bluuebunny/crossref_metadata_2025_split huggingface dataset:
Downregulation of the E2 Subunit of 2-Oxoglutarate Dehydrogenase Modulates Plant Growth by Impacting Carbon–Nitrogen Metabolism inArabidopsis thaliana
Authors: Condori-Apfata Jorge A , Batista-Silva Willian , Medeiros David Barbosa , Vargas Jonas Rafael , Valente Luiz M Lopes , Pérez-Díaz Jorge Luis , Fernie Alisdair R , Araújo Wagner L , Nunes-Nesi Adriano 
Published: March 2021

AbstractIn Arabidopsis thaliana, two genes encode the E2 subunit of the 2-oxoglutarate dehydrogenase (2-OGDH), a multimeric complex composed of three subunits. To functionally characterize the isoforms of E2 subunit, we isolated Arabidopsis mutant lines for each gene encoding the E2 subunit and performed a detailed molecular and physiological characterization of the plants under controlled growth conditions. The functional lack of expression of E2 subunit isoforms of 2-OGDH increased plant growth, reduced dark respiration and altered carbohydrate metabolism without changes in the photosynthetic rate. Interestingly, plants from e2-ogdh lines also exhibited reduced seed weight without alterations in total seed number. We additionally observed that downregulation of 2-OGDH activity led to minor changes in the levels of tricarboxylic acid cycle intermediates without clear correlation with the reduced expression of specific E2-OGDH isoforms. Furthermore, the e2-ogdh mutant lines exhibited a reduction by up to 25% in the leaf total amino acids without consistent changes in the amino acid profile. Taken together, our results indicate that the two isoforms of E2 subunit play a similar role in carbon–nitrogen metabolism, in plant growth and in seed weight.
Bacterial effector targeting of a plant iron sensor facilitates iron acquisition and pathogen colonization
Authors: Xing Yingying , Xu Ning , Bhandari Deepak D , Lapin Dmitry , Sun Xinhua , Luo Xuming , Wang Yeqiong , Cao Jidong , Wang Hongbin , Coaker Gitta , Parker Jane E , Liu Jun 
Published: March 2021

Abstract
Acquisition of nutrients from different species is necessary for pathogen colonization. Iron is an essential mineral nutrient for nearly all organisms, but little is known about how pathogens manipulate plant hosts to acquire iron. Here, we report that AvrRps4, an effector protein delivered by Pseudomonas syringae bacteria to plants, interacts with and targets the plant iron sensor protein BRUTUS (BTS) to facilitate iron uptake and pathogen proliferation in Arabidopsis thaliana. Infection of rps4 and eds1 by P. syringae pv. tomato (Pst) DC3000 expressing AvrRps4 resulted in iron accumulation, especially in the plant apoplast. AvrRps4 alleviates BTS-mediated degradation of bHLH115 and ILR3(IAA-Leucine resistant 3), two iron regulatory proteins. In addition, BTS is important for accumulating immune proteins Enhanced Disease Susceptibility1 (EDS1) at both the transcriptional and protein levels upon Pst (avrRps4) infections. Our findings suggest that AvrRps4 targets BTS to facilitate iron accumulation and BTS contributes to RPS4/EDS1-mediated immune responses.
Building Social Cohesion in Ethnically Mixed Schools: An Intervention on Perspective Taking
Authors: Alan Sule , Baysan Ceren , Gumren Mert , Kubilay Elif 
Published: March 2021

AbstractWe evaluate the effect of an educational program that aims to build social cohesion in ethnically mixed schools by developing perspective-taking ability in children. The program is implemented in Turkish elementary schools affected by a large influx of Syrian refugee children. We measure a comprehensive set of outcomes that characterize a cohesive school environment, including peer violence incidents, the prevalence of interethnic social ties, and prosocial behavior. Using randomized variation in program implementation, we find that the program significantly lowers peer violence and victimization on school grounds. The program also reduces the likelihood of social exclusion and increases interethnic social ties in the classroom. We find that the program significantly improves prosocial behavior, measured by incentivized tasks: treated students exhibit significantly higher trust, reciprocity, and altruism toward each other as well as toward anonymous out-school peers. We show that this enhanced prosociality is welfare improving from the ex post payoff perspective. We investigate multiple channels that could explain the results, including ethnic bias, impulsivity, empathetic concern, emotional intelligence, behavioral norms, and perspective taking. Children’s increased effort to take others’ perspectives emerges as the most robust mechanism to explain our results.
The representation of mental state information in schizophrenia and first-degree relatives: a multivariate pattern analysis of fMRI data
Authors: Dodell-Feder David , Tully Laura M , Dudek Emily , Hooker Christine I 
Published: March 2021

Abstract
Individuals with a schizophrenia-spectrum disorder (SSD) and those at familial high risk (FHR) for SSDs experience social difficulties that are related to neural abnormalities in the network of brain regions recruited during theory of mind (ToM). Prior work with these groups has focused almost exclusively on characterizing the involvement of these regions in ToM. Here, we examine the representational content of these regions using multivariate pattern analysis. We analyzed two previously collected datasets of SSD, FHR and control participants who, while undergoing functional magnetic resonance imaging, completed the false-belief task in which they read stories describing beliefs or physical representations (e.g. photographs). Univariate and multivariate analyses were performed in regions of interest to evaluate group differences in task-based activation and representational content, respectively. Compared to non-SSDs, SSDs showed reduced decoding accuracy for the category of mental states in the right temporo-parietal junction—which was related to false-belief accuracy—and the dorsal medial prefrontal cortex (DMPFC) and reduced involvement of DMPFC for mental state understanding. FHR showed no differences in decoding accuracy or involvement compared to non-FHR. Given prior studies of disrupted neural involvement in FHR and the lack of decoding differences observed here, the onset of illness may involve processes that corrupt how mental state information is represented.
Novel Claims-Based Outcome Phenotypes in Survivors of Pediatric Traumatic Brain Injury
Authors: Maddux Aline B. , Sevick Carter , Cox-Martin Matthew , Bennett Tellen D. 
Published: March 2021

Objective:
For children hospitalized with acute traumatic brain injury (TBI), to use postdischarge insurance claims to identify: (1) healthcare utilization patterns representative of functional outcome phenotypes and (2) patient and hospitalization characteristics that predict outcome phenotype.

Setting:
Two pediatric trauma centers and a state-level insurance claim aggregator.

Patients:
A total of 289 children, who survived a hospitalization after TBI between 2009 and 2014, were in the hospital trauma registry, and had postdischarge insurance eligibility.

Design:
Retrospective cohort study.

Main Measures:
Unsupervised machine learning to identify phenotypes based on postdischarge insurance claims. Regression analyses to identify predictors of phenotype.

Results:
Median age 5 years (interquartile range 2-12), 29% (84/289) female. TBI severity: 30% severe, 14% moderate, and 60% mild. We identified 4 functional outcome phenotypes. Phenotypes 3 and 4 were the highest utilizers of resources. Morbidity burden was highest during the first 4 postdischarge months and subsequently decreased in all domains except respiratory. Severity and mechanism of injury, intracranial pressure monitor placement, seizures, and hospital and intensive care unit lengths of stay were phenotype predictors.

Conclusions:
Unsupervised machine learning identified postdischarge phenotypes at high risk for morbidities. Most phenotype predictors are available early in the hospitalization and can be used for prognostic enrichment of clinical trials targeting mitigation or treatment of domain-specific morbidities.
Research Letter: Blast Exposure and Brain Volume
Authors: Martindale Sarah L. , Shura Robert D. , Rostami Ramona , Taber Katherine H. , Rowland Jared A. 
Published: March 2021

Objective:
To determine whether blast exposure is associated with brain volume beyond posttraumatic stress disorder (PTSD) diagnosis and history of traumatic brain injury (TBI).

Setting:
Veterans Affairs Medical Center.

Participants:
One hundred sixty-three Iraq and Afghanistan combat veterans, 86.5% male, and 68.10% with a history of blast exposure. Individuals with a history of moderate to severe TBI were excluded.

Main Measures:
Clinician-Administered PTSD Scale (CAPS-5), Mid-Atlantic MIRECC Assessment of TBI (MMA-TBI), Salisbury Blast Interview (SBI), and magnetic resonance imaging. Maximum blast pressure experienced from a blast event represented blast severity.

Methods:
Hierarchical regression analysis evaluated effects of maximum pressure experienced from a blast event on bilateral volume of hippocampus, anterior cingulate cortex, amygdala, orbitofrontal cortex, precuneus, and insula. All analyses adjusted for effects of current and lifetime PTSD diagnosis, and a history of deployment mild TBI.

Results:
Maximum blast pressure experienced was significantly associated with lower bilateral hippocampal volume (left: ΔR2 = 0.032, P < .001; right: ΔR2 = 0.030, P < .001) beyond PTSD diagnosis and deployment mild TBI history. Other characteristics of blast exposure (time since most recent exposure, distance from closest blast, and frequency of blast events) were not associated with evaluated volumes.

Conclusion:
Exposure to a blast is independently associated with hippocampal volume beyond PTSD and mild TBI; however, these effects are small. These results also demonstrate that blast exposure in and of itself may be less consequential than severity of the exposure as measured by the pressure gradient.
Healthcare Providers' Self-Reported Pediatric Mild Traumatic Brain Injury Diagnosis, Prognosis, and Management Practices: Findings From the 2019 DocStyles Survey
Authors: Sarmiento Kelly , Daugherty Jill , Haarbauer-Krupa Juliet 
Published: March 2021

Objective:
To assess adherence to 5 key recommendations in the Centers for Disease Control and Prevention evidence-based guideline on pediatric mild traumatic brain injury, this article presents results from the 2019 DocStyles survey.

Study Design:
Cross-sectional, web-based survey of 653 healthcare providers.

Results:
Most healthcare providers reported adhering to the recommendations regarding the use of computed tomography and providing education and reassurance to patients and their families. However, less than half reported routinely examining their patients with mild traumatic brain injury (mTBI) using age-appropriate, validated symptom scales, assessing for risk factors for prolonged recovery, and advising patients to return to noncontact, light aerobic activities within 2 to 3 days. Self-reported mTBI diagnosis, prognosis, and management practices varied by specialty. Only 3.8% of healthcare providers answered all 7 questions in a way that is most consistent with the 5 recommendations examined from the Centers for Disease Control and Prevention Pediatric mTBI Guideline.

Conclusion:
This study highlights several important information gaps regarding pediatric mTBI diagnosis and management. Further efforts to improve adoption of guideline recommendations may be beneficial to ensure optimal outcomes for children following an mTBI.
Diagnosis and management of Clostridioides difficile infection in patients with inflammatory bowel disease
Authors: Dalal Rahul S. , Allegretti Jessica R. 
Published: March 2021

Purpose of review

Clostridioides difficile infection (CDI) may complicate the course of ulcerative colitis and Crohn's disease. The clinical presentation of CDI in this population is often atypical, and patients may experience exacerbations of their underlying inflammatory bowel disease (IBD) secondary to C. difficile. In this review, we aim to review the risk factors, diagnosis, and management of CDI in the context of IBD.

Recent findings
Patients with colonic involvement of their IBD are at higher risk for CDI and colonization may be more common than in the general population. Therefore, CDI is confirmed using a two-step approach to stool testing. Oral vancomycin or fidaxomicin are the preferred agents for nonfulminant disease, and oral metronidazole is no longer recommended as first-line therapy. For all patients with CDI recurrence, fecal microbiota transplant (FMT) should be considered, as this has been shown to be safe and effective. Among those who have worsening of their underlying IBD, retrospective research suggest that outcomes are improved for those who undergo escalation of immunosuppression with appropriate antimicrobial treatment of C. difficile, however prospective data are needed.

Summary
CDI may complicate the course of IBD, however the presentation may not be typical. Therefore, all patients with worsening gastrointestinal symptoms should be evaluated for both CDI and IBD exacerbation. Providers should consider FMT for all patients with recurrent CDI as well as escalation of immunosuppression for patients who fail to improve with appropriate antimicrobial therapy.
Consequences of coronavirus infections for primitive and mature hematopoietic cells: new insights and why it matters
Authors: Ropa James , Trinh Thao , Aljoufi Arafat , Broxmeyer Hal E. 
Published: March 2021

Purpose of review
In recent history there have been three outbreaks of betacoronavirus infections in humans, with the most recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; causing Coronavirus disease 2019 [COVID-19]) outbreak leading to over two million deaths, with a rapidly rising death toll. Much remains unknown about host cells and tissues affected by coronavirus infections, including the hematopoietic system. Here, we discuss the recent findings examining effects that coronavirus infection or exposure has on hematopoietic cells and the clinical implications for these effects.

Recent findings
Recent studies have centered on SARS-CoV-2, demonstrating that hematopoietic stem and progenitor cells and mature immune cells may be susceptible to infection and are impacted functionally by exposure to SARS-CoV-2 Spike protein. These findings have important implications regarding hematologic complications arising from COVID-19 and other coronavirus-induced disease, which we discuss here.

Summary
Infection with coronaviruses sometimes leads to hematologic complications in patients, and these hematologic complications are associated with poorer prognosis. These hematologic complications may be caused by coronavirus direct infection or impact on primitive hematopoietic cells or mature immune cells, by indirect effects on these cells, or by a combination thereof. It is important to understand how hematologic complications arise in order to seek new treatments to improve patient outcomes.
A Concept Analysis of Oral Anticancer Agent Self-management
Authors: Mason Madilyn , Harris Marcelline R. , Greer Joseph A. , Jiang Yun 
Published: March 2021

Background
The rapid development and adoption of oral anticancer agents (OAAs) for cancer management have shifted patients’ roles from recipient to owner of their care delivery, assuming their responsibilities for self-managing their OAA treatments at home, while the concept of oral anticancer agent self-management (OAA-SM) has not been well clarified and defined.

Objective
This study was to clarify the concept of OAA-SM and identify major components, influential factors, and consequences of OAA-SM, as well as propose a representative conceptual model of OAA-SM.

Methods
A literature review was conducted concerning the concept and application of OAA-SM. The Walker and Avant method for concept analysis was utilized to guide the examination of OAA-SM.

Results
OAA-SM is a multifaceted and dynamic process that requires continuous adaptation by patients as multiple self-management challenges can emerge throughout OAA treatments. The defining attributes of OAA-SM include OAA adherence, adverse-effect self-management, patient-provider communication, and OAA safe storage, handling, and administration practices. Oral anticancer agent–SM is potentially influenced by a variety of patient-related, OAA-related, and healthcare system factors. Effective OAA-SM is associated with better patient and healthcare outcomes.

Conclusions
The clarification of the concept of OAA-SM and the identification of attributes of OAA-SM and their interrelationships contribute to the body of knowledge in OAA-SM.

Implications for Practice
This concept analysis provides the foundation to increase healthcare providers’ understanding of patients’ needs for OAA-SM support and guides the development of patient-centered interventions to empower and engage patients and their families in effective OAA-SM, and improve patients’ quality of life and care.
Spouse Caregivers’ Experiences of Suffering in Relation to Care for a Partner With Brain Tumor
Authors: Francis Sara R. , Hall Elisabeth O. C. , Delmar Charlotte 
Published: March 2021

Background
Spouses often undertake the main caring role for a partner with primary malignant brain tumor (PMBT). Yet, demanding and challenging caring responsibilities especially because of the partner’s cognitive declines can affect the spouse caregiver’s well-being.

Objective
The aim of this study was to investigate spouses’ experiences of suffering in their role as main caregiver of a partner with PMBT.

Methods
A hermeneutical qualitative design was used to collect and analyze data. Ten spouses (aged 36–76 years) were interviewed in depth twice 1 year apart, using semistructured interview guides.

Results
The spouse caregivers’ experiences of suffering in their role as their partner’s main caregiver were interpreted according to 3 central themes: “Enduring everyday life,” “Being overlooked and hurt,” and “Being acknowledged and feeling good.”

Conclusion
Spouse caregivers of a partner with PMBT are suffering from exhaustion and suppression of their own emotions to endure the caring responsibilities. They need support to manage their everyday hardship; however, their experiences seem to be easily overlooked. This causes disappointment and hurts their dignity. Acknowledgment through simple acts of practical help or time to talk are consoling and alleviate their experiences of suffering.

Implications for Practice
An intervention that supports healthcare professionals to facilitate the spouse caregivers’ suffering is welcoming. The focus of the intervention may involve a sensitive awareness toward the spouse caregiver’s individual resources and limitations and the relational and communicative competences of the healthcare professionals in their encounters with spouse caregivers that avoid hurting the spouse caregiver’s dignity.
Influencing Medical Students’ Knowledge and Attitudes Related to Disability
Authors: Almhdawi Khader A. 
Published: March 2021

Purposes
The aims of the study were to evaluate and to compare the efficacy of an online and a traditionally delivered undergraduate elective course in improving medical students’ disability-related knowledge and attitudes.

Methods
A randomized controlled design was implemented. Participants were medical students randomly assigned into summer 8-wk disability and the society (OT100) online course, OT100 traditional course, or wellness and lifestyles (PT100) control. Demographics were collected in addition to participants’ level disability knowledge and attitudes toward people with disability scale scores (1 wk before the semester and 1 wk after it). Multivariate analysis of covariance using general linear model was conducted to evaluate groups’ differences in main outcome measures.

Results
In total, 198 undergraduate medical students successfully completed the study conditions: OT100 online (n = 74), OT100 traditional (n = 59), and PT100 (n = 65). OT100 groups (traditional and online) change scores were statistical similar for disability knowledge (P = 0.966) and attitudes (P = 0.705) but significantly better (P < 0.001) than the control group.

Conclusions
OT100 course delivered traditionally or online seemed effective in improving medical students’ disability knowledge and attitudes toward people with disability. More studies are needed to create effective methods improving healthcare professionals’ disability-related knowledge and attitudes.
What is the Impact of Prenatal Counseling on Postnatal Cleft Treatment? Multidisciplinary Pathway for Prenatal Orofacial Cleft Care
Authors: Zimmerman Carrie E. , Folsom Nancy , Humphries Laura S. , Kalmar Christopher L. , Vu Giap H. , Bushold Julia , Swanson Jordan W. , Taylor Jesse A. 
Published: March 2021

Abstract
In the pediatric general surgery literature, it has been shown that prenatal diagnosis of a congenital anomaly is an independent predictor of parental psychological distress. Surgical prenatal counseling can decrease parental anxiety by helping families understand the surgical needs and potential outcomes of their infant. In this retrospective analysis (n = 440), the authors sought to present our care pathway for prenatally diagnosed cleft lip and palate (CL/P) and explore the impact of cleft lip and palate-specific prenatal counseling on patient care by comparing the timing of clinical and surgical care between a cohort of patients who received prenatal CL/P consultation and a cohort of patients only seen postnatally. The authors hypothesize that our multidisciplinary prenatal care intervention is associated with earlier postnatal clinic visits and surgical repair. The care of all patients whose mother's presented for prenatal CL/P consultation (prenatal cohort, n = 118) was compared to all new CL/P patients without prenatal consultation at our institution (postnatal cohort, n = 322) from January 2015 through August 2019. 81.4% (n = 96) of the prenatal cohort returned for care postnatally while 2 pregnancies were interrupted, four neonates died, and 15 patients did not return for care. Prenatal consultation was associated with earlier postnatal clinic appointments (P < 0.001) as well as a shorter time to CL repair in patients with CL only (P = 0.002) and CLP (P = 0.047). Our described pre- and postnatal CL/P pathway is a multidisciplinary model associated with high retention rates from the prenatal period through complete surgical repair.
Throat Packs in Cleft and Craniofacial Surgery
Authors: Martin Serena , Blacklock Calum , McBride Michael , Quinn James , Hill Chris 
Published: March 2021

Abstract
Throat packs are used in a wide range of surgical and dental procedures. Indications for use include; airway stabilization, reducing the risk of aspiration, and postoperative nausea and vomiting. Despite these perceived benefits, a retained throat pack can be fatal. This has been highlighted since the 1970s but as of yet no effective fail-safe mechanisms exist to prevent the potential tragic consequences of a retained throat pack.
A multifaceted questionnaire was distributed at the annual Craniofacial Society of Great Britain and Ireland 2017 to identify current views and practices amongst cleft surgeons. The questionnaire contained seventeen questions related to throat pack use. The responses to the questions were collated and discussed in the context of the current literature.
Twenty-four cleft surgeons completed the questionnaire; 67% always use a throat pack, with 84% not securing the throat pack in any way. Almost half (48%) had encountered a serious adverse incident secondary to the use of a throat pack.
This survey and review of the literature highlight ongoing discrepancies and a lack of standardization on a national basis. Adverse incidents and fatalities are still occurring. Overwhelming evidence now confirms the lack of benefit regarding postoperative nausea and vomiting and the authors urge both surgeons and anesthetists to strongly consider the need for a throat pack in routine elective procedures.