bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevated CO2 causes different growth stimulation, water- and nitrogen-use efficiencies, and leaf ultrastructure responses in two conifer species under intra- and interspecific competition
Authors: Yu Lei , Dong Haojie , Huang Zongdi , Korpelainen Helena , Li Chunyang 
Published: April 2021

AbstractThe continuously increasing atmospheric carbon dioxide concentration ([CO2]) has substantial effects on plant growth, and on the composition and structure of forests. However, how plants respond to elevated [CO2] (e[CO2]) under intra- and interspecific competition has been largely overlooked. In this study, we employed Abies faxoniana Rehder & Wilson and Picea purpurea Mast. seedlings to explore the effects of e[CO2] (700 p.p.m.) and plant–plant competition on plant growth, physiological and morphological traits, and leaf ultrastructure. We found that e[CO2] stimulated plant growth, photosynthesis and nonstructural carbohydrates (NSC), affected morphological traits and leaf ultrastructure, and enhanced water- and nitrogen (N)- use efficiencies in A. faxoniana and P. purpurea. Under interspecific competition and e[CO2], P. purpurea showed a higher biomass accumulation, photosynthetic capacity and rate of ectomycorrhizal infection, and higher water- and N-use efficiencies compared with A. faxoniana. However, under intraspecific competition and e[CO2], the two conifers showed no differences in biomass accumulation, photosynthetic capacity, and water- and N-use efficiencies. In addition, under interspecific competition and e[CO2], A. faxoniana exhibited higher NSC levels in leaves as well as more frequent and greater starch granules, which may indicate carbohydrate limitation. Consequently, we concluded that under interspecific competition, P. purpurea possesses a positive growth and adjustment strategy (e.g. a higher photosynthetic capacity and rate of ectomycorrhizal infection, and higher water- and N-use efficiencies), while A. faxoniana likely suffers from carbohydrate limitation to cope with rising [CO2]. Our study highlights that plant–plant competition should be taken into consideration when assessing the impact of rising [CO2] on the plant growth and physiological performance.
Sensitive and Specific qPCR and Nested RT-PCR Assays for the Detection of Tobacco Streak Virus in Soybean
Authors: Zambrana-Echevarría Cristina , Roth Mitchell G. , Dasgupta Ranjit , German Thomas L. , Groves Carol L. , Smith Damon L. 
Published: April 2021

Tobacco streak virus (TSV) is a reemerging and understudied pathogen of soybean (Glycine max). Management of TSV is challenging due to the multiple modes of transmission, widespread susceptibility of commercial soybean, and lack of reliable diagnostic tests for the virus. Soybean plants with TSV-like, virus-like, or no symptoms were collected from commercial and research fields in seven counties in Wisconsin. Two sensitive assays were developed for the detection of TSV: a fluorescent dye-based quantitative reverse-transcription PCR (qPCR) assay and a nested reverse-transcription PCR (nRT-PCR). TSV was detected in 47 and 91% of symptomatic samples using the qPCR and nRT-PCR assays, respectively, suggesting that the nRT-PCR assay has higher sensitivity for detecting TSV. The qPCR assay’s limit of detection was determined at 10 fg and the assay was used to estimate the viral load in TSV-symptomatic samples. The titer of TSV in these samples was determined by absolute quantification and ranged from 15 fg to 0.796 ng. The two assays reported here provide diagnostic tools for the rapid and accurate detection of TSV that can aid in monitoring outbreaks, assessing management strategies, or screening soybean cultivars or accessions for resistance to the virus. [Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Current concepts in the evaluation and management of preoperative anemia
Authors: Neef Vanessa , Choorapoikayil Suma , Piekarski Florian , Schlesinger Tobias , Meybohm Patrick , Zacharowski Kai 
Published: April 2021

Purpose of review
In the past years, patient blood management (PBM) has evolved to improve patient‘s care and safety. Anemia is one of the most common medical diseases in the world and is an independent risk factor for morbidity and mortality. Iron deficiency is the main cause for anemia and constitutes a potentially preventable condition with a great impact on surgical outcome. However, preoperative anemia management is not yet established in most hospitals. Changing workflows and re-thinking is challenging. Numerous published studies confirmed the positive effect of preoperative anemia diagnosis and treatment recently.

Recent findings
Iron supplementation in iron-deficient anemic (IDA) patients reduce the need for allogenic blood transfusion thereby improving perioperative outcome.

Summary
Since the introduction of PBM programs, important movements towards early detection and therapy of preoperative anemia have been observed. However, preoperative anemia management is not implemented on a large scale as many healthcare professionals are not aware of the most recent findings in the field. Preoperative anemia management, particularly iron supplementation in IDA patients, has proven to be highly effective and has a tremendous effect on patient safety and outcome.
Pediatric obesity and perioperative medicine
Authors: Mpody Christian , Owusu-Bediako Kwaku , Raman Vidya T. , Nafiu Olubukola O. 
Published: April 2021

Purpose of review
Childhood obesity is a public health emergency that has reached a pandemic level and imposed a massive economic burden on healthcare systems. Our objective was to provide an update on (1) challenges of obesity definition and classification in the perioperative setting, (2) challenges of perioperative patient positioning and vascular access, (3) perioperative implications of childhood obesity, (3) anesthetic medication dosing and opioid-sparing techniques in obese children, and (4) research gaps in perioperative childhood obesity research including a call to action.

Recent findings
Despite the near axiomatic observation that obesity is a pervasive clinical problem with considerable impact on perioperative health, there have only been a handful of research into the many ramifications of childhood obesity in the perioperative setting. A nuanced understanding of the surgical and anesthetic risks associated with obesity is essential to inform patients’ perioperative consultation and their parents’ counseling, improve preoperative risk mitigation, and improve patients’ rescue process when complications occur.

Summary
Anesthesiologists and surgeons will continue to be confronted with an unprecedented number of obese or overweight children with a high risk of perioperative complications.
Use of Simulation to Improve Nurses' Response to COVID-19 Code Blue
Authors: Shelton Charity L. 
Published: April 2021

Abstract
Simulation is an innovative teaching tool that is widely used to improve nursing practice. The recent COVID-19 pandemic has revealed new areas of learning for nurses who care for patients in acute healthcare settings. Particularly, the COVID-19-positive patient who experiences a medical emergency, such as a code blue, needs nurses who are skilled in safely delivering lifesaving interventions. This article provides a review of the literature on the use of simulation to improve nurses' response to a code blue emergency with patients with COVID-19. This review includes literature on using simulation to enhance donning and doffing of personal protective equipment. No previous literature discussed conducting a code blue rescue with a patient who has COVID-19. On the basis of the literature reviewed, simulation should be considered as a tool to improve code blue outcomes, confidence of nurse responders, and compliance in proper donning and doffing of personal protective equipment. This article offers implications for further research on the use of simulation to advance knowledge about best practices for nurse response to COVID-19 code blue.

Highlights:
• Simulation is a tool that improves code blue outcomes, such as improving early recognition of cardiac emergencies and time to first compressions.
• The COVID-19 pandemic has left nurses with increased fear and anxiety when caring for patients with COVID-19.
• Simulation provides a safe environment for nurses to practice donning and doffing of personal protective equipment in preparation of a COVID-19 rescue.

Key Points:
• Simulation helps nurses deliver quality interventions in a code blue emergency.
• Self-confidence of nurses caring for patients with COVID-19 must be addressed so quality of care can be delivered.
• Simulation of COVID-19 code blue should be used as a training tool to improve outcomes for the patient and safety for nurses.
Chronic Medial Collateral Ligament Sprain Treated With Percutaneous Ultrasonic Debridement: A Case Report
Authors: Park David J. , Rucci Paul , Sussman Walter I. 
Published: April 2021

Abstract:
The medial collateral ligament (MCL) is the most commonly injured ligament of the knee. Most grade I and II injuries respond to conservative management, but symptoms persist in some patients. In these cases, treatment options are limited. Percutaneous ultrasonic debridement is increasingly being used for tendinopathy and fasciopathy refractory to conservative management, but this has not been reported as a treatment for ligament injury. Here, we present a case of a chronic grade II MCL sprain successfully treated with percutaneous ultrasonic debridement.
Evaluation of Minimal Change Lesions Using Linked Color Imaging in Patients With Nonerosive Reflux Esophagitis
Authors: Zhang Ni-Na , Ma Yi-Min , Sun Qi , Shi Liang-Liang , Xie Yin , Zou Xiao-Ping 
Published: April 2021

Background and Aims:
High prevalence of minimal change lesion (MCL) in nonerosive reflux esophagitis (NERD) patients is commonly recognized by many endoscopists. However, it is difficult to detect MCL with conventional white-light imaging (WLI) endoscopy. Linked color imaging (LCI), a novel image-enhanced endoscopy technology with strong, unique color enhancement, is used for easy recognition of early gastric cancer and detection of Helicobacter pylori infection. The aim of the study was to compare the efficacy of LCI and WLI endoscopy in evaluating MCL in patients with NER.

Materials and Methods:
Forty-one patients with NERD and 38 subjects with nongastroesophageal reflux disease (non-GERD) were recruited in this study between August 2017 and July 2018. During upper gastrointestinal endoscopy, the distal 5 cm of the esophageal mucosal morphology at the squamocolumnar junction was visualized using WLI followed by LCI. MCL was defined as areas of erythema, blurring of the Z-line, friability, decreased vascularity, white turbid discoloration, and edema or accentuation of the mucosal folds. Three experienced endoscopists evaluated the color patterns for MCL on WLI images and on WLI combined with LCI images in both groups. A biopsy was taken 2 cm above the esophagogastric junction. Histologic slides were scored by a pathologist in a blinded manner.

Results:
The proportion of MCL was higher in the patients with NERD (70.7%, 29/41) than in patients with non-GERD (39.5%, 15/38) using WLI combined with LCI. In 12 patients with NERD, both WLI and LCI showed normal mucosa. The MCL detection rate was significantly higher when using WLI combined with LCI than when using WLI (70.7% vs. 51.2%, P=0.039) in patients with NERD. The histopathologic score of MCL (+) was significantly higher than that of MCL (−) patients in both the NERD group (4.59±0.32 vs. 2.36±0.34, P<0.01) and the non-GERD group (3.47±0.50 vs. 2.00±0.28, P<0.01). The intraobserver reproducibility levels and interobserver agreement were better with LCI than with WLI alone.

Conclusions:
Frequency of MCL was higher in patients with NERD than in those with non-GERD. MCL can be identified by using WLI combined with LCI in patients with NERD. By enhancing endoscopic images, LCI is more sensitive in detecting MCL compared with WLI.
The role of nursing care in the type 2 diabetes treatment associated with chronic liver diseases
Authors: Fu Bai Yu , Wang Xue Jiao 
Published: April 2021

Objective
Diabetes is the fifth leading cause of death in the People’s Republic of China. The aim of the article is to compare the effects of nursing care on the laboratory findings and ultrasound results of diabetic patients with chronic liver diseases (CLD) who were treated with antiglycemic drugs.

Methods
Diabetic were patients treated with metformin hydrochloride in combination with gliclazide, pioglitazone hydrochloride, sitagliptin, exenatide or liraglutide. Non-alcoholic fatty liver disease (NAFLD) was evaluated by abdominal ultrasound, and fibrosis stages were evaluated at baseline and 8 months. All the patients were equally divided into two groups depending on the therapeutic approach.

Results
The first group of patients additionally received nursing care, and the second group adhered to the prescribed therapy on their own. In total 90 patients, or 55.6%, had NAFLD at baseline, and its course was dependent upon changes in the weight (P = 0.009) and waist circumference (P = 0.012). The proportions of patients who demonstrated an ultrasonographic improvement in the control group were: 24 (56.8%) with gliclazide, 15 (41.3%) with pioglitazone hydrochloride, 28 (66.1%) with sitagliptin, 16 (79%) with exenatide and 15 (66.7%) with liraglutide (P = 0.2). For the group that received nursing care an ultrasonographic improvement was in: 29 (68.16%) with gliclazide, 18 (49.56%) with pioglitazone hydrochloride, 33 (79.32%) with sitagliptin, 19 (94.8%) with exenatide and 21 80.04% with liraglutide (P = 0.2).

Conclusions
Outcomes from the type 2 diabetes treatment paralleling of CLD were presented. Treatment of type 2 diabetes with pioglitazone hydrochloride, gliclazide, sitagliptin, liraglutide and exenatide was proven effective.
High Levels of Prevention-Effective Adherence to HIV PrEP: An Analysis of Substudy Data From the EPIC-NSW Trial
Authors: Bavinton Benjamin R. , Vaccher Stefanie , Jin Fengyi , Prestage Garrett P. , Holt Martin , Zablotska-Manos Iryna B. , Guy Rebecca , Amin Janaki , Templeton David J. , Yeung Barbara , Hammoud Mohamed A. , Lewis David , Baker David , Dharan Nila , McNulty Anna M. , Grulich Andrew E. ,   for the Expanded PrEP Implementation in Communities in New South Wales (EPIC-NSW) research group
Published: April 2021

Background:
Preexposure prophylaxis (PrEP) prevents HIV infection but relies on good adherence at times of risk, termed “prevention-effective adherence.” Most studies assess adherence without reference to sexual behaviur, making it challenging to determine if poor adherence coincides with HIV risk.

Setting:
We examined data from a behavioral substudy of a large-scale PrEP implementation trial in New South Wales, Australia.

Methods:
Trial participants completed optional brief quarterly surveys, reporting the number of pills taken and sexual behavior with male partners for each day of the “last full week” before each survey. Condomless sex (CLS) was defined as “higher risk” for HIV when with HIV-positive men with detectable/unknown viral loads or unknown HIV status men. Adequate PrEP protection was defined as ≥4 pills for participants assigned male sex at birth and ≥6 pills for participants assigned female sex at birth (including transgender men).

Results:
Of 9596 participants dispensed PrEP, 4401 completed baseline and ≥1 follow-up survey. Participants reported on 12,399 “last full weeks”: 7485 weeks (60.4%) involved CLS and 2521 weeks (33.7% of CLS-weeks) involved higher risk CLS. There were 103 weeks in which participants did not have adequate PrEP protection and had higher risk CLS: 4.1% of higher-risk CLS weeks (n = 103/2521), 1.4% of all CLS weeks (n = 103/7485), and 0.8% of all observed weeks (n = 103/12,399).

Conclusions:
In a large PrEP trial, prevention-effective adherence to PrEP was very high at 99%. Our findings illustrate the importance of measuring pill-taking and sexual behavior in the same period so that prevention-effective adherence can be better estimated.
EAST Oriens Award: Why I want a career in trauma and acute care surgery
Authors: Carlin Margo Nicole 
Published: April 2021

ABSTRACT
The opportunity to compose this essay for the Eastern Association for the Surgery Trauma’s Oriens Award has been the most terrific privilege of my training thus far. This award gave my passion a voice. It helped me better understand myself and my need to be a part of this world, this universe that selflessly dedicates every moment of themselves to the care of the critically ill and injured patient. I found every single past Oriens Essay and Keynote Address is a testament to the pure resilience, strength, and grit necessary to embody the calm and collected exterior of the internally screaming trauma surgeon. To me, this award, and all the previous essays, represents the genuine passion of this community and its continued support of each other. As I continue to process the honor of being selected for this prestigious award, I would like to thank my peers, mentors, and the entire trauma community for your perpetual inspiration and education. Your success and timeless dedication to the evolution of this field simply fascinates me. In preparing to join this society, it is my hope that some of these words may inspire, in an effort to reprise my mentors and truly thank you for selecting my essay for this year’s award.
Strong anti-viral responses in pediatric COVID-19 patients in South Brazil
Authors: Fazolo Tiago , Lima Karina , Fontoura Julia C. , de Souza Priscila Oliveira , Hilario Gabriel , Zorzetto Renata , Júnior Luiz Rodrigues , Pscheidt Veridiane Maria , de Castilhos Ferreira Neto Jayme , Haubert Alisson F. , Gambin Izza , Oliveira Aline C. , Mello Raissa S. , de Bastos Balbe e Gutierres Matheus , Gassen Rodrigo Benedetti , Sauthier Sartor Ivaine Tais , Zavaglia Gabriela Oliveira , Fernandes Ingrid Rodrigues , Varela Fernanda Hammes , Polese-Bonatto Márcia , Borges Thiago J. , Callegari-Jacques Sidia Maria , da Costa Marcela Santos Correa , de Araujo Schwartz Jaqueline , Scotta Marcelo Comerlato , Stein Renato T. , Bonorino Cristina 
Published: April 2021

AbstractEpidemiological evidence that COVID-19 manifests as a milder disease in children compared to adults has been reported by numerous studies, but the mechanisms underlying this phenomenon have not been characterized. It is still unclear how frequently children get infected, and/or generate immune responses to SARS-CoV-2. We have performed immune profiling of pediatric and adult COVID-19 patients in Brazil, producing over 38 thousand data points, asking if cellular or humoral immune responses could help explain milder disease in children. In this study, pediatric COVID-19 patients presented high viral titers. Though their non-specific immune profile was dominated by naive, non-activated lymphocytes, their dendritic cells expressed high levels of HLA-DR and were low in CX3CR1, indicating competence to generate immune responses that are not targeted to inflamed tissue. Finally, children formed strong specific antibody and T cell responses for viral structural proteins. Children’s T cell responses differed from adults in that their CD8+ TNFα+ T cell responses were low for S peptide but significantly higher against N and M peptide pools. Altogether, our data support a scenario in which SARS-CoV-2 infected children may contribute to transmission, though generating strong and differential responses to the virus that might associate with protection in pediatric COVID-19 presentation.
Just Say No to Postmortem Drug Dose Calculations
Authors: Maskell Peter D 
Published: April 2021

AbstractIt has long been known that forensic and clinical toxicologists should not determine the dose of a drug administered based on postmortem blood drug concentrations but to date there has been limited information as to how unreliable these dose calculations can be. Using amitriptyline as a model drug this study used the empirically determined pharmacokinetic variables for amitriptyline from clinical studies and clinical, overdose (where the individual survived) and death (ascribed to amitriptyline toxicity) case studies in which the dose of drug administered or taken was known. Using these data, standard pharmacokinetic equations and general error propagation it was possible to estimate the accuracy of the consumed dose of amitriptyline compared to the actual dose consumed. As was expected in postmortem cases, depending on the pharmacokinetic equation used, the accuracy (mean +128 to +2347 %) and precision (SD ± 383 to 3698%) were too large to allow reliable estimation of the dose of drug taken or administered prior to death based on postmortem blood drug concentrations. This work again reinforces that dose calculations from postmortem blood drug concentrations should not be carried out.
A multiscale model predicts the sensitivity ofChlorella vulgaristo light and nitrogen levels in photobioreactors
Authors: Tibocha-Bonilla Juan D. , Zuniga Cristal , Broddrick Jared T. , Zengler Karsten , Godoy-Silva Rubén D. 
Published: April 2021

AbstractThe maximization of lipid productivity in microalgae is crucial for the biofuel industry, and it can be achieved by manipulating their metabolism. However, little efforts have been made to apply metabolic models in a dynamic framework to predict possible outcomes to scenarios observed at an industrial scale. Here, we present a dynamic framework for the simulation of large-scale photobioreactors. The framework was generated by merging the genome-scale metabolic model ofChlorella vulgaris(iCZ843) with reactor-scale parameters, thus yielding a multiscale model. This multiscale model was employed to predict the sensitivity of growth and composition variation ofC. vulgarison light and nitrogen levels. Simulations of lipid accumulation quantified the tradeoff between growth and lipid biosynthesis under nitrogen limitation. Moreover, our modeling approach quantitatively predicted the dependence of microalgal metabolism on light intensity and circadian oscillations. Finally, we use the model to design a reactor irradiance profile that maximized lipid accumulation, thus achieving a lipid productivity increase of 46% at a constant intensity of 966 μE m−2s−1. Our modeling framework elucidated how metabolism and external factors can be combined to predict optimized parameters for industrial applications.
Methylation of 23S rRNA G748 and the ribosomal protein L22 Lys-94 are critical factors for maintaining the association between ribosome stalling and proteome composition inStreptococcus pneumoniae
Authors: Shoji Tatsuma 
Published: April 2021

AbstractBackground23S rRNA modification located at the nascent peptides exit tunnel plays an important role in both translation processes and the binding of the antibiotics. Methylation of the guanine at position 748 (m1G748) in 23S rRNA inStreptococcus pneumoniaeis involved in the ribosome stalling and the binding of the antibiotic telithromycin (TEL). The disruption of the gene encoding RlmAIIwhich methylates 23S rRNA G748 results in the increased resistance of TEL inS. pneumoniae. However, an isolated high-level TEL-resistantS. pneumoniaestrain indicated that additional undescribed factors were involved in TEL resistance inS. pneumoniae.ResultsWe successfully isolated a high-level TEL-resistantS. pneumoniaeRlmAIImutant and determined the whole-genome sequence. The lysine residue at the position 94 in ribosomal protein 22 (L22 K94) was critical in binding of TEL to the ribosome. A growth competition assay showed that L22 K94 was required for the function of m1G748. Ribosome profiling revealed that m1G748 and L22 K94 were both essential to maintain the relationship between the ribosome stalling and proteome composition.ConclusionInS. pneumoniae, the combination of methylation status of G748 and the residue at position 94 in L22 are essential for both the distribution of ribosome stalling and the binding of TEL to ribosomes.