bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genome‐wide association study reveals the genetic basis for petal‐size formation in rapeseed (Brassica napus) and CRISPR‐Cas9‐mediated mutagenesis of BnFHY3 for petal‐size reduction
Authors: Wang Ruisen , Li Yafei , Xu Shiqi , Huang Qi , Tu Mengxin , Zhu Yang , Cen Haiyan , Dong Jie , Jiang Lixi , Yao Xiangtan 
Published: December 2023

SUMMARYPetals in rapeseed (Brassica napus) serve multiple functions, including protection of reproductive organs, nutrient acquisition, and attraction of pollinators. However, they also cluster densely at the top, forming a thick layer that absorbs and reflects a considerable amount of photosynthetically active radiation. Breeding genotypes with large, small, or even petal‐less varieties, requires knowledge of primary genes for allelic selection and manipulation. However, our current understanding of petal‐size regulation is limited, and the lack of markers and pre‐breeding materials hinders targeted petal‐size breeding. Here, we conducted a genome‐wide association study on petal size using 295 diverse accessions. We identified 20 significant single nucleotide polymorphisms and 236 genes associated with petal‐size variation. Through a cross‐analysis of genomic and transcriptomic data, we focused on 14 specific genes, from which molecular markers for diverging petal‐size features can be developed. Leveraging CRISPR‐Cas9 technology, we successfully generated a quadruple mutant of Far‐Red Elongated Hypocotyl 3 (q‐bnfhy3), which exhibited smaller petals compared to the wild type. Our study provides insights into the genetic basis of petal‐size regulation in rapeseed and offers abundant potential molecular markers for breeding. The q‐bnfhy3 mutant unveiled a novel role of FHY3 orthologues in regulating petal size in addition to previously reported functions.
Monetary union in Southeast Asia: An assessment of the optimum currency area theory*
Authors: Hafner Kurt A. 
Published: December 2023

AbstractThis paper applies optimum currency area (OCA) theory to Southeast Asia to assess the potential for a monetary union in that region. We construct a panel of 10 Southeast Asian countries over the period 1990–2018 and apply the dynamic OLS estimator to quantify the costs and benefits of a potential OCA. A possible monetary union in Southeast Asia is vulnerable to asymmetric shocks, although the degree of specialisation has decreased and the openness index increased. Estimates confirm that both OCA criteria favour an increase in the region's income and FDI inflows and a reduction of its unemployment rate. However, inadequate labour mobility and stagnating intra‐trade shares are major obstacles in this regard, but if addressed they could benefit economic development and GDP per capita in the ASEAN region. We conclude that Southeast Asia is far from being an optimum currency area, but if it were to form a common currency area, the loss of economic sovereignty and its costs would be more than offset by the resulting monetary efficiency gain.
Northern Shanghai Study II: systematic assessment and management of early organ damage and its role in preventing and reducing cardiovascular risk—protocol of a prospective study
Authors: Hou Jingjing , Li Moran , Han Jun , Yu Shikai , Jia Xinming , Sun Fenyong , Zhang Yi 
Published: December 2023

IntroductionCardiovascular diseases are the leading cause of death and disease burden in China. However, there is a lack of prospective cohort studies suitable for evaluating early organ damage and its role in preventing and reducing cardiovascular risk among Chinese residents. This study intends to establish the first database based on the phenotypes of all early structural and functional damage of cardiovascular organs in Chinese population. Moreover, a digital follow-up mechanism will be formed, a prospective population cohort will be established, a biological sample bank for early cardiovascular organ damage will be established, and an intervention and management system for early damage of cardiovascular organs will be explored.Methods and analysisThis study is a prospective cohort study built on the foundation of the Northern Shanghai Study I. People aged 18–75 years are enrolled. After the recruitment, first, corresponding physical measurements and clinical examinations are conducted to collect cardiovascular risk factors and establish the demographic baseline of the study population. Next, the latest equipment is used to evaluate early structural and functional cardiovascular organ damage including heart, macrovessels, microcirculation, renal function and fundus. Meanwhile, the blood, urine, faeces and other biological samples of participants are collected to establish the cardiometabolic and gut microbiota analysis databases. The population is followed up every 2 years. Comprehensive assessment of early organ damage will be used to predict cardiovascular risk, guide people to change lifestyles to achieve early prevention and provide corresponding treatment recommendations.Ethics and disseminationThis study was approved by the Shanghai Tenth People’s Hospital Institutional Review Board. All participants signed a written consent form. The results of this study will be disseminated in peer-reviewed journals. Ethics approval: SHYS-IEC-5.0/22k148/P01.Trial registration numberNCT05435898.
Trends in liver cancer mortality in China from 1990 to 2019: a systematic analysis based on the Global Burden of Disease Study 2019
Authors: Chen Taili , Zhang Yan , Liu Jiayi , Rao Zhenzhen , Wang Mian , Shen Hong , Zeng Shan 
Published: December 2023

ObjectiveWe aimed to examine trends in overall mortality rates for liver cancer and those within subgroups according to sex, age, aetiological factors and modifiable risk factors in China from 1990 to 2019.DesignThe design of this study involved analysing liver cancer mortality rates in China from 1990 to 2019 using joinpoint regression analysis to identify significant changes in mortality rates. Annual percentage changes (APCs) and 95% CIs were used to quantify the magnitude of changes in mortality rates. The study also conducted subgroup analyses based on sex, age, aetiological factors and risk factors to better understand trends in liver cancer mortality rates.ResultsThe age-standardised mortality from liver cancer in China first increased from 28.12 to 31.54 deaths per 100 000 population in 1990–1996 (APC=2.1%, 95% CI: 1.5% to 2.6%), then dropped at varying rates (1996–2000, APC=−3.7%, 95% CI: −5.2% to –2.1%; 2000–2004, APC=−17.4%, 95% CI: −18.7% to –16.1%; 2004–2007, APC=−5.4%, 95% CI: −8.3% to –2.3%; and 2007–2012, APC=−1.4%, 95% CI: −2.3% to –0.4%), and began to increase again after 2012 (APC=1.3%, 95% CI: 0.9% to 1.7%). Hepatitis B and C virus infections accounted for 63% and 18% of liver cancer-related deaths, respectively, in China from 1990 to 2019. Smoking, drug use, alcohol use and elevated body mass index were the four leading risk factors for liver cancer mortality in China during the study period. Notable variations in both liver cancer mortality rates and changes in mortality rates were observed across sexes and age groups.ConclusionsThe age-standardised liver cancer mortality rate in China significantly decreased from 1996 to 2019. The major differences in liver cancer mortality rates and inconsistent changes in mortality rates between 1990 and 2019 merit the attention of researchers and policymakers.
Have interventions aimed at assisting general practitioners in facilitating earlier diagnosis of type 1 diabetes in children been successful? A systematic review protocol
Authors: Beccia Chiara , Hunter Barbara , Birkic Vesna , White Mary , Manski-Nankervis Jo-Anne 
Published: December 2023

BackgroundEarly diagnosis of type 1 diabetes in children is critical to prevent deterioration to diabetic ketoacidosis (DKA), a state where the body’s insulin levels are critically low resulting in the use of fat for fuel and the accumulation of ketones. DKA is a life-threatening emergency where dehydration and cerebral oedema can quickly develop and lead to death. Despite treatment, DKA also has harmful impacts on cognition and brain development. Most children admitted to a hospital with DKA see their general practitioner in the week leading up to their admission. A delay in referral from general practice can result in delays in commencing lifesaving insulin therapy. Prior systematic reviews have explored publicity campaign interventions aimed at recognising type 1 diabetes earlier; however, no reviews have explored these interventions targeted at reducing the delay after presentation to the general practitioner. This systematic review aims to summarise interventions that target the diagnostic delay emerging from general practice and to evaluate their effectiveness in reducing DKA admissions.MethodsSix databases (Ovid (MEDLINE), Web of Science, EMBASE, CINAHL, Evidence-Based Medicine Reviews (EBMR) and Google Scholar) will be searched to identify studies exploring interventions to reduce diagnostic delay in children with type 1 diabetes, and hence DKA, in general practice. The primary outcome will be the number of DKA admissions to a hospital following a delay in general practice. The secondary outcome will be the behaviour of general practitioners with respect to urgent referral of children with type 1 diabetes. Title, abstract and full-text screening for exclusion and inclusion of publications will be completed by two independent reviewers. Any risks of bias within individual studies will be assessed by two independent reviewers, using the Risk Of Bias In Non-Randomized Studies of Interventions tool. Our confidence in the overall body of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation.Ethics and disseminationThe systematic review will be disseminated via publication and potentially in conference presentations. Ethics is not required for a systematic review of secondary data.PROSPERO registration numberCRD42023412504
Optimisation of Organ Preservation treatment strategies in patients with rectal cancer with a good clinical response after neoadjuvant (chemo)radiotherapy: Additional contact X-ray brachytherapy versus eXtending the observation period and local excision (OPAXX) — protocol for two multicentre, parallel, single-arm, phase II studies
Authors: Geubels Barbara M , van Triest Baukelien , Peters Femke P , Maas Monique , Beets Geerard L , Marijnen Corrie A M , Custers Petra A , Rutten Harm J T , Theuws Jaqueline C M , Verrijssen An-Sofie E , Cnossen Jeltsje S , Burger Jacobus W A , Grotenhuis Brechtje A 
Published: December 2023

IntroductionStandard treatment for patients with intermediate or locally advanced rectal cancer is (chemo)radiotherapy followed by total mesorectal excision (TME) surgery. In recent years, organ preservation aiming at improving quality of life has been explored. Patients with a complete clinical response to (chemo)radiotherapy can be managed safely with a watch-and-wait approach. However, the optimal organ-preserving treatment strategy for patients with a good, but not complete clinical response remains unclear. The aim of the OPAXX study is to determine the rate of organ preservation that can be achieved in patients with rectal cancer with a good clinical response after neoadjuvant (chemo)radiotherapy by additional local treatment options.Methods and analysisThe OPAXX study is a Dutch multicentre study that investigates the efficacy of two additional local treatments aiming at organ preservation in patients with a good, but not complete response to neoadjuvant treatment (ie near-complete response or a small residual tumour mass <3 cm). The sample size will be 168 patients in total. Patients will be randomised (1:1) between two parallel single-arm phase II studies: study arm 1 involves additional contact X-ray brachytherapy (an intraluminal radiation boost), while in study arm 2 the observation period is extended followed by a second response evaluation and optional transanal local excision. The primary endpoint of the study is the rate of successful organ preservation at 1 year following randomisation. Secondary endpoints include toxicity, morbidity, oncological and functional outcomes at 1 and 2 years of follow-up. Finally, an observational cohort study for patients who are not eligible for randomisation is conducted.Ethics and disseminationThe trial protocol has been approved by the medical ethics committee of the Netherlands Cancer Institute (METC20.1276/M20PAX). Informed consent will be obtained from all participants. The trial results will be published in an international peer-reviewed journal.Trial registration numberNCT05772923.
What factors facilitate partnerships between higher education and local mental health services for students? A case study collective
Authors: Broglia Emma , Nisbet Kirsty , Bone Claire , Simmonds-Buckley Melanie , Knowles Louise , Hardy Gillian , Gibbon Laura , Barkham Michael 
Published: December 2023

BackgroundHigher education institutions face challenges in providing effective mental health services for diverse student needs. In the UK, discrepancies between healthcare and education service provision create barriers for students and require stronger alignment through partnerships.ObjectivesThis study aimed to identify risks, barriers and enablers to developing service partnerships between universities and the National Health Service (NHS) in England. It investigated existing partnerships and strategies that facilitate effective collaborative working.Design and settingA case study approach was employed, including coproduction and stakeholder involvement with staff and service users, to gather information from eight English universities developing regional student mental health hubs. This research received appropriate ethical approval.ParticipantsIn total, 27 professional staff from counselling, mental health, disability and well-being services participated and represented their respective services.Outcome measuresDescriptive information was collected from service websites, handbooks, reports and 11 focus groups using a standardised data collection template. Inter-rater reliability was used to determine the agreement between coders and finalise focus group themes. EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Standards for Reporting Qualitative Research were adopted.ResultsUsing inductive thematic analysis, five themes were identified for developing partnerships: building blocks, facing barriers, achieving positive outcomes, shaping student services and developing coordinated care. Fleiss’ kappa showed strong agreement between raters regarding the partnership factors (k=0.84 (95% CI 0.81 to 0.87), p<0.0005). Effective communication, shared understanding and trust were essential. Barriers included restrictions to information sharing and incompatible data infrastructures between services.ConclusionsStronger partnerships between universities and NHS are needed to meet increasing student mental health demands. Addressing barriers and implementing strategies to develop partnerships can enhance student services.Preregistrationhttps://osf.io/u54qk/
Antibiotic use among hospitalised patients in Sierra Leone: a national point prevalence survey using the WHO survey methodology
Authors: Kamara Ibrahim Franklyn , Kanu Joseph , Maruta Anna , Fofanah Bobson Derrick , Kamara Kadijatu Nabie , Sheriff Bockarie , Katawera Victoria , D'Almeida Selassi A , Musoke Robert , Nuwagira Innocent , Lakoh Sulaiman , Kamara Rugiatu Z , Tengbe Sia Morenike , Mansaray Abdul Razak , Koroma Zikan , Thomas Fawzi , Abiri Onome T , Koroma Aminata Tigiedankay , Russell James Baligeh Walter , Squire James , Vandi Mohamed Alex 
Published: December 2023

ObjectiveInappropriate use of antibiotics is a major driver of antibiotic resistance. A few studies conducted in Africa have documented that about half of hospitalised patients who receive antibiotics should not have received them. A few hospital-based studies that have been conducted in Sierra Leone have documented a high usage of antibiotics in hospitals. Therefore, we conducted a nationwide point prevalence survey on antibiotic use among hospitalised patients in Sierra Leone.DesignWe conducted a hospital-based, cross-sectional survey on the use of antibiotics using the WHO point prevalence survey methodology.SettingThe study was conducted in 26 public and private hospitals that are providing inpatient healthcare services.ParticipantsAll patients admitted to paediatric and adult inpatient wards before or at 08:00 on the survey date were enrolled.Outcome measuresPrevalence of antibiotic use, antibiotics Access, Watch and Reserve (AWaRe) categorisation, indication for antibiotic use prevalence and proportion of bacteria culture done.ResultsOf the 1198 patient records reviewed, 883 (73.7%, 95% CI 71.1% to 76.2%) were on antibiotics. Antibiotic use was highest in the paediatric wards (306, 85.7%), followed by medical wards (158, 71.2%), surgical wards (146, 69.5%), mixed wards (97, 68.8%) and lowest in the obstetrics and gynaecology wards (176, 65.7%). The most widely prescribed antibiotics were metronidazole (404, 22.2%), ceftriaxone (373, 20.5%), ampicillin (337, 18.5%), gentamicin (221, 12.1%) and amoxicillin (90, 5.0%). Blood culture was only done for one patient and antibiotic treatments were given empirically. The most common indication for antibiotic use was community-acquired infection (484, 51.9%) followed by surgical prophylaxis (222, 23.8%).ConclusionThere was high usage of antibiotics in hospitals in Sierra Leone as the majority of patients admitted received an antibiotic. This has the potential to increase the burden of antibiotic resistance in the country. We, therefore, recommend the establishment of hospital antimicrobial stewardship programmes according to the WHO core components.
Prevalence and influencing factors of sleep disorders in patients with CRS: a protocol for systematic review and meta-analysis
Authors: Wu Yuqi , Fu Yijie , He Yuanqiong , Gong Xinru , Fan Hongli , Han Zhoutong , Zhu TianMin , Li Hui 
Published: December 2023

BackgroundChronic rhinosinusitis (CRS) is a common chronic disease that seriously affects patients’ quality of life and imposes a heavy physical and mental burden on patients. There is growing evidence that sleep disorders are strongly associated with patients with CRS. However, there is no systematic evidence to clarify the prevalence and influencing factors of sleep disorders in patients with CRS with nasal polyps (NP) (CRSwNP) and CRS without NP (CRSsNP). For this reason, this study will systematically analyse the prevalence of sleep disorders in patients with CRSwNP and CRSsNP and explore the related influencing factors.Methods and analysisWe will electronically search PubMed, Web of Science, Embase, Cochrane, Ovid, Scopus, the China National Knowledge Infrastructure, the Wanfang database, the China Biomedical Literature Database and the China Scientific Journals Database from the establishment of the database to September 2023 to collect the prevalence of sleep disorders in patients with CRSwNP or CRSsNP and related studies on factors affecting sleep disorders. Two researchers will independently conduct literature screening and data extraction and evaluate the quality of the included studies using the Newcastle-Ottawa Quality Scale and Agency for Healthcare Research and Quality scales. The extracted data will be meta-analysed using Review Manager 5.3 and Stata 14.0 software, and the quality of the evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation. Publication bias will be assessed using the funnel plots, Egger’s test and Begg’s test.Ethics and disseminationThis review will not require ethical approval, as we will only use research data from the published documents. Our final findings will be published in a peer-reviewed, open-access journal for dissemination.PROSPERO registration numberCRD42023446833.
Perceptions of medical error among general practitioners in rural China: a qualitative interview study
Authors: Li Hange , Guo Ziting , Yang Wenbin , He Yanrong , Chen Yanhua , Zhu Jiming 
Published: December 2023

BackgroundMedical error (ME) is a serious public health problem and a leading cause of death. The reported adverse incidents in China were much less than western countries, and the research on patient safety in rural China’s primary care institutions was scarce. This study aims to identify the factors contributing to the under-reporting of ME among general practitioners in township health centres (THCs).MethodsA qualitative semi-structured interview study was conducted with 31 general practitioners working in 30 THCs across 6 provinces. Thematic analysis was conducted using a grounded theory approach.ResultsThe understanding of ME was not unified, from only mild consequence to only almost equivalent to medical malpractice. Common coping strategies for THCs after ME occurs included concealing and punishment. None of the participants reported adverse events through the National Clinical Improvement System website since they worked in THCs. Discussions about ME always focused on physicians rather than the system.ConclusionsThe low reported incidence of ME could be explained by unclear concept, unawareness and blame culture. It is imperative to provide supportive environment, patient safety training and good examples of error-based improvements to rural primary care institutions so that ME could be fully discussed, and systemic factors of ME could be recognised and improved there in the future.
Surgical informed consent practices and influencing factors in sub-Saharan Africa: a scoping review of the literature
Authors: Pittalis Chiara , Sackey Cherie , Okeny Paul , Nandi Bip , Gajewski Jakub 
Published: December 2023

IntroductionCurrent international standards in consent to surgery practices are usually derived from health systems in Western countries, while little attention has been given to other contexts such as sub-Saharan Africa (SSA), despite this region facing the highest burdens of disease amenable to surgery globally. The aim of this study was to examine how the concept of informed consent for surgery is interpreted and applied in the context of SSA, and factors affecting current practices.MethodsA systematic search of Medline, Embase and African Journal OnLine databases as well as grey sources was executed in May 2023 to retrieve relevant literature published since 2010 in English language against a set of given criteria. The socioecological framework for health was used for organising and summarising the identified evidence.ResultsA total of 27 papers were included in the review. Findings revealed that consent to surgery practices is generally substandard across SSA and the process is not adequate. Patients’ understanding of informed consent is limited, likewise awareness of their rights to decision-making. A range of factors at the individual, interpersonal, institutional and system/societal levels affect the informed consent process.ConclusionThere is a need to find more culturally acceptable and ethical ways to include the participation of patients in the decision-making process for surgical treatment in the SSA and define standards more closely aligned with the local context.