bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of the COVID-19 pandemic on general health and malaria control in Ghana: a qualitative study with mothers and health care professionals
Authors: Heuschen Anna-Katharina , Abdul-Mumin Alhassan , Abubakari Abdulai , Agbozo Faith , Lu Guangyu , Jahn Albrecht , Müller Olaf 
Published: March 2023

Abstract
Background
COVID-19 has severely impacted health systems and the management of non-COVID-19 diseases, including malaria, globally. The pandemic has hit sub-Saharan Africa less than expected; even considering large underreporting, the direct COVID-19 burden was minor compared to the Global North. However, the indirect effects of the pandemic, e.g. on socio-economic inequality and health care systems, may have been more disruptive. Following a quantitative analysis from northern Ghana, which showed significant reductions in overall outpatient department visits and malaria cases during the first year of COVID-19, this qualitative study aims to provide further explanations to those quantitative findings.

Methods
In the Northern Region of Ghana, 72 participants, consisting of 18 health care professionals (HCPs) and 54 mothers of children under the age of five, were recruited in urban and rural districts. Data were collected using focus group discussions with mothers and through key informant interviews with HCPs.

Results
Three main themes occurred. The first theme—general effects of the pandemic—includes impacts on finances, food security, health service provision as well as education and hygiene. Many women lost their jobs, which increased their dependance on males, children had to drop out of school, and families had to cope with food shortages and were considering migration. HCPs had problems reaching the communities, suffered stigmatisation and were often barely protected against the virus. The second theme—effects on health-seeking—includes fear of infection, lack of COVID-19 testing capacities, and reduced access to clinics and treatment. The third theme—effects on malaria—includes disruptions of malaria preventive measures. Clinical discrimination between malaria and COVID-19 symptoms was difficult and HCPs observed increases in severe malaria cases in health facilities due to late reporting.

Conclusion
The COVID-19 pandemic has had large collateral impacts on mothers, children and HCPs. In addition to overall negative effects on families and communities, access to and quality of health services was severely impaired, including serious implications on malaria. This crisis has highlighted weaknesses of health care systems globally, including the malaria situation; a holistic analysis of the direct and indirect effects of this pandemic and an adapted strengthening of health care systems is essential to be prepared for the future.
The prognostic significance of duodenal wall invasion in pancreatic adenocarcinoma
Authors: Alkhasawneh Ahmad , Rashid Tasnuva , Mohammed Ibraheem , Elhaddad Basma , Al-Balas Hassan , Virarkar Mayur , Awad Ziad , Baskovich Brett , Gopinath Arun 
Published: March 2023

Abstract
Objective
The most recent edition of the American Joint Committee on Cancer Staging Manual (AJCC, 8th edition) relies only on tumor size for staging resectable pancreatic adenocarcinoma, and the presence of duodenal wall invasion (DWI) no longer has an impact on staging. However, very few studies have evaluated its significance. In this study, we aim to evaluate the prognostic significance of DWI in pancreatic adenocarcinoma.

Methods
We reviewed 97 consecutive internal cases of resected pancreatic head ductal adenocarcinoma, and clinicopathologic parameters were recorded. All cases were staged according to the 8th edition of AJCC, and the patients were divided into two groups based on the presence or absence of DWI.

Results
Out of our 97 cases, 53 patients had DWI (55%). In univariate analysis, DWI was significantly associated with lymphovascular invasion and lymph node metastasis (AJCC 8th edition pN stage). In univariate analysis of overall survival, age > 60, absence of DWI, and African American race were associated with worse overall survival. In multivariate analysis, age > 60, absence of DWI, and African American race were associated with worse progression-free survival and overall survival.

Conclusion
Although DWI is associated with lymph node metastasis, it is not associated with inferior disease-free/overall survival.
Laparoscopic D3 lymph node dissection with left colic artery and first sigmoid artery preservation in rectal cancer
Authors: Huang Xing , Xiao Zhigang , Huang Zhongcheng , Li Dan 
Published: March 2023

Abstract
Background
D3 lymph node dissection with left colic artery (LCA) preservation in rectal cancer surgery seems to have little effect on reducing postoperative anastomotic leakage. So we first propose D3 lymph node dissection with LCA and first sigmoid artery (SA) preservation. This novel procedure deserves further study.

Methods
Rectal cancer patients who underwent laparoscopic D3 lymph node dissection with LCA preservation or with LCA and first SA preservation between January 2017 and January 2020 were retrospectively assessed. The patients were categorized into two groups: the preservation of the LCA group and the preservation of the LCA and first SA group. A 1:1 propensity score-matched analysis was performed to decrease confounding.

Results
Propensity score matching yielded 56 patients in each group from the eligible patients. The rate of postoperative anastomotic leakage in the preservation of the LCA and first SA group was significantly lower than that in the LCA preservation group (7.1% vs. 0%, P=0.040). No significant differences were observed in operation time, length of hospital stay, estimated blood loss, length of distal margin, lymph node retrieval, apical lymph node retrieval, and complications. A survival analysis showed patients’ 3-year disease-free survival (DFS) rates of group 1 and group 2 were 81.8% and 83.5% (P=0.595), respectively.

Conclusion
D3 lymph node dissection with LCA and first SA preservation for rectal cancer may help reduce the incidence of anastomotic leakage without compromising oncological outcomes compare with D3 lymph node dissection with LCA preservation alone.
Lactation duration and lifetime progression to metabolic syndrome in women according to their history of gestational diabetes: a prospective longitudinal community-based cohort study
Authors: Farahmand Maryam , Rahmati Maryam , Azizi Fereidoun , Ramezani Tehrani Fahimeh 
Published: March 2023

Abstract
Background
Despite the many signs of progress in pharmacotherapies, metabolic syndrome (MetS) is one of the main public-health burdens worldwide. Our study aimed to compare the effect of breastfeeding (BF) in women with and without gestational diabetes mellitus (GDM) on MetS incidence.

Methods
Of females who participated in the Tehran Lipid and glucose study, women who met our inclusion criteria were selected. The Cox proportional hazards regression model, with adjustment of potential confounders, was done to evaluate the relationship between duration of BF and incident of MetS in women with a GDM history compared to non-GDM.

Results
Out of 1176 women, there were 1001 non-GDM and 175 GDM. The median follow-up was 16.3 (11.9, 19.3) years. Results of the adjusted model illustrated that the total BF duration was negatively associated with MetS incidence risk (hazard ratio (HR) 0.98, 95% CI 0.98–0.99) in total participants indicating that per one-month increase of BF duration, the hazard of MetS reduced by 2%. The HR of MetS in Comparison between GDM and non-GDM women demonstrated significantly more reduced MetS incidence with a longer duration of exclusive BF (HR 0.93, 95% CI 0.88–0.98).

Conclusions
Our findings illustrated the protective effect of BF, especially exclusive BF, on MetS incidence risk. BF is more effective in reducing the risk of MetS among women with a history of GDM than among women without such a history.
Antioxidant activities in relation to the transport of heavy metals from the soil to different parts of Betula pendula (Roth.)
Authors: Makuch-Pietraś Iwona , Grabek-Lejko Dorota , Górka Anna , Kasprzyk Idalia 
Published: March 2023

Abstract
Background
Birch is a tree with a common occurrence in the environment and its organs are used in the form of herbal material. An important aspect of this study is birch pollen, which is a problem for allergy sufferers, and due to a variety of environmental conditions, its allergenicity may increase. Among the organs studied, inflorescences deserve attention, which, as seen from an overview of the literature, are analysed for the content of heavy metals for the first time in this study.

Results
This paper investigated the relationship between antioxidant properties and the content of heavy metals (Cu, Zn, Cd, Pb, Ni and Cr) as the plant's response to stress, taking into account both the vegetative and generative organs of the tree Betula pendula. While studying the accumulation of elements in individual organs, the research was extended to include the aspect of different environmental conditions, reflected in two soil types of differing physicochemical properties: sandy and silty soils. In order to thoroughly analyse the transport of the studied heavy metals from the soil to individual organs (leaves, inflorescences and pollen), ecotoxicological indicators were used. A modified translocation factor (TF) index into sTF (sap translocation factor) was presented as a novelty in research, calculated based on the content of selected heavy metals in the sap flowing to individual birch organs. This allowed for a more complete description of the transport of elements in the aerial parts of plants, indicating the accumulation of zinc and cadmium, especially in leaves. Among the studied environmental conditions which may affect the accumulation of heavy metals, sandy soil is of particular significance, conditioning lower pH values, among other things. However, analysis of the reaction of birch to the conditions of the soil environment and the content of heavy metals, based on antioxidant properties, demonstrated an evident reaction to stress, but without an unambiguous response among the studied vegetative and generative organs.

Conclusions
As birch is a plant with wide utility values, monitoring studies are advisable to exclude the risk of accumulation of heavy metals in its organs, and for this purpose it may be useful to use the sTF indicator and assess the antioxidant potential.
Laser capture microdissection as a method for investigating the human hair follicle microbiome reveals region-specific differences in the bacteriome profile
Authors: Lousada Marta B. , Edelkamp J , Lachnit T , Fehrholz M , Jimenez F , Paus R 
Published: March 2023

Abstract
Objective
Human hair follicles (HFs) are populated by a rich and diverse microbiome, traditionally evaluated by methods that inadvertently sample the skin microbiome and/or miss microbiota located in deeper HF regions. Thereby, these methods capture the human HF microbiome in a skewed and incomplete manner. This pilot study aimed to use laser-capture microdissection of human scalp HFs, coupled with 16S rRNA gene sequencing to sample the HF microbiome and overcome these methodological limitations.

Results
HFs were laser-capture microdissected (LCM) into three anatomically distinct regions. All main known core HF bacterial colonisers, including Cutibacterium, Corynebacterium and Staphylococcus, were identified, in all three HF regions. Interestingly, region-specific variations in α-diversity and microbial abundance of the core microbiome genera and Reyranella were identified, suggestive of variations in microbiologically relevant microenvironment characteristics. This pilot study therefore shows that LCM-coupled with metagenomics is a powerful tool for analysing the microbiome of defined biological niches. Refining and complementing this method with broader metagenomic techniques will facilitate the mapping of dysbiotic events associated with HF diseases and targeted therapeutic interventions.
Rationale for the selection of dual primary endpoints in prevention studies of cognitively unimpaired individuals at genetic risk for developing symptoms of Alzheimer’s disease
Authors: Caputo Angelika , Racine Amy , Paule Ines , Tariot Pierre N. , Langbaum Jessica B. , Coello Neva , Riviere Marie-Emmanuelle , Ryan J. Michael , Lopez Cristina Lopez , Graf Ana ,   for the National Alzheimer’s Coordinating Center,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: March 2023

Abstract
Background
There is a critical need for novel primary endpoints designed to detect early and subtle changes in cognition in clinical trials targeting the asymptomatic (preclinical) phase of Alzheimer’s disease (AD). The Alzheimer’s Prevention Initiative (API) Generation Program, conducted in cognitively unimpaired individuals at risk of developing AD (e.g., enriched by the apolipoprotein E (APOE) genotype), used a novel dual primary endpoints approach, whereby demonstration of treatment effect in one of the two endpoints is sufficient for trial success. The two primary endpoints were (1) time to event (TTE)—with an event defined as a diagnosis of mild cognitive impairment (MCI) due to AD and/or dementia due to AD—and (2) change from baseline to month 60 in the API Preclinical Composite Cognitive (APCC) test score.

Methods
Historical observational data from three sources were used to fit models to describe the TTE and the longitudinal APCC decline, both in people who do and do not progress to MCI or dementia due to AD. Clinical endpoints were simulated based on the TTE and APCC models to assess the performance of the dual endpoints versus each of the two single endpoints, with the selected treatment effect ranging from a hazard ratio (HR) of 0.60 (40% risk reduction) to 1 (no effect).

Results
A Weibull model was selected for TTE, and power and linear models were selected to describe the APCC score for progressors and non-progressors, respectively. Derived effect sizes in terms of reduction of the APCC change from baseline to year 5 were low (0.186 for HR = 0.67). The power for the APCC alone was consistently lower compared to the power of TTE alone (58% [APCC] vs 84% [TTE] for HR = 0.67). Also, the overall power was higher for the 80%/20% distribution (82%) of the family-wise type 1 error rate (alpha) between TTE and APCC compared to 20%/80% (74%).

Conclusions
Dual endpoints including TTE and a measure of cognitive decline perform better than the cognitive decline measure as a single primary endpoint in a cognitively unimpaired population at risk of AD (based on the APOE genotype). Clinical trials in this population, however, need to be large, include older age, and have a long follow-up period of at least 5 years to be able to detect treatment effects.
Asthma occurrence in children and early life systemic antibiotic use: an incidence density study
Authors: Bentouhami Hayat , Bungwa Milcah Kahkelam , Casas Lidia , Coenen Samuel , Weyler Joost 
Published: March 2023

Abstract
Background
Results of studies evaluating the relationship between asthma occurrence and early life antibiotic use have been conflicting. The aim of this study was to investigate the relationship between occurrence of asthma in children and systemic antibiotic use in the first year of life based on an incidence density study with careful consideration of the temporal aspects of the determinant-outcome relationship.

Methods
We conducted an incidence density study nested in a data collection project with information on 1128 mother–child pairs. Systemic antibiotic use in the first year of life was defined as excessive (≥ 4 courses) vs. non-excessive (< 4 courses) use based on information from weekly diaries. Events (cases) were defined as the first parent-reported occurrence of asthma in a child between 1 and 10 years of age. Population time ‘at risk’ was probed by sampling population moments (controls). Missing data were imputed. Multiple logistic regression was used to assess the association between current first asthma occurrence (incidence density) and systemic antibiotic use in the first year of life, to evaluate effect modification and adjust for confounding.

Results
Forty-seven first asthma events and 147 population moments were included. Excessive systemic antibiotic use in the first year of life showed more than twice the incidence density of asthma compared to non-excessive use (adjusted IDR [95% CI]: 2.18 [0.98, 4.87], p = 0.06). The association was more pronounced in children who have had lower respiratory tract infections (LRTIs) in the first year of life compared to children who had no LRTIs in the first year of life (adjusted IDR [95% CI]: 5.17 [1.19, 22.52] versus 1.49 [0.54, 4.14]).

Conclusions
Excessive use of systemic antibiotics in the first year of life may play a role in the genesis of asthma in children. This effect is modified by the occurrence of LRTIs in the first year of life, with a stronger association observed in children experiencing LRTIs in the first year of life.
Going dark? Analysing the impact of end-to-end encryption on the outcome of Dutch criminal court cases
Authors: Hartel Pieter , van Wegberg Rolf 
Published: March 2023

AbstractLaw enforcement agencies struggle with criminals using end-to-end encryption (E2EE). A recent policy paper states: “while encryption is vital and privacy and cyber security must be protected, that should not come at the expense of wholly precluding law enforcement”. The main argument is that E2EE hampers attribution and prosecution of criminals who rely on encrypted communication - ranging from drug syndicates to child sexual abuse material (CSAM) platforms. This statement - in policy circles dubbed ‘going dark’ - is not yet supported by empirical evidence. That is why, in our work, we analyse public court data from the Netherlands to show to what extent law enforcement agencies and the public prosecution service are impacted by the use of E2EE in bringing cases to court and their outcome. Our results show that in cases brought to court, the Dutch courts appear to be as successful in convicting offenders who rely on E2EE as those who do not. Our data do not permit us to draw conclusions on the effect of E2EE on criminal investigations.
Characterization of bone marrow heterogeneity in NK-AML (M4/M5) based on single-cell RNA sequencing
Authors: Wu Wenqi , Shi Zeyan , Tang Zhongyuan , Li Huiqun , Huang Xiaoke , Liang Xiaolin , Li Jing , Yao Yibin , Zhao Weihua , Wu Meiqing , Luo Jun , Liu Zhenfang 
Published: March 2023

AbstractNormal karyotype acute myeloid leukemia (NK-AML) is a heterogeneous hematological malignancy that contains a minor population of self-renewing leukemia stem cells (LSCs), which complicate efforts to achieve long-term survival. We performed single-cell RNA sequencing to profile 39,288 cells from 6 bone marrow (BM) aspirates including 5 NK-AML (M4/M5) patients and 1 healthy donor. The single-cell transcriptome atlas and gene expression characteristics of each cell population in NK-AML (M4/M5) and healthy BM were obtained. In addition, we identified a distinct LSC-like cluster with possible biomarkers in NK-AML (M4/M5) and verified 6 genes using qRT‒PCR and bioinformatic analyses. In conclusion, we utilized single-cell technologies to provide an atlas of NK-AML (M4/M5) cell heterogeneity, composition, and biomarkers with implications for precision medicine and targeted therapies.
Exploring female otolaryngologists’ experiences with gender bias and microaggressions: A cross sectional Canadian survey
Authors: Hu Amanda C. , Nguyen Kelly , Meyer Tanya K. 
Published: March 2023

Background Gender bias is behavior that shows favoritism towards one gender over another. Microaggressions are defined as subtle, often unconscious, discriminatory, or insulting actions that communicate demeaning or negative attitudes. Our objective was to explore how female otolaryngologists experience gender bias and microaggressions in the workplace. Methods Anonymous web-based cross-sectional Canadian survey was distributed to all female otolaryngologists (attendings and trainees) using the Dillman's Tailored Design Method from July to August of 2021. Quantitative survey included demographic data, validated 44-item Sexist Microaggressions Experiences and Stress Scale (MESS) and validated 10-item General Self-efficacy scale (GSES). Statistical analysis included descriptive and bivariate analysis. Results Sixty out of 200 participants (30% response rate) completed the survey (mean age 37 ± 8.3 years, 55.0% white, 41.7% trainee, 50% fellowship-trained, 50% with children, mean 9.2 ± 7.4 years of practice). Participants scored mild to moderate on the Sexist MESS—Frequency (mean ± standard deviation) 55.8 ± 24.2 (42.3% ± 18.3%), Severity 46.0 ± 23.9 (34.8% ± 18.1%), Total 104.5 ± 43.7 (39.6% ± 16.6%) and high on GSES (32.7 ± 5.7). Sexist MESS score was not associated with age, ethnicity, fellowship-training, having children, years of practice, or GSES. In the sexual objectification domain, trainees had higher frequency (p = 0.04), severity (p = 0.02) and total MESS (p = 0.02) scores than attendings. Conclusions This was the first multicenter, Canada-wide study exploring how female otolaryngologists experience gender bias and microaggressions in the workplace. Female otolaryngologists experience mild to moderate gender bias, but have high self-efficacy to manage this issue. Trainees had more severe and frequent microaggressions than attendings in the sexual objectification domain. Future efforts should help develop strategies for all otolaryngologists to manage these experiences, and thereby improve the culture of inclusiveness and diversity in our specialty. Graphical Abstract
Climate-relevant properties of black carbon aerosols revealed by in situ measurements: a review
Authors: Moteki Nobuhiro 
Published: March 2023

AbstractLight-absorbing aerosols affect atmospheric radiation, dynamics, and precipitations through shortwave absorption in the atmosphere and snowpack. Black carbon (BC) is considered the most significant contributor to global shortwave absorption among all the known light-absorbing aerosol components. In analyses and predictions of BC’s lifecycle and climate effects, multiscale field observations are needed to test the fundamental assumptions in the climate model. In situ measurements, the focus of this review, fill the gap of observational information accessible from remote sensing and laboratory analyses. This article reviews historical backgrounds, recent advances in in situ measurements of BC, and the resulting observational findings used to update the assumptions in climate models and remote sensing. Finally, we raise open problems that demand a rethinking and future investigation.Illustrating the physical principle of detecting the light-absorbing black carbon and iron oxides
aerosol particles using the single-particle laser-induced incandescence