bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beliefs around help-Seeking and Support for Dementia in the Australian Arabic Speaking Community
Authors: Allam Issra , Gresham Meredith , Phillipson Lyn , Brodaty Henry , Low Lee-Fay 
Published: March 2023

Background The number of people with dementia in multicultural Australia is rapidly increasing. Despite its culturally diverse population, there is limited research about how people from ethnic minority groups understand and approach help-seeking and support for dementia. The aim of this study is to understand the perceptions of dementia symptoms, help-seeking and support in the Australian Arabic-speaking community. Methods This study used a cross-sectional qualitative research design. Individual, semi-structured interviews using projective stimulus techniques were used. Participants were three Arabic-speaking people aged over 70 who were experiencing cognitive changes or dementia symptoms, six carers, and five health or social care practitioners experienced in working with Arab-Australians. Phone or video chat interviews were conducted in either Arabic or English. Interviews were audiotaped, translated when needed, transcribed verbatim and inductive thematic analysis was undertaken. Findings Seven themes were identified. Participants described dementia as relating to symptoms of confusion and memory loss. Carers and older people believe that when older people are experiencing these cognitive symptoms, they must be cared for primarily by ensuring their happiness and comfort. Barriers to help-seeking and support included a lack of help-seeking due to cultural norms of family orientated care, families are unsure of where to seek help and fear of community judgement. Two ways to facilitate help-seeking and support were to build trust through culturally appropriate support and to educate the community. Conclusion Family, trust and community were identified as central pillars of the Australian-Arabic-speaking community. There is a need to increase dementia literacy in this community particularly around help-seeking and decreasing stigma. Education should be promoted by trusted community members and religious leaders. As the first point of professional contact, general practitioners need to be upskilled to support Arabic-speaking Australians around dementia.
Clinical Validation and Treatment Plan Evaluation Based on Autodelineation of the Clinical Target Volume for Prostate Cancer Radiotherapy
Authors: Shen Jing , Tao Yinjie , Guan Hui , Zhen Hongnan , He Lei , Dong Tingting , Wang Shaobin , Chen Yu , Chen Qi , Liu Zhikai , Zhang Fuquan 
Published: March 2023

Purpose Clinical target volumes (CTVs) and organs at risk (OARs) could be autocontoured to save workload. This study aimed to assess a convolutional neural network for automatic and accurate CTV and OARs in prostate cancer, while comparing possible treatment plans based on autocontouring CTV to clinical treatment plans. Methods Computer tomography (CT) scans of 217 patients with locally advanced prostate cancer treated at our hospital were retrospectively collected and analyzed from January 2013 to January 2019. A deep learning-based method, CUNet, was used to delineate CTV and OARs. A training set of 195 CT scans and a test set of 28 CT scans were randomly chosen from the dataset. The mean Dice similarity coefficient (DSC), 95th percentile Hausdorff distance (95HD), and subjective evaluation were used to evaluate the performance of this strategy. Predetermined evaluation criteria were used to grade treatment plans, and percentage errors for clinical doses to the planned target volume (PTV) and OARs were calculated. Results The mean DSC and 95HD values of the defined CTVs were (0.84 ± 0.05) and (5.04 ± 2.15) mm, respectively. The average delineation time was < 15 s for each patient's CT scan. The overall positive rates for clinicians A and B were 53.15% versus 46.85%, and 54.05% versus 45.95%, respectively ( P > .05) when CTV outlines from CUNet were blindly chosen and compared with the ground truth (GT). Furthermore, 8 test patients were randomly chosen to design the predicted plan based on the autocontouring CTVs and OARs, demonstrating acceptable agreement with the clinical plan: average absolute dose differences in mean value of D2, D50, D98, Dmax, and Dmean for PTV were within 0.74%, and average absolute volume differences in mean value of V45 and V50 for OARs were within 3.4%. Conclusion Our results revealed that the CTVs and OARs for prostate cancer defined by CUNet were close to the GT. CUNet could halve the time spent by radiation oncologists in contouring, demonstrating the potential of the novel autocontouring method.
Endovascular Strategy for Inferior Vena Cava Thrombosis Secondary to Deep Venous Thrombosis of the Lower Extremities: Early Experience From Two Centres
Authors: Wang Yue , Gu Jingxiao , Lu Liu , Yang Yadan , Zhang Wenwen , Huang Chen 
Published: March 2023

Purpose To evaluate the safety, feasibility and technical aspects of endovascular treatments for inferior vena cava (IVC) thrombosis secondary to deep venous thrombosis of the lower extremities. Materials and Methods A retrospective study of patients from two centres who received endovascular treatment for IVC thrombosis from January 2015 to December 2020. Under the protection of the IVC filter, all lesions were treated with manual aspiration thrombectomy (MAT) followed by catheter-directed thrombolysis (CDT). Technical aspects, complications, IVC patency, Venous Clinical Severity Score (VCSS) score and Villalta score were recorded during the follow-up observation. Results Endovascular procedures including MAT and CDT were performed successfully in 36 patients (97.3%). The average duration of the endovascular procedure was 71 minutes (range: 35-152 min). To protect against fatal pulmonary artery embolism, 33 filters (91.7%) were deployed in the inferior renal IVC, while three patients (8.3%) received filter implantation in the retrohepatic IVC. No severe complications occurred during the procedure. In the follow-up observations, the cumulative primary and secondary patency rates in IVC were 95% and 100%, respectively. The patency rates for the iliac vein were as follows: a primary patency rate of 77% and a secondary patency rate of 85%. The average VCSS score was 5.9 ± 2.6, and the Villalta score was 3.9 ± 2.2. The rate of post thrombotic syndrome is 22% in our study as assessed by the villalta score (Villalta score>4). Conclusions Endovascular treatment for IVC thrombosis secondary to DVT of the lower extremities is feasible, safe, and effective. This strategy alleviates venous insufficiency and results in a high patency rate in IVC.
Impact of Reverse Septal Flap on Morbidity of Nasoseptal Flap Reconstruction of Skull Base Defects
Authors: Strober William A , Valappil Benita , Snyderman Carl H 
Published: March 2023

Background The workhorse for endonasal reconstruction of skull base defects is the posteriorly-based nasoseptal flap (NSF). Postoperative nasal deformities and decreased olfaction are potential complications of NSF. The reverse septal flap (RSF) minimizes the donor site morbidity of the NSF by covering the exposed cartilage of the anterior septum. Currently, there are minimal data examining its effect on outcomes including nasal dorsum collapse and olfaction. Objective Our study aims to clarify whether the RSF should be utilized when the option exists. Methods Adult patients undergoing endoscopic endonasal approach (EEA) surgery of the skull base (transsellar/transplanum/transclival approaches) with NSF reconstruction were identified. Data from 2 separate cohorts, one retrospective and one prospective, were collected. Follow-up was at least 6 months. Patients were photographed preoperatively and postoperatively using standard rhinoplastic nasal views. Patients completed the University of Pennsylvania Smell Identification Test (UPSIT) and the 22-item Sino-Nasal Outcome Test (SNOT-22) preoperatively and postoperatively and were also queried regarding subjective changes in nasal appearance and plans for cosmetic surgery following EEA. Results There were no statistically significant differences in the change in UPSIT and SNOT-22 scores between patients receiving RSF and other reconstructive groups (either NSF without RSF or no NSF). One of 25 patients who were reconstructed with an NSF with RSF reported a change in nasal appearance; none were considering reconstructive surgery. The proportion of patients reporting changes in appearance was significantly lower in the NSF with RSF group as compared to the NSF without RSF group ( P = .012). Conclusion The use of an RSF to limit donor site morbidity of the NSF was shown to significantly decrease the proportion of patients who reported nasal deformities and did not show a significant difference in patient-reported sinonasal outcomes. Given these findings, RSF should be considered whenever an NSF is used for reconstruction.
iDHU-Ensem: Identification of dihydrouridine sites through ensemble learning models
Authors: Suleman Muhammad Taseer , Alturise Fahad , Alkhalifah Tamim , Khan Yaser Daanial 
Published: March 2023

Background Dihydrouridine (D) is one of the most significant uridine modifications that have a prominent occurrence in eukaryotes. The folding and conformational flexibility of transfer RNA (tRNA) can be attained through this modification. Objective The modification also triggers lung cancer in humans. The identification of D sites was carried out through conventional laboratory methods; however, those were costly and time-consuming. The readiness of RNA sequences helps in the identification of D sites through computationally intelligent models. However, the most challenging part is turning these biological sequences into distinct vectors. Methods The current research proposed novel feature extraction mechanisms and the identification of D sites in tRNA sequences using ensemble models. The ensemble models were then subjected to evaluation using k-fold cross-validation and independent testing. Results The results revealed that the stacking ensemble model outperformed all the ensemble models by revealing 0.98 accuracy, 0.98 specificity, 0.97 sensitivity, and 0.92 Matthews Correlation Coefficient. The proposed model, iDHU-Ensem, was also compared with pre-existing predictors using an independent test. The accuracy scores have shown that the proposed model in this research study performed better than the available predictors. Conclusion The current research contributed towards the enhancement of D site identification capabilities through computationally intelligent methods. A web-based server, iDHU-Ensem, was also made available for the researchers at https://taseersuleman-idhu-ensem-idhu-ensem.streamlit.app/ .
The Missing Gender: Examining the Barriers to Women’s Participation in Sports in India
Authors: Das Debashree , Kumar Patanjal , Dixit Aasheesh , Vivek  
Published: March 2023

The advent of modernity has changed the sports landscape of the world, wherein all barriers, especially gender discrimination, have been broken, with men and women competing shoulder to shoulder in the sports arena. However, the sports landscape in India is completely different, as all the major sports activities are dominated by men. The aim of this study is to classify and rank the barriers that deter women’s participation in sports in India. For achieving this objective, a multi-criteria decision-making technique of Interpretive Structural Modelling (ISM) and MICMAC analysis has been used for relative ranking and classification of barriers that lead to gender discrimination in sports in India. The study encapsulates significant barriers that hinder women from actively participating in sports in India. The findings of our study suggest that economic barriers, lack of sporting infrastructure and culture, lack of potential career opportunities, knowledge barriers, and socio-cultural barriers are vital reasons that have implications for limiting women’s participation in sports and society alike. From a policy perspective, the proposed model will help identify the key barriers that ought to be addressed to bridge the gap between men and women in the sports sector in India.
Effect of proximal blood flow arrest during endovascular thrombectomy (ProFATE): Study protocol for a multicentre randomised controlled trial
Authors: Dhillon Permesh Singh , Butt Waleed , Podlasek Anna , Bhogal Pervinder , McConachie Norman , Lenthall Robert , Nair Sujit , Malik Luqman , Lynch Jeremy , Goddard Tony , Barrett Emma , Krishnan Kailash , Dineen Robert A , England Timothy J 
Published: March 2023

Background: Observational studies have demonstrated improved outcomes with the adjunctive use of balloon guide catheters (BGC) during endovascular thrombectomy (EVT) for anterior circulation acute ischaemic stroke (AIS). However, the lack of high-level evidence and global practice heterogeneity justifies a randomised controlled trial (RCT) to investigate the effect of transient proximal blood flow arrest on the procedural and clinical outcomes of patients with AIS following EVT. Hypothesis: Proximal blood flow arrest in the cervical internal carotid artery during EVT for proximal large vessel occlusion is superior to no flow arrest in achieving complete vessel recanalisation. Methods: ProFATE is an investigator-initiated, pragmatic, multicentre RCT with blinding of participants and outcome assessment. An estimated 124 participants with an anterior circulation AIS due to large vessel occlusion, an NIHSS of ⩾2, ASPECTS ⩾ 5 and eligible for EVT using a first-line combined technique (contact aspiration and stent retriever) or contact aspiration only will be randomised (1:1) to receive BGC balloon inflation or no inflation during EVT. Outcomes: The primary outcome is the proportion of patients achieving near-complete/complete vessel recanalisation (eTICI 2c-3) at the end of the EVT procedure. Secondary outcomes include the functional outcome (modified Rankin Scale at 90 days), new or distal vascular territory clot embolisation rate, near-complete/complete recanalisation after the first pass, symptomatic intracranial haemorrhage, procedure-related complications and death at 90 days. Discussion: This is the first RCT to investigate the effect of proximal blood flow arrest during EVT using a BGC on the procedural and clinical outcomes of patients with AIS due to large vessel occlusion.
Benefits of integrating palliative care: a qualitative exploration of the perspectives of palliative care providers in a tertiary health facility in Ghana
Authors: Okyere Joshua , Kissah-Korsah Kwaku 
Published: March 2023

Background: Integration of palliative care (PC) services entails combining administrative, organisational, clinical and service elements to ensure continuity of care between all parties participating in the care network of patients. There is a need to understand the benefits of integrating PC to inform policy making and advance advocacy, especially in resource-constrained settings such as Ghana where PC is sub-optimally implemented. Yet, existing research in Ghana is sparse on what benefits are likely to be experienced as a result of integrating PC. Objective: The study explored service providers’ perspectives on the benefits of integrating PC in Ghana. Design: The design was an exploratory descriptive qualitative research design. Methods: A total of seven in-depth interviews were conducted using semi-structured interview guides. The data were managed using NVivo-12. Inductive thematic analysis was carried out following Haase’s modification of Colaizzi’s approach to qualitative research analysis. The study follows the COREQ guidelines and the ICMJE recommendations. Result: Two main themes emerged: patient-related outcomes, and system/institution-related outcomes. For the patient-related outcomes, the following sub-themes emerged: restored hope, appreciated care and better preparation for the end of life (EoL). The emerging sub-themes under the system/institution-related outcomes include the following: early initiation of care, enhanced communication between primary healthcare providers and the PC team and strengthening staff capacity to provide PC services. Conclusion: In conclusion, there are substantial benefits to be experienced from integrating PC. For the patients, it would restore shattered hopes, result in appreciated care and better preparation for the EoL. For the healthcare system, it would promote early initiation of care, enhance communication between primary healthcare providers and the PC team and strengthen service providers’ capacity to provide PC services. This study, thus, furthers the case for a more integrated PC service in Ghana.
Genome-wide identification and expression analysis of DREB family genes in cotton
Authors: Su Jiuchang , Song Shanglin , Wang Yiting , Zeng Yunpeng , Dong Tianyu , Ge Xiaoyang , Duan Hongying 
Published: March 2023

Abstract
Background
Dehydration responsive element-binding (DREB) transcription factors are widely present in plants, and involve in signalling transduction, plant growth and development, and stress response. DREB genes have been characterized in multiple species. However, only a few DREB genes have been studied in cotton, one of the most important fibre crops. Herein, the genome‑wide identification, phylogeny, and expression analysis of DREB family genes are performed in diploid and tetraploid cotton species.

Results
In total, 193, 183, 80, and 79 putative genes containing the AP2 domain were identified using bioinformatics approaches in G. barbadense, G. hirsutum, G. arboretum, and G. raimondii, respectively. Phylogenetic analysis showed that based on the categorization of Arabidopsis DREB genes, 535 DREB genes were divided into six subgroups (A1–A6) by using MEGA 7.0. The identified DREB genes were distributed unevenly across 13/26 chromosomes of A and/or D genomes. Synteny and collinearity analysis confirmed that during the evolution, the whole genome duplications, segmental duplications, and/or tandem duplications occurred in cotton DREB genes, and then DREB gene family was further expanded. Further, the evolutionary trees with conserved motifs, cis-acting elements, and gene structure of cotton DREB gene family were predicted, and these results suggested that DREB genes might be involved in the hormone and abiotic stresses responses. The subcellular localization showed that in four cotton species, DREB proteins were predominantly located in the nucleus. Further, the analysis of DREB gene expression was carried out by real-time quantitative PCR, confirming that the identified DREB genes of cotton were involved in response to early salinity and osmotic stress.

Conclusions
Collectively, our results presented a comprehensive and systematic understanding in the evolution of cotton DREB genes, and demonstrated the potential roles of DREB family genes in stress and hormone response.
Impact of non-pharmaceutical interventions, weather, vaccination, and variants on COVID-19 transmission across departments in France
Authors: Paireau Juliette , Charpignon Marie-Laure , Larrieu Sophie , Calba Clémentine , Hozé Nathanaël , Boëlle Pierre-Yves , Thiebaut Rodolphe , Prague Mélanie , Cauchemez Simon 
Published: March 2023

Abstract
Background
Multiple factors shape the temporal dynamics of the COVID-19 pandemic. Quantifying their relative contributions is key to guide future control strategies. Our objective was to disentangle the individual effects of non-pharmaceutical interventions (NPIs), weather, vaccination, and variants of concern (VOC) on local SARS-CoV-2 transmission.

Methods
We developed a log-linear model for the weekly reproduction number (R) of hospital admissions in 92 French metropolitan departments. We leveraged (i) the homogeneity in data collection and NPI definitions across departments, (ii) the spatial heterogeneity in the timing of NPIs, and (iii) an extensive observation period (14 months) covering different weather conditions, VOC proportions, and vaccine coverage levels.

Findings
Three lockdowns reduced R by 72.7% (95% CI 71.3–74.1), 70.4% (69.2–71.6) and 60.7% (56.4–64.5), respectively. Curfews implemented at 6/7 pm and 8/9 pm reduced R by 34.3% (27.9–40.2) and 18.9% (12.04–25.3), respectively. School closures reduced R by only 4.9% (2.0–7.8). We estimated that vaccination of the entire population would have reduced R by 71.7% (56.4–81.6), whereas the emergence of VOC (mainly Alpha during the study period) increased transmission by 44.6% (36.1–53.6) compared with the historical variant. Winter weather conditions (lower temperature and absolute humidity) increased R by 42.2% (37.3–47.3) compared to summer weather conditions. Additionally, we explored counterfactual scenarios (absence of VOC or vaccination) to assess their impact on hospital admissions.

Interpretation
Our study demonstrates the strong effectiveness of NPIs and vaccination and quantifies the role of weather while adjusting for other confounders. It highlights the importance of retrospective evaluation of interventions to inform future decision-making.
Genetic diversity of the human immunodeficiency virus of type 1 in Gabonese transfusional settings
Authors: Mangala Christian , Fokam Joseph , Maulot-Bangola Denis , Rebienot-Pellegrin Olivier , Nkoa Thérèse 
Published: March 2023

Abstract
Background
The high endemicity of transfusion-transmissible infections (TTIs) in sub-Saharan Africa is a real public health problem. To reduce the risk of HIV transmission through blood donation, the NBTC of Gabon has launched in recent years a reorganization of its blood transfusion system. This study aims to characterize the molecular strains of HIV-1 circulating in donors and to estimate the risk of viral transmission.

Materials and methods
A cross-sectional study was carried out during the period from August 2020 to August 2021 among 381 donors who had agreed to donate blood at the National Blood Transfusion Center (NBTC). Viral load was determined by Abbott Real-Time (Abbott m2000®, Abbott) and sequencing by the Sanger method (ABI 3500 Hitachi®). The phylogenetic tree was constructed by MEGA X software. Data were checked, entered, and analyzed using SPSS version 21.0 software, with p ≤ 0.05 considered statistically significant.

Results
A total of 381 donors were enrolled in the study. Among the 359 seronegative donors, five (5) seronegative donors were detected positive for HIV-1 using Real-Time PCR. The residual risk was 648 per 1,000,000 donations. The prevalence of residual infection was 1.4% [0,01; 0,03]. Sixteen (16) samples were sequenced. The strains obtained were CRF02_AG (50%), subtype A1 (18.8%), subtype G (12.5%), CRF45_cpx (12.5%) and subtype F2 (6.2%). Six sequences clustered with A1, G, CRF02_AG, and CRF45_cpx subtypes.

Conclusion
The residual risk of HIV-1 transmission by blood transfusion remains a concern in the Gabonese transfusional settings. A policy based on improving the current screening strategy would involve the implementation of the nucleic acid test (NAT) in order to optimize the safety of the donation by detecting the HIV-1 subtypes in circulation in the donors.