bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modified fructan accumulation through overexpression of wheat fructan biosynthesis pathway fusion genes Ta1SST:Ta6SFT
Authors: Chen Tong , Hayes Matthew , Liu Zhiqian , Isenegger Daniel , Mason John , Spangenberg German 
Published: April 2024

Abstract
Background
Fructans are water-soluble carbohydrates that accumulate in wheat and are thought to contribute to a pool of stored carbon reserves used in grain filling and tolerance to abiotic stress.

Results
In this study, transgenic wheat plants were engineered to overexpress a fusion of two fructan biosynthesis pathway genes, wheat sucrose: sucrose 1-fructosyltransferase (Ta1SST) and wheat sucrose: fructan 6-fructosyltransferase (Ta6SFT), regulated by a wheat ribulose-1,5-bisphosphate carboxylase/oxygenase small subunit (TaRbcS) gene promoter. We have shown that T4 generation transgene-homozygous single-copy events accumulated more fructan polymers in leaf, stem and grain when compared in the same tissues from transgene null lines. Under water-deficit (WD) conditions, transgenic wheat plants showed an increased accumulation of fructan polymers with a high degree of polymerisation (DP) when compared to non-transgenic plants. In wheat grain of a transgenic event, increased deposition of particular fructan polymers such as, DP4 was observed.

Conclusions
This study demonstrated that the tissue-regulated expression of a gene fusion between Ta1SST and Ta6SFT resulted in modified fructan accumulation in transgenic wheat plants and was influenced by water-deficit stress conditions.
RhMED15a-like, a subunit of the Mediator complex, is involved in the drought stress response in Rosa hybrida
Authors: Xie Nanxin , Shi Haoyang , Shang Xiaoman , Zhao Zixin , Fang Yan , Wu Huimin , Luo Ping , Cui Yongyi , Chen Wen 
Published: April 2024

Abstract
Background
Rose (Rosa hybrida) is a globally recognized ornamental plant whose growth and distribution are strongly limited by drought stress. The role of Mediator, a multiprotein complex crucial for RNA polymerase II-driven transcription, has been elucidated in drought stress responses in plants. However, its physiological function and regulatory mechanism in horticultural crop species remain elusive.

Results
In this study, we identified a Tail module subunit of Mediator, RhMED15a-like, in rose. Drought stress, as well as treatment with methyl jasmonate (MeJA) and abscisic acid (ABA), significantly suppressed the transcript level of RhMED15a-like. Overexpressing RhMED15a-like markedly bolstered the osmotic stress tolerance of Arabidopsis, as evidenced by increased germination rate, root length, and fresh weight. In contrast, the silencing of RhMED15a-like through virus induced gene silencing in rose resulted in elevated malondialdehyde accumulation, exacerbated leaf wilting, reduced survival rate, and downregulated expression of drought-responsive genes during drought stress. Additionally, using RNA-seq, we identified 972 differentially expressed genes (DEGs) between tobacco rattle virus (TRV)-RhMED15a-like plants and TRV controls. Gene Ontology (GO) analysis revealed that some DEGs were predominantly associated with terms related to the oxidative stress response, such as ‘response to reactive oxygen species’ and ‘peroxisome’. Furthermore, Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment highlighted pathways related to ‘plant hormone signal transduction’, in which the majority of DEGs in the jasmonate (JA) and ABA signalling pathways were induced in TRV-RhMED15a-like plants.

Conclusion
Our findings underscore the pivotal role of the Mediator subunit RhMED15a-like in the ability of rose to withstand drought stress, probably by controlling the transcript levels of drought-responsive genes and signalling pathway elements of stress-related hormones, providing a solid foundation for future research into the molecular mechanisms underlying drought tolerance in rose.
POSITIVE: experiences of an intervention aiming for reversing and preventing frailty using a home monitoring and communication platform within primary health care
Authors: Timm Linda , Guidetti Susanne , Taloyan Marina 
Published: April 2024

Abstract
Background
Frailty is increasing worldwide as the population ages. Physical activity is one component that has been shown to hinder and even reverse the process. The POSITIVE system (i.e., maintaining and imPrOving the intrinSIc capaciTy Involving primary care and caregiVErs) is a prevention program that consists of home-monitoring equipment and a communication platform to support the initial treatment of frailty symptoms in primary health care. The participants, older aged (+ 70) frail persons and those at risk for frailty, took part in the program that promoted physical activity at home for six months. The aim was to explore and describe older persons’ experiences of participating in a new prevention program using the POSITIVE system including technological tools intended to prevent the development of frailty.

Methods
Nine interviews were conducted about experiences of participating in an intervention including use of technological tools to support physical activity. Qualitative content analysis was applied.

Results
Two themes revealed: (1) Perceptions of being old are seldom positive, and (2) A rewarding and fruitful participation in the project with suggestions for improvement. Becoming older was related to physical pain and tiredness reducing the performance of former meaningful activities as well as an increase in mental stress. There was also a tendency to postpone the start of everyday activities, and in general, fewer activities were planned for one day than at younger ages. Participating in a physical activity intervention, including the use of technical tools, was considered meaningful and added motivation for engaging in other physical activities, this despite some difficulties with technical tools provided by the program. The contact with health care and the research team was appreciated. In addition, contact with other participants was requested and reported to be highly valued if added to the intervention, which could have been an expression of loneliness.

Conclusion
Participation in a prevention program motivated activities and social interaction. Adding opportunities for participants to meet each other is suggested for improving the intervention in terms of increasing the social dimensions. Our findings conclude that despite difficulties with handling the technical tools for the home-monitoring and communication platform, participation in the POSITIVE intervention was in general a positive experience.
Longitudinal changes in body mass index, height, and weight in children with acute myeloid leukemia
Authors: Wen Xiaojia , He Hongbo , Zhang Ruidong , Wu Ying , Zhang Yuanyuan , Lin Wei , Yu Jiaole , Fan Jia , Huang Pengli , Chen Jiajia , Li Wenjing , Gong Chunxiu , Zheng Huyong 
Published: April 2024

Abstract
Background
This study reported height prediction and longitudinal growth changes in Chinese pediatric patients with acute myeloid leukemia (AML) during and after treatment and their associations with outcomes.

Methods
Changes in 88 children with AML in percentages according to the growth percentile curve for Chinese boys/girls aged 2–18/0–2 years for body mass index (BMI), height, and weight from the time of diagnosis to 2 years off therapy were evaluated. The outcomes of AML were compared among patients with different BMI levels.

Results
The proportion of underweight children (weight < 5th percentile) increased significantly from the initial diagnosis to the end of consolidation treatment. The proportion of patients with low BMI (BMI < 5th percentile) was highest (23.08%) during the consolidation phase, and no children were underweight, but 20% were overweight (BMI > 75th percentile) after 2 years of drug withdrawal. Unhealthy BMI at the initial diagnosis and during intensive chemotherapy leads to poorer outcomes. For height, all patients were in the range of genetic height predicted based on their parents’ height at final follow-up.

Conclusions
Physicians should pay more attention to the changes in height and weight of children with AML at these crucial treatment stages and intervene in time.
Survival status and its predictors among undernourished children on antiretroviral therapy in Bahir Dar city, Northwest Ethiopia, 2010 – 2020, a multicenter retrospective cohort study
Authors: Moga Lencha Fikre , Mekonnen Workie Hailemariam , Tadesse Mequanint Fikir , Jebero Zaza Zenebe 
Published: April 2024

AbstractBackgroundIn environments with limited resources, undernutrition is a serious public health risk. Its dual relationship to human immunodeficiency virus infection (HIV) leads to crises in a child's physical, emotional, social, and economic spheres of life. Nevertheless, little research has been done on the survival rate and risk factors that lead to poor survival outcomes in undernourished children receiving antiretroviral therapy. This study sought to evaluate survival status and its predictors among undernourished children on antiretroviral therapy (ART) in public health facilities, Bahir Dar city, September 1, 2010 – December 31, 2020.MethodsAn institution-based retrospective cohort study design was used among 414 study participants from September 1, 2010 – December 31, 2020. A simple random sampling method was applied to select study participants. All collected data were entered into epi data version 4.6 and exported to STATA version 14.0 for analysis. Each independent predictor variable with ap-value < 0.05 in the multivariable Cox proportional hazard regression was considered statistically significant.ResultsThe overall incidence of mortality was 11.6 deaths per 1000 child year observation (95%CI: 7.7- 17.5). Baseline weight for age < -3 Z score (adjusted hazard ratio (AHR) = 4.9, 95% CI: 1.30–18.98), height for age < -3 Z score (AHR = 4.34, 95%CI 1.13–16.6), cotrimoxazole prophylaxis given (AHR = 0.27, 95%CI 0.08–0.87), hemoglobin level < 10 g/dl (AHR = 3.7, 95%CI 1.1–12.7), CD4 cells < threshold (AHR = 4.86, 95%CI 1.9–12.7), and WHO clinical disease stage III and IV (AHR = 8.1, 95%CI 1.97–33) were found independent predictors of mortality.Conclusion and recommendationThe incidence of mortality was determined in the study to be 11.6 per 1000 child years. Mortality was predicted by severe stunting, severe underweight, a low hemoglobin level, a low CD4 count, and WHO clinical stages III and IV. But the risk of death is reduced by starting cotrimoxazole preventative therapy early. The risk factors that result in a low survival status should be the primary focus of all concerned bodies, and early cotrimoxazole preventive treatment initiation is strongly recommended.
Patient adherence as a predictor of acute and long-term outcomes in concentrated exposure treatment for difficult-to-treat obsessive-compulsive disorder
Authors: Tjelle Kristian , Opstad Håvard Berg , Solem Stian , Kvale Gerd , Wheaton Michael G. , Björgvinsson Thröstur , Hansen Bjarne , Hagen Kristen 
Published: April 2024

Abstract
Background
Exposure and response prevention (ERP) is considered the first-line psychotherapy for obsessive-compulsive disorder (OCD). Substantial research supports the effectiveness of ERP, yet a notable portion of patients do not fully respond while others experience relapse. Understanding poor outcomes such as these necessitates further research. This study investigated the role of patient adherence to ERP tasks in concentrated exposure treatment (cET) in a sample who had previously not responded to treatment or relapsed.

Method
The present study included 163 adults with difficult-to-treat OCD. All patients received cET delivered during four consecutive days. Patients’ treatment adherence was assessed using the Patient EX/RP Adherence Scale (PEAS-P) after the second and third day of treatment. OCD severity was evaluated at post-treatment, 3-month follow-up, and 1-year follow-up by independent evaluators.

Results
PEAS-P scores during concentrated treatment were associated with OCD-severity at post-treatment, 3-month follow-up, and 1-year follow-up. Moreover, PEAS-P scores predicted 12-month OCD severity adjusting for relevant covariates. Adherence also predicted work- and social functioning at 1-year follow-up.

Conclusions
These results indicate that ERP adherence during the brief period of cET robustly relates to improvement in OCD symptoms and functioning in both the short and long term. Assessing adherence might identify patients at risk of poor outcomes, while improving adherence may enhance ERP for treatment resistant patients.

Trial Registration
ClinicalTrials.gov identifier: NCT02656342.
Sildenafil Versus Placebo for Early Pulmonary Vascular Disease in Scleroderma (SEPVADIS): protocol for a randomized controlled trial
Authors: Lammi Matthew R. , Mukherjee Monica , Saketkoo Lesley Ann , Carey Kyle , Hummers Laura , Hsu Steven , Krishnan Amita , Sandi Marie , Shah Ami A. , Zimmerman Stefan L. , Hassoun Paul M. , Mathai Steven C. 
Published: April 2024

Abstract
Background
Pulmonary hypertension (PH) is a leading cause of death in patients with systemic sclerosis (SSc). An important component of SSc patient management is early detection and treatment of PH. Recently the threshold for the diagnosis of PH has been lowered to a mean pulmonary artery pressure (mPAP) threshold of > 20 mmHg on right heart catheterization (RHC). However, it is unknown if PH-specific therapy is beneficial in SSc patients with mildly elevated pressure (SSc-MEP, mPAP 21–24 mmHg).

Methods
The SEPVADIS trial is a randomized, double-blind, placebo-controlled phase 2 trial of sildenafil in SSc-MEP patients with a target enrollment of 30 patients from two academic sites in the United States. The primary outcome is change in six-minute walk distance after 16 weeks of treatment. Secondary endpoints include change in pulmonary arterial compliance by RHC and right ventricular function by cardiac magnetic resonance imaging at 16 weeks. Echocardiography, serum N-terminal probrain natriuretic peptide, and health-related quality of life is being measured at 16 and 52 weeks.

Discussion
The SEPVADIS trial will be the first randomized study of sildenafil in SSc-MEP patients. The results of this trial will be used to inform a phase 3 study to investigate the efficacy of treating patients with mild elevations in mPAP.

Trial registration
ClinicalTrials.gov Identifier NCT04797286.
High prevalence of erectile dysfunction in men with hyperthyroidism: a meta-analysis
Authors: Liu Xiaowen , Wang Yanling , Ma Li , Wang Danhui , Peng Zhihong , Mao Zenghui 
Published: April 2024

Abstract
Objective
The objective of this study was to evaluate the association between hyperthyroidism and the risk of developing erectile dysfunction (ED).

Methods
A comprehensive search of multiple databases, including PubMed, Embase, Cochrane, and Web of Science, was conducted to identify relevant studies investigating the relationship between hyperthyroidism and ED in men. The quality of the included studies was assessed using the Newcastle‒Ottawa Quality Rating Scale, and a meta-analysis was performed using Stata 16.0 and RevMan 5.3 software.

Results
A total of four papers encompassing 25,519 study subjects were included in the analysis. Among these, 6,429 individuals had hyperthyroidism, while 19,090 served as controls. The overall prevalence of ED in patients with hyperthyroidism was determined to be 31.1% (95% CI 0.06–0.56). In patients with uncomplicated hyperthyroidism, the incidence of ED was 21.9% (95% CI 0.05–0.38). The combined odds ratio (OR) for the four studies was 1.73 (OR: 1.73; 95% CI [1.46–2.04]; p < .00001).

Conclusion
Our findings demonstrate a higher incidence of ED in patients with hyperthyroidism. These results provide valuable information for healthcare professionals and can facilitate discussions surrounding appropriate treatment options for ED in patients with hyperthyroidism.
Risky sexual behavior and associated factors among reproductive age women in eastern African countries: a multilevel analysis of the recent demographic and health survey
Authors: Workneh Belayneh Shetie , Zegeye Alebachew Ferede , Tamir Tadesse Tarik , Mekonen Enyew Getaneh 
Published: April 2024

Abstract
Introduction
Risky sexual behavior exposes an individual to the risk of contracting sexually transmitted infections including human immunodeficiency virus (HIV). Even though risky sexual behavior is a devastating problem in low- and middle-income countries, studies on risky sexual behavior and associated factors among reproductive-age women in Eastern African countries are limited. Therefore, this study aimed to assess the magnitude of risky sexual behavior and associated factors among reproductive-age women in Eastern African countries that help to target high-risk groups and set appropriate intervention.

Method
The appended and recent Demographic and Health Survey dataset of 10 Eastern African countries from 2012 to 2022 was used for data analysis. A total of 111,895 participants were included in this study as a weighted sample. Associated factors were determined using a multilevel mixed-effects logistic regression model. Significant factors in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results.

Result
The overall magnitude of risky sexual behavior among reproductive-age women in Eastern African countries was 28.16% (95% CI 27.90%, 28.43%), which ranged from 3.80% in Ethiopia to 67.13% in Kenya. In the multivariable analysis, being a younger woman, being an educated woman, being tested for human immunodeficiency virus, having work, drinking alcohol, and being an urban dweller were factors that were significantly associated with higher odds of risky sexual behavior.

Conclusion
The overall magnitude of risky sexual behavior among reproductive-age women in Eastern African countries was high. Individual-level (being a younger woman, being an educated woman, being tested for human immunodeficiency virus, having work, and drinking alcohol) and community-level (being an urban dweller) variables were associated with higher odds of risky sexual behavior. Therefore, policymakers and other stakeholders should give special consideration to urban dwellers, educated, worker and younger women. Better to improve the healthy behavior of women by minimizing alcohol consumption and strengthening HIV testing and counseling services to reduce the magnitude of risky sexual behavior.
Psychological impact and associated factors of the COVID-19 pandemic among pregnant women in Fafan Zone health institutions, Somali Region, Eastern Ethiopia, 2021
Authors: Jibril Meka Kedir , Yimam Ahmed Adem , Abdu Neima Ridwan , Ali Seid Yimam 
Published: April 2024

Abstract
Background
Despite pregnant women's vulnerability to respiratory illnesses and pregnancy complications during the COVID-19 pandemic, research on its psychological impact in the study area, is limited.

Objective
This study aims to fill this gap by examining the prevalence and factors linked to the psychological impact among pregnant women in the Fafan zone, Somali region of Ethiopia.

Methods
A cross-sectional study conducted from April 1st to April 30th, 2021, randomly selected health facilities for inclusion. The Impact of Event Scale-Revised (IES-R) assessed psychological impact, and data were analyzed using SPSS V 22. Variables with a p-value ≤ 0.25 in bivariate analysis were considered for multivariate analysis via multiple logistic regressions with the backward elimination method.

Results
The study involved 294 pregnant women, constituting 73% of the respondents. The prevalence of psychological impact attributed to the COVID-19 pandemic was 27.2%. Factors such as being in the first trimester of pregnancy (AOR: 5.32), travel history to infected areas (AOR: 3.71), obtaining COVID-19 information from television (AOR: 4.81), and using social media for 1 to 2 hours daily for updates (AOR: 1.35) were significantly associated with this impact.

Conclusion
While the psychological impact among pregnant women in this study was relatively lower compared to other research, factors such as gestational age, TV media exposure, travel history, and social media usage for COVID-19 updates were strongly linked to this impact, highlighting the necessity for psychological support services for pregnant women during challenging times.
Designing, implementation and evaluation of story reading: a solution to increase general empathy in medical students
Authors: Mahmoudi Masoumeh , Ghorbani Ali Asghar , Pourasghar Mehdi , Balaghafari Azita , Charati Jamshid Yazdani , Ghahrani Nassim , Amini Farzaneh 
Published: April 2024

Abstract
Background
Communication and mutual understanding among healthcare providers is a significant concern within the healthcare system, and enhancing empathy is one way to foster effective communication and mutual understanding. The aim of this research is to evaluate and compare the impact of story reading on the level of empathy in medical students at Mazandaran University of Medical Sciences.

Methods
The study employed an intervention educational design (a quasi-experimental), with a convenience sample of 51 medical students selected as the statistical population. The process of story reading was conducted over six two-hour virtual sessions in the students' classroom, spanning six weeks. Selected stories were discussed in an online virtual class under the supervision of an instructor, focusing on story elements. To assess students' empathy in this educational program, the Davis General Empathy Questionnaire was administered before each of the six sessions, after, and one week later at the end of the course. Statistical analysis of the collected data was performed using repeated measures analysis of variance and Bonferroni's post hoc test through SPSS version 28 software, with a significance level set at 0.05.

Results
The findings revealed that 27 participants (58.7%) were female students, with the remaining being male students, having an average age of 19.5 ± 0.86 years. The level of general empathy among the students significantly increased after the intervention compared to before the intervention (P<0.001). Furthermore, the analysis of variance with repeated measures indicated a significant effect of the story reading program on enhancing empathy in terms of emotional and cognitive transfer among students in the intervention group (P<0.001).

Conclusions
The research findings suggest that the story reading program effectively enhances the overall sense of empathy among medical students at the University of Medical Sciences. Therefore, implementing this method in universities, higher education centers, libraries, and psychology centers for teaching empathy can be valuable in fostering empathy skills and improving healthcare.