bluuebunny/crossref_metadata_2025_split huggingface dataset:
Floral morph variation mediated by clonal growth and pollinator functional groups of Limonium otolepis in a heterostylous fragmented population
Authors: Ren Dengfu , Jiao Fangfang , Zhang Aiqin , Zhao Jing , Zhang Jing 
Published: March 2024

Abstract
Abstract. Heterostyly, a genetic style polymorphism, is linked to symmetric pollen transfer, vital for its maintenance. Clonal growth typically impacts sexual reproduction by influencing pollen transfer. However, the floral morph variation remains poorly understood under the combined effects of pollinators and clonal growth in heterostyly characterized by negative frequency-dependent selection and disassortative mating. We estimated morph ratios, ramets per genet and heterostylous syndrome and quantified legitimate pollen transfer via clonal growth, pollinators and reciprocal herkogamy between floral morphs in Limonium otolepis, a fragmented population composed of five subpopulations in the desert environment of northwestern China, with small flower and large floral morph variation. All subpopulations but one exhibited pollen-stigma morphology dimorphism. The compatibility between mating types with different pollen-stigma morphologies remained consistent regardless of reciprocal herkogamy. Biased ratios and ramets per genet of the two mating types with distinct pollen-stigma morphologies caused asymmetric pollen flow and varying fruit sets in all subpopulations. Short-tongued insects were the primary pollinators due to small flower sizes. However, pollen-feeding Syrphidae sp. triggered asymmetry in pollen flow between high and low sex organs, with short-styled morphs having lower stigma pollen depositions and greater variation. Clonal growth amplified this variation by reducing intermorph pollen transfer. All in all, pollinators and clonal growth jointly drive floral morph variation. H-morphs with the same stigma-anther position and self-incompatibility, which mitigate the disadvantages of sunken low sex organs with differing from the classical homostyly, might arise from long- and short-styled morphs through a ‘relaxed selection’. This study is the first to uncover the occurrence of the H-morph and its associated influencing factors in a distylous plant featuring clonal growth, small flowers and a fragmented population.
Clinical and gonadal transcriptome analysis of 38,XX disorder of sex development pigs
Authors: Wu Jinhua , Tan Shuwen , Zhou Yi , Zhao Haiquan , Yu Hui , Zhong Bingzhou , Yu Congying , Wang Haoming , Yang Yin , Li Hua , Li Yugu 
Published: March 2024

Abstract
Pigs serve as a robust animal model for the study of human diseases, notably in the context of disorders of sex development (DSD). This study aims to investigate the phenotypic characteristics and molecular mechanisms underlying the reproductive and developmental abnormalities of 38,XX ovotestis-DSD (OT-DSD) and 38,XX testis-DSD (T-DSD) in pigs. Clinical and transcriptome sequencing analyses were performed on DSD and normal female pigs. Cytogenetic and SRY analyses confirmed that OT/T-DSD pigs exhibited a 38,XX karyotype and lacked the SRY gene. The DSD pigs had higher levels of follicle-stimulating hormone, luteinizing hormone, and progesterone, but lower testosterone levels when compared with normal male pigs. The reproductive organs of OT/T-DSD pigs exhibit abnormal development, displaying both male and female characteristics, with an absence of germ cells in the seminiferous tubules. Sex determination and development-related differentially expressed genes shared between DSD pigs were identified in the gonads, including WT1, DKK1, CTNNB1, WTN9B, SHOC, PTPN11, NRG1, and NXK3–1. DKK1 is proposed as a candidate gene for investigating the regulatory mechanisms underlying gonadal phenotypic differences between OT-DSD and T-DSD pigs. Consequently, our findings provide insights into the molecular pathogenesis of DSD pigs and present an animal model for studying into DSD in humans.
Case weighted power priors for hybrid control analyses with time-to-event data
Authors: Kwiatkowski Evan , Zhu Jiawen , Li Xiao , Pang Herbert , Lieberman Grazyna , Psioda Matthew A 
Published: March 2024

ABSTRACT
We develop a method for hybrid analyses that uses external controls to augment internal control arms in randomized controlled trials (RCTs) where the degree of borrowing is determined based on similarity between RCT and external control patients to account for systematic differences (e.g., unmeasured confounders). The method represents a novel extension of the power prior where discounting weights are computed separately for each external control based on compatibility with the randomized control data. The discounting weights are determined using the predictive distribution for the external controls derived via the posterior distribution for time-to-event parameters estimated from the RCT. This method is applied using a proportional hazards regression model with piecewise constant baseline hazard. A simulation study and a real-data example are presented based on a completed trial in non-small cell lung cancer. It is shown that the case weighted power prior provides robust inference under various forms of incompatibility between the external controls and RCT population.
Putting Outcomes into Practice: The Implementation of a Framework of Outcome Measures within a Child and Family Service
Authors: Flynn Susan , Lakkshme Sundaresan Sowmia , Caffrey Louise 
Published: March 2024

Abstract
Of utmost concern for effective child protection and child and family services is evidence-based practice. There is an onus of accountability on providers of therapeutic services to establish the merit and cost efficiency of their work. Developing standardised evidence-based outcome measures for children and families, towards which the service provider can strive, is assuredly required as a yardstick against which progress can be measured and modified. Yet, outcome measures will only work in conducive organisational conditions. Specifically, to operationalise a suite of outcome measures into a complex organisation, from administrative policy to grassroots practice, requires understanding of barriers and facilitators of implementation. Through funded research, we investigate these factors within the implementation of a new outcomes framework in a European child and family service. Following a literature review exercise, qualitative research findings from two focus groups targeted, respectively, at the managerial and front line practitioner level, illuminate complex conditions and underlying mechanisms, as well as attitudinal, resource and knowledge factors upon which implementation is predicated. We conclude with recommendations around establishing sustainable conditions and arrangements in organisations, to ensure outcome measures act as effective instruments, rather than costly and dispensable paper exercises.
A phylogenomic reconstruction of the Endangered Malagasy tree genusCapurodendron(Sapotaceae) with nine new species and an identification key
Authors: Boluda Carlos G , Naciri Yamama , Gautier Laurent 
Published: March 2024

AbstractCapurodendron is the second largest endemic genus of vascular plants in Madagascar. It comprises mainly trees that are frequently logged for their valued wood. This, together with deforestation, led to 76% of the known species being Endangered or Critically Endangered. However, a confident species identification is often not possible with the current available literature and many morphotypes do not fit any described taxa, which has impeded the implementation of conservation measures. We performed a phylogenomic revision studying c. 900 collections morphologically, and sequencing 638 nuclear genetic markers of 180 representative specimens up to 90 years old, including all the described species and some undescribed morphotypes. Our results show that Capurodendron may contain up to 21 undescribed species in addition to the 35 already known. Nine of these are confirmed as valid species supported by genetic, morphological, and ecological data, and we describe them here (Capurodendron ainae, C. ambanizanense, C. antilahimenae, C. christeae, C. nataliae, C. ratovosonii, C. razakamalalae, C. sommerae, and C. vulcanicola). For the remaining 12 candidate new species, three are genetically analysed but require more sampling, and nine are only supported by morphological and ecological data so far, and therefore require genetic analyses to confirm their validity. For practical purposes and to assist with conservation assessments we provide an identification key, based mainly on vegetative characters, that also include the undescribed species.
Pollination of thermogenic inflorescence of Pandanus odorifer by a specialist Amystrops sap beetle that reproduces on the male inflorescence
Authors: Miyamoto Toru , Mochizuki Ko , Kawakita Atsushi 
Published: March 2024

Abstract
Pandanus is a morphologically unique plant group of the Paleotropical flora, with approximately 450 known species occupying diverse habitats. Because the male inflorescences of this genus are pendent and nectarless, they are commonly assumed to be wind-pollinated; however, their floral scent coupled with the observation that female inflorescences mature while still covered by bracts suggest the possibility of an alternative pollination mechanism. We studied the pollination system of Pandanus odorifer in subtropical Japan. A peroxidase assay was conducted to determine the timing of stigma receptivity, which showed that the stigmas were sensitive to peroxidase while the female inflorescences were covered by bracts. We found numerous pollen-bearing adult beetles of the genus Amystrops on both male and female inflorescences. Nitidulid larvae were also found on male inflorescences, and the larvae became adults of the same Amystrops species as found on the inflorescences by feeding only on Pandanus pollen. Last, floral temperature was monitored to test for floral thermogenesis. Both male and female inflorescences were thermogenic at night when insect visitation occurred. This study provides the first examples of insect pollination and floral thermogenesis in Pandanaceae. Most known Amystrops species are associated with Pandanus inflorescences, suggesting a widespread, specialized Pandanus–Amystrops association.
Inflation regimes and hyperinflation: a Post-Keynesian/structuralist typology
Authors: Bastian Eduardo F , Charles Sébastien , Marie Jonathan 
Published: March 2024

Abstract
The article proposes a typology of inflation regimes based on the Post-Keynesian and structuralist literature. We identify three separate regimes: the low, moderate and high inflation regimes. Hyperinflation is also defined and described. Each regime presents different characteristics. We identify the key role played by the distributive conflict between workers and capitalists in all the regimes, the role played by the indexation of wages on domestic prices in the moderate and high inflation regimes and the specific roles played by the widespread indexation on a short-term basis in the high inflation regime. Hyperinflation is explained by self-fulfilling prophecies about exchange rate variations and by the rejection of the domestic currency.
Case report: the ‘vanished’ left pulmonary artery
Authors: Chan Jiahui Charmaine , Kotecha Monika Kantilal , Choo Jonathan Tze Liang , Fortier Marielle V , Sundararaghavan Sreekanthan 
Published: March 2024

Abstract

Background
We report a case of isolated ductal origin of pulmonary artery (DOPA) diagnosed in an asymptomatic newborn. The primary aim of this case is to highlight the need to investigate for DOPA in patients diagnosed with an ‘absent branch pulmonary artery’.

Case summary
Our patient was an asymptomatic newborn infant, with normal intracardiac anatomy. He was initially diagnosed post-natally with ‘absent left pulmonary artery’ (LPA), though the LPA was seen in antenatal scans. He underwent angiography and was re-diagnosed with bilateral arterial ducts, with ductal origin of the LPA from the left arterial duct. The LPA was salvaged by first stenting the left arterial duct on Day 11 of life, with subsequent surgery to connect the LPA to the main pulmonary artery at 4.5 months old. The patient had an uneventful recovery after the surgery.

Discussion
Ductal origin of pulmonary artery is a rare vascular anomaly characterized by continuity of the left or right pulmonary artery (PA) with the distal end of the arterial duct, and discontinuity with the main PA. It is commonly misdiagnosed as pulmonary artery agenesis when the patent arterial duct constricts, with cessation of blood flow into the affected pulmonary artery. A high index of suspicion is necessary for diagnosis of DOPA. Once diagnosed, this lesion is clearly amenable to intervention, with benefits from unifocalization, to prevent late onset pulmonary hypertension or cardiac failure.
Impact of multimorbidity patterns on outcomes and treatment in patients with coronary artery disease
Authors: Zheng Wen , Huang Xin , Wang Xiao , Suo Min , Yan Yan , Gong Wei , Ai Hui , Que Bin , Nie Shaoping 
Published: March 2024

Abstract

Aims
With an aging population and better survival rates, coronary artery disease (CAD) with multimorbidity has become more prevalent, complicating treatment and impacting life quality and longevity. This study identifies multimorbidity patterns in CAD patients and their effect on clinical outcomes, emphasizing treatment strategies.

Methods and results
The study analysed data from the DCEM registry (173 459 patients) and BleeMACS cohort (15 401 patients) to categorize CAD patients into three multimorbidity patterns. The focus was on how these patterns influence outcomes, especially concerning the efficacy and safety of dual antiplatelet therapy (DAPT). The study identified three distinct multimorbidity patterns: Class 1 encompassed cardiovascular–kidney–metabolic comorbidities indicating the highest risk; Class 2 included hypertension–dyslipidaemia comorbidities, reflecting intermediate risk; and Class 3 involved non-specific comorbidities, indicating the lowest risk. Class 1 patients demonstrated a six-fold increase in in-hospital mortality and a four-fold increase in severe in-hospital complications compared with Class 3. Over a 1-year period, Class 1 was associated with the highest risk, displaying a significant increase in all-cause mortality [adjusted hazard ratio (HR) 1.87, 95% confidence interval (CI) 1.52–2.31, P &lt; 0.001] and a notable risk for major bleeding (adjusted HR 1.74, 95% CI 1.36–2.24, P &lt; 0.001) compared with Class 3. The use of DAPT, particularly aspirin combined with clopidogrel, significantly reduced the 1-year all-cause mortality in Class 1 patients (adjusted HR 0.60, 95% CI 0.37–0.98, P = 0.04) without increasing in major bleeding.

Conclusion
Coronary artery disease patients with a cardiovascular–kidney–metabolic profile face the highest mortality risk. Targeted DAPT, especially aspirin and clopidogrel, effectively lowers mortality without significantly raising bleeding risks.

Registration
DCEM registry (NCT05797402) and BleeMACS registry (NCT02466854).
Current frailty knowledge, awareness, and practices among physicians following the 2022 European consensus document on Frailty in Cardiology
Authors: Wong Jie Jun , Wang Laureen Yi-Ting , Hasegawa Koji , Ho Kay Woon , Huang Zijuan , Teo Louis L Y , Tan Jack Wei Chieh , Kasahara Kazuyuki , Tan Ru-San , Ge Junbo , Koh Angela S 
Published: March 2024

Abstract

Aims
Aging-related cardiovascular disease and frailty burdens are anticipated to rise with global aging. In response to directions from major cardiovascular societies, we investigated frailty knowledge, awareness, and practices among cardiologists as key stakeholders in this emerging paradigm a year after the European Frailty in Cardiology consensus document was published.

Methods and results
We launched a prospective multinational web-based survey via social networks to broad cardiology communities representing multiple World Health Organization regions, including Western Pacific and Southeast Asia regions. Overall, 578 respondents [38.2% female; ages 35–49 years (55.2%) and 50–64 years (34.4%)] across subspecialties, including interventionists (43.3%), general cardiologists (30.6%), and heart failure specialists (HFSs) (10.9%), were surveyed. Nearly half had read the consensus document (38.9%). Non-interventionists had better perceived knowledge of frailty assessment instruments (fully or vaguely aware, 57.2% vs. 45%, adj. P = 0.0002), exercise programmes (well aware, 12.9% vs. 6.0%, adj. P = 0.001), and engaged more in multidisciplinary team care (frequently or occasionally, 52.6% vs. 41%, adj. P = 0.002) than interventionists. Heart failure specialists more often addressed pre-procedural frailty (frequently or occasionally, 43.5% vs. 28.2%, P = 0.004) and polypharmacy (frequently or occasionally, 85.5% vs. 71%, adj. P = 0.014) and had consistently better composite knowledge (39.3% vs. 21.6%, adj. P = 0.001) and practice responses (21% vs. 11.1%, adj. P = 0.018) than non-HFSs. Respondents with better knowledge responses also had better frailty practices (40.3% vs. 3.6%, adj. P &lt; 0.001).

Conclusion
Distinct response differences suggest that future strategies strengthening frailty principles should address practices peculiar to subspecialties, such as pre-procedural frailty strategies for interventionists and rehabilitation interventions for HFSs.
Increased risk of diabetes mellitus and hyperlipidemia in patients with differentiated thyroid cancer
Authors: Ahn Hwa Young , Lee Jooyoung , Kang Jinmo , Lee Eun Kyung 
Published: March 2024

Abstract

Objective
This study aimed to assess the risk of cardiometabolic disease (CMD) in patients with differentiated thyroid cancer (DTC) using a population-based nationwide cohort in Korea.

Design
This was a population-based cohort study.

Methods
We selected 2649 patients with DTC and 7947 matched controls. The primary outcome was the composite of CMD including diabetes mellitus (DM), hypertension, hyperlipidemia, cerebrovascular disease, and ischemic heart disease. The secondary outcomes were each individual type of CMD, all-cause mortality, and CMD-specific mortality. The cause-specific hazard ratios (HRs) for each outcome were estimated based on cause-specific Cox proportional hazard regression models.

Results
Patients with DTC had an 11% higher risk of the primary composite outcome than controls (HR, 1.11; 95% confidence interval [CI], 1.04–1.19). The risks of DM (HR, 1.22; 95% CI, 1.08–1.38) and hyperlipidemia (HR, 1.36; 95% CI, 1.24–1.48) were higher in patients with DTC. In contrast, the risk of CMD-specific mortality was lower in those with DTC (HR, 0.24; 95% CI, 0.09–0.68). A nonlinear, U-shaped relationship was observed between the daily dose of levothyroxine and the risk of DM (P = .021), but the risk of hyperlipidemia was low with high doses of levothyroxine in patients with DTC (P = .003).

Conclusions
Patients with DTC had an increased risk of CMD, especially DM and hyperlipidemia, but a low risk of CMD mortality. Special attention to metabolic diseases is required in the long-term follow-up of patients with DTC.
A call for action to include psychosocial management into holistic, integrated care for patients with atrial fibrillation
Authors: Brandes Axel , Pedersen Susanne S , Hendriks Jeroen M 
Published: March 2024

Abstract
Contemporary management of atrial fibrillation (AF) has become increasingly complex. Therefore, strong efforts have been made during the past decade to develop models for structured, integrated care for patients with AF. These have also been incorporated in international guidelines for the management of patients with AF. However, implementation of integrated care approaches in daily clinical practice is scarce and far from optimal, and it may require a re-thinking of the structure of the healthcare system. The reasons for the poor implementation are many, from limited time and economic resources to deficits in postgraduate education of healthcare professionals, lack of involvement of patients in how integrated care should be designed, and fragmentation of the healthcare system. Moreover, patients’ psychological challenges, which not only impact patients’ adherence to treatment but, if untreated, increase their risk of morbidity, mortality, and poor quality of life, are not given sufficient attention. It is time to start a necessary discussion of what integrated care should be, what it should contain, and what is necessary to implement it in daily clinical practice.
Bacterial and fungal communities in sub-Arctic tundra heaths are shaped by contrasting snow accumulation and nutrient availability
Authors: Männistö Minna K , Ahonen Saija H K , Ganzert Lars , Tiirola Marja , Stark Sari , Häggblom Max M 
Published: March 2024

Abstract
Climate change is affecting winter snow conditions significantly in northern ecosystems but the effects of the changing conditions for soil microbial communities are not well-understood. We utilized naturally occurring differences in snow accumulation to understand how the wintertime subnivean conditions shape bacterial and fungal communities in dwarf shrub-dominated sub-Arctic Fennoscandian tundra sampled in mid-winter, early, and late growing season. Phospholipid fatty acid (PLFA) and quantitative PCR analyses indicated that fungal abundance was higher in windswept tundra heaths with low snow accumulation and lower nutrient availability. This was associated with clear differences in the microbial community structure throughout the season. Members of Clavaria spp. and Sebacinales were especially dominant in the windswept heaths. Bacterial biomass proxies were higher in the snow-accumulating tundra heaths in the late growing season but there were only minor differences in the biomass or community structure in winter. Bacterial communities were dominated by members of Alphaproteobacteria, Actinomycetota, and Acidobacteriota and were less affected by the snow conditions than the fungal communities. The results suggest that small-scale spatial patterns in snow accumulation leading to a mosaic of differing tundra heath vegetation shapes bacterial and fungal communities as well as soil carbon and nutrient availability.
Monitoring Progress Towards the Elimination of Hepatitis C as a Public Health Threat in Norway: A Modelling Study Among People Who Inject Drugs and Immigrants
Authors: Whittaker Robert , Midtbø Jørgen E , Kløvstad Hilde 
Published: March 2024

Abstract

Background
The global incidence target for the elimination of hepatitis C among people who inject drugs (PWID) is &lt;2/100. In Norway, the hepatitis C epidemic is concentrated in PWID. Immigrants are the second most important risk group for chronic infection. We modelled the incidence of hepatitis C among active PWID, and the prevalence of chronic infection among active PWID, ex-PWID, and immigrants in Norway to 2022.

Methods
We built a stochastic compartmental model, which was informed using data from national data sources, literature, and expert opinion. We report median values with 95% credible intervals (CrI).

Results
The model estimated 30 (95% Crl, 13–52) new infections among active PWID in 2022, or 0.37/100 (95% Crl, 0.17–0.65), down from a peak of 726 (95% Crl, 506–1067) in 2000. Across all groups, the model estimated 3202 (95% Crl, 1273–6601) chronically infected persons in 2022. Results were robust in sensitivity analyses.

Conclusions
Norway provides an example of the feasibility of hepatitis C elimination in a setting with a concentrated epidemic, high coverage of harm reduction services, and no treatment restrictions. Continued momentum is needed to further reduce the transmission and burden of hepatitis C in Norway.