bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel insights into the pleiotropic health effects of growth differentiation factor 11 gained from genome-wide association studies in population biobanks
Authors: Strosahl Jessica , Ye Kaixiong , Pazdro Robert 
Published: September 2024

Abstract
Background
Growth differentiation factor 11 (GDF11) is a member of the transforming growth factor-β (TGF-β) superfamily that has gained considerable attention over the last decade for its observed ability to reverse age-related deterioration of multiple tissues, including the heart. Yet as many researchers have struggled to confirm the cardioprotective and anti-aging effects of GDF11, the topic has grown increasingly controversial, and the field has reached an impasse. We postulated that a clearer understanding of GDF11 could be gained by investigating its health effects at the population level.

Methods and results
We employed a comprehensive strategy to interrogate results from genome-wide association studies in population Biobanks. Interestingly, phenome-wide association studies (PheWAS) of GDF11 tissue-specific cis-eQTLs revealed associations with asthma, immune function, lung function, and thyroid phenotypes. Furthermore, PheWAS of GDF11 genetic variants confirmed these results, revealing similar associations with asthma, immune function, lung function, and thyroid health. To complement these findings, we mined results from transcriptome-wide association studies, which uncovered associations between predicted tissue-specific GDF11 expression and the same health effects identified from PheWAS analyses.

Conclusions
In this study, we report novel relationships between GDF11 and disease, namely asthma and hypothyroidism, in contrast to its formerly assumed role as a rejuvenating factor in basic aging and cardiovascular health. We propose that these associations are mediated through the involvement of GDF11 in inflammatory signaling pathways. Taken together, these findings provide new insights into the health effects of GDF11 at the population level and warrant future studies investigating the role of GDF11 in these specific health conditions.
Oral magnesium reduces levels of pathogenic autoantibodies and skin disease in murine lupus
Authors: Verlato Alberto , Laragione Teresina , Bin Sofia , Kim Randie H. , Salem Fadi , Gulko Percio S. , Cravedi Paolo 
Published: September 2024

Abstract
Background
Systemic Lupus Erythematosus (SLE) has a strong genetic susceptibility, but little is known about the impact of diet on disease severity. The Western diet is typically deficient in magnesium (Mg), and given the immunomodulatory effects of Mg, we hypothesized that the low Mg intake increases disease risk and that increasing Mg intake would reduce severity of murine lupus. Here, we placed 12-week old MRL/lpr female lupus mice on a normal (Mg500) or a high (Mg2800) Mg diet for 9 weeks. Urine and blood were collected during the study for quantification of urinary albumin, BUN, anti-dsDNA antibodies, and immune phenotyping.

Results
MRL/lpr lupus mice on high Mg2800 diet had significantly fewer skin lesions and less severe skin histology score, and reduced levels of pathogenic anti-dsDNA antibodies, compared with the Mg500 group (143.8±75.0 vs. 47.4±36.2 × 106U/ml; P < 0.05). The high Mg2800 group had a nearly two-fold increase in the percentage of CD4+FOXP3+ Treg cells compared to controls (19.9±5.4 vs. 11.4±5.5%; P < 0.05). Treg percentages inversely correlated with the concentration of anti-dsDNA. None of the mice developed arthritis during the observation period and there were no significant differences in weight, proteinuria, BUN or kidney histology.

Conclusion
In conclusion, oral supplementation of Mg has a protective effect in a murine lupus model and may represent an inexpensive and safe adjuvant in the treatment of SLE.
Results from a retrospective case finding and re-engagement exercise for people previously diagnosed with hepatitis C virus to increase uptake of directly acting antiviral treatment
Authors: Etoori David , Simmons Ruth , Desai Monica , Foster Graham R. , Stuart Avelie , Sabin Caroline , Mandal Sema , Rosenberg William 
Published: September 2024

Abstract
Background
Direct acting antivirals (DAAs) for the Hepatitis C virus (HCV) have shifted the World Health Organisation global strategic focus to the elimination of HCV by 2030. In England, the UK Health Security Agency (UKHSA) led a national ‘patient re-engagement exercise’, using routine surveillance data, which was delivered through the HCV Operational Delivery Networks (ODNs) with support from National Health Service England (NHSE), to help find and support people with a positive HCV PCR test result to access treatment. We report a quantitative evaluation of outcomes of this exercise.

Methods
Individuals with a recorded positive HCV antibody or PCR result between 1996 and 2017 were identified using UKHSA’s records of HCV laboratory diagnosis. Linkage with established health-care datasets helped to enhance patient identification and minimise attempts to contact deceased or previously treated individuals. From September to November 2018 each ODN was provided with a local list of diagnosed individuals. ODNs were asked to perform further data quality checks through local systems and then write to each individual’s GP to inform them that the individual would be contacted by the ODN to offer confirmatory HCV PCR testing, assessment and treatment unless the GP advised otherwise. Outcomes of interest were receipt of treatment, a negative PCR result, and death. Data were collected in 2022.

Results
Of 176,555 individuals with a positive HCV laboratory report, 55,329 individuals were included in the exercise following linkage to healthcare datasets and data reconciliation. Participants in the study had a median age of 51 years (IQR: 43, 59), 36,779 (66.5%) were males, 47,668 (86.2%) were diagnosed before 2016 and 11,148 (20.2%) lived in London. Of the study population, 7,442 (13.4%) had evidence of treatment after the re-engagement exercise commenced, 6,435 (11.6%) were reported as PCR negative (96% had no previous treatment records), 4,195 (7.6%) had prescription data indicating treatment before the exercise commenced or were reported to have been treated previously by their ODN, and 2,990 (5.4%) had died. The status of 32,802 (59.3%) people remains unknown.

Conclusions
A substantial number of those included had treatment recorded after the exercise commenced, however, many more remain unengaged. Evaluation of the exercise highlighted areas that could be streamlined to improve future exercises.
Study preferences and exam outcomes in medical education: insights from renal physiology
Authors: Heltne Sofie Fagervoll , Hovdenakk Sigrid , Kvernenes Monika , Tenstad Olav 
Published: September 2024

Abstract
Background
Efficient learning strategies and resource utilization are critical in medical education, especially for complex subjects like renal physiology. This is increasingly important given the rise in chronic renal diseases and the decline in nephrology fellowships. However, the correlations between study time, perceived utility of learning resources, and academic performance are not well-explored, which led to this study.

Methods
A cross-sectional survey was conducted with second-year medical students at the University of Bergen, Norway, to assess their preferred learning resources and study time dedicated to renal physiology. Responses were correlated with end-of-term exam scores.

Results
The study revealed no significant correlation between time spent studying and overall academic performance, highlighting the importance of study quality over quantity. Preferences for active learning resources, such as Team-Based Learning, interactive lessons and formative assignments, were positively correlated with better academic performance. A notable correlation was found between students’ valuation of teachers’ professional competence and their total academic scores. Conversely, perceived difficulty across the curriculum and reliance on self-found online resources in renal physiology correlated negatively with academic performance. ‘The Renal Pod’, a locally produced renal physiology podcast, was popular across grades. Interestingly, students who listened to all episodes once achieved higher exam scores compared to those who listened to only some episodes, reflecting a strategic approach to podcast use. Textbooks, while less popular, did not correlate with higher exam scores. Despite the specific focus on renal physiology, learning preferences are systematically correlated with broader academic outcomes, reflecting the interconnected nature of medical education.

Conclusion
The study suggests that the quality and strategic approaches to learning significantly impact academic performance. Successful learners tend to be proactive, engaged, and strategic, valuing expert instruction and active participation. These findings support the integration of student-activating teaching methods and assignments that reward deep learning.
The transformation of Jordan’s healthcare system in an area of conflict
Authors: Tamimi Ahmad , Al-Abbadi Mousa , Tamimi Iskandar , Juweid Malik , Ahmad Muayyad , Tamimi Faleh 
Published: September 2024

Abstract
Background
The Jordanian healthcare system has evolved over the past decades expanding its services, technological, and educational resources. A comprehensive view of this system is lacking. The objective of this report is to describe the structure of the Jordanian healthcare system, the challenges facing it, and the current and recommended health policies.

Materials and methods
This study reviewed the current status of the Jordanian healthcare system. The following parameters were analyzed: health indicators, infrastructure, human resources, insurance system, pharmaceutical expense, health education system, and medical tourism. Data were collected from various relevant official institutions and related published literature.

Results
Jordan has a young population with a median age of 23.8 years. Life expectancy is 78.8 years for females and 77.0 years for males. The Jordanian healthcare system is divided into three major categories: (1) Governmental Insurance (i.e., the Ministry of Health (MOH), the Royal Medical Services (RMS) and semi-governmental insurance); (2) Private Insurance; and (3) Refugee Insurance, including the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) and the United Nations High Commissioner for Refugees (NHUR). The Governmental Insurance covers 64.30% of the total population. Health expenditure is 6.37% of the gross domestic product (GDP). Pharmaceutical expenses make up 26.6% of the total national healthcare budget. Human resource assessment shows a high ratio of medical staff per 10.000 inhabitants, especially concerning physicians (31.7), dentists (7.9), and pharmacists (15.1). However, the ratio of nursing staff per 10.000 inhabitants is considered low (37.5). The Hospital bed/1000 population ratio is also relatively low (1.4). Healthcare accreditation is implemented through the Joint Commission International (JCI) accreditation which was achieved by 7 hospitals and by the National Health Care Accreditation Certificate (HCAC) achieved by 17 hospitals and 42 primary healthcare centers. Postgraduate medical education covers almost all medical and surgical fields. Medical tourism is currently well-established.

Conclusions
Assessment of the Jordanian healthcare system shows high ratios of physicians, dentists, and pharmacists but a low ratio of nursing staff per 10.000 inhabitants. The hospital bed/1000 population ratio is also relatively low. Pharmaceutical expenses are significantly high and medical tourism is well-developed.
Employers most desirable attributes in early-career physiotherapists: a content analysis of job advertisements
Authors: McAleer R. , Hanson L. , Kenny A. 
Published: September 2024

Abstract
Background
Ensuring a sufficient, appropriately qualified health workforce is of global concern. Understanding the attributes that employers seek is critical in recruitment, retention, and educational design. In physiotherapy, there is a dearth of evidence on desirable attributes that employers seek from early-career physiotherapists. This study directly addresses this gap. The aims of this study were to identify the characteristics of the jobs advertised for early-career physiotherapists in Australia; determine which attributes were most desired when employing an early-career physiotherapist; and identify if there were differences in the attributes required based upon workplace location.

Methods
New graduate and early-career physiotherapy job advertisements were collected for six months from 1st October 2020 until 31st March 2021 from SEEK.com.au, a large online employment marketplace that operates across ten countries in the Asia Pacific and Latin America. Job advertisements needed to specify new graduate or early-career physiotherapist eligibility and be located within Australia. Data extraction were completed using QuestionPro®. The Modified Monash Model was used to classify rurality of job location. Job advertisements were analysed descriptively and using content analysis to identify attributes.

Results
The search yielded 578 job advertisements with the greatest number collected in October 2020 (25.3%). Of the advertisements, 428 (74.0%) were in metropolitan locations (Modified Monash 1), 47 (8.1%) were in regional (Modified Monash 2), 99 (17.1%) were in rural locations (Modified Monash 3–5), and 4 (0.8%) were in remote locations (Modified Monash 6–7). Most roles were in private practice (63.3%) or aged care (21.7%). The top five attributes requested by employers were client focus, communication and interpersonal skills, team player, willingness to learn, and being able to build rapport, relationships, and networks. Academic results, resilience, and empathy were the least requested attributes. Differences in requested employability attributes increased with rurality.

Conclusions
This study addresses the current knowledge about attributes sought by employers for early-career physiotherapists. The most prevalent attributes requested were client focus and communication and interpersonal skills. This exploration of attributes can help to better prepare graduates for their first roles, align expectations, and increase understanding of priorities for entry level university programs, as well as identify priorities for support during transition to practice. Desired attributes should be clearly defined by employers in recruitment and retention processes.
Bladder duplication in the male cat: the first case report in China
Authors: Li Mingyuan , Deng Yuqing , Liu Haoqian , Sun Jiaxu , Hong Shaokang , Lu Chen , Mannion Christopher R. , Gútiez Marta Carreño , Liu Bo , Yu Feng 
Published: September 2024

Abstract
Background
Bladder duplication is a rare congenital lower urinary tract anomaly disease characterized by the presence of two bladders, possibly with duplication of the urethra. This disease is rarely reported in cats. The clinical symptoms are commonly occult, with increased difficulty in making a definitive diagnosis, especially if there is no obvious urethral duplication. The diagnosis is typically based on radiographs and ultrasound, with computer tomography serving as a more advanced imaging diagnostic modality. Cases of duplicated bladders with accessory tubular tissues are even scarcer in both human and veterinary medicine.

Case presentation
A 6-year-old male neutered cat was brought to the hospital because of vomiting and constipation. Cystography revealed increased soft tissue density of a fusiform structure in the lower middle abdomen. The purulent-filled cavitary structure and the accessory tubular structure were removed via surgery, and histopathological examination confirmed a double bladder with attached accessory tubular tissue. After antibiotic treatment, the cat recovered uneventfully.

Conclusion
This is the first case of bladder duplication in China and the first case of feline bladder duplication with tubular structure attachment in the world. This information will provide a reference for the diagnosis and treatment of similar cases in the future.
First hip hemiarthroplasty in a Göttingen Minipig; surgical and post-mortem protocol
Authors: Hartmann Katrine Top , Odgaard Anders , Knudsen Ulrik Kragegaard , Aalbæk Bent , Kvich Lasse , Birch Julie Melsted , Petersen Andreas , Bjarnsholt Thomas , Jensen Henrik Elvang , Jensen Louise Kruse 
Published: September 2024

Abstract
Background
Prosthetic joint infections (PJI) are recalcitrant, hard-to-treat infections and severe complications of joint arthroplasty. Therefore, there is a need to develop new effective treatment strategies, and animal models of high clinical relevance are needed. This study aimed to develop a detailed surgical protocol for hip hemiarthroplasty in Göttingen minipigs and a thorough post-mortem sampling protocol to pave the way for creating a minipig PJI model.

Methods
Three adult female Göttingen minipigs underwent surgery with insertion of a hip hemiarthroplasty, using the anterior approach to the hip joint. After surgery the minipigs were followed closely with daily clinical evaluation and gait scoring. Comprehensive post-mortem analyses were performed with evaluation of macroscopic lesions, microbiology, synovial fluid analysis and histology.

Results
The study resulted in the first Göttingen minipig with hip hemiarthroplasty and identified several points of awareness when inserting a hip prosthesis in minipigs, especially the high risk of joint dislocation. A spontaneous PJI occurred in one of the minipigs, revealing an impaired ability of the immune cells to reach the bacteria at the bone-prosthesis interface.

Conclusion
The present study provides a detailed description of surgical technique and post-mortem sampling and validates the suitability of the hip hemiarthroplasty minipig model for future experimental modeling of PJI.
Neurological monitoring and management for adult extracorporeal membrane oxygenation patients: Extracorporeal Life Support Organization consensus guidelines
Authors: Cho Sung-Min , Hwang Jaeho , Chiarini Giovanni , Amer Marwa , Antonini Marta V. , Barrett Nicholas , Belohlavek Jan , Brodie Daniel , Dalton Heidi J. , Diaz Rodrigo , Elhazmi Alyaa , Tahsili-Fahadan Pouya , Fanning Jonathon , Fraser John , Hoskote Aparna , Jung Jae-Seung , Lotz Christopher , MacLaren Graeme , Peek Giles , Polito Angelo , Pudil Jan , Raman Lakshmi , Ramanathan Kollengode , Dos Reis Miranda Dinis , Rob Daniel , Salazar Rojas Leonardo , Taccone Fabio Silvio , Whitman Glenn , Zaaqoq Akram M. , Lorusso Roberto 
Published: September 2024

Abstract
Background
Critical care of patients on extracorporeal membrane oxygenation (ECMO) with acute brain injury (ABI) is notable for a lack of high-quality clinical evidence. Here, we offer guidelines for neurological care (neurological monitoring and management) of adults during and after ECMO support.

Methods
These guidelines are based on clinical practice consensus recommendations and scientific statements. We convened an international multidisciplinary consensus panel including 30 clinician-scientists with expertise in ECMO from all chapters of the Extracorporeal Life Support Organization (ELSO). We used a modified Delphi process with three rounds of voting and asked panelists to assess the recommendation levels.

Results
We identified five key clinical areas needing guidance: (1) neurological monitoring, (2) post-cannulation early physiological targets and ABI, (3) neurological therapy including medical and surgical intervention, (4) neurological prognostication, and (5) neurological follow-up and outcomes. The consensus produced 30 statements and recommendations regarding key clinical areas. We identified several knowledge gaps to shape future research efforts.

Conclusions
The impact of ABI on morbidity and mortality in ECMO patients is significant. Particularly, early detection and timely intervention are crucial for improving outcomes. These consensus recommendations and scientific statements serve to guide the neurological monitoring and prevention of ABI, and management strategy of ECMO-associated ABI.
Political violence, racial violence, and new gun ownership: results from the 2023 National Survey of Gun Policy
Authors: Valek Rebecca , Ward Julie A. , Jones Vanya , Crifasi Cassandra K. 
Published: September 2024

Abstract
Background
U.S. firearm sales surged during the COVID-19 pandemic, with many purchases by first-time firearm owners. The 2023 National Survey of Gun Policy sought to understand the public health implications of this surge by comparing the purchasing motivations and firearm policy views of pandemic-era first-time purchasers to prior gun owners.

Methods
We fielded a nationally representative public opinion survey of U.S. adults (n = 3096) from 1/4/23 to 2/6/23. We oversampled for gun owners and Black, Hispanic, and Asian Americans. Survey weights were applied to generate representative estimates. New gun owners were identified through affirmative responses to: “Have you bought any guns since January 1, 2020?” and “Did you buy your first gun after January 1, 2020?” Recent purchasers were additionally asked whether concerns of 1) political or 2) racial violence motivated their purchase. Purchase motivations and gun policy support were examined among new and prior gun owners (n = 1002) and compared using logistic regression and predictive probabilities.

Results
Overall, 11% of respondents reported purchasing a gun since 1/1/20, 35% for the first time. Among recent purchasers, larger proportions of Democrat, Black, Asian, and Hispanic respondents were new gun owners than Republican or white respondents. Compared to prior owners, odds were 4.5-times higher that new gun owners’ recent purchase was motivated by racial violence and 3.2-times higher for political violence.
Majority support was found for protective gun policies, with few differences by purchase recency or motivations. The only policy for which support by new and prior gun owners differed significantly was the permit-to-purchase policy (76% v. 63%, respectively). Similarly, few significant differences in support were observed when stratifying by purchase motivation. Notably, both those who reported recent purchase motivations of racial violence and of political violence expressed significantly higher support for a “stand-your-ground” policy compared to those who did not report such motivations.

Conclusions
Racial and political violence appear to be larger concerns among new gun owners, motivating purchasing among demographic groups with traditionally lower gun ownership rates. These findings suggest a need for safety assurances amid racial and political tensions and growing gun ownership. Gun owners’ support for such policies remains strong.