bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cellular export of sugars and amino acids: role in feeding other cells and organisms
Authors: Kim Ji-Yun , Loo Eliza P -I , Pang Tin Yau , Lercher Martin , Frommer Wolf B , Wudick Michael M 
Published: May 2021

AbstractSucrose, hexoses, and raffinose play key roles in the plant metabolism. Sucrose and raffinose, produced by photosynthesis, are translocated from leaves to flowers, developing seeds and roots. Translocation occurs in the sieve elements or sieve tubes of angiosperms. But how is sucrose loaded into and unloaded from the sieve elements? There seem to be two principal routes: one through plasmodesmata and one via the apoplasm. The best-studied transporters are the H+/SUCROSE TRANSPORTERs (SUTs) in the sieve element-companion cell complex. Sucrose is delivered to SUTs by SWEET sugar uniporters that release these key metabolites into the apoplasmic space. The H+/amino acid permeases and the UmamiT amino acid transporters are hypothesized to play analogous roles as the SUT-SWEET pair to transport amino acids. SWEETs and UmamiTs also act in many other important processes—for example, seed filling, nectar secretion, and pollen nutrition. We present information on cell type-specific enrichment of SWEET and UmamiT family members and propose several members to play redundant roles in the efflux of sucrose and amino acids across different cell types in the leaf. Pathogens hijack SWEETs and thus represent a major susceptibility of the plant. Here, we provide an update on the status of research on intercellular and long-distance translocation of key metabolites such as sucrose and amino acids, communication of the plants with the root microbiota via root exudates, discuss the existence of transporters for other important metabolites and provide potential perspectives that may direct future research activities.
A microProtein repressor complex in the shoot meristem controls the transition to flowering
Authors: Rodrigues Vandasue L. , Dolde Ulla , Sun Bin , Blaakmeer Anko , Straub Daniel , Eguen Tenai , Botterweg-Paredes Esther , Hong Shinyoung , Graeff Moritz , Li Man-Wah , Gendron Joshua M. , Wenkel Stephan 
Published: May 2021

Abstract
MicroProteins are potent post-translational regulators. In Arabidopsis (Arabidopsis thaliana), the miP1a/b microProteins delay floral transition by forming a complex with CONSTANS (CO) and the co-repressor protein TOPLESS. To better understand the function of the miP1a microProtein in floral repression, we performed a genetic suppressor screen to identify suppressors of miP1a (sum) function. One mutant, sum1, exhibited strong suppression of the miP1a-induced late-flowering phenotype. Mapping of sum1 identified another allele of the gene encoding the histone H3K4 demethylase JUMONJI14 (JMJ14), which is required for miP1a function. Plants carrying mutations in JMJ14 exhibit an early flowering phenotype that is largely dependent on CO activity, supporting an additional role for CO in the repressive complex. We further investigated whether miP1a function involves chromatin modification, performed whole-genome methylome sequencing studies with plants ectopically expressing miP1a, and identified differentially methylated regions (DMRs). Among these DMRs is the promoter of FLOWERING LOCUS T (FT), the prime target of miP1a that is ectopically methylated in a JMJ14-dependent manner. Moreover, when aberrantly expressed at the shoot apex, CO induces early flowering, but only when JMJ14 is mutated. Detailed analysis of the genetic interaction among CO, JMJ14, miP1a/b, and TPL revealed a potential role for CO as a repressor of flowering in the shoot apical meristem (SAM). Altogether, our results suggest that a repressor complex operates in the SAM, likely to maintain it in an undifferentiated state until leaf-derived florigen signals induce SAM conversion into a floral meristem.
Microstructure and continuous phase transition of a regular Hayward black hole in anti-de Sitter spacetime
Authors: Naveena Kumara A , Ahmed Rizwan C L , Hegde Kartheek , Ali Md Sabir , Ajith K M 
Published: May 2021

Abstract
In this article we study the thermodynamic phase transition of a regular Hayward-AdS black hole, by introducing a new order parameter, which is the potential conjugate to the magnetic charge arising from a non-linearly coupled electromagnetic field. We use Landau continuous phase transition theory to discuss the van der Waals-like critical phenomena of the black hole. The well-known interpretation of the phase transition of an AdS black hole as being a large and small black hole transition is re-interpreted as being a transition between a high-potential phase and a low-potential phase. The microstructure associated with this phase transition is studied using the Ruppeiner geometry. By investigating the behaviour of the Ruppeiner scalar curvature, we find that charged and uncharged (effective) molecules of the black hole have distinct microstructure, which is analogous to that of fermion and boson gas.
Creating an e-cohort of individuals with lived experience of homelessness and subsequent mortality in Wales, UK
Authors: Song Jiao , Grey Charlotte N B , Davies Alisha R 
Published: May 2021

Abstract

Background
Homelessness is an extreme form of social exclusion, with homeless people experiencing considerable social and health inequities. Estimates of morbidity and mortality amongst homeless populations is limited due to the lack of recording of housing status across health datasets. The aim of this study is to: (i) identify a homelessness e-cohort by linking routine health data in Wales, and (ii) explore whether a period of reported past homelessness, places this population at greater risk of morbidity and mortality.

Methods
Homelessness identified through linkage across primary, secondary care and substance misuse datasets in the Secure Anonymised Information Linkage (SAIL) Databank. Mortality was examined through linkage to the Office for National Statistics mortality data.

Results
E-cohort of 15 472 individuals with lived experience of homelessness identified. Of those, 21 individuals died between February and July 2020 involving coronavirus disease of 2019 (COVID-19). Those with lived experience of homelessness had increased mortality from many causes including accidents, liver diseases and suicides.

Conclusion
Linking multiple routine datasets provides a more comprehensive dataset of a marginalized population, including individuals who are not included in government homeless statistics. Application of the cohort demonstrated that individuals with lived experience of homelessness have increased mortality involving COVID-19 and other causes. The underlying reasons, health needs and causes of death warrant further exploration.
The extrapyramidal syndromes of chronic kidney disease and dialysis (EPS-CKDD): diagnostic criteria, risk factors and prognosis
Authors: Manickavasagar R , Chemmanam T , Youssef A , Agarwal A , Prentice D A , Irish A B 
Published: May 2021

Summary

Background
Acute extrapyramidal movement disorders in dialysis patients are rare, inconsistently defined and have uncertain aetiology and prognosis.

Aim
Define diagnostic criteria, prognosis and risk factors

Design and Methods
Retrospective case series review of 20 patients (14 female, mean age 62 years) receiving dialysis for a median of 15 (interquartile range 4–35) months who presented with acute parkinsonism (AP = 11) or chorea/athetosis (CA = 9).

Results
All patients had type 2 diabetes (HbA1c 6.8 ± 1.0) and had received metformin. Lactic acidosis was present in 2 patients at presentation and serum lactate was elevated in 7/15 patients tested. No patient had abnormal copper or thyroid metabolism and 5/8 patients tested returned marginal abnormalities in heavy metal screening. Magnetic resonance imaging (MRI) revealed characteristic bilateral symmetric T2 hyperintensity of the basal ganglia (BG), predominantly putamen and globus pallidus (the lentiform nucleus) and more extensive involvement of the external and internal capsules in patients with AP presentation. Post-mortem demonstrated cytotoxic necrosis of the BG. Therapy included thiamine, intensive dialysis and cessation of metformin. Two patients died acutely, nine recovered and nine had residual symptoms. Median survival did not differ by presentation: AP 24 [95% confidence interval (CI) 21–27] and CA 33 (95% CI 32–35) months, P = 0.21.

Conclusions
There are two distinct clinical extrapyramidal movement disorders associated with specific diagnostic MRI imaging that support the diagnosis of the extrapyramidal syndromes of chronic kidney disease and dialysis. The associations with diabetes, metformin and metabolic acidosis suggest a common pathogenic mechanism but require additional study. Early recognition and treatment may improve outcomes.
Flexibility unbound: understanding the heterogeneity of preferences among food delivery platform workers
Authors: Piasna Agnieszka , Drahokoupil Jan 
Published: May 2021

Abstract
This article investigates the preferences of food delivery platform workers regarding their employment status and working hours. We focus on the relationship between flexibility and protection, both of which can be understood—from a worker’s perspective—as a means towards increased autonomy and control. The analysis is based on a case study of Deliveroo in Belgium, which hired riders as employees through an intermediary, SMart. Despite their flexible working lives, most riders preferred employee status to self-employment. However, riders were divided in their preferences regarding working time flexibility, with many in favour of more regular working time patterns. To explain this divergence, we develop an embeddedness framework that relates worker preferences to the degree of their dependency as shaped by labour market and institutional factors. We thus link divergence in preferences concerning flexibility to workers’ scope for exercising control, their labour market vulnerability and economic attachment to the platform.
APRNs' controlled substance prescribing and readiness following Florida legislative changes
Authors: Reynolds Annie M. , Reynolds Caleb J. , Craig-Rodriguez Alicia 
Published: May 2021

Abstract:
Two years after the Florida legislature expanded APRN prescribing to include schedule II-IV drugs in 2017, we studied APRN utilization of this prescriptive authority. Study results reveal that Florida APRNs are meeting the educational requirements to prescribe and apply the use of these drugs in practice, improving patient access to care.
Management strategies for STE-ACS
Authors: El Hussein Mohamed Toufic , Hakkola Jonah 
Published: May 2021

Abstract:
Using guideline-driven interventions, NPs are well suited for management of ST-segment elevation (STE)-acute coronary syndrome (ACS). This second article in a two-part series on ACS management presents an updated overview to help NPs in applying evidence-based interventions while caring for patients with STE-ACS.
Challenges of Diagnosing and Managing Designer Benzodiazepine Dependence and Withdrawal: A Case Report
Authors: Peng Linda , Lawrence David , Levander Ximena A. 
Published: May 2021

Background:
Over the last 10 years, an increasing number of unregulated novel psychoactive substances, including “designer benzodiazepines” (DBZDs), have emerged on the recreational drug market. Despite the rapidly increasing usage of DBZDs, there is a significant lack of information regarding clinical management. Here we present a case illustrating the difficulties of diagnosing and managing DBZD related sedative-hypnotic use disorder.

Case Presentation:
Our patient is a 30-year-old man with severe opioid and sedative-hypnotic use disorders. He had a 10-year history of using heroin, clonazolam, and alprazolam. He stopped using heroin when on methadone maintenance therapy but continued using clonazolam and nonprescribed alprazolam. His opioid treatment program discontinued methadone due to benzodiazepine intoxication, and he returned to heroin use. He then presented for residential withdrawal management where he underwent successful buprenorphine induction and benzodiazepine withdrawal management. During a 3-month period of benzodiazepine abstinence, he struggled with ongoing cravings and post-acute withdrawal syndrome, ultimately leading to return to DBZD use.

Discussion:
Despite the increasing prevalence of DBZD use, the usage of DBZDs is likely under-recognized because these compounds are generally not included on standard in-office urine drug immunoassay tests. Initial studies suggest that DBZDs have high potencies, shorter half-lives, are more addictive, and can result in more severe withdrawal symptoms compared to known benzodiazepines. However, there remains a lack of information about the pharmacokinetics and pharmacodynamics of DBZDs, making clinical management for DBZD related sedative-hypnotic use disorders challenging to treat.
Pressure Necrosis Requiring Fasciotomy After Kratom Overdose
Authors: Tobarran Natasha , Wolf Carl , Cumpston Kirk L. , Wills Brandon K. 
Published: May 2021

Introduction:
Kratom (Mitragyna speciosa) is a popular plant-based extract that has dose-dependent stimulatory and sedative effects. It has been used for self-treatment of opioid withdrawal and can result in seizures, hepatotoxicity, and infectious complications from bacterial contamination. Reports of morbidity and mortality associated with Kratom may be confounded by coingestants. We report a case of severe rhabdomyolysis and pressure necrosis leading to fasciotomy in a patient who was using Kratom.

Case report:
A 31-year-old male with substance use presented to the emergency department after loss of consciousness for 6 hours after smoking Kratom. He was found to have rhabdomyolysis, acute renal and hepatic injury, and electrolyte disturbances. No ethanol was detected, and urine drug screen was negative. Over the next 3 hours, the patient developed signs of compartment syndrome and he was transferred to the operating room for fasciotomy. He required continuous renal replacement therapy for 48 hours and his labs and clinical status improved. He was discharged 18 days later. A serum and urine sample from the first day of presentation were analyzed for mitragynine and 7-hydroxymitragynine using an Ultra Performance Liquid Chromatography-Tandem Mass Spectrometer (UPLC-MSMS) method. The serum mitragynine was 5 ng/mL and the urine mitragynine 6 ng/mL.

Conclusions:
Although there are numerous reports of opioids resulting in prolonged periods of immobilization and rhabdomyolysis, this is not commonly reported in Kratom overdoses.
This case report highlights the profound sedative effect of Kratom and the potential of pressure necrosis injury resulting in rhabdomyolysis and compartment syndrome requiring fasciotomy.
The Use of Kratom (Mitragyna speciosa Korth.) Among People Who Co-use Heroin and Methamphetamine in Malaysia
Authors: Singh Darshan , Narayanan Suresh , Vicknasingam Balasingam , Prozialeck Walter C. , Smith Kirsten Elin , Corazza Ornella , Henningfield Jack E. , Grundmann Oliver 
Published: May 2021

Objectives:
Kratom (Mitragyna speciosa Korth.), an indigenous medicinal plant, has been widely used as a traditional remedy in Southeast Asia. However, its combined consumption with other substances has received scarce attention. This study investigates the use of kratom among adults with a history of using heroin and methamphetamine in Malaysia.

Methods:
A total of 332 patients who were mandated to undergo drug rehabilitation participated in this cross-sectional study. The study data were collected through face-to-face interviews using a semi-structured questionnaire.

Results:
The majority were males (95%, n = 314/332) and Malays (98%, n = 325/332) with a mean age of 32.3 years (SD = 9.16). Over two thirds of the respondents used kratom to alleviate heroin withdrawal symptoms and to reduce methamphetamine intake; 59% used it as a substitute for heroin and methamphetamine. A similar proportion used kratom to reduce heroin intake (58%), while only 15% used it for its euphoric effects. Multivariate analysis showed that previous attendees of government rehabilitation programs had lower odds of using kratom as a heroin substitute.

Conclusions:
The potential of kratom to alleviate heroin withdrawal symptoms, and to reduce methamphetamine and heroin intake, among people who co-use heroin and methamphetamine warrants further research.
Muscular Forces Responsible for Proximal Humeral Deformity After Fracture
Authors: Chalmers Christen E. , Wright David J. , Patel Nilay , Hitchens Hunter , McGarry Michelle , Lee Thay Q. , Scolaro John A. 
Published: May 2021

Objectives:
To evaluate the contribution of each of the rotator cuff muscles and deltoid to fracture deformity in a 2-part proximal humerus fracture model. Our hypothesis was that superior cuff muscles would have the greatest contribution to coronal plane deformity, whereas muscles with anterior and posterior attachments would have the greatest contribution to axial and sagittal plane deformity.

Methods:
A medial wedge osteotomy was created in 8 cadaveric shoulder specimens. A custom shoulder testing system was used to load each rotator cuff muscle and deltoid under increasing loading conditions. Fracture displacement was measured using a Microscribe digitizing system. The primary outcome was the contribution of each muscle to varus collapse. Secondary outcomes included contributions of each muscle to apex anterior/posterior deformity and humeral head anteversion/retroversion.

Results:
Unbalanced loading of the supraspinatus resulted in the greatest varus deformity (34.5 ± 2.3 degrees), followed by the infraspinatus (22.3 ± 3.6 degrees) and subscapularis (21.7 ± 3.1 degree) (P < 0.05). Unbalanced loading of the subscapularis induced the greatest apex posterior (27.5 ± 4.8 degrees, P < 0.05) and retroversion (39.0 ± 5.6 degrees, P < 0.05) deformity, whereas the infraspinatus induced the greatest apex anterior (8.7 ± 3.4 degrees, P > 0.05) and anteversion (17.7 ± 5.7 degrees, P > 0.05) deformity.

Conclusions:
In this proximal humerus fracture model, the supraspinatus was the primary driver of varus deformity, whereas the subscapularis and infraspinatus contributed to apex posterior/retroversion and apex anterior/anteversion, respectively. The subscapularis and infraspinatus are also important secondary drivers of varus deformity. This study establishes a physiologically relevant fracture model that mimics in vivo conditions for future biomechanical testing.
Volume Resuscitation and Progression to Organ Failure in Shiga Toxin-Producing Escherichia coli Infection in Adults
Authors: Volk Charles G. , Cusmano Paul M. , Bower Richard J. , Sanders Terrel , Maves Ryan C. 
Published: May 2021

OBJECTIVES:
Shiga toxin-producing Escherichia coli infection is associated with dysentery and the hemolytic uremic syndrome, marked by the triad of microangiopathic hemolytic anemia, acute kidney failure, and thrombocytopenia. Descriptions of Shiga toxin-producing Escherichia coli outbreaks causing hemolytic uremic syndrome in adults are sparse, and management strategies are largely adapted from pediatric literature where aggressive fluid administration is recommended. However, these may not be ideal for adults.

DESIGN:
We present a case series of an Shiga toxin-producing Escherichia coli outbreak in U.S. Marine Corps recruits.

SETTING:
We review the clinical course, laboratory data, and fluid resuscitation used in hospitalized patients during the 2017 Shiga toxin-producing Escherichia coli outbreak at Marine Corps Recruit Depot, San Diego.

PATIENTS:
Patients admitted to the hospital for complications from Shiga toxin-producing Escherichia coli infection. All were previously healthy men between the ages of 17 and 20 years.

INTERVENTIONS:
Isotonic crystalloid fluid resuscitation during the first 72 hours.

MEASUREMENTS AND MAIN RESULTS:
Of 244 identified cases of Shiga toxin-producing Escherichia coli infection, 30 required hospitalization, 15 progressed to hemolytic uremic syndrome, and five required hemodialysis. Patients were admitted and given aggressive IV fluid hydration. Those who progressed to hemolytic uremic syndrome received on average 8.4 L of isotonic crystalloid over the initial 72 hours, with up to 18% of body weight delivered. The six critically ill patients received a mean 12.2 L in the first 72 hours. Those who did not progress to hemolytic uremic syndrome received a mean 3.0 L of crystalloid. If oligoanuria developed, a net-even fluid balance was maintained. The amount of volume infused was not associated with improved outcomes. The patients with the highest fluid balance totals more often required dialysis than those who received less fluid. One hemolytic uremic syndrome patient developed flash pulmonary edema.

CONCLUSIONS:
The aggressive IV hydration protocols (as a percentage of body weight) in the pediatric literature may not be applicable to adults diagnosed with hemolytic uremic syndrome. A more conservative fluid strategy in adults with hemolytic uremic syndrome merits further investigation.
Comparison of Attention-Deficit Hyperactivity Disorder in Typically Developing Children and Children with Down Syndrome
Authors: Esbensen Anna J. , Epstein Jeffery N. , Vincent Lori B. , Kamimura-Nishimura Kelly , Wiley Susan , Angkustsiri Kathleen , Abbeduto Leonard , Fidler Deborah , Froehlich Tanya E. 
Published: May 2021

ABSTRACT:

Objective:
This study aimed to evaluate attention-deficit hyperactivity disorder (ADHD) symptom patterns among children with Down syndrome (DS) with or without ADHD and typically developing (TD) children with ADHD.

Methods:
Parents and teachers rated symptoms of inattention, hyperactivity, and general behavioral concerns for 22 children with DS and comorbid diagnoses of ADHD (DS + ADHD), 66 gender-matched and age-matched children with DS with no diagnosis of ADHD (DS − ADHD), and 66 gender-matched and age-matched TD children with ADHD (TD + ADHD). Children with DS were recruited from the community. TD children with ADHD were recruited from a specialty clinic evaluating for ADHD.

Results:
Parents tended to report higher scores of inattention and hyperactivity for TD children with ADHD compared with children with DS and no ADHD. Although mean ADHD symptom summary scores were not significantly different in DS + ADHD and DS − ADHD, specific parent-report items (e.g., distractibility and being “on the go”) did tend to differentiate these groups. By contrast, teachers tended to report higher inattention and hyperactivity scores for DS + ADHD compared with both DS − ADHD and TD + ADHD. Specific teacher-reported items tending to differentiate DS + ADHD and DS − ADHD included difficulties following through on tasks, avoiding tasks, leaving one's seat, and excessive talking.

Conclusion:
Variability in response patterns between parent and teacher reports for children with and without DS highlights the need to evaluate ADHD symptoms across environments. Our findings also suggest specific items that may particularly be helpful in distinguishing children with DS who do and do not have ADHD, although replication is needed.