bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding variants of unknown significance: the computational frontier
Authors: Fu Xi , Rabadan Raul 
Published: June 2024

Abstract
The rapid advancement of sequencing technologies has led to the identification of numerous mutations in cancer genomes, many of which are variants of unknown significance (VUS). Computational models are increasingly being used to predict the functional impact of these mutations, in both coding and noncoding regions. Integration of these models with emerging genomic datasets will refine our understanding of mutation effects and guide clinical decision making. Future advancements in modeling protein interactions and transcriptional regulation will further enhance our ability to interpret VUS. Periodic incorporation of these developments into VUS reclassification practice has the potential to significantly improve personalized cancer care.
Structure, function, and assembly of PSI in thylakoid membranes of vascular plants
Authors: Rolo David , Schöttler Mark A , Sandoval-Ibáñez Omar , Bock Ralph 
Published: June 2024

Abstract
The photosynthetic apparatus is formed by thylakoid membrane-embedded multiprotein complexes that carry out linear electron transport in oxygenic photosynthesis. The machinery is largely conserved from cyanobacteria to land plants, and structure and function of the protein complexes involved are relatively well studied. By contrast, how the machinery is assembled in thylakoid membranes remains poorly understood. The complexes participating in photosynthetic electron transfer are composed of many proteins, pigments, and redox-active cofactors, whose temporally and spatially highly coordinated incorporation is essential to build functional mature complexes. Several proteins, jointly referred to as assembly factors, engage in the biogenesis of these complexes to bring the components together in a step-wise manner, in the right order and time. In this review, we focus on the biogenesis of the terminal protein supercomplex of the photosynthetic electron transport chain, PSI, in vascular plants. We summarize our current knowledge of the assembly process and the factors involved and describe the challenges associated with resolving the assembly pathway in molecular detail.
An intronless tau class glutathione transferase detoxifies several herbicides in flufenacet-resistant ryegrass
Authors: Dücker Rebecka , Lümmen Peter , Wolf Thomas , Brabetz Veronika , Beffa Roland 
Published: June 2024

Abstract
Resistance to preemergence herbicides, e.g. inhibitors of the biosynthesis of very-long-chain fatty acids (VLCFAs), is evolving in response to increased use of these compounds. Grass weeds such as ryegrasses (Lolium spp.) have accumulated resistance to various herbicide modes of action. Here, an RNA-seq analysis was conducted using 3 ryegrass populations resistant to the VLCFA biosynthesis inhibitor flufenacet to investigate this phenomenon. Besides various transcripts, including putative long noncoding RNAs (lncRNAs), a single putatively functional tau class glutathione transferase (GST) was constitutively differentially expressed. It was further induced by herbicide application. This GST was expressed as a recombinant protein in Escherichia coli along with other GSTs and detoxified flufenacet rapidly in vitro. Detoxification rates of other herbicides tested in vitro were in accordance with cross-resistance patterns previously determined in vivo. A genome-wide GST analysis revealed that the candidate GST was located in a cluster of 3 intronless GSTs. Their intronless nature possibly results from the retroposition of cellular mRNAs followed by tandem duplication and may affect gene expression. The large number of GSTs (≥195) in the genome of rigid ryegrass (Lolium rigidum) compared with other plant organisms is likely a key factor in the ability of this weed to evolve resistance to different herbicide chemistries. However, in the case of flufenacet resistance, a single upregulated GST with high affinity for the substrate flufenacet possibly contributes overproportionally to rapid herbicide detoxification in planta. The regulation of this gene and the role of differentially expressed transcripts, including various putative lncRNAs, require further investigation.
Financial Effects of Remote Product Delivery: Evidence from Hospitals
Authors: Cornaggia Kimberly , Li Xuelin , Ye Zihan 
Published: June 2024

Abstract
We study financial effects of remote product delivery in the healthcare industry. Exploiting staggered law adoption for identification, we find that telehealth provision redistributes hospital operations and access to capital away from rural communities. As urban telehealth providers acquire rural patients, rural hospitals experience decreased revenue and profit, credit rating downgrades, increased cost of capital, and ultimately risk of closure. Although telehealth reduces travel costs, some communities lose access to acute care. Overall, we conclude that remote healthcare services have financial consequences as well as real effects, and their benefits are unequally distributed.
Preoperative Cervical Epidural Steroid Injections
Authors: Alasadi Husni , Baidya Joydeep , Alasadi Yazan , Chakrani Zakaria , Herrera Michael M. , Zubizarreta Nicole , Stern Brocha Z. , Poeran Jashvant , Chaudhary Saad B. 
Published: June 2024

Study Design:
Retrospective cohort study.

Objective:
Identify factors associated with cervical epidural steroid injection (CESI) receipt before anterior cervical discectomy and fusion (ACDF), posterior cervical decompression and fusion (PCDF), or decompression; evaluate the association between CESI receipt and 90-day postoperative complications; and determine characteristics of CESI associated with complications.

Summary of Background Data:
Previous literature has suggested that a preoperative CESI may increase the risk of postoperative complications. However, these studies were limited in the procedures and complications they evaluated.

Methods:
The IBM MarketScan database was queried for patients aged 18 years or older who underwent ACDF, PCDF, or cervical decompression for disc herniation, stenosis, radiculopathy, myelopathy, and/or spondylosis without myelopathy between January 1, 2014 and September 30, 2020. CESI receipt within 12 months preoperatively, injection characteristics, and postoperative complications were extracted. Multivariable logistic regression models were used to investigate associations between patient characteristics and receipt of CESI, receipt of a CESI and each 90-day postoperative complication, and CESI characteristics and each 90-day complication.

Results:
Among the unique patients who underwent each procedure, 20,371 ACDF patients (30.93%), 1259 (22.24%) PCDF patients, and 3349 (36.30%) decompression patients received a preoperative CESI. In all 3 cohorts, increasing age, increasing comorbidity burden, smoker status, and diagnosis of myelopathy were associated with decreased odds of preoperative CESI receipt, while female sex and diagnosis of radiculopathy and spondylosis without myelopathy were associated with increased odds. There were no meaningful between-group comparisons or significant associations between preoperative CESI receipt and any 90-day postoperative complications in multivariable models (all P>0.05).

Conclusions:
This study elucidated the main determinants of CESI receipt and found no differences in the odds of developing 90-day postoperative complications, but did identify differential outcomes with regard to some injection characteristics.

Level of Evidence:
Level III.
Gender Differences in Quality of Bowel Preparation for Colonoscopy
Authors: Maida Marcello , Vitello Alessandro , Zullo Angelo , Ramai Daryl , Facciorusso Antonio , Vassallo Roberto 
Published: June 2024

Objective:
Bowel cleansing is a key element for a quality colonoscopy. Despite recent advances, not all predictors of successful cleansing are fully known. This post hoc analysis of an RCT aims to explore gender differences in bowel cleansing quality.

Methods:
The “OVER” trial was a multicenter phase-4 RCT including 478 patients randomized 1:1 to receive split-dose 1L polyethylene glycol plus ascorbate (PEG+ASC) or 4L-PEG. In this post hoc analysis, multivariable logistic regression models were designed to assess predictors of cleansing success (CS) and adenoma detection rate (ADR) by gender.

Results:
Of the 478 randomized patients, 50.2% were males and 49.8% females.
Overall, CS was comparable between females and males (87.1% vs 88.4, P = 0.6), whereas CS in the right (95.7% vs 90.9, P = 0.049) and transverse colon (98.6% vs 93.9, P=0.011) was significantly higher in females.
At multivariable regression analysis for CS outpatient setting (OR = 5.558) and higher withdrawal time (OR = 1.294) were independently associated with CS in females, whereas screening/surveillance indication (OR = 6.776) was independently associated with CS in males.
At multivariable regression analysis for ADR, running time <5 hours (OR = 3.014) and higher withdrawal time (OR = 1.250) were independently associated with ADR in females, whereas older age (OR = 1.040) and higher withdrawal time (OR = 1.093) were independently associated with ADR in males.

Conclusions:
This study showed different results in bowel preparation quality and different predictors of CS and ADR by gender. These findings suggest the need for further research to explore gender-specific approaches for bowel preparation.
Role of scalp nerve block in improving the quality of rehabilitation in patients after meningioma resection: A randomized controlled clinical trial
Authors: Zhang Yongguo , He Kai , Chen Lvlv , Ji Kuiquan , Zhang Zhongwei , Wang Weijun 
Published: June 2024

Background:
In this study, we analyzed whether scalp nerve block with ropivacaine can improve the quality of rehabilitation in patients after meningioma resection.

Methods:
We included 150 patients who were undergoing craniotomy in our hospital and categorized them into 2 groups – observation group (patients received an additional regional scalp nerve block anesthesia) and control group (patients underwent intravenous general anesthesia for surgery), using the random number table method approach (75 patients in each group). The main indicator of the study was the Karnofsky Performance Scale scores of patients at 3 days postoperatively, and the secondary indicator was the anesthesia satisfaction scores of patients after awakening from anesthesia. The application value of different anesthesia modes was studied and compared in the 2 groups.

Results:
Patients in the observation group showed better anesthesia effects than those in the control group, with significantly higher Karnofsky Performance Scale scores at 3 days postoperatively (75.02 vs 66.43, P < .05) and anesthesia satisfaction scores. Compared with patients in the control group, patients in the observation group had lower pain degrees at different times after the surgery, markedly lower dose of propofol and remifentanil for anesthesia, and lower incidence of adverse reactions and postoperative complications. In addition, the satisfaction score of the patients and their families for the treatment was higher and the results of all the indicators were better in the observation group than in the control group, with statistically significant differences (P < .05).

Conclusion:
Scalp nerve block with ropivacaine significantly improves the quality of short-term postoperative rehabilitation in patients undergoing elective craniotomy for meningioma resection. This is presumably related to the improvements in intraoperative hemodynamics, relief from postoperative pain, and reduction in postoperative nausea and vomiting.
Effect of herbal medicine on postoperative nausea and vomiting after laparoscopic surgery: A systematic review and meta-analysis
Authors: Ha Na-Yeon , Park Mu-Jin , Ko Seok-Jae , Park Jae-Woo , Kim Jinsung 
Published: June 2024

Background:
Traditionally, herbal medicines have been used to alleviate nausea and vomiting; however, a comprehensive clinical evaluation for postoperative nausea and vomiting (PONV), especially after laparoscopic surgery, remains limited. This review aimed to evaluate the efficacy and safety of herbal medicine as an alternative therapy to prevent and manage nausea and vomiting after laparoscopic surgery compared with untreated, placebo, and Western medicine groups.

Methods:
We searched 11 databases, including EMBASE, PubMed, and the Cochrane Library, to collect randomized controlled trials (RCTs) of herbal medicines on PONV after laparoscopic surgery on July 7, 2022. Two independent reviewers screened and selected eligible studies, extracted clinical data, and evaluated the quality of evidence using the Cochrane risk-of-bias tool. The primary outcome was the incidence of PONV, whereas the secondary outcomes included the frequency and intensity of PONV, symptom improvement time, antiemetic requirement frequency, and incidence of adverse events. Review Manager Version 5.3. was used for the meta-analysis.

Results:
We identified 19 RCTs with 2726 participants comparing herbal medicine with no treatment, placebo, and Western medicine. The findings showed that compared with no treatment, herbal medicine demonstrated significant effects on vomiting incidence (risk ratio [RR] = 0.43, 95% confidence interval [CI] 0.32–0.57, P < .00001). Compared with placebo, herbal medicine revealed a significant effect on the severity of nausea 12 hours after laparoscopic surgery (standardized mean difference = −2.04, 95% CI −3.67 to −0.41, P = .01). Herbal medicines showed similar effects with Western medicine on the incidence of postoperative nausea (RR = 0.94, 95% CI 0.63–1.42, P = .77) and vomiting (RR = 0.68, 95% CI 0.25–1.84, P = .45). Furthermore, comparing the experimental group containing herbal medicine and control group excluding herbal medicine, adverse events were considerably lower in the group with herbal medicine (RR = 0.45, 95% CI 0.27–0.72, P = .001).

Conclusion:
Herbal medicine is an effective and safe treatment for nausea and vomiting secondary to laparoscopic surgery. However, the number of studies was small and their quality was not high; thus, more well-designed RCTs are warranted in the future.
Intervention for work–family conflict and work deviance behavior among female workers in Tourism, Museum, Art Gallery Exhibition Centers: Implications for sustainable Tourism development intervention study
Authors: Ejikeme Joy Nneka Uchenye , Ede Moses Onyemaechi , Mawila Daphney , Oneli Joy Obiageli 
Published: June 2024

Background:
This study was motivated due to psychological exhaustion, demands, and conflict degenerating from the work environment and family responsibilities facing career female workers. These roles and expectations have posed serious dilemmas to female populations in workplaces. Leaving them untreated is risky and could lead to severe psychological disturbances. Based on these, this study investigated the effect of the occupation health model of Rational Emotive Behaviour Therapy on work–family conflict and work-deviant behavior among female workers in Tourism, Museum, Art Gallery and Exhibition Centers in Enugu State.

Methods:
A randomized control design was used. A total of 119 female workers were randomized into intervention and control groups, measured at 3 points (pretest, posttest, and follow-up test), and the data collected were analyzed using repeated measure statistics.

Results:
The finding showed that the intervention is significantly effective in reducing the work–family conflict and work deviance behavior among female workers in Tourism, Museum, and Art Gallery Exhibition Centers. Nonetheless, the findings show that the gender and time interaction effects did not significantly affect the work–family conflict and work deviance behavior scores of the workers. The follow-up stage improved the intervention’s favorable impact on the reduction of work–family conflict and work-deviant behaviors.

Conclusion:
This suggest that occupation health model of Rational Emotive Behaviour Therapy has significant impact in reducing and changing female workers’ perceptions of work–family conflict and work deviant behaviors.
Efficacy and safety of electroacupuncture for urinary retention: A systematic review and meta-analysis
Authors: Xu Hanyu , Wu Linna , Ba Te , Niu Liqing , Zhang Yuan , Zhao Xiaofeng 
Published: June 2024

Background:
Electroacupuncture (EA) is considered as an effective treatment for urinary retention (UR).

Methods:
Up to April 7, 2023, randomized controlled trials (RCTs) of EA for UR were extensively searched in 8 databases, including Pubmed, Cochrane, Embase, Web of Science, Chinese Biomedical Literature Database, Chinese Journal Full-text Database, Wanfang Data, and VIP Full-text e-Journals Database. The Cochrane Risk of Bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) were utilized to evaluate the quality of all included RCTs. Meta-analysis was conducted using Stata 15.0 software.

Results:
A total of 23 trials were included, and the meta-analysis results suggested that compared with the control group, EA can effectively treat various types of UR (risk ratio [RR] = 1.22, 95CI%: 1.14, 1.31) and promote bladder function recovery, with a significant reduce in residual urine volume (weighted mean differences [WMD] = −49.60, 95CI%: −64.10, −35.11), an increase in maximum bladder capacity (WMD = 47.00, 95CI%: 12.76, 81.24), a shorten in the first urination time (standardized mean difference [SMD] = −1.42, 95CI%: −2.08, −0.76), and less adverse reactions (RR = 0.21, 95CI%: 0.07, 0.65).

Conclusion:
EA has significant advantages in treating UR, but the efficacy and safety are still needed to be further verified through large-sample and high-quality RCTs.
Does subclinical hypothyroidism affect the prognosis of patients with chronic systolic heart failure: A systematic review and meta-analysis
Authors: Han Xiao , Wang Xiuge 
Published: June 2024

Background:
Chronic systolic heart failure (CSHF) is a significant health burden with high morbidity and mortality. The role of subclinical hypothyroidism (SCH) in the prognosis of CSHF patients remains a critical area of inquiry. This systematic review and meta-analysis aim to elucidate the impact of SCH on the prognosis of patients with CSHF.

Methods:
Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this meta-analysis employed a comprehensive search strategy across major databases including PubMed, Embase, Web of Science, and the Cochrane Library. The Patient, Intervention, Comparison, Outcome framework guided the inclusion of studies focusing on patients with CSHF, comparing those with and without SCH. Quality assessment was performed using the Newcastle–Ottawa scale. Statistical analyses assessed heterogeneity and publication bias, employing fixed-effect or random-effects models based on heterogeneity levels.

Results:
From an initial pool of 1439 articles, 8 studies met the stringent inclusion criteria. These studies, conducted across diverse geographical regions, highlighted the relationship between SCH and all-cause mortality, cardiac events, and subgroup differences in CSHF patients. The meta-analysis revealed SCH as a significant risk factor for all-cause mortality (HR = 1.42) and cardiac events (HR = 1.46). Subgroup analysis indicated variability in risk based on region, sample size, age, and follow-up duration. Sensitivity analysis confirmed the stability of these findings, and publication bias assessment indicated symmetric funnel plot and nonsignificant Egger test results.

Conclusions:
SCH emerges as a predictive factor for all-cause mortality, cardiovascular events, and rehospitalization in CSHF patients. This finding underscores the importance of screening for SCH in CSHF patients, highlighting its potential role in improving patient prognosis.
Effect of different anesthetic modalities on postoperative delirium in elderly hip fractures: A meta-analysis
Authors: Fan Guangya , Zhong Musen , Su Wenshuo , An Zhongcheng , Zhu Yuchen , Chen Chen , Dong Liqiang , Wu Lianguo , Zhang Xiaoping 
Published: June 2024

Background:
Previous findings on the effect of general versus spinal anesthesia on postoperative delirium in elderly people with hip fractures are somewhat controversial. This article included the latest randomized controlled study for meta-analysis to evaluate the effect of general anesthesia (GA) and spinal anesthesia (SA) on delirium after hip fracture surgery in the elderly, so as to guide the clinical.

Methods:
Cochrane Library, PubMed, Web Of Science, and Embase were searched from inception up to January 16, 2024. Randomized controlled trial (RCT) was included to evaluate the postoperative results of GA and SA in elderly patients (≥50 years old) undergoing hip fracture surgery. Two researchers independently screened for inclusion in the study and extracted data. Heterogeneity was assessed by the I²and Chi-square tests, and P < .1 or I² ≥ 50% indicated marked heterogeneity among studies. The Mantel–Haenszel method was used to estimate the combined relative risk ratio (RR) and the corresponding 95% confidence interval (CI) for the binary variables.

Results:
Nine randomized controlled trials were included. There was no significant difference (RR = 0.93, 95% CI = 0.774–1.111, P > .05) in the incidence of postoperative delirium between the GA group and the SA group. In intraoperative blood transfusion (RR = 1.0, 95% CI = 0.77–1.28, Z = 0.04, P = .971), pulmonary embolism (RR = 0.795, 95% CI = 0.332–1.904, Z = 0.59, P = .606), pneumonia (RR = 1.47, 95% CI = 0.75–2.87, P = .675), myocardial infarction (RR = 0.97, 95% CI = 0.24–3.86, Z = 0.05, P = .961), heart failure (RR = 0.80, 95% CI = 0.26–2.42, Z = 0.40, P = .961), urinary retention (RR = 1.42, 95% CI = 0.77–2.61, Z = 1.11, P = .267) were similar between the 2 anesthetic techniques.

Conclusion:
There is no significant difference in the effect of GA and SA on postoperative delirium in elderly patients with hip fracture, and their effects on postoperative complications are similar.
A bibliometric analysis of myocardial bridge combined with myocardial infarction
Authors: Zhang Haiyuan , Cao Yuejuan 
Published: June 2024

Background:
The aim of this study is to analyze the process and frontiers of research in myocardial bridges (MB) to identify future research directions in the last 3 decades.

Methods:
Relevant literature on MB combined with myocardial infarction (MI) was searched from 1991 to 2023 in the Web of Science database, and was analyzed by bibliometric analysis using VOSviewer, CiteSpace, and the R package “bibliometrix.”

Results:
A total of 1233 English articles were included in this study. The number of published articles showed an increasing trend yearly. From 2017 to 2022, the annual publication volume rose rapidly, and in 2021 the publication volume even reached 95 articles, which was the highest in all years. These publications were from 68 countries and 1854 institutions, with the leading country being the U.S. and the leading institution being Columbia University. Myoho Clinical International has a close collaborative relationship with Columbia University, while in recent years, the Harvard Medical School has explored the study of MB combined with MI. Annals of Thoracic Surgery was the journal with the highest number of publications, and Takayama Hiroo and Naka Yoshifumi were the authors with the highest number of publications. The most common keywords were MI, cardiogenic shock, and MB.

Conclusions:
Our findings can help researchers explore the current status of MB combined with MI research and choose new survey routes for upcoming studies. Prevalence and prognosis, mechanism of MB combined with MI and molecular mechanism may become the focus of future research. In addition, more research and cooperation are needed worldwide.