bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brassinosteroid-dependent phosphorylation of PHOSPHATE STARVATION RESPONSE2 reduces its DNA-binding ability in rice
Authors: Zhang Guoxia , Wang Hongru , Ren Xiangle , Xiao Yunhua , Liu Dapu , Meng Wenjing , Qiu Yahong , Hu Bin , Xie Qingjun , Chu Chengcai , Tong Hongning 
Published: February 2024

Abstract
Brassinosteroids (BRs) are widely used as plant growth regulators in modern agriculture. Understanding how BRs regulate nutrient signaling is crucial for reducing fertilizer usage. Here we elucidate that the central BR signaling inhibitor GSK3/SHAGGY-LIKE KINASE2 (GSK2) interacts directly with and phosphorylates PHOSPHATE STARVATION RESPONSE2 (OsPHR2), the key regulator of phosphate (Pi) signaling, to suppress its transcription factor activity in rice (Oryza sativa). We identify a critical phosphorylation site at serine residue S269 of OsPHR2 and demonstrate that phosphorylation by GSK2 or phosphor-mimic mutation of S269 substantially impairs the DNA-binding activity of OsPHR2, and thus diminishes expression of OsPHR2-induced genes and reduces Pi levels. Like BRs, Pi starvation noticeably induces GSK2 instability. We further show that this site-specific phosphorylation event is conserved in Arabidopsis (Arabidopsis thaliana), but varies among the PHR-family members, being present only in most land plants. These results unveil a distinctive post-transcriptional regulatory mechanism in Pi signaling by which BRs promote Pi acquisition, with a potential contribution to the environmental adaptability of plants during their evolution.
Unlocking Nature's Defense: Plant Pattern Recognition Receptors as Guardians Against Pathogenic Threats
Authors: Zhang Chao , Xie Yingpeng , He Ping , Shan Libo 
Published: February 2024

Embedded in the plasma membrane of plant cells, receptor kinases (RKs) and receptor proteins (RPs) act as key sentinels, responsible for detecting potential pathogenic invaders. These proteins were originally characterized more than three decades ago as disease resistance (R) proteins, a concept that was formulated based on Harold Flor's gene-for-gene theory. This theory implies genetic interaction between specific plant R proteins and corresponding pathogenic effectors, eliciting effector-triggered immunity (ETI). Over the years, extensive research has unraveled their intricate roles in pathogen sensing and immune response modulation. RKs and RPs recognize molecular patterns from microbes as well as dangers from plant cells in initiating pattern-triggered immunity (PTI) and danger-triggered immunity (DTI), which have intricate connections with ETI. Moreover, these proteins are involved in maintaining immune homeostasis and preventing autoimmunity. This review showcases seminal studies in discovering RKs and RPs as R proteins and discusses the recent advances in understanding their functions in sensing pathogen signals and the plant cell integrity and in preventing autoimmunity, ultimately contributing to a robust and balanced plant defense response. [Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2024.
Phage-Dependent Alteration of Rhizosphere Microbiota in Tomato Plants
Authors: Lee Seung Yeup , Magar Roniya Thapa , Choi Kihyuck , Kim Hyo Jeong , Park Insoo , Lee Seon-Woo 
Published: February 2024

Bacteriophages (phages) that infect bacterial pathogens are an alternative means of controlling bacterial diseases in humans, animals, and plants. However, the effects of targeted phage therapy on indigenous microbial communities are not fully understood. In this study, we hypothesized that phages infecting plant pathogenic bacteria play a role in modulating the microbial community in the plant rhizosphere. To explore this, we used the soil-borne plant bacterial pathogen Ralstonia pseudosolanacearum as the host bacterium and its phages as a model system in the tomato rhizosphere. The effect of phages on the microbiota was examined using a narrow host range phage RpY1 and a combination of two phages (RpY2 and RpT1, termed the phage combo) with a broad host range under the natural rhizosphere microbiota of tomato plants. Both RpY1 and the phage combo altered the tomato rhizosphere microbiota. The phage combo displayed phage effects mostly in the presence of R. pseudosolanacearum. However, RpY1 affected the rhizosphere microbiota even in the absence of the host bacterium. The effect of phage RpY1 on the microbiota was further investigated in the tomato rhizosphere using a synthetic community (SynCom) mimicking the natural tomato rhizosphere microbiota. Phage RpY1 affected the microbial community structure of the SynCom in the tomato rhizosphere in the absence of the host bacterium. Analyses of the natural microbiota and SynCom in the tomato rhizosphere indicated an indirect effect of phage RpY1 on the microbiota. This study suggests that phage application modulates the indigenous microbiota through unknown interactions with nonhost bacterial members in the plant rhizosphere. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Teaching Social Determinants of Health in Undergraduate Medical Education: A Longitudinal Curricular and Experiential Program in the United Arab Emirates
Authors: Al-Habbal Khairat , Ibrahim Halah 
Published: February 2024

Abstract
Social determinants of health (SDH) have a major impact on illness and wellness. However, research shows a lack of training on SDH in both undergraduate and postgraduate medical education, with studies confirming that the social needs of patients are not routinely identified or addressed by health care professionals in clinical practice. The medical education community is currently working to incorporate SDH into undergraduate training but has had limited guidance regarding educational topics, modes of teaching, and evaluation criteria in this domain. This article describes the evolution, process, and structure, along with student perceptions, lessons learned, and future directions, of an SDH educational program in the United Arab Emirates. Using the Institute of Medicine’s behavioral and social science knowledge domains as a framework, the program includes a didactic component with workshops, reflective practice training, and an experiential component that integrates home visits with social activities in collaboration with community partners. The program began in 2019. To date, 114 students have completed the didactic sessions and at least 1 year of the experiential component. Student surveys and reflective narratives reveal positive perceptions of the program and improved SDH knowledge, skills, and attitudes.
Learning From Clinical Supervisor Practice Variability: Exploring Medical Resident and Fellow Experiences and Interpretations
Authors: Mithoowani Siraj , Khattak Shahzaib , Lieberman Susan , Tseng Eric K. , Zeller Michelle P. , van Merriënboer Jeroen 
Published: February 2024

Abstract

Purpose
Clinical practice variability is characterized by 2 or more clinicians making different treatment decisions despite encountering a similar case. This study explores how medical residents and fellows experience and interpret intersupervisor clinical practice variability and how these variations influence learning.

Method
Seventeen senior residents or fellows in internal medicine, hematology, or thrombosis medicine (postgraduate year 3 or above) participated in semistructured interviews after a clinical rotation in thrombosis medicine from December 2019 to March 2021. Data collection and analysis occurred iteratively and concurrently in a manner consistent with constructivist grounded theory. Variation theory was used to guide the development of some interview questions. A central tenet of this theory is that learning occurs by experiencing 3 sequential patterns of variation: contrast, generalization, and fusion. Participants were recruited purposively with respect to specialty until theoretical sufficiency was reached.

Results
Clinical practice variability was experienced by all participants. Residents and fellows attributed practice variability to intrinsic differences among supervisors; interinstitutional differences; selection and interpretation of evidence; patient preferences, priorities, and fears; and their own participation in the decision-making process. Clinical practice variability helped residents and fellows discern key features of cases that influenced decision-making (contrast), group similar cases so that the appropriate evidence could be applied (generalization), and develop attitudes consistent with providing individualized patient care (fusion). Observing practice variability was more helpful for fifth- and sixth-year residents and less helpful for third- and fourth-year residents.

Conclusions
Clinical practice variability helped residents and fellows discern critical aspects, group similar patients, and practice individualized medicine. Future research should characterize how clinical practice variability influences learning across the spectrum of training, how supervisors could encourage learning from practice variability, and how curricula could be modified to allow learners greater opportunity to reflect on and consolidate the practice differences they observe.
Comparing Cosmetic Outcomes of Straight-Line Versus W-Plasty Techniques for Linear Postauricular Wound Closure: A Randomized Evaluator Blind Split-Scar Trial
Authors: Mehrzad Mehrnaz , Kang Alison S. , Armstrong April W. , Eisen Daniel B. 
Published: February 2024

BACKGROUND
Surgeons' opinions vary on the cosmetic outcome of straight-line (SL) versus broken-line (W-plasty) closure methods. To date, no studies have compared the 2 techniques in the split-scar design model that resolves the confounding individual patient factors that affects the scar outcome.

OBJECTIVE
Compare outcomes and wound cosmesis with SL versus W-plasty closure techniques.

METHODS
This clinical trial was conducted with 50 linear surgical wounds randomized to SL closure on half and W-plasty on the other half. At 3 months, patients and 2 masked observers evaluated each scar using the Patient and Observer Scar Assessment Scale (Patient Observer Scar Assessment Scale [POSAS]).

RESULTS
The mean (SD) sum of the POSAS observer component scores were 16.6 (6.18) for the SL side and 15.5 (6.37) for the W-plasty side (p = .49). The mean (SD) sum of the POSAS patient scores were 14.4 (6.8) in SL and 15.1 (8.2) in W-plasty (p = .59). The mean (SD) complications were 0.08 (0.06) for SL and 0.02 (0.14) for W-plasty (p = .18).

CONCLUSION
No statistically significant difference in wound cosmesis or complications was noted between SL versus W-plasty closure techniques. Surgeons may want to consider whether the extra time involved in placing zigzag W-plasty lines is worthwhile.
Protective Effect of CD137 Deficiency Against Postinfarction Cardiac Fibrosis and Adverse Cardiac Remodeling by ERK1/2 Signaling Pathways
Authors: Zang Guangyao , Chen Yiliu , Guo Ge , Wan Aijun , Li Bo , Wang Zhongqun 
Published: February 2024

Abstract:
Myocardial fibrosis, a common complication of myocardial infarction (MI), is characterized by excessive collagen deposition and can result in impaired cardiac function. The specific role of CD137 in the development of post-MI myocardial fibrosis remains unclear. Thus, this study aimed to elucidate the effects of CD137 signaling using CD137 knockout mice and in vitro experiments. CD137 expression levels progressively increased in the heart after MI, particularly in myofibroblast, which play a key role in fibrosis. Remarkably, CD137 knockout mice exhibited improved cardiac function and reduced fibrosis compared with wild-type mice at day 28 post-MI. The use of Masson's trichrome and picrosirius red staining demonstrated a reduction in the infarct area and collagen volume fraction in CD137 knockout mice. Furthermore, the expression of alpha-smooth muscle actin and collagen I, key markers of fibrosis, was decreased in heart tissues lacking CD137. In vitro experiments supported these findings because CD137 depletion attenuated cardiac fibroblast differentiation, and migration, and collagen I synthesis. In addition, the administration of CD137L recombinant protein further promoted alpha-smooth muscle actin expression and collagen I synthesis, suggesting a profibrotic effect. Notably, the application of an inhibitor targeting the extracellular signal-regulated kinase 1/2 (ERK1/2) signaling pathway attenuated the profibrotic effects of CD137L. To conclude, this study provides evidence that CD137 plays a significant role in promoting myocardial fibrosis after MI. Inhibition of CD137 signaling pathways may hold therapeutic potential for mitigating pathological cardiac remodeling and improving post-MI cardiac function.
High-value innovations in otolaryngology born from a tertiary hospital in Rwanda: opportunities for bi-directional learning
Authors: Nuss Sarah , Shaye David , Tuyishimire Gratien , Bukuru John ,   Co-PI, Nuss Roger , Ncogoza Isaie 
Published: February 2024

Introduction:
The objective of this paper is to discuss bidirectional innovation sharing between high-income countries (HICs) and low-income countries and middle-income countries (LMICs) in otolaryngology surgery. The authors aim to highlight several high-value, context-appropriate innovations in otolaryngology care that have been developed in a tertiary hospital in Rwanda and discuss their safety and efficacy compared to the standard of care.

Methods:
Five surgeons (three Rwandan surgeons, two United States surgeons with longitudinal experience in Rwanda) provided their recommendations for high-value innovations currently being employed in their experience at a tertiary hospital in Rwanda.

Results:
Otolaryngologists provided feedback on the utility, safety, and efficacy of ten ‘innovations’ that aim to optimize resource utilization and improve access to otolaryngology care. The authors emphasize the need for tailored, context-appropriate solutions in surgical care and the importance of research and evaluation to ensure the safety and efficacy of LMIC innovations. The authors also highlight the potential for HICs to learn from LMICs in terms of high-value and environmentally sustainable surgical practices. Further research is needed to guide national health systems in prioritizing their infrastructure, equipment, and training needs for scaling up otolaryngology services.

Discussion:
Our review highlights the importance of bidirectional learning in surgical innovation and the potential for high-value innovations to improve surgical care in LMICs.
Social Support and Social Stress Among Suicidal Inpatients at Military Treatment Facilities
Authors: Darmour Charles A. , Luk Jeremy W. , LaCroix Jessica M. , Perera Kanchana U. , Goldston David B. , Soumoff Alyssa A. , Weaver Jennifer J. , Ghahramanlou-Holloway Marjan 
Published: February 2024

Abstract
The associations between social support and stress with internalizing symptoms (depressive symptoms and hopelessness) and hazardous drinking were tested in an inpatient sample of suicidal military personnel. Baseline data from a randomized clinical trial were analyzed. Different sources of support and stressors in the social context of military personnel were differentially linked to internalizing symptoms and hazardous drinking. In the full sample (n = 192), family and nonfamily support were both inversely associated with internalizing symptoms but not hazardous drinking. Family stress was positively associated with internalizing symptoms. In a subsample of service members who had a history of deployment (n = 98), postdeployment social support was protective against internalizing symptoms, whereas deployment harassment was associated with increased odds of hazardous drinking. Results underscore the need for assessment of various dimensions of social support and stress to guide case formulation and optimize strategies to support patients' mental well-being and adaptive coping.
Assessment of the Readability and Quality of Online Information for Patients and Their Families Regarding Schizophrenia
Authors: Ekinci Okan , Koyuncu Alcin Naz 
Published: February 2024

Abstract
To our knowledge, this is the first study that specifically aims to assess the readability and quality of online information about schizophrenia. The analysis is performed on 93 of 195 websites that appeared in an advanced Google search of the term “schizophrenia” performed on a single day. The websites were categorized as commercial, nonprofit, professional, and government. The websites were evaluated using the Health on the Net Foundation (HON) code certificate, DISCERN tool, and Journal of the American Medical Association (JAMA) benchmark criteria for quality and the Flesch Reading Ease Formula, Flesch-Kincaid Grade Level (FKGL) Formula, Simple Measure of Gobbledygook, and Gunning Fog indices for readability. A total of 21.5% of all websites had a HON code certificate, 50.5% were accepted as high quality (JAMA score ≥3), and 25.8% reached the recommended readability level (FKGL ≤8). Only three websites scored at a fifth- to sixth-grade reading level. Commercial and government websites had significantly lower DISCERN scores. Commercial websites had significantly lower Flesch Reading Ease Score and FKGL score than nonprofit websites. In conclusion, the current findings indicate that the quality of online information on schizophrenia is generally acceptable, but the readability is insufficient. Website creators, physicians, and health authorities should be more sensitive to the readability of online information about schizophrenia, considering the poor cognitive capacity of the patients and the unique nature of the disease.
Vestibular Decompensation Following COVID-19 Infection in a Person With Compensated Unilateral Vestibular Loss: A Rehabilitation case study
Authors: Weston Angela R. , Doar Grayson , Dibble Leland E. , Loyd Brian J. 
Published: February 2024

Background and Purpose:
Surgical removal of a vestibular schwannoma (vestibular schwannoma resection; VSR) results in a unilateral vestibular hypofunction with complaints of dizziness and imbalance. Although the anatomic lesion is permanent, recovery of balance and diminution of dizziness occurs through central neurophysiologic compensation. Compensation of the system is maintained through daily activity. Unfortunately, interruption of stimulus, such as decreased activities due to illness, can cause decompensation. Decompensation is described as the return of symptoms consistent with that experienced during the initial insult/injury (eg, dizziness, oscillopsia, balance difficulty). This case study describes a reoccurrence of vestibular dysfunction in a person with a history of VSR following hospitalization and protracted recovery from a COVID-19 infection. It further documents her recovery that may be a result of vestibular rehabilitation.

Case Description:
A 49-year-old woman (M.W.) with a surgical history of VSR (10 years prior) and a medical history of significant COVID-19 infection, resulting in an intensive care unit stay and prolonged use of supplemental oxygen, presented to physical therapy with persistent dizziness and imbalance. The video head impulse test confirmed unilateral vestibular hypofunction.

Intervention:
M.W. attended biweekly vestibular rehabilitation for 6 weeks and completed daily home exercises.

Outcomes:
At discharge, M.W. demonstrated improvements in patient-reported outcomes (Dizziness Handicap Inventory), functional testing (MiniBEST, 2-Minute Walk Test), and gaze stability measures (video head impulse testing, dynamic visual acuity).

Discussion:
Vestibular decompensation preluded by a COVID-19 infection caused a significant decrease in functional mobility. Vestibular rehabilitation targeted at gaze and postural stability effectively reduced symptoms and facilitated recovery to M.W.’s pre-COVID-19 level of function.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A458).
Perceptions of good physicians in patients’ online consultations: Evidence from a Chinese platform
Authors: Peng Quanming , Li Jun , Zheng Lutong , Guo Liping 
Published: February 2024

Abstract

Objective:
This article aimed to offer insights into patients’ expectations regarding the traits of physicians, with the goal of helping physicians gain a better understanding of patient needs and provide better care.

Method:
This study used a Python crawler script to collect patients’ comments from haodf.com, a major online consultation platform in China, to examine the expected character traits of physicians by patients. A total of 83,315 comments were obtained. We selected positive comments from patients, performed text segmentation using Jieba, and utilized the TextRank algorithm to identify high-ranking words based on the Index of Relative Importance (IRI) within these comments. To make the findings comprehensible and practical for physicians and medical educators, we utilized a word cloud to visualize the results. We classified the high-ranking words into four dimensions—professional competence, communication attitude, communication ability, and character traits—based on the categorization of positive physician qualities found in relevant literature.

Results:
Key findings from the study included: (1) The top 23 high ranking words for traits of good physicians (in descending order) were: patient, meticulous, proficient, precise, kind, moderate, successful, gentle, rigorous, explicit, clear, effective, humorous, sincere, skilled, kindhearted, modest, awesome, practical (and not flashy), unhurried, experienced, clean, and excellent; (2) Patients placed the highest value on the professional competence of physicians, followed by their communication attitude, communication ability, and character traits; (3) Despite the highest IRI score for professional competence, it was exceeded by the combined scores of communication attitude and communication ability. This underscored the significance of effective communication in medical encounters.

Conclusions:
Drawing from these findings, recommendations are proposed for physicians and medical educators to enhance the quality of medical encounters. These suggestions include implementing Narrative Medicine training to improve communication awareness and skills as well as encouraging lifelong continuing medical education to maintain professional competence among practitioners. This study contributes to the establishment of positive physician-patient relationships in both telemedicine and face-to-face medical interactions.