bluuebunny/crossref_metadata_2025_split huggingface dataset:
Data from Heritable Traits and Lung Cancer Risk: A Two-Sample Mendelian Randomization Study
Authors: Pettit Rowland W. , Byun Jinyoung , Han Younghun , Ostrom Quinn T. , Coarfa Cristian , Bondy Melissa L. , Amos Christopher I. 
Published: October 2023

<div>AbstractIntroduction:<p>Lung cancer is a complex polygenic disorder. Analysis with Mendelian randomization (MR) allows for genetically predicted risks to be estimated between exposures and outcomes.</p>Methods:<p>We analyzed 345 heritable traits from the United Kingdom Biobank and estimated their associated effects on lung cancer outcomes using two sample MR. In addition to estimating effects with overall lung cancer, adenocarcinoma, small cell lung cancer, and squamous cell lung cancers, we performed conditional effect modeling with multivariate MR (MVMR) and the traits of alcohol use, smoking initiation, average pre-tax income, and educational attainment.</p>Results:<p>Univariate MR provided evidence for increased age at first sexual intercourse (OR, 0.55; <i>P</i> = 6.15 × 10<sup>−13</sup>), educational attainment (OR, 0.24; <i>P</i> = 1.07 × 10<sup>−19</sup>), average household income (OR, 0.58; <i>P</i> = 7.85 × 10<sup>−05</sup>), and alcohol usually taken with meals (OR, 0.19; <i>P</i> = 1.06 × 10<sup>−06</sup>) associating with decreased odds of overall lung cancer development. In contrast, a lack of additional educational attainment (OR, 8.00; <i>P</i> = 3.48 × 10<sup>−12</sup>), body mass index (OR, 1.28; <i>P</i> = 9.00 × 10<sup>−08</sup>), pack years smoking as a proportion of life span (OR, 9.93; <i>P</i> = 7.96 × 10<sup>−12</sup>), and weekly beer intake (OR, 3.48; <i>P</i> = 4.08 × 10<sup>−07</sup>) were associated with an increased risk of overall lung cancer development.</p>Conclusions:<p>Many heritable traits associated with an increased or inverse risk of lung cancer development. Effects vary based on histologic subtype and conditional third trait exposures.</p>Impact:<p>We identified several heritable traits and presented their genetically predictable impact on lung cancer development, providing valuable insights for consideration.</p></div>
PERBANDINGAN KARAKTERISTIK KLINIS PASIEN COVID 19 VARIAN OMICRON DAN VARIAN DELTA DI RUMAH SAKIT UMUM DAERAH DR. MOEWARDI SURAKARTA
Authors: Permana Septian Adi , Purwoko P , Thamrin Muhammad Husni , Anggoro Pandu 
Published: October 2023

PENDAHULUAN
Perkembangan SARS-CoV-2 telah ditandai dengan pengenalan "Variant Of Concern," atau perubahan sifat virus seperti penularan penyakit dan antigenisitas. VOC Delta SARS-CoV-2 40% -60% lebih mudah menular daripada VOC Alpha (B.1.1.7) dan dapat dikaitkan dengan peningkatan risiko rawat inap.
TUJUAN
Untuk mengetahui karakteristik klinis pasien COVID-19 varian Delta dan Omicron di High Care Unit (HCU) dan Intensive Care Unit (ICU) Rumah Sakit Dr Moewardi.
METODE
Penelitian deskriptif analitik kuantitatif dengan pendekatan retrospektif yang dilakukan pada Juni 2021-Maret 2022. Sampel penelitian adalah pasien terkonfirmasi positif COVID-19 yang di rawat di ICU dan HCU isolasi pada Agustus-Oktober 2021 dan Januari-Maret 2022. Diukur tanda vital, komorbid, hasil laboratorium, status intubasi dan mortalitas.
HASIL
Angka kematian pasien yang terinfeksi Covid-19 varian delta dan varian omicron masing-masing adalah 10% dan 10,8%. Varian Delta lebih signifikan berdampak terhadap CVA (p=0.001) dan penyakit jantung (p<0.001) dibandingkan pada CVA (p=0.015) dan penyakit jantung (p=0.190) pada pasien SARS-CoV-2 varian Omicron. Varian Omicron lebih signifikan berdampak terhadap sepsis (p=0.012) dibandingkan varian Delta (p=0.026).
KESIMPULAN
Tidak didaptakan perbedaan angka mortalitas antara varian COVID-19 omicron dan delta. Kematian pada kelompok omicron sebagian besar disebabkan penyakit komorbid, sedangkan pada kelompok delta, kematian disebabkan karena COVID-19 menyebabkan disfungsi endotel.
Motives and Barriers to Exercise among Underweight Filipino College Students
Authors: Manasan Patrick L. , Quitor Cristine G. , Ronquillo Vincent P. , Dabu Darelle C. , Dela Cruz Jennilyn T. , Sode Ma. Angela V. , Cruz Salvador Jr. L. 
Published: October 2023

In many cases, underweight students may be left behind due to poor nutrition, health issues, or lack of access to resources that would help them thrive and achieve their academic goals. This condition is often overlooked, but it can have serious health consequences. In this paper, the researchers used the free-listing method to ascertain the perceived motives and barriers to exercise among underweight Filipino university students. This quantitative-descriptive study comprised 300 underweight Filipino college students enrolled in ‘PATHFIT-2: Exercise-Based Fitness Activities' for first-year students during their Second Semester of the Academic Year 2022-2023 from the main campus of a state university in Pampanga, Philippines, who were classified as having BMIs below the normal weight. Furthermore, EMI-2 from Mullan et al. (1997) subscales were used to categorize responses in the free list for motives, whereas Myers and Roth's (1997) subscales were utilized to categorize barriers. The top five reported motives for underweight students were "positive health," "strength and endurance", "ill health avoidance", "appearance", and "weight management". While "competition", "nimbleness", "affiliation", and "health pressures" did not elicit a response. On the other hand, most respondents do not have enough time and are too lazy to exercise since it may interfere with their school-related tasks. The findings provided educational institutions with precise recommendations on how to establish exercise programs that are in line with what motivates students and examine any barriers that may prevent such physical activity engagement.
Abstract 211: Fibromuscular Dysplasia Causing Upper Extremity Acute Limb Ischemia
Authors: Earthineni Geethika , Njoh Roland 
Published: October 2023

Fibromuscular dysplasia (FMD) is a non-atherosclerotic arterial disease that affects mainly the renal and cervical arteries. It can also affect peripheral arteries leading to acute or chronic ischemia of the limbs. We present a rare case of FMD causing acute limb ischemia.

Case Presentation:
A 45-year-old male presented with acute onset pain and coldness in his left upper extremity, associated with numbness and tingling sensation in his left hand. He denied any history of trauma or recent surgery. His medical history was significant for hypertension. He was a non-smoker and denied any use of illicit drugs.

On exam, his left hand was pale, cold, with absent distal pulses. The capillary refill time was prolonged, and the skin was mottled. There was tenderness in the hand muscles with no signs of compartment syndrome. Rest of the exam was normal.
A diagnosis of acute limb ischemia was made, and the patient was urgently taken to the cath lab. Angiogram showed string and beads pattern of the radial artery with distal occlusion suggestive of FMD. Balloon angioplasty of the radial artery failed to improve blood flow. He subsequently underwent radial artery bypass using autologous vein graft with restoration of blood flow. Renal and carotid arteries were unaffected on CTA.

Discussion:
Fibromuscular dysplasia is a non-atherosclerotic, non-inflammatory disease that affects medium to small sized arteries. It is characterized by hyperplasia and fibrosis within the arterial wall. The exact etiology of FMD is unknown, and it is believed to be multifactorial.

Renal artery FMD may present with renovascular hypertension, cervical artery involvement may present with headache, tinnitus, and vertigo. Patients with peripheral artery involvement may present with intermittent claudication, acute limb ischemia, or limb loss.
CTA, MRA, or conventional angiography are diagnostic. In patients with acute limb ischemia, emergent intervention with thrombectomy, embolectomy, or bypass surgery may be necessary. Anti platelets and anticoagulants are also used.

Conclusion:
FMD is a rare disease that can present with a variety of clinical manifestations, including acute limb ischemia. Prompt diagnosis and treatment are essential to prevent limb loss and other serious complications.
Airborne Radar Doppler Spectrum Width as a Scale-Dependent Turbulence Metric
Authors: Majewski Adam , French Jeffrey R. , Haimov Samuel 
Published: October 2023

Abstract
High-resolution airborne cloud Doppler radars such as the W-band Wyoming Cloud Radar (WCR) have, since the 1990s, investigated cloud microphysical, kinematic, and precipitation structures down to 30-m resolution. These measurements revolutionized our understanding of fine-scale cloud structure and the scales at which cloud processes occur. Airborne cloud Doppler radars may also resolve cloud turbulent eddy structure directly at 10-m scales. To date, cloud turbulence has been examined as variances and dissipation rates at coarser resolution than individual pulse volumes. The present work advances the potential of near-vertical pulse-pair Doppler spectrum width as a metric for turbulent air motion. Doppler spectrum width has long been used to investigate turbulent motions from ground-based remote sensors. However, complexities of airborne Doppler radar and spectral broadening resulting from platform and hydrometeor motions have limited airborne radar spectrum width measurements to qualitative interpretation only. Here we present the first quantitative validation of spectrum width from an airborne cloud radar. Echoes with signal-to-noise ratio greater than 10 dB yield spectrum width values that strongly correlate with retrieved mean Doppler variance for a range of nonconvective cloud conditions. Further, Doppler spectrum width within turbulent regions of cloud also shows good agreement with in situ eddy dissipation rate (EDR) and gust probe variance. However, the use of pulse-pair estimated spectrum width as a metric for turbulent air motion intensity is only suitable for turbulent air motions more energetic than the magnitude of spectral broadening, estimated to be <0.4 m s−1 for the WCR in these cases.

Significance Statement
Doppler spectrum width is a widely available airborne radar measurement previously considered too uncertain to attribute to atmospheric turbulence. We validate, for the first time, the response of spectrum width to turbulence at and away from research aircraft flight level and demonstrate that under certain conditions, spectrum width can be used to diagnose atmospheric turbulence down to scales of tens of meters. These high-resolution turbulent air motion intensity measurements may better connect to cloud hydrometeor process and growth response seen in coincident radar reflectivity structures proximate to turbulent eddies.
Investigating the Development and Characteristics of Streamwise Vorticity Currents Produced by Outflow Surges in Simulated Supercell Thunderstorms
Authors: Gray Kevin T. , Frame Jeffrey W. 
Published: October 2023

Abstract
Streamwise vorticity currents (SVCs) have been hypothesized to enhance low-level mesocyclones within supercell thunderstorms and perhaps increase the likelihood of tornadogenesis. Recent observational studies have confirmed the existence of SVCs in supercells and numerical simulations have allowed for further investigation of SVCs. A suite of 19 idealized supercell simulations with varying midlevel shear orientations is analyzed to determine how SVC formation and characteristics may differ between storms. In our simulations, SVCs develop on the cold side of left-flank convergence boundaries and their updraft-relative positions are partially dependent on downdraft location. The magnitude, duration, and mean depth of SVCs do not differ significantly between simulations or between SVCs that precede tornado-like vortices (TLVs) and those that do not. Trajectories initialized within SVCs reveal two primary airstreams, one that flows through an SVC for the majority of its length, and another that originates in the modified inflow in the forward flank and then merges with the SVC. Vorticity budgets calculated along trajectories reveal that the first airstream exhibits significantly greater maximum streamwise vorticity magnitudes than the second airstream. The vorticity budgets also indicate that stretching of horizontal streamwise vorticity is the dominant contributor to the large values of streamwise vorticity within the SVCs. TLV formation does not require the development of an SVC beforehand; 44% of TLVs in the simulations are preceded by SVCs. When an SVC occurs, it is followed by a TLV 53% of the time, indicating not all SVCs lead to TLV formation.

Significance Statement
Streamwise vorticity currents (SVCs) are features within thunderstorms hypothesized to strengthen updraft rotation and increase the likelihood of tornado formation. SVCs in a suite of 19 thunderstorm simulations are analyzed to investigate how they develop, if their characteristics differ between storms, and how often they precede tornado production. The rotation in an SVC is amplified as air accelerates toward the updraft, which is the main process contributing to SVC formation. The likelihood of SVCs may vary with differences in the winds 3–6 km above the ground. These findings may aid in developing strategies for better observing SVCs.
Public transport: lessons learned by the sector through the COVID-19 pandemic
Authors: Gartland Nicola , Coleman Anna , Farrell Bernadine , Fishwick David , Johnson Sheena , van Tongeren Martie 
Published: October 2023

Abstract
Background
The COVID-19 pandemic had a significant impact on the operations and functionality of the public transport sector in the UK. This paper reflects on the experience of this sector through the pandemic period, and considers recommendations for any future mitigations required for either new COVID-19 waves or a different public health emergency.

Methods
Semi-structured interviews were carried out with public transport experts, organisational leaders, workers and passengers in two phases: Phase 1 from January to May 2021, and Phase 2 from December 2021 to February 2022. Interviews were analysed thematically.

Results
Using the ‘What? So What? Now What?’ reflective model, ideas are drawn out to describe (a) what changes occurred, (b) what effects these changes had on service provision as well as perceptions of risk and mitigation and (c) what lessons have been learned and how these findings can feed into pandemic preparedness for the future. Respondent reflections focussed on the importance of communication, leadership, and maintaining compliance.

Conclusions
The wealth of experience gained through the COVID-19 pandemic in the public transport sector is extremely valuable. Through reflection on this experience, specific recommendations are made relating to these factors, covering: maintaining links across industry, access to information and data, understanding of mitigation effectiveness, improving messaging, challenges of behavioural mitigations, and clear lines of accountability. The recommendations made on the basis of this reflective process will help to improve public health strategy within the public transport sector.
Opportunities and challenges of supervised machine learning for the classification of motor evoked potentials according to muscles
Authors: Wermelinger Jonathan , Parduzi Qendresa , Sariyar Murat , Raabe Andreas , Schneider Ulf C. , Seidel Kathleen 
Published: October 2023

Abstract
Background
Even for an experienced neurophysiologist, it is challenging to look at a single graph of an unlabeled motor evoked potential (MEP) and identify the corresponding muscle. We demonstrate that supervised machine learning (ML) can successfully perform this task.

Methods
Intraoperative MEP data from supratentorial surgery on 36 patients was included for the classification task with 4 muscles: Extensor digitorum (EXT), abductor pollicis brevis (APB), tibialis anterior (TA) and abductor hallucis (AH). Three different supervised ML classifiers (random forest (RF), k-nearest neighbors (kNN) and logistic regression (LogReg)) were trained and tested on either raw or compressed data. Patient data was classified considering either all 4 muscles simultaneously, 2 muscles within the same extremity (EXT versus APB), or 2 muscles from different extremities (EXT versus TA).

Results
In all cases, RF classifiers performed best and kNN second best. The highest performances were achieved on raw data (4 muscles 83%, EXT versus APB 89%, EXT versus TA 97% accuracy).

Conclusions
Standard ML methods show surprisingly high performance on a classification task with intraoperative MEP signals. This study illustrates the power and challenges of standard ML algorithms when handling intraoperative signals and may lead to intraoperative safety improvements.
Evaluation of preventive care for swallowing difficulty through policy changes in Japanese long-term care insurance: analysis of a nationwide claims dataset for long-term care insurance
Authors: Mori Hiroko , Nakane Ayako , Tohara Haruka , Nakayama Takeo 
Published: October 2023

Abstract
Background
Swallowing/feeding difficulty is a serious hidden health problem in the older population. Although oral intake services based on the degree of this difficulty have been provided and revised in Japanese public long-term care (LTC) insurance since 2006, their implementation has not been examined. We evaluated the impact of policy changes on these services.

Methods
The nationwide database of LTC service uses in Japan was analysed for three oral intake services: Enhanced Oral Function in daycare facilities whose users were slightly disabled, Maintenance of Oral Ingestion and Transition to Oral Ingestion from tube feeding in residential facilities. Data were extracted for each June from 2015 to 2020 when monthly usage of these services was aligned and each June from 2009 to 2020 for the proportion of users according to LTC insurance certification. The major policy changes were the addition of municipal provision in Enhanced Oral Function and a requirement for multidisciplinary collaboration in Maintenance of Oral Ingestion in 2015. The impact of the medical fee reduction for developing percutaneous gastro-tubing to Transition to Oral Ingestion was also examined.

Results
Between 2015 and 2020, the use of Enhanced Oral Function and Maintenance of Oral Ingestion increased and Transition to Oral Ingestion decreased, resulting in a total increase in use of 275,000 times or approximately 5,000 times per 100,000 among all older adults with LTC insurance certification. Concerning the proportion of users’ disability status, the major users of Enhanced Oral Function in 2020 were slightly disabled and independent older adults (70%, up from 55% to 2009). Regarding the major users of Maintenance of Oral Ingestion between 2013 and 2020, care-need level 5 (most severe) decreased by 11%, whereas the total of care-need levels 4 and 3 increased by 9%. The use of Transition to Oral Ingestion, which had been declining, showed a further decline after reduction of the medical fee for percutaneous gastro-tubing in 2014.

Conclusions
Due to policy changes, Enhanced Oral Function and Maintenance of Oral Ingestion have increased in the number of use among slightly disabled persons. However, this increase may be insufficient given the hidden swallowing/feeding difficulty.
The role of primary care during the pandemic: shared experiences from providers in five European countries
Authors: Kraus Markus , Stegner Christoph , Reiss Miriam , Riedel Monika , Børsch Anne Sofie , Vrangbaek Karsten , Michel Morgane , Turmaine Kathleen , Cseh Borbála , Dózsa Csaba László , Dandi Roberto , Mori Angelo Rossi , Czypionka Thomas 
Published: October 2023

Abstract
Background
The COVID-19 pandemic necessitated wide-ranging adaptations to the organisation of health systems, and primary care is no exception. This article aims to collate insights on the role of primary care during the pandemic. The gained knowledge helps to increase pandemic preparedness and resilience.

Methods
The role of primary care during the pandemic in five European countries (Austria, Denmark, France, Hungary, Italy) was investigated using a qualitative approach, namely case study, based on document analysis and semi-structured interviews. In total, 31 interviews were conducted with primary care providers between June and August 2022. The five country case studies were subjected to an overarching analysis focusing on successful strategies as well as gaps and failures regarding pandemic management in primary care.

Results
Primary care providers identified disruptions to service delivery as a major challenge emerging from the pandemic which led to a widespread adoption of telehealth. Despite the rapid increase in telehealth usage and efforts of primary care providers to organise face-to-face care delivery in a safe way, some patient groups were particularly affected by disruptions in service delivery. Moreover, primary care providers perceived a substantial propagation of misinformation about COVID-19 and vaccines among the population, which also threatened patient-physician relationships. At the same time, primary care providers faced an increased workload, had to work with insufficient personal protective equipment and were provided incongruous guidelines from public authorities. There was a consensus among primary care providers that they were mostly sidelined by public health policy in the context of pandemic management. Primary care providers tackled these problems through a diverse set of measures including home visits, implementing infection control measures, refurbishing used masks, holding internal meetings and relying on their own experiences as well as information shared by colleagues.

Conclusion
Primary care providers were neither well prepared nor the focus of initial policy making. However, they implemented creative solutions to the problems they faced and applying the learnings from the pandemic could help in increasing the resilience of primary care. Attributes of an integrated health system with a strong primary care component proved beneficial in addressing immediate effects of the pandemic.
The molecular regulatory mechanisms of meiotic arrest and resumption in Oocyte development and maturation
Authors: Pei Zhenle , Deng Ke , Xu Congjian , Zhang Shuo 
Published: October 2023

AbstractIn human female primordial germ cells, the transition from mitosis to meiosis begins from the fetal stage. In germ cells, meiosis is arrested at the diplotene stage of prophase in meiosis I (MI) after synapsis and recombination of homologous chromosomes, which cannot be segregated. Within the follicle, the maintenance of oocyte meiotic arrest is primarily attributed to high cytoplasmic concentrations of cyclic adenosine monophosphate (cAMP). Depending on the specific species, oocytes can remain arrested for extended periods of time, ranging from months to even years. During estrus phase in animals or the menstrual cycle in humans, the resumption of meiosis occurs in certain oocytes due to a surge of luteinizing hormone (LH) levels. Any factor interfering with this process may lead to impaired oocyte maturation, which in turn affects female reproductive function. Nevertheless, the precise molecular mechanisms underlying this phenomenon has not been systematically summarized yet. To provide a comprehensive understanding of the recently uncovered regulatory network involved in oocyte development and maturation, the progress of the cellular and molecular mechanisms of oocyte nuclear maturation including meiosis arrest and meiosis resumption is summarized. Additionally, the advancements in understanding the molecular cytoplasmic events occurring in oocytes, such as maternal mRNA degradation, posttranslational regulation, and organelle distribution associated with the quality of oocyte maturation, are reviewed. Therefore, understanding the pathways regulating oocyte meiotic arrest and resumption will provide detailed insight into female reproductive system and provide a theoretical basis for further research and potential approaches for novel disease treatments.