bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the Swedish Quality Register for Ear Surgery – SwedEar
Authors: Berglund Malin , Olaison Sara , Westman Eva , Eriksson P. O. , Steger Lena , Bonnard Åsa 
Published: October 2023

Abstract
Background
The Swedish Quality Register for Ear Surgery (SwedEar) is a national register monitoring surgical procedures and outcomes of ear surgery to facilitate quality improvement. The value of the register is dependent on the quality of its data. SwedEar has never been validated regarding data quality or missing entries. Therefor, the purpose of this study was to assess coverage, completeness and response rate in the register and validate the physicians’ reported data accuracy.

Methods
In this validation study, the completeness, response rate and missing registrations were analysed. Data in SwedEar were compared with the yearly collected statistics of otosurgical procedures in The Swedish Otosurgical Society and the comparison of rates between groups was calculated with Fisher’s exact test. Validation of registered data accuracy was performed on every 20th registered case during a five-year period. Data were reabstracted from medical records and compared with the original registration. Interrater agreement, reliability measures, Cohen’s kappa, Gwet’s AC1 and positive predictive value were calculated.

Results
SwedEar has a coverage of 100%. The completeness of registered cases was 84% and the response rate was 74%. The validation of data accuracy assessed 13 530 variables, including audiograms. Less than 3% of incorrect or missing variables were identified. For most of the pre- and postoperative variables the Kappa and Gwet´s AC1 results show an almost perfect agreement (> 0.80). For audiogram data the ICC shows an excellent reliability (> 0.9) for all but one value.

Conclusion
This validation shows that SwedEar has excellent coverage, high completeness, and that the data in the register have almost perfect reliability. The data are suitable for both clinical and research purposes. Further efforts to improve completeness are warranted.
Integrating COM-B and the person-based approach to develop an ACT based therapy programme to raise self-determination in adolescents with obesity
Authors: Cox Jennifer S. , Searle Aidan , Thornton Gail , Hamilton-Shield Julian P. , Hinton Elanor C. 
Published: October 2023

Abstract
Background
This paper details the development of the Adolescent Intrinsic Motivation ‘AIM2Change’ intervention to support weight-management in young people previously unable to make changes whilst attending a tier 3 weight management service for children and young people. AIM2Change is an acceptance and commitment therapy based intervention that will be delivered one-to-one online over a seven-week period.

Methods
To develop this intervention, we have triangulated results from a qualitative research study, patient and public involvement groups (PPI) and a COM-B (capability, opportunity, motivation, behaviour) analysis, in a method informed by the person-based approach.

Results
The integrated development approach yielded a broad range of perspectives and facilitated the creation of a tailored intervention to meet the needs of the patient group whist remaining pragmatic and deliverable.

Conclusions
The next steps for this intervention will be in-depth co-development of the therapy sessions with service users, before implementing a proof of concept trial.
Development and validation of primary health care quality assessment tool
Authors: Farrokhi Pouria , Zarei Ehsan , Bagherzadeh Rafat , Irannejad Behrooz , Hashjin Asgar Aghaei 
Published: October 2023

Abstract
Background
Assessing the quality of health services gives insights to managers about the status of services delivered by them, especially from the client’s perspective. Although various tools have been developed to measure the quality of primary health care (PHC), no specific tool was found in this field in Iran. Therefore, the present study was conducted to develop and validate the quality assessment tool of PHC in Iran.

Methods
This methodological study was conducted in 2021. In the first step, based on a literature review, an initial questionnaire was designed, and its face validity, content validity, construct validity, and reliability were evaluated. Descriptive tests, Kolmogorov-Smirnov, exploratory factor analysis, Kaiser-Myer-Olkin (KMO), and Cronbach’s alpha were performed by using SPSS 22.

Results
The initial questionnaire included 33 items, of which three items were removed due to inconsistency with factorization. The final questionnaire consisted of 30 items and nine dimensions: interaction, efficiency, timeliness, accuracy, consultation, tangibility, safety, accessibility, and environment. The KMO and Cronbach’s alpha index values were 0.734 and 0.82, respectively, indicating acceptable reliability and validity. The developed dimensions represented about 73% of the total variance.

Conclusion
The designed questionnaire has relatively good validity and reliability and can be used to measure the quality of PHC and to identify weaknesses in service delivery. However, researchers should carefully examine it to enhance its applicability as a standard tool for measuring PHC quality.
Canine diffuse large B-cell lymphoma downregulates the activity of CD8 + T-cells through tumor-derived extracellular vesicles
Authors: Weng Hsin-Pei , Ke Chiao-Hsu , Tung Chun-Wei , Tani Akiyoshi , Wang Chia-Chi , Yang Wen-Yuan , Wang Yu-Shan , Han Winston , Liao Chi-Hsun , Tomiyasu Hirotaka , Lin Chen-Si 
Published: October 2023

Abstract
Background
Tumor-derived extracellular vesicles (EVs) have been proposed as the essential mediator between host immunity and cancer development. These EVs conduct cellular communication to facilitate tumor growth, enable invasion and metastasis, and shape the favorable tumor microenvironment. Lymphoma is one of the most common hematological malignancies in humans and dogs. Effective T-cell responses are required for the control of these malignancies. However, the immune crosstalk between CD8 + T-cells, which dominates anti-tumor responses, and canine lymphoma has rarely been described.

Methods
This study investigates the immune manipulating effects of EVs, produced from the clinical cases and cell line of canine B cell lymphoma, on CD8 + T-cells isolated from canine donors.

Results
Lymphoma-derived EVs lead to the apoptosis of CD8 + T-cells. Furthermore, EVs trigger the overexpression of CTLA-4 on CD8 + T-cells, which indicates that EV blockade could serve as a potential therapeutic strategy for lymphoma patients. Notably, EVs transform the CD8 + T-cells into regulatory phenotypes by upregulating their PD-1, PD-L1, and FoxP3 mRNA expression. The regulatory CD8 + T-cells secret the panel of inhibitory cytokines and angiogenic factors and thus create a pro-tumorigenic microenvironment.

Conclusion
In summary, the current study demonstrated that the EVs derived from canine B cell lymphoma impaired the anti-tumor activity of CD8 + T-cells and manipulated the possible induction of regulatory CD8 + T-cells to fail the activation of host cellular immunity.
Immunological role and clinical prognostic significance of P2RY6 in lung adenocarcinoma: a multi-omics studies and single-cell sequencing analysis
Authors: Wu Hong , Dong Xuhui 
Published: October 2023

Abstract
Background
There is increasing evidence that recombinant human P2Y purinoceptor 6 (P2RY6) may be involved in inflammatory responses. However, the role of P2RY6 in lung adenocarcinoma (LUAD) remains unknown.

Methods
We used transcriptomic, genomic, single-cell transcriptomic, and methylation sequencing data from The Cancer Genome Atlas database to analyze the aberrant status and prognostic value of P2RY6 in a variety of tumors. The LUAD single-cell sequencing dataset was used to explore the effect of P2RY6 on the tumor microenvironment. Cell-type identification by estimating relative subsets of RNA transcripts (CIBERSORT) was used to quantify immune cells in the tumor microenvironment. We also analyzed the correlation of P2RY6 with immune checkpoints and immune regulation-related genes. The correlation of between tumor mutation burden (TMB), microsatellite instability (MSI), and P2RY6 expression was also analyzed simultaneously. Tissue microarray and immunohistochemistry were employed to assess the expression of P2RY6 in internal tumor samples.

Results
Our findings indicate that P2RY6 exhibits significantly higher expression levels in various cancer tissues, particularly in LUAD. High expression of P2RY6 was closely associated with a poor prognosis for patients, and it plays a role in regulating immune-related pathways, such as cytokine-cytokine receptor interaction. Notably, P2RY6 expression is closely linked to the abundance of CD8 + T cells. Furthermore, we have developed a P2RY6-related inflammation prediction model that demonstrates promising results in predicting the prognosis of LUAD patients, with an AUC (area under the curve) value of 0.83. This performance is significantly better than the traditional TNM staging system. Through single-cell transcriptome sequencing analysis, we observed that high P2RY6 expression is associated with increased intercellular communication. Additionally, pathway enrichment analysis revealed that P2RY6 influences antigen presentation and processing pathways within the LUAD microenvironment.

Conclusions
This study suggests that P2RY6 would be a new target for immunotherapy in LUAD.
Prognostic value of the systemic immune-inflammation index in patients with upper tract urothelial carcinoma after radical nephroureterectomy
Authors: Luo Zhenkai , Yan Yangxuanyu , Jiao Binbin , Huang Tao , Liu Yuhao , Chen Haijie , Guan Yunfan , Ding Zhenshan , Zhang Guan 
Published: October 2023

Abstract
Background
To investigate the prognostic significance of the systemic immune-inflammation index (SII) for patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU) and develop nomogram models for predicting overall survival (OS), intravesical recurrence (IVR), and extra-urothelial recurrence (EUR).

Methods
We retrospectively studied the clinical and pathological features of 195 patients who underwent RNU for UTUC. All patients were randomly divided into a training cohort (99 cases) and a validation cohort (96 cases). The training cohort was used to develop nomogram models, and the models were validated by the validation cohort. The least absolute shrinkage and selection operator (LASSO) regression and Cox regression were performed to identify independent predictors. The concordance index (C-index), receiver operator characteristics (ROC) analysis, and calibration plot were used to evaluate the reliability of the models. The clinical utility compared with the pathological T stage was assessed using the net reclassification index (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA).

Results
SII was an independent risk factor in predicting OS and EUR. The C-index values of the nomogram predicting OS, IVR, and EUR were 0.675, 0.702, and 0.756 in the training cohort and 0.715, 0.756, and 0.713 in the validation cohort. A high level of SII was correlated with the invasion of the mucosa, muscle layer of the ureter, nerves, vessels, and fat tissues.

Conclusion
We developed nomogram models to predict the OS, IVR, and EUR of UTUC patients. The efficacy of these models was substantiated through internal validation, demonstrating favorable discrimination, calibration, and clinical utility. A high level of SII was associated with both worse OS and shorter EUR-free survival.
Clinicopathologic and mutational profiles of primary breast diffuse large B cell lymphoma in a male patient: case report and literature review
Authors: Huang Fengbo , Ruan Yachao , He Xiaojuan , Lian Hui , Yang Jinhua 
Published: October 2023

Abstract
Introduction
Primary breast lymphoma (PBL) is rare, and most cases occur in female patients, with few reported cases in male patients. The clinical presentation is similar to that of breast cancer, but the condition needs to be well understood, as treatment options and clinical course vary. Hence, we provide a relatively rare case of primary breast diffuse large B cell lymphoma (PB-DLBCL) in a male, including its complete clinicopathological features, radiological findings, genomic mutational profiles, and clinical course.

Case presentation
A 45-year-old male presented with a lump in his right breast for 1 week and was pathologically diagnosed with breast malignancy after a breast puncture biopsy at the local hospital. He came to our hospital for further treatment and underwent breast ultrasound and systemic positron emission tomography/computed tomography (PET/CT) imaging, followed by right mastectomy and sentinel lymph node biopsy. Histomorphology showed diffuse hyperplasia of tumor cells with clear boundaries and surrounding normal breast ducts. The adhesion of tumor cells was poor with obvious atypia. Immunohistochemical results showed that the tumor cells were positive for CD20, Bcl6, and MUM-1 but negative for CK (AE1/AE3), ER, PR, CD3, and CD10. Forty percent of the tumor cells were positive for c-Myc, and 80% of tumor cells were positive for Bcl2. The Ki-67 proliferation index was up to 80%. The tumor cells were negative for MYC and BCL2 rearrangements but positive for BCL6 rearrangement by fluorescent in situ hybridization. No abnormality was found in the pathological examination of bone marrow aspiration. Therefore, the male was diagnosed with PB-DLBCL, nongerminal center (non-GCB) phenotype, dual-expression type. The sample were sequenced by a target panel of 121 genes related to lymphoma. Next-generation sequencing revealed six tumor-specific mutated genes (IGH/BCL6, TNFAIP3, PRDM1, CREBBP, DTX1, and FOXO1). The patient was given six cycles of orelabrutinib plus R-CHOP chemotherapy and two cycles of intrathecal injection of cytarabine. The last follow-up was on April 13, 2023 (17 months). No recurrence or metastasis was found in laboratory and imaging examinations.

Conclusion
We reported a relatively rare PB-DLBCL in a male, non-GBC phenotype, dual-expression type. It is worth mentioning that this case had IgH/BCL6 fusion, nonsense mutations in TNFAIP3, frameshift mutations in PRDM1, and missense mutations in CREBBP, DTX1, and FOXO1. To the best of our knowledge, this case is the first report of genomic mutational profiles of PB-DLBCL in males.
PREB inhibits the replication of prototype foamy virus by affecting its transcription
Authors: Zhang Junshi , Xu Yali , Wang Chenchen , Tuo Xiaopeng , Zhao Xingli , Qiao Wentao , Tan Juan 
Published: October 2023

Abstract
Background
Foamy viruses (FVs) are unique nonpathogenic retroviruses, which remain latent in the host for a long time. Therefore, they may be safe, effective gene transfer vectors. In this study, were assessed FV–host cell interactions and the molecular mechanisms underlying FV latent infection.

Methods
We used the prototype FV (PFV) to infect HT1080 cells and a PFV indicator cell line (PFVL) to measure virus titers. After 48 h of infection, the culture supernatant (i.e., cell-free PFV particles) and transfected cells (i.e., cell-associated PFV particles) were harvested and incubated with PFVL. After another 48 h, the luciferase activity was used to measure virus titers.

Results
Through transcriptomics sequencing, we found that PREB mRNA expression was significantly upregulated. Moreover, PREB overexpression reduced PFV replication, whereas endogenous PREB knockdown increased PFV replication. PREB interacted with the Tas DNA-binding and transcriptional activation domains and interfered with its binding to the PFV long terminal repeat and internal promoter, preventing the recruitment of transcription factors and thereby inhibiting the transactivation function of Tas. PREB C-terminal 329–418 aa played a major role in inhibiting PFV replication; PREB also inhibited bovine FV replication. Therefore, PREB has a broad-spectrum inhibitory effect on FV replication.

Conclusions
Our results demonstrated that PREB inhibits PFV replication by impeding its transcription.
Intersectionality, vulnerability and foot health inequity
Authors: Almeida Joana , Brocklehurst Jonathan , Sharples Adrienne 
Published: October 2023

AbstractFoot health and wellbeing in the UK are often overlooked in healthcare. Foot health outcomes are strongly interlinked to the social determinants of health, in that the way these determinants intersect can impact an individual's vulnerability to foot pain and disorders. In this commentary we explore some social determinants that hinder individuals from improving their foot health behaviour and ultimately reducing foot pain and foot disorder vulnerability. We focus on socioeconomic status, gender, disability, age, culture and ethnicity, and footwear quality; we also highlight the potential impact of the Covid‐19 pandemic and the cost‐of‐living crisis on foot health inequities; rises in inflation have resulted in footcare becoming less affordable among vulnerable groups, like those with intellectual disabilities and chronic illness, older people, those living in rural and inner‐city communities, and the ethnically and linguistically diverse population living in the UK. There is an urgent need to raise awareness of the social determinants of foot health, their intersectionality, and their impact on foot pain and disorder vulnerability. Despite the Black Report and both Marmot Reviews, little progress has been made in raising this awareness. It is recommended to widen the range of foot health interventions, by including it in GP consultations, developing cultural sensitivity within foot health services, creating more comprehensive educational foot health programmes, and developing a more sustainable footwear industry.
Ecology, behavior and bionomics: functional response of Heterotermes tenuis Hagen (Insecta: Blattaria: Isoptera: Rhinotermitidae) in forests of the Colombian Orinoquía
Authors: Salazar-Salazar Luis Ricardo , Pinzón-Florian Olga Patricia 
Published: October 2023

Abstract
Background
Land use intensification may affect diversity, abundance, and functional morphological traits (FMT) related to dispersal, food acquisition, digestion, and nesting in some insects, possibly impacting their ecological role. Most studies of termites on the effects of afforestation focus on diversity and abundance, but changes in FMT have yet to be studied.

Aim
To better understand the response mechanisms to land use intensification, we compared the FMT of the worker and soldier caste of Heterotermes tenuis among Pinus caribaea plantations of four different ages and gallery forests of the Colombian Orinoquía.

Methodology
We measured thirty-eight FMTs in the worker and soldier castes of H. tenuis from gallery forests and pine plantations. Then, we used a Community-Weighted Mean (CWM), a PERMANOVA, and a nonmetric multidimensional scaling (NMDS) to estimate the possible effect of land use type on the FMT of both castes. We selected the FMTs with the lowest intraspecific coefficient of variation (CV) from each caste to compare their size among the land use types and pine plantation ages.

Results
Land use type had a more significant impact on the FMT size of pine plantation workers than the age of the afforestation. FMT of the worker caste tends to be larger in gallery forests than in pine plantations, while the results were inconclusive for soldiers.

Conclusion
The results suggested a homogenization mainly of the feeding FMT of the worker caste of H. tenuis in pine plantations associated with the increase in the softwood food resource of P. caribaea.
Towards a systematic and knowledge-based requirements and conceptual engineering for modular electrolysis plants
Authors: Markaj Artan , Lorenz Julius , Scholz Lena , Henkel Vincent , Fay Alexander 
Published: October 2023

AbstractThe production of green hydrogen and its scale-up require the enginering and installation of new electrolysis plants. Modular electrolysis plants ease the scale-up as they allow to add further modules with growing demand. While many engineering methods focus on the detailed planning of the plants and their automation systems, the early engineering phases are scarcely considered, supported or formalized. However, especially these phases are crucial in the current scale-up of modular electrolysis plants. In this paper, an intention-based engineering approach for the early engineering phases Requirements Engineering and Conceptual Engineering for modular electrolysis plants is presented and evaluated based on three different use cases. The approach is based on Goal-oriented Requirements Engineering from Software Engineering and relies on an early, systematic as well as formalized description and analysis of intentions of different engineering disciplines.
Polypharmacy in the treatment of people diagnosed with borderline personality disorder: repeated cross-sectional study using New Zealand's national databases
Authors: Tennant Matthew , Frampton Chris , Mulder Roger , Beaglehole Ben 
Published: October 2023

Background
There is insufficient evidence to support the pharmacological treatment of borderline personality disorder. However, previous out-patient cohorts have described high rates of polypharmacy in this group. So far, there have been no national studies that have considered polypharmacy in borderline personality disorder.

Aims
To describe psychotropic polypharmacy in people with borderline personality disorder in New Zealand.

Method
New Zealand's national databases have been used to link psychotropic medication dispensing data and diagnostic data for borderline personality disorder. Annual dispensing data for 2014 and 2019 have been compared.

Results
Fifty percent of people with borderline personality disorder who were dispensed medications had three or more psychotropic medications in 2014. This increased to 55.9% in 2019 (P < 0.001). Those on seven or more psychotropics increased from 8.4 to 10.7% (P < 0.023). Quetiapine was the most dispensed psychotropic medication, being given to 53.8% of people dispensed medication with borderline personality disorder in 2019. Lorazepam dispensing showed the largest increase, going from 15.5 to 26.7% between 2014 and 2019 (P < 0.001).

Conclusions
There is a large burden of psychotropic polypharmacy in people with borderline personality disorder. This is concerning because of the lack of evidence regarding the efficacy of these medications in this group.