bluuebunny/crossref_metadata_2025_split huggingface dataset:
False negative result of polymerase chain reaction in very early stages of acute retinal necrosis
Authors: Wang Haibo , Qian Zhuyun , Cui Lin , Liu Beichen , Zou Jixin , Wang Lu , Tao Yong , Zhang Lijun , Jin Lei 
Published: November 2023

Abstract
Background
Viral nucleic acid testing of intraocular fluid using polymerase chain reaction (PCR) is a major laboratory examination in the diagnosis of acute retinal necrosis (ARN). Importantly, false negative PCR results may occur in several special situations. We reported a case of ARN with a negative PCR result in the aqueous humour in the very early stages of disease.

Case presentation
A female patient presented to the ophthalmologist with complaints of blurred vision and redness in her left eye. Her medical history included ARN in her right eye 10 years prior. Although the result of the aqueous viral analysis by PCR in her left eye was negative the first time (one day after the appearance of ocular symptoms), ARN in her left eye was presumed based on the clinical signs. With timely antiviral and anti-inflammatory treatments, the retinal lesions diminished. The viral load of herpes simplex virus (HSV) turned positive (7.25 × 103 copies/mL) one week later, increased to 2.49 × 105 copies/mL after three weeks, and finally turned negative about five weeks after the onset of disease. The initial HSV-IgG level in the aqueous humour was 0.01 U/mL and increased to 222.64 U/mL in the final sampling.

Conclusions
The results of PCR analysis can be negative in the very early stages of ARN. Diagnosis of ARN should be made based on the clinical features, and antiviral treatments should not be delayed. Repeated PCR analysis of the aqueous humour is necessary to confirm the diagnosis and monitor the disease process.
The expression of the NPR1-dependent defense response pathway genes in Persea americana (Mill.) following infection with Phytophthora cinnamomi
Authors: Backer Robert , Naidoo Sanushka , van den Berg Noëlani 
Published: November 2023

AbstractA plant’s defense against pathogens involves an extensive set of phytohormone regulated defense signaling pathways. The salicylic acid (SA)-signaling pathway is one of the most well-studied in plant defense. The bulk of SA-related defense gene expression and the subsequent establishment of systemic acquired resistance (SAR) is dependent on the nonexpressor of pathogenesis-related genes 1 (NPR1). Therefore, understanding the NPR1 pathway and all its associations has the potential to provide valuable insights into defense against pathogens. The causal agent of Phytophthora root rot (PRR), Phytophthora cinnamomi, is of particular importance to the avocado (Persea americana) industry, which encounters considerable economic losses on account of this pathogen each year. Furthermore, P. cinnamomi is a hemibiotrophic pathogen, suggesting that the SA-signaling pathway plays an essential role in the initial defense response. Therefore, the NPR1 pathway which regulates downstream SA-induced gene expression would be instrumental in defense against P. cinnamomi. Thus, we identified 92 NPR1 pathway-associated orthologs from the P. americana West Indian pure accession genome and interrogated their expression following P. cinnamomi inoculation, using RNA-sequencing data. In total, 64 and 51 NPR1 pathway-associated genes were temporally regulated in the partially resistant (Dusa®) and susceptible (R0.12) P. americana rootstocks, respectively. Furthermore, 42 NPR1 pathway-associated genes were differentially regulated when comparing Dusa® to R0.12. Although this study suggests that SAR was established successfully in both rootstocks, the evidence presented indicated that Dusa® suppressed SA-signaling more effectively following the induction of SAR. Additionally, contrary to Dusa®, data from R0.12 suggested a substantial lack of SA- and NPR1-related defense gene expression during some of the earliest time-points following P. cinnamomi inoculation. This study represents the most comprehensive investigation of the SA-induced, NPR1-dependent pathway in P. americana to date. Lastly, this work provides novel insights into the likely mechanisms governing P. cinnamomi resistance in P. americana.
Morphological characterization and interspecific variation among five species of Ziziphus genus to select superiors in Iran
Authors: Khadivi Ali 
Published: November 2023

Abstract
Background
Several species of the genus Ziziphus are used worldwide for their medicinal and therapeutic properties. The present study aimed to investigate the phenotypic variation of five species of the Ziziphus genus, including Z. jujuba Mill. (25 accessions), Z. mauritiana Lam. (25 accessions), Z. spina-christi L. (25 accessions), Z. nummularia L. (10 accessions), and Z. xylopyrus Willd. (10 accessions) from Markazi, Sistan-va-Baluchestan, and Khuzestan provinces, Iran.

Results
The investigated accessions have significant differences in terms of all the measured as revealed using analysis of variance (ANOVA, P < 0.01). The range of fruit weight was 0.43–1.29 g in Z. jujuba, 17.85–29.87 g in Z. mauritiana, 0.94–3.44 g in Z. spina-christi, 0.93–2.02 g in Z. nummularia, and 0.91–3.02 g in Z. xylopyrus. All the measured traits showed significant and positive correlations with each other. Multiple regression analysis (MRA) results showed that fruit length, stone width, stone weight, stone length, and fruit width have significant effects on fruit weight, and thus their fluctuations have a significant effect on increasing or decreasing fruit weight. The accessions were grouped into two main clusters using hierarchical cluster analysis. The first cluster (I) included all the accessions of Z. mauritiana, while the second cluster (II) contained the accessions of the rest species forming two sub-clusters.

Conclusion
Based on the commercial characters, accessions no. 12, 13, 17, 23, and 24 in Z. jujuba, accessions no. 3, 9, 17, 18, 20, 22, and 23 in Z. mauritiana, accessions no. 5, 6, 8, 13, 19, 22, and 24 in Z. spina-christi, accessions no. 3, 7, and 9 in Z. nummularia, and accessions no. 2, 4, 7, and 10 in Z. oxyphylla showed the highest fruit weight and thus can be suggested as superior for cultivation or use in breeding programs due to having larger fruits.
Prevalence and risk factors of oral human papillomavirus infection among 4212 healthy adults in Hebei, China
Authors: Yu Shuting , Zhu Yingying , He Huijing , Hu Yaoda , Zhu Xiaoli , Diao Wenwen , Li Shuguang , Shan Guangliang , Chen Xingming 
Published: November 2023

Abstract
Background
Human papillomavirus (HPV) infection is an essential cause of oropharyngeal squamous cell carcinoma that is increasing in incidence worldwide. However, little is known about the epidemiology of oral HPV infection among healthy adults in China.

Methods
A study in northern China was conducted in 2021 as baseline data of Diverse Life-Course Cohort (DLCC). Residents who aged above 20 were eligible to participate. Oral swab specimens and questionnaires were collected from 4226 participants. HPV DNA in oral exfoliated cells was tested by Nested Polymerase Chain Reaction approach and sequencing. Univariate and multivariate analyses were performed to assess the associations between exposure factors and oral HPV infection.

Results
Overall prevalence of oral HPV infection was 4.08% (95%CI, 3.69%-4.68%). The most prevalent HPV type detected was HPV-81 (1.35%; 95% CI, 1.00%–1.70%), followed by HPV-16 (0.64%; 95% CI, 0.40%–0.88%). Oral HPV infection presented a bimodal pattern with respect to age in male and female participants. Oral HPV prevalence of male participants was significantly higher than prevalence of female participants (5.0% versus 3.6%, P = 0.041). Prevalence of oral HPV was higher among current smokers (OR = 1.59; 95% CI, 1.11–2.29; P = 0.039) and current drinkers (OR = 1.60; 95% CI, 1.14–2.25; P = 0.023). Current alcohol consumption was independently associated with oral HPV infection (OR = 1.74; 95% CI, 1.22–2.50; P = 0.010).

Conclusions
Among healthy adults aged above 20 in Hebei, China, the prevalence of high-risk HPV infection was 1.92% (95%CI, 1.51%-2.34%). Oral HPV prevalence was independently associated with alcohol consumption. More tailored prevention strategies are needed to prevent oral HPV infection through smoking cessation, reduction of alcohol consumption, and HPV vaccination.
The effect of zoledronic acid on hip geometry in renal transplant recipients: a double-blind placebo-controlled randomized study
Authors: Dabbaghmanesh Alireza , Bakhshayeshkaram Marzieh , Roshanzamir Sharareh , Naseri Arzhang , Dabbaghmanesh Mohammad Mahdi , Heydari Seyed Taghi , Talehzadeh Pedram , Dabbaghmanesh Mohammad Hossein , Jahromi Shahrokh Ezzatzadegan 
Published: November 2023

Abstract
Background
In renal transplant patients, bisphosphonates may prevent bone loss, but little is known about their effects on bone microarchitecture and geometrical hip parameters, as the key factors of bone stability. This study aimed to analyze the effect of zoledronic acid on the mentioned parameters in kidney transplant patients.

Methods
In this double-blind, randomized trial, 33 patients were followed for six months after administering either 4mg of zoledronic acid or a placebo. Bone mineral density (BMD) measurement of the spine, hip, radius, and whole body was obtained, and trabecular bone score (TBS) was evaluated using the software. Geometric assessment at the proximal femur was performed by the HSA program.

Results
Eighteen patients in the intervention group and 15 in the control group completed the study. The mean percentages of the changes in the BMD at the lumbar spine and whole body were significantly different between the placebo and intervention groups (-0.23% vs. 4.91% and -2.03% vs. 1.23%) (P < 0.05). Zoledronic acid appeared to enhance the subperiosteal diameter, endocortical diameter, and cross-sectional moment of inertia (CSMI) at the narrow neck in comparison with placebo (P < 0.05); however, no difference in TBS was observed between both groups (P > 0.05).

Conclusions
We concluded that a single administration of zoledronic acid might ameliorate bone loss at the lumbar spine and the whole body and maintain the subperiosteal diameter, endocortical diameter, and CSMI as parameters of bone strength at the narrow neck of the proximal femur after six months in renal-transplant recipients.

Trial registration
This study was registered in IRCT (ID: IRCT20181202041821N1) on 04–05-2019.
Impact of a surfer rescue training program in Australia and New Zealand: a mixed methods evaluation
Authors: Koon William , Peden Amy E. , Brander Robert W. 
Published: November 2023

Abstract
Background
Surfers play a critical role in coastal drowning prevention, conservatively estimated to make as many rescues as beach lifeguards. The Surfer Rescue 24/7 (SR24/7) program is a coastal safety intervention in Australia and New Zealand that teaches surfers safe rescue skills and promotes prevention activities. This multi-part, mixed-methods study aimed to evaluate the impact of the SR24/7 program.

Methods
The study consisted of three parts employing quantitative and qualitative methods: a retrospective survey of course participants, in-depth interviews with course participants who had conducted rescues, and an analysis of self-reported skills confidence ratings before and after the program.

Results
Triangulated results from the three study components indicated that after the course, participants exhibited high levels of satisfaction with their experience in the program and would encourage others to attend, were more observant and aware of safety concerns while surfing, had a better understanding of ocean conditions and hazards, learned new rescue techniques and skills, grasped important course concepts related to their own personal safety, and improved their confidence in responding to an emergency situation. Several participants had conducted rescues in real life and indicated that the course was effective in providing them with the baseline knowledge and skills to keep safe while helping others in the ocean. This study also provides new insight on the role of surfers in coastal safety, specifically that surfers are engaged in a range of prevention activities before rescue is required.

Conclusions
Despite persistent challenges in combating coastal drowning rates, the SR24/7 program is an effective intervention that helps save lives. Importantly, this study provides evidence that the course successfully equips surfers with techniques to act responsibly and safely. Expanding coastal safety focus and resources towards surfers, an often-overlooked demographic in beach safety strategies, could substantially enhance community-level capacity to prevent and respond to ocean emergencies.
Handgrip strength is associated with mortality in community-dwelling older adults: the Yilan cohort study, Taiwan
Authors: Hsu Nai-Wei , Lin Ching-Heng , Yang Nan-Ping , Chen Hsi-Chung , Chou Pesus 
Published: November 2023

Abstract
Introduction
Hand grip strength (HGS) is one of the methods to help early identification of physical frailty and sarcopenia, the major concerns in the aging societies. It is also crucial to evaluate its impact on mortality. However, the available evidence regarding such impact among specific age cohorts (65 to 74 years and above) is limited. This study tried to investigate the relationship between HGS and mortality among specific cohorts of the community-dwelling older individuals in Yilan, Taiwan.

Methods
A seven-year longitudinal follow-up study was conducted involving 2,468 community-dwelling older individuals in Yilan. The participants were divided into two groups based on their quartiles of hand grip strength: with poor HGS and with good HGS. The association between HGS and mortality was examined using Cox proportional hazards models.

Results
The analysis revealed that age, HGS, gender, medical history of cardiovascular diseases, body mass index, and wrist-hip ratio had significant impacts on seven-year survival. Specifically, individuals with poor HGS exhibited increased mortality, with an adjusted hazard ratio (HR) of 1.87 (95% CI: 1.52–2.30). Furthermore, the adverse effect of poor HGS on mortality was more pronounced in males aged 65–74 years (adjusted HR 4.12, 95% CI: 2.16–7.84), females aged 75 years or older (2.09, 1.43–3.04) and males aged 75 years or older (1.49, 1.07–2.07).

Conclusion
Poor hand grip strength is an independent risk factor for mid-term mortality among community-dwelling older individuals in Yilan. The assessment of HGS can serve as a valuable tool in identifying older individuals at higher risk of death.
The effect of combining different sampling tools on the performance of electromagnetic navigational bronchoscopy for the evaluation of peripheral lung lesions and factors associated with its diagnostic yield
Authors: Flandes Javier , Martinez-Muñiz Francisco B. , Cruz-Rueda Juan José , Soto Francisco J. , Majid Adnan , Tuta-Quintero Eduardo , Giraldo-Cadavid Luis F. 
Published: November 2023

Abstract
Background
We assessed the performance of Electromagnetic navigational bronchoscopy (ENB) as a standalone diagnostic technique and the performance of different sampling tools used during the procedure.

Methods
We recruited 160 consecutive patients who underwent ENB for peripheral lung lesions (PLL) at a tertiary care centre. The diagnostic performance of ENB and sampling tools was assessed using a logistic regression model and a ROC-curve in which the dependent variable was diagnostic success. A multivariate model was built to predict diagnostic success before performing ENB to select the best candidates for the procedure.

Results
Most patients with PLLs in the study were male (65%), with a mean age of 67.9 years. The yield was 66% when the most common techniques were used together as suction catheter + transbronchial biopsy forceps (TBBx) + bronchoalveolar lavage + bronchial washing (p < 0.001) and increased to 69% when transbronchial needle aspiration (TBNA) and cytology brush were added (p < 0.001). Adding diagnostic techniques such as TBBx and TBNA resulted in an increase in diagnostic performance, with a statistically significant trend (p = 0.002). The logistic model area-under the ROC-curve for diagnostic success during ENB was 0.83 (95% CI:0.75–0.90; p < 0.001), and a logit value ≥ 0.12 was associated with ≥ 50% probability of diagnostic success.

Conclusions
ENB, as a stand-alone diagnostic tool for the evaluation of PLLs when performed by experienced operators using a multi-modality technique, has a good diagnostic yield. The probability of having a diagnostic ENB could be assessed using the proposed model.
Assessment of a novel deep learning-based software developed for automatic feature extraction and grading of radiographic knee osteoarthritis
Authors: Yoon Ji Soo , Yon Chang-Jin , Lee Daewoo , Lee Jae Joon , Kang Chang Ho , Kang Seung-Baik , Lee Na-Kyoung , Chang Chong Bum 
Published: November 2023

Abstract
Background
The Kellgren-Lawrence (KL) grading system is the most widely used method to classify the severity of osteoarthritis (OA) of the knee. However, due to ambiguity of terminology, the KL system showed inferior inter- and intra-observer reliability. For a more reliable evaluation, we recently developed novel deep learning (DL) software known as MediAI-OA to extract each radiographic feature of knee OA and to grade OA severity based on the KL system.

Methods
This research used data from the Osteoarthritis Initiative for training and validation of MediAI-OA. 44,193 radiographs and 810 radiographs were set as the training data and used as validation data, respectively. This AI model was developed to automatically quantify the degree of joint space narrowing (JSN) of medial and lateral tibiofemoral joint, to automatically detect osteophytes in four regions (medial distal femur, lateral distal femur, medial proximal tibia and lateral proximal tibia) of the knee joint, to classify the KL grade, and present the results of these three OA features together. The model was tested by using 400 test datasets, and the results were compared to the ground truth. The accuracy of the JSN quantification and osteophyte detection was evaluated. The KL grade classification performance was evaluated by precision, recall, F1 score, accuracy, and Cohen's kappa coefficient. In addition, we defined KL grade 2 or higher as clinically significant OA, and accuracy of OA diagnosis were obtained.

Results
The mean squared error of JSN rate quantification was 0.067 and average osteophyte detection accuracy of the MediAI-OA was 0.84. The accuracy of KL grading was 0.83, and the kappa coefficient between the AI model and ground truth was 0.768, which demonstrated substantial consistency. The OA diagnosis accuracy of this software was 0.92.

Conclusions
The novel DL software known as MediAI-OA demonstrated satisfactory performance comparable to that of experienced orthopedic surgeons and radiologists for analyzing features of knee OA, KL grading and OA diagnosis. Therefore, reliable KL grading can be performed and the burden of the radiologist can be reduced by using MediAI-OA.
Healthcare provider experiences interacting with survivors of intimate partner violence: a qualitative study to inform survivor-centered approaches
Authors: Anguzu Ronald , Cassidy Laura D. , Nakimuli Annettee O. , Kansiime Judith , Babikako Harriet M. , Beyer Kirsten M. M. , Walker Rebekah J. , Wandira Christopher , Kizito Felix , Dickson-Gomez Julia 
Published: November 2023

Abstract
Background
Intimate partner violence (IPV) remains a pervasive form of gender-based violence (GBV) that is largely undisclosed, especially among women seeking healthcare services in Uganda. Prioritizing survivor needs may improve IPV disclosure. This study explores healthcare worker experiences from provider-patient interactions with survivors seeking antenatal care services (ANC) in Uganda.

Methods
In-depth interviews were conducted among twenty-eight experienced healthcare providers in a rural and an urban-based ANC clinic in Eastern and Central Uganda. Providers were asked what they viewed as the needs and fears of women identified as having experienced any form of IPV. Iterative, inductive/deductive thematic analysis was conducted to discover themes regarding perceived needs, fears, and normalizing violence experienced by IPV survivors.

Results
According to healthcare providers, IPV survivors are unaware of available support services, and have need for support services. Providers reported that some survivors were afraid of the consequences of IPV disclosure namely, community stigma, worries about personal and their children’s safety, retaliatory abuse, fear of losing their marriage, and partners’ financial support. Women survivors also blamed themselves for IPV. Contextual factors underlying survivor concerns included the socio-economic environment that ‘normalizes’ violence, namely, some cultural norms condoning violence, and survivors’ unawareness of their human rights due to self-blame and shame for abuse.

Conclusions
We underscore a need to empower IPV survivors by prioritizing their needs. Results highlight opportunities to create a responsive healthcare environment that fosters IPV disclosure while addressing survivors’ immediate medical and psychosocial needs, and safety concerns. Our findings will inform GBV prevention and response strategies that integrate survivor-centered approaches in Uganda.
Factors associated with traction alopecia in women living in Yaoundé (Cameroon)
Authors: Nzeng Letitia Fiona Mbussuh , Nguefack-Tsague Georges , Tounouga Dahlia Noëlle , Soumah Mohamed Maciré , Mbang Franck Albert Armand , Sigha Odette Berline , Nkoro Grace Anita , Kotto Rose , Kouotou Emmanuel Armand 
Published: November 2023

Abstract
Background
Traction alopecia (TA) is very common in Africa but few studies on African population are available. We sought to determine factors associated with TA and measure the association between these factors and TA.

Methods
We carried out an analytical cross-sectional study in 29 hairdressing saloons in the city of Yaoundé. A questionnaire was administered and scalp exams were performed in order to look for TA and determine Marginal TA severity score if present. Participants were separated in two groups: TA group and a group without TA.

Results
We finally included 223 women (77 having TA and 146 without TA). The median age was 26 years for women with TA and 24 years for women without TA. The factors associated with traction alopecia we found included: age ≥ 35 years (adjusted OR = 4; p = 0.016). Hairdressing undertaken by hairdressers only (adjusted OR = 0.2; p = 0.008), the avoidance of the regular use of nets, caps and head ties (OR = 0.2; p = 0.006) and relaxing hairs once a year or less (adjusted OR = 0.2; p = 0.005) could be protective factors. As well, we found a positive correlation between age and TA severity (r = 0.235; p < 0.001).

Conclusion
Age and some haircare practices are associated to TA occurrence in our context. Women therefore need to be educated on these various factors that could be able to cause, worsen or prevent TA.