bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing Genetic Causality of Periodontal Disease and Atrial Fibrillation by Potential Mediators: A Two-Step Mediating Mendelian Randomization Study
Authors: Lian Chengzhong , Zhang Xiaohan , Li Jiaran , Shi Jing , Shi Shuqing , Wang Lianxin , Guo Zezhen , Liu Naixu , Wang Huan , Shi Shuai , Hu Yuanhui , Du Bai 
Published: February 2024

Abstract

Background
The independent causality of periodontal disease on atrial fibrillation (AF) and the modifiable risk factors mediating the pathogenesis remain unclear.
Method
First, to confirm the independent causality, this study underwent the bidirectional and multivariable Mendelian Randomization (MR) underlying the genome-wide association studies (GWAS) of periodontal disease (87497 cases/259234 controls) from the FinnGen and AF (55114 cases/482295 controls) from AFGen. Then, the two-step Mendelian randomization evaluated the mediating role and proportions of 25 candidate factors.
Result
Periodontal disease was associated with a higher risk of AF with an odds ratio of 1.16 ([95% CI, 1.027–1.314], p = 0.017), independently of dental caries and pulp and periapical disease. Reversely, there is no causation of AF on periodontal disease status. Using the two-step MR, we identified 5 out of 25 candidate mediators as statistically significant; sorted by the mediation proportion, including weight (30.3%), IL-17 (17.2%), TNF (14.08%), coronary atherosclerosis (13.4%) and hypertension (11.6%).
Conclusion
Our findings preliminarily demonstrated the genetic causality between periodontal disease and atrial fibrillation. For patients suffering from periodontal disease status, it is noted that maintaining oral hygiene, accepting standardized periodontal treatment, and managing body weight are crucial targets for controlling the disease progression towards AF.
Understanding Barriers and Facilitators to Integrated HIV and Hypertension Care in South Africa
Authors: Johnson Leslie C.M. , Khan Suha H. , Ali Mohammed K. , Galaviz Karla I. , Waseem Fatima , Ordóñez Claudia E. , Siedner Mark J. , Nyatela Athini , Marconi Vincent C. , Lalla-Edward Samanta T 
Published: February 2024

Abstract

Background
The burden of hypertension among people with HIV is high, particularly in low-and middle-income countries, yet gaps in hypertension screening and care in these settings persist. The objective of this study was to identify facilitators of and barriers to hypertension screening, treatment, and management among people with HIV seeking treatment in primary care clinics in Johannesburg, South Africa.
Methods
Using a cross-sectional study design, data were collected via interviews (n = 53) with people with HIV and hypertension and clinic managers and focus group discussions (n = 9) with clinic staff. A qualitative framework analysis approach guided by the Theoretical Domains Framework was used to identify and compare determinants of hypertension care across different stakeholder groups.
Results
Data from clinic staff and managers generated three themes characterizing facilitators of and barriers to the adoption and implementation of hypertension screening and treatment: 1) clinics have limited structural and operational capacity to support the implementation of integrated care models, 2) education and training on chronic care guidelines is inconsistent and often lacking across clinics, and 3) clinicians have the goal of enhancing chronic care within their clinics but first need to advocate for health system characteristics that will sustainably support integrated care. Patient data generated three themes characterizing existing facilitators of and barriers to clinic attendance and chronic disease self-management: 1) the threat of hypertension-related morbidity and mortality as a motivator for lifestyle change, 2) the emotional toll of clinic’s logistical, staff, and resource challenges, and 3) hypertension self-management as a patchwork of informational and support sources. The main barriers to hypertension screening, treatment, and management were related to environmental resources and context (i.e., lack of enabling resources and siloed flow of clinic operations) the patients’ knowledge and emotions (i.e., lack of awareness about hypertension risk, fear, and frustration). Clinical actors and patients differed in perceived need to prioritize HIV versus hypertension care.
Conclusions
The convergence of multi-stakeholder data regarding barriers to hypertension screening, treatment, and management highlight key areas for improvement, where tailored implementation strategies may address challenges recognized by each stakeholder group.
National Health Insurance Scheme Enrolees’ Satisfaction with Quality of Care and Willingness to Retain Membership in a tertiary hospital in Nigeria: Implications for Community-Based Health Insurance uptake
Authors: Ibeneme Georgian Chiaka , Ugochukwu Chika , Ibeneme Sam Chidi , Nwosu Akachukwu Omumuagwula , Fortwengel Gerhard , Oko Constance Chioma , Okpua Nelson C. 
Published: February 2024

Abstract

Background;Low enrolment into National Health Insurance scheme is a barrier to universal health coverage in Nigeria and could be connected to consumer/enrolees’ satisfaction which is an important index of willingness to retain any service provider. Therefore, enrolees’ satisfaction with the quality of received healthcare services and willingness to retain membership of NHIS at a tertiary hospital in Ebonyi State, Nigeria was evaluated.Method:The embedded nested design was implemented under an integrative mixed-method approach to study 376 NHIS enrolees selected using a convenience sampling technique at Alex Ekwueme University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria. Researcher-developed questionnaire and interview guide were used for data collection. Quantitative data were analysed using Z test, at two-tailed p < 0.05 while qualitative data were analysed thematically.Results:Proportion of satisfied enrolees (232, 61.70%) was higher than unsatisfied enrolees (Z= 6.42; p = <.0002 two-tailed; 95% CI= 0.16 – 0.30). Reasons for enrolees satisfaction were quick recovery, assurance of receiving unadulterated drugs, easy accessibility to specialized services, and significant healthcare expenditure reduction. Reasons for enrolees unsatisfaction were drug stock-out, poor drug quality, poor accessibility, arduous bureaucracy, poor Information quality and poor attitude of nurses. Proportion of enrolees willing to retain membership of NHIS (312, 61.70%) was higher than unwilling enrolees (18.233, p = <.0002 two-tailed; 95% CI= 0.60 – 0.71). Reasons for enrolees unwillingness to retain membership of NHIS include long waiting times, drug stock-out, arduous bureaucracy, and poor attitude of nursing personnel. There was a strong association between willingness to retain membership of NHIS and enrolees’ satisfaction with the quality of care received (X2= 121.14, df=1; Crammer’s V = 0.57; P<.0001).Conclusion:Most NHIS enrolees are satisfied, but some are unsatisfied as they are impacted by low institutional capacities and organizational weaknesses like long waiting times, drug stock-out, bureaucratic bottlenecks, and poor nurse attitudes, which also hindered their willingness to retain membership of the NHIS. Therefore, data on enrolee satisfaction with care quality is crucial for policy adjustments and preventing poor institutional governance and practices that could hinder NHIS membership retention or uptake.
Identifying the best reference gene for RT-qPCR analyses of the three-dimensional osteogenic differentiation of human-induced pluripotent stem cells
Authors: Okamoto Masakazu , Inagaki Yusuke , Okamura Kensuke , Uchihara Yoshinobu , Saito Kenichiro , Ogawa Munehiro , Kido Akira , Mori Eiichiro , Tanaka Yasuhito 
Published: February 2024

Abstract
Reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) is an essential tool for gene expression analysis; however, choosing appropriate reference genes for normalization is crucial to ensure data reliability. Most studies on osteogenic differentiation have had limited success in identifying optimal reference genes; to the best of our knowledge, no optimal reference genes in three-dimensional (3D) osteogenic differentiation culture experiments using human induced pluripotent stem cells (hiPSCs) have been identified. In this study, we aimed to identify stable reference genes that could be used for normalization in gene expression analyses during the 3D osteogenic differentiation of hiPSCs using an atelocollagen sponge as the scaffold. Four algorithms—ΔCt, BestKeeper, NormFinder, and geNorm—were used to evaluate the stability of 14 candidate reference genes. TATA box-binding protein, hypoxanthine phosphoribosyltransferase 1, and 14-3-3 protein zeta polypeptide emerged as the most stable reference genes. In comparison, conventionally used reference genes (beta-2 microglobulin and beta-actin) ranked among those with low stability. We also demonstrated the successful 3D osteogenic differentiation of hiPSCs on the atelocollagen sponge. Our findings provide valuable insights into reference gene selection and bone tissue regeneration from hiPSCs, which will improve the treatment prospects for bone defects and other similar conditions in regenerative medicine.
Correlation between segmental Phase Angles and motor function of DMD children and predictive value of Phase angels for lower limb motor function loss
Authors: Hu Qin , Chen Xiaoyong , Luo Shaojie , Wang Yanhong , Fan Peicong , Wu Xiaona , Zhou Hui , Xu Huayan , Li Na , Cai Xiaotang 
Published: February 2024

Abstract
Background: Duchenne muscular dystrophy (DMD) is a prevalent X-linked recessive muscle degeneration disorder that involves the gradual loss of functional muscle mass. The Phase Angle (PhA) can indicate changes in cell membrane integrity and intercellular space. It has been recognized as a valuable tool for assessing disease severity and predicting patient outcomes. However, there is limited research on the application of PhA in children with neuromuscular diseases, including DMD.
Objective：we investigated the relationship between Phase Angle (PhA) and motor function in children with DMD. We specifically examined the correlation between segmental PhAs and motor function and evaluated the effectiveness of segmental PhAs as a measure for assessing motor function in DMD children
Method: 399 DMD patients were divided into loss of lower limb motor function group (n = 57) and preserve lower limb motor function group (n = 342). The correlation between PhA and motor function were analyzed through spearman correlation analysis. The predictive value of PhA and PhA combining age for lower limb motor function loss was analyzed by ROC curve.
Result: TR-PhA reaches its peak at 6 years old, while other PhAs reaches its peak at 5-6years old and subsequently declines over time. There was a significant correlation between PhAs and the NSAA score, with the strongest correlation observed in leg PhA (r=0.753, P<0.001). ROC curve was used and showed that PhAs (LA, RA, LL, RL, TR, and whole) can predict the loss of lower limb function in DMD children (AUC from 0.725 to 0.863).The corresponding cut-off PhA values were 2.55°, 2.95°, 2.65°, 2.55°, 4.25°, and 2.85°, respectively. Additionally, PhAs combined with age had more excellent predictive ability for lower limb function loss than PhAs((AUC from 0.929 to 0.951).
Conclusion: The time of peak of PhAs are earlier than NNSA score (peak at 6-7years old). PhAs in legs demonstrate the strongest correlation and highest predictive value for lower limb motor function loss. PhA could serve as a simple, fast, and non-invasive marker to predict the loss of lower limb motor function in DMD children.
Tagging polymorphisms in CTLA4 gene with esophageal squamous cell carcinomas: a case-control study
Authors: Tang Weifeng , Wang Jian , Liu Chao , Qiu Hao , Chen Shuchen , Hu Zhendong 
Published: February 2024

Abstract
Objective: To assess the role of Cytotoxic T-lymphocyte antigen-4 (CTLA4) loci on ESCC risk.
Method: we recruited 829 ESCC cases and 1,522 healthy controls to explore the correlation of tagging polymorphisms in CTLA4gene with ESCC extensively.
Results: For rs16840252 C>T, rs733618 T>C, rs3087243 G>A, and rs231775 G>A loci in CTLA4, frequency of these genotypes in ESCC cases and controls was not different in overall comparison. Compared with rs3087243 GG in CTLA4, we found that there were significant differences in frequency of the rs3087243 GA and rs3087243 GA/AA between ESCC cases and controls in female subgroup (GA vs. GG: adjusted OR=1.50, P=0.038; GA/AA vs. GG: adjusted OR=1.54, P=0.024). CTLA4 haplotype analysis suggested that others haplotypes could increase the risk of ESCC with 2.05-fold (P=0.027). However, we found that locus in CTLA4 was not associated with the susceptibility of lymph node metastasis. Conclusion: Our investigation highlights that CTLA4 rs3087243 locus is associated with ESCC development in female subgroup.
Clinical profile of adult patients referred to congenital heart surgery; a single center experience in Egypt.
Authors: Samaan Amir Anwar , Mostafa Amir , AbdElAziz Osama , Shazly Mahmoud El , Lotfy Sherif , Abdrabou Mostafa M. , Hassan Mohamed , Elamragy Ahmed A. 
Published: February 2024

Abstract

Background
A major challenge facing adult congenital heart disease (ACHD) service in developing countries is the lack of adequate data on the disease burden and specific needs of this group. We aimed to describe ACHD patients in Egypt who need further surgical correction, their various presentations, and the types of surgeries required.
Methods
The study included ACHD patients considered for further surgical correction after a heart team discussion at a tertiary cardiac center in Egypt. Data about age, gender, presentation, functional capacity, resting oxygen saturation, diagnosis, previous intervention and its timing, and the type of surgery decided were collected.
Results
Over one year, 103 cases (49.5% males, mean age 23 years) were referred to surgery out of 134 cases discussed at the heart team committee. One-third of the patients (34%) were cyanotic, and the majority presented in NYHA functional class II (44.7%) and III (35.95%). More than half of the patients (56.3%) had a previous surgical or trans-catheter intervention with a median age of 4 years at the time of the first procedure. The most frequently encountered diagnoses were: Tetralogy of Fallot (ToF) (23.3%), atrial septal defect (ASD) (18.4%), double outlet right ventricle (11.6%), and transposition of great arteries (7.8%). Surgical procedures that were required most were: Fontan procedure (20.3%), surgical ASD closure (18.4%), surgical pulmonary valve replacement (14.5%), total ToF repair (9.7%), subaortic membrane resection (6.7%) and tricuspid valve surgery (5.8%).
Conclusion
The group of ACHD patients in Egypt who require further surgical correction is heterogeneous, with various presentations and needs. The required surgeries vary from simple to complex. An efficient ACHD program necessitates the collaboration of dedicated cardiologists, radiologists, and cardiothoracic surgeons who are familiar with the unique demands and difficulties of this patient group.
Molecular mechanisms of Rhizoma Dioscoreae in breast cancer treatment: a network pharmacology and experimental verification
Authors: Wang Jia , Gao Shilei , Zhang Lihan , Zhang Lu , Sun Xu , Li Huahua , Niu Hong , Ma Xuhui , Liu Huaimin 
Published: February 2024

Abstract

Background Breast cancer poses a significant threat on human health. Rhizoma Dioscoreae (RD), a traditional Chinese medicinal herb, has shown positive effect in breast cancer treatment; however, the underlying molecular mechanisms remain unknown.
Methods We identified the active pharmaceutical ingredients (APIs) in RD and their potential targets using the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database. Targets related to breast cancer were gathered from GeneCards and Online Mendelian Inheritance in Man (OMIM) database. We constructed RD API-gene interaction network using Cytoscape software. Protein-protein interaction (PPI) data were obtained from the Search Tool for the Retrieval of Interacting Genes (STRING) database. Key APIs and hub genes were screened via network topological parameters. Gene Ontology (GO) and Kyoto Encyclopedia of Genes (KEGG) pathway enrichment analyses were conducted. Molecular docking and in vitro experiments were performed to validate our network pharmacology findings.
Results We identified 12 APIs in RD and 28 genes overlapped between RD and breast cancer. Molecular docking showed stable binding between key ingredients and hub genes. Stigmasterol and diosgenin served as the most critical APIs. Further experimental findings demonstrated that RD inhibited breast cancer via downregulating HIF-1α, RELA, VEGFA, PGR, and NCOA1, critical in tumor angiogenesis and hormone-mediated signaling.
Conclusion RD might inhibit breast cancer angiogenesis and hormone-mediated oncogenesis by downregulating HIF-1α, RELA, VEGFA, PGR, and NCOA1, which provides more evidence for the application of RD in the management of breast cancer.
Reporting MRONJ as an Adverse Drug Reaction: An Oral Surgery Survey
Authors: Martin Katy , Martin Sarah 
Published: February 2024

Abstract
Introduction
Medication related osteonecrosis of the jaw (MRONJ) is a significant adverse drug reaction associated with anti-angiogenic and anti-resorptive medications. The aim of this survey was to establish the knowledge and understanding of the reporting of adverse drug reactions with a particular focus on MRONJ within the local department.
Methodology
An electronic survey was disseminated to dentists working in the Oral Surgery department within the Dental Division of Birmingham Community Healthcare Trust in November 2021. The survey consisted of 14 open and closed questions relating to the identification and reporting of MRONJ as an adverse drug reaction.
Results
Although 97% of participants had seen a patient with MRONJ, only 19% had reported an adverse drug reaction to any medication. Interestingly 27% of respondents felt that MRONJ should be classified as a ‘postoperative complication’ rather than an ‘adverse drug reaction’. 22% of participants were unaware of how to report an adverse drug reaction.
Conclusion
This survey acts as an important reminder to encourage both patients and dental professionals to consider reporting adverse drug reactions, including suspected MRONJ, to the MHRA. Reporting aids accurate national data collection, highlights risk and supports ongoing research in this area.
Monocytes enter microporous β-TCP ceramics
Authors: Waldmann Marco , Bohner Marc , Le Long-Quan , Baghnavi Anna , Riedel Bianca , Seidenstuecker Michael 
Published: February 2024

Abstract
β-TCP ceramics are versatile bone substitute materials and show many interactions with cells of the monocyte-macrophage-lineage. The possibility of monocytes entering microporous β-TCP ceramics has however not yet been researched. We used flow chambers to unidirectionally load BC, PRP or PPP into slice models of either 2 mm or 6 mm β-TCP. Immunofluorescence for CD68 and live/dead staining was performed after the loading process. Our results show that monocytes were present in a relevant number of PRP and BC slices representing the inside of our 2 mm slice model and also present on the actual inside of our 6 mm model. For PPP, monocytes were not found beyond the surface in either model. Our results indicate the possibility of a new and so far neglected constituent in β-TCP degradation, perhaps causing the process of ceramic degradation also starting from inside the ceramics as opposed to the current understanding. We also demonstrated flow chambers as a possible new in vitro model for interactions between blood and β-TCP.
The acceptability and effectiveness of artificial intelligence-based chatbot for hypertensive patients in community: protocol for a mixed-methods study
Authors: chen Ping , Li Yi , Zhang Xuxi , Feng Xinglin , Sun Xinying 
Published: February 2024

Abstract

Background
Chatbots can provide immediate assistance tailored to patients' needs, making them suitable for sustained accompanying interventions. Nevertheless, there is currently no evidence regarding their acceptability by hypertensive patients and the factors influencing the acceptability in the real-world. Existing evaluation scales often focus solely on the technology itself, overlooking the patients' perspective. Utilizing mixed methods can offer a more comprehensive exploration of influencing factors, laying the groundwork for the future integration of artificial intelligence in chronic disease management practices.
Methods
The mixed methods will provide a holistic view to understand the effectiveness and acceptability of the intervention. Participants will either receive the standard primary health care or obtain a chatbot speaker. The speaker can provide timely reminders, on-demand consultations, personalized data recording, knowledge broadcasts, as well as entertainment features such as telling jokes. The quantitative part will be conducted as a quasi-randomized controlled trial in community in Beijing. And the convergent design will be adopted. When patients use the speaker for 1 month, scales will be used to measure patients' intention to use the speaker. At the same time, semi-structured interviews will be conducted to explore patients' feelings and influencing factors of using speakers. Data on socio-demography, physical examination, blood pressure, acceptability and self-management behavior will be collected at baseline, as well as 1,3,6, and 12 months later. Furthermore, the cloud database will continuously collect patients’ interactions with the speaker. The primary outcome is the efficacy of the chatbot on blood pressure control. The secondary outcome includes the acceptability of the chatbot speaker and the changes of self-management behavior.
Discussion
Artificial intelligence-based chatbot speaker not only caters to patients' self-management needs at home but also effectively organizes intricate and detailed knowledge system for patients with hypertension through a knowledge graph. Patients can promptly access information that aligns with their specific requirements, promoting proactive self-management and playing a crucial role in disease management. This study will serve as a foundation for the application of artificial intelligence technology in chronic disease management, paving the way for further exploration on enhancing the communicative impact of artificial intelligence technology.
Trial registration:
Biomedical Ethics Committee of Peking University: IRB00001052-21106, 2021/10/14; Clinical Trials: ChiCTR2100050578,2021/08/29.