Moreover, they are black box models, making them difficult to explain and interpret in clinical practice.
The performance of balance exercises during daily tooth brushing is not sufficient to improve balance and muscle strength in healthy older adults
Authors: Granacher Urs , Muehlbauer Thomas , Göstemeyer Gerd , Gruber Stefanie , Gruber Markus 
Published: April 2021

Abstract
Background
High prevalence rates have been reported for physical inactivity, mobility limitations, and falls in older adults. Home-based exercise might be an adequate means to increase physical activity by improving health- (i.e., muscle strength) and skill-related components of physical fitness (i.e., balance), particularly in times of restricted physical activity due to pandemics.

Objective
The objective of this study was to examine the effects of home-based balance exercises conducted during daily tooth brushing on measures of balance and muscle strength in healthy older adults.

Methods
Fifty-one older adults were randomly assigned to a balance exercise group (n = 27; age: 65.1 ± 1.1 years) or a passive control group (n = 24; age: 66.2 ± 3.3 years). The intervention group conducted balance exercises over a period of eight weeks twice daily for three minutes each during their daily tooth brushing routine. Pre- and post-intervention, tests were included for the assessment of static steady-state balance (i.e., Romberg test), dynamic steady-state balance (i.e., 10-m single and dual-task walk test using a cognitive and motor interference task), proactive balance (i.e., Timed-Up-and-Go Test [TUG], Functional-Reach-Test [FRT]), and muscle strength (i.e., Chair-Rise-Test [CRT]).

Results
Irrespective of group, the statistical analysis revealed significant main effects for time (pre vs. post) for dual-task gait speed (p < .001, 1.12 ≤ d ≤ 2.65), TUG (p < .001, d = 1.17), FRT (p = .002, d = 0.92), and CRT (p = .002, d = 0.94) but not for single-task gait speed and for the Romberg-Test. No significant group × time interactions were found for any of the investigated variables.

Conclusions
The applied lifestyle balance training program conducted twice daily during tooth brushing routines appears not to be sufficient in terms of exercise dosage and difficulty level to enhance balance and muscle strength in healthy adults aged 60–72 years. Consequently, structured balance training programs using higher exercise dosages and/or more difficult balance tasks are recommended for older adults to improve balance and muscle strength.
A systematic review of the evidence for deprescribing interventions among older people living with frailty
Authors: Ibrahim Kinda , Cox Natalie J. , Stevenson Jennifer M. , Lim Stephen , Fraser Simon D. S. , Roberts Helen C. 
Published: April 2021

Abstract
Background
Older people living with frailty are often exposed to polypharmacy and potential harm from medications. Targeted deprescribing in this population represents an important component of optimizing medication. This systematic review aims to summarise the current evidence for deprescribing among older people living with frailty.

Methods
The literature was searched using Medline, Embase, CINAHL, PsycInfo, Web of Science, and the Cochrane library up to May 2020. Interventional studies with any design or setting were included if they reported deprescribing interventions among people aged 65+ who live with frailty identified using reliable measures. The primary outcome was safety of deprescribing; whereas secondary outcomes included clinical outcomes, medication-related outcomes, feasibility, acceptability and cost-related outcomes. Narrative synthesis was used to summarise findings and study quality was assessed using Joanna Briggs Institute checklists.

Results
Two thousand three hundred twenty-two articles were identified and six (two randomised controlled trials) were included with 657 participants in total (mean age range 79–87 years). Studies were heterogeneous in their designs, settings and outcomes. Deprescribing interventions were pharmacist-led (n = 3) or multidisciplinary team-led (n = 3). Frailty was identified using several measures and deprescribing was implemented using either explicit or implicit tools or both. Three studies reported safety outcomes and showed no significant changes in adverse events, hospitalisation or mortality rates. Three studies reported positive impact on clinical outcomes including depression, mental health status, function and frailty; with mixed findings on falls and cognition; and no significant impact on quality of life. All studies described medication-related outcomes and reported a reduction in potentially inappropriate medications and total number of medications per-patient. Feasibility of deprescribing was reported in four studies which showed that 72–91% of recommendations made were implemented. Two studies evaluated and reported the acceptability of their interventions and further two described cost saving.

Conclusion
There is a paucity of research about the impact of deprescribing in older people living with frailty. However, included studies suggest that deprescribing could be safe, feasible, well tolerated and can lead to important benefits. Research should now focus on understanding the impact of deprescribing on frailty status in high risk populations.

Trial registration
The review was registered on the international prospective register of systematic reviews (PROSPERO) ID number: CRD42019153367.
Comparison of clinical features on admission between coronavirus disease 2019 and influenza a among children: a retrospective study in China
Authors: Liang Feng , Wang Xianfeng , Shao Jianbo , Chen Jun , Liu Lei , Li Hui , Xu Yi , He Liya , Liang Huiying , Li Kuanrong , Gong Sitang , Xia Huimin 
Published: April 2021

Abstract
Background
Coronavirus disease 2019 (COVID-19) share similar symptoms with influenza A (IA), but it is more worthwhile to understand the disparities of the two infections regarding their clinical characteristics on admission.

Methods
A total of 71 age-matched pediatric IA and COVID-19 patient pairs were formed and their clinical data on admission were compared.

Results
Fever, cough, nasal congestion and nausea/vomiting were the most common symptoms on admission for both infections but occurred less often in COVID-19. The IA patients were more likely to have lower-than-normal levels of lymphocyte count and percentage and to have higher-than-normal levels of activated partial thromboplastin time, prothrombin time, serum C-reactive protein, and serum procalcitonin, while the COVID-19 patients had higher odds of having lower-than-normal levels of neutrophil count and percentage.

Conclusions
This study suggests that influenza A is more symptomatic than COVID-19 for children and might be an overall more severe infection at the time of admission.
Association between the frequency of surgeries for video-assisted thoracic surgery and the incidence of consequent surgical site infections: a retrospective observational study based on national surveillance data
Authors: Kajihara Toshiki , Yahara Koji , Hirabayashi Aki , Kurosu Hitomi , Sugai Motoyuki , Shibayama Keigo 
Published: April 2021

Abstract
Background
The association between the frequency of surgeries and the incidence of surgical site infections (SSIs) has been reported for various surgeries. However, no previous study has explored this association among video-assisted thoracic surgeries (VATS). Hence, we aimed to investigate the association between the frequency of surgeries and SSI in video-assisted thoracic surgeries.

Methods
We analyzed the data of 26,878 thoracic surgeries, including 21,154 VATS, which were collected during a national surveillance in Japan between 2014 and 2018. The frequency of surgeries per hospital department was categorized into low (< 50/year), moderate (50–100/ year), and high (> 100/year). Chi-squared test or Fisher’s exact test was used for discrete explanatory variables, whereas Wilcoxon’s rank-sum test or Kruskal-Wallis test was used for continuous explanatory variables. Univariate analysis of the department groups was conducted to explore confounding factors associated with both SSIs and the department groups. We used a multiple logistic regression model focusing on VATS and stratified by the National Nosocomial Infections Surveillance System (NNIS) risk index.

Results
The rates of SSIs in the hospital groups with low, moderate, and high frequency of surgeries were 1.39, 1.05, and 1.28%, respectively. In the NNIS risk index 1 stratum, the incidence of SSIs was significantly lower in the moderate-frequency of surgeries group than that in the other groups (odds ratio [OR]: vs. low-frequency of surgeries: 2.48 [95% confidence interval [CI]: 1.20–5.13], P = 0.0143; vs. high-frequency of surgeries: 2.43 [95% CI: 1.44–4.11], P = 0.0009). In the stratum of NNIS risk indices 2 and 3, the incidence of SSI was significantly higher in the low-frequency of surgeries group (OR: 4.83, 95% CI: 1.47–15.93; P = 0.0095).

Conclusion
The result suggests that for departments with low-frequency of surgeries, an increase in the frequency of surgeries to > 50 per department annually potentially leads to a decrease in the incidence of SSIs. This occurs through an increase in the experience of the departmental surgeons and contributes to the improvement of VATS outcomes in thoracic surgeries.
Severe pneumonia caused by Parvimonas micra: a case report
Authors: Yu Qing , Sun Lingling , Xu Zuqing , Fan Lumei , Du Yunbo 
Published: April 2021

Abstract
Background
Parvimonas micra (P. micra) is a gram-positive anaerobic coccus that is detected widely on the skin, in the oral mucosa and in the gastrointestinal tract. In certain circumstances, P. micra can cause abdominal abscesses, bacteraemia and other infections. To the best of our knowledge, there have been no case reports describing the biological characteristics of P. micra-related pneumonia. These bacteria do not always multiply in an aerobic organ, such as the lung, and they could be easily overlooked because of the clinical mindset.

Case presentation
A 35-year-old pregnant woman was admitted to the emergency department 4 weeks prior to her due date who was exhibiting 5 points on the Glasgow coma scale. A computed tomography (CT) scan showed a massive haemorrhage in her left basal ganglia. She underwent a caesarean section and brain surgery before being admitted to the ICU. She soon developed severe pneumonia and hypoxemia. Given that multiple sputum cultures were negative, the patient’s bronchoalveolar lavage fluid was submitted for next-generation sequencing (NGS) to determine the pathogen responsible for the pneumonia; as a result, P. micra was determined to be the causative pathogen. Accordingly the antibiotic therapy was altered and the pneumonia improved.

Conclusion
In this case, we demonstrated severe pneumonia caused by the anaerobic organism P. micra, and the patient benefited from receiving the correct antibiotic. NGS was used as a method of quick diagnosis when sputum culture failed to distinguish the pathogen.
Evaluation of pooling of samples for testing SARS-CoV- 2 for mass screening of COVID-19
Authors: Mahmoud Sally A. , Ibrahim Esra , Thakre Bhagyashree , Teddy Juliet G. , Raheja Preety , Ganesan Subhashini , Zaher Walid A. 
Published: April 2021

Abstract
Background
The current pandemic of the SARS-CoV-2 virus, widely known as COVID-19, has affected millions of people around the world. The World Health Organization (WHO) has recommended vigorous testing to differentiate SARS-CoV-2 from other respiratory infections to aid in guiding appropriate care and management. Situations like this have demanded robust testing strategies and pooled testing of samples for SARS-CoV-2 virus has provided the solution to mass screening of people for COVID-19. A pooled testing strategy can be very effective in testing when resources are limited, yet it comes with its own limitations. These benefits and limitations need critical consideration when it comes to testing highly infectious diseases like COVID-19.

Methods
This study evaluated the pooled testing of nasopharyngeal swabs for SARS-COV-2 by comparing the sensitivity of individual sample testing with 4-and 8-pool sample testing. Median cycle threshold (Ct) values were compared, and the precision of pooled testing was assessed through an inter- and intra-assay of pooled samples. Coefficient of variance was calculated for inter- and intra-assay variability.

Results
The sensitivity becomes considerably lower when the samples are pooled. There is a high percentage of false negative reports with larger sample pool size and when the patient viral load is low or weak positive samples. High variability was seen in the intra- and inter-assay, especially among weak positive samples and when more number of samples are pooled together.

Conclusion
As COVID − 19 infection numbers and need for testing remain high, we must meticulously evaluate the testing strategy for each country depending on its testing capacity, infrastructure, economic strength, and need to determine the optimal balance on the cost-effective strategy of resource saving and risk/ cost of missing positive patients.
Food-related taboos and misconceptions during pregnancy among rural communities of Illu Aba Bor zone, Southwest Ethiopia. A community based qualitative cross-sectional study
Authors: Tsegaye Dereje , Tamiru Dessalegn , Belachew Tefera 
Published: April 2021

Abstract
Background
Poor maternal nutrition adversely affects pregnancy and birth outcomes. In many societies, there are dietary restrictions due to misconceptions or food taboos during pregnancy which consequently results in the depletion of important nutrients. These cultural malpractices and beliefs can influence the dietary intake of pregnant women which subsequently affects the birth outcome. The study aimed at exploring the extent of food taboos and misconceptions during pregnancy in rural communities of Illu Aba Bor Zone, Southwest Ethiopia.

Methods
A qualitative study was conducted using an in-depth interviews of key informants and focus group discussions among purposively selected pregnant women and their husbands, health care workers, health extension workers, and elderly people. Data were transcribed verbatim, thematized; color-coded, and analyzed manually using the thematic framework method.

Result
Thorough reading and review of the transcripts generated three major themes. The primary theme was the belief and practice of taboos related to the intake of certain food items during pregnancy. Pregnant women, their husbands, and mothers-in-law believed that certain foods should be avoided during pregnancy. The second theme was foods that were held as taboo and the reason attached to it. The most common food items held as taboo were related to the consumption of vegetables like cabbage, pumpkin, milk and milk products, sugar cane, fruits like bananas and avocado and egg. The main reasons to avoid these foods were beliefs that it can be plastered on the fetal head, making fatty baby which is difficult for delivery. The third theme was the reasons underlying adherence to food taboos which is deeply embedded in the person’s believes and attitudes of the pregnant women, who were nested within the influence of the social environment surrounding them and the traditional beliefs and values of the society in general.

Conclusions
The results showed a widespread practice of food taboos during pregnancy in the study area. The finding suggested that there is a need for strengthening the nutrition counseling components of antenatal care follow-up and planning comprehensive nutrition education through involving important others to dispel such traditional beliefs and prevent food taboo practices in the study community.
Mitochondrial DNA abnormalities provide mechanistic insight and predict reactive oxygen species-stimulating drug efficacy
Authors: Zaidieh Tarek , Smith James R. , Ball Karen E. , An Qian 
Published: April 2021

Abstract
Background
Associations between mitochondrial genetic abnormalities (variations and copy number, i.e. mtDNAcn, change) and elevated ROS have been reported in cancer compared to normal cells. Since excessive levels of ROS can trigger apoptosis, treating cancer cells with ROS-stimulating agents may enhance their death. This study aimed to investigate the link between baseline ROS levels and mitochondrial genetic abnormalities, and how mtDNA abnormalities might be used to predict cancer cells’ response to ROS-stimulating therapy.

Methods
Intracellular and mitochondrial specific-ROS levels were measured using the DCFDA and MitoSOX probes, respectively, in four cancer and one non-cancerous cell lines. Cells were treated with ROS-stimulating agents (cisplatin and dequalinium) and the IC50s were determined using the MTS assay. Sanger sequencing and qPCR were conducted to screen the complete mitochondrial genome for variations and to relatively quantify mtDNAcn, respectively. Non-synonymous variations were subjected to 3-dimensional (3D) protein structural mapping and analysis.

Results
Our data revealed novel significant associations between the total number of variations in the mitochondrial respiratory chain (MRC) complex I and III genes, mtDNAcn, ROS levels, and ROS-associated drug response. Furthermore, functional variations in complexes I/III correlated significantly and positively with mtDNAcn, ROS levels and drug resistance, indicating they might mechanistically influence these parameters in cancer cells.

Conclusions
Our findings suggest that mtDNAcn and complexes I/III functional variations have the potential to be efficient biomarkers to predict ROS-stimulating therapy efficacy in the future.