bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tolerance for uncertainty and medical students' specialty choices: A myth revisited
Authors: Wegwarth Odette , Pfoch Moritz , Spies Claudia , Möckel Martin , Schaller Stefan J. , Wehler Markus , Giese Helge 
Published: January 2025

AbstractBackgroundIn 1962, the idea emerged that medical students' tolerance of uncertainty could determine their specialty choice. While some studies supported this claim, others refuted it, often using independently developed instruments. We explored whether the reported link between specialty choice and uncertainty tolerance is more myth than evidence by employing established instruments to investigate whether specialty choice could be explained by variance in uncertainty tolerance.MethodWe conducted a cross‐sectional online survey at two periods of time. From February to June 2023, we queried 563 final‐year medical students from 34 German medical universities (1) on their uncertainty tolerance using three validated tools (the modified tolerance for ambiguity scale, the physicians' reaction to uncertainty scale and the uncertainty intolerance scenario method) and (2) on their intended specialty choice. In a follow‐up 1 year later (May to June 2024), 263 of those medical students responded to our query on their final specialty choice and again on their uncertainty tolerance.ResultsParticipants' (N = 563) median age was 26.0 years (mean: 27.2; SD = 3.8), and 70% (n = 396) were female. Originally reported differences and rank orders in uncertainty tolerance among medical students with different intended specialty choices could not be replicated for any of the three scales. Instead, our results suggest different rank orders of uncertainty tolerance by different tools, as well as nonsignificant differences between intended medical specialties. Intercorrelation coefficient analyses demonstrated that, depending on the scale, only 0.3% to 1.5% of the variance in uncertainty tolerance could be attributed to specialty choice. Follow‐up data using actual instead of intended medical choices left findings unchanged.DiscussionOur findings suggest that the presumed link between uncertainty tolerance and specialty choice is more myth than evidence. Instead of teaching this link or using it as an admissions criterion, medical schools should equip students with the skills needed to navigate uncertainty across their careers.
Diurnal Regulation of SOS Pathway and Sodium Excretion Underlying Salinity Tolerance of Vigna marina
Authors: Noda Yusaku , Wang Fanmiao , Chankaew Sompong , Ariga Hirotaka , Muto Chiaki , Iki Yurie , Ohashi Haruko , Takahashi Yu , Sakai Hiroaki , Iseki Kohtaro , Ogiso‐Tanaka Eri , Suzui Nobuo , Yin Yong‐Gen , Miyoshi Yuta , Enomoto Kazuyuki , Kawachi Naoki , Somta Prakit , Furukawa Jun , Tomooka Norihiko , Naito Ken 
Published: January 2025

ABSTRACTVigna marina (Barm.) Merr. is adapted to tropical marine beaches and has an outstanding tolerance to salt stress. Given there are growing demands for cultivating crops in saline soil or with saline water, it is important to understand how halophytic species are adapted to the saline environments. Here we revealed by positron‐emitting tracer imaging system (PETIS) that V. marina actively excretes sodium from the root during the light period but not the dark period. The following whole genome sequencing accompanied with forward genetic study identified a QTL region harbouring SOS1, encoding plasma membrane Na+/H+ antiporter, which was associated with not only salt tolerance but also the ability of sodium excretion. We also found the QTL region contained a large structural rearrangement that suppressed recombination across ~14 Mbp, fixing multiple gene loci potentially involved in salt tolerance. RNA‐seq and promoter analyses revealed SOS1 in V. marina was highly expressed even without salt stress and its promoter shared common cis‐regulatory motifs with those exhibiting similar expression profiles. Interestingly, the cis‐regulatory motifs seemed installed by a transposable element (TE) insertion. Though not identified by genetic analysis, the transcriptome data also revealed SOS2 transcription was under diurnal regulation, explaining the pattern of sodium excretion together with upregulated expression of SOS1. Altogether, the study elucidated one aspect of the strategy adopted by V. marina to adapt to marine beach, which is highly saline and transpiring.
Effects of Exercise Training on the Bone Marrow Immune Microenvironment and Minimal Residual Disease in Multiple Myeloma Patients Following First‐Line Treatment
Authors: Spiliopoulou Polyxeni , Rousakis Pantelis , Panteli Chrysanthi , Eleutherakis‐Papaiakovou Evangelos , Migkou Magdalini , Kanellias Nikolaos , Ntanasis‐Stathopoulos Ioannis , Malandrakis Panagiotis , Theodorakakou Foteini , Fotiou Despina , Terpos Evangelos , Gavriatopoulou Maria , Tsitsilonis Ourania E. , Kastritis Efstathios , Dimopoulos Meletios Athanasios , Terzis Gerasimos 
Published: January 2025

ABSTRACTThe purpose of the study was to investigate the effects of exercise training on the bone marrow immune microenvironment and on minimal residual disease of multiple myeloma patients who completed first‐line induction treatment. Eight multiple myeloma patients underwent 5 months of exercise training along with standard medical treatment. Eight age‐ and sex‐matched patients who received medical treatment only, served as controls. Before and after the intervention, white blood cells, red blood cells, and platelets, as well as the percentages of neutrophils, lymphocytes, monocytes, eosinophils, and basophils, were measured in the peripheral blood. Abnormal plasma cells, normal plasma cells, B cells, T cells, NK/NKT cells, monocytes, neutrophils, eosinophils, basophils, mast cells, myeloid progenitors, erythroid progenitors, and erythroblasts were assessed in the bone marrow. Exercise training increased the percentage of blood monocytes (mean difference 3.5% ± 2.6%; p = 0.006), while no change was detected in the control group. In the bone marrow, the CD27+ T cell subset increased (mean difference 18.2% ± 21.9%; p = 0.043) and the ratio of CD27−/CD27+ T lymphocytes decreased (pre: 1.06 ± 0.59; post: 0.76 ± 0.47; p = 0.049) in the exercise group, but remained unaltered in the control group. In conclusion, the study provides evidence that 5 months of exercise training can induce an increase in the percentage of activated T lymphocytes, as shown by the higher expression of the costimulatory CD27 marker. It also suggests that exercise‐induced changes in the bone marrow microenvironment may be beneficial in the control of clonal cell proliferation.
Molecular epidemiology of β-lactamases in ceftriaxone-resistant Enterobacterales bloodstream infections in the mid-Atlantic United States
Authors: Hareza Dariusz A. , Bergman Yehudit , Jacobs Emily , Lu Jennifer , Hanson Nancy D. , Conzemius Rick , Cosgrove Sara E. , Harris Anthony D. , Simner Patricia J. , Tamma Pranita D. 
Published: January 2025

ABSTRACT

Ceftriaxone-resistant Enterobacterales remain a public health threat; contemporary data investigating their molecular epidemiology are limited. Five hundred consecutive ceftriaxone-resistant (MIC ≥ 4 µg/mL) Enterobacterales bloodstream isolates were collected between 2018 and 2022 from three Maryland hospitals. Broth microdilution confirmed antibiotic susceptibilities. Whole-genome sequencing identified extended-spectrum β-lactamase (ESBL) and
ampC
genes both in bacterial chromosomes (c-
ampC
) and on plasmids (p-
ampC
). Mutations in promoter or attenuator regions of the
Escherichia coli
c-
ampC
gene (i.e.,
bla
EC
gene) with the potential to result in
ampC
derepression were investigated. The presence of ESBL or
ampC
genes was confirmed in 497 (99.4%) isolates. Two hundred seventy-nine (55.8%) isolates had both ESBL and
ampC
genes. ESBL families were identified among 398 (80%) patients:
bla
CTX-M
(
n
= 370),
bla
SHV
(
n
= 17),
bla
OXY
(
n
= 14), and
bla
VEB
(
n
= 5). Ceftriaxone-resistant Enterobacterales species carrying ESBL genes included the following:
E. coli
(67%),
Klebsiella pneumoniae
(24%),
Klebsiella oxytoca
(4%),
Proteus mirabilis
(2%),
Enterobacter cloacae
complex (2%),
Klebsiella aerogenes
(1%),
Providencia stuartii
(<1%), and
Serratia marcescens
(<1%). c-
ampC
genes were identified in 374 (75%) of the 500 isolates. Only 7% of
E. coli
isolates with mutations in the promoter or attenuator region of the c-
ampC
gene exhibited resistance to cefoxitin, a proxy for increased AmpC production. Two p-
ampC
genes were confirmed in 25 (5%) of the 500 isolates:
bla
CMY-59
(72%) and
bla
DHA-1
(28%; confined to
E. coli
[92%] and
K. pneumoniae
[8%]). Until comprehensive β-lactamase molecular testing is available, the species-specific prevalence of ESBL and
ampC
genes in ceftriaxone-resistant Enterobacterales should be considered to promote effective albeit judicious antibiotic prescribing. Mutations in promoter or attenuator regions of the
E. coli
c-
ampC
gene do not appear to contribute significantly to increased AmpC production in this species.
The stress-protectant molecule trehalose mediates fluconazole tolerance in
Candida glabrata
Authors: Zhu Qingjuan , Wijnants Stefanie , Feil Regina , Van Genechten Wouter , Vergauwen Rudy , Van Goethem Odessa , Lunn John E. , Van Ende Mieke , Van Dijck Patrick 
Published: January 2025

ABSTRACT

The incidence of non-
albicans Candida
infections has witnessed a substantial rise in recent decades.
Candida glabrata (Nakaseomyces glabratus
), an opportunistic human fungal pathogen, is accountable for both superficial mucosal and life-threatening bloodstream infections, particularly in immunocompromised individuals. Distinguished by its remarkable resilience to environmental stressors,
C. glabrata
exhibits intrinsic tolerance to azoles and a high propensity to swiftly develop azole resistance during treatment. The molecular mechanism for the high tolerance is not fully understood. In this work, we investigated the possible role of trehalose in this tolerance. We generated mutants in the
C. glabrata TPS1
,
TPS2
, and
NTH1
genes, encoding trehalose 6-phosphate synthase (Tps1), trehalose 6-phosphate phosphatase (Tps2), and neutral trehalase (Nth1), respectively. As expected, the
tps1∆
strain cannot grow on glucose. The
tps2
∆ strain demonstrated diminished trehalose accumulation and very high levels of trehalose 6-phosphate (T6P), the biosynthetic intermediate, in comparison to the wild-type (WT) strain. Whereas these higher T6P levels did not affect growth, the lower trehalose levels clearly resulted in lower environmental stress tolerance and a lower susceptibility to fluconazole. More interestingly, the
tps2∆
strain completely lost tolerance to fluconazole, characterized by the absence of slow growth at supra-MIC concentrations of this drug. All these phenotypes are reversed in the
nth1
∆ strain, which accumulates high levels of trehalose. Our findings underscore the role of trehalose in enabling tolerance toward fluconazole in
C. glabrata
. We further show that the change in tolerance is a result of the effect that trehalose has on the sterol pattern in the cell.
Shifts in fungal communities drive soil profile nutrient cycling during grassland restoration
Authors: Xu Yuting , Cui Ke , Zhang Xiaoshan , Diwu Guodong , Zhu Yuanjun , Deng Lei , Zhong Yangquanwei , Yan Weiming 
Published: January 2025

ABSTRACT

Soil microbial diversity and community life strategies are crucial for nutrient cycling during vegetation restoration. Although the changes in topsoil microbial communities during restoration have been extensively studied, the structure, life strategies, and function of microbial communities in the subsoil remain poorly understood, especially regarding their role in nutrient cycling during vegetation restoration. In this study, we conducted a comprehensive investigation of the changes in the soil microbial community, assembly process, life strategies, and nutrient cycling functional genes in soil profiles (0–100 cm) across a 36 year chronosequence (5, 15, 28, and 36 years) of fenced grassland and one grazing grassland on the Loess Plateau of China. Our results revealed that soil organic carbon increased by 76.0% in topsoil and 91.6% in subsoil after 36 years of restoration. The bacterial communities were influenced primarily by soil depth, while the fungal communities were highly sensitive to the years of restoration. Microbes in the subsoil recovered faster, and the microbial community structure and functional genes in the soil profiles gradually became more consistent following restoration. In addition, we observed a transition in microbial life history strategies from a persistent
K
-strategy to a rapid
r
-strategy during restoration. Notably, the fungal community assembly process played an important role in changes in nutrient cycling genes, which were accompanied by increased carbon fixation and nitrogen mineralization function. Overall, our findings provide several novel insights into the impact of changes in the fungal community on soil nutrient cycling in the soil profile during vegetation restoration.

IMPORTANCE
Our study revealed that microbes in the subsoil recovered faster than those in the topsoil, which contributed to the reduction in differences in microbial community structure and the distribution of functional genes throughout the soil profile during the restoration process. Importantly, the assembly of fungal communities plays a pivotal role in driving changes in nutrient cycling genes, such as increased carbon fixation and nitrogen mineralization, alongside a reduction in carbon degradation gene abundance. These alterations increase soil organic carbon and nutrient availability during restoration. Our results increase the understanding of the critical role of fungal communities in soil nutrient cycling genes, which facilitate nutrient accumulation in soil profiles during grassland restoration. This insight can guide the development of strategies for manipulating fungal communities to increase soil nutrients in grasslands.
Effects of vaginal microbiota on
in vitro
fertilization outcomes in women with different infertility causes
Authors: Zhao Huimin , Wang Cong , Narsing Rao Manik Prabhu , Rafiq Muhammad , Luo Gang , Li Shijun , Kang Ying-Qian 
Published: January 2025

ABSTRACT

Backed by advancements in technologies like microbial sequencing, many studies indicate that the vaginal microbiome is a key marker of female reproductive health. However, further studies are still needed to investigate the correlation between vaginal microbiota (VMB) and outcomes of assisted reproductive technology (ART). Therefore, this study compared the VMB of two types of infertile women undergoing
in vitro
fertilization (IVF) with normal control women during the implantation window period and investigated the effects of VMB characteristics on IVF outcomes. Vaginal swabs from IVF patients (
n
= 85) were collected before embryo transfer (ET), and vaginal swabs from normal control women (
n
= 37) were collected during the 6–8 days of ovulation detection. Results showed differences in the vaginal community structure between infertile women with polycystic ovary syndrome (PCOS) and with tubal factor infertility (TFI) undergoing IVF treatment. The results revealed a higher relative abundance of
Lactobacillus iners
in the non-pregnant group compared with the pregnant group. The results also demonstrated the abundance of
Pseudomonas
spp. in both non-pregnant groups of infertile women. The findings suggested that the VMB composition affects the IVF outcomes and that the pre-ET high abundance of
L. iners
may potentially indicate an IVF failure. The abundance of
Pseudomonas
spp. in the vagina may be an adverse factor for ART pregnancy.

IMPORTANCE

Many studies suggest that vaginal microbiota (VMB) may affect
in vitro
fertilization-embryo transfer (IVF-ET) outcomes. Assessing VMB before embryo transfer can optimize timing for better assisted reproductive technology (ART) results. This study examined VMB distribution in infertile women undergoing ART using 16S rRNA sequencing. Results revealed that VMB structure impacted ART outcomes in women with polycystic ovary syndrome (PCOS) and tubal factor infertility (TFI) before embryo transfer ([less than or equal to] 24 hours).
Lactobacillus iners
and
Pseudomonas
spp. were identified as adverse factors for post-ET pregnancy. The study also showed differences in pre-ET VMB between normal women and women with PCOS and TFI during the ovulatory window. These findings highlight the importance of considering VMB composition to optimize embryo transfer timing and personalize ART treatment based on infertility type, improving the chances of success.
Classification of kinesiophobia in patients after cardiac surgery under extracorporeal circulation in China: latent profile and influencing factors analysis from a cross-sectional study
Authors: Xing Wenhui , Piao Jing Jing , Ren Tong , Liang Yujing , Li Qi , Gu Yanmei , Wang Rong 
Published: January 2025

ObjectiveTo investigate the potential classification of kinesiophobia in patients after cardiac surgery under extracorporeal circulation from a psychosocial perspective, and analyse the characteristic differences among different latent levels of patients.Study designThis is a cross-sectional study of Chinese adults after cardiac surgery under extracorporeal circulation, aged 18 years and older, recruited from a tertiary hospital in North China.MethodsThis study uses latent profile analysis to identify potential classifications of kinesiophobia in questionnaires from 348 patients undergoing cardiac surgery under extracorporeal circulation. Multiple logistic regression analysis was used to evaluate the influencing factors at different latent classifications.ResultsThe average performance of each indicator in Model 3 is best suited for analysis, Entropy=0.873 and bootstrap likelihood ratio test (p)＜0.0001. The result of regression equation shows postoperative time (p<0.001), age, self-efficacy, pain and social support level (p<0.05) were the factors influencing the potential profile classification of patients after cardiac surgery under extracorporeal circulation.ConclusionThe study identified three distinct classifications of patients: the low kinesiophobia group, the moderate kinesiophobia—high-risk perceived symptoms group and the high kinesiophobia—high exercise avoidance group (HK-HEAG). Addressing kinesiophobia, especially in older male patients during the early postoperative period, is crucial. Enhancing self-efficacy seems effective in reducing kinesiophobia, while increasing social support may not be as beneficial for the HK-HEAG. These findings provide a basis for implementing preventive interventions in cardiac rehabilitation.Trial registration numberThe research is registered with the Chinese Clinical Trial Registry (ChiCTR2200057895).
Behavioural factors associated with cigarette quitting behaviour: an analysis of cross-sectional survey data collected in three low-income South African communities
Authors: Filby Samantha , Rossouw Laura 
Published: January 2025

ObjectiveTo study the behavioural factors associated with sustained cigarette smoking cessation, and those associated with a current smoker attempting to quit, among current and former cigarette smokers living in low-income South African communities.SettingThree low-income areas in South Africa.DesignIn-person surveys with structured questions that asked respondents about their cigarette smoking and quitting behaviour, sociodemographic information and behavioural attributes.ParticipantsCurrent smokers were eligible to participate if they had smoked at least one cigarette in the week prior to the interview (n=569). Former smokers were eligible if they had ever smoked cigarettes regularly in the past and had abstained from smoking for at least 6 months (n=106).Outcomes(1) Abstinence from cigarette smoking for at least 6 months and (2) attempting to quit cigarette smoking in the past 12 months.ResultsCompared with low levels of self-control, high levels of self-control increase the odds of sustained cessation (OR=2.690, 95% CI: 2.480 to 2.917) and of making a quit attempt (OR=1.271, 95% CI: 1.254 to 1.288). Relative to low levels of stress, high levels of stress reduce the odds of sustained cessation (OR=0.938, 95% CI: 0.927 to 0.948) and of attempting to quit (OR=0.824, 95% CI: 0.666 to 1.019). Hyperbolic discounting reduces the odds of sustained cessation (OR=0.841, 95% CI: 0.822 to 0.862) while exhibiting more quitting self-efficacy increases these odds (OR=2.063, 95% CI: 1.745 to 2.439). Being impatient reduces the odds of making a quit attempt (OR=0.814, 95% CI: 0.702 to 0.943), as does a tendency to postpone important tasks (OR=0.784, 95% CI: 0.644 to 0.956).ConclusionsNon-pharmacological cessation support to low-income smokers should challenge potential lifetime quitters to practice self-control, equip them with tools to manage stress, and tackle temptations to time-discounting. Existing healthcare infrastructure should be leveraged to question people who smoke about their behavioural attributes, and to use this information to deliver behavioural support that motivates and facilitates sustained smoking cessation.
Burden and mortality of breast cancer attributed to diabetes and smoking in women: a secondary analysis based on Global Burden of Disease 2019 in North Africa and the Middle East
Authors: Shadmani Fatemeh Khosravi , Abedi Gheshlaghi Leili , Jafari-Khounigh Ali , Rezakhani Leila , Khazaei Mozafar 
Published: January 2025

BackgroundBreast cancer (BC) is the second most common cancer in the world. This study aimed to investigate the burden of BC due to some risk factors in the Middle East and North Africa (MENA) countries from 1990 to 2019.MethodsThis study is a secondary analysis based on the Global Burden of Disease 2019 data. In this study, we used data for disability-adjusted life years (DALYs) and mortality of BC in MENA countries. Also, we presented data for DALYs and mortality attributed to diabetes, smoking and passive smoking among women with BC.ResultsThe age-standardised DALY due to BC in women increased slowly from 395 (95% CI: 357 to 458) per 100 000 in 1990 to 473 (95% CI: 409 to 544) per 100 000 in 2019. But Kuwait, Bahrain, Jordan and Turkey saw a decrease in age-standardised DALY trends between 1990 and 2019. In 1990, the age-standardised mortality rate was 12.3 (95% CI: 11.0 to 14.2) per 100 000 people, and by 2019, it had increased to 15.2 (95% CI: 13.3 to 17.3) per 100 000. The rate in 2019 varied between countries. Diabetes, smoking and passive smoking contribute significantly to the burden of disease and mortality from BC, with diabetes playing a more impactful role than the other risk factors. Across the MENA region, the burden and mortality attributed to diabetes vary among countries.ConclusionIn the MENA region, the attributable fraction of risk factors such as diabetes, smoking and secondary smoking over BC deaths and DALY has increased in recent years.