bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Extended Parallel Process Model Training on Enhancing Physical Activity of Overweight Pregnant Women: a randomized controlled trial
Authors: Hakimzadeh Atena , Hajian Sepideh , Afrakhteh Maryam , Rafiei Fatemeh 
Published: July 2023

Abstract
Background
Pregnancy overweight can bring about undesirable complications to the mother, fetus, and neonate. Thus, one of the goals of pregnancy care should be lifestyle modification that improves physical activity and healthy nutrition. The present study determined the effect of Extended Parallel Process Model (EPPM)-based training on enhancing the physical activity of overweight pregnant women.
Method
This randomized controlled clinical trial examined 100 overweight pregnant women referred to two teaching hospitals in Tehran, Iran. The participants were assigned into two intervention and control groups through random allocation. The intervention group underwent EPPM-based training three times (18–20, 26–30, and 37–38 weeks of gestation), while the control group received regular prenatal care. The training content and approach were designed and presented based on the four constructs of EPPM, i.e., perceived susceptibility, perceived severity, perceived efficacy, and perceived self-efficacy. The 32-item Pregnancy Physical Activity Questionnaire (PPAQ) was used to measure and compare the participants’ four activity types at three rounds (18–20, 26–30, and 37–38 weeks of gestation) and their physical activity calendar in two periods. The data were analyzed by the SPSS − 26 software at a significance level of < 0.05.
Results
After the educational intervention, the mean physical activity scores of the intervention and control groups were 1462.2 ± 477.67 and 861 ± 381.29 (P < 0.001; CI = 95%) in the first round, 1278.15 ± 480.31 and 675 ± 375.03 (P < 0.001; CI: 95%) in the second round, respectively. The mean weight gain value in the second trimester equaled 4.09 ± 0.76 and 4.52 ± 0.71 for the intervention and the control group, orderly. This difference was significant in the second trimester (P = 0.002) but not in the third. Likewise, a comparative analysis of the neonates’ anthropometric indices and prenatal complications revealed no significant differences.
Conclusion
The EPPM-based educational intervention effectively contributes to motivating pregnant women and changing their behavior toward improving their physical activity and can be employed to encourage them to enhance their physical activity during pregnancy.
Trial registration:
This study was registered in the Iranian Registry of Clinical Trials (IRCT) under the IRCT20211207053310N1 Number(17/12/2021).
Molecular switching in transcription through splicing and proline-isomerization regulates stress responses in plants
Authors: Theisen Frederik , Prestel Andreas , Elkjær Steffie , Leurs Yannick , Morffy Nicholas , Strader Lucia , O'Shea Charlotte , Teilum Kaare , Kragelund Birthe , Skriver Karen 
Published: July 2023

Abstract
The Arabidopsis thaliana DREB2A transcription factor interacts with the negative regulator RCD1 and the ACID domain of subunit 25 of the transcriptional activator mediator (Med25) to integrate stress signals for gene expression, with elusive molecular interplay. Using biophysical and structural analyses together with high-throughput screening, we revealed a bivalent binding switch in DREB2A containing a novel ACID-binding motif (ABS) and the RCD1-binding motif (RIM). The RIM is lacking in a stress-induced DREB2A splice variant with retained activity. ABS and RIM bound to separate sites on Med25-ACID, and NMR uncovered a structurally heterogeneous complex deriving from a DREB2A-ABS proline residue populating cis- and trans-isomers with remote impact on the RIM. The cis-isomer stabilized an α-helix, while the trans-isomer may introduce energetic frustration facilitating rapid exchange between activators and repressors. Thus, DREB2A uses a post-transcriptionally and post-translationally modulated switch for transcriptional regulation.
Action researchers as “orchestrators” of coinnovation: A theoretical and methodological framework
Authors: Mliassen Marianne , Arntzen¹ Carthrine , Forslund¹ Lina , Nikolaisen¹ Morten , Alexandersson² Patrik , Gramstad¹ Astrid , Hellström² Andreas 
Published: July 2023

Abstract
Background
With the increasing complexity of health care services, more comprehensive and integrated services need to be redesigned. Action research and collaborative innovation processes that emphasize multiactor participation and user-centered approaches are suggested to balance research that is meaningful for both the research community and health service development. Engagement by actors with a diverse range of perspectives, experiences, resources, and competences is emphasized to enhance creative problem solving and innovation. However, “orchestrating” innovation, in which actors have diverse attitudes, agendas, positions of power, and horizons of understanding, is challenging. The purpose of this article was therefore to explore how researchers can support collaborative and creative processes to enhance coinnovation in complex health care contexts.
Methods
Experiences from two Scandinavian cases of coinnovation form the foundation of this theoretical paper.
Results
We identified four central components that are essential for action researchers to facilitate collaborative and creative coinnovation processes: 1) relational power reflexibility, 2) resource integration, 3) joint understanding, and 4) the facilitation of creativity.
Conclusions
This paper offers a theoretical contribution to orchestrating diverse actors and their contributions by leveling out the asymmetrical distribution of power, ensuring the integration of relevant resources, creating a joint understanding, and facilitating creativity in coinnovation processes/projects.
Estimation of the mortality attributable to heat in France between 2014 and 2022
Authors: Pascal Mathilde , Wagner Verene , Lagarrigue Robin , Casamatta Delphine , Pouey Jérôme , Vincent Nicolas , Boulanger Guillaume 
Published: July 2023

Abstract
Heat waves are associated with large excess mortality in France, but the extent of the total-heat related mortality is unknown. We estimated the fraction of mortality attributable to heat in France during summers 2014 to 2022, to complement the estimations of all-cause excess mortality during heat waves. Temperature-mortality relationships were developed for each of the 96 metropolitan French departments, for June-September, between 2014–2022. Several approaches were tested to control for a possible influence of the COVID-19 pandemic since 2020 (models including COVID-19 indicators, stratified models before/after the pandemic). The fraction of mortality attributable to heat was computed during summer and during heat waves. Taking COVID-19 into account did not improved the models. Relative risks (RR) tended to be slighly higher after the pandemic ; an increase from 19.8°C to 28.5°C was associated with a RR of 1.25 [CI 95% 1.21 :1.30] in 2004–2019, and 1.31 [1.24 :1.38] in 2020–2022. Between 2014 and 2022, 32,658 deaths [IC95% 29,612 : 34,975] were attributable to heat, 28% of these occured during heat waves. The largest impacts are observed in 2022 (6,969 [6,277 : 7,445]), and 2019 (4,441 [4,086 : 4,717]). Results suggest that a specific focus on heat waves is justified from an operational point of view ; they represent 28% of the heat-related mortality impact concentrated on only 6% of summer days. However, this reactive adaptation during heat waves must be complemented by structural adaptation to reduce the risk throughout the summer.
Period of hospitalization and mortality in transferred versus non-transferred COVID-19 patients: Results from Germany
Authors: Suski Pascal , Jörres Rudolf , Engelhardt Sebastian , Kahnert Kathrin , Lenherr Katharina , Bauer Andreas , Budweiser Stephan 
Published: July 2023

Abstract
Since its beginning, COVID-19 was a challenge for health-care systems worldwide, causing large numbers of hospitalizations and inter-hospital transfers. We studied whether transfer, as well as its reason, was associated with the duration of hospitalization in non-ICU and ICU patients. For this purpose, all patients hospitalized due to COVID-19 between August 1st and December 31st, 2021, in a network of hospitals in Southern Germany were comprehensively characterized regarding their clinical course, therapy, complications, transfers, reasons for transfer, involved levels of care, total period of hospitalization and in-hospital mortality. While mortality was not significantly associated with transfer, the period of hospitalization was. In non-ICU patients (n = 545), median (quartiles) times were 7.0 (4.0–11.0) and 18.0 (11.0–29.0) days in non-transferred (n = 458) and transferred (n = 87) patients, respectively, in ICU patients (n = 215), 12.0 (8.3–18.0) and 22.0 (15.0–34.0) days, respectively (n = 100 transferred, n = 115 non-transferred) (p < 0.001 each). Beyond ECMO therapy (4.5%), reasons for transfer were medical (33.2%) or capacity (61.9%) reasons, with medical/capacity reasons in 32/49 of non-ICU and 21/74 of ICU patients. Thus, the transfer of COVID-19 patients between hospitals was statistically associated with longer periods of hospitalization, corresponding to greater health care utilization, for which however specific patient characteristics and clinical decisions played a role.
A Novel Patient-controlled Analgesia Pump Allocator Improves Anesthesia Nurses’ Working Efficiency in Pump Allocation
Authors: Zheng Hongcai , Zhang Jing , Wang Chen , Li Jun , Huo Jinjin , Wang Fang , Wang Rong , Zhou Yang , Li Baohua , Li Zhengqian 
Published: July 2023

Abstract

Background: The allocation of patient-controlled analgesia (PCA) pumps is a routine task for anesthesia nurses. This study investigated the impact of our previously developed PCA pump allocator on anesthesia nurses’ PCA pump allocation efficiency.
Methods: Seven anesthesia nurses received standardized training in the operation of traditional manual allocation of PCA pumps and allocation using the PCA pump allocator. The allocation of 280 PCA pumps was randomly divided into two groups: thecontrol group and the test group (140 patients in each group). Traditional manual allocation of PCA pumps was performed for the control group, and allocation using the allocator was performed for the test group. The operation time, nurses’ satisfaction with pump allocation, and the cleanliness of the operating table after pump allocation were compared between the two groups.
Results: Operation of a 100 ml PCA pump in the test group took 107.9±22.1 seconds, which was significantly shorter than in the control group (136.6±25.7 seconds; p<0.05). For a 250 ml PCA pump, the operation time in the test group was also significantly shorter than in the control group (214.0±34.7 seconds vs. 256.1±42.6 seconds; p<0.05). Further hierarchical analysis based on nurses’ seniority showed that allocation time using the allocator was significantly shorter for low-seniority anesthesia nurses (levels N1–N3) than manual allocation (p<0.05). There was no significant difference in the operation time between the two allocation methods among senior (level N4) nurses (p>0.05). Most (86%, 6/7) anesthesia nurses expressed satisfaction with the allocation method using the allocator, and all nurses expressed a preference for choosing the allocation method using the allocator in their work. The bacterial culture results for the surface of the operating table were negative after the operation of both allocation methods.
Conclusion： The novel PCA pump allocator can significantly improve anesthesia nurses’ efficiency in allocating PCA pumps and improve their satisfaction. The PCA pump allocator complies with aseptic principles.
Optimizing Spectrum Efficiency in 6G Multi-UAV Networks Through Source Correlation Exploitation
Authors: Alnakhli Mohammad 
Published: July 2023

Abstract
In disaster areas With growing number of user demands and the exponential growth and development of Internet of Everything (IoE), the improvement in the achieved spectrum efficiency in Unmanned Aerial Vehicles (UAVs) communication-enabled wireless networks in 6G and 5G are needed. This work aim to improve the spectrum efficiency when redundancies (e.g., correlations in the source like co-located video sensors) are exploited. While it is intuitive that redundancies can be exploited to enhance spectrum efficiency. Here, a linear program is formulated to optimally allocate bandwidth to the links according the demands on each link, while satisfying the spatial spectrum reuse constraints. The linear program is then used to analytically establish the enhancement in spectrum efficiency in the presence of source correlation. Then, different mechanisms are identified to exploit correlations to maximize the improvement in the spectrum efficiency with a trade-off between accuracy and computational complexity. Results indicate that the spectrum efficiency can be enhanced by one to two orders of magnitude by identifying the correct set of source correlations. In terms of network performance, almost 100% of delay intolerant traffic can be admitted into the network by suitably exploiting source correlations and the mean delay for delay tolerant traffic can be reduced by 50 − 88%.
Exploring the ceRNA Network of Differentially Expressed lncRNAs in Gout: A Bioinformatics Analysis
Authors: Guo Jiemei , Fu Xiaopeng , Peng Siwei , Xiao Yan , Chen Peng , Chen Yu , Qiu Mengting , Liu Jun , Lin Siyuan , Su You Xin 
Published: July 2023

Abstract
Objective: To elucidate the regulatory mechanisms of the competing endogenous RNA (ceRNA) network associated with gout, and to investigate potential targets for diagnosis and treatment of this disease.
Methodology: The GSE160170 dataset was downloaded from the GEO database, annotated, and gene attributes were added. Differential expression of lncRNAs and mRNAs between gout patients and non-gout patients was analyzed using R software. The miRNAs targeted by differentially expressed lncRNAs and mRNAs were predicted, and a lncRNA-miRNA-mRNA network was constructed to analyze the competing relationships between lncRNAs and mRNAs. Functional enrichment analysis was performed to investigate the molecular functions of mRNAs regulated by lncRNAs in the ceRNA network. Key mRNAs were identified by constructing protein-protein interaction (PPI) networks and ROC curves, and their diagnostic efficacy was evaluated.
Results: Ten differential lncRNAs were identified and analyzed using the ceRNA approach. Functional enrichment analysis showed that the mRNA regulated by differential lncRNAs was significantly enriched in protein phosphatase, DNA transcription factor binding activity, TNF pathway, and toll-like receptor-related pathway. Among the seven mRNAs with high diagnostic value identified through PPI and ROC curve analysis were BTG2, FOS, GATA2, JUN, MAPK6, and NAR4, which were the core genes of this study and have the potential to be used as diagnostic and therapeutic targets for gout. Additionally, five lncRNAs, including FAM182A, UCA1, MIR22HG, TTY10, and FAM215B, affected the expression of key mRNAs by adsorbing miRNAs such as hsa-miR-27a-3p and hsa-miR-1297, which may play a crucial role in the pathogenesis of gout.
Efficient Estimation of Generative Models using Tukey Depth
Authors: Vo Minh-Quan , Nguyen Thu , Riegler Michael , Hammer Hugo L. 
Published: July 2023

Abstract
Generative models have recently received a lot of attention. However, a challenge with such models is that it usually is not possible to compute the likelihood function, making parameter estimation or training of the models challenging. The most commonly used alternative strategy is called likelihood-free estimation, based on finding values of the model parameters such that a set of selected statistics have similar values in the dataset and in samples generated from the model. However, a challenge is how to select statistics that are efficient in estimating unknown parameters. The most commonly used statistics are the mean vector, variances, and correlations between variables, but may be less relevant in estimating the unknown parameters. We suggest utilizing Tukey depth contours (TDCs) as statistics in likelihood-free estimation. TDCs are highly flexible and can capture almost any property of multivariate data, in addition, they seem not have been explored for likelihood-free estimation.
We demonstrate that TDC statistics are able to estimate the unknown parameters more efficiently than mean, variance, and correlation in likelihood-free estimation. We further apply the TDC statistics to estimate the properties of requests to a computer system, demonstrating its real-life applicability. The suggested method is able to efficiently find the unknown parameters of the request distribution, and quantify the estimation uncertainty.
CRP inhibits the osteoblastic differentiation of OPCs via the up-regulation of primary cilia and repression of the Hedgehog signaling pathway
Authors: Xu Jie , Wu Xiangmei , Zhu Huifang , Zhu Yinghua , Du Kailong , Deng Xiaoyan , wang changdong 
Published: July 2023

Abstract
Inflammation disrupts bone metabolism and causes bone damage. C-reactive protein (CRP) is a typical marker of inflammation. Although the measurement of CRP has been conducted for many decades, the precise influence on the molecular mechanisms of osteoblastic differentiation remains largely unknown. The present study aimed to investigate the effects of CRP on primary cultured osteoblast precursor cells (OPCs) and elucidate the underlying molecular mechanisms. OPCs were isolated from suckling Sprague-Dawleyrats. Fewer OPCs were observed after treatment with recombinant C-reactive protein. In a series of experiments, it was found that CRP inhibited the proliferation of OPCs, osteoblastic differentiation, and the gene expression of the hedgehog(Hh) signaling pathway in OPCs cells. The inhibitory effect of CRP on the proliferation of OPCs occurred via blockade of the G1-S transition of the cell cycle. In addition, the regulation effect of regulation of protocilium on osteoblasticdifferentiation was analyzed from the perspective of bioinformatics, from which the effect of primary cilia activation of recombinantCRP on OPCs was revealed in in vitro experiments. A specific Sonic Hedgehog signaling agonist (SAG) rescued osteoblasticdifferentiation that was inhibited by recombinantCRP. Moreover, chloral hydrate, which removes primary cilia, inhibited the formation of Suppressor of Fused (SUFU) and blocked the degradation of Gli2, counteracting the inhibition of osteogenesis caused by CRP. Thus, these data indicate that CRP can inhibit the proliferation and osteoblastic differentiation of OPCs. The underlying mechanism may be related to the activation of primary cilia and repression of the Hh pathway.
Health literacy and associated factors in China: findings from a “direct fast-forward” ethnic minority in border regions
Authors: Yang Wanqiu , Liu Yi , yao Yu , Wang Yanqing , Leng Dan , Li Chaoxiao , Liu Kunjie , Liu Jiazhou , Pu Yongjie , Li Mufei , Zhang Shuting , Di Mu , Yang Borui , Zhang Xiangyang 
Published: July 2023

Abstract
Background The health literacy of ethnic minorities in remote areas of China is far from satisfactory. However, the health literacy of some “direct fast-forward” ethnic minorities is unclear. The aim of this study was to explore the health literacy of the Wa ethnic group and its influencing factors.Methods A cross-sectional study was conducted using a stage sampling method in the Wa ethnic minority in the border region of southwest China. We used the Health Literacy Questionnaire (HLQ) to assess the level of health literacy. We defined low health literacy as less than 60% of the total score and adequate health literacy as more than 80% of the total score.Results A total of 668 individuals met the inclusion criteria and the mean age was 42.19 (SD 10.56) years. The mean HLQ total score was 29.9 (SD 10.56). The prevalence of adequate health literacy was 0.89%. There were significant differences between the low and the non-low health literacy groups in terms of gender, age, education, marital status, occupation, residing place, current smoking status, and waist circumference (all P < 0.05). Multiple linear regression analysis showed that women (t = 9·418, p < 0·001), older age (B=-0.0091, t=-2.644,p = 0.008), low educational level(B = 0.766, t = 6.018, p < 0.001), current smoking(B=-2.66, t=-3.038, p = 0.008), and residence far from township(B=-5.761, t=-4.1, p < 0.001) were associated with low HLQ total score.Conclusion Our findings suggest that the health literacy of the Wa ethnic group in border areas is far from favorable. It indicates that more attention should be paid to improving the health literacy level of “direct fast-forward” ethnic minorities.
A NAC Triad Mediates Plant Immunity by Negatively Regulating N-Hydroxy Pipecolic Acid Biosynthesis
Authors: Aharoni Asaph , Cai Jianghua , Panda Sayantan , Kazachkova Yana , Amzallag Eden , Meir Sagit , Rogachev Ilana 
Published: July 2023

Abstract

N-hydroxy-pipecolic acid (NHP) plays an important role in plant immunity. In contrast to its biosynthesis, our current knowledge with respect to the transcriptional regulation of the NHP pathway is limited. This study commenced with the engineering of Arabidopsis plants that constitutively produce high NHP levels and display enhanced immunity. Label-free proteomics revealed a NAC-type transcription factor (NAC90) that is strongly induced in these plants. We found that NAC90 is a target gene of SAR DEFICIENT 1 (SARD1) and induced by pathogen, salicylic acid (SA), and NHP. NAC90 knockout mutants exhibit constitutive immune activation, earlier senescence, higher levels of NHP and SA, as well as increased expression of NHP and SA biosynthetic genes. In contrast, NAC90 overexpression lines were compromised in disease resistance and accumulated reduced levels of NHP and SA. NAC90 could interact with NAC61 and NAC36 which are also induced by pathogen, SA, and NHP. We next discovered that this protein triad directly represses expression of the NHP and SA biosynthetic genes AGD2-LIKE DEFENSE RESPONSE PROTEIN 1 (ALD1), FLAVIN MONOOXYGENASE 1 (FMO1), and ISOCHORISMATE SYNTHASE 1 (ICS1). Constitutive immune response in nac90 is abolished once blocking NHP biosynthesis in the fmo1 background, signifying that NAC90 negative regulation of immunity is mediated via NHP biosynthesis. Our findings expand the currently documented NHP regulatory network suggesting a model that together with NHP glycosylation, NAC repressors take part in a ‘gas-and-brake’ transcriptional mechanism to control NHP production and the plant growth and defense trade-off.
Ketamine Cystitis in a Female Patient Ketamine Therapy for Treatment Resistant Depression – Case Report
Authors: Chang Minna 
Published: July 2023

Abstract
Ketamine has been shown to be a novel and exciting antidepressant medication in patients with treatment-resistant depression. A complication commonly seen in frequent and heavy recreational use of ketamine is ulcerative cystitis, which presents with lower urinary tract symptoms (LUTS) and upper renal tract damage, seen in over 25% of regular users (3, 4). Although KIC is a recognised complication in recreational use of ketamine, its occurrence in therapeutic use for depression has so far not been reported. The exact pathogenesis of ketamine induced cystitis is currently unknown, making treatment and prevention much more difficult. Early diagnosis of ketamine induced cystitis and immediate cessation of ketamine use has been shown to improve adverse urinary tract symptoms and prevent further damage. We present a case of a 28-year-old female who was started on ketamine treatment for depression, who developed symptoms of cystitis, which was confirmed by urine microscopy, culture and analysis. To our knowledge, this is the first reported case of ketamine-induced cystitis in a patient receiving treatment-dose ketamine for antidepressant therapy.