bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gene expression and alternative splicing dynamics are perturbed in female head transcriptomes following heterospecific copulation
Authors: Diaz Fernando , Allan Carson W. , Markow Therese Ann , Bono Jeremy M. , Matzkin Luciano M. 
Published: May 2021

AbstractBackgroundDespite the growing interest in the female side of copulatory interactions, the roles played by differential expression and alternative splicing mechanisms ofpre-RNAon tissues outside of the reproductive tract have remained largely unknown. Here we addressed these questions in the context of con- vs heterospecific matings betweenDrosophila mojavensisand its sister species,D. arizonae. We analyzed transcriptional responses in female heads using an integrated investigation of genome-wide patterns of gene expression, including differential expression (DE), alternative splicing (AS) and intron retention (IR).ResultsOur results indicated that early transcriptional responses were largely congruent between con- and heterospecific matings but are substantially perturbed over time. Conspecific matings induced functional pathways related to amino acid balance previously associated with the brain’s physiology and female postmating behavior. Heterospecific matings often failed to activate regulation of some of these genes and induced expression of additional genes when compared with those of conspecifically-mated females. These mechanisms showed functional specializations withDEgenes mostly linked to pathways of proteolysis and nutrient homeostasis, whileASgenes were more related to photoreception and muscle assembly pathways.IRseems to play a more general role inDEregulation during the female postmating response.ConclusionsWe provide evidence showing thatASgenes substantially perturbed by heterospecific matings in female heads evolve at slower evolutionary rates than the genome background. However,DEgenes evolve at evolutionary rates similar, or even higher, than those of male reproductive genes, which highlights their potential role in sexual selection and the evolution of reproductive barriers.
Identification of cell wall-associated kinases as important regulators involved in Gossypium hirsutum resistance to Verticillium dahliae
Authors: Yang Jun , Xie Meixia , Wang Xingfen , Wang Guoning , Zhang Yan , Li Zhikun , Ma Zhiying 
Published: May 2021

Abstract
Background
Verticillium wilt, caused by the soil borne fungus Verticillium dahliae, is a major threat to cotton production worldwide. An increasing number of findings indicate that WAK genes participate in plant−pathogen interactions, but their roles in cotton resistance to V. dahliae remain largely unclear.

Results
Here, we carried out a genome-wide analysis of WAK gene family in Gossypium hirsutum that resulted in the identification of 81 putative GhWAKs, which were all predicated to be localized on plasma membrane. In which, GhWAK77 as a representative was further located in tobacco epidermal cells using transient expression of fluorescent fusion proteins. All GhWAKs could be classified into seven groups according to their diverse protein domains, indicating that they might sense different outside signals to trigger intracellular signaling pathways that were response to various environmental stresses. A lot of cis-regulatory elements were predicted in the upstream region of GhWAKs and classified into four main groups including hormones, biotic, abiotic and light. As many as 28 GhWAKs, playing a potential role in the interaction between cotton and V. dahliae, were screened out by RNA-seq and qRT-PCR. To further study the function of GhWAKs in cotton resistance to V. dahliae, VIGS technology was used to silence GhWAKs. At 20 dpi, VIGSed plants exhibited more chlorosis and wilting than the control plants. The disease indices of VIGSed plants were also significantly higher than those of the control. Furthermore, silencing of GhWAKs significantly affected the expression of JA- and SA-related marker genes, increased the spread of V. dahliae in the cotton stems, dramatically compromised V. dahliae-induced accumulation of lignin, H2O2 and NO, but enhanced POD activity.

Conclusion
Our study presents a comprehensive analysis on cotton WAK gene family for the first time. Expression analysis and VIGS assay provided direct evidences on GhWAKs participation in the cotton resistance to V. dahliae.
Dynamic prediction based on variability of a longitudinal biomarker
Authors: Campbell Kristen R. , Martins Rui , Davis Scott , Juarez-Colunga Elizabeth 
Published: May 2021

AbstractBackgroundTacrolimus is given post-kidney transplant to suppress the immune system, and the amount of drug in the body is measured frequently. Higher variability over time may be indicative of poor drug adherence, leading to more adverse events. It is important to account for the variation in Tacrolimus, not just the average change over time.MethodsUsing data from the University of Colorado, we compare methods of assessing how the variability in Tacrolimus influences the hazard of de novo Donor Specific Antibodies (dnDSA), an early warning sign of graft failure. We compare multiple joint models in terms of fit and predictive ability. We explain that the models that account for the individual-specific variability over time have the best predictive performance. These models allowed each patient to have an individual-specific random error term in the longitudinal Tacrolimus model, and linked this to the hazard of dnDSA model.ResultsThe hazard for the variance and coefficient of variation (CV) loading parameter were greater than 1, indicating that higher variability of Tacrolimus had a higher hazard of dnDSA. Introducing the individual-specific variability improved the fit, leading to more accurate predictions about the individual-specific time-to-dnDSA.ConclusionsWe showed that the individual’s variability in Tacrolimus is an important metric in predicting long-term adverse events in kidney transplantation. This is an important step in personalizing the dosage of TAC post-transplant to improve outcomes post-transplant.
Shared decision making and patient-centeredness for patients with poorly controlled type 2 diabetes mellitus in primary care—results of the cluster-randomised controlled DEBATE trial
Authors: Wollny Anja , Löffler Christin , Drewelow Eva , Altiner Attila , Helbig Christian , Daubmann Anne , Wegscheider Karl , Löscher Susanne , Pentzek Michael , Wilm Stefan , Feldmeier Gregor , Santos Sara 
Published: May 2021

Abstract
Background
We investigate whether an educational intervention of GPs increases patient-centeredness and perceived shared decision making in the treatment of patients with poorly controlled type 2 diabetes mellitus?

Methods
We performed a cluster-randomized controlled trial in German primary care. Patients with type 2 diabetes mellitus defined as HbA1c levels ≥ 8.0% (64 mmol/mol) at the time of recruitment (n = 833) from general practitioners (n = 108) were included. Outcome measures included subjective shared decision making (SDM-Q-9; scale from 0 to 45 (high)) and patient-centeredness (PACIC-D; scale from 1 to 5 (high)) as secondary outcomes. Data collection was performed before intervention (baseline, T0), at 6 months (T1), at 12 months (T2), at 18 months (T3), and at 24 months (T4) after baseline.

Results
Subjective shared decision making decreased in both groups during the course of the study (intervention group: -3.17 between T0 and T4 (95% CI: -4.66, -1.69; p < 0.0001) control group: -2.80 (95% CI: -4.30, -1.30; p = 0.0003)). There were no significant differences between the two groups (-0.37; 95% CI: -2.20, 1.45; p = 0.6847). The intervention's impact on patient-centeredness was minor. Values increased in both groups, but the increase was not statistically significant, nor was the difference between the groups.

Conclusions
The intervention did not increase patient perceived subjective shared decision making and patient-centeredness in the intervention group as compared to the control group. Effects in both groups might be partially attributed to the Hawthorne-effect. Future trials should focus on patient-based intervention elements to investigate effects on shared decision making and patient-centeredness.

Trial registration
The trial was registered on March 10th, 2011 at ISRCTN registry under the reference ISRCTN70713571.
Examining primary care physician rationale for not following geriatric choosing wisely recommendations
Authors: Rowe Theresa A. , Brown Tiffany , Doctor Jason N. , Linder Jeffrey A. , Persell Stephen D. 
Published: May 2021

Abstract
Background
The objective is to understand why physicians order tests or treatments in older adults contrary to published recommendations.

Methods
Participants: Physicians above the median for ≥ 1 measures of overuse representing 3 Choosing Wisely topics. Measurements: Participants evaluated decisions in a semi-structured interview regarding: 1) Screening men aged ≥ 76 with prostate specific antigen 2) Ordering urine studies in women ≥ 65 without symptoms 3) Overtreating adults aged ≥ 75 with insulin or oral hypoglycemic medications. Two investigators independently coded transcripts using qualitative analysis.

Results
Nineteen interviews were conducted across the three topics resulting in four themes. First, physicians were aware and knowledgeable of guidelines. Second, perceived patient preference towards overuse influenced physician action even when physicians felt strongly that testing was not indicated. Third, physicians overestimated benefits of a test and underemphasized potential harms. Fourth, physicians were resistant to change when patients appeared to be doing well.

Conclusions
Though physicians expressed awareness to avoid overuse, deference to patient preferences and the tendency to distort the chance of benefit over harm influenced decisions to order testing. Approaches for decreasing unnecessary testing must account for perceived patient preferences, make the potential harms of overtesting salient, and address clinical inertia among patients who appear to be doing well.
The mental health crises of the families of COVID-19 victims: a qualitative study
Authors: Mohammadi Fateme , Oshvandi Khodayar , Shamsaei Farshid , Cheraghi Fateme , Khodaveisi Masoud , Bijani Mostafa 
Published: May 2021

Abstract
Background
The bereaved families of COVID-19 victims are among the most vulnerable social groups in the COVID-19 pandemic. This highly infectious and contagious disease has afflicted these families with numerous psychological crises which have not been studied much yet. The present study is an attempt at investigating the psychological challenges and issues which the families of COVID-19 victims are faced with. The present study aims to identify the Mental Health crises which the families of COVID-19 deceased victims are going through.

Methods
A qualitative research, the present study uses a conventional content analysis design. The participants were 16 members of the families of COVID-19 victims selected from medical centers in Iran from February to May 2020 via purposeful sampling. Sampling continued to the point of data saturation Data were collected via semi-structured individual interviews conducted online. The collected data were analyzed according to the conventional qualitative content analysis approach.

Results
Analyses of the data yielded two main themes and seven categories. Emotional shock included (feelings of guilt and rumination, bitter farewell, strange burial and concern about unreligious burial), and fear of the future included (instability in the family, lack of job security and difficult financial conditions, Stigmatization and complications in social interactions).

Conclusion
The families of COVID-19 deceased victims are affected by various psychological crises which have exposed them to a deep sense of loss and emotional shock. Therefore, there is an urgent need for a cultural context which recognizes and supports all the various aspects of the mental health of these families.
The period from prodromal fever onset to rash onset in laboratory-confirmed rubella cases: a cross-sectional study
Authors: Ogata Tsuyoshi , Murooka Maki , Akashi Makoto , Ishitsuka Akemi , Miyazaki Akari , Osawa Shuuichi , Ishikawa Kanako , Tanaka-Taya Keiko , Uehara Ritei 
Published: May 2021

Abstract
Background
In resource-limited settings, where rubella is endemic, it is difficult to determine which sporadic case should be tested for rubella. The study aimed to provide useful evidence to help screen rubella cases for real-time reverse transcriptase-polymerase chain reaction (RT-PCR) examination for rubella in resource-limited settings.

Method
Suspected rubella patients identified by a physician and brought to the notice of the Ryugasaki public health center or the Tsuchiura public health center were enrolled from April 2018 through December 2019. The inclusion criterion was a confirmed rubella diagnosis based on laboratory tests. We studied the distribution of the time from the onset of fever until the onset of rash.

Results
The study included 86 cases with simultaneous presentation of fever and rash. Twenty-nine cases had confirmed rubella based on the laboratory diagnosis. Among these, the time from the onset of fever until the onset of rash was limited to − 1 day to 2 days. The number of rubella cases was the highest when the onset of rash was on the following day of the onset of fever. Of the 78 patients who underwent the RT-PCR test, 48% tested positive for rubella among those with a time from the onset of fever to the onset of rash between − 1 day and 2 days (22 out of 46, 95% confidence interval 34–62%); no positive results (0 out of 30, 95% confidence interval - 14%) were seen in patients with a time from fever to rash onset ≥3 days.

Conclusion
The period from the onset of fever to the onset of rash was limited to − 1 day to 2 days among confirmed rubella patients. If the period from onset of fever to the onset of rash was ≥3 days for a patient, the likelihood of rubella was low.
Reduction in massive postpartum haemorrhage and red blood cell transfusion during a national quality improvement project, Obstetric Bleeding Strategy for Wales, OBS Cymru: an observational study
Authors: Bell Sarah F. , Collis Rachel E. , Pallmann Philip , Bailey Christopher , James Kathryn , John Miriam , Kelly Kevin , Kitchen Thomas , Scarr Cerys , Watkins Adam , Edey Tracey , Macgillivray Elinore , Greaves Kathryn , Volikas Ingrid , Tozer James , Sengupta Niladri , Roberts Iolo , Francis Claire , Collins Peter W. 
Published: May 2021

Abstract
Background
Postpartum haemorrhage (PPH) is a major cause of maternal morbidity and mortality and its incidence is increasing in many countries despite management guidelines. A national quality improvement programme called the Obstetric Bleeding Strategy for Wales (OBS Cymru) was introduced in all obstetric units in Wales. The aim was to reduce moderate PPH (1000 mL) progressing to massive PPH (> 2500 mL) and the need for red cell transfusion.

Methods
A PPH care bundle was introduced into all 12 obstetric units in Wales included all women giving birth in 2017 and 2018 (n = 61,094). The care bundle prompted: universal risk assessment, quantitative measurement of blood loss after all deliveries (as opposed to visual estimation), structured escalation to senior clinicians and point-of-care viscoelastometric-guided early fibrinogen replacement. Data were submitted by each obstetric unit to a national database. Outcome measures were incidence of massive PPH (> 2500 mL) and red cell transfusion. Analysis was performed using linear regression of the all Wales monthly data.

Results
Uptake of the intervention was good: quantitative blood loss measurement and risk assessment increased to 98.1 and 64.5% of all PPH > 1000 mL, whilst ROTEM use for PPH > 1500 mL increased to 68.2%. Massive PPH decreased by 1.10 (95% CI 0.28 to 1.92) per 1000 maternities per year (P = 0.011). Fewer women progressed from moderate to massive PPH in the last 6 months, 74/1490 (5.0%), than in the first 6 months, 97/1386 (7.0%), (P = 0.021). Units of red cells transfused decreased by 7.4 (95% CI 1.6 to 13.2) per 1000 maternities per year (P = 0.015). Red cells were transfused to 350/15204 (2.3%) and 268/15150 (1.8%) (P = 0.001) in the first and last 6 months, respectively. There was no increase in the number of women with lowest haemoglobin below 80 g/L during this time period. Infusions of fresh frozen plasma fell and there was no increase in the number of women with haemostatic impairment.

Conclusions
The OBS Cymru care bundle was feasible to implement and associated with progressive, clinically significant improvements in outcomes for PPH across Wales. It is applicable across obstetric units of widely varying size, complexity and staff mixes.
A multicenter evaluation of viral bloodstream detections in children presenting to the Emergency Department with suspected systemic infection
Authors: Rostad Christina A. , Kanwar Neena , Yi Jumi , Morris Claudia R. , Bard Jennifer Dien , Leber Amy , Dunn James , Chapin Kimberle C. , Blaschke Anne J. , Daly Judy A. , Hueschen Leslie A. , Jones Matthew , Ott Elizabeth , Bastar Jeffrey , Bourzac Kevin M. , Selvarangan Rangaraj 
Published: May 2021

Abstract
Background
Fever is a common symptom in children presenting to the Emergency Department (ED). We aimed to describe the epidemiology of systemic viral infections and their predictive values for excluding serious bacterial infections (SBIs), including bacteremia, meningitis and urinary tract infections (UTIs) in children presenting to the ED with suspected systemic infections.

Methods
We enrolled children who presented to the ED with suspected systemic infections who had blood cultures obtained at seven healthcare facilities. Whole blood specimens were analyzed by an experimental multiplexed PCR test for 7 viruses. Demographic and laboratory results were abstracted.

Results
Of the 1114 subjects enrolled, 245 viruses were detected in 224 (20.1%) subjects. Bacteremia, meningitis and UTI frequency in viral bloodstream-positive patients was 1.3, 0 and 10.1% compared to 2.9, 1.3 and 9.7% in viral bloodstream-negative patients respectively. Although viral bloodstream detections had a high negative predictive value for bacteremia or meningitis (NPV = 98.7%), the frequency of UTIs among these subjects remained appreciable (9/89, 10.1%) (NPV = 89.9%). Screening urinalyses were positive for leukocyte esterase in 8/9 (88.9%) of these subjects, improving the ability to distinguish UTI.

Conclusions
Viral bloodstream detections were common in children presenting to the ED with suspected systemic infections. Although overall frequencies of SBIs among subjects with and without viral bloodstream detections did not differ significantly, combining whole blood viral testing with urinalysis provided high NPV for excluding SBI.
Social isolation, physical inactivity and inadequate diet among European middle-aged and older adults
Authors: Delerue Matos Alice , Barbosa Fátima , Cunha Cláudia , Voss Gina , Correia Filipa 
Published: May 2021

AbstractBackgroundSocial isolation is a growing public health concern for older adults, as it has been associated with poor health and premature mortality. On the other hand, physical inactivity and an inadequate diet are important health risk behaviours associated with physical and mental health problems. Considering that there is no research examining the possible relationship between social isolation and the above mentioned health risk behaviours of European middle-aged and older adults, this cross-sectional study aims to contribute to filling this gap.MethodsWe used data from the SHARE project (Survey of Health, Ageing and Retirement in Europe), wave 6 (2015), release 7.0.0 (N = 67,173 individuals from 17 European countries plus Israel). Statistical tests for a two-group comparison were carried out to assess the differences between highly socially isolated individuals and low/intermediate socially isolated ones. Logistic regressions by country were performed to examine whether social isolation is associated with physical inactivity and an inadequate diet in the population aged 50 + .ResultsOur results point out that, for the majority of the countries analysed, highly socially isolated individuals are more likely than low/intermediate isolated ones to be physically inactive and to consume less fruit or vegetables on a daily basis. In 9 European countries (Austria, Germany, Sweden, Denmark, Greece, Belgium, Poland, Luxembourg and Estonia) highly socially isolated individuals are more likely to be physically inactive. On the other hand, in 14 European countries (Austria, Germany, Sweden, Italy, France, Denmark, Greece, Switzerland, Belgium, Czech Republic, Luxembourg, Slovenia, Estonia and Croatia), high social isolation increases the likelihood of having an inadequate diet.ConclusionHighly socially isolated European middle-aged and older adults are more prone to be physically inactive and to have an inadequate diet in terms of daily consumption of fruit and vegetables. The reduced social integration, social support and companionship of the highly socially isolated individuals may explain this association. Our results reinforce the importance of social and health policies targeting highly socially isolated European individuals aged 50 + .
Prediction model for prolonged fever in patients with Mycoplasma pneumoniae pneumonia: a retrospective study of 716 pediatric patients
Authors: Jang Min Sik , Kim Bit Gyeol , Kim Jihye 
Published: May 2021

Abstract
Objective
To identify patients with Mycoplasma pneumoniae pneumonia (MPP) with a risk of prolonged fever while on macrolides.

Methods
A retrospective study was performed with 716 children admitted for MPP. Refractory MPP (RMPP-3) was defined as fever persisting for > 72 h without improvement in clinical and radiologic findings after macrolide antibiotics (RMPP-3) or when fever persisted for > 120 h (RMPP-5) without improvement in clinical and radiologic findings. Radiological data, laboratory data, and fever profiles were compared between the RMPP and non-RMPP groups. Fever profiles included the highest temperature, lowest temperature, and frequency of fever. Prediction models for RMPP were created using the logistic regression method and deep neural network. Their predictive values were compared using receiver operating characteristic curves.

Results
Overall, 716 patients were randomly divided into two groups: training and test cohorts for both RMPP-3 and RMPP-5. For the prediction of RMPP-3, a conventional logistic model with radiologic grouping showed increased sensitivity (63.3%) than the model using laboratory values. Adding laboratory values in the prediction model using radiologic grouping did not contribute to a meaningful increase in sensitivity (64.6%). For the prediction of RMPP-5, laboratory values or radiologic grouping showed lower sensitivities ranging from 12.9 to 16.1%. However, prediction models using predefined fever profiles showed significantly increased sensitivity for predicting RMPP-5, and neural network models using 12 sequential fever data showed a greatly increased sensitivity (64.5%).

Conclusion
RMPP-5 could not be effectively predicted using initial laboratory and radiologic data, which were previously reported to be predictive. Further studies using advanced mathematical models, based on large-sized easily accessible clinical data, are anticipated for predicting RMPP.