bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case Study: Lessons learned from online tutorial to improve clinical reasoning for Family Medicine residents in Palestine
Authors: Colton Benjamin , Al-Saudi Lubna , Smalldridge Ann , Spicer Nicki , Zink Therese 
Published: October 2023

Abstract
Background
Geopolitical and socioeconomic challenges limit faculty development and clinical teaching in the Occupied Territories of Palestine and many other developing countries. The first, and still only, Family Medicine residency program is a four-year program based out of An-Najah University in the West Bank. Training in primary care clinics occurs in the final two years and there are many challenges to adequate supervision in the clinical setting that were exacerbated during the pandemic. To improve the clinical reasoning skills of 13 Palestinian FM residents a three-month tutorial program was organized in 2020. An NGO that has worked to support Family Medicine development in the region engaged experienced British General Practitioners trained as tutors to offer online tutorials. We evaluate the program as case study research to understand the factors that facilitated or impaired a positive virtual learning environment.
Methods
The tutors and residents were divided into groups and met virtually between June and September 2020. Evaluations and session reports collected during the program, the text of an online chat, and responses to an online survey two years later were collected. Using thematic analysis techniques, we evaluated the value for the residents at the time and two years later and identified factors that facilitated or impaired a positive virtual learning environment.
Results
Themes of knowledge, skills, attitudes, cultural disconnects, and tutorial logistics emerged. The group with the most stable tutor pairing, including one Arabic-speaker familiar with the context, was the most engaged. The all-female group formed a chat group to share real-time case questions during clinical practice, and focused on skills (e.g. conducting a thorough medication review) and attitudes (e.g. open to sharing and discussing uncertainties). Other groups were less cohesive.
Conclusions
Transnational tutorials that focused on clinical thinking and decision-making skills were most successful when the tutorial pair was stable, offered familiarity with the language and addressed cultural differences. Intrinsic factors such as lacking the motivation to participate and extrinsic factors such as unstable internet and rolling electric cuts, and clinical structures that made applying new skills challenging were more difficult to address but must be considered.
Optimising policies and regulations for zero routine gas flaring and net zero
Authors: Aigbe Godwin O. , Stringer Lindsay C. , Cotton Matthew 
Published: October 2023

Abstract

Global policy actions to reduce the environmental and social impacts of gas-flaring are primarily derived from voluntary arrangements. This paper evaluates stakeholder preferences for different policies and regulatory options, determining the most optimised and effective to help eliminate routine gas-flaring by 2030 and achieve net zero emissions by 2050 whilst addressing good governance, justice, and fair implementation. Its mixed methods incorporate literature and document review, interviews, expert surveys, Analytical Hierarchy Process (AHP) and Technique for Order of Preference by Similarity to Ideal Solution (G-TOPSIS), deriving two competing perspectives on gas flaring policy strategy, with differences revealed through the AHP ranking process of individual criteria. All criteria and sub-criteria identified were integral to achieving the flaring and emissions targets, with “policy and targets” and “enabling framework” the most important individual criteria. The “background and the role of reductions in meeting environmental and economic objectives” and “nonmonetary penalties” were the most crucial sub-criteria. G-TOPSIS showed that fully implementing gas-flaring policies and regulatory framework criteria to limit warming to 1.5°C is the most effective policy alternative. Globally coordinated, uniform and reciprocal legally binding agreements between countries to supplement national initiatives are imperative to improve the effectiveness of country-specific gas flaring policy strategies.
Polygenic risk score predicting susceptibility of female overactive bladder in the Han Chinese
Authors: Hung Sheng-Chun , Chang Li-Wen , Lin Guan-Cheng , Li Jian-Ri , Chen I-Chieh 
Published: October 2023

Abstract
Objective:
Our study aims to explore the predictive potential of a polygenic risk score (PRS) in overactive bladder (OAB) as well as its impact on drug compliance.
Materials and methods:
This retrospective cohort study involved 29,812 female participants from Taichung Veterans General Hospital, enrolled in the Taiwan Precision Medicine Initiative (TPMI), and genotyped using the Affymetrix Genome-Wide TWB 2.0 SNP Array. PRS was determined using PGS002112 for depression, which included 748,601 single nucleotide polymorphisms. PRS scores were categorized into quartiles (Q1-Q4) and their association with OAB incidence was analyzed using logistic regression model, including overactive bladder (ICD-9-CM code 596.51), urinary incontinence (ICD-9-CM code 788.3) and frequency (ICD-9-CM code 788.4).
Results:
Among 29,812 female participants, 2,583 were diagnosed with OAB. Risk of non-neurogenic female low urinary tract was higher in the fourth quartile (Q4) than the first quartile (Q1) (OR=1.16, 95% CI=1.03-1.30, p=0.016). In addition, the PGS002112 Q4 group displayed a heightened prevalence of depression and anxiety. Our results reveal that PRS effectively predicts the occurrence of depression (Q4 vs. Q1, OR=1.21, 95% CI=1.03-1.43, p=0.021) and anxiety (Q4 vs. Q1, OR=1.25, 95% CI=1.12-1.38, p<0.001). However, the PRS score did not correlate with drug compliance, including antimuscarinic (p=0.509), beta-3 agonist (p=0.411), or both types of drugs (p=0.352).
Conclusions and relevance:
In this hospital-based cohort, a higher PRS was associated with the susceptibility to OAB in female Han Chinese, as well with susceptibility to depression and anxiety. Prospective large-scale study with longer follow-up would be needed to validate our result.
High Rate of Complications In Subacute And Chronic Cases of Peripartum Pubic Symphysis Disrupture After Surgical Treatment: Series of Five Cases and A Review of The Literature
Authors: Doroszewski Grzegorz , Wasielewski Jan , Bartosz Paweł , Caban Adam , Białecki Jerzy 
Published: October 2023

Abstract
● Background:
Peripartum disruption of the pubic symphysis is a rare injury of the pelvic ring that occurs in 1/300-1/30000 births. In the majority of cases, it is successfully treated conservatively. Nevertheless, some cases require surgical treatment. We analysed 5 cases treated surgically in our department and found 23 articles with case presentations of patients treated surgically. The aim of our paper is to analyse our experiences and the available literature in this regard and propose a treatment algorithm.
● Case presentation:
Five women, aged 25–38, with perinatal symphysis disruption were primarily treated conservatively. Due to the lack of improvement, all patients were treated surgically at subacute and chronic stages. In four cases, early loosening of screws and partial or complete loss of reduction were observed. In one case, the plate and screws were removed, and in three cases, revision surgery was performed, one with a larger plate and two with two plates (“box plate fixation”). The mean follow-up was 7.4 years. Two excellent and two good results after final treatment in the modified Majeed scale were noticed.
● Conclusions:
Cases from our department and found in the literature review were analysed. We found that the number of complications in surgically treated patients was higher in the subacute and chronic groups than in the acute group (50% vs. 20%, p = 0.041), and the number of complications in the group where external fixators were used was higher than that in the group where plate fixation was used (37,5% vs. 0%, p = 0,027). In acute cases where symphysis disruption exceeds 25 mm and walking is impaired, surgical treatment with fixation of the pubic symphysis with an anterior plate and, in cases with widening of the S-I joint, S-I screw fixation should be considered. Surgical treatment performed more than two weeks after delivery is associated with a higher rate of complications. Therefore, for patients with pain persisting longer than two weeks considering another vaginal delivery, two anterior plate fixation (“box plate fixation”) is recommended, and for patients who do not consider further vaginal parturition, symphysiodesis is recommended.
Anti-PD-1 Therapy Reverses TIGIT + CD226 + NK Depletion in Immunotherapy Resistance of Hepatocellular Carcinoma through PVR/TIGIT Pathway
Authors: Wang Jing , Yang Lin , Zhao Yang , Cui Song-ping , Gao Ya , Hu Bin , Zhou Lin , Lang Ren 
Published: October 2023

Abstract
Background: Immunotherapy combined with targeted therapy significantly improved the prognosis of patients with hepatocellular carcinoma (HCC). Immunotherapy resistance conducts the main reason for the failure of PD-1-based immune checkpoint inhibitors (ICIs). The gist of this study was to clarify the mechanism of Nature kill cells (NK) depletion in immunotherapy resistance of HCC.
Methods: Cancerous /paracancerous tissues and peripheral blood (PB) of 55 patients with HCC treated in our hospital from Sep. 2019 to Sep. 2021 were collected. Patients were grouped according to the degree of differentiation, FCM, IHC, and in vitro lymphocyte culture drug intervention experiments were used to determine the degree of NK cell depletion. Furthermore, a novel mouse model of HCC in situ was constructed and divided into different groups according to the various intervention measures of ICIs. Immunofluorescence thermography was used to observe the changes in tumor burden for survival analysis.
Results: NK cells in cancerous tissues significantly up-regulated the expression of TIGIT compared with paracancerous tissues (P < 0.001). FCM for PB indicated a more severe depletion of NK cells and higher expression of TIGIT and PD-1 in poorly differentiated HCC (P < 0.001). Intervention experiments in vitro revealed that expression of TIGIT and PD-1 decreased gradually with the increase of PD-1 inhibitor dose in moderately-highly differentiated patients (P < 0.05), while there was no change in poorly differentiated patients. Animal experiment showed that the proliferation of tumors in the experimental group was significantly inhibited compared with the control group after being blocked by PD-1 through immunofluorescence thermography, meanwhile, WB results of tumor tissues indicated that ICIs effectively decreased the expression of TIGIT, increased the expression of CD226, decreased the expression of PVRL1 protein and increased the expression level of PVRL3 protein.
Conclusion: TIGIT+NK cells competitively bind to PVR with activator receptor CD226, thus promoting NK cell depletion. Anti-PD-1 efficiently decreases the expression of PVRL1 through the PD-1/PD-L1 pathway, promoting the independent endocytosis of PVRL3 and PVR binding, reducing the PVR/TIGIT inhibitory signal pathway, and enhancing the function of PVR/CD226 activation signal, which provides a theoretical basis for improving the immunotherapy resistance of HCC.
Adsorption of fluoride from water using Al–Mg–Ca ternary metal oxide-coated sand
Authors: Modaresahmadi Kiana , Khodadoust Amid P. , Wescott James 
Published: October 2023

Abstract

An aluminum–magnesium–calcium-coated sand (AMCCS) sorbent was evaluated as a low-cost ternary metal oxide adsorbent for adsorption and removal of fluoride from water with potential application in flow-through water filtration systems. The AMCCS sorbent coating contained mostly amorphous oxides of aluminum, magnesium, and calcium. The adsorption of fluoride occurred in less than an hour, while fluoride adsorption followed pseudo-second-order kinetics. The favorable adsorption of fluoride onto the AMCCS sorbent occurred according to the Langmuir and Freundlich adsorption equations, whereas the physical adsorption of fluoride onto the AMCCS sorbent occurred based on the Dubinin–Radushkevich adsorption equation. The adsorption of fluoride occurred over a broad pH range from 2 to 10.5 with a decrease in adsorption at pH above 10.5, indicative of the adsorption of fluoride onto the positively charged surface of AMCCS sorbent at pH below the AMCCS sorbent pHPZC of 10.4. The AMCCS sorbent was able to remove fluoride from natural waters with appreciable alkalinity, total hardness and total dissolved solids, indicative of AMCCS sorbent selectivity for fluoride adsorption. The AMCCS sorbent was re-coated and reused after several adsorption cycles, rendering the AMCCS sorbent a recyclable and sustainable adsorbent for effective and rapid removal of fluoride from water.
The Effects of Resveratrol Supplementation on the Metabolism of
Lipids in Metabolic Disorders
Authors: Ghavidel Farideh , Hashemy Seyed Isaac , Aliari Mahdeyeh , Rajabian Arezoo , Tabrizi Masoud Homayouni , Atkin Stephen L. , Jamialahmadi Tannaz , Hosseini Hossein , Sahebkar Amirhossein 
Published: October 2023

Abstract:
Lipids are stored energy sources in animals, and disturbance of lipid
metabolism is associated with metabolic disorders, including cardiovascular diseases,
obesity, nonalcoholic fatty liver disease, and diabetes. Modifying dysregulated lipid
metabolism homeostasis can lead to enhanced therapeutic benefits, such as the use of
statin therapy in cardiovascular disease. However, many natural compounds may have
therapeutic utility to improve lipid metabolism. Resveratrol is a polyphenol extracted
from dietary botanicals, including grapes and berries, which has been reported to affect
many biological processes, including lipid metabolism. This review evaluates the effects
of resveratrol on lipid metabolism dysregulation affecting atherosclerosis, diabetes, and
nonalcoholic fatty liver disease (NAFLD). In addition, it details the mechanisms by
which resveratrol may improve lipid metabolism homeostasis.
EPHA2 Receptor as a Possible Therapeutic Target in Viral Infections
Authors: Vincenzi Marian , Mercurio Flavia Anna , Leone Marilisa 
Published: October 2023

Background:
The receptor tyrosine kinase EphA2 plays a role in many diseases,
like cancer, cataracts, and osteoporosis. Interestingly, it has also been linked to viral
infections.

Objective:
Herein, current literature has been reviewed to clarify EphA2 functions in viral
infections and explore its potential role as a target in antiviral drug discovery strategies.

Methods:
Research and review articles along with preprints connecting EphA2 to different
viruses have been searched through PubMed and the web. Structures of complexes
between EphA2 domains and viral proteins have been retrieved from the PDB database.

Results:
EphA2 assumes a key role in Kaposi’s sarcoma-associated herpesvirus (KSHV)
and Epstein Barr virus (EBV) infections by directly binding, through its ligand
binding domain, viral glycoproteins. For human cytomegalovirus (HCMV), the role of
EphA2 in maintaining virus latency state, through cooperation with specific viral proteins,
has also been speculated. In certain cells, with high EphA2 expression levels, following
ligand stimulation, receptor activation might contribute to severe symptoms accompanying
a few viral infections, including lung injuries often related to severe acute
respiratory syndrome coronavirus-2 (SARS-CoV-2).

Conclusion:
Since EphA2 works as a host receptor for certain viruses, it might be worth
more deeply investigating known compounds targeting its extracellular ligand binding
domain as antiviral therapeutics. Due to EphA2's function in inflammation, its possible
correlation with SARS-CoV-2 cannot be excluded, but more experimental studies are
needed in this case to undoubtedly attribute the role of this receptor in viral infections.
The Impact of Alcohol-Induced Epigenetic Modifications in the Treatment of Alcohol use Disorders
Authors: Fanfarillo Francesca , Ferraguti Giampiero , Lucarelli Marco , Fuso Andrea , Ceccanti Mauro , Terracina Sergio , Micangeli Ginevra , Tarani Luigi , Fiore Marco 
Published: October 2023

:
Alcohol use disorders are responsible for 5.9% of all death annually and 5.1%
of the global disease burden. It has been suggested that alcohol abuse can modify gene
expression through epigenetic processes, namely DNA and histone methylation, histone
acetylation, and microRNA expression. The alcohol influence on epigenetic mechanisms
leads to molecular adaptation of a wide number of brain circuits, including the
hypothalamus-hypophysis-adrenal axis, the prefrontal cortex, the mesolimbic-dopamine
pathways and the endogenous opioid pathways. Epigenetic regulation represents an important
level of alcohol-induced molecular adaptation in the brain. It has been demonstrated
that acute and chronic alcohol exposure can induce opposite modifications in epigenetic
mechanisms: acute alcohol exposure increases histone acetylation, decreases histone
methylation and inhibits DNA methyltransferase activity, while chronic alcohol exposure
induces hypermethylation of DNA. Some studies investigated the chromatin status
during the withdrawal period and the craving period and showed that craving was associated
with low methylation status, while the withdrawal period was associated with elevated
activity of histone deacetylase and decreased histone acetylation. Given the effects
exerted by ethanol consumption on epigenetic mechanisms, chromatin structure
modifiers, such as histone deacetylase inhibitors and DNA methyltransferase inhibitors,
might represent a new potential strategy to treat alcohol use disorder. Further investigations
on molecular modifications induced by ethanol might be helpful to develop new
therapies for alcoholism and drug addiction targeting epigenetic processes.
Bacterial Polyhydroxyalkanoates-based Therapeutics-delivery Nano-systems
Authors: Durán-Lara Esteban F. , Rafael Diana , Andrade Fernanda , G. Olga Lobos , Vijayakumar Sekar 
Published: October 2023

:
Microbial polyhydroxyalkanoates (PHAs) are bio-based aliphatic biopolyester
produced by bacteria as an intracellular storage material of carbon and energy under
stressed conditions. PHAs have been paid attention to due to their unique and impressive
biological properties including high biodegradability, biocompatibility, low cytotoxicity,
and different mechanical properties. Under this context, the development of
drug-delivery nanosystems based on PHAs has been revealed to have numerous advantages
compared with synthetic polymers that included biocompatibility, biodegradability,
non-toxic, and low-cost production, among others. In this review article, we present
the available state of the art of PHAs. Moreover, we discussed the potential benefits,
weaknesses, and perspectives of PHAs to the develop drug delivery systems.
Significant Advancement in Various Synthetic Strategies and Pharmacotherapy of Piperine Derivatives: A Review
Authors: Joshi Sagar , Salahuddin  , Mazumder Avijit , Kumar Rajnish , Shabana Km , Tyagi Sonakshi , Rana Kavita , Ahsan Mohamed Jawed , Yar Mohammad Shahar , Arya Arvind , Khurana Navneet 
Published: October 2023

Background:
Piperine is a natural compound found in black pepper that has been traditionally
used for various therapeutic purposes. In the ayurvedic system of medication there is a lot
of evidence which shows that the piperine is widely used for different therapeutic purpose. In recent
years, there has been an increasing interest in the pharmacological and therapeutic potential
of piperine and its derivatives in modern medicine. In order to increase the bioavailability and therapeutic
effectiveness of piperine and its analogs, researchers have been looking at various extraction
methods and synthesis approaches. Many studies have been conducted in this area because of
the promise of piperine as a natural substitute for synthetic medications.

Objectives:
The objective of this review article is to provide an up-to-date analysis of the literature
on the synthesis of piperine analogs, including their extraction techniques and various biological
activities such as antihypertensive, antidiabetic, insecticidal, antimicrobial, and antibiotic effects.
Additionally, the review aims to discuss the potential of piperine in modern medicine, given its traditional
use in various medicinal systems such as Ayurveda, Siddha, and Unani. The article also
provides a comprehensive analysis of the plant from which piperine is derived.

Conclusion:
This review article provides a thorough examination of piperine and the source plant.
The best extraction technique for the extraction of piperine and the synthesis of its analogs with
various biological activities, including antihypertensive, antidiabetic, insecticidal, antibacterial,
and antibiotic properties, are covered in the article. This review aims to provide an updated analysis
of the literature on the synthesis of piperine analogs.
Comprehensive Study on Scoring and Grading Systems for Predicting the
Severity of Knee Osteoarthritis
Authors: Mahendrakar Pavan , Kumar Dileep , Patil Uttam 
Published: October 2023

Abstract:
Knee Osteoarthritis (KOA) is a degenerative joint ailment characterized by cartilage loss, which can be seen using imaging modalities and converted into imaging features. The older population is the most affected by knee OA, which affects 16% of people worldwide who are 15 years of age and older. Due to cartilage tissue degradation, primary knee OA develops in older people. In contrast, joint overuse or trauma in younger people can cause secondary knee OA. Ear-ly identification of knee OA, according to research, may be a successful management tactic for the condition. Scoring scales and grading systems are important tools for the management of knee osteoarthritis as they allow clinicians to measure the progression of the disease's severity and provide suggestions on suitable treatment at identified stages. The comprehensive study reviews various subjective and objective knee evaluation scoring systems that effectively score and grade the KOA based on where defects or changes in articular cartilage occur. Recent studies reveal that AI-based approaches, such as that of DenseNet, integrating the concept of deep learning for scoring and grading the KOA, outperform various state-of-the-art methods in order to predict the KOA at an early stage.
A Review of Medicinal Plants and Phytochemicals for the Management of Gout
Authors: Frazaei Mohammad Hosein , Nouri Roghayeh , Arefnezhad Reza , Pour Pardis Mohammadi , Naseri Maryam , Assar Shirin 
Published: October 2023

Abstract:Gout, characterized by elevated uric acid levels, is a common inflammatory joint dis-ease associated with pain, joint swelling, and bone erosion. Existing treatments for gout often re-sult in undesirable side effects, highlighting the need for new, safe, and cost-effective anti-gout drugs. Natural products, including medicinal plants and phytochemicals, have gained attention as potential sources of anti-gout compounds. In this review, we examined articles from 2000 to 2020 using PubMed and Google Scholar, focusing on the effectiveness of medicinal plants and phyto-chemicals in managing gout. Our findings identified 14 plants and nine phytochemicals with anti-gout properties. Notably, Teucrium polium, Prunus avium, Smilax riparia, Rhus coriaria, Foenic-ulum vulgare, Allium cepa, Camellia japonica, and Helianthus annuus exhibited the highest xan-thine oxidase inhibitory activity, attributed to their unique natural bioactive compounds such as phenolics, tannins, coumarins, terpenoids, and alkaloids. Herbal plants and their phytochemicals have demonstrated promising effects in reducing serum urate and inhibiting xanthine. This review aims to report recent studies on plants/phytochemicals derived from herbs beneficial in gout and their different mechanisms.