bluuebunny/crossref_metadata_2025_split huggingface dataset:
Victim of changes? Marine macroalgae in a changing world
Authors: Hanley Mick E , Firth Louise B , Foggo Andy 
Published: November 2023

Abstract

Background
Marine macroalgae (‘seaweeds’) are a diverse and globally distributed group of photosynthetic organisms that together generate considerable primary productivity, provide an array of different habitats for other organisms, and contribute many important ecosystem functions and services. As a result of continued anthropogenic stress on marine systems, many macroalgal species and habitats face an uncertain future, risking their vital contribution to global productivity and ecosystem service provision.

Scope
After briefly considering the remarkable taxonomy and ecological distribution of marine macroalgae, we review how the threats posed by a combination of anthropogenically induced stressors affect seaweed species and communities. From there we highlight five critical avenues for further research to explore (long-term monitoring, use of functional traits, focus on early ontogeny, biotic interactions and impact of marine litter on coastal vegetation).

Conclusions
Although there are considerable parallels with terrestrial vascular plant responses to the many threats posed by anthropogenic stressors, we note that the impacts of some (e.g. habitat loss) are much less keenly felt in the oceans than on land. Nevertheless, and in common with terrestrial plant communities, the impact of climate change will inevitably be the most pernicious threat to the future persistence of seaweed species, communities and service provision. While understanding macroalgal responses to simultaneous environmental stressors is inevitably a complex exercise, our attempt to highlight synergies with terrestrial systems, and provide five future research priorities to elucidate some of the important trends and mechanisms of response, may yet offer some small contribution to this goal.
Geographic Differences in Patient Demographics and Performance of Gender-Affirming Surgery From 2016 to 2019
Authors: Das Rishub K , Galdyn Izabela , McCaffrey Rachel L , Drolet Brian C , Al Kassis Salam 
Published: November 2023

Abstract

Background
Although legislation prohibiting gender identity discrimination in health insurance has shown some improvement in insurance coverage for gender-affirming surgery (GAS), recent bills criminalizing GAS providers in the South and Midwest regions pose threats to patient care.

Objectives
To investigate the influence of US census region on patient demographics and GAS rates in the ambulatory surgery setting.

Methods
Individuals with gender dysphoria who underwent GAS in the ambulatory setting from 2016 to 2019 were identified in the Nationwide Ambulatory Surgery Sample (NASS) with billing codes. Demographic and clinical characteristics were analyzed and stratified by US census region.

Results
The data set included a weighted estimate of 33,174 encounters with 72.8% (95% CI, 69.1-76.2) for chest reconstruction; 24.1% (95% CI, 20.9-27.5) for surgery on the genitals and reproductive organs; and 6.0% (95% CI, 4.6-7.8) for facial surgery. Overall, the rates of GAS increased by 187%, from 4320 encounters in 2016 to 12,396 encounters in 2019. In the Midwest, GAS increased by 257% compared to 203% in the Northeast, 218% in the South, and 154% in the West. Compared to patients in the West, those in other regions had higher odds of anxiety and depression (odds ratio, 1.57; 95% CI, 1.09-2.26; P &lt; .05) and were more likely to have lower incomes than other ambulatory surgery patients in the region (P &lt; .001).

Conclusions
Between 2016 and 2019, there was substantial growth of GAS in the Midwest, South, and Northeast. Regional differences in insurance coverage, socioeconomic status, availability of facial surgery, and comorbidities were observed.

Level of Evidence: 2
Combined WNT-activated deep-penetrating/plexiform melanocytoma: insights into clinicopathological and molecular characterization
Authors: Castillo Paola , Castrejon Natalia , Marginet Marta , Massi Daniela , Alamon Francesc , Teixido Cristina , Montironi Carla , Garcia-Herrera Adriana , Albero-Gonzalez Raquel , Matas Jessica , Puig Susana , Alos Llucia 
Published: November 2023

Abstract

Background
A combined deep-penetrating tumour redefined as WNT-activated deep-penetrating/plexiform melanocytoma (DPM), may pose challenging clinical and histological diagnoses.

Objectives
To review the clinicopathological characteristics of combined DPMs and characterize the molecular profile of atypical and malignant forms.

Methods
The study included 51 patients with combined DPMs diagnosed at the Hospital Clinic of Barcelona and the University of Florence between 2012 and 2020. Clinical data, dermoscopy images (when available) and histological characteristics were reviewed. Immunohistochemistry for β-catenin, LEF1, HMB45, Ki67, p16 and PRAME (preferentially expressed antigen in melanoma) was performed. Atypical forms underwent next-generation sequencing (NGS) panel analysis, including driver genes implicated in DPMs, TERT-promoter (p) mutations and the investigation of the 9p21 locus via fluorescence in situ hybridization.

Results
Among the 51 patients (32 females and 19 males, age range 4–74 years), 68% with available clinical data (15/22) were initially suspected of having melanoma. Except for one patient, complete excision resulted in no recurrences or metastases. One patient who had an incompletely excised combined DPM developed a lymph node melanoma metastasis 10 years later. In the 51 patients, 10 samples (20%) showed atypical histological features; 7 (14%) exhibited a significant loss of p16 expression; and 2 (4%) showed a high-proliferative index (Ki67 over 5%). NGS analysis in 11 patients revealed a double mutation BRAFV600E and exon 3 CTNNB1; no TERTp mutations were detected.

Conclusions
Clinical suspicion of melanoma is common in combined DPMs, but malignant progression is infrequent in tumours lacking high-grade atypia or proliferation. These findings are congruent with the consideration of these lesions as intermediate-grade tumours or melanocytomas.
Daylight photodynamic therapy as a treatment for actinic field change in patients diagnosed with oculocutaneous albinism in sub-Saharan Africa
Authors: Twigg Emily , Roberts Elizabeth , Sharp Andrew , Iraba Jacqueline , Chapa Peter , Freeland Harry , Mavura Daudi 
Published: November 2023

Abstract

Background
Oculocutaneous albinism (OCA) is a genetically inherited condition, whereby melanin is reduced or absent in the skin. A lack of melanin predisposes people to actinic damage and skin malignancies. In Tanzania, a resource-limited country, the treatment of choice for precancerous skin lesions is cryotherapy.

Objectives
To investigate whether daylight photodynamic therapy (dPDT) is a safe and well-tolerated treatment for actinic field change in the OCA population in Tanzania.

Methods
Twelve participants with actinic damage were recruited from a Standing Voice skin surveillance clinic and treated with dPDT. Study participants completed tolerability and acceptability questionnaires at day 5 and 3 months after treatment. A dermatologist assessed their clinical response to dPDT at 3 months.

Results
dPDT was well-tolerated and acceptable to the majority of patients. Actinic damage was reduced by 25–90%. No skin cancers developed during the treatment.

Conclusions
This pilot study suggests that dPDT is a safe and tolerable treatment for actinic damage in people with OCA in Tanzania. Further work is required to compare the efficacy of dPDT against other topical therapies for actinic field change.
Microbiology, Public Health, and the Murals of Diego Rivera
Authors: Cabello Felipe C , Godfrey Henry P 
Published: November 2023

Abstract
Diego Rivera, an acclaimed Mexican painter active during the first half of the 20th century, painted multiple frescoes in Mexico and the United States. Some include depictions of bacteria, their interactions with human hosts, and processes related to microbiology and public health, including the microbial origin of life, diagnosis of infection, vaccine production, and immunization. Microbiological subjects in Rivera's murals at the Mexican Ministry of Health in Mexico City; the Detroit Institute of Art, Detroit; Rockefeller Center, New York/Palacio de Bellas Artes, Mexico City; Chapultepec Park, Mexico City; and the Institute of Social Security, Mexico City, span almost 25 years, from 1929 to 1953. Illustrating the successes of the application of microbiological discoveries and methods to public health and the prevention and treatment of infectious diseases, they benefited from Rivera's creativity in melding microbiology's unique technological and scientific aspects and public health elements with industrial and political components.
Performance of the PRIMaCY sudden death risk prediction model for childhood hypertrophic cardiomyopathy: implications for implantable cardioverter-defibrillator decision-making
Authors: Norrish Gabrielle , Protonotarios Alexandros , Stec Maria , Boleti Olga , Field Ella , Cervi Elena , Elliott Perry M , Kaski Juan P 
Published: November 2023

Abstract

Aims
The validated HCM Risk-Kids model provides accurate individualized estimates of sudden cardiac death risk in children with hypertrophic cardiomyopathy (HCM). A second validated model, PRIMaCY, also provides individualized estimates of risk, but its performance and clinical impact has not been independently investigated. The aim of this study was to investigate the clinical impact of using the PRIMaCY sudden cardiac death (SCD) risk model in childhood HCM.

Methods and results
The estimated 5-year SCD risk was calculated for children meeting diagnostic criteria for HCM in a large single-centre cohort using PRIMaCY (clinical and genetic) and HCM Risk-Kids model, and model performance was assessed. Three hundred one patients [median age 10 (interquartile range 4–14)] were followed up for an average of 4.9 (±3.8) years, during which 30 (10.0%) reached the SCD or equivalent event endpoint. Harrell’s C-statistic for the clinical and genetic models was 0.66 [95% confidence interval (CI) 0.52–0.8] and 0.66 (95% CI 0.54–0.80) with a calibration slope of 0.19 (95% CI 0.04–0.54) and 0.26 (95% CI −0.03–0.62), respectively. The number needed to treat to potentially treat one life-threatening arrhythmia for the PRIMaCY clinical, PRIMaCY genetic, and HCM Risk-Kids models was 13.7, 14.5, and 9.4, respectively.

Conclusion
Although PRIMaCY has a similar discriminatory ability to that reported for HCM Risk-Kids, estimated risk estimates did not correlate well with observed risk. A higher proportion of patients met implantable cardioverter-defibrillator thresholds using PRIMaCY model compared with HCM Risk-Kids. This has important clinical implications as these patients will be exposed to a lifetime risk of complications and inappropriate therapies.
Pollinator and habitat-mediated selection as potential contributors to ecological speciation in two closely related species
Authors: Campbell Diane R , Powers John M , Crowell Madison 
Published: November 2023

Abstract
In ecological speciation, incipient species diverge due to natural selection that is ecologically based. In flowering plants, different pollinators could mediate that selection (pollinator-mediated divergent selection) or other features of the environment that differ between habitats of 2 species could do so (environment-mediated divergent selection). Although these mechanisms are well understood, they have received little rigorous testing, as few studies of divergent selection across sites of closely related species include both floral traits that influence pollination and vegetative traits that influence survival. This study employed common gardens in sites of the 2 parental species and a hybrid site, each containing advanced generation hybrids along with the parental species, to test these forms of ecological speciation in plants of the genus Ipomopsis. A total of 3 vegetative traits (specific leaf area, leaf trichomes, and photosynthetic water-use efficiency) and 5 floral traits (corolla length and width, anther insertion, petal color, and nectar production) were analyzed for impacts on fitness components (survival to flowering and seeds per flower, respectively). These traits exhibited strong clines across the elevational gradient in the hybrid zone, with narrower clines in theory reflecting stronger selection or higher genetic variance. Plants with long corollas and inserted anthers had higher seeds per flower at the Ipomopsis tenuituba site, whereas selection favored the reverse condition at the Ipomopsis aggregata site, a signature of divergent selection. In contrast, no divergent selection due to variation in survival was detected on any vegetative trait. Selection within the hybrid zone most closely resembled selection within the I. aggregata site. Across traits, the strength of divergent selection was not significantly correlated with width of the cline, which was better predicted by evolvability (standardized genetic variance). These results support the role of pollinator-mediated divergent selection in ecological speciation and illustrate the importance of genetic variance in determining divergence across hybrid zones.
‘We stay silent and keep it in our hearts’: a qualitative study of failure of complaints mechanisms in Malawi’s health system
Authors: Chilumpha Maryam , Chatha Gertrude , Umar Eric , McKee Martin , Scott Kerry , Hutchinson Eleanor , Balabanova Dina 
Published: November 2023

Abstract
A responsive health system must have mechanisms in place that ensure it is accountable to those it serves. Patients in Malawi have to overcome many barriers to obtain care. Many of these barriers reflect weak accountability. There are at least 30 mechanisms through which Malawian patients in the public sector can assert their rights, yet few function well and, as a consequence, they are underused. Our aim was to identify the various channels for complaints and why patients are reluctant to use them when they experience poor quality or inappropriate care, as well as the institutional, social and political factors that give rise to these problems. The study was set in the Blantyre district. We used qualitative methods, including ethnographic observations, focus group discussions, document analysis and interviews with stakeholders involved in complaint handling both in Blantyre and in the capital, Lilongwe. We found that complaints mechanisms and redress procedures are underutilized because of lack of trust, geographical inaccessibility and lack of visibility leading to limited awareness of their existence. Drawing on these results, we propose a series of recommendations for the way forward.
Do Indian women know about and use the emergency contraceptive pill? An analysis of nationally representative data from 2005–06 and 2019–21
Authors: Renu  , Arora Pooja , Scott Kerry , Balabanova Dina 
Published: November 2023

Abstract
The emergency contraceptive pill (ECP) is a post-coital contraceptive method that prevents unintended pregnancy and is useful in specific circumstances. This study examined the awareness and use of the ECP in India, as there is scarce evidence in this area to guide policy development. This study used data from the 2005–06 (n = 124 385) and 2019–21 (n = 724 115) rounds of the National Family Health Survey of India. Bivariate analysis and multivariate logistic regression were applied to explore how demographic characteristics including age, education (none, primary, secondary, higher), wealth quintile, place of residence (urban, rural), marital status, parity, desire for children, whether current pregnancy was wanted, whether the women had had an abortion in the past 5 years, and whether current use of contraceptive methods affected the likelihood of knowledge and use of ECP. In the past 15 years, knowledge of ECP has increased by 37 percentage points but still remains relatively low at 48%. Less than 1% of the sample (0.55%) used ECP. Women aged 30–34 years, from wealthier and more educated backgrounds, living in urban areas, and currently using condoms had a higher likelihood of using ECP in comparison with women from age group 15–19 years, those from the poorest backgrounds, those with no education, those living in rural areas and those not using any contraceptive method, respectively. In comparison to married women, never-married women exhibited a higher awareness of ECP but lower use. More efforts must be made to improve awareness of the ECP, especially among adolescents, those with less education, poorer women and those in rural areas. The government is taking steps to improve access to ECP, and India’s female community health workers, the ASHAs, could be further supported to enhance awareness of ECP.
Unique risk factors for unplanned preterm delivery in the uterus transplant recipient
Authors: Johannesson Liza , Testa Giuliano , Petrillo Nicole , Gregg Anthony R 
Published: November 2023

Abstract

STUDY QUESTION
Do characteristics of the lower uterine segment and cervix modify the risk of preterm delivery in uterus transplant (UTx) recipients?

SUMMARY ANSWER
The cervical length showed little association with preterm delivery, however, cervical inflammation deserves further exploration as a cause of preterm delivery.

WHAT IS KNOWN ALREADY
UTx recipients do not have the risk factors normally used to stratify pregnancies that would benefit from cervical length assessment. In addition, unique factors related to absent tissues, a different blood supply, inflammatory processes of rejection, cervical biopsies, and a different microbiome challenge the normal progressive remodeling of the cervix and thus cervical competence.

STUDY DESIGN, SIZE, DURATION
This is a subanalysis of a clinical trial of 20 women undergoing uterus transplantation at Baylor University Medical Center from 2016 to 2020, in addition to two women who received transplantation outside of a research protocol at our institution through September 2022. In this report, the first 16 UTx recipients that achieved live birth are included.

PARTICIPANTS/MATERIALS, SETTING, METHODS
The focus of this study was 20 pregnancies that reached the second trimester in 16 women following UTx. We analyzed recipient, transplant, and donor factors to determine if characteristics were associated with delivery outcome. We compared obstetrical outcomes, including planned versus unplanned delivery, by factors such as number of superior venous anastomoses, warm ischemia and cold ischemia times, donor factors including cesarean sections, cervical biopsy results, and cervical ultrasound results.

MAIN RESULTS AND THE ROLE OF CHANCE
Planned term deliveries occurred in 44% (8/18) of live births. Of the preterm births, 30% (3/10) were planned and 70% (7/10) were unplanned. Unplanned deliveries occurred in women with spontaneous preterm labor, severe rejection, subchorionic hematoma, and placenta previa. Cervical length in UTx recipients averaged 33.5 mm at 24 weeks and 31.5 mm at 28 weeks, comparable to values from the general population. No relationship was seen between delivery outcome and number of veins used, ischemic time, or number of previous cesarean sections.

LIMITATIONS, REASONS FOR CAUTION
The study’s small size allows limited conclusions. The obstetric history of all donors was limited to mode of delivery.

WIDER IMPLICATIONS OF THE FINDINGS
Cervical length measurements in the UTx population are not expected to deviate from those with a native uterus. While cervical length surveillance remains important, attention must be paid to the results of cervical biopsies which are obtained to monitor rejection. Inflammatory processes seem most predictive of preterm delivery.

STUDY FUNDING/COMPETING INTEREST(S)
No funding was provided for this study. The authors report no conflicts of interest.

TRIAL REGISTRATION NUMBER
NCT02656550
Astragalus additive in feed improved serum immune function, rumen fermentation and the microbiota structure of early-weaned lambs
Authors: Shao Pengyang , Sha Yuzhu , Liu Xiu , He Yanyu , Guo Xinyu , Hu Jiang , Wang Jiqing , Li Shaobin , Zhu Caiye , Chen Guoshun , Li Wenhao 
Published: November 2023

Abstract

Aim
The purpose of this study was to determine the mechanism of Astragalus activity on the immune function, rumen microbiota structure, and rumen fermentation of early-weaned lambs.

Methods and results
Thirty healthy early-weaned lambs with similar body weights (17.42 ± 2.02 kg) were selected for the feeding experiment. The control group (KB) was fed a basal diet, and the Astragalus group (HQ) was fed 0.3% Astragalus additive on the basis of a basic diet. The formal trial period was 60 days. The results showed that the concentrations of blood immunoglobulin A (IgA) and immunoglobulin M (IgM) in the HQ group were significantly higher than those in the KB group (P &lt; 0.05). Compared with the KB group, the concentrations of acetic acid, butyric acid, and total volatile fatty acids (VFAs) in the HQ group were higher (P &lt; 0.01). The expression levels of the rumen epithelial-related genes MCT1, MCT4, NHE2, and ZO1 in the Astragalus group were significantly higher than those in the KB group (P &lt; 0.05). 16S rRNA analysis showed that at the phylum level, Bacteroidetes in the HQ group significantly increased (P &lt; 0.01); at the genus level, Prevotella (P &lt; 0.01) and Succiniclasticum (P &lt; 0.01) in the HQ group were found at significantly higher abundances than those in the KB group, and the results of microbiota gene and function prediction showed that “energy metabolism,” “glycan biosynthesis and metabolic” pathways were significantly enriched in the HQ group (P &lt; 0.05).

Conclusion
As a feed additive, Astragalus can improve the immunity of early-weaned lambs, the structure of the rumen microbiota of lambs, and the fermentation capacity of the rumen.
A Study on Central Banks and Social Responsibility: the Case of the ESCB
Authors: Felicetti Raffaele 
Published: November 2023

ABSTRACT
Can and should central banks have a social responsibility (‘central banks’ social responsibility’—CBSR) to play a role in social issues, such as economic inequality? This article provides a conceptual account and analysis of the benefits and challenges associated with CBSR. After showing that CBSR is gaining momentum through the pull of influential actors including central banks themselves, policy-makers, and public opinion, I discuss two types of CBSR the European Central Bank (ECB) could engage in. The moderate approach involves action based on the primary mandate, whereas use of the secondary mandate would present an enlarged version of CBSR. While action based on the primary mandate is both legally possible and desirable, the ‘powered’ version of CBSR comes with significant legal hurdles. Absent clear prioritization by the Union’s political institutions of certain economic policies and objectives, selection and prioritization by the ECB of one or more policies would risk opening the floodgates to policy-making. The enlarged version of CBSR is also undesirable, as it would make the scrutiny of the ECB’s activity more challenging for the European Parliament, negatively alter the public trust the ECB enjoys, and heighten the risk of friction within the European System of Central Banks.