bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genitourinary Fistula: epidemiology, changing trends in etiology and management: A tertiary care institute’s perspective
Authors: Vikram Singh , Om Kumar Yadav , Arjun Singh Sandhu , Mahendra Singh , Deepak Prakash Bhirud , Shashank Tripathi , Priyank Bhargava , Rahul Jena , Shivcharan Navriya , Gautam Ram Choudhary 
Published: March 2024

Introduction: Urogenital fistula is a physically, socially and psychologically devastating condition for the patient. In developed countries, these fistulae are typically related to gynecological surgery, pelvic pathology like malignancy or post radiation therapy. In contrast, classical teaching is that urogenital fistulae in the developing countries like India are usually associated with prolonged labor and obstetric complications. This retrospective study conducted at a tertiary care health Institute shows a paradigm shift in epidemiology, etiology and management of genitourinary fistulae in India in recent times. Methods: This retrospective study included patients undergoing surgical repair for various genitourinary fistulae at our institute from 2016 to 2022. Epidemiology, etiology, site, size and number of fistulae, clinical presentation, and management records of these patients were recorded and reviewed retrospectively. Results: In our study, the mean age of the patients was 38.4 ± 10.2 years. Vesicovaginal Fistula (VVF) was found to be most common fistula in the study population (87.5%) followed by vesicouterine (7.1%) and urethrovaginal fistula (5.4%). The causes of genitourinary fistula were iatrogenic (73.2%), carcinoma of cervix (16.1%), obstructed prolonged labor (7.1%), and genitourinary tuberculosis (3.57%). Among the 48 vesicovaginal fistulas that underwent surgery, 45.8% were treated using a transvaginal approach, 29.2% were managed through a laparoscopic transabdominal repair, and 25% were addressed using a robotic approach. Recurrence occurred in 7.1% of the operated patients. Conclusion: Enhanced healthcare services in the country have contributed to a decrease in the incidence of obstructed labor, subsequently reducing related injuries. Iatrogenic injuries resulting from gynecological surgeries and carcinoma cervix have given rise to more complex fistulas, necessitating the implementation of advanced treatment strategies.
The Analgesic Mechanism of Radix Wikstroemia indica “Sweat Soaking Method” Processed Product Based on Metabolomics and Network Pharmacology
Authors: Han Caiyao , Feng Guo , Ren Chenchen , Li Wei , Liu Wen , Liu Gang , Song Xueli , Zhang Ju , Lei Yan , He Zhengyan , Liu Tingting , Ma Kexin , Hou Jinxin 
Published: March 2024

Background Miao medicine Radix Wikstroemia indica (RWI) is derived from the root of W. indica (L.) C. A. Mey. which has an analgesic effect, but its mechanism is not clear. Because of the toxicity of RWI, the research group used the “Sweat soaking method” to process RWI in the early stage to reduce its toxicity. Therefore, this study explored the analgesic effect and mechanism of processed RWI through network pharmacology and metabolomics. Purpose To explore the analgesic effect and therapeutic mechanism of RWI processed by “Sweat soaking method”. Materials and Methods The torsion experiment was carried out with acetic acid. The metabolomic analysis of serum samples was carried out based on 1H-NMR technology, and the intersection targets of RWI and pain diseases were screened by network pharmacology for gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Results RWI has an analgesic effect and is related to metabolites such as 4-pyridoxic acid, l-glutamic acid, and agmatine. It is involved in arginine and proline metabolism, arginine biosynthesis, and alanine, aspartate, and glutamate metabolism. In network pharmacology, there were 404 common targets between RWI and pain diseases, and eight core targets were screened, including SRC, STAT3, and HSP90AA1. GO functional enrichment analysis found that RWI had effects on molecular processes such as protein phosphorylation and response to xenobiotic stimulus, cell composition such as receptor complex and membrane raft, and molecular functions such as enzyme binding. KEGG pathway enrichment analysis obtained 193 pathways. Arginine proline metabolism and nitrogen metabolism are involved in the same pathway as metabolomic analysis. Conclusion RWI has an analgesic effect, and its therapeutic mechanism mainly involves arginine and proline metabolism.
CRYL1 is a Potential Prognostic Biomarker of Clear Cell Renal Cell Carcinoma Correlated with Immune Infiltration and Cuproptosis
Authors: Li Peng , Xu Qiangqiang , Liu Ken , Ye Junjie 
Published: March 2024

Background Clear cell renal cell carcinoma (ccRCC) is a widespread urogenital neoplasm. However, the therapeutic efficacy of these methods is unsatisfactory. In-depth screening of biomarkers could aid early diagnosis and therapy and predict patient prognosis. Methods The GEO datasets were selected with specific criteria. Differentially expressed gene (DEG), weighted gene coexpression network analysis (WGCNA), protein–protein interaction, LASSO, random forest, and Cox regression analyses were applied to identify the independent prognostic biomarkers. Survival analysis, correlation with clinical features, gene set enrichment analysis (GSEA), GO enrichment, immune infiltration analysis, and correlation with cuproptosis-related genes were carried out to determine the prognostic value and possible molecular mechanisms of the TSVR. Wound healing assays, transwell assays, cell colony formation experiments, flow cytometry, and immunohistochemistry (IHC) analysis were used to validate the functional attributes of CRYL1. Results Four GEO datasets were included to screen for hub genes. DEG combined with WGCNA showed a key module with 300 genes having the strongest correlation with “survival state” (R2 = -0.24 and P = 7e−8); six genes were identified by LASSO, random forest, and Cytoscape. Finally, CRYL1 (hazard ratio (HR) = 2.01, P < 0.001) was selected as an independent prognostic biomarker. The higher CRYL1 expression group had better DFS and overall survival (OS). GSEA demonstrated that the CRYL1-related DEGs were enriched mainly in the metabolism of sugar, fat, and amino acids. CRYL1 is positively correlated with FDX1 and the LIAS pathway, which are important molecule involved in cuproptosis. CRYL1 affects the infiltration abundance of four immune cells and can predict a positive OS. Wound healing, transwell, cell colony formation, and flow cytometry assays demonstrated that CRYL1 silencing enhances migration and proliferation and leads to a decreased apoptotic ratio. IHC analysis suggested that CRYL1 was highly expressed in adjacent tissues. Conclusions CRYL1 is a robust predictive marker for clinicopathological characteristics and survival status in ccRCC patients.
Management of periprosthetic humerus fractures after shoulder arthroplasty
Authors: Cox Ryan M , Mandava Nikhil , Vaughan Alayna , Ramsey Matthew L , Getz Charles L , Namdari Surena 
Published: March 2024

Background The purpose of this retrospective study was to analyze time to fracture union, complications, and outcomes of postoperative periprosthetic humerus fractures after primary shoulder arthroplasty. Methods Retrospective review of patients who sustained a postoperative periprosthetic humerus fracture after primary shoulder arthroplasty at a single institution. Fractures were classified according to the Worland Classification system. Both non-operatively and operatively treated patients were included. The primary study outcomes were time to union and complications. Results There were 46 patients who sustained a postoperative periprosthetic humerus fracture after primary shoulder arthroplasty, 18 were treated non-operatively and 28 were treated operatively. There were seven (25%) patients who underwent surgery after failed non-operative management. There was only one (2.2%) patient who had a nonunion at final follow-up. The average American Shoulder and Elbow Surgeons Shoulder Score, Single Assessment Numeral Evaluation, and visual analog scale pain scores were 73.5 ± 22.7, 66.5 ± 23.1, and 2.2 ± 2.4, respectively. Conclusion There was a high rate of union for both non-operatively and operatively treated periprosthetic fractures. However, there was a high rate of cross-over from non-operative to operative treatment and a high complication rate for both cohorts. For properly indicated patients, non-operative and operative treatment can result in satisfactory patient outcomes.
Rural/Urban differences in uptake of preventive healthcare services: Variability in observed relationships across measures of rurality
Authors: Calatayud Brittney M , Moss Jennifer L 
Published: March 2024

Rural residents are generally less likely to receive preventive healthcare than are urban residents, but variable measurement of rurality introduces inconsistency to these findings. We assessed the relationships between perceived and objective measures of rurality and uptake of preventive healthcare. In our sample, rural participants generally had equal or higher uptake of healthcare (i.e. private health insurance, check-up in the past year, being up-to-date on colorectal and cervical cancer screening) than urban participants. Importantly, the perceived measure of rurality performed similarly to the objective measures, suggesting that participant report could be a valid way to assess rurality in health studies. Significance for Public Health The ability to access routine preventive healthcare is a key component of public health. Comparing uptake of cancer screening in rural versus urban areas is one way to assess equity of healthcare access. Generally, rural areas have a higher burden of cancer than urban areas. The built environment, socioeconomic status, and patient perceptions can impact an individual’s access to routine cancer screening. Preventive healthcare is of great importance to public health as a whole because screening can facilitate earlier diagnosis and more successful treatment for many preventable cancers, which may ultimately increase the quality and quantity of life.
Depression in Final-Year Medical Students in Ho Chi Minh City, Vietnam: The Role of Career-Choice Motivation
Authors: Uyen Binh Pham Duong , Vo Thi Minh Tam , Hoai Do Thuong Thi , Huynh Giao , Tran Mai Hoang , Phung Hai Ngoc , An Pham Le 
Published: March 2024

OBJECTIVES Depression in medical students is concerning, potentially fueled by many stressors including career choice-relating stress. Choosing Medicine is a life-long commitment, and low intrinsic motivation or excessive dependence on family can complicate this decision and adding stress throughout their training. This stress intensifies in the final year, as students lacking personal drive struggle to see themselves continuing the career. Given limited studies on this crucial topic in Asia and Vietnam, we explored direct linkage between career choice motivation and depression in final-year medical students. METHODS A cross-sectional study was conducted with 569 final-year students between June and July 2020. The Vietnamese Patient Health Questionnaire 9 (PHQ-9) and 16-item CCM questionnaire were used as survey tools. Univariate analysis was used for descriptive statistics (absolute and relative frequency, mean (M), standard deviation (SD). Multinomial logistic regression models were used to explore the relationship between variables using STATA 5.1. RESULTS The depression among participants was about 24.6% (PHQ-9 cut-off ≥ 12). No difference in gender was found regarding depression. The most acknowledged motivator is securing employment (M = 4.14, SD = 1.02) and the least is parental wishes (M = 3.17, SD = 1.32). Familial influence on career choice significantly increased odds of having “ moderately-severe depression” (OR = 1.17, 95% CI 1.04-1.32) and “ severe depression” (OR = 1.36, 95% CI 1.10-1.68), whereas, career-choice motivators including satisfaction (OR = .76, 95% CI .60-.97), self-competence (OR = .80, 95% CI .66-.97) and career success (OR = .84, 95% CI .71-.99) were found to be protective factors for depression. CONCLUSIONS Roughly a quarter of final-year medical students encountered depression. Occupational security ranked as the primary motivator, with parental wish being the least. Familial influence heightened depression risk, while career prospects, satisfaction and self-efficacy acted as protective factors. Medical career paths should align with intrinsic motivations and personal interests for better mental health outcomes.
Shared Medical Appointment: A Novel Model for Incorporating Group Visits Into Residency Training for Substance Use Disorders
Authors: Cavallo Dana A. , Salwan Jasleen K. , Doernberg Molly , Tetrault Jeanette M. , Holt Stephen R. 
Published: March 2024

Background: Shared medical appointments (SMAs) are a novel modality for treating patients with similar conditions, together, by a team of interdisciplinary providers. SMAs benefit patients with substance use disorder (SUD), but no research has focused on the feasibility of implementation of SMAs in a teaching clinic. Methods: Primary care residents rotated in a half-day ambulatory addiction clinic for 4 weeks where a third-year resident co-facilitated 4 SMAs. Confidence, knowledge, and attitudes about SUD care were assessed using web-based surveys at weeks 0, 4, and 8. Pre- and post-intervention scores were compared using a t test for paired samples. Results: Ten residents were included in the analyses. Using a 10-point Likert scale, confidence in SUD knowledge (7.0-8.3, P = .003), confidence in counseling patients with SUD (7.1-8.2, P = .023), and confidence in facilitating an SMA (5.7-8.3, P = .007) showed statistically significant increases from baseline following exposure to the SMAs. Confidence that counseling and other treatments will make a difference for patients with illicit drug use increased (7.1-8.0, P = .142), but did not differ statistically. Furthermore, on a 4-point Likert scale, understanding of behavioral therapies for treating and preventing the relapse of SUD (2.9-3.2, P = .180) showed a similar increase. Attitudes toward patients with SUD (42.4-42.1, P = .303) and physician empathy (119.3-119.2, P = .963) did not change from pre- to post-intervention. Conclusions: SMAs are a feasible training tool in the education of primary care residents on an addiction medicine rotation. Residents develop confidence co-facilitating SMAs after 4 weeks. Overall, exposure to SMAs during residency can provide an opportunity to increase confidence in treating patients with SUD, as well as provide a training modality that may shift the way residents interact with patients receiving SUD treatment.
Model Parameters Identification and Backstepping Control of Lower Limb Exoskeleton Based on Enhanced Whale Algorithm
Authors: Shi Yan , Kou Jiange , Chen Zhenlei , Wang Yixuan , Guo Qing 
Published: March 2024

AbstractExoskeletons generally require accurate dynamic models to design the model-based controller conveniently under the human-robot interaction condition. However, due to unknown model parameters such as the mass, moment of inertia and mechanical size, the dynamic model of exoskeletons is difficult to construct. Hence, an enhanced whale optimization algorithm (EWOA) is proposed to identify the exoskeleton model parameters. Meanwhile, the periodic excitation trajectories are designed by finite Fourier series to input the desired position demand of exoskeletons with mechanical physical constraints. Then a backstepping controller based on the identified model is adopted to improve the human-robot wearable comfortable performance under cooperative motion. Finally, the proposed Model parameters identification and control are verified by a two-DOF exoskeletons platform. The knee joint motion achieves a steady-state response after 0.5 s. Meanwhile, the position error of hip joint response is less than 0.03 rad after 0.9 s. In addition, the steady-state human-robot interaction torque of the two joints is constrained within 15 $${\text{N}\cdot\text{m}}$$

N
·
m

. This research proposes a whale optimization algorithm to optimize the excitation trajectory and identify model parameters. Furthermore, an enhanced mutation strategy is adopted to avoid whale evolution's unsatisfactory local optimal value.
A comparative study on biosynthesized silver nanoparticles from H. undatus fruit peel and their therapeutic applications
Authors: Anguraj Aswini , Michael Helan Soundra Rani , Sugumaran Sathish , Madhusudhanan Gogul Ramnath , Sivaraman Rathish Kumar 
Published: March 2024

AbstractThe green synthesis of nanoparticles (NPs) gained significant impacts in various fields due to the use of eco-friendly approaches. In this study, silver nanoparticles (AgNPs) were synthesized from the aqueous extract of Hylocereus undatus fruit peel. The presence of AgNPs was analysed using characterization methods such as UV‒Vis, FTIR, GCMS, XRD, EDAX, and FESEM. The synthesized AgNPs showed greater antibacterial activity against Escherichia coli than against Streptococcus pneumoniae. The antifungal activity against Candida albicans was greater than that against Candida tropicalis. The IC50 value for the antibiofilm activity of the AgNPs was 2.81 µg/mL, whereas that of the H. undatus peel extract was 1.34 µg/mL. The invitro antioxidant activity of the AgNPs was evaluated using two different methods. The DPPH radical scavenging activity of the AgNPs and fruit peel extract was observed with IC50 values of 3.8 and 2.03 µg/mL respectively. On the other hand, nitric oxide radical scavenging activities were recorded and the IC50 values were calculated to be 2.8 and 2.3 µg/mL. The AgNPs demonstrated thrombolytic activity in human blood with 10, 32.36, and 56.25% lysis. The cytotoxicity of the AgNPs was minimal, with an IC50 of 0.2 µg/mL and the peel extract had the greatest cytotoxicity with an IC50 of 0.3 µg/mL. The findings of this study demonstrated that the synthesized AgNPs from H. undatus peel extract could be potential candidates for treating prostate cancer.
Graphical abstract
Fitness difference between two synonymous mutations of Phytophthora infestans ATP6 gene
Authors: Nkurikiyimfura Oswald , Waheed Abdul , Fang Hanmei , Yuan Xiaoxian , Chen Lixia , Wang Yan-Ping , Lu Guodong , Zhan Jiasui , Yang Lina 
Published: March 2024

Abstract
Background
Sequence variation produced by mutation provides the ultimate source of natural selection for species adaptation. Unlike nonsynonymous mutation, synonymous mutations are generally considered to be selectively neutral but accumulating evidence suggests they also contribute to species adaptation by regulating the flow of genetic information and the development of functional traits. In this study, we analysed sequence characteristics of ATP6, a housekeeping gene from 139 Phytophthora infestans isolates, and compared the fitness components including metabolic rate, temperature sensitivity, aggressiveness, and fungicide tolerance among synonymous mutations.

Results
We found that the housekeeping gene exhibited low genetic variation and was represented by two major synonymous mutants at similar frequency (0.496 and 0.468, respectively). The two synonymous mutants were generated by a single nucleotide substitution but differed significantly in fitness as well as temperature-mediated spatial distribution and expression. The synonymous mutant ending in AT was more common in cold regions and was more expressed at lower experimental temperature than the synonymous mutant ending in GC and vice versa.

Conclusion
Our results are consistent with the argument that synonymous mutations can modulate the adaptive evolution of species including pathogens and have important implications for sustainable disease management, especially under climate change.
Biodiversity and distribution patterns of blooming jellyfish in the Bohai Sea revealed by eDNA metabarcoding
Authors: Ye Lijing , Peng Saijun , Ma Yuanqing , Zhang Wenjing , Wang Lei , Sun Xiyan , Zhang Chen , Yeasmin Munjira , Zhao Jianmin , Dong Zhijun 
Published: March 2024

Abstract
Background
The mass occurrence of scyphozoan jellyfish severely affects marine ecosystems and coastal economies, and the study of blooming jellyfish population dynamics has emerged in response. However, traditional ecological survey methods required for such research have difficulties in detecting cryptic life stages and surveying population dynamics owing to high spatiotemporal variations in their occurrence. The environmental DNA (eDNA) technique is an effective tool for overcoming these limitations.

Results
In this study, we investigated the biodiversity and spatial distribution characteristics of blooming jellyfish in the Bohai Sea of China using an eDNA metabarcoding approach, which covered the surface, middle, and bottom seawater layers, and sediments. Six jellyfish taxa were identified, of which Aurelia coerulea, Nemopilema nomurai, and Cyanea nozakii were the most dominant. These three blooming jellyfish presented a marked vertical distribution pattern in the offshore regions. A. coerulea was mainly distributed in the surface layer, whereas C. nozakii and N. nomurai showed a upper-middle and middle-bottom aggregation, respectively. Horizontally, A. coerulea and C. nozakii were more abundant in the inshore regions, whereas N. nomurai was mainly distributed offshore. Spearman’s correlation analysis revealed a strong correlation between the eDNA of the three dominant blooming jellyfish species and temperature, salinity, and nutrients.

Conclusions
Our study confirms the applicability of the eDNA approach to both biodiverstiy evaluation of blooming jellyfish and investigating their spatial distribution, and it can be used as a supplementary tool to traditional survey methods.
Chalkiness and premature controlled by energy homeostasis in OsNAC02 Ko-mutant during vegetative endosperm development
Authors: Yan Mei , Jiao Guiai , Shao Gaoneng , Chen Ying , Zhu Maodi , Yang Lingwei , Xie Lihong , Hu Peisong , Tang Shaoqing 
Published: March 2024

Abstract
Background
Chalkiness is a common phenotype induced by various reasons, such as abiotic stress or the imbalance of starch synthesis and metabolism during the development period. However, the reason mainly for one gene losing its function such as NAC (TFs has a large family in rice) which may cause premature is rarely known to us.

Results
The Ko-Osnac02 mutant demonstrated an obviously early maturation stage compared to the wild type (WT) with 15 days earlier. The result showed that the mature endosperm of Ko-Osnac02 mutant exhibited chalkiness, characterized by white-core and white-belly in mature endosperm. As grain filling rate is a crucial factor in determining the yield and quality of rice (Oryza sativa, ssp. japonica), it's significant that mutant has a lower amylose content (AC) and higher soluble sugar content in the mature endosperm. Interestingly among the top DEGs in the RNA sequencing of N2 (3DAP) and WT seeds revealed that the OsBAM2 (LOC_Os10g32810) expressed significantly high in N2 mutant, which involved in Maltose up-regulated by the starch degradation. As Prediction of Protein interaction showed in the chalky endosperm formation in N2 seeds (3 DAP), seven genes were expressed at a lower-level which should be verified by a heatmap diagrams based on DEGs of N2 versus WT. The Tubulin genes controlling cell cycle are downregulated together with the MCM family genes MCM4 ( ↓), MCM7 ( ↑), which may cause white-core in the early endosperm development. In conclusion, the developing period drastically decreased in the Ko-Osnac02 mutants, which might cause the chalkiness in seeds during the early endosperm development.

Conclusions
The gene OsNAC02 which controls a great genetic co-network for cell cycle regulation in early development, and KO-Osnac02 mutant shows prematurity and white-core in endosperm.