bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in Clinical Indicators of Diabetes, Hypertension, and Dyslipidemia Among Workers Who Worked Long Hours and Shift Work
Authors: Kang EunKyo 
Published: April 2021

Background Many studies have reported an association between overwork, shift work, and chronic disease. However, there is little research on the influence of working hours and shift work and management of chronic diseases. The objective of this retrospective study was to examine the association between working hours, shift work type in workers with hypertension, diabetes, and dyslipidemia. Methods Among 18,513 hourly wageworkers from the Korea National Health and Nutrition Examination Survey, 4,313 with hypertension, diabetes, and hyperlipidemia were selected. An analysis of covariance with general linear modeling was used to estimate group differences in clinical indices of chronic diseases according to weekly working hours and types of shift work, both unadjusted and adjusted for gender, age, education, marital status, household income, and medication usage. Findings Clinical indicators were worse in workers with diabetes (differences in HbA1c = 0.15%; fasting blood glucose = 4.84 mg/dL), hypertension (differences in diastolic blood pressure = 1.2 mmHg), or dyslipidemia (differences in total cholesterol = 3.3 mg/dL) who worked for more than 40 hours/week compared with workers who worked less than 40 hours per week. Clinical indicators in workers with diabetes and hypertension were worse in shift workers, including evening and night shifts, relative to those who did not work shiftwork. Conclusions/Application to Practice Working more than 40 hours per week and shift work were negatively associated with adverse clinical indicators among workers with chronic diseases. To improve the health of workers with chronic diseases, these findings suggest that adjustment of working hours and shift work may be warranted.
Biomechanical Comparison of an All-Inside Meniscal Repair Device Construct Versus Pullout Sutures for Arthroscopic Transtibial Repair of Posterior Medial Meniscus Root Tears: A Matched-Pair Cadaveric Study
Authors: Vertullo Christopher J. , Cadman Joseph , Dabirrahmani Danè , Appleyard Richard 
Published: April 2021

Background: Meniscus root repairs are important for restoring knee function after a complete meniscus root tear. Various suturing patterns have been proposed for the root repair. The 2-simple-stitches (TSS) method is currently the preferred technique, as it is simplest to perform and allows the least displacement of the meniscus root. Purpose: To compare the biomechanical properties of a posterior medial meniscus transtibial root repair consisting of an all-inside meniscal repair device (AMRD) construct with the TSS pullout suture pattern. Study Design: Controlled laboratory study. Methods: Ten pairs of cadaveric medial menisci were prepared with 1 of the 2 constructs. The constructs were randomized between pairs. All constructs were subjected to preloading with 2 N for 10 seconds and then cyclic loading from 5 N to 20 N for 1000 cycles at a frequency of 0.5 Hz. Subsequently, the menisci were loaded to failure at a rate of 0.5 mm/s. All loads were applied in-line with the circumferential meniscal fibers near the posterior medial meniscal horn. Results: The mean yield load and stiffness were similar for both constructs. The elongation after cyclic loading was greater for the AMRD. The displacement at both yield load and ultimate failure were also higher for the AMRD. The ultimate failure load of the AMRD was also significantly higher. During load to failure, the mode of failure in the AMRD was heterogeneous. All the TSS constructs failed by suture cutout. Conclusion: Posterior medial meniscus root repairs using both the AMRD and TSS constructs have elongation under the biomechanically acceptable threshold of 3 mm. The stiffness and yield loads indicate similar mechanical properties of the constructs. However, the significantly higher elongation for the AMRD leaves the TSS method as the preferred option for transtibial repairs. Despite this, the AMRD construct may still represent a viable alternative to the TSS suture pattern, comparable to alternative suture patterns with similar limitations. Clinical Relevance: The AMRD construct may represent a viable alternative to the TSS suture pattern.
Differences in Passive Shoulder Range of Motion Between Baseball Players With Neurogenic Thoracic Outlet Syndrome and Matched Healthy Controls
Authors: Garrison J. Craig , Hannon Joseph P. , Conway John E. 
Published: April 2021

Background: Neurogenic thoracic outlet syndrome (nTOS) is becoming more recognized as a diagnosis in the throwing athlete. Currently, there is limited information on the clinical presentation and development of nTOS in baseball players. Purpose: To compare passive shoulder range of motion (ROM) and anatomic humeral retrotorsion (HRT) of baseball players diagnosed with nTOS with a group of healthy, matched controls. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 53 adolescent baseball players diagnosed with nTOS (age, 17.2 ± 2.3 years; height, 180.9 ± 10.1 cm; weight, 80.0 ± 13.3 kg) were compared with 53 healthy baseball players (age, 17.2 ± 2.4 years; height, 183.9 ± 9.0 cm; weight, 83.8 ± 11.5 kg). Participants were measured for shoulder internal rotation (IR) and external rotation (ER) ROM and HRT. All measurements were taken bilaterally, and the differences (throwing to nonthrowing arm) were used to calculate mean values for glenohumeral internal rotation difference, glenohumeral external rotation difference (GERD), total rotational motion difference (TRMdiff), and anatomic humeral retrotorsion difference. Group comparisons were made between the nTOS and control players using multivariate analysis of variance, and descriptive comparisons were made with independent t tests. Results: There were no significant differences between groups in age, height, weight, or years of experience. Players in the nTOS group had significantly less throwing arm ER compared with controls (103.4° ± 10.4° vs 109.6° ± 7.5°, respectively; P = .001) and GERD (3.0° ± 9.2° vs 8.8° ± 9.2°, respectively; P = .002). TRMdiff was significantly greater in nTOS (–11.1° ± 11.1°) than in controls (–3.7° ± 9.4°) ( P < .001). Conclusion: In the current study, adolescent baseball players diagnosed with nTOS were evaluated with shoulder ROM differences when compared with a matched healthy cohort. A loss of throwing arm ER appeared to be the main factor behind shoulder ROM changes in the nTOS group.
Australian children and adolescents with gender dysphoria: Clinical presentations and challenges experienced by a multidisciplinary team and gender service
Authors: Kozlowska Kasia , McClure Georgia , Chudleigh Catherine , Maguire Ann M , Gessler Danielle , Scher Stephen , Ambler Geoffrey R 
Published: April 2021

This prospective study examines the clinical characteristics of children ( n = 79; 8.42–15.92 years old; 33 biological males and 46 biological females) presenting to a newly established, multidisciplinary Gender Service in New South Wales, Australia, and the challenges faced by the clinicians providing clinical services to these patients and their families. The clinical characteristics of the children were comparable to those described by other paediatric clinics providing gender services: a slight preponderance of biological females to males (1.4: 1); high levels of distress (including dysphoria about gender), suicidal ideation (41.8%), self-harm (16.3%), and suicide attempts (10.1%); and high rates of comorbid mental health disorders: anxiety (63.3%), depression (62.0%), behavioural disorders (35.4%), and autism (13.9%). The developmental stories told by the children and their families highlighted high rates of adverse childhood experiences, with family conflict (65.8%), parental mental illness (63.3%), loss of important figures via separation (59.5%), and bullying (54.4%) being most common. A history of maltreatment was also common (39.2%). Key challenges faced by the clinicians included the following: the effects of increasingly dominant, polarized discourses on daily clinical practice; issues pertaining to patient and clinician safety (including pressures to abandon the holistic [biopsychosocial] model); the difficulties of untangling gender dysphoria from comorbid factors such as anxiety, depression, and sexual abuse; and the factual uncertainties present in the currently available literature on longitudinal outcomes. Our results suggest the need to bring into play a biopsychosocial, trauma-informed model of mental health care for children presenting with gender dysphoria. Ongoing therapeutic work needs to address unresolved trauma and loss, the maintenance of subjective well-being, and the development of the self.
Extracellular vesicles shed by follicular lymphoma B cells promote polarization of the bone marrow stromal cell niche
Authors: Dumontet Erwan , Pangault Céline , Roulois David , Desoteux Matthis , Léonard Simon , Marchand Tony , Latour Maelle , Legoix Patricia , Loew Damarys , Dingli Florent , Dulong Joelle , Flecher Erwan , Coulouarn Cédric , Cartron Guillaume , Fest Thierry , Tarte Karin 
Published: April 2021

Abstract
Follicular lymphoma (FL) originates in the lymph nodes (LNs) and infiltrates bone marrow (BM) early in the course of the disease. BM FL B cells are characterized by a lower cytological grade, decreased proliferation, and a specific phenotypic and subclonal profile. Mesenchymal stromal cells (MSCs) obtained from FL BM display a specific gene expression profile (GEP), including enrichment for a lymphoid stromal cell signature, and an increased capacity to sustain FL B-cell growth. However, the mechanisms triggering the formation of the medullar FL permissive stromal niche have not been identified. In the current work, we demonstrate that FL B cells produce extracellular vesicles (EVs) that can be internalized by BM-MSCs, making them more efficient to support FL B-cell survival and quiescence. Accordingly, EVs purified from FL BM plasma activate transforming growth factor β–dependent and independent pathways in BM-MSCs and modify their GEP, triggering an upregulation of factors classically associated with hematopoietic stem cell niche, including CXCL12 and angiopoietin-1. Moreover, we provide the first characterization of BM FL B-cell GEP, allowing the definition of the landscape of molecular interactions they could engage with EV-primed BM-MSCs. This work identifies FL-derived EVs as putative mediators of BM stroma polarization and supports further investigation of their clinical interest for targeting the crosstalk between BM-MSCs and malignant B cells.
Prognostic significance of concurrent gene mutations in intensively treated patients withIDH-mutated AML: an ALFA study
Authors: Duchmann Matthieu , Micol Jean-Baptiste , Duployez Nicolas , Raffoux Emmanuel , Thomas Xavier , Marolleau Jean-Pierre , Braun Thorsten , Adès Lionel , Chantepie Sylvain , Lemasle Emilie , Berthon Céline , Malfuson Jean-Valère , Pautas Cécile , Lambert Juliette , Boissel Nicolas , Celli-Lebras Karine , Caillot Denis , Turlure Pascal , Vey Norbert , Pigneux Arnaud , Recher Christian , Terré Christine , Gardin Claude , Itzykson Raphaël , Preudhomme Claude , Dombret Hervé , de Botton Stéphane 
Published: April 2021

AbstractIn patients with isocitrate dehydrogenase (IDH)–mutated acute myeloid leukemia (AML) treated by intensive chemotherapy (IC), prognostic significance of co-occurring genetic alterations and allogeneic hematopoietic stem cell transplantation (HSCT) are of particular interest with the advent of IDH1/2 mutant inhibitors. We retrospectively analyzed 319 patients with newly diagnosed AML (127 with IDH1, 135 with IDH2R140, and 57 with IDH2R172 mutations) treated with IC in 3 Acute Leukemia French Association prospective trials. In each IDH subgroup, we analyzed the prognostic impact of clinical and genetic covariates, and the role of HSCT. In patients with IDH1 mutations, the presence of NPM1 mutations was the only variable predicting improved overall survival (OS) in multivariate analysis (P &lt; .0001). In IDH2R140-mutated AML, normal karyotype (P = .008) and NPM1 mutations (P = .01) predicted better OS. NPM1 mutations were associated with better disease-free survival (DFS; P = .0009), whereas the presence of DNMT3A mutations was associated with shorter DFS (P = .0006). In IDH2R172-mutated AML, platelet count was the only variable retained in the multivariate model for OS (P = .002). Among nonfavorable European LeukemiaNet 2010–eligible patients, 71 (36%) underwent HSCT in first complete remission (CR1) and had longer OS (P = .03) and DFS (P = .02) than nontransplanted patients. Future clinical trials testing frontline IDH inhibitors combined with IC may consider stratification on NPM1 mutational status, the primary prognostic factor in IDH1- or IDH2R140-mutated AML. HSCT improve OS of nonfavorable IDH1/2-mutated AML and should be fully integrated into the treatment strategy.
Characteristics and impact of exercise-induced laryngeal obstruction: an international perspective
Authors: Walsted Emil S. , Famokunwa Bamidele , Andersen Louise , Rubak Sune L. , Buchvald Frederik , Pedersen Lars , Dodd James , Backer Vibeke , Nielsen Kim G. , Getzin Andrew , Hull James H. 
Published: April 2021

BackgroundExercise-induced laryngeal obstruction (EILO) is a common cause of exertional breathlessness and wheeze yet is frequently misdiagnosed as asthma. Insight regarding the demographic characteristics, laryngeal abnormalities and impact of EILO is currently limited, with data only available from individual centre reports. The aim of this work was to provide a broader perspective from a collaboration between multiple international expert centres.MethodsFive geographically distinct clinical paediatric and adult centres (3 Denmark, 1 UK, 1 USA) with an expertise in assessing unexplained exertional breathlessness completed database entry of key characteristic features for all cases referred with suspected EILO over a 5-year period. All included cases completed clinical asthma workup and continuous laryngoscopy during exercise (CLE) testing for EILO.ResultsData were available for 1007 individuals (n=713 female (71%)) with a median (range) age of 24 (8–76) years, and of these 586 (58%) were diagnosed with EILO. In all centres, EILO was frequently misdiagnosed as asthma; on average there was a 2-year delay to diagnosis of EILO, and current asthma medication was discontinued in 20%. Collapse at the supraglottic level was seen in 60%, whereas vocal cord dysfunction (VCD) was only detected/visualised in 18%. Nearly half (45%) of individuals with EILO were active participants in recreational-level sports, suggesting that EILO is not simply confined to competitive/elite athletes.ConclusionOur findings indicate that key clinical characteristics and the impact of EILO/VCD are similar in globally distinct regions, facilitating improved awareness of this condition to enhance recognition and avoid erroneous asthma treatment.
GRAPES-DD: exploiting decision diagrams for index-driven search in biological graph databases
Authors: Licheri Nicola , Bonnici Vincenzo , Beccuti Marco , Giugno Rosalba 
Published: April 2021

AbstractBackgroundGraphs are mathematical structures widely used for expressing relationships among elements when representing biomedical and biological information. On top of these representations, several analyses are performed. A common task is the search of one substructure within one graph, called target. The problem is referred to as one-to-one subgraph search, and it is known to be NP-complete. Heuristics and indexing techniques can be applied to facilitate the search. Indexing techniques are also exploited in the context of searching in a collection of target graphs, referred to as one-to-many subgraph problem. Filter-and-verification methods that use indexing approaches provide a fast pruning of target graphs or parts of them that do not contain the query. The expensive verification phase is then performed only on the subset of promising targets. Indexing strategies extract graph features at a sufficient granularity level for performing a powerful filtering step. Features are memorized in data structures allowing an efficient access. Indexing size, querying time and filtering power are key points for the development of efficient subgraph searching solutions.ResultsAn existing approach, GRAPES, has been shown to have good performance in terms of speed-up for both one-to-one and one-to-many cases. However, it suffers in the size of the built index. For this reason, we propose GRAPES-DD, a modified version of GRAPES in which the indexing structure has been replaced with a Decision Diagram. Decision Diagrams are a broad class of data structures widely used to encode and manipulate functions efficiently. Experiments on biomedical structures and synthetic graphs have confirmed our expectation showing that GRAPES-DD has substantially reduced the memory utilization compared to GRAPES without worsening the searching time.ConclusionThe use of Decision Diagrams for searching in biochemical and biological graphs is completely new and potentially promising thanks to their ability to encode compactly sets by exploiting their structure and regularity, and to manipulate entire sets of elements at once, instead of exploring each single element explicitly. Search strategies based on Decision Diagram makes the indexing for biochemical graphs, and not only, more affordable allowing us to potentially deal with huge and ever growing collections of biochemical and biological structures.
Gene coexpression networks reveal molecular interactions underlying cichlid jaw modularity
Authors: Singh Pooja , Ahi Ehsan Pashay , Sturmbauer Christian 
Published: April 2021

AbstractBackgroundThe oral and pharyngeal jaw of cichlid fishes are a classic example of evolutionary modularity as their functional decoupling boosted trophic diversification and contributed to the success of cichlid adaptive radiations. Most studies until now have focused on the functional, morphological, or genetic aspects of cichlid jaw modularity. Here we extend this concept to include transcriptional modularity by sequencing whole transcriptomes of the two jaws and comparing their gene coexpression networks.ResultsWe show that transcriptional decoupling of gene expression underlies the functional decoupling of cichlid oral and pharyngeal jaw apparatus and the two units are evolving independently in recently diverged cichlid species from Lake Tanganyika. Oral and pharyngeal jaw coexpression networks reflect the common origin of the jaw regulatory program as there is high preservation of gene coexpression modules between the two sets of jaws. However, there is substantial rewiring of genetic architecture within those modules. We define a global jaw coexpression network and highlight jaw-specific and species-specific modules within it. Furthermore, we annotate a comprehensive in silico gene regulatory network linking the Wnt and AHR signalling pathways to jaw morphogenesis and response to environmental cues, respectively. Components of these pathways are significantly differentially expressed between the oral and pharyngeal jaw apparatus.ConclusionThis study describes the concerted expression of many genes in cichlid oral and pharyngeal jaw apparatus at the onset of the independent life of cichlid fishes. Our findings suggest that – on the basis of an ancestral gill arch network—transcriptional rewiring may have driven the modular evolution of the oral and pharyngeal jaws, highlighting the evolutionary significance of gene network reuse. The gene coexpression and in silico regulatory networks presented here are intended as resource for future studies on the genetics of vertebrate jaw morphogenesis and trophic adaptation.
Chloroplast phylogenomic insights into the evolution of Distylium (Hamamelidaceae)
Authors: Dong Wenpan , Liu Yanlei , Xu Chao , Gao Yongwei , Yuan Qingjun , Suo Zhili , Zhang Zhixiang , Sun Jiahui 
Published: April 2021

AbstractBackgroundMostDistyliumspecies are endangered.Distyliumspecies mostly display homoplasy in their flowers and fruits, and are classified primarily based on leaf morphology. However, leaf size, shape, and serration vary tremendously making it difficult to use those characters to identify most species and a significant challenge to address the taxonomy ofDistylium.To infer robust relationships and develop variable markers to identifyDistyliumspecies, we sequenced most of theDistyliumspecies chloroplast genomes.ResultsTheDistyliumchloroplast genome size was 159,041–159,127 bp and encoded 80 protein-coding, 30 transfer RNAs, and 4 ribosomal RNA genes. There was a conserved gene order and a typical quadripartite structure. Phylogenomic analysis based on whole chloroplast genome sequences yielded a highly resolved phylogenetic tree and formed a monophyletic group containing fourDistyliumclades. A dating analysis suggested thatDistyliumoriginated in the Oligocene (34.39 Ma) and diversified within approximately 1 Ma. The evidence shows thatDistyliumis a rapidly radiating group. Four highly variable markers,matK-trnK,ndhC-trnV,ycf1, andtrnT-trnL, and 74 polymorphic simple sequence repeats were discovered in theDistyliumplastomes.ConclusionsThe plastome sequences had sufficient polymorphic information to resolve phylogenetic relationships and identifyDistyliumspecies accurately.
The use of experimental vignette studies to identify drivers of variations in the delivery of health care: a scoping review
Authors: Sheringham Jessica , Kuhn Isla , Burt Jenni 
Published: April 2021

Abstract
Background
Identifying how unwarranted variations in healthcare delivery arise is challenging. Experimental vignette studies can help, by isolating and manipulating potential drivers of differences in care. There is a lack of methodological and practical guidance on how to design and conduct these studies robustly. The aim of this study was to locate, methodologically assess, and synthesise the contribution of experimental vignette studies to the identification of drivers of unwarranted variations in healthcare delivery.

Methods
We used a scoping review approach. We searched MEDLINE, Embase, Web of Science and CINAHL databases (2007–2019) using terms relating to vignettes and variations in healthcare. We screened title/abstracts and full text to identify studies using experimental vignettes to examine drivers of variations in healthcare delivery. Included papers were assessed against a methodological framework synthesised from vignette study design recommendations within and beyond healthcare.

Results
We located 21 eligible studies. Study participants were almost exclusively clinicians (18/21). Vignettes were delivered via text (n = 6), pictures (n = 6), video (n = 6) or interactively, using face-to-face, telephone or online simulated consultations (n = 3). Few studies evaluated the credibility of vignettes, and many had flaws in their wider study design. Ten were of good methodological quality. Studies contributed to understanding variations in care, most commonly by testing hypotheses that could not be examined directly using real patients.

Conclusions
Experimental vignette studies can be an important methodological tool for identifying how unwarranted variations in care can arise. Flaws in study design or conduct can limit their credibility or produce biased results. Their full potential has yet to be realised.