bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metabolome and transcriptome analyses identify the plant immunity systems that facilitate sesquiterpene and lignan biosynthesis in Syringa pinnatifolia Hemsl.
Authors: Gao Jiaqi , Li Tianxiao , Jiao Lichao , Jiang Chao , Chen Suyile , Huang Luqi , Liu Juan 
Published: March 2022

Abstract
Background
Syringa pinnatifolia Hemsl. is a shrub belonging to the Oleaceae family. The peeled woody stems and roots of S. pinnatifolia are used in Chinese traditional medicine. This plant has been used for centuries, and modern pharmacological research has revealed its medicinal value. However, the wild populations of S. pinnatifolia have been decreasing, and it has been listed as an endangered plant in China. To elucidate the molecular mechanism leading to the synthesis of the major components of S. pinnatifolia for its further development and sustainable use, this study compared peeled stems and twigs at the metabolic and molecular levels.

Results
Peeled stems with the purple substance visible (SSP) and peeled twigs without the purple substance (TSP) were compared at different levels. Microscopic observation showed resin-like fillers in SSP and wood fiber cell walls approximately 1.0 μm thicker than those in TSP (wood fiber cell thickness approximately 2.7 μm). In addition, 104 volatile organic compounds and 870 non-volatile metabolites were detected in the non-targeted and widely-targeted metabolome analyses, respectively. Among the 76 differentially accumulated metabolites (DAMs) detected, 62 were up-accumulated in SSP. Most of these DAMs were terpenes, of which 90% were identified as sesquiterpenes in the volatile organic compound analysis. In the analysis of the non-volatile metabolites, 21 differentially accumulated lignans were identified, of which 18, including five subtypes, were accumulated in SSP. RNA sequencing revealed 4,421 upregulated differentially expressed genes (DEGs) and 5,522 downregulated DEGs in SSP compared with TSP, as well as 33,452 genes that were not differentially expressed. Analysis of the DEGs suggested that sesquiterpenes and lignans were mostly biosynthesized via the mevalonate and phenylpropanoid pathways, respectively. Additionally, in SSP, the enriched Gene Ontology terms included response to biotic stimulus and defense response, while the enriched Kyoto Encyclopedia of Genes and Genomes pathways included plant–pathogen interaction and many other pathways related to plant immunity.

Conclusions
This study provides metabolome and transcriptome information for S. pinnatifolia, suggesting that biotic stimuli, including pathogens, are potential and valuable approaches to promoting the biosynthesis of the metabolites linked to the medicinal properties of this plant.
Effectiveness of action observation therapy based on virtual reality technology in the motor rehabilitation of paretic stroke patients: a randomized clinical trial
Authors: Errante Antonino , Saviola Donatella , Cantoni Matteo , Iannuzzelli Katia , Ziccarelli Settimio , Togni Fabrizio , Simonini Marcello , Malchiodi Carolina , Bertoni Debora , Inzaghi Maria Grazia , Bozzetti Francesca , Menozzi Roberto , Quarenghi Annamaria , Quarenghi Paola , Bosone Daniele , Fogassi Leonardo , Salvi Gian Piero , De Tanti Antonio 
Published: March 2022

Abstract
Background
The rehabilitation of paretic stroke patients uses a wide range of intervention programs to improve the function of impaired upper limb. A new rehabilitative approach, called action observation therapy (AOT) is based on the discovery of mirror neurons and has been used to improve the motor functions of adult stroke patients and children with cerebral palsy. Recently, virtual reality (VR) has provided the potential to increase the frequency and effectiveness of rehabilitation treatment by offering challenging and motivating tasks.

Methods
The purpose of the present project is to design a randomized controlled six-month follow-up trial (RCT) to evaluate whether action observation (AO) added to standard VR (AO + VR) is effective in improving upper limb function in patients with stroke, compared with a control treatment consisting of observation of naturalistic scenes (CO) without any action content, followed by VR training (CO + VR).

Discussion
AO + VR treatment may provide an addition to the rehabilitative interventions currently available for recovery after stroke and could be utilized within standard sensorimotor training or in individualized tele-rehabilitation.

Trial registration
The trial has been prospectively registered on ClinicalTrials.gov. NCT05163210. 17 December 2021.
Association of surfactant protein D gene polymorphism with susceptibility to gestational diabetes mellitus: a case–control study
Authors: Xu Jingwei , Chen Yi , Tang Liangfang , Teng Xinyuan , Feng Lin , Jin Ligui , Wang Guirong , Wang Liquan 
Published: March 2022

Abstract
Background
Surfactant protein D (SP-D) is a critical component of the innate immune system intrinsically linked to energy metabolism. However, the relationship of SP-D gene polymorphisms and gestational diabetes mellitus (GDM) remains unclear. In this study, we analyzed SP-D gene polymorphisms in GDM patients and nondiabetic controls and then determined the association of SP-D gene polymorphisms with GDM.

Methods
We examined a common genetic polymorphism located in the SP-D coding region (rs721917, Met31Thr) in GDM patients (n = 147) and healthy pregnant controls (n = 97) by using a cleaved amplification polymorphism sequence-tagged sites (PCR–RFLP) technique. The level of SP-D protein in the serum of GDM patients and nondiabetic controls was determined by ELISA. The gene and allele frequencies of SP-D and their association with GDM as well as SP-D protein levels were analyzed and expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs).

Results
We found that there was a significant association of the SP-D polymorphism (rs721917) with GDM. The SP-D (T/T) genotype was found in 11.6% and 21.6% of GDM patients and matched healthy controls, respectively (odds ratio, 0.473; 95% confidence interval, 0.235–0.952; P = 0.033), indicating that women with the (T/T) genotype had a lower prevalence of GDM (OR = 0.473). Women with the T/C genotype showed an increased risk of GDM (odds ratio, 2.440; 95% confidence interval, 1.162–5.123; P = 0.017). We did not observe corrections between glucose homeostasis markers and SP-D genotypes in women with GDM. Furthermore, serum SP-D levels were higher in GDM patients than in matched healthy controls.

Conclusions
This study found the first evidence that an SP-D gene polymorphism (rs721917) was associated with GDM, which may provide the basis for further study on how SP-D plays a regulatory role in GDM.
The role of maternal age on the risk of preterm birth among singletons and multiples: a retrospective cohort study in Lombardy, Northern Italy
Authors: Esposito Giovanna , Mauri Paola Agnese , Cipriani Sonia , Franchi Matteo , Corrao Giovanni , Parazzini Fabio 
Published: March 2022

AbstractBackgroundAll over the world, especially in the developed countries, maternal age at birth is rising. This study aimed to assess the role of maternal age on the occurrence of preterm birth (PTB) in a large birth cohort of Lombardy Region, Northern Italy.MethodsThis population-based study used data from regional healthcare utilization databases of Lombardy to identify women who delivered between 2007 and 2017. PTBs were defined as births before 37 completed weeks of gestation and considered according to the gestational age (two categories: < 32 weeks and 32 to 36 weeks). Six maternal age groups were defined (< 20, 20–24, 25–29, 30–34, 35–39, ≥40 years). Logistic regression models were fitted to estimate the crude and adjusted odds ratio (aOR) and the corresponding 95% confidence interval (CI) for PTB among different maternal age groups. Analyses were separately performed according to type of pregnancy (singletons and multiples). Reference group was the age group with the lowest frequency of PTB.ResultsOverall, 49,759 (6.6%) PTBs were observed, of which 41,807 were singletons and 7952 were multiples. Rates of PTB were lowest in the women aged 25–29 years among singletons and in the 30–34 years old group among multiples. Our results described a U-shaped association between maternal age and risk of PTB. In particular, the risk of a singleton PTB between 32 and 36 weeks was significantly higher for women aged less than 20 years (aOR = 1.16, CI 95%: 1.04–1.30) and more than 40 years (aOR = 1.62 CI 95%: 1.54–1.70). The highest risk of a multiple delivery between 32 and 36 weeks was observed among women aged less than 25 years and more than 40 years (aOR = 1.79, CI 95%: 1.01–3.17, aOR = 1.47, CI 95%: 1.16–1.85 and aOR = 1.36, CI 95%: 1.19–1.55 respectively for < 20, 20–24 and > 40 age categories). PTB before 32 completed weeks occurred more frequently in the same age categories, except that among multiples no association with advanced maternal age emerged.ConclusionOur study suggested that, after adjustment for potential confounders, both advance and young maternal age were associated with an increased risk of PTB.
Disparities in healthcare expenditures according to economic status in cancer patients undergoing end-of-life care
Authors: Han Kyu-Tae , Kim Woorim , Kim Seungju 
Published: March 2022

Abstract
Backgrounds
A desire for better outcome influences cancer patients’ willingness to pay. Whilst cancer-related costs are known to have a u-shaped distribution, the actual level of healthcare utilized by patients may vary depending on income and ability to pay. This study examined patterns of healthcare expenditures in the last year of life in patients with gastric, colorectal, lung, and liver cancer and analyzed whether differences exist in the level of end-of-life costs for cancer care according to economic status.

Methods
This study is a retrospective cohort study which used data from the Korean National Elderly Sampled Cohort, 2002 to 2015. End-of-life was defined as 1 year before death. Economic status was classified into three categorical variables according to the level of insurance premium (quantiles). The relationship between the dependent and independent variables were analyzed using multiple gamma regression based on the generalized estimated equation (GEE) model.

Results
This study included 3083 cancer patients, in which total healthcare expenditure was highest in the high-income group. End-of-life costs increased the most in the last 3 months of life. Compared to individuals in the ‘middle’ economic status group, those in the ‘high’ economic status group (RR 1.095, 95% CI 1.044–1.149) were likely to spend higher amounts. The percentage of individuals visiting a general hospital was highest in the ‘high’ economic status group, followed by the ‘middle’ and ‘low’ economic status groups.

Conclusion
Healthcare costs for cancer care increased at end-of-life in Korea. Patients of higher economic status tended to spender higher amounts of end-of-life costs for cancer care. Further in-depth studies are needed considering that end-of-life medical costs constitute a large proportion of overall expenditures. This study offers insight by showing that expenditures for cancer care tend to increase noticeably in the last 3 months of life and that differences exist in the amount spent according economic status.
Severe bradycardia in a teenager as the initial manifestation for Guillain Barré syndrome: a case report
Authors: Bonilla C. , Alvarez-Olmos M. I. , Uribe C. , Fernández-Sarmiento J. 
Published: March 2022

Abstract
Background
Guillain-Barré syndrome is the most common cause of flaccid paralysis, with multiple known clinical variants. Autonomic dysfunction, although frequently reported in the clinical course, is often overlooked in the pediatric population and is usually not the initial presenting symptom in this age group

Case presentation
We present the case of a previously healthy 17-year-old who arrived at the Emergency Department complaining of gastrointestinal symptoms associated with lipothymia. An initial electrocardiogram (ECG) showed sustained sinus bradycardia subsequently associated with arterial hypertension. Structural and inflammatory cardiac pathology were ruled out, as well as auriculoventricular conduction block and posterior reversible encephalopathy syndrome. On the ninth day after initial symptoms, the patient presented sensory and motor nerve disturbances with the cerebrospinal fluid analysis showing a clear albumin-cytologic dissociation, consistent with an atypical presentation of GBS with autonomic dysfunction. Immunoglobulin therapy was administered, developing subsequent aseptic meningitis, that required discontinuation of previous therapy and treatment with plasmapheresis. Clinical improvement was achieved with full motor function recovery.

Conclusion
This case illustrates a Guillain-Barré syndrome variant in which autonomic dysfunction preceded neurologic deficit, a finding uncommon in children, emphasizing this as an important differential diagnosis for severe bradycardia in pediatric patients.
Inter- and intra-observer reliability of the “Assessment of Motor Repertoire- 3 to 5 Months” based on video recordings of infants with Prader-Willi syndrome
Authors: Wang Jun , Shen Xiushu , Yang Hong , Shi Wei , Zhu Xiaoyun , Gao Herong , Yin Huanhuan , Meng Fanzhe , Wu Yun 
Published: March 2022

Abstract
Background
The “Assessment of Motor Repertoire—3 to 5 Months”, which is a part of Prechtl's General Movements Assessment (GMA), has been gradually applied to infants with genetic metabolic disorders. However, there have been no studies on the application of the GMA for infants with Prader-Willi syndrome (PWS).

Aims
The purpose of this study was to determine the inter- and intra-observer reliability of the assessment tool in a population of infants with PWS.

Study design
This was a reliability and agreement study.

Subjects
This was a cross-sectional study with15 infants with PWS born at an average gestational age of 38 weeks.

Outcome measures
Standardized video recordings of 15 infants with PWS (corrected ages of 3 to 5 months) were independently assessed by three observers. Kappa and ICC statistics were applied in inter- and intra- observer reliability analyses.

Results
The overall reliability ICC values of the “Motor Optimality Score” (MOS) ranged from 0.84 to 0.98, and the pairwise agreement ranged between 0.86 and 0.95 for inter- observe reliability. In addition, ICC values for the MOS ranged between 0.95 and 0.98 for tester agreement in intra-observer reliability.
Complete agreement reliability (100%) was achieved in the subcategories of “Fidgety Movements” and “Movement Character” for the inter- and intra-observer reliability. Moderate to high inter- and intra-observer reliability were found in the subcategories of “Repertoire of Co-Existent Other Movements”, “Quality of Other Movements” and “Posture”, with kappa values ranging between 0.63 and 1.00.

Conclusion
There were high levels of inter-and intra-observer agreement in the “Assessment of Motor Repertoire—3 to 5 Months” for infants with PWS. It is possible to carry out standardized quantitative assessments of the motor performance of infants with PWS.
Comparison of an automated smartphone-based smoking cessation intervention versus standard quitline-delivered treatment among underserved smokers: protocol for a randomized controlled trial
Authors: Vidrine Jennifer I. , Shih Ya-Chen Tina , Businelle Michael S. , Sutton Steven K. , Hoover Diana Stewart , Cottrell-Daniels Cherell , Fennell Bethany Shorey , Bowles Kristina E. , Vidrine Damon J. 
Published: March 2022

AbstractBackgroundSmoking is the leading cause of preventable morbidity and mortality in the United States. Individuals with low socioeconomic status have disproportionately high smoking rates and greater difficulty quitting smoking. Efficiently connecting underserved smokers to effective tobacco cessation programs is crucial for disease prevention and the elimination of health disparities. Smartphone-based interventions have the potential to enhance the reach and efficacy of smoking cessation treatments targeting underserved smokers, but there is little efficacy data for these interventions. In this study, we will partner with a large, local hunger-relief organization to evaluate the efficacy and economic impact of a theoretically-based, fully-automated, and interactive smartphone-based smoking cessation intervention.MethodsThis study will consist of a 2-group randomized controlled trial. Participants (N = 500) will be recruited from a network of food distribution centers in West Central Florida and randomized to receive either Standard Treatment (ST,n = 250) or Automated Treatment (AT,n = 250). ST participants will be connected to the Florida Quitline for telephone-based treatment and will receive a 10-week supply of nicotine replacement therapy (NRT; transdermal patches and lozenges). AT participants will receive 10 weeks of NRT and a fully-automated smartphone-based intervention consisting of interactive messaging, images, and audiovisual clips. The AT intervention period will span 26 weeks, with 12 weeks of proactive content and 26 weeks of on-demand access. ST and AT participants will complete weekly 4-item assessments for 26 weeks and 3-, 6-, and 12-month follow-up assessments. Our primary aim is to evaluate the efficacy of AT in facilitating smoking abstinence. As secondary aims, we will explore potential mediators and conduct economic evaluations to assess the cost and/or cost-effectiveness of ST vs. AT.DiscussionThe overall goal of this project is to determine if AT is better at facilitating long-term smoking abstinence than ST, the more resource-intensive approach. If efficacy is established, the AT approach will be relatively easy to disseminate and for community-based organizations to scale and implement, thus helping to reduce tobacco-related health disparities.Trial registrationClinical Trials RegistryNCT05004662. Registered August 13, 2021.
Association of long-term exposure to PM2.5 with hypertension and diabetes among the middle-aged and elderly people in Chinese mainland: a spatial study
Authors: Ye Zirong , Li Xueru , Han Yaofeng , Wu Yafei , Fang Ya 
Published: March 2022

AbstractBackgroundEpidemiological evidence has shown an association between long-term exposure to fine particulate matter (PM2.5) and hypertension and diabetes, but few studies have considered the spatial properties of the samples. This study aimed to investigate the long-term effect of PM2.5exposure on hypertension and diabetes among middle-aged and elderly people in China based on a spatial study.MethodsWe conducted a national cross-sectional study of the most recently launched wave 4 2018 data of the China Health and Retirement Longitudinal Study (CHARLS) to calculate the prevalence of hypertension and diabetes. The exposure data of annual average PM2.5concentrations were estimated combined with satellite observations, chemical transport modeling, and ground-based monitoring. A shared component model (SCM) was used to explore the association of PM2.5with hypertension and diabetes, in which these two diseases borrowed information on spatial variations from each other. Then, we evaluated the effect variations in PM2.5in different periods and smoking status on changes in outcomes.ResultsThe prevalence of hypertension and diabetes was 44.27% and 18.44%, respectively, among 19,529 participants. The annual average PM2.5concentration in 31 provinces ranged from 4.4 μg/m3to 51.3 μg/m3with an average of 27.86 μg/m3in 2018. Spatial auto-correlations of the prevalence of hypertension and diabetes and PM2.5concentrations were seen (Moran’sI = 0.336,p = 0.01; Moran’sI = 0.288,p = 0.03; Moran’sI = 0.490,p = 0.01). An interquartile range (IQR: 16.2 μg/m3) increase in PM2.5concentrations was significantly associated with a higher prevalence of hypertension and diabetes with odds ratios (ORs) of 1.070 [95% credible interval (95% CrI): 1.034, 1.108] and 1.149 (95% CrI: 1.100, 1.200), respectively. Notably, the effect of PM2.5on both hypertension and diabetes was relatively stronger among non-smokers than smokers.ConclusionOur nationwide study demonstrated that long-term exposure to PM2.5might increase the risk of hypertension and diabetes, and could provide guidance to public policymakers to prevent and control hypertension and diabetes according to the spatial distribution patterns of the above effects in China.
Prevalence and correlates of perceived age-related discrimination among older adults in India
Authors: Maurya Priya , Sharma Palak , Muhammad T. 
Published: March 2022

AbstractBackgroundAge is one of the predominant reasons for perceived discrimination in developing world where older people are considered a non-contributing burden. The present study explores the prevalence and correlates of perceived age discrimination among older Indian adults.MethodsA cross-sectional study was conducted using a large representative survey data from the Longitudinal Ageing Study in India conducted during 2017–18. Participants included 31,464 older adults aged 60 years and above. Multivariable logistic regression analysis was used to test the associations between selected background characteristics and perceived age discrimination.ResultsThe analysis revealed that 10.33 percent of older adults perceived their age as the main reason for discrimination, which was 11.86% among the oldest-old. Older adults with more than 10 years of schooling were 32% [adjusted odds ratio (AOR): 0.68; confidence interval (CI): 0.51—0.89] less likely to perceive age discrimination compared to their uneducated counterparts. The odds of perceived age discrimination were higher among older adults who earlier worked [AOR: 1.73; CI: 1.46—2.05] and currently working [AOR: 1.61; CI: 1.31—1.96] as compared to those who never worked. Further, having difficulty in instrumental activities of daily living (IADL) [AOR: 1.43; CI: 1.25 -1.65] and having one chronic condition [AOR: 1.16; CI: 1.02 -1.34] were associated with increased odds of perceived age discrimination among older adults.ConclusionOlder adults with lower socioeconomic status, currently working, having more chronic conditions, difficulty in IADL and belonging to rural areas were found to perceive higher age discrimination than their counterparts. The findings of the study have important implications for policy makers with respect to strategies such as making the vulnerable populations aware of their legal rights that help in the prevention of age-based discrimination in the country.