bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thinking Outside the Box: Advancing Clinical Education in an Era of Preceptor Shortage
Authors: Kayingo Gerald , Gordes Karen L. , Fleming Shani , Cawley James F. 
Published: May 2023

AbstractThe expansion of health professions educational programs has led to an acute shortage of available clinical training sites. Rapid growth in the number of medical schools, physician assistant (PA) programs, and advanced nurse practitioner (APRN) programs, all of which share a need for similar types of clinical training experiences, has increased competition for clinical training sites and placed new challenges on educational institutions. Solutions are urgently needed to increase the quantity and quality of supervised clinical practice experiences as well as to ensure diversity among preceptors and geographical clinical sites. This article identifies key barriers to securing sufficient clinical training sites, notes emerging trends, and presents potential innovations through stakeholder collaboration for enhancing clinical training across health professions.
Foundational Skill-Building in a Novel Well-being Curriculum
Authors: Neary Stephanie , Ruggeri Mary , Roman Christopher , Hoover Eve , Butaney Bhupin , Weller Indigo 
Published: May 2023

IntroductionMental illness and decreased well-being are pervasive throughout physician assistant (PA) training, and the accreditation standards require a wellness curriculum. The purpose of this study was to determine if a mandatory, multifaceted virtual wellness curriculum can mitigate the decline in well-being experienced by first-year PA students.MethodsFirst-year PA students from 5 programs (n = 259) participated in a 16-week asynchronous virtual course. The course integrated evidence-based content on vulnerability and stigma, mindfulness and decentering, and reflective writing. Total weekly content averaged 30-60 minutes and was presented in multiple formats including recorded lectures and panels, readings, and discussion forums. Students completed anonymous pre- and postsurveys, and ordinary least squares (OLS) regression with a fixed effect for each school was used for data analysis.ResultsIn total, 157 of 259 (60.6%) students completed both surveys with matching unique identifiers. The majority of students (73.6%; 134/182) thought this course had a positive impact on their training as a PA student. Baseline scores were significantly predictive of end-point scores for the PHLMS, OMS-HC-15, SSOSH, RPQ, and UCLA-3 (see Methods section for full names of surveys). Race was significantly predictive of PHLMS and OMS-HC-15 scores; age was significantly predictive of SSOSH scores; and gender was significantly predictive of RPQ scores.DiscussionFor a student with low baseline well-being who is entering a PA program, dedicated curricula focusing on foundational wellness skills can be successful in improving well-being. Future work is needed to more fully characterize the scope and extent of this program’s impact on PA learners. Additional efforts are also necessary to optimize the delivery and provide access to PA students nationwide.
Fall Prevention Care Management
Authors: Yoder Claire L. McKinley , Kyoshi-Teo Hiroko , Ochoa-Cosler Olivia 
Published: May 2023

Background:
Accidental falls are common among older adults and may lead to devastating consequences. One promising approach to reduce falls is to engage older adults in fall risk reduction through care management.

Purpose:
This article describes the implementation by undergraduate nursing students of a 6-week interdisciplinary Fall Prevention Care Management (FPCM) intervention to improve the safety of older adults living in assisted living facilities.

Methods:
A secondary qualitative descriptive analysis of narrative visit notes was conducted using the Meyer et al taxonomy to characterize fall prevention interventions with older adults.

Results:
Individualized fall prevention interventions including motivational interviewing and care management supported clients' engagement with fall prevention by facilitating behavior change related to fall prevention, helping clients identify and reflect on meaning and/or perceptions related to fall prevention.

Conclusion:
The FPCM project was acceptable, facilitated high fall risk older adults' engagement with fall prevention, and yielded many positive outcomes.
Hyperferritinemia in Severe Dengue Infection: Single-Center Retrospective Cohort Study
Authors: Lakshmanan Chidhambharam , Ranjit Suchitra , Natraj Rajeswari , Venkatachalapathy Priyavarthini , Kumar Vasanth S. , Lum Lucy Chai See 
Published: May 2023

OBJECTIVES:
Hyperferritinemia in the critical phase of dengue infections may correlate with severe dengue (sd) disease, and our primary objective was to examine the association between ferritin level on day 1 of PICU admission and 2009 World Health Organization (WHO) criteria for sd. Our secondary objective was outcome in relation to care. It is unclear whether immunomodulatory therapy during the critical phase may restore immune homeostasis and mitigate disease severity.

DESIGN, SETTING, AND PATIENTS:
Retrospective cohort study of children with dengue 1 month to 16 years old with admission ferritin greater than or equal to 500 ng/mL requiring PICU admission. Demographics, clinical, and laboratory parameters, presence of the 2009 WHO sd criteria and outcomes were analyzed. Immunomodulatory therapy was used when there was persistent hyperinflammation beyond the critical phase of plasma leakage.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Fifty-five patients were admitted in the critical phase of dengue with median (interquartile range) ferritin levels of 8,105 ng/mL (2,350–15,765 ng/mL). Patients with at least one WHO sd category had higher ferritin levels compared to those without any sd criteria, with the highest levels in eight patients with all three sd categories. In our cohort of 55, 52 patients (94%) recovered with standard supportive therapy. Recovery was associated with decreased ferritin levels that occurred in parallel with improved circulation and platelet counts; this included 22 of 24 patients with admission ferritin levels greater than or equal to 10,000 ng/mL and two with ferritin greater than 1,00,000 ng/mL. Immunomodulation was used in three patients with unremitting fever, persistent hyperferritinemia, and progressive multiple organ dysfunction beyond the critical phase, of whom two died.

CONCLUSIONS:
Hyperferritinemia in the critical phase of sd is associated with the number of 2009 WHO sd criteria present. Our data also indicate that many patients with sd recover well with supportive care.
Socioeconomic Inequalities and Predictors of Cardiac Rehabilitation Referral
Authors: Rocha José Afonso , Azevedo Luís F. , Freitas Alberto , Cardoso José Carlos S. 
Published: May 2023

Objective
The aim of the study is to identify factors associated with cardiac rehabilitation referral after an acute coronary syndrome at a university hospital.

Design
We analyzed 2814 hospitalizations due to acute coronary syndrome between 2017 and 2019 in Centro Hospitalar São João. The hospital’s morbidity database was used to retrieve patient information. Cardiac rehabilitation referral and participation were identified from administrative databases and clinical records. Socioeconomic data were obtained from municipality of residence-level data rather than patient-specific data.

Results
Of 2814 hospitalizations, 72% (2028 cases) were eligible for cardiac rehabilitation. Mean age was 65.2 ± 13.4 yrs; 72% men, 33% diabetic, 57.1% hypertensive, and 63.6% dyslipidemic. Cardiac rehabilitation referral rate was low, at 18.8%, with 42 (11.0%) not attending cardiac rehabilitation and 39 (10.2%) dropping out. Females (odds ratio = 0.72 [95% confidence interval = 0.52–1.00]), older patients (odds ratio = 0.57 [0.42–0.77]; 55–64 vs. <55 yrs), and those coming from lower-income municipalities (odds ratio = 0.53 [0.41–0.69], below median vs. above median) with lower education level (odds ratio = 0.70 [0.54–0.92]; ≤4 vs. >4 yrs) were less likely to be referred to cardiac rehabilitation.

Conclusions
There is a need for new strategies to promote cardiac rehabilitation in disadvantaged groups, as sex, age, and socioeconomic inequities in access to cardiac rehabilitation remain unresolved.
Craniofacial Microsomia: New Updates in Spinal Anomalies
Authors: Gonçalves Ferraz Beatriz , Vendramini-Pittoli Siulan , Gomes Luiz Paulo , Madeira Brandão Michele , Alonso Nivaldo , Tonello Cristiano 
Published: May 2023

Introduction:
Craniofacial microsomia (CFM) involves anomalies of the first and second pharyngeal arches, mainly of the mandible, maxilla, ears, and vertebral spine. This study aimed to identify the frequency and morphology of spinal anomalies of individuals with clinical diagnoses of CFM. In addition, the correlation between spinal anomalies and craniofacial involvement was performed.

Materials and Methods:
This study was a retrospective review of individuals with a clinical diagnosis of craniofacial microsomia. The inclusion criteria were a clinical diagnosis of CFM with no overlap with any other syndromes of first and second pharyngeal arches and radiograph availability in the hospital’s database. Prevalence and morphology of spinal anomalies were calculated and clinical details were recorded: types of spinal anomalies and correlations according to OMENS score.

Results:
The sample consisted of 46 individuals with a clinical diagnosis of CFM, 24 (52,2%) female and 22 (47,8%) male (1M:1F). Twenty-one (45,7%) had unilateral craniofacial involvement and 25 (54,3%), bilateral. Twenty-eight (60,9%) individuals presented spinal anomalies. Those with unaltered spinal morphology showed a slight preference toward OMENS scores under 5: 7 patients did, only one of which had spinal alterations (14,3%); 68,8% (22) in the group with scores 5 to 9 (n=32) and 71,4% (5) in the 10 to 15 group (n=7) did as well.

Discussion and conclusions:
Spinal anomalies in individuals with CFM are more common than usually reported in medical literature, mainly when associated with radial anomalies and correlate with statistical significance to facial features, mainly the OMENS score.
Current use and utility of magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, and pancreatic duct stents: A secondary analysis from the Western Trauma Association multicenter trials group on pancreatic injuries
Authors: Biffl Walter L. , Ball Chad G. , Moore Ernest E. , West Michaela , Russo Rachel M. , Balogh Zsolt J. , Kornblith Lucy , Castelo Matthew ,   the WTA Multicenter Trials Group on Pancreatic Injuries
Published: May 2023

INTRODUCTION
The single most important predictor of pancreas-specific complications (PSCs) after pancreatic trauma is injury to the main pancreatic duct (MPD). Pancreatography has been recommended to evaluate the integrity of the MPD. In addition, pancreatic duct stents have been proposed to prevent or treat PSC. The primary purpose of this study was to determine the accuracy of magnetic resonance cholangiopancreatography (MRCP) in diagnosing MPD injury. We further sought to determine whether stents were effective in preventing PSC or facilitated the resolution of pancreatic leaks or fistulae.

METHODS
A secondary analysis of a multicenter retrospective review of pancreatic injuries in patients 15 years and older from 2010 to 2018, focusing on patients who underwent MRCP or endoscopic retrograde cholangiopancreatography (ERCP), was performed. Final pancreatic injury grade was determined based on all available assessments, ultimately adjudicated by the site principal investigator. Data were analyzed using various statistical tests where appropriate.

RESULTS
Thirty-three centers reported on 1,243 patients. A total of 216 underwent pancreatography—137 had MRCP and 115 ERCP, with 36 having both. The sensitivity of MRCP for MPD injury was 37%, the specificity was 94%, the positive predictive value was 77%, and the negative predictive value was 73%. When compared with ERCP, MRCP findings were discordant in 64% of cases. Pancreatic stents were placed in 77 patients; 48 (62%) were to treat PSC, with no clear benefit. Twenty-nine had prophylactic stents placed. There did not appear to be benefit in reduced PSC compared with the entire study group or among patients with high-grade pancreatic injuries.

CONCLUSION
The accuracy of MRCP to evaluate the integrity of the MPD does not appear to be superior to computed tomography scan. Consequently, the results of MRCP should be interpreted with caution. The current data do not support prophylactic use of pancreatic stents; they should be studied in a prospective trial.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
Targeting hypoxia-induced circSTT3A decreases breast cancer stem cell formation via degradation of PGK1 protein and serine synthesis
Authors: Xu Ming , Liu Manran , Zhou Xinyue , Qin Yilu , Yang Liping , Wen Siyang , Qiu Yuxiang , Jin Ting , Chen Shangchun , Tang Rui , Guo Yuetong , Sun Yan 
Published: May 2023

AbstractBackgroundHypoxia is a key feature of tumor microenvironment that can cause fundamental changes in cancer cells, and may also lead to the development of breast cancer stem cells (BCSCs) with self-renewal ability. However, the mechanism of hypoxia in inducing BCSCs is not fully understood.MethodsPerforming RNA sequence and bioinformatics analysis, a hypoxia specific circular RNA (circRNA), named circSTT3A, was identified in hypoxic breast cancer cells and tissues. The clinical significance of circSTT3A was investigated in breast cancer (BC) tissues and tissue array. The loss and acquisition of circSTT3A were carried out in vivo and in vitro to confirm its functional roles in BCSC stemness maintenance. HIF1α droved circSTT3A expression was evaluated by chromatin immunoprecipitation and dual luciferase reporter assays. RNA pull-down, RNA immunoprecipitation, silver staining detection, mass spectrographic analysis, co-immunoprecipitation assays and western blotting were exerted to determine circSTT3A directly binding with HSP70 and PGK1 proteins. CircSTT3A-mediated serine metabolism was determined by UHPLC-QTRAP-MS system and ELISA kit. BC mouse model was used to assess the effects of circSTT3A/Hsp70/PGK1 on tumorigenesis and chemotherapy resistance in vivo.ResultsA novel hypoxia specific circSTT3A was significantly upregulated in clinical breast cancer tissues, and was related to the clinical stage and poor prognosis of BC patients. The hypoxia inducible factor 1 alpha (HIF1α)-regulated circSTT3A has remarkable effect on mammosphere formation in breast cancer cells. Our work revealed that circSTT3A directly interacting with nucleotide-binding domain of heat shock protein 70 (HSP70) increases the ability of HSP70 to recruit phosphoglycerate kinase 1 (PGK1) via its substrate-binding domain, which reduces the ubiquitination of PGK1 and increases the stability of PGK1. The enhanced PGK1 catalyzes 1,3-diphosphoglycerate (1, 3-BPG) into 3-phosphoglycerate (3-PG) leading to 3-PG accumulation and increase of serine synthesis, thus to facilitate BCSC enrichment under hypoxic microenvironment. Loss of circSTT3A or PGK1 substantially induces suppression in tumor initiation and tumor growth, which dramatically increases tumor sensitivity to Doxorubicin treatment in mice.ConclusionsHypoxia induced circSTT3A/HSP70/PGK1 axis plays a critical role in maintaining BCSC properties and may be meaningful for treating patients with breast cancer.
Exploring Ethylene-Related Genes inCannabis sativa: Implications for Sexual Plasticity
Authors: Monthony Adrian S. , de Ronne Maxime , Torkamaneh Davoud 
Published: May 2023

AbstractSexual plasticity is a phenomenon wherein organisms possess the ability to alter their phenotypic sex in response to environmental and physiological stimuli, without modifying their sex chromosomes.Cannabis sativaL., a medically valuable plant species, exhibits sexual plasticity when subjected to specific chemicals that influence ethylene biosynthesis and signaling. Nevertheless, the precise contribution of ethylene-related genes (ERGs) to sexual plasticity in cannabis remains unexplored. The current study employedArabidopsis thalianaL. as a model organism to conduct gene orthology analysis and reconstruct the Yang Cycle, ethylene biosynthesis, and ethylene signaling pathways inC. sativa. Additionally, two transcriptomic datasets comprising male, female, and chemically induced male flowers were examined to identify expression patterns in ERGs associated with sexual determination and sexual plasticity. These ERGs involved in sexual plasticity were categorized into two distinct expression patterns: floral organ concordant (FOC) and unique (uERG). Furthermore, a third expression pattern, termed karyotype concordant (KC) expression, was proposed, which plays a role in sex determination. The study revealed that CsERGs associated with sexual plasticity are dispersed throughout the genome and are not limited to the sex chromosomes, indicating a widespread regulation of sexual plasticity inC. sativa.Key MessagePresented here are model Yang cycle, ethylene biosynthesis and signaling pathways inCannabis sativa.C. sativafloral transcriptomes were used to predict putative ethylene-related genes involved in sexual plasticity in the species.
Open-loop lab-on-a-chip technology enables remote computer science training in Latinx life sciences students
Authors: Sano Tyler , Sampad Mohammad Julker Neyen , Gonzalez-Ferrer Jesus , Hernandez Sebastian , Vera-Choqqueccota Samira , Vargas Paola A. , Urcuyo Roberto , Duran Natalia Montellano , Teodorescu Mircea , Haussler David , Schmidt Holger , Mostajo-Radji Mohammed A. 
Published: May 2023

ABSTRACTDespite many interventions, science education remains highly inequitable throughout the world. Among all life sciences fields, Bioinformatics and Computational Biology suffer from the strongest underrepresentation of racial and gender minorities. Internet-enabled project-based learning (PBL) has the potential to reach underserved communities and increase the diversity of the scientific workforce. Here, we demonstrate the use of lab-on-a-chip (LoC) technologies to train Latinx life science undergraduate students in concepts of computer programming by taking advantage of open-loop cloud-integrated LoCs. We developed a context-aware curriculum to train students at over 8,000 km from the experimental site. We showed that this approach was sufficient to develop programming skills and increase the interest of students in continuing careers in Bioinformatics. Altogether, we conclude that LoC-based Internet-enabled PBL can become a powerful tool to train Latinx students and increase the diversity in STEM.
Plant neopolyploidy and genetic background differentiates the microbiome of duckweed across a variety of natural freshwater sources
Authors: Anneberg Thomas J. , Turcotte Martin M. , Ashman Tia-Lynn 
Published: May 2023

AbstractWhole genome duplication has long been appreciated for its role in driving phenotypic novelty in plants, often altering the way organisms interface with the abiotic environment. Only recently, however, have we begun to investigate how polyploidy influences interactions of plants with other species, despite the biotic niche being predicted as one of the main determinants of polyploid establishment. Nevertheless, we lack critical information about how polyploidy affects the diversity and composition of the microbial taxa that colonize plants, and whether this is genotype-dependent and repeatable across natural environments. This information is a critical first step toward understanding whether the microbiome contributes to polyploid establishment. We thus tested the immediate effect of polyploidy on the diversity and composition of the bacterial microbiome of the aquatic plantSpirodela polyrhizausing four pairs of diploids and synthetic autotetraploids. Under controlled conditions, axenic plants were inoculated with pond waters collected from 10 field sites across a broad environmental gradient. Autotetraploids hosted 4-11 % greater bacterial taxonomic and phylogenetic diversity than their diploid progenitors. Polyploidy, along with its interactions with the inoculum source and genetic lineage, collectively explained 7 % of the total variation in microbiome composition. Furthermore, polyploidy broadened the core microbiome, with autotetraploids having 15 unique bacterial taxa in addition to the 55 they shared with diploids. Our results show that whole genome duplication directly leads to novelty in plant microbiome and importantly, that the effect is dependent on the genetic ancestry of the polyploid and generalizable over many environmental contexts.
Stomatal closure in maize is mediated by subsidiary cells and the PAN2 receptor
Authors: Liu Le , Ashraf M. Arif , Morrow Taylor , Facette Michelle 
Published: May 2023

AbstractStomata are epidermal pores that facilitate plant gas exchange. Grasses have fast stomatal movements, likely due to their dumbbell-shaped guard cells and lateral subsidiary cells. Subsidiary cells reciprocally exchange water and ions with guard cells. However, the relative contribution of subsidiary cells during stomatal closure is unresolved. We compared stomatal gas exchange and stomatal aperture dynamics in wild type andpan1,pan2, andpan1;pan2 Zea mays (L.)(maize) mutants, which have varying percentages of aberrantly formed subsidiary cells. Stomata with 1 or 2 defective subsidiary cells cannot close properly, indicating that subsidiary cells are essential for stomatal function. Even though the percentage of aberrant stomata is similar inpan1andpan2, pan2showed a more severe defect in stomatal closure. Inpan1, only stomata with abnormal subsidiary cells fail to close normally. Inpan2, all stomata have stomatal closure defects, indicating that PAN2 has an additional role in stomatal closure. MaizePan2is orthologous to ArabidopsisGHR1,which is also required for stomatal closure. PAN2 acts downstream of Ca2+in maize to promote stomatal closure. This is in contrast to GHR1, which acts upstream of Ca2+, and suggests the pathways could be differently wired.