bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attitudes towards Telemedicine Services and Associated Factors among health professionals in Ethiopia: a systematic review and meta-analysis
Authors: Chereka Alex Ayenew , Mekonnen Gebrehiwot Berie , Yirsaw Amlaku Nigusie , Mengistie Berihun Agegn , Getachew Eyob , Lakew Gebeyehu , Shibabaw Adamu Ambachew , Kitil Gemeda Wakgari 
Published: November 2024

Abstract
Background
Telemedicine is a vital tool for improving healthcare delivery in Ethiopia, where geographic, economic, and infrastructural challenges limit access to care, particularly in rural areas. With a shortage of healthcare professionals and limited medical services, telemedicine offers a solution by enabling remote consultations and continuous monitoring, extending healthcare to underserved populations. However, the successful adoption of telemedicine depends largely on the attitudes of healthcare professionals, whose acceptance and use of the technology are crucial for its integration. This study reviews the factors influencing Ethiopian health professionals’ attitudes toward telemedicine to provide insights that can support its adoption and improve healthcare delivery in the country.

Methods
Following the PRISMA guidelines, we conducted a systematic review of studies on telemedicine attitudes, initially identifying 15,900 articles. After screening, 5 full-text articles were selected for inclusion. The data were analyzed using STATA version 11, where heterogeneity was assessed using the I² test, and publication bias was evaluated through funnel plots and Egger’s regression. The pooled effect size was calculated using a random-effects model, with a 95% confidence interval to ensure the robustness and precision of the findings.

Results
The finding that 53.42% (95% CI: 42.02–64.83) of Ethiopian health professionals hold positive attitudes towards telemedicine suggests a moderate level of acceptance. Factors associated with these positive attitudes included receiving computer training in telemedicine (AOR 4.47, 95% CI: 1.94–10.26), possessing advanced digital literacy (AOR 4.08, 95% CI: 1.30–12.81), comprehensive knowledge of telemedicine technology (AOR 3.28, 95% CI: 1.73–6.23), access to reliable internet (AOR 3.04, 95% CI: 1.67–5.53), and availability of electronic devices in healthcare settings (AOR 2.59, 95% CI: 1.73–3.87).

Conclusion and recommendations
This meta-analysis reveals that 53.42% of Ethiopian health professionals hold positive attitudes towards telemedicine, influenced by specialized training, digital literacy, and resource access. To enhance adoption, initiatives should focus on targeted training, reliable internet connectivity, availability of devices in healthcare settings, and promoting broader awareness about telemedicine benefits and applications among healthcare professionals.
Prognostic significance of YKL-40 expression in canine cutaneous mast cell tumors
Authors: Kuo Chien-Chun , Huang Wei-Hsiang , Yang Su-Ya , Chang Yen-Chen , Chang Hui-Wen , Jeng Chian-Ren , Lee Jih-Jong , Liao Albert Taiching 
Published: November 2024

Abstract
Background
YKL-40, a secretory glycoprotein, is involved in tumor cell proliferation, metastasis, and angiogenesis in human cancers. Its overexpression has been correlated with unfavorable prognosis in many human cancers. In veterinary medicine, elevated YKL-40 levels in the serum of canine cutaneous mast cell tumors (cMCTs) were observed in our previous study. However, the expression pattern of YKL-40 in canine cMCT tissues, along with its association with clinical and pathological features, is still unknown. This study aims to retrospectively investigate the expression level of YKL-40 in the tissues of canine cMCTs and its correlation with clinical features, pathological characteristics, and clinical outcomes. Forty formalin-fixed paraffin-embedded cMCT tissues collected from forty dogs were diagnosed as low-grade (n = 20) or high-grade s(n = 20) MCT according to the Kiupel grading system. The expression level of YKL-40 in cMCT tissues was investigated using immunohistochemical staining and immunoreactivity score (IRS).

Results
YKL-40 was expressed in all cMCTs at different levels, with significantly stronger expression in low-grade cMCTs compared to high-grade cMCTs. The expression level was also associated with tumor diameter, histological grade, mitotic counts, vessel density, and survival of cMCTs. The overall survival of cMCT dogs showed significant differences (p < 0.01) among mild (n = 15, MST 219 days), moderate (n = 19, MST not reached), and high (n = 6, MST not reached) YKL-40 expression groups. Among low-grade cMCTs, overall survival was significantly different between mild YKL-40 expression (MST 319 days) and moderate to high YKL-40 (MST not reached) expression (p < 0.01). In high-grade cMCTs, overall survival was not correlated with YKL-40 expression (p = 0.6589).

Conclusions
This study found that the YKL-40 expression level was significantly stronger in low-grade than in high-grade canine cutaneous mast cell tumors and was associated with various clinical and pathological features. Stronger YKL-40 expression level correlated with longer survival time, especially in low-grade cMCTs. Therefore, YKL-40 could serve as a prognostic marker for cMCTs.
Sex differences in MAGEL2 gene promoter methylation in high functioning autism - trends from a pilot study using nanopore Cas9 targeted long read sequencing
Authors: Wieting Jelte , Jahn Kirsten , Bleich Stefan , Deest Maximilian , Frieling Helge 
Published: November 2024

Abstract
Background
MAGEL2 is an autism susceptibility gene whose deficiency has been associated with autism-related behaviors in animal models and in syndromic human autism spectrum disorders (ASDs) such as Schaaf-Yang syndrome, but has not been studied in the broader autism spectrum. Given the capabilities of long-read sequencing technologies, this pilot study used a targeted nanopore sequencing approach to simultaneously examine MAGEL2 DNA sequence and methylation in adults with high-functioning autism (HFA) compared to neurotypical controls (NC).

Methods
Using DNA extracted from peripheral blood, Cas9-targeted nanopore DNA sequencing was used to analyze MAGEL2, including its entire regulatory construct (chr15:23639316–23651466), for sequence variation and 5-methyl-cytosine (5mC) modification in a cohort of adults with HFA compared to sex- and age-matched NC. Given the known sex differences in ASD and MAGEL2 KO animal models, results were further analyzed by sex.

Results
20 adults with HFA (10 males, 10 females) and 20 NC were included. While there were no overall differences in MAGEL2 DNA sequence and 5mC modification between HFA and NC, we found a significant difference in MAGEL2 gene promoter methylation between males and females with HFA and NC of both sexes, with HFA males tending to show hypomethylation in a 300 bp long differentially methylated region (chr15:23647640–23647939) around the MAGEL2 transcription start site.

Conclusions
In this pilot study utilizing nanopore Cas9 targeted DNA sequencing, significant sex-specific differences in MAGEL2 gene promoter methylation were identified in male adults with HFA in comparison to control groups, suggesting the potential for sex-specific epigenetic differences. However, further replication in larger cohorts is required to validate these findings.
The risk of thyroid cancer in relation to residential proximity to nuclear power plants: a systematic review and meta-analysis
Authors: Cottagiri Susanna Abraham , King Will , Rodriguez-Villamizar Laura , Villeneuve Paul J. 
Published: November 2024

Abstract
Introduction
Ionizing radiation is a human carcinogen, and there is a public concern but limited evidence that it increases the incidence of cancer among those who live near nuclear power plants (NPPs). Previous analyses of thyroid cancer in these populations have been inconsistent, and the last synthesis was published nearly a decade ago. To address these gaps, we undertook a systematic review and meta-analysis.

Methods
A search strategy was developed and applied to PubMed, Scopus, and Web of Science databases. A total of 2006 publications were identified, with 11 studies of thyroid cancer incidence that met the inclusion criteria. Study quality was assessed using the Office of Health Assessment and Translation (OHAT) tool. Summary risk estimates relating residential proximity to the NPPs and thyroid cancer were generated using a random effects model. Heterogeneity in the risk estimates was assessed for study features that included: distance to the NPP, study quality, and biological sex.

Results
The 11 studies were categorized as either highly (n = 8) or plausibly (n = 3) prone to bias, primarily due to the reliance on ecological study designs. The meta-analysis summary relative risk of thyroid cancer among those who live close to NPPs (defined by ≤ 25 km distance or jurisdictional areas (e.g., community, county) relative to those who lived further away was 1.09 (95% CI: 0.93–1.29). The risk estimates were higher for studies that modelled more proximal residential distances (≤ 5 km) to NPPs than larger distances (≤ 25 km and jurisdictional areas). We found that the summary risk (RR=1.29, 95% CI: 0.77-2.16) was stronger among those studies less prone to bias. A non-significant increased risk was found among both men and women, but there was no evidence of sex differences in risk.

Conclusion
Overall, the findings suggest that living near a nuclear power plant increases the risk of thyroid cancer. The small number of studies on this topic, and the finding of higher risks in studies less prone to bias highlights the need for better-designed studies.
Impact of daily fasting duration on body composition and cardiometabolic risk factors during a time-restricted eating protocol: a randomized controlled trial
Authors: Sampieri A. , Paoli A. , Spinello G. , Santinello E. , Moro T. 
Published: November 2024

Abstract
Background
Time-restricted eating (TRE) is a dietary regimen that limits food intake for at least 12 h daily. Unlike other fasting protocols, TRE does not dictate what or how much to eat but rather focuses on the timing of meals. This approach has been previously demonstrated to improve body composition in individuals with obesity or metabolic impairments. However, its impact on body composition and cardiometabolic factors in healthy individuals remains unclear. Furthermore, the optimal fasting duration is still debated. Thus, we aimed to compare the effects of 8 weeks of different fasting durations on body composition and biochemical parameters in metabolically healthy, non-trained individuals using a parallel randomized controlled trial.

Methods
Forty-one volunteers were randomly assigned to one of the four experimental groups: TRE 16:8 (16 h of fasting,8 h of eating), TRE 14:10 (14 h of fasting,10 h of eating), TRE 12:12 (12 h of fasting,12 h of eating) or a normal diet group (ND; no dietary restriction). Participants underwent body composition measurements and blood tests for lipid profiles (i.e., total cholesterol, LDL, HDL, and triglycerides), fasting glucose, leptin, and anabolic hormones (i.e., insulin and testosterone) levels. Data were analyzed using both intention-to-treat (ITT) and per-protocol (PP) analysis to account for compliance. A two-way ANOVA for repeated measures was employed to assess interactions between time and group.

Results
In the ITT analysis, TRE 16:8 reduced body mass (-2.46%, p = 0.003) and absolute fat mass (-8.65%, p = 0.001) with no changes in lean soft tissue and in calorie intake. These results were consistent with the PP analysis which included 8 participants in TRE 16:8, 5 in TRE 14:10, 9 in TRE 12:12, and the entire ND group. Participants in the TRE 16:8 group spontaneously reduced their total caloric intake, although this reduction was not statistically significant. None of the other measurements significantly changed after 8 weeks.

Conclusions
Our results suggest that a 16-hour fasting window, even without caloric restriction, may be a viable strategy for improving body composition in healthy and non-trained individuals, whereas a shorter fasting period may be insufficient to produce significant changes in a healthy population.

Trial registration
NCT, NCT04503005. Registered 4 August 2020, https://clinicaltrials.gov/study/NCT04503005.
Impact of perinatal factors on T cells and transcriptomic changes in preterm infant brain injury
Authors: Zhang Xiaoli , Yang Yu , Xu Yiran , Chen Liuji , Niu Ming , Zhu Jinjin , Zhang Shan , Wu Yanan , Li Bingbing , Zhang Lingling , Song Juan , Xu Falin , Bi Dan , Zhao Xin , Zhu Changlian , Wang Xiaoyang 
Published: November 2024

Abstract
Background
T cells have been implicated in various neurological conditions, yet their role in neonatal brain injuries remains unclear. This study aimed to investigate the impact of perinatal factors on frequencies of T cell subsets in preterm infants and to explore the differences in blood genome expression profiles between preterm infants with and without brain injury.

Materials and methods
Three cohorts of preterm infants were used. Blood samples were collected soon after birth for the first cohort and late timepoint for the second and third cohorts. In the first cohort (88 infants), flow cytometry measured the proportions of αβT and γδT cell subsets in peripheral blood, analyzing associations with gestational age, birth weight, sex, delivery type, and maternal conditions. The second cohort focused on the relationship between T cell subsets and brain injury. In the third cohort, transcriptome sequencing identified differentially expressed genes and pathways in infants with brain injury, highlighting immune-related changes.

Results
Infants born at 29–30 weeks or with a birth weight of 1000–1500 g had significantly higher proportions of Vδ2+ T cells compared to those born at 30–32 weeks or with a birth weight > 1500 g, while no significant difference was found between infants born at < 29 weeks or with a birth weight < 1000 g. A negative correlation was observed between gestational age and Vδ2+ T cell frequency. No significant associations were found between Vδ2+ T cell proportions and perinatal factors other than gestational age or brain injury. Blood transcriptome analysis revealed 173 differentially expressed genes, characterized by downregulated interferon signaling and upregulated antimicrobial and neutrophil pathways in infants with brain injury.

Conclusions
Gestational age and birth weight influence Vδ2+ T cell proportions in preterm infants, likely reflecting immune maturation. While no direct link to brain injury was found, altered immune pathways suggest potential biomarkers for prognosis, warranting further research into their roles and therapeutic implications in neonatal brain injuries.
Navigating health policies and programs in India: exploring opportunities to improve rare disease management and orphan drug research
Authors: Mishra Sangita , Bhat Deepa , Venkatesh M. P. 
Published: November 2024

Abstract
Background
Rare disease (RD) management and orphan drug development in India face various hurdles regarding the implementation and adoption of comprehensive policies, lack of dedicated regulatory frameworks, and absence of epidemiological data. Current rare disease policy focuses more on strengthening the diagnostics and lacks a proper comprehensive treatment framework to ensure favorable clinical outcomes. Indian patients are largely excluded from global orphan drug clinical trials. This further alienates patients from access to rare disease treatment and available treatments come at high cost. This review-based study assesses the landscape of health policies and programs in India through a review of literature and guidelines, to identify strategic opportunities and recommendations for enhancing the overall care and support for the Rare Disease (RD) patient population and improving the orphan drug research ecosystem in India.

Discussion
The absence of specific regulations, shortage of healthcare resources, budget constraints, competing health priorities, lack of patient data, and insufficient research incentives discourage orphan drug development and global clinical trial inclusion, resulting in treatment inaccessibility and high costs. The Indian Government introduced the National Policy for Treatment of Rare Diseases (NPRD) to address these challenges. Several initiatives have been introduced to attract stakeholders with government-funded research, grants, incentives, and accelerated regulatory approvals of novel therapies that can ensure timely prevention and treatment of rare diseases. The National RD Registry by the Indian Council of Medical Research (ICMR) aims to provide prevalence data. Innovative approaches are required to improve rare disease management and promote orphan drug research. This will ensure the accessibility and affordability of life-saving therapeutics for India’s rare disease patients.

Conclusion
An integrated RD management and orphan drug research framework focusing on robust data management, patient-oriented policies to improve the treatment landscape, flexible regulations, strengthening rare disease registry with clinical and diagnostic data, and a favorable research ecosystem to promote indigenous research catering to the Indian population, will improve the treatment landscape and orphan drug research and development in India. This will ensure timely availability of therapeutics at affordable prices.
Soft X-ray tomography analysis of mitochondria dynamics in Saccharomyces cerevisiae
Authors: Huang Wei-Ling , Chen Chang-Lin , Lin Zi-Jing , Hsieh Chia-Chun , Hua Mo Da-Sang , Cheng Chih-Chan , Cheng Tzu-Hao , Lai Lee-Jene , Chang Chuang-Rung 
Published: November 2024

Abstract
Background
Mitochondria are highly dynamic organelles that constantly undergo processes of fission and fusion. The changes in mitochondrial dynamics shape the organellar morphology and influence cellular activity regulation. Soft X-ray tomography (SXT) allows for three-dimensional imaging of cellular structures while they remain in their natural, hydrated state, which omits the need for cell fixation and sectioning. Synchrotron facilities globally primarily use flat grids as sample carriers for SXT analysis, focusing on adherent cells. To investigate mitochondrial morphology and structure in hydrated yeast cells using SXT, it is necessary to establish a method that employs the flat grid system for examining cells in suspension.

Results
We developed a procedure to adhere suspended yeast cells to a flat grid for SXT analysis. Using this protocol, we obtained images of wild-type yeast cells, strains with mitochondrial dynamics defects, and mutant cells possessing distinctive mitochondria. The SXT images align well with the results from fluorescent microscopy. Optimized organellar visualization was achieved by constructing three-dimensional models of entire yeast cells.

Conclusions
In this study, we characterized the mitochondrial network in yeast cells using SXT. The optimized sample preparation procedure was effective for suspended cells like yeast, utilizing a flat grid system to analyze mitochondrial structure through SXT. The findings corresponded with the mitochondrial morphology observed under fluorescence microscopy, both in regular and disrupted dynamic equilibrium. With the acquired image of unique mitochondria in Δhap2 cells, our results revealed that intricate details of organelles, such as mitochondria and vacuoles in yeast cells, can be characterized using SXT. Therefore, this optimized system supports the expanded application of SXT for studying organellar structure and morphology in suspended cells.
Rodent group borreliae do occur in wild rodents from the Caribbean region of Colombia
Authors: López Yesica , Galeano Ketty , Faccini-Martínez Álvaro A. , Muñoz-Leal Sebastián , Lopez-Mejia Yeimi , Muñoz Marina , Ramírez Juan D. , Guzman Camilo , Calderon Alfonso , Mattar Salim 
Published: November 2024

Abstract
Background
Bacteria of the genus Borrelia are agents of disease in both domestic animals and humans and pose a significant public health risk. Borrelia species have complex transmission cycles, often using rodents as vertebrate reservoir hosts. These bacteria are classified into three well-defined monophyletic groups: Borrelia burgdorferi sensu lato (Bbsl) complex, the relapsing fever (RF) group, and a third group associated with reptiles and echidnas. Moreover, a new group of Borrelia associated with rodents has recently been proposed, as these bacteria form a phylogenetic group separated from the previously mentioned groups. This study aimed to investigate the presence of DNA of Borrelia spirochetes in rodents in specific areas of the Colombian Caribbean.

Methods
A total of 155 rodent spleen samples were selected from the tissue bank. These samples were obtained in the departments of La Guajira and Córdoba (Northern Colombia). DNA extraction and specific real-time polymerase chain reaction (PCR) targeting Borrelia 16S ribosomal RNA (rRNA) gene were performed, followed by nested PCR (nPCR) on positive samples to obtain larger fragments of the 16S rRNA gene and characterize the flaB gene. Alignments of generated sequences and ortholog sequences downloaded from Genbank were performed in Clustal Omega. A phylogenetic tree was built with the maximum likelihood method in IQTREE.

Results
Spleen samples from rodents of the genera Heteromys, Mus, Necromys, Olygoryzomys, Proechymis, Rattus, Sigmodon, and Zygodontomys were processed. Overall, 6.5% (4/162) of the animals tested positive for Borrelia by real-time PCR. All quantitative PCR (qPCR)-positive samples were also positive for nPCR targeting the 16S rRNA gene, yielding fragments of 344–408 bp and 603–673 bp from two Sigmodon rodents and two Zygodontomys rodents from La Guajira and Córdoba. All samples were negative for the flaB gene. Only samples from Zygodontomys rodents presented good quality sequences. A BLASTn analysis showed a percentage of identity ranging between 98.16 and 96.06% with Borrelia sp. R57. Phylogenetic analysis revealed that sequences of the present study clustered with species of the recently proposed Borrelia “rodent group.”

Conclusions
This is the first detection of borreliae of the “rodent group” in South America. Our results reaffirm the occurrence of a group of spirochetes associated with rodents, extending its geographic distribution to the Colombian Caribbean.

Graphical abstract