bluuebunny/crossref_metadata_2025_split huggingface dataset:
Governance and societal impact of blockchain-based self-sovereign identities
Authors: Benchaya Gans Rachel , Ubacht Jolien , Janssen Marijn 
Published: June 2022

Abstract
Traditionally, governments and companies store data to identify persons for services provision and interactions. The rise of self-sovereign identities (SSIs) based on blockchain technologies provides individuals with ownership and control over their personal data and allows them to share their data with others using a sort of “digital safe.” Fundamentally, people have the sole ownership of their identity data and control when and how it is shared, protecting their privacy. As these data need to be validated to be trusted, they may become a more important data source for digital information sharing and transactions than the formal source of identity controlled by governments. Furthermore, SSIs can be used for interacting digitally with any organization. These developments change the relationship between government, companies, and individuals. We explore information sharing and governance in the digital society using blockchain-based SSIs. In addition, the impact of SSIs on data storage in the digital world is assessed. Technology enactment might result in no greater control or privacy and might only reinforce current practices. Finally, we argue that regulation and a combination of centralized and decentralized governance are still required to avoid misuse and ensure that envisaged benefits are realized.
Risk factors associated with non-vaccination in Gambian children: a population-based cohort study
Authors: Young Benjamin , Sarwar Golam , Hossain Ilias , Mackenzie Grant 
Published: June 2022

Abstract

Background
We determined the risk factors associated with unvaccinated children in rural Gambia.

Methods
We conducted prospective demographic surveillance and recorded immunisations in real time in the Upper River Region, The Gambia. Analysis included residents born from 1 January 2012 to 31 December 2016. Data included age, sex, household members and relationships, migrations, births, deaths, ethnicity, residential location and birth type. Children were defined as unvaccinated at 10, 15 and 24 mo of age if they missed all primary series doses (pentavalent, oral polio and pneumococcal conjugate vaccines), secondary series (first dose measles and yellow fever vaccines) or both vaccination series, respectively. Logistic regressions measured the association between risk factors and being unvaccinated.

Results
In total, 5% (1567/30 832) of infants born during the study period and who were residents at the age of 10 mo were unvaccinated. Being unvaccinated at 10 mo of age was associated with children; who did not reside with either parent (adjusted OR 2.26, 95% CI 1.60 to 3.19), whose parents were not the head of household (1.29, 1.09 to 1.52), who had experienced immigration (2.78, 1.52 to 5.08) or who were not of Mandinka ethnicity (between 1.57 and 1.85 for other ethnicities).

Conclusions
Family characteristics are associated with unimmunised children in rural Gambia. Our findings may inform strategies to increase vaccine coverage.
Loss ofDrosophila NUS1results in cholesterol accumulation and Parkinson’s disease‐related neurodegeneration
Authors: Xue Jin , Zhu Yingbao , Wei Liyi , Huang Hongjing , Li Guangxu , Huang Wen , Zhu Hua , Duan Ranhui 
Published: June 2022

AbstractNgBR is the Nogo‐B receptor, encoded byNUS1gene. As NgBR contains a C‐terminal domain that is similar to cis‐isoprenyltransferase (cis‐IPTase), NgBR was speculated to stabilize nascent Niemann‐Pick type C 2 (NPC2) to facilitate cholesterol transport out of lysosomes. Mutations in theNUS1were known as risk factors for Parkinson's disease (PD). In our previous study, it was shown that knockdown ofDrosophila NUS1orthologous genetango14causes decreased climbing ability, loss of dopaminergic neurons, and decreased dopamine contents. In this study,tango14mutant flies were generated with a mutation in the C‐terminal enzyme activity region using CRISPR/Cas9.Tango14mutant showed a reduced lifespan with locomotive defects and cholesterol accumulation in Malpighian tubules and brains, especially in dopaminergic neurons. Multilamellar bodies were found intango14mutants using electron microscopy. Neurodegenerative‐related brain vacuolization was also detected intango14knockdown flies in an age‐dependent manner. In addition,tango14knockdown increased α‐synuclein (α‐syn) neurotoxicity in α‐syn‐overexpressing flies, with decreased locomotive activities, dopamine contents, and the numbers of dopaminergic neurons in aging flies. Thus, these observations suggest a role ofNUS1, the ortholog oftango14, in PD‐related pathogenesis.
Effectiveness of a Clay Pelvic Model
Authors: Chong Woojin , Tran Nhi , Bui Anthony 
Published: June 2022

BACKGROUND:
Understanding pelvic anatomy is an important part of education during obstetrics and gynecology residency. Traditional teaching methods to learn pelvic anatomy have obstacles and are often costly.

METHOD:
We provide a self-constructed clay pelvic model to aid in the mastery of pelvic anatomy for obstetrics and gynecology residents and to estimate whether building a clay pelvic model would increase residents' confidence and knowledge in pelvic anatomy.

EXPERIENCE:
Each resident constructed a clay pelvic model on a bony pelvis, along with the traditional didactic on pelvic anatomy. Demographics of the participants were obtained, followed by a knowledge test and confidence level and satisfaction surveys. Descriptive analysis and Wilcoxon signed-rank test were used for data analysis. Nine residents (three postgraduate year [PGY]-1, one PGY-2, two PGY-3, three PGY-4) completed the knowledge and confidence questions before and after the simulation, along with the satisfaction survey. The median score from the 10 multiple-choice knowledge questions was 50% (30–70%) on the pretest and 70% (40–100%) on the posttest (P=not significant). Although most residents scored higher on the posttest, two residents scored 10% lower. Overall, 66.7% of residents improved their knowledge scores up to 30% after the simulation session. Self-assessed confidence level scores improved from 2–3 to 4 (1, lowest; 5, highest) for all questions asked (P=.010 to approximately .019). A majority of residents responded with 4 or 5 to the satisfaction statements.

CONCLUSION:
A low-budget clay pelvic model is easy to build and did increase residents' confidence in pelvic anatomy knowledge and satisfaction. Self-constructing a clay pelvic model would provide an excellent way of reviewing the major landmarks of pelvic anatomy.
Prevalence of Posttraumatic Stress Disorder Symptoms Following Traumatic Spinal Cord Injury: A Systematic Review and Meta-analysis
Authors: Yousefifard Mahmoud , Ramezani Fatemeh , Faridaalaee Gholamreza , Baikpour Masoud , Madani Neishaboori Arian , Vaccaro Alexander R. , Hosseini Mostafa , Rahimi-Movaghar Vafa 
Published: June 2022

BackgroundLimited evidence is currently available on the prevalence of posttraumatic stress disorder (PTSD) following traumatic spinal cord injury (SCI). This systematic review and meta-analysis aims to assess the prevalence and geographic distribution of PTSD symptoms after SCI.MethodsAfter a search in the MEDLINE, Embase, Scopus, and Web of Science databases, two reviewers independently summarized relevant studies published through 20 October 2021. Observational studies were included. The studies were eligible if they assessed PTSD symptoms using standard self-report or clinician-based instruments. Data and results were reported using the overall prevalence and the odds ratio (OR), with 95% confidence intervals (CIs).Results24 articles (5646 patients) met the inclusion criteria. The prevalence of PTSD symptoms ranged from 6.33% (95% CI, 2.73–13.97) to 61.76% (95% CI, 52.07–70.61). Pooled analysis demonstrated that the overall prevalence of PTSD symptoms in SCI patients was significantly higher in developing countries (41.64%; 95% CI, 31.11–52.55) than in developed countries (19.35%; 95% CI, 14.66–24.51) (OR = 1.24; 95% CI, 1.08–1.42; p = .003). The highest prevalence of PTSD symptoms was reported in South Africa (56.25%; 95% CI, 47.01–65.08), followed by Sri Lanka (45.71%; 95% CI, 30.47–61.81), and Greece (43.55%; 95% CI, 31.94–55.91). By contrast, Norway (6.33%; 95% CI, 2.73–13.97), Switzerland/Germany (8.65%; 95% CI, 4.8–13.42), and Denmark (10.71%; 95% CI, 6.89–16.30) were found to have the lowest prevalence of PTSD symptoms after SCI.ConclusionMany traumatic SCI patients suffer from PTSD symptoms, and their prevalence seems to be higher in developing countries than in developed countries. These findings underscore the need to consider the psychological aspects of traumatic SCI.
Understanding the ins and outs of lipoprotein (a) metabolism
Authors: Boffa Michael B. , Koschinsky Marlys L. 
Published: June 2022

Purpose of review
This review summarizes our current understanding of the processes of apolipoprotein(a) secretion, assembly of the Lp(a) particle and removal of Lp(a) from the circulation. We also identify existing knowledge gaps that need to be addressed in future studies.

Recent findings
The Lp(a) particle is assembled in two steps: a noncovalent, lysine-dependent interaction of apo(a) with apoB-100 inside hepatocytes, followed by extracellular covalent association between these two molecules to form circulating apo(a).
The production rate of Lp(a) is primarily responsible for the observed inverse correlation between apo(a) isoform size and Lp(a) levels, with a contribution of catabolism restricted to larger Lp(a) isoforms.
Factors that affect apoB-100 secretion from hepatocytes also affect apo(a) secretion.
The identification of key hepatic receptors involved in Lp(a) clearance in vivo remains unclear, with a role for the LDL receptor seemingly restricted to conditions wherein LDL concentrations are low, Lp(a) is highly elevated and LDL receptor number is maximally upregulated.

Summary
The key role for production rate of Lp(a) [including secretion and assembly of the Lp(a) particle] rather than its catabolic rate suggests that the most fruitful therapies for Lp(a) reduction should focus on approaches that inhibit production of the particle rather than its removal from circulation.
Analysis of the Pancreatic Cancer Microbiome Using Endoscopic Ultrasound–Guided Fine-Needle Aspiration–Derived Samples
Authors: Nakano Shintaro , Kawamoto Yasuyuki , Komatsu Yoshito , Saito Rika , Ito Ken , Yamamura Takahiro , Harada Kazuaki , Yuki Satoshi , Kawakubo Kazumichi , Sugiura Ryo , Kato Shin , Hirata Koji , Hirata Hajime , Nakajima Masahito , Furukawa Ryutaro , Takishin Yunosuke , Nagai Kousuke , Yokota Isao , Ota Keisuke H. , Nakaoka Shinji , Kuwatani Masaki , Sakamoto Naoya 
Published: June 2022

Objectives
Most previous studies have analyzed bacteria in tumors using resected pancreatic cancer (PC) tissues, because it is difficult to obtain tissue samples from unresectable advanced PC. We aimed to determine whether minimal tissue obtained by endoscopic ultrasound–guided fine-needle aspiration is useful for microbiome analysis.

Methods
Thirty PC and matched duodenal and stomach tissues (N = 90) were prospectively collected from 30 patients who underwent endoscopic ultrasound–guided fine-needle aspiration. Bacterial DNA was extracted, and 16S rRNA sequencing was performed. The primary outcome was the success rate of bacterial detection in tumors. Bacterial diversity and structure were investigated.

Results
The bacterial detection rates were 80%, 100%, and 97% in PC, gastric, and duodenal samples, respectively. Pancreatic cancer tissues showed a lower α-diversity and a significantly different microbial structure than stomach and duodenal tissues. Proteobacteria were more abundant, whereas Firmicutes, Bacteroidetes, and Fusobacteria were less abundant in PC tissues than in stomach and duodenal tissues. Acinetobacter was more abundant in PC tissues than in stomach and duodenal tissues, and Delftia was more frequently detected in resectable PC.

Conclusions
Endoscopic ultrasound–guided fine-needle aspiration samples were valuable for PC microbiome analysis, revealing that the bacterial composition of PC is different from that of the stomach and duodenum.
A Study of the Association Between Carotid Artery Curvature and Intracranial Aneurysms
Authors: Zhao Jun , Xiang Xiang , Zhang Hongxia , Ye Ying , He Zhaohui 
Published: June 2022

Background:
Carotid artery curvature is considered a sign of a weak vessel wall, and we hypothesize that a weak vascular wall under the effect of hemodynamics may cause intracranial aneurysms.

Materials and Methods:
The general data of 534 patients with aneurysms and 473 control patients were retrospectively analyzed in a case-control study. Carotid artery curvature was characterized as none, tortuosity, kinking, and coiling by computed tomography angiography images. Univariate analysis was performed to determine the degree of carotid artery tortuosity and to analyze the general data between the aneurysm group and the control group, and then, multivariate statistical logistic regression analysis was used to analyze the statistical significance of the univariate analysis. Finally, the correlation between aneurysm-related features and carotid artery curvature was analyzed.

Results:
Univariate analysis showed that kinking was significantly related to the occurrence of intracranial aneurysms (P=0.009). The results of multivariate regression analysis showed that kinking was an independent risk factor for the occurrence of aneurysms (odds ratio: 1.942; 95% confidence interval: 1.387-2.720 for model 1; odds ratio: 1.995; 95% confidence interval: 1.419-2.805 for model 2). In the analysis of the correlation between the characteristics of intracranial aneurysms and the curvature of the internal carotid artery, there was no correlation between the curvature of the internal carotid artery and the size, location or number of aneurysms, or whether the intracranial aneurysm was ruptured.

Conclusion:
Intracranial aneurysms are associated with carotid artery curvature. Kinking of the internal carotid artery may indicate a higher risk for aneurysm formation.
Utilization of Family as Faculty: A Patient Directed Simulation Education to Improve Patient and Family Communication during Patient-Family Centered Rounds (PFCR)
Authors: Asuncion Arsenia M. , Quintos-Alagheband Maria Lyn , Leavens-Maurer Jill , Akerman Meredith , Janicke Patricia , Cavanaugh Sean 
Published: June 2022

Introduction:
Patient-family-centered care (PFCC) is based on the understanding that the family is the child’s source of strength and support. Effective communication between families and providers is an essential component of PFCC. Our interprofessional team designed an initiative to improve medical providers’ communication in partnership with the Patient and Family Advisory Council (PFAC). Strategies included the creation of a competency rubric and simulation curriculum using the family as faculty. The SMART aim was to improve the percentage of respondents who answered “Always” to doctor communication domains from 72% to 75.6% in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) by December 2020.

Methods:
Pediatric residents, medical students, faculty, nurses, and PFAC members formed a Quality Improvement (QI) team to address PFCR competency. The team created a PFCC checklist to address competency. PFAC volunteers served as standardized parents in an in situ simulation of PFCR scenarios involving interprofessional in-patient teams. Evaluators observed rounds for the pre and postintervention assessment using the checklist. The outcome measure was the percentage of respondents who answered “Always” in the HCAPHS domain for physician communication. The process measure was the PFCR pre and postintervention, using Fisher’s exact test for analysis.

Results:
Using a statistical process chart (SPC), HCAHPS data from 2018 to 2020 showed that we exceeded our aim of >5% increase in the physician communication performance. Pre-post intervention data showed improvement in PFCR competency.

Conclusion:
Family as faculty simulation led to improved physician communication, translating to improved performance in the HCAHPS score and PFCR competency communication domains.
Reducing the Time to Blood Administration after Pediatric Injury: A Quality Improvement Initiative
Authors: Sullivan Travis M. , Milestone Zachary P. , Alberto Emily C. , Waibel Elizabeth M. , Gestrich-Thompson Waverly V. , Tempel Peyton E. , Fritzeen Jennifer L. , O’Connell Karen J. , Cheng Jacob , Burd Randall S. 
Published: June 2022

Introduction:
Hemorrhage is the leading cause of preventable death in pediatric trauma patients. Timely blood administration is associated with improved outcomes in children and adults. This study aimed to identify delays to transfusion and improve the time to blood administration among injured children.

Methods:
A multidisciplinary team identified three activities associated with blood transfusion delays during the acute resuscitation of injured children. To address delays related to these activities, we relocated the storage of un-crossmatched blood to the emergency department (ED), created and disseminated an intravenous access algorithm, and established a nursing educator role for resuscitations. We performed comparative and regression analyses to identify the impact of these factors on the timeliness and likelihood of blood administration.

Results:
From January 2017 to June 2021, we treated 2159 injured children and adolescents in the resuscitation area, 54 (2.5%) of whom received blood products in the ED. After placing a blood storage refrigerator in the ED, we observed a centerline change that lowered the adjusted time-to-blood administration to 17 minutes (SD 11), reducing the time-to-blood administration by 11 minutes (β = −11.0, 95% CI = −22.0 to −0.9). The likelihood of blood administration was not changed after placement of the blood refrigerator. We observed no reduction in time following the implementation of the intravenous access algorithm or a nursing educator.

Conclusions:
Relocation of un-crossmatched blood storage to the ED decreased the time to blood transfusion. This system-based intervention should be considered a strategy for reducing delays in transfusion in time-critical settings.
Rheumatology Clinic Staff Needs
Authors: Tong Michelle , Gilmore-Bykovskyi Andrea , Block Laura , Ramly Edmond , White Douglas W. , Messina Monica L. , Bartels Christie M. 
Published: June 2022

Objective
Patients with rheumatologic conditions are at elevated risk of cardiovascular disease (CVD) due to inflammatory and traditional risk factors, such as high blood pressure (BP) and smoking. However, rheumatology clinics rarely address traditional risk factors, although they are routinely assessed and modifiable in primary care. The present study sought to (1) characterize rheumatology clinic staff's work process for addressing high BP and smoking and (2) identify barriers and strategies for effective management of these risk factors.

Methods
We conducted 7 focus groups with medical assistants, nurses, and scheduling staff from 4 adult rheumatology clinics across 2 health systems (BP focus groups, n = 23; smoking, n = 20). Transcripts were analyzed using thematic analysis to elucidate barriers and strategies.

Results
We found 3 clinic work processes for the management of high BP and smoking risk: (1) risk identification, (2) follow-up within the clinic, and (3) follow-up with primary care and community resources. Within these processes, we identified barriers and strategies grouped into themes: (1) time, (2) clinic workflows, (3) technology and resources, (4) staff's attitudes and knowledge, and (5) staff's perceptions of patients. The most pervasive barriers were (1) no structured system for follow-up and (2) staff confidence and skill in initiating conversations about health-related behavior change.

Conclusions
Our study identified generalizable gaps in rheumatology staff's work processes and competencies for addressing high BP and smoking in patients. Future efforts to support staff needs should target (1) systems for follow-up within and outside the clinic and (2) conversation support tools.
The emergence of supergenes from inversions in Atlantic salmon
Authors: Stenløkk Kristina , Saitou Marie , Rud-Johansen Live , Nome Torfinn , Moser Michel , Árnyasi Mariann , Kent Matthew , Barson Nicola Jane , Lien Sigbjørn 
Published: June 2022

Supergenes link allelic combinations into non-recombining units known to play an essential role in maintaining adaptive genetic variation. However, because supergenes can be maintained over millions of years by balancing selection and typically exhibit strong recombination suppression, both the underlying functional variants and how the supergenes are formed are largely unknown. Particularly, questions remain over the importance of inversion breakpoint sequences and whether supergenes capture pre-existing adaptive variation or accumulate this following recombination suppression. To investigate the process of supergene formation, we identified inversion polymorphisms in Atlantic salmon by assembling eleven genomes with nanopore long-read sequencing technology. A genome assembly from the sister species, brown trout, was used to determine the standard state of the inversions. We found evidence for adaptive variation through genotype–environment associations, but not for the accumulation of deleterious mutations. One young 3 Mb inversion segregating in North American populations has captured adaptive variation that is still segregating within the standard arrangement of the inversion, while some adaptive variation has accumulated after the inversion. This inversion and two others had breakpoints disrupting genes. Three multigene inversions with matched repeat structures at the breakpoints did not show any supergene signatures, suggesting that shared breakpoint repeats may obstruct supergene formation.This article is part of the theme issue ‘Genomic architecture of supergenes: causes and evolutionary consequences’.
Unbalanced selection: the challenge of maintaining a social polymorphism when a supergene is selfish
Authors: Tafreshi Alireza G. , Otto Sarah P. , Chapuisat Michel 
Published: June 2022

Supergenes often have multiple phenotypic effects, including unexpected detrimental ones, because recombination suppression maintains associations among co-adapted alleles but also allows the accumulation of recessive deleterious mutations and selfish genetic elements. Yet, supergenes often persist over long evolutionary periods. How are such polymorphisms maintained in the face of selection, drive and drift? We present a population genetic model that investigates the conditions necessary for a stable polymorphic equilibrium when one of the supergene haplotypes is a selfish genetic element. The model fits the characteristics of the Alpine silver ant,Formica selysi, in which a large supergene underlies colony social organization, and one haplotype distorts Mendelian transmission by killing progeny that did not inherit it. The model shows that such maternal-effect killing strongly limits the maintenance of social polymorphism. Under random mating, transmission ratio distortion prevents rare single-queen colonies from invading populations of multiple-queen colonies, regardless of the fitness of each genotype. A stable polymorphic equilibrium can, however, be reached when high rates of assortative mating are combined with large fitness differences among supergene genotypes. The model reveals that the persistence of the social polymorphism is non-trivial and expected to occur only under restrictive conditions that deserve further empirical investigation.This article is part of the theme issue ‘Genomic architecture of supergenes: causes and evolutionary consequences’.