bluuebunny/crossref_metadata_2025_split huggingface dataset:
High prevalence of β-lactam and fluoroquinolone resistance in various phylotypes of Escherichia coli isolates from urinary tract infections in Jiroft city, Iran
Authors: Afsharikhah Saleh , Ghanbarpour Reza , Mohseni Parvin , Adib Nasrin , Bagheri Mahboube , Jajarmi Maziar 
Published: April 2023

Abstract
Background
Urinary tract infection (UTI) is one of the most prevalent infectious diseases with worldwide health threatening. Antimicrobial resistant strains of Escherichia coli (E. coli) are a common cause of UTI which were identified as a treatment challenge. This study aimed to assay the prevalence of common β-lactam resistance genes including blaTEM, blaSHV, blaCTX-M and blaCMY and phenotypic resistance to commonly used β-lactam and fluoroquinolone antibiotics in UTIs. These factors were evaluated in various phylogenetic groups (phylotypes) of E. coli isolates. Real-time PCR was applied to detect β-lactam resistance genes and conventional PCR was used to determine the phylotypes. Phenotypic resistance against β-lactams (ceftazidime, cefotaxime, aztreonam and ceftriaxone) and fluoroquinolones (ciprofloxacin) were identified by the disc diffusion technique. The ability of extended spectrum β-lactamases (ESBLs) production in E. coli isolates was detected using the combined disc diffusion method.

Results
The prevalence of resistance genes were 89.6% for blaTEM, 44.3% for blaCTX-M, 6.6% for blaSHV and 0.9% for blaCMY. The two high prevalent phylotypes were B2 (29.2%) and D (17.9%) followed by E (14.1%), F (9.4%), C (6.6%) and 10.3% of isolates were unknown in phylotyping. Disc diffusion results showed high prevalence of antibiotic resistance to cefotaxime (88.6%), aztreonam (83%), ceftireaxon (77.3%), ceftazidime (76.4%) and ciprofloxacin (55.6%). Totally, 52.8% of isolates were found as phenotypical ESBL-producers.

Conclusions
This study’s results confirmed an explosion of antibiotic resistance amongst E. coli isolates from UTI against β-lactams and fluoroquinolones. Findings explain the necessity of deep changes in quantity and quality of drug resistance diagnosis and antibiotic therapy strategies. More studies are suggested to better and confident evaluations.
Altered profile of floral volatiles and lignin content by down-regulation of Caffeoyl Shikimate Esterase in Petunia
Authors: Kim Joo Young , Cho Keun Ho , Keene Shea A. , Colquhoun Thomas A. 
Published: April 2023

Abstract
Background
The floral volatile profile of Petunia x hybrida ‘Mitchell diploid’ (MD) is dominated by phenylpropanoids, many of which are derived from p-coumaric acid. However, the downstream processes involved in the production of caffeoyl-CoA and feruloyl-CoA from p-coumaric acid are complex, as the genes and biosynthesis steps are associated with flavonoids and lignin synthesis as well as floral volatiles benzenoid/phenylpropanoid (FVBP). Caffeoyl shikimate esterase (CSE) converts caffeoyl shikimate to caffeic acid and is considered one of the essential regulators in lignin production. Moreover, CSE in involved in phenylpropanoid production. To investigate the roles of CSE in FVBP biosynthesis, we used RNAi-mediated CSE down-regulated (ir-PhCSE) petunias.

Results
Lowered CSE transcript accumulation in ir-PhCSE plants resulted in reduced lignin layers in the stems and stunted growth, suggesting a positive correlation between lignin layers and lignin content. The altered CSE level influenced the expression of many FVBP genes, including elevated transcripts of p-coumarate-3-hydroxylase (C3H), hydroxycinnamoyl transferase (HCT), and 4-coumaric acid:CoA ligase (4CL). In particular, the expression of C4H in ir-PhCSE plants was more than twice the expression in MD plants. Moreover, the production of volatile compounds was alterend in ir-PhCSE plants. Most floral volatiles decreased, and the amounts of phenylalanine and caffeic acid were significantly lower.

Conclusions
Reduced lignin layers in the stems and stunted growth in ir-PhCSE plants suggest that PhCSE is essential for lignin production and plant growth in petunia. The decreased CSE level influenced the expression of many FVBP genes, and interference of shikimate derivates altered volatile compound production. Significantly decreased caffeic acid, but not ferulic acid, in ir-PhCSE plants suggest that CSE is primarily involved in the reaction of caffeoyl shikimate. Higher C3H and C4H transcripts seem to alleviate accumulated p-coumaric acid resulting from altered CSE. Finally, alteration in C3H, HCT, and 4CL in CSE down-regulated plants suggests an interaction of the FVBP genes, leading to the regulation of floral volatiles of petunia.
Grapevine scion gene expression is driven by rootstock and environment interaction
Authors: Harris Zachary N. , Pratt Julia E. , Kovacs Laszlo G. , Klein Laura L. , Kwasniewski Misha T. , Londo Jason P. , Wu Angela S. , Miller Allison J. 
Published: April 2023

Abstract
Background
Grafting is a horticultural practice used widely across woody perennial crop species to fuse together the root and shoot system of two distinct genotypes, the rootstock and the scion, combining beneficial traits from both. In grapevine, grafting is used in nearly 80% of all commercial vines to optimize fruit quality, regulate vine vigor, and enhance biotic and abiotic stress-tolerance. Rootstocks have been shown to modulate elemental composition, metabolomic profiles, and the shape of leaves in the scion, among other traits. However, it is currently unclear how rootstock genotypes influence shoot system gene expression as previous work has reported complex and often contradictory findings.

Results
In the present study, we examine the influence of grafting on scion gene expression in leaves and reproductive tissues of grapevines growing under field conditions for three years. We show that the influence from the rootstock genotype is highly tissue and time dependent, manifesting only in leaves, primarily during a single year of our three-year study. Further, the degree of rootstock influence on scion gene expression is driven by interactions with the local environment.

Conclusions
Our results demonstrate that the role of rootstock genotype in modulating scion gene expression is not a consistent, unchanging effect, but rather an effect that varies over time in relation to local environmental conditions.
Elevation of the head of bed reduces splanchnic blood flow in patients with intra-abdominal hypertension
Authors: Zhou Yuankai , He Huaiwu , Cui Na , Wang Xiaoting , Long Yun , Liu Dawei 
Published: April 2023

Abstract
Background
Elevation of the head of bed (HOB) increases intra-abdominal pressure (IAP), but the effect of body position on abdominal splanchnic perfusion is not clear. The current study aimed to evaluate the effect of body position on the superior mesenteric artery (SMA) and the celiac artery (CA) blood flow by Doppler ultrasound in mechanically ventilated patients with intra-abdominal hypertension (IAH).

Methods
This prospective cohort study included 53 mechanically ventilated patients with IAH. IAP, hemodynamic variables, and Doppler parameters of the SMA and CA were measured in the supine position. The measurements were repeated after the HOB angle was raised to 15° for 5 min and similarly at HOB angles of 30° and 45°. Finally, the patient was returned to the supine and these variables were re-measured.

Results
The median (interquartile range, IQR) superior mesenteric artery blood flow (SMABF) decreased from 269 (244–322) to 204 (183–234) mL/min and the median (IQR) celiac artery blood flow (CABF) from 424 (368–483) to 376 (332–472) mL/min (both p<0.0001) while median (IQR) IAP increased from 14(13–16) to 16(14–18) mmHg (p<0.0001) when the HOB angle was changed from 0° to 15°. However, SMABF and CABF were maintained at similar levels from 15° to 30°, despite median (IQR) IAP increased to 17(15–18) mmHg (p = 0.0002). Elevation from 30° to 45° further reduced median (IQR) SMABF from 200(169–244) to 164(139–212) mL/min and CABF from 389(310–438) to 291(241–383) mL/min (both p<0.0001), Meanwhile, median (IQR) IAP increased to 19(18–21) mmHg (p<0.0001).

Conclusions
In mechanically ventilated patients with IAH, progressive elevation of the HOB from a supine to semi-recumbent position was associated with a gradual reduction in splanchnic blood flow. However, the results indicate that splanchnic blood flow is not further reduced when the HOB is elevated from 15° to 30°.This study confirms the influence of head-up angle on blood flow of the splanchnic organs and may contribute to the selection of the optimal position in patients with abdominal hypertension.
The global prevalence of myocardial infarction: a systematic review and meta-analysis
Authors: Salari Nader , Morddarvanjoghi Fatemeh , Abdolmaleki Amir , Rasoulpoor Shabnam , Khaleghi Ali Asghar , Hezarkhani Leila Afshar , Shohaimi Shamarina , Mohammadi Masoud 
Published: April 2023

Abstract
Background

Myocardial infarction (MI) is one of the life-threatening coronary-associated pathologies characterized by sudden cardiac death. The provision of complete insight into MI complications along with designing a preventive program against MI seems necessary.

Methods
Various databases (PubMed, Web of Science, ScienceDirect, Scopus, Embase, and Google scholar search engine) were hired for comprehensive searching. The keywords of “Prevalence”, “Outbreak”, “Burden”, “Myocardial Infarction”, “Myocardial Infarct”, and “Heart Attack” were hired with no time/language restrictions. Collected data were imported into the information management software (EndNote v.8x). Also, citations of all relevant articles were screened manually. The search was updated on 2022.9.13 prior to the publication.

Results
Twenty-two eligible studies with a sample size of 2,982,6717 individuals (< 60 years) were included for data analysis. The global prevalence of MI in individuals < 60 years was found 3.8%. Also, following the assessment of 20 eligible investigations with a sample size of 5,071,185 individuals (> 60 years), this value was detected at 9.5%.

Conclusion
Due to the accelerated rate of MI prevalence in older ages, precise attention by patients regarding the complications of MI seems critical. Thus, determination of preventive planning along with the application of safe treatment methods is critical.
The association between physical symptoms and self-care behaviours in heart failure patients with inadequate self-care behaviours: a cross-sectional study
Authors: Liu Xu , Liu Li , Li Yan , Cao Xi 
Published: April 2023

Abstract
Background
Patients with heart failure frequently report inadequate self-care behaviours. Physical symptoms can impact patients’ ability to perform self-care behaviours. However, studies investigating the association between physical symptoms and heart failure self-care behaviours have produced inconsistent findings, potentially due to variations in the determinants of self-care behaviours among patients with differing levels of self-care proficiency. Understanding the association between physical symptoms and self-care behaviours in heart failure patients with inadequate self-care behaviours could improve care for this subpopulation. The study aimed to explore the association between physical symptoms and self-care behaviours in Chinese heart failure patients with inadequate self-care behaviours.

Methods
This analysis was based on primary data from a cross-sectional study that aimed to investigate factors associated with self-care in heart failure patients. Physical symptoms were measured using the Heart Failure Somatic Perception Scale. Self-care behaviours (i.e., self-care maintenance and management) of heart failure were measured using the Self-Care of Heart Failure Index (version 6.2). Patients who reported scores < 70 on both self-care maintenance and management behaviours were eligible and included in the analysis. Hierarchical regression analysis was performed to explore the association between physical symptoms and self-care behaviours.

Results
A total of 189 patients were included in the analysis, with a mean age of 65 years and a median duration of living with heart failure of 24 months. Most participants were classified as New York Heart Association class III or IV. Dyspnoea symptoms were the most frequently reported physical symptoms. The results of the hierarchical regression analysis showed that the severity of physical symptoms was positively associated with self-care management behaviours (β = 0.157, 95% CI: 0.010, 0.368, p = 0.039) but not significantly associated with self-care maintenance behaviours (β = -0.133, 95% CI: -0.316, 0.026, p = 0.097).

Conclusions
Based on the data collected in Changsha, China, we found that patients with HF with poor self-care experienced more dyspnoea symptoms. Severe HF physical symptoms might serve as drivers for better self-care management in patients with inadequate self-care behaviours. Effective care and support should be provided when physical symptoms worsen to facilitate patients’ engagement in self-care behaviour in this subpopulation.
The development of a self-management evaluation scale for elderly adults with hypertension based on the capability, opportunity, and motivation-behaviour (COM-B) model
Authors: Wu Lirong , Liu Minhui , Huang Chongmei , Yin Jinzhi , Zhou Hui , Hu Hongjuan 
Published: April 2023

Abstract
Background
Using accurate assessment tools to assess patients in clinical practice is important to mining influencing factors and implementing interventions. However, most evaluation tools for the self-management of elderly patients with hypertension lack a theoretical basis and wide applicability, which makes the intervention effect insignificant.

Methods
Based on the Capability, Opportunity, and Motivation-Behaviour (COM-B) model, combined with literature review and qualitative research, a questionnaire item pool was initially formulated; then the initial items were screened and adjusted through expert consultation and pre-testing to form an initial scale. A field survey of 450 elderly hypertensive patients was then performed using the initial scale to test the reliability and validity of the scale. Cronbach’s alpha, test–retest reliability and composite reliability were used to test the reliability of the scale, and the validity of the scale was evaluated from two aspects: content validity and construct validity. The evaluation results of the content validity of the scale by experts were used as the content validity index; the results of exploratory factor analysis and confirmatory factor analysis were used as the structural validity index to further verify the model structure of the scale and develop a formal scale.

Results
The final self-management scale included 4 dimensions and 33 items. The Scale-Content Validity Index was 0.920. Exploratory factor analysis extracted four factors that explained 71.3% of the total variance. Cronbach’s alpha of the formal scale was 0.867, test–retest reliability was 0.894, and composite reliability of the 4 dimensions were within 0.943 ~ 0.973. Confirmatory factor analysis showed the scale had good construct validity.

Conclusions
The Self-management Capability, Support and Motivation-Behaviour scale for elderly hypertensive patients has good reliability and validity, providing a tool for medical staff to evaluate the self-management level of elderly hypertensive patients.
Risk factors of immune checkpoint inhibitor-associated acute kidney injury: evidence from clinical studies and FDA pharmacovigilance database
Authors: Chen Pengwei , Zhu Jianhong , Xu Yanchun , Huang Qiuyan , Su Jianan , Gao Ziqing , Feng Min 
Published: April 2023

Abstract
Background
Several risk factors of immune checkpoint inhibitors (ICIs)-associated acute kidney injury (AKI) have been reported sporadically. To identify the risk factors of ICIs-associated AKI in a large-scale population, therefore we conducted a systematic review and a real-world retrospective study.

Methods
We search literature concerning risk factors of ICIs-associated AKI in ClinicalTrials.gov and electronic databases (PubMed, Cochrane Library, Embase) up to January 2022. Meta-analysis was performed by using odds ratios (ORs) with 95%CIs. In a separate retrospective pharmacovigilance study by extracting data from US FDA Adverse Event Reporting System (FAERS) database, disproportionality was analyzed using the reporting odds ratio (ROR).

Results
A total of 9 studies (5927 patients) were included in the meta-analysis. The following factors were associated with increased risk of ICIs-associated AKI, including proton pump inhibitors(PPIs) (OR = 2.07, 95%CI 1.78–2.42), angiotensin-converting enzyme inhibitors (ACEIs)/ angiotensin receptor blockers (ARBs) (OR = 1.56, 95%CI 1.24–1.95), nonsteroidal anti-inflammatory drugs (NSAIDs) (OR = 1.29, 95%CI 1.01–1.65), diuretics (OR = 2.00, 95%CI 1.38–2.89), diabetes mellitus (OR = 1.28, 95%CI 1.04–1.57), genitourinary cancer (OR = 1.46, 95%CI 1.15–1.85), combination therapy of ICIs (OR = 1.93, 95%CI 1.25–2.97) and extrarenal immune-related adverse events(irAEs) (OR = 2.51, 95%CI 1.96–3.20). Furthermore, analysis from FAERS database verified that concurrent exposures of PPIs (ROR = 2.10, 95%CI 1.91–2.31), ACEIs/ARBs (ROR = 3.25, 95%CI 2.95–3.57), NSAIDs (ROR = 3.06, 95%CI 2.81–3.32) or diuretics (ROR = 2.82, 95%CI 2.50–3.19) were observed significant signals associated with AKI in ICIs-treated patients.

Conclusions
Concurrent exposures of PPIs, ACEIs/ARBs, NSAIDs or diuretics, diabetes mellitus, genitourinary cancer, combination therapy, and extrarenal irAEs seem to increase the risk of AKI in ICIs-treated patients.
Spatial distribution of short birth interval and associated factors among reproductive age women in Ethiopia: spatial and multilevel analysis of 2019 Ethiopian mini demographic and health survey
Authors: Kassie Sisay Yitayih , Ngusie Habtamu Setegn , Demsash Addisalem Workie , Alene Tilahun Dessie 
Published: April 2023

Abstract
Background
Short Birth Interval negatively affects the health of both mothers and children in developing countries. Studies conducted in Ethiopia on the spatial variation and determinants of individual and community-level factors about short birth intervals were limited. Thus, this study was intended to assess the spatial variation of the short birth interval and its determinants in Ethiopia.

Methods
This study is a secondary analysis of the Ethiopian Demographic and Health Survey (mini EDHS 2019). A total of 1784 reproductive-age women were included in the analysis. The global spatial autocorrelation (Global Moran’s I) and the Getis-Ord statistics tool were used to detect the presence of clustering and the high/low hotspot areas of SBI respectively. Ordinary kriging was used to interpolate short birth intervals, and spatial scan statistics were employed to identify spatial clusters with high and low SBI. A multilevel multivariable model was used to identify predictors of a short birth interval.

Results
The prevalence of SBI was 62.89% (95%CI: 59.3, 69.7) in Ethiopia. High clustering of SBI was observed in all parts of Somali, in Afar (zones 1, 3, 4, &5), Oromia (Guje, Bale, & West Harerge), and northern Tigray. The most likely significant primary cluster was observed in the Somali region. Women who lived in the primary cluster were 24% more likely to have a short birth interval than those who lived outside the window. In the multilevel mixed-effect analysis age 25–34 [(AOR = 0.40, 95% CI: 0.35, 0.45)], 35–49 [(AOR = 0.44, 95% CI: 0.38, 0.51)], Muslim religion follower [(AOR = 3.5, 95% CI: 2.7, 4.69)], no formal education [(AOR = 0.5, 95% CI: 0.37, 0.70)], primary education[(AOR = 0.4, 95%CI: 0.28, 0.53)], and secondary education [(AOR = 0.3, 95% CI: 0.24, 0.48)], middle [(AOR: 1.3, 95% CI: 1.2, 1.52)], rich wealth status [(AOR: 1.4, 95% CI: 1.3, 1.68)], female sex children [(AOR: 1.2, 95% CI: 1.09, 1.42)], and two or fewer ideal number of children [(AOR = 0.2, 95% CI: 0.25, 0.32)] were found to be significant predictors of SBI.

Conclusion
Overall, SBI was high and significantly clustered across the region of Ethiopia. Age, religion, education, wealth status, the sex of the indexed child, and the ideal number of children were found to be significantly associated with short birth intervals. Hence, the government should design a health promotion strategy and public health awareness in the identified hotspot areas of SBI and should scale up family planning and the wealth status of reproductive-age women.
Meta-analysis of corneal endothelial changes after phacoemulsification in diabetic and non-diabetic patients
Authors: Yang Yingqin , Chai Hongtao , Ding Zhixiang , Tang Chengye , Liang Yongshun , Li Yihong , Liang Hao 
Published: April 2023

Abstract
Background
Currently, there is still controversy about the differential changes in corneal endothelium function and morphology after phacoemulsification between Diabetes Mellitus (DM) and non-Diabetes Mellitus (non-DM) patients. In this study, we aimed to evaluate the influence of phacoemulsification on the corneal endothelium in DM and non-DM patients.

Methods
Databases of PubMed, Embase, Web of Science, and the Cochrane Library were searched for studies published between January 1, 2011 and December 25, 2021. The weighted mean difference and 95% confidence interval were used to estimate the outcomes of statistical analyses performed.

Results
Thirteen studies involving 1744 eyes were included in this meta-analysis. No significant difference was observed in the central corneal thickness (CCT), endothelial cell density (ECD), coefficients of variation (CV), or hexagonal cell percentage (HCP) between the DM and non-DM groups (CCT: P = 0.91; ECD: P = 0.07; CV: P = 0.06; HCP: P = 0.09) preoperatively. The CCT was significantly thicker in the DM group at 1 month (P = 0.003) and 3 months (P = 0.0009) postoperatively, and there was no significant difference at 6 months postoperatively (P = 0.26) than non-DM group. The CV was significantly higher and HCP was significantly lower in the DM group at 1 month (CV:P < 0.0001, HCP: P = 0.002), with no significant difference at 3 months (CV: P = 0.09, HCP: P = 0.36) and 6 months (CV: P = 0.32, HCP: P = 0.36) postoperatively than non-DM group. DM patients had lower ECD than non-DM patients at all postoperative time points (1 month, 3 months: P < 0.00001, 6 months: P < 0.0001).

Conclusions
The influence of phacoemulsification on corneal endothelial damage is greater in diabetic patients. Moreover, the recovery of corneal endothelial function and morphology is delayed in these patients. Clinicians should be more attentive to the corneal health of DM patients when considering phacoemulsification.