bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparative analysis of non-invasive prenatal testing in Ontario and Quebec: the role of governing style in health technology innovation & adoption
Authors: Saleh Lena , Parker Gillian , Stevenson Michael , Miller Fiona A. 
Published: March 2023

Abstract
Background
While processes of adoption and the impacts of various health technologies have been extensively studied by health services and policy researchers, the influence of policy makers’ governing styles on these processes have been largely neglected. Through a comparative analysis of non-invasive prenatal testing (NIPT) in the Canadian provinces of Ontario and Quebec, this article examines how decisions about this technology were shaped by contrasting political ideologies, resulting in vastly different innovation and adoption strategies and outcomes.

Methods
A comparative qualitative investigation comprising of a document analysis followed by semi-structured interviews with key informants. Interview participants were researchers, clinicians, and private sector medical laboratory employees based in Ontario and Quebec, Canada. Interviews were conducted both in person and virtually– owing partly to the COVID-19 pandemic – to garner perspectives regarding the adoption and innovation processes surrounding non-invasive prenatal testing in both provinces. All interviews were recorded and transcribed verbatim and data were analyzed using thematic analysis.

Results
Through an analysis of 21 in-depth interview transcripts and key documents, the research team identified three central themes: 1) health officials in each province demonstrated a unique approach to using the existing scholarly literature on NIPT; 2) each provincial government demonstrated its own preference for service delivery, with Ontario preferring private and Quebec preferring public; and finally, 3) both Ontario and Quebec’s strategies to NIPT adoption and innovation was contextualized within each province’s unique financial positioning and concerns. These findings illustrate how both Quebec’s nationalist focus and use of industrial policy and Ontario’s ‘New Public Management’ style had implications for how this emerging healthcare technology was made available within each province’s publicly-financed health system.

Conclusions
Our study reveals how these governments’ differing approaches to using data and research, public versus private service delivery, and financial goals and concerns resulted in distinct testing technologies, access, and timelines for NIPT adoption. Our analysis demonstrates the need for health policy researchers, policy makers, and others to move beyond analyses solely considering clinical and health economic evidence to understand the impact of political ideologies and governing styles.
Alpha-2-macroglobulin is involved in the occurrence of early-onset pre-eclampsia via its negative impact on uterine spiral artery remodeling and placental angiogenesis
Authors: Wang Jingyun , Zhang Ping , Liu Mengyuan , Huang Zhengrui , Yang Xiaofeng , Ding Yuzhen , Liu Jia , Cheng Xin , Xu Shujie , He Meiyao , Zhang Fengxiang , Wang Guang , Li Ruiman , Yang Xuesong 
Published: March 2023

Abstract
Background
Pre-eclampsia (PE) is one of the leading causes of maternal and fetal morbidity/mortality during pregnancy, and alpha-2-macroglobulin (A2M) is associated with inflammatory signaling; however, the pathophysiological mechanism by which A2M is involved in PE development is not yet understood.

Methods
Human placenta samples, serum, and corresponding clinical data of the participants were collected to study the pathophysiologic mechanism underlying PE. Pregnant Sprague–Dawley rats were intravenously injected with an adenovirus vector carrying A2M via the tail vein on gestational day (GD) 8.5. Human umbilical artery smooth muscle cells (HUASMCs), human umbilical vein endothelial cells (HUVECs), and HTR-8/SVneo cells were transfected with A2M-expressing adenovirus vectors.

Results
In this study, we demonstrated that A2M levels were significantly increased in PE patient serum, uterine spiral arteries, and feto-placental vasculature. The A2M-overexpression rat model closely mimicked the characteristics of PE (i.e., hypertension in mid-to-late gestation, histological and ultrastructural signs of renal damage, proteinuria, and fetal growth restriction). Compared to the normal group, A2M overexpression significantly enhanced uterine artery vascular resistance and impaired uterine spiral artery remodeling in both pregnant women with early-onset PE and in pregnant rats. We found that A2M overexpression was positively associated with HUASMC proliferation and negatively correlated with cell apoptosis. In addition, the results demonstrated that transforming growth factor beta 1 (TGFβ1) signaling regulated the effects of A2M on vascular muscle cell proliferation described above. Meanwhile, A2M overexpression regressed rat placental vascularization and reduced the expression of angiogenesis-related genes. In addition, A2M overexpression reduced HUVEC migration, filopodia number/length, and tube formation. Furthermore, HIF-1α expression was positively related to A2M, and the secretion of sFLT-1 and PIGF of placental origin was closely related to PE during pregnancy or A2M overexpression in rats.

Conclusions
Our data showed that gestational A2M overexpression can be considered a contributing factor leading to PE, causing detective uterine spiral artery remodeling and aberrant placental vascularization.
Severe malaria in Gabon: epidemiological, clinical and laboratory features in Amissa Bongo Hospital of Franceville
Authors: Imboumy-Limoukou Roméo Karl , Lendongo-Wombo Judicael Boris , Nguimbyangue-Apangome Andhra Fecilia , Biteghe Bi Essone Jean-Claude , Mounioko Franck , Oyegue-Libagui Lydie Sandrine , Ngoungou Brice Edgar , Lekana-Douki Jean-Bernard 
Published: March 2023

AbstractBackgroundMalaria is the most deadly parasitic disease and continues to claim more than a half million of deaths across the world each year, mainly those of under-fives children in sub-Saharan Africa. The aim of this study was to determine the epidemiological, clinical and laboratory features of patients with severe malaria at the Centre Hospitalier Régional Amissa Bongo (CHRAB), a referral hospital in Franceville.MethodsIt was an observational descriptive study conducted at CHRAB over 10 months. All admitted patients at the emergency ward of all ages presenting with positive test to falciparum malaria diagnosed by microscopy and rapid test with clinical signs of severe illness describe by World Health Organization were enrolled.ResultsDuring this study, 1065 patients were tested positive for malaria, of them 220 had severe malaria. Three quarters (75.0%) were less than 5 years of age. The mean time to consultation was 3.5 ± 1 days. The most frequent signs of severity on admission were dominated by neurological disorders 92.27% (prostration 58.6% and convulsion 24.1%), followed by severe anemia 72.7%, hyperlactatemia 54.6%, jaundice 25% and respiratory distress 21.82%.The other forms such as hypoglycemia, haemoglobinuria, renal failure were found in low proportions < 10%. Twenty-one patients died, coma (aOR = 15.54, CI 5.43–44.41, p < 0.01), hypoglycemia (aOR = 15.37, CI 2.17–65.3, p < 0.01), respiratory distress (aOR = 3.85, CI 1.53–9.73, p = 0.004) and abnormal bleeding (aOR = 16.42, CI 3.57–104.73, p = 0.003) were identified as independent predictors of a fatal outcome. Anemia was associated with decreased mortality.ConclusionSevere malaria remains a public health problem affecting mostly children under 5 years. Classification of malaria helps identify the most severely ill patients and aids early and appropriate management of the severe malaria cases.
Cooked pork-derived exosome nanovesicles mediate metabolic disorder—microRNA could be the culprit
Authors: Shen Linyuan , Ma Jianfeng , Yang Yiting , Liao Tianci , Wang Jinyong , Chen Lei , Zhang Shunhua , Zhao Ye , Niu Lili , Hao Xiaoxia , Jiang Anan , Li Xuewei , Gan Mailin , Zhu Li 
Published: March 2023

AbstractIn this study, exosomes from cooked meat were extracted by ultra-high-speed centrifugation. Approximately 80% of exosome vesicles were within 20–200 nm. In addition, the surface biomarkers of isolated exosomes were evaluated using flow cytometry. Further studies showed the exosomal microRNA profiles were different among cooked porcine muscle, fat and liver. Cooked pork-derived exosomes were chronically administered to ICR mice by drinking for 80 days. The mice plasma levels of miR-1, miR-133a-3p, miR-206 and miR-99a were increased to varying degrees after drinking exosome enriched water. Furthermore, GTT and ITT results confirmed an abnormal glucose metabolism and insulin resistance in mice. Moreover, the lipid droplets were significantly increased in the mice liver. A transcriptome analysis performed with mice liver samples identified 446 differentially expressed genes (DEGs). Functional enrichment analysis found that DEGs were enriched in metabolic pathways. Overall, the results suggest that microRNAs derived form cooked pork may function as a critical regulator of metabolic disorder in mice.
CRS: a circadian rhythm score model for predicting prognosis and treatment response in cancer patients
Authors: Liu Yuwei , Guo Shuang , Sun Yue , Zhang Caiyu , Gan Jing , Ning Shangwei , Wang Junwei 
Published: March 2023

Abstract
Background
Circadian rhythm regulates complex physiological activities in organisms. A strong link between circadian dysfunction and cancer has been identified. However, the factors of dysregulation and functional significance of circadian rhythm genes in cancer have received little attention.

Methods
In 18 cancer types from The Cancer Genome Atlas (TCGA), the differential expression and genetic variation of 48 circadian rhythm genes (CRGs) were examined. The circadian rhythm score (CRS) model was created using the ssGSEA method, and patients were divided into high and low groups based on the CRS. The Kaplan–Meier curve was created to assess the patient survival rate. Cibersort and estimate methods were used to identify the infiltration characteristics of immune cells between different CRS subgroups. Gene Expression Omnibus (GEO) dataset is used as verification queue and model stability evaluation queue. The CRS model's ability to predict chemotherapy and immunotherapy was assessed. Wilcoxon rank-sum test was used to compare the differences of CRS among different patients. We use CRS to identify potential "clock-drugs" by the connective map method.

Results
Transcriptomic and genomic analyses of 48 CRGs revealed that most core clock genes are up-regulated, while clock control genes are down-regulated. Furthermore, we show that copy number variation may affect CRGs aberrations. Based on CRS, patients can be classified into two groups with significant differences in survival and immune cell infiltration. Further studies showed that patients with low CRS were more sensitive to chemotherapy and immunotherapy. Additionally, we identified 10 compounds (e.g. flubendazole, MLN-4924, ingenol) that are positively associated with CRS, and have the potential to modulate circadian rhythms.

Conclusions
CRS can be utilized as a clinical indicator to predict patient prognosis and responsiveness to therapy, and identify potential "clock-drugs".
APE1 promotes non-homologous end joining by initiating DNA double-strand break formation and decreasing ubiquitination of artemis following oxidative genotoxic stress
Authors: Zhang Qin , Yang Lujie , Gao Han , Kuang Xunjie , Xiao He , Yang Chen , Cheng Yi , Zhang Lei , Guo Xin , Zhong Yong , Li Mengxia 
Published: March 2023

Abstract
Background
Apurinic/apyrimidinic endonuclease 1 (APE1) imparts radio-resistance by repairing isolated lesions via the base excision repair (BER) pathway, but whether and how it is involved in the formation and/or repair of DSBs remains mostly unknown.

Methods
Immunoblotting, fluorescent immunostaining, and the Comet assay were used to investigate the effect of APE1 on temporal DSB formation. Chromatin extraction, 53BP1 foci and co-immunoprecipitation, and rescue assays were used to evaluate non-homologous end joining (NHEJ) repair and APE1 effects. Colony formation, micronuclei measurements, flow cytometry, and xenograft models were used to examine the effect of APE1 expression on survival and synergistic lethality. Immunohistochemistry was used to detect APE1 and Artemis expression in cervical tumor tissues.

Results
APE1 is upregulated in cervical tumor tissue compared to paired peri-tumor, and elevated APE1 expression is associated with radio-resistance. APE1 mediates resistance to oxidative genotoxic stress by activating NHEJ repair. APE1, via its endonuclease activity, initiates clustered lesion conversion to DSBs (within 1 h), promoting the activation of the DNA-dependent protein kinase catalytic subunit (DNA-PKcs), a key kinase in the DNA damage response (DDR) and NHEJ pathway. APE1 then participates in NHEJ repair directly by interacting with DNA- PKcs. Additionally, APE1 promotes NHEJ activity by decreasing the ubiquitination and degradation of Artemis, a nuclease with a critical role in the NHEJ pathway. Overall, APE1 deficiency leads to DSB accumulation at a late phase following oxidative stress (after 24 h), which also triggers activation of Ataxia-telangiectasia mutated (ATM), another key kinase of the DDR. Inhibition of ATM activity significantly promotes synergistic lethality with oxidative stress in APE1-deficient cells and tumors.

Conclusion
APE1 promotes NHEJ repair by temporally regulating DBS formation and repair following oxidative stress. This knowledge provides new insights into the design of combinatorial therapies and indicates the timing of administration and maintenance of DDR inhibitors for overcoming radio-resistance.
Different associations of general and abdominal obesity with upper and lower extremity artery disease among a community population in China
Authors: Wang Yong , Guo Xiaoyan , Zhang Yi , Zhang Ruiyan , Li Jue 
Published: March 2023

Abstract
Background
The associations between obesity and abnormalities of upper and lower extremity arteries remain to be elucidated. This study is aimed to investigate whether general obesity and abdominal obesity are associated with upper and lower extremity artery diseases in a Chinese community population.

Methods
This cross-sectional study included 13,144 participants in a Chinese community population. The associations between obesity parameters and abnormalities of upper and lower extremity arteries were evaluated. Multiple logistic regression analysis was used to assess the independence of associations between obesity indicators and abnormalities of peripheral arteries. Nonlinear relationship between body mass index (BMI) and risk of ankle-brachial index (ABI) ≤ 0.9 was evaluated using a restricted cubic spline model.

Results
The prevalence of ABI ≤ 0.9 and interarm blood pressure difference (IABPD) ≥ 15 mmHg in the subjects was 1.9% and 1.4% respectively. Waist circumference (WC) was independently associated with ABI ≤ 0.9 (OR 1.014, 95% CI 1.002–1.026, P = 0.017). Nevertheless, BMI was not independently associated with ABI ≤ 0.9 using linear statistical models. Meanwhile, BMI and WC were independently associated with IABPD ≥ 15 mmHg respectively (OR 1.139, 95% CI 1.100–1.181, P < 0.001, and OR 1.058, 95% CI 1.044–1.072, P < 0.001). Furthermore, prevalence of ABI ≤ 0.9 was displayed with a U-shaped pattern according to different BMI (< 20, 20 to < 25, 25 to < 30, and ≥ 30). Compared with BMI 20 to < 25, risk of ABI ≤ 0.9 was significantly increased when BMI < 20 or ≥ 30 respectively (OR 2.595, 95% CI 1.745–3.858, P < 0.001, or OR 1.618, 95% CI 1.087–2.410, P = 0.018). Restricted cubic spline analysis indicated a significant U-shaped relationship between BMI and risk of ABI ≤ 0.9 (P for non-linearity < 0.001). However, prevalence of IABPD ≥ 15 mmHg was significantly increased with incremental BMI (P for trend < 0.001). Compared with BMI 20 to < 25, the risk of IABPD ≥ 15 mmHg was significantly increased when BMI ≥ 30 (OR 3.218, 95% CI 2.133–4.855, P < 0.001).

Conclusions
Abdominal obesity is an independent risk factor for upper and lower extremity artery diseases. Meanwhile, general obesity is also independently associated with upper extremity artery disease. However, the association between general obesity and lower extremity artery disease is displayed with a U-shaped pattern.
Developing non-invasive 3D quantificational imaging for intelligent coconut analysis system with X-ray
Authors: Zhang Yu , Liu Qianfan , Chen Jing , Sun Chengxu , Lin Shenghuang , Cao Hongxing , Xiao Zhaolin , Huang Mengxing 
Published: March 2023

Abstract
Background
As one of the largest drupes in the world, the coconut has a special multilayered structure and a seed development process that is not yet fully understood. On the one hand, the special structure of the coconut pericarp prevents the development of external damage to the coconut fruit, and on the other hand, the thickness of the coconut shell makes it difficult to observe the development of bacteria inside it. In addition, coconut takes about 1 year to progress from pollination to maturity. During the long development process, coconut development is vulnerable to natural disasters, cold waves, typhoons, etc. Therefore, nondestructive observation of the internal development process remains a highly important and challenging task. In this study, We proposed an intelligent system for building a three-dimensional (3D) quantitative imaging model of coconut fruit using Computed Tomography (CT) images. Cross-sectional images of coconut fruit were obtained by spiral CT scanning. Then a point cloud model was built by extracting 3D coordinate data and RGB values. The point cloud model was denoised using the cluster denoising method. Finally, a 3D quantitative model of a coconut fruit was established.

Results
The innovations of this work are as follows. 1) Using CT scans, we obtained a total of 37,950 non-destructive internal growth change maps of various types of coconuts to establish a coconut data set called “CCID”, which provides powerful graphical data support for coconut research. 2) Based on this data set, we built a coconut intelligence system. By inputting a batch of coconut images into a 3D point cloud map, the internal structure information can be ascertained, the entire contour can be drawn and rendered according to need, and the long diameter, short diameter and volume of the required structure can be obtained. We maintained quantitative observation on a batch of local Hainan coconuts for more than 3 months. With 40 coconuts as test cases, the high accuracy of the model generated by the system is proven. The system has a good application value and broad popularization prospects in the cultivation and optimization of coconut fruit.

Conclusion
The evaluation results show that the 3D quantitative imaging model has high accuracy in capturing the internal development process of coconut fruits. The system can effectively assist growers in internal developmental observations and in structural data acquisition from coconut, thus providing decision-making support for improving the cultivation conditions of coconuts.
Comparison of 270-degree percutaneous transforaminal endoscopic decompression under local anesthesia and minimally invasive transforaminal lumbar interbody fusion in the treatment of geriatric lateral recess stenosis associated with degenerative lumbar spondylolisthesis
Authors: Li Yubo , Cheng Xiaokang , Chen Bin 
Published: March 2023

Abstract
Purpose
Various lumbar decompression techniques have been used for the treatment of degenerative lumbar spondylolisthesis (DLS). Few studies have compared the clinical efficacy of percutaneous transforaminal endoscopic decompression (PTED) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lateral recess stenosis associated with DLS (LRS-DLS) in geriatric patients. The objective of the study was to compare the safety and short-term clinical efficacy of 270-degree PTED under local anesthesia and MIS-TLIF in the treatment of LRS-DLS in Chinese geriatric patients over 60 years old.

Materials and methods
From January 2017 to August 2019, the data of 90 consecutive geriatric patients with single-level L4-5 LRS-DLS were retrospectively reviewed, including those in the PTED group (n = 44) and MIS-TLIF group (n = 46). The patients were followed up for at least 1 year. Patient demographics and perioperative outcomes were reviewed before and after surgery. The Oswestry Disability Index (ODI), visual analog scale (VAS) for leg pain, and modified MacNab criteria were used to evaluate the clinical outcomes. X-ray examinations were performed 1 year after surgery to assess the progression of spondylolisthesis in the PTED group and bone fusion in the MIS-TLIF group.

Results
The mean patient ages in the PTED and MIS-TLIF groups were 70.3 years and 68.6 years, respectively. Both the PTED and MIS-TLIF groups demonstrated significant improvements in the VAS score for leg pain and ODI score, and no significant differences were found between the groups at any time point (P > 0.05). Although the good-to-excellent rate of the modified MacNab criteria in the PTED group was similar to that in the MIS-TLIF group (90.9% vs. 91.3%, P > 0.05), PTED was advantageous in terms of the operative time, estimated blood loss, incision length, drainage time, drainage volume, length of hospital stay, and complications.

Conclusions
Both PTED and MIS-TLIF led to favorable outcomes in geriatric patients with LRS-DLS. In addition, PTED caused less severe trauma and fewer complications. In terms of perioperative quality-of-life and clinical outcomes, PTED could supplement MIS-TLIF in geriatric patients with LRS-DLS.
Rehabilitation of severe dentofacial deformity after early radiotherapy of retinoblastoma: a case report
Authors: Kim So-Hyun , Choi Tae-Hyun , Lee You-Sun , Kim Young-Kyun , Jo Deuk-Won , Kim Baek-Kyu , Choi He-Li , Lee Nam-Ki 
Published: March 2023

Abstract
Background
Retinoblastoma is an intraocular cancer of infancy and childhood, which has been treated with radiation therapy and chemotherapy. Radiation on growing patients can cause deterioration in maxillofacial growth and development that leads to severe skeletal discrepancies between the maxilla and mandible, and dental problems such as crossbite, openbite, and hypodontia.

Case presentation
We present the case of a 19-year-old Korean man with chewing disability and dentofacial deformities. He had undergone enucleation of the right eye and radiation therapy of the left eye due to retinoblastoma 100 days after birth. Subsequently, he received cancer therapy for the secondary nasopharyngeal cancer at the age of 11 years. He was diagnosed with severe skeletal deformity including sagittal, transverse, and vertical growth deficiency of the maxilla and midface, and with class III malocclusion, severe anterior and posterior crossbite, posterior openbite, multiple missing upper incisors, right premolars, and second molars, and impaction of the lower right second molars. To restore impaired functions and esthetics of the jaw and dentition, the orthodontic treatment combined with two jaw surgery was performed. At the end of surgical orthodontics, dental implants were placed for prosthetic treatment of missing teeth. Additional plastic surgery for zygoma elevation was done with calvarial bone graft followed by fat graft. Facial esthetics and occlusal functions of patient were favorably enhanced with the improvement of skeletal discrepancy and the rehabilitation of maxillary dentition by prosthetic work. At the 2-year follow-up, the skeletal and dental relationships and implant prosthetics were well maintained.

Conclusion
In an adult patient with dentofacial deformities caused by early cancer therapy in the head and neck area, interdisciplinary interventions including additional plastic surgery of zygoma depression and prosthetic work of missing teeth as well as surgical–orthodontic treatment could establish favorable facial esthetics and oral rehabilitation.