bluuebunny/crossref_metadata_2025_split huggingface dataset:
In vitro propagation of Codonopsis pilosula (Franch.) Nannf. using apical shoot segments and phytochemical assessments of the maternal and regenerated plants
Authors: Gang Roggers , Komakech Richard , Chung Yuseong , Okello Denis , Kim Wook Jin , Moon Byeong Cheol , Yim Nam-Hui , Kang Youngmin 
Published: January 2023

Abstract
Background
Codonopsis pilosula (Franch.) Nannf. is a medicinal plant traditionally used in China, Korea, and Japan to treat many diseases including poor gastrointestinal function, low immunity, gastric ulcers, and chronic gastritis. The increasing therapeutic and preventive use of C. pilosula has subsequently led to depletion of the natural populations of this species thus necessitating propagation of this important medicinal plant. Here, we developed an efficient and effective in vitro propagation protocol for C. pilosula using apical shoot segments. We tested various plant tissue culture media for the growth of C. pilosula and evaluated the effects of plant growth regulators on the shoot proliferation and rooting of regenerated C. pilosula plants. Furthermore, the tissues (roots and shoots) of maternal and in vitro-regenerated C. pilosula plants were subjected to Fourier-transform near-infrared (FT-NIR) spectrometry, Gas chromatography-mass spectrometry (GC–MS), and their total flavonoids, phenolics, and antioxidant capacity were determined and compared.

Results
Full-strength Murashige and Skoog (MS) medium augmented with vitamins and benzylaminopurine (1.5 mg·L−1) regenerated the highest shoot number (12 ± 0.46) per explant. MS medium augmented with indole-3-acetic acid (1.0 mg·L−1) produced the highest root number (9 ± 0.89) and maximum root length (20.88 ± 1.48 mm) from regenerated C. pilosula shoots. The survival rate of in vitro-regenerated C. pilosula plants was 94.00% after acclimatization. The maternal and in vitro-regenerated C. pilosula plant tissues showed similar FT-NIR spectra, total phenolics, total flavonoids, phytochemical composition, and antioxidant activity. Randomly amplified polymorphic DNA (RAPD) test confirmed the genetic fidelity of regenerated C. pilosula plants.

Conclusions
The proposed in vitro propagation protocol may be useful for the rapid mass multiplication and production of high quality C. pilosula as well as for germplasm preservation to ensure sustainable supply amidst the ever-increasing demand.
A first look at sea-lavenders genomics – can genome wide SNP information tip the scales of controversy in the Limonium vulgare species complex?
Authors: Pina-Martins Francisco , Caperta Ana D. , Conceição Sofia I. R. , Nunes Vera L. , Marques Isabel , Paulo Octávio S. 
Published: January 2023

AbstractBackgroundSea-lavenders (LimoniumMill., Plumbaginaceae) are a cosmopolitan group of diploid and polyploid plants often adapted to extreme saline environments, with a mostly Tethyan distribution, occurring in the Mediterranean, Irano-Turanian, Euro-Siberian and in the New World. The halophylicLimonium vulgarepolyploid complex in particular, presents a large distribution throughout extreme salt-marsh habitats and shows little morphological but high taximetric variation, frequently blurring species delimitation. In this work we pursue three main goals: assert whether SNP data from polyploid individuals has the resolution to distinguish the seven sampled species, to better understand how genetically structuredLimonium vulgareis, and attempt to identify specific molecular mechanisms for the differentiation betweenL. maritimumandL. vulgare. For this purpose, 95 individuals were genotyped using Genotyping by Sequencing (GBS), which were assembled as two independent datasets usingipyrad. All analyses performed downstream of assembly were fully automated. Phylogenetic inference, PCA, and admixture plots were used to infer answers to the study’s main goals.ResultsClose to 10,000 SNPs were obtained for each dataset. Phylogenetic analyses reveal that polyploid data can be used to infer species relationships. Population structure analyses suggest a genetically structuredL. vulgare. A set of 34 SNPs were found to be fully segregated betweenL. vulgareandL. maritimum, two of which are potentially linked to proteins that might be involved in the speciation process.ConclusionDespite polyploid data analyses shortcomings, GBS generated SNPs have the resolution to discern all seven included species.Limonium vulgarerevealed pronounced genetic structure along a geographical north-south cline.L. maritimumalways appears as a distinct genetic entity. Segregated SNPs betweenL. vulgareandL. maritimumindicate salinity response and morphological trait control genes as potentially interesting to follow up for studying these species’ divergence process.
Unplanned 30-day readmissions, comorbidity and impact on one-year mortality following incident heart failure hospitalisation in Western Australia, 2001–2015
Authors: Weber Courtney , Hung Joseph , Hickling Siobhan , Li Ian , Murray Kevin , Briffa Tom 
Published: January 2023

Abstract
Background
Readmissions within 30 days after heart failure (HF) hospitalisation is considered an important healthcare quality metric, but their impact on medium-term mortality is unclear within an Australian setting. We determined the frequency, risk predictors and relative mortality risk of 30-day unplanned readmission in patients following an incident HF hospitalisation.

Methods
From the Western Australian Hospitalisation Morbidity Data Collection we identified patients aged 25–94 years with an incident (first-ever) HF hospitalisation as a principal diagnosis between 2001 and 2015, and who survived to 30-days post discharge. Unplanned 30-day readmissions were categorised by principal diagnosis. Logistic and Cox regression analysis determined the independent predictors of unplanned readmissions in 30-day survivors and the multivariable-adjusted hazard ratio (HR) of readmission on mortality within the subsequent year.

Results
The cohort comprised 18,241 patients, mean age 74.3 ± 13.6 (SD) years, 53.5% males, and one-third had a modified Charlson Comorbidity Index score of ≥ 3. Among 30-day survivors, 15.5% experienced one or more unplanned 30-day readmission, of which 53.9% were due to cardiovascular causes; predominantly HF (31.4%). The unadjusted 1-year mortality was 15.9%, and the adjusted mortality HR in patients with 1 and ≥ 2 cardiovascular or non-cardiovascular readmissions (versus none) was 1.96 (95% confidence interval (CI) 1.80–2.14) and 3.04 (95% CI, 2.51–3.68) respectively. Coexistent comorbidities, including ischaemic heart disease/myocardial infarction, peripheral arterial disease, pneumonia, chronic kidney disease, and anaemia, were independent predictors of both 30-day unplanned readmission and 1-year mortality.

Conclusion
Unplanned 30-day readmissions and medium-term mortality remain high among patients who survived to 30 days after incident HF hospitalisation. Any cardiovascular or non-cardiovascular readmission was associated with a two to three-fold higher adjusted HR for death over the following year, and various coexistent comorbidities were important associates of readmission and mortality risk. Our findings support the need to optimize multidisciplinary HF and multimorbidity management to potentially reduce repeat hospitalisation and improve survival.
Long term clinical outcome after success re-attempt percutaneous coronary intervention of chronic total occlusion
Authors: Li Wenzheng , Wu Zheng , Liu Tong , Wu Xiaofan , Liu Jinghua 
Published: January 2023

Abstract
Background
To evaluate the long-term outcome after re-attempt CTO-PCI.

Methods
This is a retrospective cohort study that included 113 re-attempt CTO-PCI patients who were consecutively registered from January 2019 to December 2020 at Beijing Anzhen Hospital's Center of Coronary Artery Disease. All patients were divided into two groups based on procedural success or failure. The primary endpoint was major adverse cardiac events (MACE), a composite of all-cause mortality, myocardial infarction and target vessel revascularization (TVR). The secondary endpoint was angina after PCI.

Results
Overall, the successful re-attempt CTO-PCI was archived in 77 patients, the failed CTO-PCI was performed in 36 patients. After a median follow-up of 21.7 months (interquartile range: 10.9–26.0), the incidence of the primary outcome was significantly lower in the success group [14.2% vs. 38.9%, adjusted hazard ratio (HR) 0.351, 95% CI 0.134–0.917, P = 0.033], mainly driven by the reduction of TVR (9.1% vs. 30.6%, adjusted HR 0.238, 95% CI: 0.078–0.72, P = 0.011). Furthermore, patients who had successful re-attempt CTO-PCI had a lower risk of angina after PCI (27.3% vs.61.1%, adjusted HR 0.357, 95% CI 0.167–0.76, P = 0.008). The risk factors of TVR in the patients with successful re-attempt CTO-PCI were stent length > 100 mm (adjusted HR 21.805, 95% CI 1.765–269.368, P = 0.016) and J-CTO score > 3(adjusted HR: 9.733, 95% CI:1.533–61.797, P = 0.016).

Conclusions
For the patients with previous CTO-PCI failure, a successful re-attempt CTO-PCI was associated with significantly lower MACE, which was primarily driven by a lower TVR rate. More complex CTO lesions and longer stents were the independent predictors of TVR after successful CTO-PCI.
Automated 4D flow cardiac MRI pipeline to derive peak mitral inflow diastolic velocities using short-axis cine stack: two centre validation study against echocardiographic pulse-wave doppler
Authors: Assadi Hosamadin , Li Rui , Grafton-Clarke Ciaran , Uthayachandran Bhalraam , Alabed Samer , Maiter Ahmed , Archer Gareth , Swoboda Peter P. , Sawh Chris , Ryding Alisdair , Nelthorpe Faye , Kasmai Bahman , Ricci Fabrizio , van der Geest Rob J. , Flather Marcus , Vassiliou Vassilios S. , Swift Andrew J. , Garg Pankaj 
Published: January 2023

Abstract
Background
Measurement of peak velocities is important in the evaluation of heart failure. This study compared the performance of automated 4D flow cardiac MRI (CMR) with traditional transthoracic Doppler echocardiography (TTE) for the measurement of mitral inflow peak diastolic velocities.

Methods
Patients with Doppler echocardiography and 4D flow cardiac magnetic resonance data were included retrospectively. An established automated technique was used to segment the left ventricular transvalvular flow using short-axis cine stack of images. Peak mitral E-wave and peak mitral A-wave velocities were automatically derived using in-plane velocity maps of transvalvular flow. Additionally, we checked the agreement between peak mitral E-wave velocity derived by 4D flow CMR and Doppler echocardiography in patients with sinus rhythm and atrial fibrillation (AF) separately.

Results
Forty-eight patients were included (median age 69 years, IQR 63 to 76; 46% female). Data were split into three groups according to heart rhythm. The median peak E-wave mitral inflow velocity by automated 4D flow CMR was comparable with Doppler echocardiography in all patients (0.90 ± 0.43 m/s vs 0.94 ± 0.48 m/s, P = 0.132), sinus rhythm-only group (0.88 ± 0.35 m/s vs 0.86 ± 0.38 m/s, P = 0.54) and in AF-only group (1.33 ± 0.56 m/s vs 1.18 ± 0.47 m/s, P = 0.06). Peak A-wave mitral inflow velocity results had no significant difference between Doppler TTE and automated 4D flow CMR (0.81 ± 0.44 m/s vs 0.81 ± 0.53 m/s, P = 0.09) in all patients and sinus rhythm-only groups. Automated 4D flow CMR showed a significant correlation with TTE for measurement of peak E-wave in all patients group (r = 0.73, P < 0.001) and peak A-wave velocities (r = 0.88, P < 0.001). Moreover, there was a significant correlation between automated 4D flow CMR and TTE for peak-E wave velocity in sinus rhythm-only patients (r = 0.68, P < 0.001) and AF-only patients (r = 0.81, P = 0.014). Excellent intra-and inter-observer variability was demonstrated for both parameters.

Conclusion
Automated dynamic peak mitral inflow diastolic velocity tracing using 4D flow CMR is comparable to Doppler echocardiography and has excellent repeatability for clinical use. However, 4D flow CMR can potentially underestimate peak velocity in patients with AF.
Grouped data with survey revision
Authors: Liang Chung-Han , Wang Da-Wei , Pan Mei-Lien 
Published: January 2023

Abstract
Introduction
Surveys are common research tools, and questionnaires revisions are a common occurrence in longitudinal studies. Revisions can, at times, introduce systematic shifts in measures of interest. We formulate that questionnaire revision are a stochastic process with transition matrices. Thus, revision shifts can be reduced by first estimating these transition matrices, which can be utilized in estimation of interested measures.

Materials and method
An ideal survey response model is defined by mapping between the true value of a participant’s response to an interval in the grouped data type scale. A population completed surveys multiple times, as modeled with multiple stochastic process. This included stochastic processes related to true values and intervals. While multiple factors contribute to changes in survey responses, here, we explored the method that can mitigate the effects of questionnaire revision. We proposed the Version Alignment Method (VAM), a data preprocessing tool, which can separate the transitions according to revisions from all transitions via solving an optimization problem and using the revision-related transitions to remove the revision effect. To verify VAM, we used simulation data to study the estimation error and a real life MJ dataset containing large amounts of long-term questionnaire responses with several questionnaire revisions to study its feasibility.

Result
We compared the difference of the annual average between consecutive years. Without adjustment, the difference is 0.593 when the revision occurred, while VAM brought it down to 0.115, where difference between years without revision was in the 0.005, 0.125 range. Furthermore, our method rendered the responses to the same set of intervals, thus comparing the relative frequency of items before and after revisions became possible. The average estimation error in L infinity was 0.0044 which occupied the 95% CI which was constructed by bootstrap analysis.

Conclusion
Questionnaire revisions can induce different response bias and information loss, thus causing inconsistencies in the estimated measures. Conventional methods can only partly remedy this issue. Our proposal, VAM, can estimate the aggregate difference of all revision-related systematic errors and can reduce the differences, thus reducing inconsistencies in the final estimations of longitudinal studies.
Intentional and actional components of engaged participation in public health research studies: qualitative synthesis of a recruitment and retention process into the theory-informed INTACT-RS framework
Authors: Lander Jonas , Heiberger Andrea , Von Sommoggy Julia , Schulz Anja Alexandra , Dresch Carolin , Altawil Hala , Schmitt Gwendolyn , Wirtz Markus Antonius 
Published: January 2023

Abstract
Background
Ensuring motivated and successful study participation is a key challenge in the design and conduct of health research studies. Previously, recruitment barriers and facilitators have been identified mainly from experience, and rarely based on theoretical approaches. We developed a framework of intentional and actional components of engaged participation in public health research studies (INTACT-RS), informed by psychological behavioral models. We aimed a) to identify precise indicators for each framework component and b) to better understand which components and decision processes are essential for study participants.

Methods
Within a multicenter research network, we applied various approaches to recruit parents of newborns, pediatricians, and midwives. All recruitment processes were documented from the perspective of both participants and researchers. We used different qualitative and quantitative data material, which we applied in a multistage process according to the basic principles of qualitative content analysis.

Results
INTACT-RS encompasses pre-intentional, intentional and actional phases with a total of n = 15 components covering all aspects of an individual’s involvement with a research study. During intention formation, an understanding of efforts and benefits, why participation is valuable beyond contributing to research, and how others perceive the study, were particularly important to (potential) participants. Subsequently (intentional phase), participants consider how and when participation is compatible with their own resources, ability and availability, and hence seek for close communication with, and flexibility and support from the research team. During and after (initial) participation (actional phase), participants’ assessment of whether expectations and interests have been met impact crucial further steps, especially the willingness to continue and to recommend participation to others. A strong topic-wise and or supportive participation interest as well as active, continuous exchange with the researchers appeared to be central determinants of study completion and data validity.

Conclusions
A theoretical framework is now available to plan and conduct recruitment of different target groups, which accounts for essential motivational and volitional decision-making processes. Based on empirically specified constructs, possible barriers can be addressed even before the initial recruitment process. Therefore, recommendations for scientific practice have been formulated.
Development of eConsult reflective learning tools for healthcare providers: a pragmatic mixed methods approach
Authors: Archibald Douglas , Grant Rachel , Tuot Delphine S. , Liddy Clare , Sewell Justin L. , Price David W. , Grad Roland , Shipman Scott A. , Campbell Craig , Guglani Sheena , Wood Timothy J. , Keely Erin 
Published: January 2023

Abstract
Background
Electronic consultation (eConsult) programs are crucial components of modern healthcare that facilitate communication between primary care providers (PCPs) and specialists. eConsults between PCPs and specialists. They also provide a unique opportunity to use real-world patient scenarios for reflective learning as part of professional development. However, tools that guide and document learning from eConsults are limited. The purpose of this study was to develop and pilot two eConsult reflective learning tools (RLTs), one for PCPs and one for specialists, for those participating in eConsults.

Methods
We performed a four-phase pragmatic mixed methods study recruiting PCPs and specialists from two public health systems located in two countries: eConsult BASE in Canada and San Francisco Health Network eConsult in the United States. In phase 1, subject matter experts developed preliminary RLTs for PCPs and specialists. During phase 2, a Delphi survey among 20 PCPs and 16 specialists led to consensus on items for each RLT. In phase 3, we conducted cognitive interviews with three PCPs and five specialists as they applied the RLTs on previously completed consults. In phase 4, we piloted the RLTs with eConsult users.

Results
The RLTs were perceived to elicit critical reflection among participants regarding their knowledge and practice habits and could be used for quality improvement and continuing professional development.

Conclusion
PCPs and specialists alike perceived that eConsult systems provided opportunities for self-directed learning wherein they were motivated to investigate topics further through the course of eConsult exchanges. We recommend the RLTs be subject to further evaluation through implementation studies at other sites.
Health-related quality of life and anxiety levels among patients under surveillance for intraductal papillary mucinous neoplasm
Authors: Nieminen Heini , Roine Risto , Ristimäki Ari , Lantto Eila , Välimaa Norma , Kirveskari Erika , Sintonen Harri , Haglund Caj , Seppänen Hanna 
Published: January 2023

Abstract
Background
Because of the premalignant nature of intraductal papillary mucinous neoplasms (IPMNs), patients should undergo surveillance as long as they remain fit for surgery. This surveillance, with imaging and laboratory tests every 6 to 12 months, is expensive and may psychologically burden patients. This study aimed to determine the effects of IPMN surveillance on patients´ health-related quality of life (HRQoL) and anxiety levels.

Methods
We included a random subgroup of all IPMN patients undergoing a follow-up check-up at Helsinki University Hospital (HUH) between August 2017 and November 2018. Patients were asked to complete the 15D HRQoL and state-trait anxiety inventory (STAI) questionnaires just before and three months after an IPMN control.

Results
Among 899 patients in IPMN follow-up, 232 participated. The 15D HRQoL results showed differences in some IPMN patients’ 15 analyzed dimensions compared to a sex- and age-standardized general population cohort, but the clinical relevance of these differences appear doubtful. We detected no significant difference in the anxiety levels determined using the STAI questionnaires before or three months after the IPMN control.

Conclusion
Surveillance should be less harmful than the risk of disease. Among our patients, the recommended IPMN follow-up carried minimal negative impact on patients’ HRQoL or anxiety levels. This result is important, because the number of patients under IPMN surveillance is rapidly increasing and the cancer risk among the majority of these patients remains small.
Trial registration: The Surgical Ethics Committee of Helsinki University Hospital approved this study (Dnro HUS 475/2017) and it was registered at ClinicalTrials.gov (NCT03131076) before patient enrollment began.
Examining the association between neuropsychiatric symptoms among people with dementia and caregiver mental health: are caregiver burden and affiliate stigma mediators?
Authors: Chen Yi-Jung , Su Jian-An , Chen Jung-Sheng , Liu Chieh-hsiu , Griffiths Mark D. , Tsai Hsin-Chi , Chang Chih-Cheng , Lin Chung-Ying 
Published: January 2023

Abstract
Background
Neuropsychiatric disturbances are common manifestations of dementia disorders and are associated with caregiver burden and affiliate stigma. The present study investigated affiliate stigma and caregiver burden as mediators for the association between neuropsychiatric symptoms of people with dementia (PWD) and caregiver mental health such as depression and anxiety.

Methods
A cross-sectional survey study was carried out with 261 dyads of PWD and informal caregivers from the outpatient department of a general hospital in Taiwan. The survey included the Caregiver Burden Inventory (CBI), the Affiliate Stigma Scale (ASS), the Taiwanese Depression Questionnaire (TPQ), and the Beck Anxiety Inventory (BAI). Mediation models were tested using the Hayes’ PROCESS macro (Model 4 for parallel mediation model; Model 6 for sequentially mediation model).

Results
Caregiver burden, affiliate stigma, caregiver depression, and caregiver anxiety were significantly associated with neuropsychiatric symptoms. After controlling for several potentially confounding variables, it was found that PWD’s neuropsychiatric symptoms, caregiver burden and affiliate stigma significantly explained 52.34% of the variance in caregiver depression and 37.72% of the variance in caregiver anxiety. The parallel mediation model indicated a significantly indirect path from PWD’s neuropsychiatric symptoms to caregiver mental health through caregiver burden and affiliate stigma, while the direct effect was not significant. Moreover, there was a directional association between caregiver burden and affiliate stigma in the sequential mediation model.

Conclusions
These findings show that it is imperative to improve caregivers’ perception of those with dementia to reduce internalized stigma and to improve caregivers’ mental health. Implementation of affiliate stigma assessment in clinical practice would allow distinctions to be made between the impact of affiliate stigma and the consequences of caregiver burden to help inform appropriate intervention.