bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of the quality, accuracy, and readability of patient information on polycystic ovarian syndrome (PCOS) on the internet available in English: a cross-sectional study
Authors: Vågenes Helene , Pranić Shelly Melissa 
Published: May 2023

Abstract
Background
Online information about PCOS lacks reliability for patients seeking information about the disease. Thus, we aimed to perform an updated analysis of the quality, accuracy, and readability of patient information on PCOS available online.

Methods
We conducted a cross-sectional study using the top five Google Trends search terms in English associated with PCOS, including “symptoms,” “treatment,” “test,” “pregnancy,” and “causes.” Five separate searches in Bing, Yahoo, and Google were performed to obtain the first 10 unique webpages for each term that was categorized as commercial, non-profit organization, scientific resources, or private foundation. We used the 16-item DISCERN with Likert-responses (minimum 1, maximum 5) where the total is 80 and lowest is 16, clarity with the 32-item EQIP, where responses of no = 0 and yes = 1 (minimum 0, maximum 32), and accuracy scores with 1 denoting poor and 5 completely accurate information; low scores of each corresponded to poorly reported information. We assessed readability with Flesch-Kincaid reading ease index, where higher scores correspond to reading ease, and lower grades correspond to easier readability with Flesch-Kincaid grade level, Gunning-Fog, Coleman-Liau index, automated readability index, New Dale-Chall Readability, and simple measure of gobbledygook. We additionally assessed word and sentence characteristics. We used Kruskal-Wallis test to compare scores according to webpage categories.

Results
Out of 150 webpages, most were commercial (n = 85, 57%), followed by non-profit organizations (n = 44, 29%), scientific resources (n = 13, 9%) and private foundations (n = 6, 4%). Google webpages had higher median DISCERN score ([Md] = 47.0) than Bing ([Md] = 42.0) and Yahoo ([Md] = 43.0) webpages; P = 0.023. No difference in EQIP scores according to search engine was found (P = 0.524). Predominantly, webpages from private foundations had higher DISCERN and EQIP scores, although comparisons were not statistically significant (P = 0.456) and P = 0.653.). Accuracy and readability were similar across search engines and webpage categories (P = 0.915, range 5.0–5.0) and (P = 0.208, range 4.0–5.0).

Conclusions
Quality and clarity of the data were fair according to search engine and category. Accuracy of information was high, showing that the public may encounter accurate information about PCOS. However, the readability of the information was high, reflecting a need for more readable resources about PCOS.
Structural and non-structural proteins in SARS-CoV-2: potential aspects to COVID-19 treatment or prevention of progression of related diseases
Authors: Kakavandi Sareh , Zare Iman , VaezJalali Maryam , Dadashi Masoud , Azarian Maryam , Akbari Abdullatif , Ramezani Farani Marzieh , Zalpoor Hamidreza , Hajikhani Bahareh 
Published: May 2023

AbstractCoronavirus disease 2019 (COVID-19) is caused by a new member of the Coronaviridae family known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There are structural and non-structural proteins (NSPs) in the genome of this virus. S, M, H, and E proteins are structural proteins, and NSPs include accessory and replicase proteins. The structural and NSP components of SARS-CoV-2 play an important role in its infectivity, and some of them may be important in the pathogenesis of chronic diseases, including cancer, coagulation disorders, neurodegenerative disorders, and cardiovascular diseases. The SARS-CoV-2 proteins interact with targets such as angiotensin-converting enzyme 2 (ACE2) receptor. In addition, SARS-CoV-2 can stimulate pathological intracellular signaling pathways by triggering transcription factor hypoxia-inducible factor-1 (HIF-1), neuropilin-1 (NRP-1), CD147, and Eph receptors, which play important roles in the progression of neurodegenerative diseases like Alzheimer's disease, epilepsy, and multiple sclerosis, and multiple cancers such as glioblastoma, lung malignancies, and leukemias. Several compounds such as polyphenols, doxazosin, baricitinib, and ruxolitinib could inhibit these interactions. It has been demonstrated that the SARS-CoV-2 spike protein has a stronger affinity for human ACE2 than the spike protein of SARS-CoV, leading the current study to hypothesize that the newly produced variant Omicron receptor-binding domain (RBD) binds to human ACE2 more strongly than the primary strain. SARS and Middle East respiratory syndrome (MERS) viruses against structural and NSPs have become resistant to previous vaccines. Therefore, the review of recent studies and the performance of current vaccines and their effects on COVID-19 and related diseases has become a vital need to deal with the current conditions. This review examines the potential role of these SARS-CoV-2 proteins in the initiation of chronic diseases, and it is anticipated that these proteins could serve as components of an effective vaccine or treatment for COVID-19 and related diseases.
Bacillus cereus extracellular vesicles act as shuttles for biologically active multicomponent enterotoxins
Authors: Buchacher Tanja , Digruber Astrid , Kranzler Markus , Del Favero Giorgia , Ehling-Schulz Monika 
Published: May 2023

Abstract
Background
Extracellular vesicles (EVs) from Gram-positive bacteria have gained considerable importance as a novel transport system of virulence factors in host–pathogen interactions. Bacillus cereus is a Gram-positive human pathogen, causing gastrointestinal toxemia as well as local and systemic infections. The pathogenicity of enteropathogenic B. cereus has been linked to a collection of virulence factors and exotoxins. Nevertheless, the exact mechanism of virulence factor secretion and delivery to target cells is poorly understood.

Results
Here, we investigate the production and characterization of enterotoxin-associated EVs from the enteropathogenic B. cereus strain NVH0075-95 by using a proteomics approach and studied their interaction with human host cells in vitro. For the first time, comprehensive analyses of B. cereus EV proteins revealed virulence-associated factors, such as sphingomyelinase, phospholipase C, and the three-component enterotoxin Nhe. The detection of Nhe subunits was confirmed by immunoblotting, showing that the low abundant subunit NheC was exclusively detected in EVs as compared to vesicle-free supernatant. Cholesterol-dependent fusion and predominantly dynamin-mediated endocytosis of B. cereus EVs with the plasma membrane of intestinal epithelial Caco2 cells represent entry routes for delivery of Nhe components to host cells, which was assessed by confocal microscopy and finally led to delayed cytotoxicity. Furthermore, we could show that B. cereus EVs elicit an inflammatory response in human monocytes and contribute to erythrocyte lysis via a cooperative interaction of enterotoxin Nhe and sphingomyelinase.

Conclusion
Our results provide insights into the interaction of EVs from B. cereus with human host cells and add a new layer of complexity to our understanding of multicomponent enterotoxin assembly, offering new opportunities to decipher molecular processes involved in disease development.
MiR-146a rs2910164 (G/C) polymorphism is associated with the development and prognosis of acute coronary syndromes: an observational study including case control and validation cohort
Authors: Qiao Xiang-Rui , Zheng Tao , Xie Yifei , yao Xinyi , Yuan Zuyi , Wu Yue , Zhou Dong , Chen Tao 
Published: May 2023

Abstract
Background
Polymorphisms in microRNAs (miRNAs) play an important role in acute coronary syndromes (ACS). The purpose of this study was to assess the association of miR-146a rs2910164 and miR-34b rs4938723 polymorphisms with the development and prognosis of ACS and to explore the underlying mechanisms.

Methods
A case–control study of 1171 subjects was included to determine the association of miR-146a rs2910164 and miR-34b rs4938723 polymorphisms with ACS risk. An additional 612 patients with different miR-146a rs2910164 genotypes, who underwent percutaneous coronary intervention (PCI) were included in the validation cohort and followed for 14 to 60 months. The endpoint was major adverse cardiovascular events (MACE). A luciferase reporter gene assay was used to validate the interaction of oxi-miR-146a(G) with the IKBA 3'UTR. Potential mechanisms were validated using immunoblotting and immunostaining.

Results
The miR-146a rs2910164 polymorphism was significantly associated with the risk of ACS (Dominant model: CG + GG vs. CC, OR = 1.270, 95% CI (1.000–1.613), P = 0.049; Recessive model: GG vs. CC + CG, OR = 1.402, 95% CI (1.017–1.934), P = 0.039). Serum inflammatory factor levels were higher in patients with the miR-146a rs2910164 G allele than in those with the C allele. MiR-146a rs2910164 polymorphism in dominant model was associated with the incidence of MACE in post-PCI patients (CG + GG vs. CC, HR = 1.405, 95% CI (1.018–1.939), P = 0.038). However, the miR-34b rs4938723 polymorphism was not associated with the prevalence and prognosis of ACS. The G allele of miR-146a rs2910164 tends to be oxidized in ACS patients. The miRNA fractions purified from monocytes isolated from ACS patients were recognized by the 8OHG antibody. Mispairing of Oxi-miR-146a(G) with the 3'UTR of IKBA results in decreased IκBα protein expression and activation of the NF-κB inflammatory pathway. P65 expression was higher in atherosclerotic plaques from patients carrying the miR-146a rs2910164 G allele.

Conclusion
The variant of miR-146a rs2910164 is closely associated with the risk of ACS in Chinese Han population. Patients carrying miR-146a rs2910164 G allele may have worse pathological change and poorer post-PCI prognosis, partly due to the oxidatively modified miR-146a mispairing with 3′UTR of IKBA and activating NF-κB inflammatory pathways.
Sexual and reproductive health services access and provision in Cambodia during the COVID-19 pandemic: a mixed-method study of urban–rural differences
Authors: Ung Mengieng , Lam Sze Tung , Tuot Sovannary , Chhoun Pheak , Prum Virak , Nagashima-Hayashi Michiko , Neo Pearlyn , Marzouk Manar , Durrance-Bagale Anna , De Beni Davide , Yi Siyan , Howard Natasha 
Published: May 2023

Abstract
Background
The COVID-19 pandemic pushed governments worldwide to implement unprecedented mitigation measures, including safe-distancing, lockdowns, disruption of non-essential services, border closures and travel restrictions, with both potential to affect rural and urban service-users differently and unintended consequences including reductions in sexual and reproductive health (SRH) services. We aimed to explore rural–urban differences in progress and challenges in SRH services provision in Cambodia, particularly during initial months of the COVID-19 pandemic.

Methods
We used a mixed-methods study design, including a household survey of 423 adolescents and women aged 18–49 and semi-structured interviews with 21 healthcare providers. We analysed survey data using multivariable logistic regression to identify associations between rural–urban setting and contraceptive perceptions or access. We analysed interview data thematically.

Results
Rural–urban residence was significantly associated with reported perceptions about and access to contraceptives. Rural participants had higher odds of stating it was possible to change contraceptive methods early in the COVID-19 pandemic, compared with urban participants. Qualitative data showed that although SRH services continued, health-workers faced differential challenges in rural and urban areas, e.g. service-users not attending due to job losses in urban areas and not complying with safe-distancing and mask-wearing requests in rural areas.

Conclusions
COVID-19 and inadequate mitigation responses differentially affected rural and urban SRH service providers and service-users, exacerbating existing socioeconomic stressors while adding new fears of infection, transport constraints, and reduced livelihoods. Added financial support could help mitigate challenges in both rural and urban areas.
Improving multi-scale detection layers in the deep learning network for wheat spike detection based on interpretive analysis
Authors: Yan Jiawei , Zhao Jianqing , Cai Yucheng , Wang Suwan , Qiu Xiaolei , Yao Xia , Tian Yongchao , Zhu Yan , Cao Weixing , Zhang Xiaohu 
Published: May 2023

Abstract
Background
Detecting and counting wheat spikes is essential for predicting and measuring wheat yield. However, current wheat spike detection researches often directly apply the new network structure. There are few studies that can combine the prior knowledge of wheat spike size characteristics to design a suitable wheat spike detection model. It remains unclear whether the complex detection layers of the network play their intended role.

Results
This study proposes an interpretive analysis method for quantitatively evaluating the role of three-scale detection layers in a deep learning-based wheat spike detection model. The attention scores in each detection layer of the YOLOv5 network are calculated using the Gradient-weighted Class Activation Mapping (Grad-CAM) algorithm, which compares the prior labeled wheat spike bounding boxes with the attention areas of the network. By refining the multi-scale detection layers using the attention scores, a better wheat spike detection network is obtained. The experiments on the Global Wheat Head Detection (GWHD) dataset show that the large-scale detection layer performs poorly, while the medium-scale detection layer performs best among the three-scale detection layers. Consequently, the large-scale detection layer is removed, a micro-scale detection layer is added, and the feature extraction ability in the medium-scale detection layer is enhanced. The refined model increases the detection accuracy and reduces the network complexity by decreasing the network parameters.

Conclusion
The proposed interpretive analysis method to evaluate the contribution of different detection layers in the wheat spike detection network and provide a correct network improvement scheme. The findings of this study will offer a useful reference for future applications of deep network refinement in this field.
Mapping the forage nitrogen, phosphorus, and potassium contents of alpine grasslands by integrating Sentinel-2 and Tiangong-2 data
Authors: Zhang Xuanfan , Liang Tiangang , Gao Jinlong , Zhang Dongmei , Liu Jie , Feng Qisheng , Wu Caixia , Wang Zhiwei 
Published: May 2023

AbstractNitrogen (N), phosphorus (P), and potassium (K) contents are crucial quality indicators for forage in alpine natural grasslands and are closely related to plant growth and reproduction. One of the greatest challenges for the sustainable utilization of grassland resources and the development of high-quality animal husbandry is to efficiently and accurately obtain information about the distribution and dynamic changes in N, P, and K contents in alpine grasslands. A new generation of multispectral sensors, the Sentinel-2 multispectral instrument (MSI) and Tiangong-2 moderate-resolution wide-wavelength imager (MWI), is equipped with several spectral bands suitable for specific applications, showing great potential for mapping forage nutrients at the regional scale. This study aims to achieve high-accuracy spatial mapping of the N, P, and K contents in alpine grasslands at the regional scale on the eastern Qinghai-Tibet Plateau. The Sentinel-2 MSI and Tiangong-2 MWI data, coupled with multiple feature selection algorithms and machine learning models, are applied to develop forage N, P, and K estimation models from data collected at 92 sample sites ranging from the vigorous growth stage to the senescent stage. The results show that the spectral bands of both the Sentinel-2 MSI and Tiangong-2 MWI have an excellent performance in estimating the forage N, P, and K contents (the R2values are 0.68–0.76, 0.54–0.73, and 0.74–0.82 for forage N, P, and K estimations, respectively). Moreover, the model integrating the spectral bands of these two sensors explains 78%, 74%, and 84% of the variations in the forage N, P, and K contents, respectively. These results indicate that the estimation ability of forage nutrients can be further improved by integrating Tiangong-2 MWI and Sentinel-2 MSI data. In conclusion, integration of the spectral bands of multiple sensors is a promising approach to map the forage N, P, and K contents in alpine grasslands with high accuracy at the regional scale. This study offers valuable information for growth monitoring and real-time determination of forage quality in alpine grasslands.
Perceived benefit of yoga among adults who have practiced yoga for a long time: a qualitative study
Authors: Akdeniz Şengül , Kaştan Özlem 
Published: May 2023

Abstract
Background
Previous quantitative studies have shown many of the perceived benefits of yoga practice on the mind and body. Although there are many quantitative studies in the international literature on yoga, the number of qualitative studies showing the experience of yoga practice is insufficient. An accurate demonstration of yoga participents experiences, opinions, and judgments on this subject requires a qualitative, rather than a quantitative approach.

Purpose
This study was to explore the benefit perceived by adults who have practiced yoga for a long time.

Design and method
This qualitative study is based on a hermeneutic–phenomenological approach. The research sample consisted of 18 adults who volunteered to participate in the research and regularly joined yoga practice. The study data were collected through individual and focus group interviews with the participants who practise yoga and analyzed by content analysis method.

Results
We created five themes. Themes coded by researchers: meaning of the concept of yoga (theme 1), physical, mental, and social state before starting yoga (theme 2), reasons for practising yoga (theme 3), the participants' experiences related to their physical and mental health and social relationships (theme 4), and difficulties of doing yoga (theme 5). In addition, individuals in the study reported their perceptions of the concept of "yoga" through the creation of metaphors that completed the following sentence “yoga is like ……”. These metaphors were used to give insight into the participants deep feelings about yoga.

Conclusions
Both in their individual and focus group interviews, almost all of the participants described that doing yoga has positive benefits on the mind and body. The positive experiences of the participants in the study included decrease in pain and flexibility, increase in sleep quality, development of positive personality traits, increase in self-esteem, and coping with anxiety and stress more effectively. Because the study was qualitative and long-term, it was able to evaluate the beliefs, attitudes and behaviors of individuals in a realistic, systematic, and detailed manner.
Implementation of a batched stepped wedge trial evaluating a quality improvement intervention for surgical teams to reduce anastomotic leak after right colectomy
Authors: Venn Mary L. , Knowles Charles H. , Li Elizabeth , Glasbey James , Morton Dion G. , Hooper Richard ,   ESCP EAGLE Safe Anastomosis Collaborative
Published: May 2023

Abstract

Background
Large-scale quality improvement interventions demand robust trial designs with flexibility for delivery in different contexts, particularly during a pandemic. We describe innovative features of a batched stepped wedge trial, ESCP sAfe Anastomosis proGramme in CoLorectal SurgEry (EAGLE), intended to reduce anastomotic leak following right colectomy, and reflect on lessons learned about the implementation of quality improvement programmes on an international scale.

Methods
Surgical units were recruited and randomised in batches to receive a hospital-level education intervention designed to reduce anastomotic leak, either before, during, or following data collection. All consecutive patients undergoing right colectomy were included. Online learning, patient risk stratification and an in-theatre checklist constituted the intervention. The study was powered to detect an absolute risk reduction of anastomotic leak from 8.1 to 5.6%. Statistical efficiency was optimised using an incomplete stepped wedge trial design and study batches analysed separately then meta-analysed to calculate the intervention effect. An established collaborative group helped nurture strong working relationships between units/countries and a prospectively designed process evaluation will enable evaluation of both the intervention and its implementation.

Results
The batched trial design allowed sequential entry of clusters, targeted research training and proved to be robust to pandemic interruptions. Staggered start times in the incomplete stepped wedge design with long lead-in times can reduce motivation and engagement and require careful administration.

Conclusion
EAGLE’s robust but flexible study design allowed completion of the study across globally distributed geographical locations in spite of the pandemic. The primary outcome analysed in conjunction with the process evaluation will ensure a rich understanding of the intervention and the effects of the study design.

Trial registration

National Institute of Health Research Clinical Research Network portfolio IRAS ID: 272,250. Health Research Authority approval 18 October 2019. ClinicalTrials.gov, identifier NCT04270721, protocol ID RG_19196.