bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Exploratory Study of Rural Parents’ Knowledge and Attitudes About HPV Vaccination Following a Healthcare Visit With Their Child’s Primary Care Provider
Authors: Dickinson Caitlin , Bumatay Sarah , Valenzuela Steele , Hatch Brigit A. , Carney Patricia A. 
Published: November 2023

Introduction/Objectives: Annually, HPV infections result in $775 million in direct medical costs and approximately 46 000 new cases of HPV-associated cancers. Safe and highly effective vaccines have been available to prevent HPV for children/adolescents since 2006. Vaccination rates remain low, especially in rural areas. Parental attitudes and beliefs affect HPV vaccination rates. Methods: We developed, tested, and administered a survey that asked how parents and healthcare providers interacted about the HPV vaccine following a healthcare visit with an age-eligible child, as part of a multicomponent randomized controlled trial designed to improve HPV vaccination rates in rural Oregon. The 21-item survey assessed parents’ information-seeking behavior, knowledge about HPV cancer risk reduction, the HPV vaccine series, and their vaccine confidence. Results: Forty-three participants (59.7%) were in the intervention group; 29 (40.3%) were controls. Over 90% of healthcare visits were illness, injury, sports physical, or well-child visits (n = 67 or 93.1%), and 6.9% of visits were vaccine-specific. No statistically significant differences were found between study groups for healthcare visits. Over half the parents reported having discussions about HPV and the HPV vaccine (54.5%) with their care providers, 31.3% had recently learned about HPV, HPV risks, and the HPV vaccine prior to the visit, 83.1% were knowledgeable about cancers associated with HPV, and 79.2% were considering vaccinating their child(ren), which did not differ between study groups. Conclusions: Knowledge about HPV-related cancers and consideration for vaccinating children was higher than expected, but not associated with the intervention tested.
Loneliness Factors in Older People and the Influence on Attitudes Toward Informal Care: A Study of Older Chinese People in Urban Areas
Authors: Zhang Zihan , Kato Chieko , Otsuka Yoshiomi 
Published: November 2023

Objectives: Loneliness is thought to be more likely to occur in older people and influences their lives. This study aimed to verify the influence of loneliness in older Chinese people on their attitudes toward informal care, as well as the demographic, social, and economic factors that may cause loneliness. Methods: Data was collected from older P (age: >60 years) using an online questionnaire. Hierarchical linear regression was used to analyze the associations between demographic, social, and economic factors, loneliness, and attitudes toward informal care. Results: Results have shown that cohabitation and family savings could significantly negatively influence loneliness. Educational background and cohabitation could significantly positively influence attitudes toward informal care. However, loneliness could significantly negatively influence attitudes toward informal care. Conclusion: Older people living alone and with worse economic conditions may need attention from the community and society because they are more likely to suffer from loneliness. Loneliness may also significantly impact older people’s attitudes toward long-term care. Older people are more likely to feel lonely may have more negative attitudes toward informal care. Communities need to make more efforts to improve community health services or formal care services for these older people to address situations where informal care is not sufficiently provided.
T-Remodeling of the Pulmonary Artery Bifurcation for Pulmonary Artery Origin Stenosis
Authors: Zheng Wayne C. , Buratto Edward , Caldaroni Federica , Ishigami Shuta , Konstantinov Igor E. , d’Udekem Yves 
Published: November 2023

Background Various surgical techniques are utilized for reconstructing hypoplastic pulmonary arteries (PAs) in patients with conotruncal anomalies and at times, may be susceptible to restenosis and reoperation. We reviewed our experience with a simple technique of T-shaped remodeling of the PA bifurcation. Methods Between 2005 and 2019, 31 patients underwent T-remodeling of central PAs by a single cardiac surgeon. The PA bifurcation was opened cranially, and the opening was augmented with an oval-shaped patch effectively transforming the V-shaped bifurcation into a T-shaped bifurcation. Both origins of the PAs were enlarged, even in the instance of single PA origin stenosis. Results Median age at time of T-remodeling was 17 months (range: 7 weeks to 14 years). The following cardiac morphologies were observed: tetralogy of Fallot (n = 12, 39%), pulmonary atresia with ventricular septal defect (VSD) and major aortopulmonary collateral arteries (n = 8, 26%), truncus arteriosus (n = 6, 19%), pulmonary atresia with VSD (n = 3, 9.7%), and transposition of the great arteries (n = 2, 6.5%). Thirteen patients (42%) had previous central shunt, and eight patients (26%) had previous modified Blalock-Taussig shunt. There were no operative mortalities. Immediately after T-remodeling, echocardiographic estimates of right ventricle to PA gradient decreased from 42 [interquartile range 28-58] mm Hg to 20 [12-36] mm Hg ( P = .03). Freedom from reoperation on the PA bifurcation for the entire cohort was 100% at one year, 88% (95% CI 68%-96%) at five years and 82% (57%-93%) at ten years. Conclusions T-remodeling for PA origin stenosis is a safe procedure with excellent freedom from reoperation that is easily reproducible and applicable to patients with all cardiac morphologies.
Non-target screening of surface water samples to identify exposome-related pollutants: a case study from Luxembourg
Authors: Aurich Dagny , Diderich Philippe , Helmus Rick , Schymanski Emma L. 
Published: November 2023

Abstract
Background
Non-target screening of surface water samples collected over an extended period can reveal interesting temporal patterns in exposome-related pollutants. Additionally, geographical data on pollution sources close to the sampling sites, chemical classification data and the consideration of flow paths can provide valuable information on the origins and potential threat of tentatively identified chemical compounds. In this study, 271 surface water samples from 20 sampling sites across Luxembourg were analysed using high-resolution mass spectrometry, complementing routine target monitoring efforts in 2019–2022. Data analysis was performed using the open source R-package patRoon, which offers a customizable non-target workflow. By employing open source workflows featuring scoring terms, like spectral match and applying identification levels, tentative identifications can be prioritized, e.g. based on spectral similarity. Furthermore, by utilizing supplementary database information such as PubChemLite annotation categories and classification software such as classyFire, an overall assessment of the potential threats posed by the tentatively identified chemicals was conducted, enabling the prioritization of chemicals for future confirmation through targeted approaches.

Results
The study tentatively identified 378 compounds associated with the exposome including benzenoids, organoheterocyclic compounds, and organic phosphoric acids and derivatives (11 classyFire superclasses, 50 subclasses). The classification analysis not only revealed temporal variations in agrochemicals, with the majority of identifications occurring in May to July, but also highlighted the prevalence of pharmaceuticals such as venlafaxine in surface waters. Furthermore, potential sources of pollutants, like metallurgic industry or household products were explored by considering common uses and geographical information, as commercial uses of almost 100% of the identified chemicals are known. 41 chemicals were suggested for potential inclusion to governmental monitoring lists for further investigation.

Conclusions
The findings of this study complement existing knowledge on the pollution status of surface water in Luxembourg and highlight the usefulness of non-target screening for identifying temporal and spatial trends in pollutant levels. This approach, performed in a complementary manner to routine monitoring, can help to tentatively identify chemicals of concern for potential inclusion in target monitoring methods following additional confirmation and quantification efforts.
Infections in the first year of living related kidney transplantation in a young transplant cohort
Authors: Khedr Lamis , Teama Nahla , El Sharkawy Magdy 
Published: November 2023

Abstract
Background
Infection after a kidney transplant is a serious cause of morbidity and mortality. Weighing the risks and benefits of immunosuppression is of paramount importance for patient wellbeing and transplant survival.

Methods
This is a prospective observational study exploring the variety of bacterial, viral and fungal infections occurring within the first year of living related kidney transplantation in a young transplant cohort. Fifty-one kidney transplant recipients (KTR) between the age of 18 and 45 who had a kidney transplant between Jan 2020 and Jan 2022 were enrolled and followed up for one year. Primary outcome was the occurrence of infection.

Results
Twenty-four patients (47%) recorded a collective 33 episodes of infection. Seven patients had repeated infections and 17 had single infections. Twenty-seven patients had an uneventful year with no infections recorded. Commonest infection was lower urinary tract infection (UTI) (27.3%) followed by SARS-COV2 and Herpes Zoster (15.2%). The commonest pathogens causing lower UTI were Escherichia coli (E coli) (21.2%) and Klebsiella (18.2%). Median Tacrolimus level was (7.8) ng/ml in KTR with infection and (8.95) ng/ml in KTR without infection, p = 0.21. Median Haemoglobin (IQR) was (10.2) g/dl (7.8–14) gm/dl in KTR with infection compared to (10.8) g/dl (7.3–15.3) in KTR without infection odds ratio (OR) = 0.78, confidence interval (CI) (0.5–1.1); p = 0.16.In KTR with infection 25% had donors above the age of 60 compared to 11% in KTR without infection ( OR 2.6,CI (0.5–12), p = 0.2). Post transplant diabetes (PTDM) occurred in (25%) in KTR with infection compared to those without, but that was not statistically significant p = 0. 365.In KTR without infection, 59.3% had a preemptive transplant compared to 20.8% in the group with infection (OR = 0.18; 95% CI: 0.052–0.631; p = 0.007). Median tacrolimus was 7.8 ng/ml in KTR with single infection compared to 7.7 ng/ml in KTR with repeated infections.

Conclusion
This study shows that the commonest infection occurring in the first-year post kidney transplant was lower urinary tract infection followed by SARS-COV2 and Herpes Zoster. There was no difference in trough tacrolimus or haemoglobin levels between KTR who developed infection with those who did not.
Unilateral adrenalectomy for a drug-resistant bilateral primary aldosteronism with heart failure: pathophysiology and surgical indication
Authors: Hoshi Seiji , Onagi Akifumi , Tanji Ryo , Honda-Takinami Ruriko , Matsuoka Kanako , Hata Junya , Sato Yuichi , Akaihata Hidenori , Kataoka Masao , Ogawa Soichiro , Kojima Yoshiyuki 
Published: November 2023

Abstract
Background
Patients with bilateral primary aldosteronism (PA) generally are treated with antihypertensive drugs, but optimal treatment for patients with complications due to refractory hypertension has not been established. In this report, we present a case with bilateral PA who presented with persistent hypertension, despite treatment with 6 drugs, and left-dominant heart failure, which was improved after unilateral adrenalectomy.

Case presentation
A 61-year-old man was admitted to our hospital because of severe left-dominant heart failure. His heart rhythm was atrial fibrillation and the left ventricle was diffusely hypertrophic and hypokinetic. Coronary arteries were normal on coronary arteriogram. Primary aldosteronism was suspected based on severe hypokalemia (2.5 mEq/L) and plasma aldosterone concentration (PAC; 1,410 pg/mL). Although computed tomography (CT) showed a single left cortical nodule, adrenal vein sampling (AVS) indicated bilateral PA. Early in the case, heart failure and hyperkalemia in this patient were improved by treatment with a combination of 6 antihypertensive drugs (spironolactone 25 mg/day, eplerenone 100 mg/day, azosemide 60 mg/day, tolvaptan 7.5 mg/day, enalapril 5 mg/day, and bisoprolol fumarate 10 mg/day); however, heart failure relapsed after four months of treatment. We hypothesized that hypertension caused by excess aldosterone was inducing the patient’s heart failure. In order to reduce aldosterone secretory tissue, a laparoscopic adrenalectomy was performed for the left adrenal gland, given the higher level of aldosterone from the left gland compared to the right. Following surgery, the patient’s heart failure was successfully controlled despite the persistence of high PAC. Treatment with anti-hypertensive medications was reduced to two drugs (eplerenone 100 mg/day and bisoprolol fumarate 10 mg/day). In order to elucidate the mechanism of drug resistance, immunohistochemistry (IHC) and real time-polymerase chain reaction (RT-PCR) assays were performed to assess the expression of steroidogenic factor 1 (SF-1), a regulator of steroid synthesis in adrenal tissue. IHC and RT-PCR demonstrated that the expression of SF-1 in this patient (at both the protein and mRNA levels) was higher than that observed in unilateral PA cases that showed good responsivity to drug treatment.

Conclusions
Unilateral adrenalectomy to reduce aldosterone secretory tissue may be useful for patients with drug-refractory, bilateral PA. Elevated expression of SF-1 may be involved in drug resistance in PA.
Development and validation of the Perceived Benefits of Team-Interaction Training Questionnaire (PBTITQ) among undergraduates
Authors: Chen Ming , Chen Hefang , Wu Yifan , Yang Ruijun , Guo Chaowei , Zhao Meizhen , Xin Chaoli , Zang Shuang 
Published: November 2023

Abstract
Background
The effectiveness of team-interaction training has been proven. However, there is a lack of objective and accurate evaluation tools for the impact and benefits of team-interaction training on participants. This study aims to develop and validate a tool for exploring undergraduates’ perception of benefits in team-interaction. It can further insight into the perceived benefits of team-interaction training for undergraduates and evaluates the effectiveness of the course, and provides a reference point for the development of university team-interaction training courses.

Methods
This study was conducted in three stages. Phase 1 consisted of item generation: A theoretical framework was crafted based on social cognitive theory, self-efficacy theory, and sports performance models. Fifty-two items were generated based on the theoretical framework, participant interviews, and literature review. After Delphi consultation and pilot tests, 39 items moved on to Phase 2. Phase 2 consisted of forming a preliminary questionnaire: the contents to be included were selected through item analysis and exploratory factor analysis (EFA). A total of 40 classes were selected for EFA. After EFA, a three-factor structure with 25 items was formed. The third stage tested psychometric properties through confirmatory factor analysis (CFA), test-retest reliability, criterion-related validity, and internal consistency.

Results
The final PBTITQ consisted of 23 items, each rated from “1” (fully disagree) to “5” (fully agree). EFA and CFA supported the three-factor structure of PBTITQ, which included Cohesion, Communication, and Efficiency. The Cronbach’s alpha of the PBTITQ was 0.90, the test-retest reliability was 0.88, and the split-half reliability was 0.81. PBTITQ significantly correlated with the GEQ (r = 0.808, p < 0.05) and the TDM (r = 0.796, p < 0.05).

Conclusion
The PBTITQ is an effective tool for assessing the perceived benefits of team-interaction training among undergraduates.
Association between vector-borne pathogen seroprevalence in shelter-housed and owned dog populations in the contiguous United States of America
Authors: Gettings Jenna R. , McMahan Christopher S. , Cleveland Christopher A. , Varela-Stokes Andrea , Hubbard Kris , Hamer Sarah A. , Walden Heather S. , Yabsley Michael J. 
Published: November 2023

AbstractDomestic dogs are susceptible to numerous vector-borne pathogens that are of significant importance for their health. In addition to being of veterinary importance, many of these pathogens are zoonotic and thus may pose a risk to human health. In the USA, owned dogs are commonly screened for exposure to or infection with several canine vector-borne pathogens. Although the screening data are widely available to show areas where infections are being diagnosed, testing of owned dogs is expected to underestimate the actual prevalence in dogs that have no access to veterinary care. The goal of this study was to measure the association between the widely available data from a perceived low-risk population with temporally and spatially collected data from shelter-housed dog populations. These data were then used to extrapolate the prevalence in dogs that generally lack veterinary care. The focus pathogens included Dirofilaria immitis, Ehrlichia spp., Anaplasma spp., and Borrelia burgdorferi. There was a linear association between the prevalence of selected vector-borne pathogens in shelter-housed and owned dog populations and, generally, the data suggested that prevalence of heartworm (D. immitis) infection and seroprevalence of Ehrlichia spp. and B. burgdorferi are higher in shelter-housed dogs, regardless of their location, compared with the owned population. The seroprevalence of Anaplasma spp. was predicted to be higher in areas that have very low to low seroprevalence, but unexpectedly, in areas of higher seroprevalence within the owned population, the seroprevalence was expected to be lower in the shelter-housed dog population. If shelters and veterinarians make decisions to not screen dogs based on the known seroprevalence of the owned group, they are likely underestimating the risk of exposure. This is especially true for heartworm. With this new estimate of the seroprevalence in shelter-housed dogs throughout the USA, shelters and veterinarians can make evidence-based informed decisions on whether testing and screening for these pathogens is appropriate for their local dog population. This work represents an important step in understanding the relationships in the seroprevalences of vector-borne pathogens between shelter-housed and owned dogs, and provides valuable data on the risk of vector-borne diseases in dogs.
Graphical abstract
Abnormal expression of PRKAG2-AS results in dysfunction of cardiomyocytes through regulating PRKAG2 transcription by interacting with PPARG
Authors: Song Xiao-Wei , Su Ting , Li Bo , Huang Yun-Jie , He Wen-Xia , Jiang Li-Li , Li Chang-Jin , Huang Song-Qun , Li Song-Hua , Guo Zhi-Fu , Wu Hong , Zhang Bi-Li 
Published: November 2023

AbstractThe role of PRKAG2 in the maintenance of heart function is well established, but little is known about how PRKAG2 is regulated in cardiomyocytes. In this study, we investigated the role of the lncRNA PRKAG2-AS, which is present at the PRKAG2 promoter, in the regulation of PRKAG2 expression. PRKAG2-AS expression was predominantly nuclear, as determined by RNA nucleoplasmic separation and fluorescence in situ hybridization. Knockdown of PRKAG2-AS in the nucleus, but not the cytoplasm, significantly decreased the expression of PRKAG2b and PRKAG2d. Interestingly, we found that PRKAG2-AS and its target genes, PRKAG2b and PRKAG2d, were reduced in the hearts of patients with ischemic cardiomyopathy, suggesting a potential role for PRKAG2-AS in myocardial ischemia. Indeed, knockdown of PRKAG2-AS in the nucleus resulted in apoptosis of cardiomyocytes. We further elucidated the mechanism by which PRKAG2-AS regulates PRKAG2 transcription by identifying 58 PRKAG2-AS interacting proteins. Among them, PPARG was selected for further investigation based on its correlation and potential interaction with PRKAG2-AS in regulating transcription. Overexpression of PPARG, or its activation with rosiglitazone, led to a significant increase in the expression of PRKAG2b and PRKAG2d in cardiomyocytes, which could be attenuated by PRKAG2-AS knockdown. This finding suggests that PRKAG2-AS mediates, at least partially, the protective effects of rosiglitazone on hypoxia-induced apoptosis. However, given the risk of rosiglitazone in heart failure, we also examined the involvement of PRKAG2-AS in this condition and found that PRKAG2-AS, as well as PRKAG2b and PRKAG2d, was elevated in hearts with dilated cardiomyopathy (DCM) and that overexpression of PRKAG2-AS led to a significant increase in PRKAG2b and PRKAG2d expression, indicating that up-regulation of PRKAG2-AS may contribute to the mechanism of heart failure by promoting transcription of PRKAG2. Consequently, proper expression of PRKAG2-AS is essential for maintaining cardiomyocyte function, and aberrant PRKAG2-AS expression induced by hypoxia or other stimuli may cause cardiac dysfunction.
Causal relationship between gut microbiota and myasthenia gravis: a bidirectional mendelian randomization study
Authors: Su Tengfei , Yin Xiang , Ren Jiaxin , Lang Yue , Zhang Weiguanliu , Cui Li 
Published: November 2023

Abstract
Background
Observational studies have demonstrated an association between gut microbiota and myasthenia gravis; however, the causal relationship between the two still lacks clarity. Our goals are to ascertain the existence of a bidirectional causal relationship between gut microbiota composition and myasthenia gravis, and to investigate how gut microbiota plays a role in reducing the risk of myasthenia gravis.

Methods
We acquired gut microbiota data at the phylum, class, order, family, and genus levels from the MiBioGen consortium (N = 18,340) and myasthenia gravis data from the FinnGen Research Project (426 cases and 373,848 controls). In the two-sample Mendelian randomization analysis, we assessed the causal relationship between the gut microbiota and myasthenia gravis. We also conducted bidirectional MR analysis to determine the direction of causality. The inverse variance weighted, mendelian randomization-Egger, weighted median, simple mode, and weighted mode were used to test the causal relationship between the gut microbiota and severe myasthenia gravis. We used MR-Egger intercept and Cochran's Q test to assess for pleiotropy and heterogeneity, respectively. Furthermore, we utilized the MR-PRESSO method to evaluate horizontal pleiotropy and detect outliers.

Results
In the forward analysis, the inverse-variance weighted method revealed that there is a positive correlation between the genus Lachnoclostridium (OR = 2.431,95%CI 1.047–5.647, p = 0.039) and the risk of myasthenia gravis. Additionally, the family Clostridiaceae1 (OR = 0.424,95%CI 0.202–0.889, p = 0.023), family Defluviitaleaceae (OR = 0.537,95%CI  0.290–0.995, p = 0.048), family Enterobacteriaceae (OR = 0.341,95%CI  0.135–0.865, p = 0.023), and an unknown genus (OR = 0.407,95%CI  0.209–0.793, p = 0.008) all demonstrated negative correlation with the risk of developing myasthenia gravis. Futhermore, reversed Mendelian randomization analysis proved a negative correlation between the risk of myasthenia gravis and genus Barnesiella (OR = 0.945,95%CI  0.906–0.985, p = 0.008).

Conclusion
Our research yielded evidence of a causality connection in both directions between gut microbiota and myasthenia gravis. We identified specific types of microbes associated with myasthenia gravis, which offers a fresh window into the pathogenesis of this disease and the possibility of developing treatment strategies. Nonetheless, more studies, both basic and clinical, are necessary to elucidate the precise role and therapeutic potential of the gut microbiota in the pathogenesis of myasthenia gravis.