bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sexual experiences of postmenopausal women in China: a qualitative study
Authors: Chen Jie , Zhai Haina , Jin Hongyun , Li Xiang , Zhang Pan , Chen Rong 
Published: December 2023

Abstract

Background
Sexual dysfunction is common among postmenopausal women and can have a significant negative impact on quality of life.

Aim
This study aimed to explore perceptions, experiences, and coping strategies related to sex among postmenopausal women in China.

Methods
We used phenomenologic qualitative methods in this study. On the basis of purposive sampling and the data saturation principle, 21 volunteers from a community cohort study were selected for semistructured interviews. The data were analyzed and themes were extracted.

Outcomes
Thematic codes pertaining to sexual experiences and coping strategies were defined and assessed in this study.

Results
Four themes and 12 subthemes were extracted from the interview data. The sexual concepts were relatively conservative for most of the Chinese women; the majority experienced physical and psychological distress with respect to sex, although negative and positive psychological experiences were described. The women often passively accepted and adapted to negative changes to their sex lives during the postmenopause period.

Clinical Implications
This study highlights the importance of and need for effective dissemination of sexual health–related knowledge and the opening of appropriate communication channels.

Strengths and Limitations
By using a qualitative approach, this study provides individuals with the opportunity to describe their cognition and attitudes toward sexuality. Limitations include limited generalizability, as is true for most qualitative research. Additionally, the study is based solely on the female perspective and cannot fully reflect the sex life of couples.

Conclusion
The sexual experiences of our respondents exhibited distinct Chinese cultural characteristics. The interviews show the importance of paying attention to postmenopausal women’s sexual health and providing relevant professional support and guidance to improve women’s overall health-related quality of life.
Physiological and autophagy evaluation of different pear varieties (Pyrus spp.) in response to Botryosphaeria dothidea infection
Authors: Wang Yun , Zhang Ye , Fan Jiaqi , Li Hongxiang , Chen Qiming , Yin Hao , Qi Kaijie , Xie Zhihua , Zhu Nan , Sun Xun , Zhang Shaoling 
Published: December 2023

Abstract
Ring rot disease is one of the most common diseases in pear orchards. To better understand the physiology, biochemistry and autophagic changes of different pear varieties after Botryosphaeria dothidea (B.dothidea) infection, we evaluated eight different pear varieties for B. dothidea resistance. The susceptible varieties had larger spot diameters, lower chlorophyll contents and higher malondialdehyde contents than the resistant varieties. In disease-resistant varieties, reactive oxygen species (ROS) levels were relatively lower, while the ROS metabolism (antioxidant enzyme activities and the ascorbic acid–glutathione cycle) was also maintained at higher levels, and it induced a significant upregulation of related gene expression. In addition, autophagy, as an important evaluation index, was found to have more autophagic activity in disease-resistant varieties than in susceptible varieties, suggesting that pathogen infestation drives plants to increase autophagy to defend against pathogens. In summary, the results of this study reveal that different resistant pear varieties enhance plant resistance to the disease through a series of physio-biochemical changes and autophagic activity after inoculation with B. dothidea. This study provides clear physiological and biochemical traits for pear disease resistance selection, potential genetic resources and material basis for pear disease control and disease resistance, breeding and points out the direction for research on the mechanism of pear resistance to B. dothidea.
La liberté statutaire dans la société par action simplifiée en droit OHADA
Authors: Tchamgwe Innocent 
Published: December 2023

Abstract
A haven for articles of association freedom, in that it constitutes a company tailored to the will of its shareholders, the Simplified Public Limited Company has henceforth imposed itself as a commercial entity whose introduction into the OHADA space has crystallized the contractual design of the commercial company. It allows the partners to freely insert in their articles of association anything that is not expressly prohibited and relating to the constitution, governance, and dissolution of the company. Nevertheless, this exuberant articles of association freedom, which contrasts sharply with the absence of personal liability of the shareholders for company debts, may be detrimental to the interests of the shareholders, the company, and the economy. Mandatory commercial companies’ rules and the general theory of commercial companies then timidly take it upon themselves to try to tame articles of association freedom and correct the defects of the Simplified Public Limited Company. All this heightens the feeling of distrust vis-à-vis articles of association freedom, which, in the absence of serious limitations, enslaves more than it releases.
Can biomarkers help identify sepsis in adults?
Authors: Narasimhan Katherine , D'Acunto Kristin 
Published: December 2023

ABSTRACT
Sepsis is increasing in incidence in the United States and is one of the most common causes of death in hospitalized patients. Sepsis affects different biochemical and immunologic pathways and can present variably. Despite efforts to unify definitions of sepsis, increase awareness, and improve treatment, mortality remains high. Because of sepsis's complex pathophysiology, diagnosis can be challenging. No diagnostic test is sensitive or specific enough to diagnose sepsis in isolation. However, three biomarkers—lactate, C-reactive protein, and procalcitonin—in combination with other diagnostics may help clinicians diagnose sepsis earlier, leading to better patient outcomes.
A versatile method to profile hepatitis B virus DNA integration
Authors: Fukano Kento , Wakae Kousho , Nao Naganori , Saito Masumichi , Tsubota Akihito , Toyoshima Takae , Aizaki Hideki , Iijima Hiroko , Matsudaira Takahiro , Kimura Moto , Watashi Koichi , Sugiura Wataru , Muramatsu Masamichi 
Published: December 2023

Background:HBV DNA integration into the host genome is frequently found in HBV-associated HCC tissues and is associated with hepatocarcinogenesis. Multiple detection methods, including hybrid capture-sequencing, have identified integration sites and provided clinical implications; however, each has advantages and disadvantages concerning sensitivity, cost, and throughput. Therefore, methods that can comprehensively and cost-effectively detect integration sites with high sensitivity are required. Here, we investigated the efficiency of RAISING (Rapid Amplification of Integration Site without Interference by Genomic DNA contamination) as a simple and inexpensive method to detect viral integration by amplifying HBV-integrated fragments using virus-specific primers covering the entire HBV genome.Methods and Results:Illumina sequencing of RAISING products from HCC-derived cell lines (PLC/PRF/5 and Hep3B cells) identified HBV-human junction sequences as well as their frequencies. The HBV-human junction profiles identified using RAISING were consistent with those determined using hybrid capture-sequencing, and the representative junctions could be validated by junction-specific nested PCR. The comparison of these detection methods revealed that RAISING-sequencing outperforms hybrid capture-sequencing in concentrating junction sequences. RAISING-sequencing was also demonstrated to determine the sites of de novo integration in HBV-infected HepG2-NTCP cells, primary human hepatocytes, liver-humanized mice, and clinical specimens. Furthermore, we made use of xenograft mice subcutaneously engrafted with PLC/PRF/5 or Hep3B cells, and HBV-human junctions determined by RAISING-sequencing were detectable in the plasma cell-free DNA using droplet digital PCR.Conclusions:RAISING successfully profiles HBV-human junction sequences with smaller amounts of sequencing data and at a lower cost than hybrid capture-sequencing. This method is expected to aid basic HBV integration and clinical diagnosis research.
A genetic variant in the CD40 gene is related to HBV infection in the Chinese Han population
Authors: Wu Wennan , Xu Siyi , Zeng Yongbin , Yu Luoli , Chen Tianbin , Shang Hongyan , Liu Can , Yang Bin , Ou Qishui 
Published: December 2023

Background:
CD40 is an important immune costimulatory molecule that has recently been found to be associated with chronic hepatitis B. This study aims to explore the association between CD40 polymorphisms and HBV infection, as well as to investigate the impact of different rs1883832 genotypes on CD40 expression and its effect on the progression of chronic HBV infection.

Methods:
We genotyped rs1883832 in 3433 individuals using MassARRAY, and quantified the CD40 expression, including CD40 mRNA, sCD40, and mCD40. The CD40 and HBV infection indicators were assessed to investigate the potential function of rs1883832 in suppressing HBV replication in HepG2.2.15 and HepAD38, CD40L in cytotoxic t lymphocytes (CTLs) and interferon-γ, TNF-α, granzyme B, and perforin were measured to elucidate the mechanism by which CD40 inhibits HBV replication.

Results:
Our study revealed that the frequencies of CC genotype and C allele of rs1883832 were significantly higher in immune recovery compared to chronic hepatitis B. Individuals with CC genotype exhibited significantly elevated CD40 in serum and B cells compared to TT genotypes in chronic hepatitis B. Additionally, CD40 is capable of inhibiting HBV replication and transcription in hepatocytes by means of interaction with CD40L. A significant negative correlation was found between HBV DNA, HBeAg, and mCD40. Conversely, the expressions of ALT and mCD40 showed a positive correlation, which aligns with the trend of CD40L.

Conclusions:
rs1883832 C allele may have a protective role in HBV immune recovery. This protective effect could potentially be attributed to the regulation of CD40 expression. The activation of the anti-HBV immune response, which occurs through binding CD40L on CTL, can suppress HBV DNA replication and potentially facilitate immune recovery in HBV infection.
Atorvastatin for patients with cirrhosis. A randomized, placebo-controlled trial
Authors: Kronborg Thit M. , Schierwagen Robert , Trošt Kajetan , Gao Qian , Moritz Thomas , Bendtsen Flemming , Gantzel Rasmus H. , Andersen Mette L. , Teisner Ane S. , Grønbæk Henning , Hobolth Lise , Møller Søren , Trebicka Jonel , Kimer Nina 
Published: December 2023

Background:
Patients with cirrhosis and portal hypertension face a high risk of complications. Besides their anti-inflammatory and antifibrotic effects, statins may reduce portal pressure and thus the risk of complications and mortality. We aimed to investigate the effects of atorvastatin on hospital admissions, mortality, inflammation, and lipidomics in cirrhosis with portal hypertension.

Methods:
We performed a double-blinded, randomized, placebo-controlled clinical trial among patients with cirrhosis and portal hypertension. Atorvastatin (10–20 mg/d) was administered for 6 months. We measured splanchnic hemodynamics, analyzed inflammatory markers, and performed lipidomics at baseline and after 6 months.

Results:
Seventy-eight patients were randomized, with 38 patients allocated to atorvastatin and 40 patients to placebo. Fifty-nine patients completed 6 months of intervention. Comparisons between changes in each group were calculated. Liver-related complications and mortality were similar between the groups. The HVPG and Model for End-stage Liver Disease score did not change between groups (p=0.95 and 0.87, respectively). Atorvastatin decreased 3 of 42 inflammatory markers, CD62-L-selectin, matrix metalloproteinases-2, and TNF-α (p-values: 0.005, 0.011, and 0.023, respectively), while lipidomics was not significantly changed.

Conclusions:
In patients with cirrhosis, atorvastatin was safe to use, but did not reduce mortality, the risk of liver-related complications, or the HVPG. Atorvastatin induced minor anti-inflammatory effects and minor effects on lipids during a 6-month treatment period.
Role and Value of the Corporate Medical Director
Authors: Stave Gregg M. , Burton Wayne N. , Heron Richard J.L. , Hudson T. Warner , Pawlecki J. Brent , Roomes David , Sepulveda Martin J. , Rendel Michael , Hymel Pamela A. 
Published: December 2023

Abstract
The role of the Corporate Medical Director (CMD) has received increased attention during the COVID-19 pandemic and has continued to evolve. This updated guidance addresses the role and value of the CMD in: health policy, strategy, and leadership; fostering a culture of health and well-being; supporting worker health and productivity/performance; addressing mental health; collaborating on employer benefits design; developing programs for global health, travel medicine, and remote/extreme environments; overseeing on- and near-site clinics; incorporating digital technology, artificial intelligence, and telehealth in health programs; supporting critical incident preparedness and business continuity planning; addressing workplace hazards; and overseeing periodic executive health examinations.
Is Oxytocin Administration During Childbirth Associated With Increased Risk for Postpartum Posttraumatic Stress Symptoms?
Authors: Tenne Yaara , Kahalon Rotem , Daari Laura , Preis Heidi , Eisner Michal , Chen Rony , Mor Pnina , Grisaru Granovsky Sorina , Samueloff Arnon , Benyamini Yael 
Published: December 2023

Introduction:
Synthetic oxytocin is one of the most regularly administered medications to facilitate labor induction and augmentation. The present study examined the associations between oxytocin administration during childbirth and postpartum posttraumatic stress symptoms (PTSS).

Materials and Methods:
In a multicenter longitudinal study, women completed questionnaires during pregnancy and at 2 months postpartum (N = 386). PTSS were assessed with the Impact of Event Scale. Logistic regression was used to examine the difference in PTSS at Time 2 between women who received oxytocin and women who did not.

Results:
In comparison with women who did not receive oxytocin, women who received oxytocin induction were 3.20 times as likely to report substantial PTSS (P = .036, 95% confidence interval: 1.08-9.52), and women who received oxytocin augmentation were 3.29 times as likely to report substantial PTSS (P = .036, 95% confidence interval: 1.08-10.03), after controlling for being primiparous, preeclampsia, prior mental health diagnosis, mode of birth, postpartum hemorrhage, and satisfaction with staff.

Discussion:
Oxytocin administration was associated with a 3-fold increased risk of PTSS. The findings may reflect biological and psychological mechanisms related to postpartum mental health and call for future research to establish the causation of this relationship.
Racial Disparities in Surgical Outcomes after Mastectomy in 223,000 Female Breast Cancer Patients – A Retrospective Cohort Study
Authors: Knoedler Samuel , Kauke-Navarro Martin , Knoedler Leonard , Friedrich Sarah , Matar Dany Y. , Diatta Fortunay , Mookerjee Vikram G. , Ayyala Haripriya , Wu Mengfan , Kim Bong-Sung , Machens Hans-Guenther , Pomahac Bohdan , Orgill Dennis P. , Broer P. Niclas , Panayi Adriana C. 
Published: December 2023

Background:Breast cancer mortality and treatment differ across racial groups. It remains unclear whether such disparities are also reflected in perioperative outcomes of breast cancer patients undergoing mastectomy.Study Design:We reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2008-2021) to identify female patients who underwent mastectomy for oncological purposes. The outcomes were stratified by five racial groups (white, Black/African American, Asian, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander) and included 30-day mortality, reoperation, readmission, surgical and medical complications, and non-home discharge.Results:The study population included 222,947 patients, 68% (n=151,522) of whom were white, 11% (n=23,987) Black/African American, 5% (n=11,217) Asian, 0.5% (n=1,198) American Indian/Alaska Native, and 0.5% (n=1,018) Native Hawaiian/Pacific Islander. While 136,690 (61%) patients underwent partial mastectomy, 54,490 (24%) and 31,767 (14%) women received simple and radical mastectomy, respectively. Overall, adverse events occurred in 17, 222 (7.7%) patients, the largest portion of which were surgical complications (n=7,246; 3.3%). Multivariable analysis revealed that being of Asian race was protective against perioperative complications (OR=0.71;P<0.001), whereas American Indian/Alaska Native women were most vulnerable to the complication occurrence (OR=1.41;P<0.001). Black/African American patients had a significantly lower risk of medical (OR=0.59;P<0.001) and surgical complications (OR=0.60;P<0.001) after partial and radical mastectomy, respectively, their likelihood of readmission (OR=1.14;P=0.045) following partial mastectomy was significantly increased.Conclusion:We identified American Indian/Alaska Native women as particularly vulnerable to complications following mastectomy. Asian patients experienced the lowest rate of complications in the perioperative period. Our analyses revealed comparable confounder-adjusted outcomes following partial and complete mastectomy between Black and white races. Our findings call for care equalization in the field of breast cancer surgery.
Carbon dioxide gas-induced pneumothorax versus one-lung ventilation in minimally invasive esophagectomy: a multicenter propensity score matching cohort study
Authors: Chen Junying , Heng Jiao , Zheng Bin , Zeng Taidui , Wang Hao , Wang Peizong , Lin Yaobin , Gao Wuyou , Chen Chun , Tan Lijie , Fu Jianhua 
Published: December 2023

Background:
Carbon dioxide gas-induced pneumoperitoneum might be the reason for the shorter postoperative survival of patients with malignant tumors. Whether CO2 gas-induced pneumothorax has unfavorable impacts on the surgical and oncological outcomes of minimally invasive esophagectomy remains unclear.

Methods:
Between 2010 and 2016, a total of 998 patients with squamous cell carcinoma of the esophagus who received video-assisted surgery were registered from three large-volume medical centers. The overall survival (OS) and disease-free survival (DFS) were compared after using propensity score-matched and inverse probability-weighted methods. In addition, the tumor-relapse state was evaluated, and the relapse pattern was compared.

Results:
A total of 422 and 576 minimally invasive esophagectomies with intraoperative one-lung ventilation and CO2-induced pneumothorax were enrolled, respectively. The 5-year OS and DFS were similar between the CO2-induced pneumothorax (64.2% and 64.7%) and one-lung ventilation (65.3% and 62.4%) groups following propensity matching. The inverse probability weighting revealed similarly equal survival results in the two groups. The 5-year relapse rates were 35.1% and 30.6% in the one-lung ventilation and CO2-induced pneumothorax groups, respectively. Moreover, the relapse patterns were not significantly different between the two groups.

Conclusion:
The results of this study suggested that the use of intraoperative one-lung ventilation and CO2-induced pneumothorax have similar oncological outcomes; therefore, the two methods are both viable options in esophagectomy.
Neoadjuvant camrelizumab combined with paclitaxel and nedaplatin for locally advanced esophageal squamous cell carcinoma: a single-arm phase 2 study (cohort study)
Authors: Yang Yingnan , Zhang Jinfeng , Meng Hongxue , Ling Xiaodong , Wang Xiaoyuan , Xin Yanzhong , Jiang Hao , Zhang Luquan , Fang Chengyuan , Liang Hao , Ma Jianqun , Zhu Jinhong 
Published: December 2023

Background:
Neoadjuvant administration of immune checkpoint inhibitors (ICIs) combined with chemotherapy demonstrated promising efficacy and manageable safety in locally advanced esophageal squamous cell carcinoma (ESCC). This prospective, single-arm, phase 2 study evaluated the efficacy and safety of neoadjuvant therapy with camrelizumab plus paclitaxel and nedaplatin for 2–4 cycles in ESCC.

Methods:
Patients with locally advanced stage IIa–IIIb ESCC were enrolled in the study and received camrelizumab (200 mg), paclitaxel (155 mg/m2), and nedaplatin (80 mg/m2) intravenously on day one every 3 weeks. Patients underwent surgery after 2–4 cycles of treatment. The primary endpoint was the pathological complete response (pCR) rate. Secondary endpoints included the major pathological response (MPR) rate, R0 resection rate, tumor regression, objective response rate (ORR), and disease-free survival (DFS). Programmed cell death 1 ligand 1 (PD-L1) expression in tumor tissues was measured and quantified using immunohistochemistry staining and combined positive score (CPS), respectively.

Results:
In total, 75 patients were enrolled and received neoadjuvant treatment. Of them, 45 (60%) received two cycles, 18 (24%) received three cycles, and 10 patients (13.3%) received four cycles of neoadjuvant therapy. Ultimately, 62 patients (82.7%) underwent surgery. The patients achieved a pCR of 27.4% (95% CI: 16.9–40.2), an MPR of 45.2% (95% CI: 33.1–59.2), and an ORR of 48.4% (95% CI: 35.5–61.4); all patients had an R0 resection. T and N downstaging occurred in 39 (62.9%) and 19 (30.6%) patients Moreover, patients with CPS ≥10 tended to have enhanced ORR, pCR, and MPR compared to those with CPS <10. Treatment-related adverse events (TRAEs) of grade 1–2 occurred in 59 (78.7%) patients, grade 3 TRAEs in four (5.3%), and one patient (1.3%) experienced a grade 4 TRAE.

Conclusions:
Neoadjuvant camrelizumab combined with chemotherapy showed promising efficacy in locally advanced ESCC, with a manageable safety profile, when administered flexibly in two to four cycles.