bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring medical students’ perceptions and understanding of the health impacts of climate change: a qualitative content analysis
Authors: Heydari Ahad , Partovi Peyman , Zarezadeh Yadolah , Yari Arezoo 
Published: October 2023

Abstract
Background
Climate change has been identified as the greatest threat to global health in the twenty-first century, with its unfavorable health consequences being among its impacts on humans. Exploring the perspectives and understanding of healthcare professionals and service providers concerning climate change becomes imperative. The aim of this study is to investigate the perceptions and understanding of final-year medical students regarding the health impacts of climate change on individuals and the healthcare system using a qualitative content analysis.

Methods
This study employed a qualitative content analysis approach. Face-to-face interviews were conducted with the aid of an interview guide to explore the students' awareness, understanding, and attitudes towards the impacts of climate change on public health and the healthcare system. The collected interview data were subsequently organized into codes, categories, and subcategories based on the students' perspectives and attitudes towards climate change.

Results
Fifteen medical intern students were interviewed for this study, and the qualitative findings were categorized into 3 categories, 23 subcategories, and 229 codes. The study's findings revealed various health impacts of climate change, which were classified into three main categories, including environmental effects with 8 subcategories, socio-economic effects with 8 subcategories, and health effects with 7 subcategories. The study's findings revealed medical students' perceptions of various health impacts of climate change and These findings suggest that medical student understand that climate change has significant impacts on individuals' health and society, mainly through environmental degradation, increased risks, and climate-related disasters, which ultimately lead to adverse health outcomes.

Conclusions
The perspectives of medical students in this study indicate that climate change may not have a direct and immediate impact on the health of individuals and communities. However, it can significantly influence their health and socio-economic well-being by exacerbating or causing environmental problems, increasing the risk of weather-related events and natural disasters, ultimately leading to adverse health outcomes. While the medical students' perspectives on the health impacts of climate change are indeed broad, incorporating scientific knowledge about this topic into the medical curriculum and educating students on how to deal with patients affected by these consequences can have a significant impact on health management. This proactive approach, despite the students' already comprehensive understanding, can enhance their preparedness to address the health effects of climate change and contribute to strengthening the healthcare system's resilience in the face of climate-related challenges.
Molecular surveillance and genetic diversity of Anaplasma spp. in cattle (Bos taurus) and goat (Capra aegagrus hircus) from Hainan island/province, China
Authors: Zhou Sa , Huang Liangyuan , Lin Yang , Bhowmick Biswajit , Zhao Jianguo , Liao Chenghong , Guan Qingfeng , Wang Jinhua , Han Qian 
Published: October 2023

AbstractAnaplasmosis is a highly prevalent tick-borne intracellular bacterial disease that affects various host species globally, particularly ruminants in tropical and subtropical regions. However, information regarding the distribution and epidemiology of anaplasmosis in small and large ruminants on Hainan Isalnd is limited. To address this knowledge gap, the present study aimed to assess the occurrence of Anaplasma spp. infections in goats (N = 731) and cattle (N = 176) blood samples using nested PCR and conventional PCR based assays. The results revealed an overall prevalence of 30.1% in goats and 14.8% in cattle. The infection rates of A. bovis, A. phagocytophilum, A. ovis and A. capra in goat samples were 22.7%, 13.8%, 2.0% and 3.4%, respectively, while the infection rates of A. bovis, A. phagocytophilum and A. marginale in cattle samples were 11.4%, 6.3% and 5.7%, respectively. A. bovis exhibited the highest prevalence among the Anaplasma spp. in both goat and cattle samples. In addition, the most frequent co-infection was the one with A. phagocytophilum and A. bovis. It was found that the age, sex and feeding habits of cattle and goats were considered to be important risk factors. Evaluation of the risk factor relating to the rearing system showed that the infection rate for the free-range goats and cattle was significantly higher when compared with stall-feeding system.This study represents one of the largest investigations on the distribution, prevalence, and risk factors associated with Anaplasma infection in ruminants on Hainan Island, highlighting a higher circulation of the infection in the region than previously anticipated. Further reasesrch is necessary to investigate tick vectors, reservoir animals, and the zoonotic potential of the Anaplasma spp. in this endemic region of Hainan Island.
The strategies to cure cancer patients by eradicating cancer stem-like cells
Authors: Mai Yansui , Su Jiyan , Yang Chuan , Xia Chenglai , Fu Liwu 
Published: October 2023

AbstractCancer stem-like cells (CSCs), a subpopulation of cancer cells, possess remarkable capability in proliferation, self-renewal, and differentiation. Their presence is recognized as a crucial factor contributing to tumor progression and metastasis. CSCs have garnered significant attention as a therapeutic focus and an etiologic root of treatment-resistant cells. Increasing evidence indicated that specific biomarkers, aberrant activated pathways, immunosuppressive tumor microenvironment (TME), and immunoevasion are considered the culprits in the occurrence of CSCs and the maintenance of CSCs properties including multi-directional differentiation. Targeting CSC biomarkers, stemness-associated pathways, TME, immunoevasion and inducing CSCs differentiation improve CSCs eradication and, therefore, cancer treatment. This review comprehensively summarized these targeted therapies, along with their current status in clinical trials. By exploring and implementing strategies aimed at eradicating CSCs, researchers aim to improve cancer treatment outcomes and overcome the challenges posed by CSC-mediated therapy resistance.
Body Mass Index is Associated with blood pressure and vital capacity in medical students
Authors: Song Lingxia , Li Jiajin , Yu Sen , Cai Yunjia , He Huan , Lun Jiayi , Zheng Li , Ye Jufeng 
Published: October 2023

Abstract
Background
The widely reported associations between body mass index (BMI) and various chronic diseases, such as hypertension and asthma, have garnered significant attention. Nonetheless, there remains a dearth of research dedicated to understanding the health impacts of medical school on the students, who experience considerable academic pressure. In that context, this study was driven by the goal of investigating the intricate interplay between BMI, blood pressure (BP), and vital capacity among medical students.

Methods
This study included a cohort of 843 medical students enrolled at Southern Medical University who were selected through random cluster sampling. Within this cohort, measurements of height, weight, BP, and vital capacity were taken. Subsequently, both BMI and vital capacity index (VCI) were calculated for each participant. By categorizing the subjects into four groups according to BMI classifications, a comprehensive analysis that included correlation assessments and binomial logistic regression was conducted.

Results
Within the participant pool, 9.4% and 3.8% of participants were classified as overweight and obese, respectively. Additionally, the prevalence of prehypertension, hypertension, and poor VCI was 18.1%, 2.7%, and 13.5%, respectively. Notably, male students exhibited a higher prevalence of the aforementioned health issues than their female counterparts. Correlation analysis revealed that BMI displayed positive associations with systolic blood pressure (SBP), diastolic blood pressure (DBP), and vital capacity (r = 0.372, 0.257, 0.428; P < 0.001). However, an inverse correlation emerged between BMI and VCI (r = -0.284, P < 0.001). Further analysis revealed that overweight and obese individuals faced an elevated risk of high blood pressure ([OR 2.05, 95% CI 1.15–3.67] and [OR 5.44, 95% CI 2.28–13.02], respectively) compared to their normal-weight counterparts. Moreover, these groups also exhibited a higher risk of poor VCI ([OR 5.25, 95% CI 3.04–9.06] and [OR 15.61, 95% CI 6.81–35.81], respectively), while underweight subjects experienced a reduced risk ([OR 0.19, 95% CI 0.07–0.52]).

Conclusions
BMI demonstrated a notably strong positive correlation with both BP and vital capacity and a negative correlation with VCI. Therefore, for medical students as well as the daily health care of patients, weight control is recommended to better combat obesity-related diseases, for example, cardiopulmonary diseases, gout and diabetes.
Screening and verifying the mutations in the LDLR and APOB genes in a Chinese family with familial hypercholesterolemia
Authors: Lv Xian , Wang Chunyue , Liu Lu , Yin Guoqing , Zhang Wen , Abdu Fuad A. , Shi Tingting , Zhang Qingfeng , Che Wenliang 
Published: October 2023

Abstract
Background
Familial hypercholesterolemia (FH) is an autosomal dominant genetic disorder. The primary objective of this study was to identify the major pathogenic mutations in a Chinese family with FH.

Methods
Whole-genome sequencing (WGS) was used to identify variants of FH-related genes, including low-density lipoprotein receptor (LDLR), apolipoprotein B (APOB), and proprotein convertase subtilisin/kexin 9 (PCSK9). Bioinformatics software was used to predict signal peptides, transmembrane structures, and spatial construction information of the mutated sequences. Western blotting was performed on the mutant protein to determine the presence of the major structural domains of the LDLR. The PCSK9 and APOB genes were screened and analyzed. Moreover, the proband and his brother were treated with a PCSK9 inhibitor for 1 year, and the effect of the treatment on lipid levels was assessed.

Results
WGS revealed two potentially pathogenic mutations in the LDLR gene. One was a novel mutation, c.497delinsGGATCCCCCAGCTGCATCCCCCAG (p. Ala166fs), and the other was a known pathogenic mutation, c.2054C>T (p. Pro685Leu). Bioinformatics prediction and in vitro experiments revealed that the novel mutation could not be expressed on the cell membrane. Numerous gene variants were identified in the APOB gene that may have a significant impact on the family members with FH. Thus, it is suggested that the severe manifestation of FH in the proband primarily resulted from the cumulative genetic effects of variants in both LDLR and APOB. However, a subsequent study indicated that treatment with a PCSK9 inhibitor (Evolocumab) did not significantly reduce the blood lipid levels in the proband or his brother.

Conclusions
The cumulative effect of LDLR and APOB variants was the primary cause of elevated blood lipid levels in this family. However, PCSK9 inhibitor therapy did not appear to be beneficial for the proband. This study emphasizes the importance of genetic testing in determining the most suitable treatment options for patients with FH.
Effect of immunology biomarkers associated with hip fracture and fracture risk in older adults
Authors: Cedeno-Veloz Bernardo Abel , Lozano-Vicario Lucía , Zambom-Ferraresi Fabricio , Fernández-Irigoyen Joaquín , Santamaría Enrique , Rodríguez-García Alba , Romero-Ortuno Roman , Mondragon-Rubio Jaime , Ruiz-Ruiz Javier , Ramírez-Vélez Robinson , Izquierdo Mikel , Martínez-Velilla Nicolás 
Published: October 2023

AbstractOsteoporosis is a skeletal disease that can increase the risk of fractures, leading to adverse health and socioeconomic consequences. However, current clinical methods have limitations in accurately estimating fracture risk, particularly in older adults. Thus, new technologies are necessary to improve the accuracy of fracture risk estimation. In this observational study, we aimed to explore the association between serum cytokines and hip fracture status in older adults, and their associations with fracture risk using the FRAX reference tool. We investigated the use of a proximity extension assay (PEA) with Olink. We compared the characteristics of the population, functional status and detailed body composition (determined using densitometry) between groups. We enrolled 40 participants, including 20 with hip fracture and 20 without fracture, and studied 46 cytokines in their serum. After conducting a score plot and two unpaired t-tests using the Benjamini-Hochberg method, we found that Interleukin 6 (IL-6), Lymphotoxin-alpha (LT-α), Fms-related tyrosine kinase 3 ligand (FLT3LG), Colony stimulating factor 1 (CSF1), and Chemokine (C-C motif) ligand 7 (CCL7) were significantly different between fracture and non-fracture patients (p < 0.05). IL-6 had a moderate correlation with FRAX (R2 = 0.409, p < 0.001), while CSF1 and CCL7 had weak correlations with FRAX. LT-α and FLT3LG exhibited a negative correlation with the risk of fracture. Our results suggest that targeted proteomic tools have the capability to identify differentially regulated proteins and may serve as potential markers for estimating fracture risk. However, longitudinal studies will be necessary to validate these results and determine the temporal patterns of changes in cytokine profiles.
Interleukin-37: associations of plasma levels and genetic variants in gout
Authors: Andres Cerezo Lucie , Navrátilová Adéla , Hulejová Hana , Pavlíková Markéta , Závada Jakub , Pavelka Karel , Šenolt Ladislav , Stiburkova Blanka 
Published: October 2023

Abstract
Objectives
IL-37 is an anti-inflammatory cytokine involved in inflammatory and autoimmune diseases. We aimed to investigate the association between IL-37 genetic variants, IL-37 plasma levels, and various clinical phases of gout.

Methods
The study included a control group with no history of primary hyperuricemia/gout, (n = 50), asymptomatic hyperuricemia (n = 74), intercritical gout (n = 200), acute gouty flare (n = 18), and chronic tophaceous gout (n = 30). Plasma IL-37 was analysed using enzyme-linked immunosorbent assay. All coding regions and intron–exon boundaries of IL-37 and exons 1–5 were amplified and sequenced.

Results
Plasma levels of IL-37 were significantly higher in asymptomatic hyperuricemic (p = 0.045), intercritical gout (p = 0.001), and chronic tophaceous gout (p = 0.021) cohorts when compared to control group. The levels of IL-37 in patients with acute gouty flare were comparable to control group (p = 0.061). We identified 15 genetic variants of IL-37: eight intron (rs2708959, rs2723170, rs2708958, rs2723169 rs2466448, rs3811045, rs3811048, rs2708944) and seven non-synonymous allelic variants (rs3811046, rs3811047, rs2708943, rs2723183, rs2723187, rs2708947, rs27231927), of which rs2708959 showed an over-presentation in gouty and acute flare cohorts (p = 0.003 and 0.033, respectively) compared to European population (minor allelic frequency MAF = 0.05) but not in control and hyperuricemic cohorts (p/MAF = 0.17/0.08 and 0.71/0.05, respectively).. On the contrary, rs3811045, rs3811046, rs3811047, and rs3811048 were underrepresented among individuals with tophaceous gout (MAF = 0.57) compared to European MAF 0.70–0.71, but not compared to the control cohort (MAF = 0.67).

Conclusions
We demonstrated the up-regulation of IL-37 levels across the clinical phases of gout: asymptomatic hyperuricemia, intercritical, and chronic tophaceous gout compared to control. Moreover, 15 genetic variants of IL-37 were identified and their associations with the clinical variants of gout were evaluated.
Accelerated DNA methylation age plays a role in the impact of cardiovascular risk factors on the human heart
Authors: Topriceanu Constantin-Cristian , Dev Eesha , Ahmad Mahmood , Hughes Rebecca , Shiwani Hunain , Webber Matthew , Direk Kenan , Wong Andrew , Ugander Martin , Moon James C. , Hughes Alun D. , Maddock Jane , Schlegel Todd T. , Captur Gabriella 
Published: October 2023

Abstract
Background
DNA methylation (DNAm) age acceleration (AgeAccel) and cardiac age by 12-lead advanced electrocardiography (A-ECG) are promising biomarkers of biological and cardiac aging, respectively. We aimed to explore the relationships between DNAm age and A-ECG heart age and to understand the extent to which DNAm AgeAccel relates to cardiovascular (CV) risk factors in a British birth cohort from 1946.

Results
We studied four DNAm ages (AgeHannum, AgeHorvath, PhenoAge, and GrimAge) and their corresponding AgeAccel. Outcomes were the results from two publicly available ECG-based cardiac age scores: the Bayesian A-ECG-based heart age score of Lindow et al. 2022 and the deep neural network (DNN) ECG-based heart age score of Ribeiro et al. 2020. DNAm AgeAccel was also studied relative to results from two logistic regression-based A-ECG disease scores, one for left ventricular (LV) systolic dysfunction (LVSD), and one for LV electrical remodeling (LVER). Generalized linear models were used to explore the extent to which any associations between biological cardiometabolic risk factors (body mass index, hypertension, diabetes, high cholesterol, previous cardiovascular disease [CVD], and any CV risk factor) and the ECG-based outcomes are mediated by DNAm AgeAccel. We derived the total effects, average causal mediation effects (ACMEs), average direct effects (ADEs), and the proportion mediated [PM] with their 95% confidence intervals [CIs]. 498 participants (all 60–64 years) were included, with the youngest ECG heart age being 27 and the oldest 90. When exploring the associations between cardiometabolic risk factors and Bayesian A-ECG cardiac age, AgeAccelPheno appears to be a partial mediator, as ACME was 0.23 years [0.01, 0.52] p = 0.028 (i.e., PM≈18%) for diabetes, 0.34 [0.03, 0.74] p = 0.024 (i.e., PM≈15%) for high cholesterol, and 0.34 [0.03, 0.74] p = 0.024 (PM≈15%) for any CV risk factor. Similarly, AgeAccelGrim mediates ≈30% of the relationship between diabetes or high cholesterol and the DNN ECG-based heart age. When exploring the link between cardiometabolic risk factors and the A-ECG-based LVSD and LVER scores, it appears that AgeAccelPheno or AgeAccelGrim mediate 10–40% of these associations.

Conclusion
By the age of 60, participants with accelerated DNA methylation appear to have older, weaker, and more electrically impaired hearts. We show that the harmful effects of CV risk factors on cardiac age and health, appear to be partially mediated by DNAm AgeAccelPheno and AgeAccelGrim. This highlights the need to further investigate the potential cardioprotective effects of selective DNA methyltransferases modulators.
RETRACTED ARTICLE: Optimized design and application research of smart interactive screen for wireless networks based on federated learning
Authors: Zhao Chang , Zhang Linghao 
Published: October 2023

AbstractThe rapid development of infinite networks and information technology has promoted the wide deployment and rapid growth of intelligent interactive devices. However, at the same time, touch interaction technology also faces many challenges such as lack of precision. This study combines federated learning with LayerGesture technology to optimize and design a touch interaction system with higher interaction accuracy and applies it to practice. The analysis results show that with the increase in the number of iterations of the federated model, the accuracy of the human–computer recognition interaction and the amount of information contained in it increases, and the accuracy curve reaches stability at about 2800 times and is at the optimal interaction adaptation. At this point, the loss function also decreases gradually, while the loss factor tends to 0, which verifies the stability of the optimized model. According to the participants’ interaction experience and experimental results, the optimized LayerGesture technique of the federated learning model has an average correctness rate of 90.4% and the lowest average selection time, while the average selection time of LayerGesture in the interaction area at the edge of the screen is 2510 ms and the average correctness rate is 93.60%, which is better than the Shift technique. In addition, the subjective survey results indicated that more participants favored the optimized LayerGesture technique. In summary, this paper’s joint learning algorithm contributes to the recognition effectiveness and efficiency of intelligent interactive systems.
CT-based navigation for total hip arthroplasty: a meta-analysis
Authors: Migliorini Filippo , Cuozzo Francesco , Oliva Francesco , Eschweiler Joerg , Hildebrand Frank , Maffulli Nicola 
Published: October 2023

Abstract
Introduction
Computer tomography (CT) based navigation is considered by some authors as an advance in total hip arthroplasty (THA). A meta-analysis was conducted to compare CT based versus conventional THA in terms of surgical duration of the procedure, leg length difference, acetabular cup position, and rate of dislocation.

Material and methods
The present study was conducted according to the PRISMA 2020. In December 2022, the following databases were accessed: PubMed, Web of Science, Google Scholar, Embase with no time constrain. All the clinical studies comparing CT based navigation versus the conventional THA were accessed.

Results
Data from 1801 procedures were collected. The mean age of the patients was 61.6 ± 5.3 years, and the mean BMI was 26.9 ± 2.3 kg/m2. There was between studies comparability at baseline in terms of age, BMI, pain score, Harris hip score, leg length discrepancy (P > 0.1). The navigated group demonstrated lower leg length discrepancy (P = 0.02), and lower degrees of cup anteversion (P = 0.002). Similarity was found in cup inclination (P = 0.98), surgical duration (P = 0.3), and the rate of dislocation (P = 0.6).

Conclusion
CT guided THA may have the potential to increase the accuracy of acetabular positioning and reduce the leg length discrepancy. Current evidence is very limited and heterogeneous, and no recommendations can be inferred. Further investigations are required to definitely clarify the role of CT based THA in current practice.