bluuebunny/crossref_metadata_2025_split huggingface dataset:
Next-generation sequencing of circulating tumor DNA in cerebrospinal fluid for detecting gene mutations in central nervous system lymphoma patients
Authors: Fu Haiying , Wang Taiqin , Yang Yong , Qiu Chenxi , Wang He , Qiu Yanyan , Liu Jianzhi , Liu Tingbo 
Published: February 2025

Background: To evaluate the potential clinical value of cerebrospinal fluid (CSF) circulating tumor DNA (ctDNA) in the diagnosis and monitors the central nervous system (CNS) lymphomas. Methods: This was a prospective study of 17 consecutive patients with B-cell lymphoma: 10 patients with CNS lymphomas and 7 patients with B-cell lymphomas at high clinical risk of CNS relapse. Genomic profiles were performed on the CSF and plasma samples of patients by next-generation sequencing. Results: In patients with CNS lymphomas, ctDNA was detected in 70.0% of CSF and 60.0% of plasma. The detection rate and gene mutation abundance of CSF were higher than plasma ( p = 0.016). CSF had a unique genetic profile. Furthermore, we newly found that gene mutations consistent with plasma or lymphoma-related were also detected in the CSF of the high-risk group without CNS involvement. Analysis of paired plasma and CSF samples from three patients at different time points, changes of CSF ctDNA abundance occurred at the same time or earlier than clinical disease changes, which could timely monitor the therapeutic response and relapse trend. Conclusion: The detection rate of ctDNA in CSF is higher than that in plasma. The dynamic monitoring of ctDNA in CSF has hint significance for therapeutic response of CNS lymphoma patients.
Leveraging of digital triage to enhance access in obstetric emergencies in the maternity units: A scoping review of digital triage interventions in healthcare
Authors: Ngwenya Mxolisi Welcome , Muthelo Livhuwani , Rasweswe Mellitah Molatelo , Mothiba Tebogo Maria 
Published: February 2025

Background Pregnancy and childbirth are supposed to give a new beautiful meaning to life and it is a time of enormous delight and anticipation for both the women and their families. In these times, not only a baby is born, but a mother is born. However, inaccessibility and delays in obstetric care remain a common concern, particularly in low- and middle-income countries. Digital health technologies are being implemented to improve healthcare access worldwide, but there is a lack of documented data on available digital triage interventions. This article sought to examine and critique existing digital triage interventions in the healthcare system with reference to obstetrics. Methods Adopting a scoping review approach, using the five iterative steps proposed by Arksey and O'Malley, approximately 17 studies retrieved from databases like PubMed, Elsevier, EBSCohost, and google scholar were reviewed. Only the literature from 2014–2024 was included. Results The review revealed that there are various types of digital triage interventions. However, they are flooded with weaknesses and threats among of which are diagnosis inaccuracy, insufficient information, and shortage of resources. Conclusions The study recommends that strengths, weaknesses, opportunities, and threats should not be overlooked, particularly when aiming to leverage digital health to improve access to emergency care in maternity units through digital triage. However, they should serve as a reference for the development of optimal digital triage systems for maternity and emergency units. Furthermore, the findings should also be a benchmark for digital triaging improvement strategies in the healthcare context.
Management of bladder cancer in kidney transplant recipients: A narrative review
Authors: Fong Khi Yung , Lim Ee Jean , So Wei Zheng , Aslim Edwin Jonathan , Tiong Ho Yee , Gan Valerie Huei Li 
Published: February 2025

Background Bladder cancer in the setting of previous a kidney transplant (KT) is challenging to manage due to complex medical and surgical considerations. Objective To provide a comprehensive evaluation of the scope of management of bladder cancer in KT patients, and describe the controversies surrounding these management options. Methods A systematic review of studies reporting management of KT patients with bladder cancer and involving ≥3 patients was performed. A narrative review was also performed for various aspects of management such as pathophysiology, surgical considerations, intravesical therapy, immunosuppression and oncological surveillance. Results Bladder cancer incidence in KT recipients is 2.8–4.1 times higher than the general population, and there is a notable association with aristolochic acid nephropathy as well as BK virus oncogenesis. Regarding surgical treatment, transurethral resection is preferred for non-muscle invasive tumors, and intravesical BCG for intermediate- and high-risk patients appears to be underutilized despite its safety and associated reduction in recurrence. Radical cystectomy with limited pelvic lymph node dissection, urinary diversion, and consideration of bilateral nephroureterectomy appears to be the safest method of oncological control in muscle-invasive tumors. A switch in immunosuppressive regimens to mTOR inhibitors may be considered in lieu of its antitumor effects. Routine surveillance in KT patients with risk factors for bladder cancer is challenging and may be warranted especially in the Asian population which has a higher rate of urothelial malignancy. Conclusions This review provides a thorough summary of management strategies for bladder cancer in the setting of previous KT.
Evaluating the Use of Artificial Intelligence as a Study Tool for Preclinical Medical School Exams
Authors: Sakelaris Peyton G. , Novotny Kaitlyn V. , Borvick Miriam S. , Lagasca Gemma G. , Simanton Edward G. 
Published: February 2025

BACKGROUND The purpose of this 2024 study was to determine if there is an association between the usage of artificial intelligence (AI) to study and exam scores of medical students in the preclinical phase of their schooling. METHODS We created and distributed a survey via an unbiased third-party to students in the class of 2027 at the Kirk Kerkorian School of Medicine at UNLV to evaluate students AI use to study for their preclinical system-based exams. Students were categorized into two groups, those that use AI to study and those who do not. Two-sample t-tests were run to compare the mean exam scores of both groups on six different organ system exams as well as the cumulative final exam score for each group. The group that did use AI was further asked about which AI tools they use and how exactly they use these tools to study for preclinical examinations. RESULTS The results of the study showed that there is no statistically significant difference in exam scores between students who use AI for study purposes and students who do not. It was also found that most AI users studied with ChatGPT. The most common way users studied was by using AI to simplify and clarify topics they did not understand. CONCLUSIONS Based on the results of this study, we concluded that usage of AI programs for students for medical examinations did not yield a positive or negative effect on students’ organ system-based exam scores.
CRISPR-Cas9-mediated deletions of FvMYB46 in Fragaria vesca reveal its role in regulation of fruit set and phenylpropanoid biosynthesis
Authors: Rai Arti , Skårn Magne Nordang , Elameen Abdelhameed , Tengs Torstein , Amundsen Mathias Rudolf , Bjorå Oskar S. , Haugland Lisa K. , Yakovlev Igor A. , Brurberg May Bente , Thorstensen Tage 
Published: February 2025

Abstract
The phenylpropanoid pathway, regulated by transcription factors of the MYB family, produces secondary metabolites that play important roles in fertilization and early phase of fruit development. The MYB46 transcription factor is a key regulator of secondary cell wall structure, lignin and flavonoid biosynthesis in many plants, but little is known about its activity in flowers and berries in F. vesca. For functional analysis of FvMYB46, we designed a CRISPR-Cas9 construct with an endogenous F. vesca-specific U6 promoter for efficient and specific expression of two gRNAs targeting the first exon of FvMYB46. This generated mutants with an in-frame 81-bp deletion of the first conserved MYB domain or an out-of-frame 82-bp deletion potentially knocking out gene function. In both types of mutant plants, pollen germination and fruit set were significantly reduced compared to wild type. Transcriptomic analysis of flowers revealed that FvMYB46 positively regulates the expression of genes involved in processes like xylan biosynthesis and metabolism, homeostasis of reactive oxygen species (ROS) and the phenylpropanoid pathway, including secondary cell wall biosynthesis and flavonoid biosynthesis. Genes regulating carbohydrate metabolism and signalling were also deregulated, suggesting that FvMYB46 might regulate the crosstalk between carbohydrate metabolism and phenylpropanoid biosynthesis. In the FvMYB46-mutant flowers, the flavanol and flavan-3-ol contents, especially epicatechin, quercetin-glucoside and kaempferol-3-coumaroylhexoside, were reduced, and we observed a local reduction in the lignin content in the anthers. Together, these results suggest that FvMYB46 controls fertility and efficient fruit set by regulating the cell wall structure, flavonoid biosynthesis, carbohydrate metabolism, and sugar and ROS signalling in flowers and early fruit development in F. vesca.
Prevalence of HPV genotypes and their association with reproductive tract inflammation and pregnancy outcomes among reproductive-age women in Ningbo, China: a retrospective cohort study (2016–2020)
Authors: He Nana , Song Xuejing , Song Qifa , Ding Huiqing 
Published: February 2025

Abstract

Background
The comprehensive impact of human papillomavirus (HPV) infection on reproductive tract inflammation and adverse pregnancy outcomes among women of reproductive age has not been fully investigated.

Methods
A retrospective cohort study was conducted among women presenting to the gynecological departments of specialized women’s hospitals in Ningbo, China, between 2016 and 2020. A total of 6506 women, with an average age of 28.7 years, who had undergone HPV testing and genotyping were included in the study.

Results
Overall, the most prevalent HPV types were HPV 52 (25.8%), HPV 16 (17.9%), and HPV 58 (7.7%). Vaginitis and cervicitis were significantly more prevalent in women with high-risk HPV (HR-HPV) compared to those with low-risk HPV(LR-HPV) (9.0% vs. 4.7%; 10.8% vs.7.1%; P < 0.05). Moreover, the incidence of cervicitis in patients with persistent HPV infection for more than two years was significantly higher than in those with HPV infection for one year (21.8% vs. 11.8%; P < 0.05). Pregnant women with HR-HPV infection had a significantly increased risk of miscarriage (9.7% vs. 6.1%; P < 0.05). Our cross-sectional analysis of potential risk factors for HPV infection during pregnancy revealed that higher pregnancy glucose levels (prevalence, 4.23%; OR, 1.10; 95% CI, 1.10–1.20; P < 0.05) significantly increased the risk of HPV infection. Women with persistent HR-HPV infection had a significantly higher risk of reproductive tract inflammation and adverse pregnancy outcomes. The analysis revealed significant associations between HPV infection and several pregnancy outcomes, including an increased risk of miscarriage, reduced live birth rate, and a higher cesarean section rate.

Conclusions
This highlights the need to monitor gestational glucose levels, reproductive tract inflammation, and HPV infection to reduce the risk of adverse pregnancy outcomes among pregnant women.
Reaching priority populations with different HIV self-testing distribution models in South Africa: an analysis of programme data
Authors: Majam Mohammed , Hatzold Karin , Mavhu Webster , Tembo Angela , Zishiri Vincent , Phiri Jane , Conserve Donaldson , Haile Zelalem , Chidarikire Thato , Johnson Cheryl C. , Moyo Sangiwe , Meyer-Rath Gesine , Venter Francois 
Published: February 2025

Abstract

Background
As in much of sub-Saharan Africa, substantial HIV testing gaps remain in South Africa, particularly among adult men ages 20–35, young people ages 15–24 and key populations. Innovative strategies, such as HIV self-testing (HIVST), are needed to reach such under-served populations. We evaluated a range of HIV self-test kit distribution models’ potential to reach adult men, young people and key populations in South Africa, to inform targeted approaches.

Methods
This cross-sectional study used data from community and facility-based HIV self-test kit distribution models implemented from October 2017 to April 2020. Self-test kits were distributed as part of the Unitaid-funded Self-Testing AfRica (STAR) programme. Data were collected from individuals who obtained self-test kits through five distribution models. Frequencies and proportions were used to describe the characteristics of the study populations and self-test kit distribution approaches.

Results
Over 2.5 years, 1 071 065 self-test kits were distributed across the five models. Community-based distribution accounted for 63% of total kits distributed, while the private sector (primarily workplace) accounted for 26%. Distribution at public sector health facilities accounted for 7% and distribution through the key population and secondary distribution models accounted for 2% each. Of those obtaining kits, and for whom we collected previous testing data (n = 771 612, 72%), 11% had never tested for HIV, 29% had not tested for at least a year, 41% had tested within the last 4–12 months and 19% had tested within the preceding three months. More men (64%) than women obtained self-test kits across all distribution models. The majority (80%) of men obtaining self-test kits were aged 20–40 years, and primarily received these at public transport terminals (36%), workplaces (18%) and hotspots (14%). A small proportion of men was reached through female sex workers.

Conclusions
This analysis of programme data enabled us to identify HIV self-test kit distribution models that are best suited to reach specific priority and under-tested populations, particularly adult men and young people. Models/sub-models that reach self-test users where they live, work and spend time, are likely to result in higher HIVST uptake. Study findings can inform future HIVST scale-up in South Africa.
Incidence and predictors of acute kidney injury among traumatic brain injury patients in Northwest Ethiopia: a cohort study using survival analysis
Authors: Anteneh Zelalem Alamrew , Kebede Semew Kassa , Azene Abebaw Gedef 
Published: February 2025

Abstract

Background
Acute kidney injury (AKI) is a sudden and reversible decrease in kidney function, causing the retention of waste products in the blood and potentially resulting in severe complications or death if not timely managed. Studies on AKI among traumatic brain injury patients in low-income nations like Ethiopia is very critical due to the limited healthcare resources, high burden of trauma-related injuries, and lack of robust data on the incidence and risk factors of AKI in such settings, which hinders effective prevention and treatment strategies tailored to these vulnerable populations Therefore, this study aimed to assess the incidence and predictors of AKI among traumatic brain injury patients.

Methods
A retrospective cohort study was conducted among 450 adult patients with traumatic brain injuries admitted to Tibebe-Ghion Specialized Hospital in Ethiopia. Kaplan- Meir curve and Log rank test were used to estimate and compare survival probability of different categories. A multivariable Cox proportional hazards model was used to identify determinants of acute kidney injury (AKI).

Results
The incidence of AKI was 10.9%, with a median follow-up period of 42 days. Significant predictors of AKI among traumatic brain injury patients included age (AHR: 1.05, 95% CI: 1.02–1.07), severe head injury (AHR: 1.46, 95% CI: 1.02–2.09), unreactive pupillary response (AHR: 4.82, 95% CI: 1.82–12.72), and hypotension (AHR: 3.45, 95% CI: 1.71–6.96).

Conclusions
The study found that AKI occurs in more than one in ten patients with traumatic brain injuries, with significant predictors including older age, severe head injury, unreactive pupillary response, and hypotension. These findings highlight the need for careful monitoring and early intervention for high-risk patients to prevent AKI and improve overall outcomes. Implementing targeted prevention and treatment strategies in settings with limited resources can help mitigate the burden of AKI and enhance patient care in vulnerable populations.
Workplace bullying among medical laboratory professionals in Ghana: insights from self-reported experiences, challenges to mitigation structures, and coping strategies
Authors: Duah Evans , Ephraim Richard Kobina Dadzie , Kotam Gabriel Pezahso , Kumordzi Samuel Mawuli , Amoah Samuel , Addy Nii Armah , Kwashie Solomon Dzidzornu Yao , Rahamani Abu Abudu 
Published: February 2025

Abstract

Background
Workplace bullying is a major concern in Ghana’s healthcare sector, often arising from power imbalances and an excessive emphasis on achieving results at the cost of employee well-being. While bullying among healthcare professionals like doctors and nurses is well-documented, little is known about its prevalence among medical laboratory professionals, who play a vital role in patient care. We assessed bullying in this group to inform strategies for mitigation.

Methods
We conducted a cross-sectional survey involving 378 medical laboratory professionals. The survey included demographic information, workplace characteristics, the Revised Negative Acts Questionnaire (NAQ-R), and questions about bullying perpetrators, mental health breaks, and anti-bullying policies. Data analysis involved descriptive statistics, the Kruskal-Wallis test, and logistic regression. Results were reported as frequencies, percentages, and odds ratios with 95% confidence intervals (CIs), and statistical significance set at p < 0.05.

Results
44% of the medical laboratory professionals reported experiencing bullying; 29% faced frequent bullying, while 71% encountered it occasionally. Common issues included ignored opinions, unmanageable workloads, gossip, and exclusion. Non-clinical administrative managers were the most frequent perpetrators. Diploma and bachelor’s degree holders had higher odds of being bullied compared to master’s degree holders (AOR = 6.13, p = 0.013; AOR = 2.56, p = 0.007). Rural professionals had higher odds than urban counterparts (AOR = 2.23, p = 0.007).

Conclusion
The high prevalence of workplace bullying among medical laboratory professionals highlights the need for effective policies to enhance workplace conditions and patient care.
Novel lipid profiles and atherosclerotic cardiovascular disease risk: insights from a latent profile analysis
Authors: Wan Hongli , Wu Haisheng , Wei Yuxi , Wang Simin , Ji Yuqiang 
Published: February 2025

Abstract

Background
Dyslipidemia is a key contributor to atherosclerotic cardiovascular disease (ASCVD). Despite the well-established correlation between abnormal lipid metabolism and ASCVD, existing diagnostic and predictive models based on lipid indices alone or in combination often exhibit suboptimal sensitivity and specificity. There is an urgent need for improved lipid indicators or novel combinations thereof.

Methods
The study included 898 cardiology inpatients who underwent coronary angiography (CAG). A latent profile analysis (LPA) was utilized to delineate lipid profiles on the basis of four routine lipid indices (total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG)) and the triglyceride‒glucose (TyG) index as a proxy for the TG. Logistic regression models were used to assess the correlations between lipid profiles and the occurrence and severity of coronary artery stenosis (CAS and severe CAS), as well as the occurrence of coronary heart disease (CHD). Predictive modeling subsequently validated the predictive power of the lipid profiles for cardiovascular outcomes.

Results
The LPA delineated four distinct lipid profiles: Profile 1 (relatively high HDL with the lowest TC, LDL and TyG, 41.20%), Profile 2 (relatively high TC, LDL, and TyG with the lowest HDL, 36.42%), Profile 3 (relatively low TC, LDL and TyG with relatively high HDL, 18.93%), and Profile 4 (the highest TC, LDL, and TyG with the highest HDL, 3.45%). Profile 1 was associated with the lowest ASCVD risk, whereas Profile 2 posed the highest risk for all adverse outcomes. The risk associated with Profile 3 and Profile 4 varied depending on the outcome. Profile 4 presented a lower odds ratio (OR) for CAS than did Profile 3, whereas Profile 3 presented a lower OR for severe CAS and CHD. The lipid profile variable substantially outperformed individual lipid indices or their combinations in predicting cardiovascular outcomes.

Conclusions
Four distinct lipid profiles were identified among patients, with a particular profile characterized by lower levels of TC, LDL, and TyG, as well as a lower HDL, emerging as the most predictive of adverse cardiovascular outcomes. This underscores the critical need for a thorough lipid profile analysis to pinpoint individuals at heightened risk for adverse cardiovascular outcomes.
Designing stepped wedge trials to evaluate physical activity interventions in schools: methodological considerations
Authors: Salway Ruth , House Danielle , Kent-Saisch Simona , Walker Robert , Emm-Collison Lydia , Porter Alice , Lubans David R , Beets Michael , de Vocht Frank , Jago Russell 
Published: February 2025

Abstract

Background
In a stepped wedge design, schools are randomised to a sequence of measurements, with each sequence transitioning to intervention status at a different time. There are several advantages to such designs, including increased statistical power, logistical benefits and the ability to explore change over time. However, stepped wedge designs have not previously been used to evaluate school-based physical activity interventions in children. This paper aimed to explore the feasibility of this design, by identifying school constraints, balancing these with statistical considerations and exploring the power of this chosen design under different scenarios.

Methods
We conducted three interlinked studies, with the results from one informing the next. Study 1 was a qualitative study to identify school constraints that inform the choice of stepped wedge configuration. Study 2 used simulation to choose a configuration that balanced these school constraints and statistical properties. Study 3 explored the statistical power for the chosen design for different school and pupil sample sizes, using an open cohort design (a mixture of new and repeated pupils).

Results
School staff considered the proposed data collection feasible, and supported a maximum of 3–4 measurements per year and an implementation period of one school term. Study 2 therefore considered incomplete stepped wedge designs with five steps. Statistically, the best designs had a mix of control and intervention measurements in terms 2–4 and a spread of measurements across the whole study duration. Power depended on a combination of the overall recruitment rate and the retention rate. For 20 schools with an eligible class size of 30 pupils, we would be able to detect a 6 min difference in average weekday moderate-to-vigorous physical activity with 80% power, provided there were > 50% of pupils measured per school at each time. A similarly powered cluster randomised controlled trial would require 42 schools.

Conclusion
Stepped wedge trials are a viable design for evaluating school-based physical activity interventions. Incomplete designs, where not all schools are measured at each point, offer the flexibility to work around practical constraints.