bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceived barriers and facilitators to the adoption of telemedicine infectious diseases consultations in southeastern Missouri hospitals
Authors: Nyoni Thabani , Evers Emily C , Pérez Maria , Jeffe Donna B , Fritz Stephanie A , Colditz Graham A , Burnham Jason P 
Published: January 2023

Introduction Telemedicine infectious diseases consultations (tele-ID consults) improves access to healthcare for underserved/resource-limited communities. However, factors promoting or hindering implementation of tele-ID consults in low-resource settings are understudied. This study sought to fill this gap by describing perceived barriers and facilitators tele-ID consults at three rural hospitals in southeastern Missouri. Methods Twelve in-depth, semi-structured interviews were conducted with a purposively sampled group of information-rich hospital stakeholders from three rural, southeastern Missouri hospitals with partial or no on-site availability of ID physicians. Our literature-informed interview guide elicited participants’ knowledge and experience with tele-ID consults, perceptions on ID consultation needs, and perceived barriers to and facilitators of tele-ID consults. Interview transcripts were coded using an iterative process of inductive analysis to identify core themes related to barriers and facilitators. Results Perceived barriers to adopting and implementing tele-ID consults included logistical challenges, technology and devices, negative emotional responses, patient-related factors, concerns about reduced quality of care when using telemedicine, lack of acceptance or buy-in from physicians or staff, and legal concerns. Key facilitators included perceived need, perceived benefits to patients and physicians, flexibility and openness to change among staff members and patients, telemedicine champions, prior experiences, and enthusiasm. Discussion Our findings demonstrate that rural hospitals need tele-ID consults and have the capacity to implement tele-ID consults, but operational and technical feasibility challenges remain. Adoption and implementation of tele-ID consults may reduce ID-physician shortage-related service gaps by permitting ID physician's greater geographic reach.
Getting Cartilage Thickness Measurements Right: A Systematic Inter-Method Comparison Using MRI Data from the Osteoarthritis Initiative
Authors: Nolte Teresa , Westfechtel Simon , Schock Justus , Knobe Matthias , Pastor Torsten , Pfaehler Elisabeth , Kuhl Christiane , Truhn Daniel , Nebelung Sven 
Published: January 2023

Objective Magnetic resonance imaging is the standard imaging modality to assess articular cartilage. As the imaging surrogate of degenerative joint disease, cartilage thickness is commonly quantified after tissue segmentation. In lack of a standard method, this study systematically compared five methods for automatic cartilage thickness measurements across the knee joint and as a function of region and sub-region: 3D mesh normals (3D-MN), 3D nearest neighbors (3D-NN), 3D ray tracing (3D-RT), 2D centerline normals (2D-CN), and 2D surface normals (2D-SN). Design Based on the manually segmented femoral and tibial cartilage of 507 human knee joints, mean cartilage thickness was computed for the entire femorotibial joint, 4 joint regions, and 20 subregions using these methods. Inter-method comparisons of mean cartilage thickness and computation times were performed by one-way analysis of variance (ANOVA), Bland-Altman analyses and Lin’s concordance correlation coefficient (CCC). Results Mean inter-method differences in cartilage thickness were significant in nearly all subregions ( P < 0.001). By trend, mean differences were smallest between 3D-MN and 2D-SN in most (sub)regions, which is also reflected by highest quantitative inter-method agreement and CCCs. 3D-RT was prone to severe overestimation of up to 2.5 mm. 3D-MN, 3D-NN, and 2D-SN required mean processing times of ≤5.3 s per joint and were thus similarly efficient, whereas the time demand of 2D-CN and 3D-RT was much larger at 133 ± 29 and 351 ± 10 s per joint ( P < 0.001). Conclusions In automatic cartilage thickness determination, quantification accuracy and computational burden are largely affected by the underlying method. Mesh and surface normals or nearest neighbor searches should be used because they accurately capture variable geometries while being time-efficient.
Evaluation of treatment simplification strategies in patients living with HIV with multi-drug resistance
Authors: Harris Taylor N. , Buscemi Lindsey R. 
Published: January 2023

Background: Patients living with HIV (PLWH) with multi-drug resistance (MDR) and prior episodes of virologic failure have few therapeutic options remaining. These patients are often prescribed ‘salvage’ antiretroviral therapy (ART) regimens with high pill burdens, leading to potential decreased medication adherence and increased side effects and drug–drug interactions. Materials & Methods: In this retrospective, observational cohort study, we included adult patients with a diagnosis of HIV-1 who received care at our institution’s Ryan White Clinic and who received ‘salvage’ ART, defined as three of more antiretroviral agents from at least three different HIV drug classes. Patients were grouped into two cohorts, simplified ART cohort and non-simplified ART cohort, based on whether their ART regimen was reduced by at least one tablet daily. The primary outcome was the percentage of patients who had their viral load suppressed (HIV-1 RNA <50 copies/ml) at their most recent clinic visit. Secondary outcomes were virologic failure (HIV-1 RNA ⩾200 copies/ml), percentage of time patients were virologically suppressed over the past 2 years, and the emergence of new treatment-resistant mutations. Results: There were 50 patients included in the final analysis, 28 in the simplified ART cohort and 22 in the non-simplified ART cohort. The percentage of patients who had their HIV-1 viral load suppressed at their most recent clinic visit was n = 24 (86%) in the simplified ART cohort and n = 16 (73%) in the non-simplified ART cohort ( p = 0.302). There were no statistically significant differences between the two cohorts in terms of the secondary outcomes. Conclusion: Our study found that simplification of ART regimens based on HIV genotype in PLWH with a history of MDR and prior virologic failures, regardless of the presence of HIV-1 viremia at the time of simplification, resulted in similar rates of virologic suppression and virologic failure as non-simplified ART regimens.
Out-of-School Education in Belarus
Authors: Liu (刘淼) Miao , Zubko Darya 
Published: January 2023

Purpose Countries with unique developmental paths and cultural lineages display significant variations in their out-of-school education systems. In this landscape, Belarus, a vestige of the disbanded Soviet Union, illustrates a distinct out-of-school education system, profoundly shaped by both Soviet and European Union countries' influences. A meticulous examination and scholarly investigation into the Belarusian out-of-school educational framework could enable a more profound comprehension of the metamorphosis and transitions in the out-of-school education systems of nations that surfaced following the dissolution of the Soviet Union. This knowledge could subsequently render a more transparent understanding of the patterns guiding the evolution of global out-of-school educational systems. Design/Approach/Methods This article focuses on out-of-school education in Belarus and discusses its development status and the following main characteristics: the dimensions of its historical development stage, legislative guarantee, essence and extension, training goals, and typical cases. Findings Influenced by historical and geopolitical factors, Belarusian out-of-school education is found to embody the characteristics of both the Soviet Union and European countries. National resources are found to play an important role in the development of out-of-school education, effectively reducing the cost of education for families and shaping students’ positive values. Originality/Value This study analyzes both the history and the current situation of out-of-school education in Belarus and summarizes the country's successful experience in the development of out-of-school education. It can provide a positive point of reference for optimizing the public out-of-school education system in China and exert a positive influence on related educational reforms.
Sex differences in outcomes after endovascular treatment of patients with vertebrobasilar artery occlusion
Authors: Zhang Pan , Li Hao , Wang Jinjing , Zhang Feng , Xiao Lulu , Fang Yirong , Yan Dingyi , Xu Guoqiang , Liu Chaolai , Huang Zhixin , Gu Mengmeng , Zhang Hanhong , Sun Wen 
Published: January 2023

Background: Current studies on the role of sex in the prognosis of acute vertebrobasilar artery occlusion (VBAO) are limited. We aimed to explore whether there are sex differences on outcomes in patients treated with endovascular therapy (EVT) for VBAO. Methods: Patients from December 2015 to December 2018 with acute VBAO within 24 h of the estimated occlusion time in 21 stroke centers in China were retrospectively analyzed. Baseline data between sexes were compared in the total population cohort and propensity score (PS)-matched cohort. Multivariate logistic regression and ordinal regression were used to analyze the association of sex with outcomes. Mixed-effects regression model was performed for changes in modified Rankin Scale (mRS) scores in men and women from 90 days to 1 year after discharge. Results: A total of 577 patients (28.4% women) were finally included. Multivariate logistic regression showed that women had a lower probability of favorable outcome (mRS score 0–3 at 90 days; OR 0.544; 95% CI 0.329–0.899) and functional independence (mRS score 0–2 at 90 days; OR 0.391; 95% CI 0.228–0.670) as well as a higher possibility of shifting to worse mRS (OR 1.484; 95% CI 1.020–2.158) than men. After PS matching, 391 patients (39.4% women) were analyzed, confirming the same results regarding favorable outcome (OR 0.580; 95% CI 0.344–0.977), functional independence (OR 0.394; 95% CI 0.218–0.712), and shift mRS (OR 1.504; 95% CI 1.023–2.210). However, the results of repeated ANOVA showed that men and women had a comparable functional recovery from 90 days to 1 year. Conclusions: Stroke due to VBAO treated with EVT is associated with worse outcomes in women than in men. However, men and women showed similar long-term improvement trends.
The Acute Female Nongravid Pelvis: A Review of Appropriate Clinical Applications of Sonography, Computed Tomography, and Magnetic Resonance Imaging
Authors: Pacione Lonni 
Published: January 2023

Objective: The objective of this literature review was to provide a summary of the primary concerns in evaluating ovarian cysts and compare the diagnostic roles of each imaging technique, in an emergent setting. Materials and Methods: A literature review of the imaging evaluation of functional ovarian cysts, emergent complications, and relevant case studies was performed using peer-reviewed articles. The literature search was conducted using PubMed, The Wiley Online Library, and Google Scholar search engines. Results: Sonography, computed tomography (CT), and magnetic resonance imaging (MRI) demonstrate comparable accuracy in the diagnosis of functional ovarian cysts and ovarian torsion. While sonography is the preferred method of imaging the female pelvis, CT and MRI demonstrate similar diagnostic capabilities. Conclusion: Functional ovarian cyst rupture/hemorrhage and ovarian torsion can be accurately demonstrated using sonography, CT, and MRI.
CMV reactivation after allogeneic HCT is associated with a reduced risk of relapse in acute lymphoblastic leukemia
Authors: Akahoshi Yu , Nakasone Hideki , Takenaka Katsuto , Yamasaki Satoshi , Nakamura Momoko , Doki Noriko , Tanaka Masatsugu , Ozawa Yukiyasu , Uchida Naoyuki , Ara Takahide , Nakamae Hirohisa , Ota Shuichi , Onizuka Makoto , Yano Shingo , Tanaka Junji , Fukuda Takahiro , Kanda Yoshinobu , Atsuta Yoshiko , Kako Shinichi , Yanada Masamitsu , Arai Yasuyuki 
Published: January 2023

Abstract
Cytomegalovirus reactivation (CMVR) after allogeneic hematopoietic cell transplantation (HCT) is a frequent complication related to survival outcomes; however, its impact on relapse remains unclear, especially in acute lymphoblastic leukemia (ALL). In this nationwide retrospective study, we included patients with acute myeloid leukemia (AML) and ALL in the first or second complete remission who underwent their first HCT using a pre-emptive strategy for CMVR. Because 90% of cases with CMVR had occurred by day 64 and 90% of cases with grades 2 to 4 acute graft-versus-host disease (GVHD) had occurred by day 58, a landmark point was set at day 65. In landmark analyses, 3793 patients with AML and 2213 patients with ALL who survived without relapse for at least 65 days were analyzed. Multivariate analyses showed that CMVR was associated with a lower incidence of relapse in both AML (hazard ratio [HR], 0.81; 95% confidence interval [CI], 0.69-0.95; P = .009) and ALL (HR, 0.81; 95% CI, 0.66-0.99; P = .045). These findings were confirmed when CMVR was used as the time-dependent covariate. Moreover, our study suggests that the protective effect of CMVR on relapse was independent of acute GVHD. A post-hoc subgroup analysis of combined AML and ALL showed that CMVR had a mild antileukemia effect without effect modification, in contrast to the impact of CMVR on NRM. Our findings may provide important implications for strategies used for CMV prophylaxis after HCT.
No differences in FBN1 genotype between men with and without abdominal aortic aneurysm
Authors: Åström Malm Ida , De Basso Rachel , Blomstrand Peter 
Published: January 2023

AbstractBackgroundAbdominal aortic aneurysm (AAA) is an aortic enlargement in which the transverse diameter reaches at least 30 mm. Certain risk factors, such as age, male gender, and smoking, are well known; however, less is known about the genetic factors involved. Fibrillin-1 (FBN1) is a protein that coordinates the deposition of elastin fibres in the extracellular matrix and is therefore likely to affect the elastic properties in the aortic wall. Previously studies have found associations between the FBN1-2/3 genotype and arterial stiffness, but how different FBN1 genotypes, AAA, and arterial stiffness are related has been less frequently investigated.AimThis study aimed to investigate whether there is a difference in FBN1 genotype between men with and without AAA. A further aim was to study whether the FBN1 genotype affects arterial wall stiffness differently in men with and without AAA.MethodsPulse wave velocity and FBN1 genotyping were performed in 229 men (159 with AAA, 70 without AAA). Participants were recruited from ultrasound AAA surveillance programs or ongoing ultrasound screening programs from 2011 to 2016.ResultsThe distribution of the FBN1 genotype in the AAA and control groups were as follows: FBN1-2/2: 62% vs. 64%; FBN1-2/3: 8% vs. 14%; and FBN1-2/4: 30% vs. 21%, respectively. Men with AAA and FBN1-2/2 had increased central pulse wave velocity (p < 0.005) compared to the control group (those without AAA) with the FBN1-2/2 genotype.ConclusionNo differences were found with respect to FBN1 genotypes between men with and without AAA. The development of AAA in men does not appear to be linked to a specific FBN1 genotype. Nevertheless, men with FBN1-2/2 and AAA have increased central arterial stiffness compared to men with the same FBN1 genotype but without AAA.
Workload and workflow implications associated with the use of electronic clinical decision support tools used by health professionals in general practice: a scoping review
Authors: Fletcher Emily , Burns Alex , Wiering Bianca , Lavu Deepthi , Shephard Elizabeth , Hamilton Willie , Campbell John L. , Abel Gary 
Published: January 2023

Abstract
Background
Electronic clinical decision support tools (eCDS) are increasingly available to assist General Practitioners (GP) with the diagnosis and management of a range of health conditions. It is unclear whether the use of eCDS tools has an impact on GP workload. This scoping review aimed to identify the available evidence on the use of eCDS tools by health professionals in general practice in relation to their impact on workload and workflow.

Methods
A scoping review was carried out using the Arksey and O’Malley methodological framework. The search strategy was developed iteratively, with three main aspects: general practice/primary care contexts, risk assessment/decision support tools, and workload-related factors. Three databases were searched in 2019, and updated in 2021, covering articles published since 2009: Medline (Ovid), HMIC (Ovid) and Web of Science (TR). Double screening was completed by two reviewers, and data extracted from included articles were analysed.

Results
The search resulted in 5,594 references, leading to 95 full articles, referring to 87 studies, after screening. Of these, 36 studies were based in the USA, 21 in the UK and 11 in Australia. A further 18 originated from Canada or Europe, with the remaining studies conducted in New Zealand, South Africa and Malaysia. Studies examined the use of eCDS tools and reported some findings related to their impact on workload, including on consultation duration. Most studies were qualitative and exploratory in nature, reporting health professionals’ subjective perceptions of consultation duration as opposed to objectively-measured time spent using tools or consultation durations. Other workload-related findings included impacts on cognitive workload, “workflow” and dialogue with patients, and clinicians’ experience of “alert fatigue”.

Conclusions
The published literature on the impact of eCDS tools in general practice showed that limited efforts have focused on investigating the impact of such tools on workload and workflow. To gain an understanding of this area, further research, including quantitative measurement of consultation durations, would be useful to inform the future design and implementation of eCDS tools.
Salicylic acid functionalized zein for improving plant stress resistance and as a nanopesticide carrier with enhanced anti-photolysis ability
Authors: Yan Haozhao , Hao Li , Chen Huayao , Zhou Xinhua , Ji Hongbing , Zhou Hongjun 
Published: January 2023

Abstract
Background
There is a serious global problem of salinization of arable land, causing large reduction in world food production. Use of plant hormones is an effective way to reduce damage caused to crops and salt stress.

Results
In this study, PEI-EDA was modified with AM-zein and grafted with plant hormone SA (AM-zein-SA) and used as a nano-pesticide carrier to load emamectin benzoate (EB). The use of AM-zein-SA as a nano-pesticide carrier could reduce the damage caused by salt stress to crops. The structure of AM-zein-SA was characterized by FTIR, UV, fluorescence, Raman, and 1H NMR spectroscopic techniques. AM-zein-SA could effectively improve the resistance of EB to ultraviolet radiations, resistance of cucumber to salt stress, and the absorption of EB by plants. The experimental results showed that AM-zein-SA could effectively improve the anti-UV property of EB by 0.88 fold. When treated with 120 mmol NaCl, the germination rate of cucumber seeds under salt stress increased by 0.93 fold in presence of 6.25 mg/L carrier concentration. The POD and SOD activities increased by 0.50 and 1.21 fold, whereas the content of MDA decreased by 0.23 fold. In conclusion, AM-zein-SA nano-pesticide carrier could be used to improve the salt resistance of crops and the adhesion of pesticides to leaves.

Conclusion
AM-zein-SA, without undergoing any changes in its insecticidal activity, could simultaneously improve the salt stress resistance and salt stress germination rate of cucumber, reduce growth inhibition due to stress under high-concentration salt, and had a good effect on crops. In addition, EB@AM-zein-SA obviously improved the upward transmission rate of EB, as compared with EB. In this study, SA was grafted onto zein-based nano-pesticide carrier, which provided a green strategy to control plant diseases, insects, and pests while reducing salt stress on crops in saline-alkali soil.

Graphical Abstract
Biochemical characteristics and potential application of a thermostable starch branching enzyme from Bacillus licheniformis
Authors: Yang Ting , Hu Qianyu , Liu Yu , Xu Rui , Wang Dongrui , Chang Zhongyi , Jin Mingfei , Huang Jing 
Published: January 2023

AbstractSlowly digestible starch (SDS) has attracted increasing attention for its function of preventing metabolic diseases. Based on transglycosylation, starch branching enzymes (1,4-α-glucan branching enzymes, GBEs, EC 2.4.1.18) can be used to regulate the digestibility of starch. In this study, a GBE gene from Bacillus licheniformis (bl-GBE) was cloned, expressed, purified, and characterized. Sequence analysis and structural modeling showed that bl-GBE belong to the glycoside hydrolase 13 (GH13) family, with which its active site residues were conserved. The bl-GBE was highly active at 80 °C and a pH range of 7.5–9.0, and retained 90% of enzyme activity at 70 °C for 16 h. bl-GBE also showed high substrate specificity (80.88 U/mg) on potato starch. The stability and the changes of the secondary structure of bl-GBE at different temperature were determined by circular dichroism (CD) spectroscopy. The CD data showed a loss of 20% of the enzyme activity at high temperatures (80 °C), due to the decreased content of the α -helix in the secondary structure. Furthermore, potato starch treated with bl-GBE (300 U/g starch) showed remarkable increase in stability, solubility, and significant reduction viscosity. Meanwhile, the slowly digestible starch content of bl-GBE modified potato starch increased by 53.03% compared with native potato starch. Our results demonstrated the potential applications of thermophilic bl-GBE in food industries.
The association of dietary and lifestyle indices for hyperinsulinemia with odds of non-alcoholic fatty liver disease in Iranian adults: a case–control study
Authors: Momeni Aref , Haghshenas Rouhollah , Jahromi Soodeh Razeghi 
Published: January 2023

Abstract
Background
Evidence on the association of insulinemic effects of dietary pattern and other lifestyle factors with the odds of non-alcoholic fatty liver disease (NAFLD) are limited. In the current study, we aimed to examine the association of the empirical dietary index for hyperinsulinemia (EDIH) and empirical lifestyle index for hyperinsulinemia (ELIH) index with the NAFLD odds in the adult population.

Methods
In the current case–control study, 120 cases of NAFLD and 240 controls aged 20–60 years were included. The ultrasonography test was used to determine NAFLD. We used a validated food frequency questionnaire to collect dietary data of individuals and determine the scores of EDIH. Also, we determined the ELIH score based on diet, body mass index, and physical activity. The odds ratio (OR) of NAFLD was calculated using logistic regression test across EDIH and ELIH tertiles.

Results
The mean ± SD age of subjects (53% men) were 41.8 ± 7.5 years. In the age and sex-adjusted model, there is a significant association between a higher ELIH score and higher odds of NAFLD (OR = 2.74;95%CI:1.51–4.96,Ptrend = 0.001). Also, based on the multivariable-adjusted model, after controlling for age and sex, smoking, SES, and dietary intake of energy a remarkable positive association was observed between the higher score of ELIH and the odds of NAFLD (OR = 2.70; 95%CI:1.46–5.01,Ptrend = 0.002). However, there is no significant relationship between the higher score of EDIH and NAFLD odds.

Conclusions
Our results showed that the high insulinemic potential of lifestyle, determined by the ELIH score, can be related to an increased NAFLD odds. However, no significant association was found between higher EDIH score and odds of NAFLD.