bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genome-wide CNV investigation suggests a role for cadherin, Wnt, and p53 pathways in primary open-angle glaucoma
Authors: Lo Faro Valeria , ten Brink Jacoline B. , Snieder Harold , Jansonius Nomdo M. , Bergen Arthur A. 
Published: August 2021

Abstract
Background
To investigate whether copy number variations (CNVs) are implicated in molecular mechanisms underlying primary open-angle glaucoma (POAG), we used genotype data of POAG individuals and healthy controls from two case-control studies, AGS (n = 278) and GLGS-UGLI (n = 1292). PennCNV, QuantiSNP, and cnvPartition programs were used to detect CNV. Stringent quality controls at both sample and marker levels were applied. The identified CNVs were intersected in CNV region (CNVR). After, we performed burden analysis, CNV-genome-wide association analysis, gene set overrepresentation and pathway analysis. In addition, in human eye tissues we assessed the expression of the genes lying within significant CNVRs.

Results
We reported a statistically significant greater burden of CNVs in POAG cases compared to controls (p-value = 0,007). In common between the two cohorts, CNV-association analysis identified statistically significant CNVRs associated with POAG that span 11 genes (APC, BRCA2, COL3A1, HLA-DRB1, HLA-DRB5, HLA-DRB6, MFSD8, NIPBL, SCN1A, SDHB, and ZDHHC11). Functional annotation and pathway analysis suggested the involvement of cadherin, Wnt signalling, and p53 pathways.

Conclusions
Our data suggest that CNVs may have a role in the susceptibility of POAG and they can reveal more information on the mechanism behind this disease. Additional genetic and functional studies are warranted to ascertain the contribution of CNVs in POAG.
Stressor controllability modulates the stress response in fish
Authors: Cerqueira Marco , Millot Sandie , Silva Tomé , Félix Ana S. , Castanheira Maria Filipa , Rey Sonia , MacKenzie Simon , Oliveira Gonçalo A. , Oliveira Catarina C. V. , Oliveira Rui F. 
Published: August 2021

AbstractBackgroundIn humans the stress response is known to be modulated to a great extent by psychological factors, particularly by the predictability and the perceived control that the subject has of the stressor. This psychological dimension of the stress response has also been demonstrated in animals phylogenetically closer to humans (i.e. mammals). However, its occurrence in fish, which represent a divergent vertebrate evolutionary lineage from that of mammals, has not been established yet, and, if present, would indicate a deep evolutionary origin of these mechanisms across vertebrates. Moreover, the fact that psychological modulation of stress is implemented in mammals by a brain cortical top-down inhibitory control over subcortical stress-responsive structures, and the absence of a brain cortex in fish, has been used as an argument against the possibility of psychological stress in fish, with implications for the assessment of fish sentience and welfare. Here, we have investigated the occurrence of psychological stress in fish by assessing how stressor controllability modulates the stress response in European seabass (Dicentrarchus labrax).ResultsFish were exposed to either a controllable or an uncontrollable stressor (i.e. possibility or impossibility to escape a signaled stressor). The effect of loss of control (possibility to escape followed by impossibility to escape) was also assessed. Both behavioral and circulating cortisol data indicates that the perception of control reduces the response to the stressor, when compared to the uncontrollable situation. Losing control had the most detrimental effect. The brain activity of the teleost homologues to the sensory cortex (Dld) and hippocampus (Dlv) parallels the uncontrolled and loss of control stressors, respectively, whereas the activity of the lateral septum (Vv) homologue responds in different ways depending on the gene marker of brain activity used.ConclusionsThese results suggest the psychological modulation of the stress response to be evolutionary conserved across vertebrates, despite being implemented by different brain circuits in mammals (pre-frontal cortex) and fish (Dld-Dlv).
The prevalence, relative risk factors and MTHFR C677T genotype of H type hypertension of the elderly hypertensives in Shanghai, China: a cross-section study
Authors: Qian Xiao-lin , Cao Hong , Zhang Jun , Gu Zhi-hui , Tang Wei-qin , Shen Lei , Hu Jia-lu , Yao Zhi-feng , Zhang Lei , Tang Min-na , Lv Xu-cheng , Zhou Jun , Jin Xue-juan , Hong Bin , Cui Zhao-qiang , Ge Jun-bo 
Published: August 2021

Abstract
Background
H type hypertension is defined as homocysteine (Hcy) ≥ 10 μmol/L in combination with primary hypertension. Studies demonstrated that the existence of hyperhomocysteine (HHcy) in hypertensive exacerbates the poor outcome of cardiocerebral incidents. This study was to investigate the current epidemic situation of H type hypertension and determine the risk factors in order to find intervention targets for H type hypertensives.

Methods
We conducted a cross-sectional study using cluster sampling design in Shanghai, China from July 2019 and April 2020. 23,652 patients with primary hypertension were enrolled in this study. Their medical information was recorded, and the level of Hcy concentrations and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms were detected.

Results
In total, 22,731 of 23,652 patients were recorded. The mean age was 68.9 ± 8.6 y and 43% were men. 80.0% of the enrolled patients had H type hypertension. The frequency of allele T was 40.9%, and the proportions of the CC, CT, and TT genotypes were 36.1%, 46.0%, and 17.9%, respectively. Compared with the TT genotype, the plasma Hcy concentration levels were lower in patients with the CC/CT genotype (18.96 ± 13.48 μmol/L vs. 13.62 ± 5.20/14.28 ± 5.36, F = 75.04, p < 0.01). The risk for H type hypertension was higher in elderly people. Men had ~ 5.55-fold odds of H type hypertension compared with women. Patients with CT genotype and TT genotype had ~ 1.36- and ~ 2.76-fold odds of H type hypertension compared with those with CC genotype, respectively. Smoking and diabetes were not significantly associated with H type hypertension.

Conclusions
The prevalence of H type hypertension in patients with primary hypertension was 80.0%, which was higher than the 75% found in prior report in China. Age, gender, and MTHFR C677T polymorphisms rather than smoking and diabetes were independently associated with H type hypertension.
The elevated expression of TLR4 and MMP9 in human abdominal aortic aneurysm tissues and its implication
Authors: Li Tan , Li Xintong , Liu Xiaozheng , Yang Jun , Ma Chunyan 
Published: August 2021

AbstractBackgroundToll-like receptor 4 (TLR4) and matrix metalloproteinase 9 (MMP9) have been investigated to play significant roles in the formation of abdominal aortic aneurysm (AAA). But the reports on the expression pattern of TLR4 and MMP9 in human AAA specimens were relatively scant. The aim of this study was to make a detailed analysis of TLR4 and MMP9 expression in situ and their association with clinical parameters involved in human AAA.Methods40 AAA specimens were obtained from full-thickness aneurysmal tissues at the maximal dilation area during the open surgical repair, and 8 non-aneurysmal abdominal aortas from transplant donors served as controls. Expression of TLR4 and MMP9 protein was determined by immunohistochemistry.ResultsThere were increased levels of TLR4 and MMP9 expression in human AAA tissues. Compared with macrophages or SMCs, lymphocytes showed a higher positive rate of TLR4 and MMP9 staining, and an elevated ratio of high MMP9 expression (allP < 0.05). There existed a significant association between TLR4 and MMP9 expression (r = 0.767,P < 0.001), and both TLR4 and MMP9 levels were statistically related to circulating CRP. Moreover, TLR4 expression in situ indicated a positive correlation with its serum level (r = 0.654,P = 0.006). Multiple analysis revealed that high TLR4 expression in situ was associated with the risk of large AAA (OR = 6.211, 95%CI = 1.226–31.480,P = 0.027), while high MMP9 expression was correlated to the presence of thrombus within AAA (OR = 5.494, 95%CI = 1.181–25.562,P = 0.030), separately compared with their low expression.ConclusionsThis study confirmed the overexpression of TLR4 and MMP9 in human AAA tissues, and their close relationship implying in the pathogenesis of AAA. We further provided evidence that TLR4 had a potential effect on AAA size and MMP9 could influence the occurrence of thrombus within AAA.
Prevalence of strongyloidiasis in Peru: systematic review and meta-analysis
Authors: Ortiz-Martínez Sonia , Ramos-Rincón José-Manuel , Vásquez-Chasnamote María-Esteyner , Gamboa-Paredes Olga-Nohelia , Arista-Flores Katty-Madeleine , Espinoza-Venegas Luis-Alfredo , de-Miguel-Balsa Eva , Pinedo-Cancino Viviana-Vanessa , Górgolas-Hernández-Mora Miguel , Casapía-Morales Martín 
Published: August 2021

AbstractBackgroundStrongyloidiasis is a disease of great public health significance, caused by the parasitic nematodesStrongyloides stercoralis,Strongyloides fuelleborni, andStrongyloides fuellebornisubsp. kellyi. This systematic review and meta-analysis aimed to assess the prevalence ofStrongyloides stercoralisinfection in Peru.MethodsThe review was based on a literature search in PubMed, SciELO and Google Scholar using the key words or root words “strongyl*” AND “Peru” on 15 July 2020. Eligible studies were published from 1 January 1981 to 15 July 2020 and written in English, Spanish, Italian, or French.ResultsWe included 21 papers in the analysis. Studies were heterogeneous in terms of study population and diagnostic methods (e.g. Baermann technique, agar, Dancescu or charcoal cultures, serology, string capsule). Prevalence ofS. stercoralisranged from 0.3 to 45%. The pooled proportion ofStrongyloidesin the general population was 7.34% (95% CI 4.97 to 10.13%). Half the studies were designed to detect parasites in general. In studies designed to detectS. stercoralis, the most widely used diagnostic method was the Baermann technique.ConclusionPrevalence ofS. stercoralisin Peru was high but varied by geographic area, techniques for stool examination, and participant characteristics.
The role of trust and hope in antipsychotic medication reviews between GPs and service users a realist review
Authors: Grünwald L. M. , Duddy C. , Byng R. , Crellin N. , Moncrieff J. 
Published: August 2021

Abstract
Background
Increasing number of service users diagnosed with schizophrenia and psychosis are being discharged from specialist secondary care services to primary care, many of whom are prescribed long-term antipsychotics. It is unclear if General Practitioners (GPs) have the confidence and experience to appropriately review and adjust doses of antipsychotic medication without secondary care support.

Aim
To explore barriers and facilitators of conducting antipsychotic medication reviews in primary care for individuals with no specialist mental health input.

Design & setting
Realist review in general practice settings.

Method
A realist review has been conducted to synthesise evidence on antipsychotic medication reviews conducted in primary care with service users diagnosed with schizophrenia or psychosis. Following initial scoping searches and discussions with stakeholders, a systematic search and iterative secondary searches were conducted. Articles were systematically screened and analysed to develop a realist programme theory explaining the contexts (C) and mechanisms (M) which facilitate or prevent antipsychotic medication reviews (O) in primary care settings, and the potential outcomes of medication reviews.

Results
Meaningful Antipsychotic medication reviews may not occur for individuals with only primary care medical input. Several, often mutually reinforcing, mechanisms have been identified as potential barriers to conducting such reviews, including low expectations of recovery for people with severe mental illness, a perceived lack of capability to understand and participate in medication reviews, linked with a lack of information shared in appointments between GPs and Service Users, perceived risk and uncertainty regarding antipsychotic medication and illness trajectory.

Conclusions
The review identified reciprocal and reinforcing stereotypes affecting both GPs and service users. Possible mechanisms to counteract these barriers are discussed, including realistic expectations of medication, and the need for increased information sharing and trust between GPs and service users.
Severe diaphoresis and fever during alcohol withdrawal cause hypovolemic shock: case report
Authors: Funayama Michitaka , Okochi Ryotaro , Asada Shintaro , Shimizu Yusuke , Kurose Shin , Takata Taketo 
Published: August 2021

Abstract
Background
Several fatal medical complications have been associated with alcohol withdrawal, such as seizure, cardiac arrhythmia, and takotsubo cardiomyopathy. However, there have been no reports on hypovolemic shock during alcohol withdrawal, although two physical signs of alcohol withdrawal, i.e., diaphoresis and fever, can lead to hypovolemia and its medical consequences.

Case presentation
We describe a patient with alcohol use disorder who exhibited hypovolemic shock and its associated acute renal failure during alcohol withdrawal with severe diaphoresis and fever even though he had consumed almost the full amount of food he was offered. Given his excessive diaphoresis and fever that were related to alcohol withdrawal, his water intake was insufficient. Infusion with extracellular fluid resolved all these medical issues.

Conclusions
The increased adrenergic activity associated with alcohol withdrawal might substantially increase a patient’s water-intake requirement through diaphoresis and fever and may cause severe hypovolemia and its associated medical complications.
Co-distribution of Light At Night (LAN) and COVID-19 incidence in the United States
Authors: Meng Yidan , Zhu Vincent , Zhu Yong 
Published: August 2021

Abstract
Background
Light at night (LAN) as a circadian disruption factor may affect the human immune system and consequently increase an individual’s susceptibility to the severity of infectious diseases, such as COVID-19. COVID-19 infections spread differently in each state in the United States (US). The current analysis aimed to test whether there is an association between LAN and COVID-19 cases in 4 selected US states: Connecticut, New York, California, and Texas.

Methods
We analyzed clustering patterns of COVID-19 cases in ArcMap and performed a multiple linear regression model using data of LAN and COVID-19 incidence with adjustment for confounding variables including population density, percent below poverty, and racial factors.

Results
Hotspots of LAN and COVID-19 cases are located in large cities or metro-centers for all 4 states. LAN intensity is associated with cases/1 k for overall and lockdown durations in New York and Connecticut (P < 0.001), but not in Texas and California. The overall case rates are significantly associated with LAN in New York (P < 0.001) and Connecticut (P < 0.001).

Conclusions
We observed a significant positive correlation between LAN intensity and COVID-19 cases-rate/1 k, suggesting that circadian disruption of ambient light may increase the COVID-19 infection rate possibly by affecting an individual’s immune functions. Furthermore, differences in the demographic structure and lockdown policies in different states play an important role in COVID-19 infections.
Self-collection for HPV-based cervical screening: a qualitative evidence meta-synthesis
Authors: Camara Hawa , Zhang Ye , Lafferty Lise , Vallely Andrew J. , Guy Rebecca , Kelly-Hanku Angela 
Published: August 2021

Abstract
Background
Cervical cancer is the fourth most common cancer affecting women worldwide, with 85% of the burden estimated to occur among women in low and middle-income countries (LMICs). Recent developments in cervical cancer screening include a novel self-collection method for the detection of oncogenic HPV strains in the collected samples. The purpose of this review is to synthesise qualitative research on self-collection for HPV-based testing for cervical screening and identify strategies to increase acceptability and feasibility in different settings, to alleviate the burden of disease.

Methods
This review includes qualitative studies published between 1986 and 2020. A total of 10 databases were searched between August 2018 and May 2020 to identify qualitative studies focusing on the perspectives and experiences of self-collection for HPV-based cervical screening from the point of view of women, health care workers and other key stakeholders (i.e., policymakers). Two authors independently assessed studies for inclusion, quality, and framework thematic synthesis findings. The Socio-Ecological Model (SEM) was used to synthesize the primary studies.

Results
A total of 1889 publications were identified, of which 31 qualitative studies were included. Using an adapted version of SEM, 10 sub-themes were identified and classified under each of the adapted model’s constructs: (a) intrapersonal, (b) interpersonal, and (c) health systems/public policy. Some of the themes included under the intrapersonal (or individual) construct include the importance of self-efficacy, and values attributed to self-collection. Under the intrapersonal construct, the findings centre around the use of self-collection and its impact on social relationships. The last construct of health systems focuses on needs to ensure access to self-collection, the need for culturally sensitive programs to improve health literacy, and continuum of care.

Conclusion
This review presents the global qualitative evidence on self-collection for HPV-based testing and details potential strategies to address socio-cultural and structural barriers and facilitators to the use of self-collection. If addressed during the design of an HPV-based cervical cancer screening testing intervention program, these strategies could significantly increase the acceptability and feasibility of the intervention and lead to more effective and sustainable access to cervical screening services for women worldwide.
Prevalence and correlates of comprehensive HIV/AIDS knowledge among adolescent girls and young women aged 15–24 years in Malawi: evidence from the 2015–16 Malawi demographic and health survey
Authors: Mandiwa Chrispin , Namondwe Bernadetta , Munthali Mtondera 
Published: August 2021

Abstract
Background
HIV epidemic remains a major public health issue in Malawi especially among adolescent girls and young women (AGYW). Comprehensive HIV/AIDS knowledge (defined as correct knowledge of two major ways of preventing the sexual transmission of HIV and rejection of three misconceptions about HIV) is a key component of preventing new HIV infections among AGYW. Therefore, the aim of this study was to identify the correlates of comprehensive HIV/AIDS knowledge among AGYW in Malawi.

Methods
The study was based on cross-sectional data from the 2015–2016 Malawi Demographic and Health Survey. It involved 10,422 AGYW aged 15–24 years. The outcome variable was comprehensive HIV/AIDS knowledge. Data were analysed using descriptive statistics, bivariate and multivariable logistic regression model. All the analyses were performed using complex sample analysis procedure of the Statistical Package for Social Sciences to account for complex survey design.

Results
Approximately 42.2% of the study participants had comprehensive HIV/AIDS knowledge. Around 28% of the participants did not know that using condoms consistently can reduce the risk of HIV and 25% of the participants believed that mosquitoes could transmit HIV. Multivariable logistic regression model demonstrated that having higher education (AOR = 2.97, 95% CI: 2.35–3.75), belonging to richest households (AOR = 1.24, 95% CI: 1.05–1.45), being from central region (AOR = 1.65, 95% CI:1.43–1.89), southern region (AOR = 1.65, 95% CI: 1.43–1.90),listening to radio at least once a week (AOR = 1.27, 95% CI: 1.15–1.40) and ever tested for HIV (AOR = 1.88, 95% CI: 1.68–2.09) were significantly correlated with comprehensive HIV/AIDS knowledge.

Conclusions
The findings indicate that comprehensive HIV/AIDS knowledge among AGYW in Malawi is low. Various social-demographic characteristics were significantly correlated with comprehensive HIV/AIDS knowledge in this study. These findings suggest that public health programmes designed to improve comprehensive HIV/AIDS knowledge in Malawi should focus on uneducated young women, those residing in northern region and from poor households. There is also a need to target AGYW who have never tested for HIV with voluntary counselling and testing services. This measure might both improve their comprehensive HIV/AIDS knowledge and awareness of their health status.
Adenomyoepithelioma of the breast with prominent cystic changes: a case report
Authors: Chen Feng , Wu Hengping , Liu Yujian , Lv Minli , Zhong Jianquan 
Published: August 2021

Abstract
Background
Adenomyoepithelioma (AME) of the breast is a rare subtype of breast tumor. Most of AMEs reported are solid, however, cystic or prominent cystic changes are extremely rare.

Case presentation
A 51-year-old woman presented a lump in the upper outer quadrant of right breast, and it was accompanied by continuous breast pain and bilateral axillary itching for more than 2 months. There were no other symptoms found. Preoperative mammography and ultrasound examination were performed. Mammography showed a noncalcified lobulated mass, and it was considered to be a benign cyst with septum on ultrasound, but ductal carcinoma of breast, adenoid cystic carcinoma could not be excluded. At first, AME was not considered preoperatively, because the imaging features of this rare tumor may vary widely, which may result in an incorrect diagnosis. But eventually, AME was diagnosed by postoperative pathology and immunohistochemistry.

Conclusion
We herein present a rare case of breast AME with prominent cystic changes. AME has no-specific imaging features, but the benign or malignant nature of the lesion might be suspected on imaging.