bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of reduced routine community mental healthcare on people from minority ethnic groups during the COVID-19 pandemic: qualitative study of stakeholder perspectives
Authors: Winsper Catherine , Bhattacharya Rahul , Bhui Kamaldeep , Currie Graeme , Edge Dawn , Ellard David , Franklin Donna , Gill Paramjit , Gilbert Steve , Khan Noreen , Miller Robin , Motala Zahra , Pinfold Vanessa , Sandhu Harbinder , Singh Swaran P. , Weich Scott , Giacco Domenico 
Published: February 2024

BackgroundEnduring ethnic inequalities exist in mental healthcare. The COVID-19 pandemic has widened these.AimsTo explore stakeholder perspectives on how the COVID-19 pandemic has increased ethnic inequalities in mental healthcare.MethodA qualitative interview study of four areas in England with 34 patients, 15 carers and 39 mental health professionals from National Health Service (NHS) and community organisations (July 2021 to July 2022). Framework analysis was used to develop a logic model of inter-relationships between pre-pandemic barriers and COVID-19 impacts.ResultsImpacts were largely similar across sites, with some small variations (e.g. positive service impacts of higher ethnic diversity in area 2). Pre-pandemic barriers at individual level included mistrust and thus avoidance of services and at a service level included the dominance of a monocultural model, leading to poor communication, disengagement and alienation. During the pandemic remote service delivery, closure of community organisations and media scapegoating exacerbated existing barriers by worsening alienation and communication barriers, fuelling prejudice and division, and increasing mistrust in services. Some minority ethnic patients reported positive developments, experiencing empowerment through self-determination and creative activities.ConclusionsDuring the COVID-19 pandemic some patients showed resilience and developed adaptations that could be nurtured by services. However, there has been a reduction in the availability of group-specific NHS and third-sector services in the community, exacerbating pre-existing barriers. As these developments are likely to have long-term consequences for minority ethnic groups’ engagement with mental healthcare, they need to be addressed as a priority by the NHS and its partners.
Differential Diagnosis of Post Pancreatitis Diabetes Mellitus Based on Pancreatic and Gut Hormone Characteristics
Authors: Lv Yingqi , Lu Xuejia , Liu Gaifang , Qi Liang , Zhong Zihang , Wang Xiaoyuan , Zhang Weizhen , Shi Ruihua , Goodarzi Mark O , Pandol Stephen J , Li Ling 
Published: February 2024

Abstract

Context
Distinguishing different types of diabetes is important in directing optimized treatment strategies and correlated epidemiological studies.

Objective
Through detailed analysis of hormone responses to mixed meal tolerance test (MMTT), we aimed to find representing characteristics of post-acute pancreatitis diabetes mellitus (PPDM-A) and post-chronic pancreatitis diabetes mellitus (PPDM-C).

Methods
Participants with PPDM-A, PPDM-C, type 1 diabetes, type 2 diabetes, and normal controls (NCs) underwent MMTT. Fasting and postprandial responses of serum glucose, C-peptide, insulin, glucagon, pancreatic polypeptide (PP), ghrelin, gastric inhibitory peptide (GIP), glucagon like peptide-1 (GLP-1), and peptide YY (PYY) were detected and compared among different groups. Focused analysis on calculated insulin sensitivity and secretion indices were performed to determine major causes of hyperglycemia in different conditions.

Results
Participants with PPDM-A were characterized by increased C-peptide, insulin, glucagon, and PP, but decreased ghrelin, GIP, and PYY compared with NCs. Patients with PPDM-C showed secretion insufficiency of C-peptide, insulin, ghrelin, and PYY, and higher postprandial responses of glucagon and PP than NCs. In particular, both fasting and postprandial levels of ghrelin in PPDM-C were significantly lower than other diabetes groups. PYY responses in patients with PPDM-A and PPDM-C were markedly reduced. Additionally, the insulin sensitivity of PPDM-A was decreased, and the insulin secretion for PPDM-C was decreased.

Conclusion
Along with the continuum from acute to chronic pancreatitis, the pathological mechanism of PPDM changes from insulin resistance to insulin deficiency. Insufficient PYY secretion is a promising diagnostic marker for distinguishing PPDM from type 1 and type 2 diabetes. Absent ghrelin secretion to MMTT may help identify PPDM-C.
EphB1 controls long-range cortical axon guidance through a cell non-autonomous role in GABAergic cells
Authors: Assali Ahlem , Chenaux George , Cho Jennifer Y. , Berto Stefano , Ehrlich Nathan A. , Cowan Christopher W. 
Published: February 2024

ABSTRACT
EphB1 is required for proper guidance of cortical axon projections during brain development, but how EphB1 regulates this process remains unclear. We show here that EphB1 conditional knockout (cKO) in GABAergic cells (Vgat-Cre), but not in cortical excitatory neurons (Emx1-Cre), reproduced the cortical axon guidance defects observed in global EphB1 KO mice. Interestingly, in EphB1 cKOVgat mice, the misguided axon bundles contained co-mingled striatal GABAergic and somatosensory cortical glutamatergic axons. In wild-type mice, somatosensory axons also co-fasciculated with striatal axons, notably in the globus pallidus, suggesting that a subset of glutamatergic cortical axons normally follows long-range GABAergic axons to reach their targets. Surprisingly, the ectopic axons in EphB1 KO mice were juxtaposed to major blood vessels. However, conditional loss of EphB1 in endothelial cells (Tie2-Cre) did not produce the axon guidance defects, suggesting that EphB1 in GABAergic neurons normally promotes avoidance of these ectopic axons from the developing brain vasculature. Together, our data reveal a new role for EphB1 in GABAergic neurons to influence proper cortical glutamatergic axon guidance during brain development.
Cranial suture lineage and contributions to repair of the mouse skull
Authors: Doro Daniel , Liu Annie , Lau Jia Shang , Rajendran Arun Kumar , Healy Christopher , Krstic Marko , Grigoriadis Agamemnon E. , Iseki Sachiko , Liu Karen J. 
Published: February 2024

ABSTRACT
The cranial sutures are proposed to be a stem cell niche, harbouring skeletal stem cells that are directly involved in development, homeostasis and healing. Like the craniofacial bones, the sutures are formed from both mesoderm and neural crest. During cranial bone repair, neural crest cells have been proposed to be key players; however, neural crest contributions to adult sutures are not well defined, and the relative importance of suture proximity is unclear. Here, we use genetic approaches to re-examine the neural crest–mesoderm boundaries in the adult mouse skull. These are combined with calvarial wounding experiments suggesting that suture proximity improves the efficiency of cranial repair. Furthermore, we demonstrate that Gli1+ and Axin2+ skeletal stem cells are present in all calvarial sutures examined. We propose that the position of the defect determines the availability of neural crest-derived progenitors, which appear to be a key element in the repair of calvarial defects.
ETS transcription factors regulate precise matrix metalloproteinase expression and follicle rupture in Drosophila
Authors: Zeng Baosheng , Knapp Elizabeth M. , Skaritanov Ekaterina , Oramas Rebecca , Sun Jianjun 
Published: February 2024

ABSTRACT
Drosophila matrix metalloproteinase 2 (MMP2) is specifically expressed in posterior follicle cells of stage-14 egg chambers (mature follicles) and is crucial for the breakdown of the follicular wall during ovulation, a process that is highly conserved from flies to mammals. The factors that regulate spatiotemporal expression of MMP2 in follicle cells remain unknown. Here, we demonstrate crucial roles for the ETS-family transcriptional activator Pointed (Pnt) and its endogenous repressor Yan in the regulation of MMP2 expression. We found that Pnt is expressed in posterior follicle cells and overlaps with MMP2 expression in mature follicles. Genetic analysis demonstrated that pnt is both required and sufficient for MMP2 expression in follicle cells. In addition, Yan was temporally upregulated in stage-13 follicle cells to fine-tune Pnt activity and MMP2 expression. Furthermore, we identified a 1.1 kb core enhancer that is responsible for the spatiotemporal expression of MMP2 and contains multiple pnt/yan binding motifs. Mutation of pnt/yan binding sites significantly impaired the Mmp2 enhancer activity. Our data reveal a mechanism of transcriptional regulation of Mmp2 expression in Drosophila ovulation, which could be conserved in other biological systems.
MUC13 negatively regulates tight junction proteins and intestinal epithelial barrier integrity via protein kinase C
Authors: Segui-Perez Celia , Stapels Daphne A. C. , Ma Ziliang , Su Jinyi , Passchier Elsemieke , Westendorp Bart , Wubbolts Richard W. , Wu Wei , van Putten Jos P. M. , Strijbis Karin 
Published: February 2024

ABSTRACT
Glycosylated mucin proteins contribute to the essential barrier function of the intestinal epithelium. The transmembrane mucin MUC13 is an abundant intestinal glycoprotein with important functions for mucosal maintenance that are not yet completely understood. We demonstrate that in human intestinal epithelial monolayers, MUC13 localized to both the apical surface and the tight junction (TJ) region on the lateral membrane. MUC13 deletion resulted in increased transepithelial resistance (TEER) and reduced translocation of small solutes. TEER buildup in ΔMUC13 cells could be prevented by addition of MLCK, ROCK or protein kinase C (PKC) inhibitors. The levels of TJ proteins including claudins and occludin were highly increased in membrane fractions of MUC13 knockout cells. Removal of the MUC13 cytoplasmic tail (CT) also altered TJ composition but did not affect TEER. The increased buildup of TJ complexes in ΔMUC13 and MUC13-ΔCT cells was dependent on PKC. The responsible PKC member might be PKCδ (or PRKCD) based on elevated protein levels in the absence of full-length MUC13. Our results demonstrate for the first time that a mucin protein can negatively regulate TJ function and stimulate intestinal barrier permeability.
Comparing Multivisceral Resection with Tumor-only Resection of Liposarcoma Using the Win Ratio
Authors: Gorji Leva , Nikahd Melica , Onuma Amblessed , Tsilimigras Diamantis , Madison Hyer J. , Ruff Samantha , Ilyas Farhan Z. , Contreras Carlo , Grignol Valerie P. , Kim Alex , Pollock Raphael , Pawlik Timothy M. , Beane Joal D. 
Published: February 2024

Abstract
Background
Multivisceral resection of retroperitoneal liposarcoma (LPS) is associated with increased morbidity and may not confer a survival benefit compared with tumor-only (TO) resection. We compared both approaches using a novel statistical method called the “win ratio” (WR).

Methods
Patients who underwent resection of LPS from 2004 to 2015 were identified from the National Cancer Database. Multivisceral resection was defined as removal of the primary site in addition to other organs. The WR was calculated based on a hierarchy of postoperative outcomes: 30-day and 90-day mortality, long-term survival, and severe complication.

Results
Among 958 patients (multivisceral 634, TO 324) who underwent resection, the median age was 63 years (interquartile range [IQR] 54–71) with a median follow-up of 51 months (IQR 30–86). There was no difference in the WR among patients who underwent TO versus multivisceral resection in the matched cohort (WR 0.82, 95% confidence interval [CI] 0.61–1.10). In patients aged 72–90 years, those who underwent multivisceral resection had 36% lower odds of winning compared with patients undergoing TO resection (WR 0.64, 95% CI 0.40–0.98). A subgroup analysis of patients classified as not having adjacent tumor involvement at the time of surgery revealed that those patients who underwent multivisceral resection had 33% lower odds of winning compared to TO resection (WR 0.67, 95% CI 0.45–0.99).

Conclusions
Based on win-ratio assessments of a hierarchical composite endpoint, multivisceral resection in patients without adjacent tumor involvement may not confer improved outcomes. This method supports the rationale for less invasive resection of LPS in select patients, especially older patients.
A Prospective Study of Sentinel Node Biopsy Omission in Women Age ≥ 65 Years with ER+ Breast Cancer
Authors: Chung Alice P. , Dang Catherine M. , Karlan Scott R. , Amersi Farin F. , Phillips Edward M. , Boyle Marissa K. , Cui Yujie , Giuliano Armando E. 
Published: February 2024

Abstract
Background
National guidelines recommend omitting SNB in older patients with favorable invasive breast cancer. However, there is a lack of prospective data specifically addressing this issue. This study evaluates recurrence and survival in estrogen receptor-positive/Her2− (ER+) breast cancer patients, aged ≥ 65 years who have breast-conserving surgery (BCS) without SNB.

Methods
This is a prospective, observational study at a single institution where 125 patients aged ≥ 65 years with clinical T1-2N0 ER+ invasive breast cancer undergoing BCS were enrolled. Patients were treated with BCS without SNB. Primary outcome measure was axillary recurrence. Secondary outcome measures include recurrence-free survival (RFS), disease-free survival (DFS), breast cancer-specific survival (BCSS), and overall survival (OS).

Results
From January 2016 to July 2022, 125 patients were enrolled with median follow-up of 36.7 months [95% confidence interval (CI) 35.0–38.0]. Median age was 77.0 years (range 65–93). Median tumor size was 1 cm (range 0.1–5.0). Most tumors were ductal (95/124, 77.0%), intermediate grade (60/116, 51.7%), and PR-positive (117/123, 91.7%). Radiation therapy was performed in 37 of 125 (29.6%). Only 60 of 125 (48.0%) who were recommended hormonal therapy were compliant at 2 years. Chemotherapy was administered to six of 125 (4.8%) patients. There were two of 125 (1.6%) axillary recurrences. Estimated 3-years rates of regional RFS, DFS, and OS were 98.2%, 91.2%, and 94.8%, respectively. Univariate Cox regression identified hormonal therapy noncompliance to be significantly associated with recurrence (p = 0.02).

Conclusions
Axillary recurrence rates were extremely low in this cohort. These results provide prospective data to support omission of SNB in this patient population

Trial Registration
ClinicalTrials.gov ID NCT02564848.
The clinical picture of bipolar affective disorders in children and adolescents hospitalized at the psychiatric ward in Sosnowiec
Authors: Cichoń Lena , Janas-Kozik Małgorzata , Chełmecka Elżbieta , Wilczyński Krzysztof M. , Jelonek Ireneusz , Rybakowski Janusz K. 
Published: February 2024

Cel pracyOkreślenie obrazu klinicznego zaburzeń afektywnych dwubiegunowych (ZAD) u hospitalizowanych dzieci oraz młodzieży Oddziału Klinicznego Psychiatrii i Psychoterapii Wieku Rozwojowego w Sosnowcu.MetodaPrzeprowadzono analizę dokumentacji 288 pacjentów z ZAD poniżej 18 roku życia. Zebrano szczegółowe dane kliniczno-demograficzne oraz oceniono objawy występujące u nich podczas pobytu w szpitalu.WynikiŚredni wiek zachorowania wynosił 13,6±1,7 lat. 86,5% badanych miało pierwszą diagnozę inną niż ZAD/epizod manii, a średni czas do postawienia właściwego rozpoznania wynosił 16,9 miesięcy. U 45,5% pierwszym epizodem choroby był epizod depresji o różnym nasileniu, u 29,2% epizod mieszany, a u 25,3% epizod manii/hipomanii. U 48,6 % osób występowały zaburzenia współtowarzyszące. Najczęstszym powodem hospitalizacji był epizod mieszany (47,6%). Wśród objawów chorobowych, drażliwość występowała u ponad 80% chorych z epizodem maniakalnym lub mieszanym, ale również u około 60% pacjentów z epizodem depresji. Myśli samobójcze mieli niemal wszyscy chorzy w epizodzie depresji, 84,7% w epizodzie mieszanym, ale również 52,6% badanych w epizodzie manii/hipomanii. Lęk występował najczęściej w epizodzie depresji (40,7%) i mieszanym (22,6%), natomiast urojenia zgodne z nastrojem w epizodzie depresji oraz manii (około 20 % przypadków). Zachowania agresywne przejawiała około połowa chorych w epizodzie manii i mieszanym.WnioskiW badanej populacji dzieci i młodzieży ZAD najczęściej rozpoczynało się epizodem depresji, towarzyszył mu wysoki wskaźnik zaburzeń współtowarzyszących oraz w większości przypadków początkowo było mylnie diagnozowane. Wyniki badania wskazują również na istotną częstość niektórych objawów chorobowych w tej populacji.
Lateral wall thickness is not associated with revision risk of medially stable intertrochanteric fractures fixed with a sliding hip screw
Authors: Chen Bin , Duckworth Andrew D. , Farrow Luke , Xu You J. , Clement Nick D. 
Published: February 2024

AimsThis study aimed to determine whether lateral femoral wall thickness (LWT) < 20.5 mm was associated with increased revision risk of intertrochanteric fracture (ITF) of the hip following sliding hip screw (SHS) fixation when the medial calcar was intact. Additionally, the study assessed the association between LWT and patient mortality.MethodsThis retrospective study included ITF patients aged 50 years and over treated with SHS fixation between 2019 and 2021 at a major trauma centre. Demographic information, fracture type, delirium status, American Society of Anesthesiologists grade, and length of stay were collected. LWT and tip apex distance were measured. Revision surgery and mortality were recorded at a mean follow-up of 19.5 months (1.6 to 48). Cox regression was performed to evaluate independent risk factors associated with revision surgery and mortality.ResultsThe cohort consisted of 890 patients with a mean age of 82 years (SD 10.2). Mean LWT was 27.0 mm (SD 8.6), and there were 213 patients (23.9%) with LWT < 20.5 mm. Overall, 20 patients (2.2%) underwent a revision surgery following SHS fixation. Adjusting for covariates, LWT < 20.5 mm was not independently associated with an increased revision or mortality risk. However, factors that were significantly more prevalent in LWT < 20.5 mm group, which included residence in care home (hazard ratio (HR) 1.84; p < 0.001) or hospital (HR 1.65; p = 0.005), and delirium (HR 1.32; p = 0.026), were independently associated with an increased mortality risk. The only independent factor associated with increased risk of revision was older age (HR 1.07; p = 0.030).ConclusionLWT was not associated with risk of revision surgery in patients with an ITF fixed with a SHS when the calcar was intact, after adjusting for the independent effect of age. Although LWT < 20.5 mm was not an independent risk factor for mortality, patients with LWT < 20.5 mm were more likely to be from care home or hospital and have delirium on admission, which were associated with a higher mortality rate.Cite this article: Bone Jt Open 2024;5(2):123–131.
Consumer and provider perceptions of the specialist unit model of care: A qualitative study
Authors: Long Janet C. , Carrigan Ann , Roberts Natalie , Clay-Williams Robyn , Hibbert Peter D. , Zurynski Yvonne , Maka Katherine , Loy Graeme , Braithwaite Jeffrey 
Published: February 2024

Background
Specialist care units cater to targeted cohorts of patients, applying evidence-based practice to people with a specific condition (e.g., dementia) or meeting other specific criteria (e.g., children). This paper aimed to collate perceptions of local consumers and health providers around specialist care units, as a model of care that may be considered for a new local healthcare facility.

Methods
This was a qualitative study using two-hour workshops and interviews to collect data. Participants were consumers and health providers in the planned facility’s catchment: 49 suburbs in metropolitan Australia. Consumers and health providers were recruited through advertisements and emails. An initial survey collected demographic details. Consumers and health providers participated in separate two-hour workshops in which a scenario around the specialist unit model was presented and discussion on benefits, barriers and enablers of the model was led by researchers. Detailed notes were taken for analysis.

Results
Five consumer workshops (n = 22 participants) and five health provider workshops (n = 42) were conducted. Participants were representative of this culturally diverse region. Factors identified by participants as relevant to the specialist unit model of care included: accessibility; a perceived narrow scope of practice; coordination with other services; resources and infrastructure; and awareness and expectations of the units. Some factors identified as risks or barriers when absent were identified as strengths and enablers when present by both groups of participants.

Conclusions
Positive views of the model centred on the higher perceived quality of care received in the units. Negative views centred on a perceived narrow scope of care and lack of flexibility. Consumers hinted, and providers stated explicitly, that the model needed to be complemented by an integrated model of care model to enable continuity of care and easy transfer of patients into and out of the specialist unit.
Rotavirus and adenovirus infections in children with acute gastroenteritis after introducing the Rotasiil® vaccine in Kisangani, Democratic Republic of the Congo
Authors: Manzemu Didier Gbebangi , Opara Jean Pierre Alworong’a , Kasai Emmanuel Tebandite , Mumbere Mupenzi , Kampunzu Véronique Muyobela , Likele Bibi Batoko , Uvoya Naura Apio , Vanzwa Hortense Malikidogo , Bukaka Gaspard Mande , Dady Falay Sadiki , Dauly Nestor Ngbonda , Belec Laurent , Tonen-Wolyec Serge 
Published: February 2024

Background
Although rotavirus vaccination has reduced the global burden of the virus, morbidity and mortality from rotavirus infection remain high in Sub-Saharan Africa. This study aimed to determine the prevalence of rotavirus and adenovirus infections in children under five years with acute gastroenteritis and to identify factors associated with rotavirus infection after the introduction of the Rotasiil® vaccine in 2019 in Kisangani, Democratic Republic of the Congo (DRC).

Methods
This study consisted of a cross-sectional hospital-based survey conducted from May 2022 to April 2023 in four health facilities in Kisangani, using a fecal-based test (rapid antigenic immuno-chromatographic diagnostic test, BYOSYNEX adenovirus/rotavirus BSS, Biosynex SA, Illkirch-Graffenstaden, France) of rotavirus and adenovirus infections among children under five years of age with acute gastroenteritis.

Results
A total of 320 children under five years of age with acute gastroenteritis were included. The prevalence of rotavirus infection was 34.4%, that of adenovirus was 6.3%, and that of both rotavirus and adenovirus coinfection was 1.3%. The prevalence of rotavirus was significantly higher in unvaccinated children than in vaccinated children (55.4% versus 23.1%; P < 0.001). This difference was observed only in children who received all three vaccine doses. Multivariate logistic regression analysis shows that the rate of rotavirus infection was significantly reduced in vaccinated children (adjusted OR: 0.31 [95% confidence intervals (CI): 0.19–0.56]; P < 0.001) and those whose mothers had an average (adjusted OR: 0.51 [95% CI: 0.25–0.91]; P = 0.018) or high level (adjusted OR: 0.34 [95% CI: 0.20–0.64]; P < 0.001) of knowledge about the rotavirus vaccine.

Conclusions
The prevalence of rotavirus infection remains high in Kisangani despite vaccination. However, the prevalence of adenovirus infections was low in our series. Complete vaccination with three doses and mothers’ average and high level of knowledge about the rotavirus vaccine significantly reduces the rate of rotavirus infection. It is, therefore, essential to strengthen the mothers’ health education, continue with the Rotasiil® vaccine, and ensure epidemiological surveillance of rotavirus infection.