bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vascular surgery patients with elevated neutrophil-to-lymphocyte ratios have downregulated neutrophil complement RNA expression
Authors: Chan Ernest R. , Lee Jasmine , Meyerson Howard , Merkulova Alona , Smith Susan , Lin Feng , Cho Jae S. , Schmaier Alvin H. 
Published: August 2022

Abstract
Elevated neutrophil-to-lymphocyte ratio (NLR) in patients who undergo elective vascular surgery (EVS) have increased mortality independent of perioperative surgical outcome. To understand why high NLR is associated with higher mortality, we investigated neutrophil and lymphocyte transcriptome expression in patients undergoing EVS. Blood samples were collected from patients undergoing EVS and healthy donors for NLR calculation. RNA samples were isolated from patients' neutrophils and lymphocytes and divided into NLR_Low (&lt;3) and NLR_High (≥3) groups (n = 6 each). Paired samples with the highest RNA integrity number (mean = 9.8 ± 0.4) were sequenced and analyzed for differential expression. Normalized data were inputted for downstream analysis using iPathwayGuide (AdvaitaBio) and gene set enrichment analysis using GenePattern and MSigDB (Broad Institute). There was no clinical difference between the patient groups with regard to clinical diagnosis, age, sex, history of hypertension, lipid abnormalities, diabetes mellitus, smoking, or statin use. The mean NLR was 4.37 ± 0.27 SEM in the NLR_High and 1.88 ± 0.16 for the NLR_Low groups. Significantly differentially expressed gene sets identified in the RNA sequence data were enriched highly (P = 1E-24) in the humoral immunity and complement systems. Neutrophils from NLR_High patients downregulated complement genes (C1QA, C1QB, C1QC, C1S, C2, CR2, C3AR1, C3, C8G, and C9 and complement regulatory genes CD59, SERPING1, C4BPA, CFH, and CFI). Downregulation of gene expressions of humoral immunity and complement within the neutrophils are associated with elevated NLR. It remains to be determined whether and how these changes contribute to increased late mortality previously observed in patients undergoing EVS.
Exploring Lead loci shared between schizophrenia and Cardiometabolic traits
Authors: He Qian , Bennett Adam N. , Liu Jundong , Fan Beifang , Han Xue , Cheng Lu , Chen Yan , Yang Xia , Chan Kei Hang Katie 
Published: August 2022

AbstractIndividuals with schizophrenia (SCZ) have, on average, a 10- to 20-year shorter expected life span than the rest of the population, primarily due to cardiovascular disease comorbidity. Genome-wide association studies (GWAS) have previously been used to separately identify common variants in SCZ and cardiometabolic traits. However, genetic variants jointly influencing both traits remain to be fully characterised. To assess overlaps (if any) between the genetic architecture of SCZ and cardiometabolic traits, we used conditional false discovery rate (FDR) and local genetic correlation statistical framework analyses. A conjunctional FDR was used to identify shared genetic traits between SCZ and cardiometabolic risk factors. We identified 144 genetic variants which were shared between SCZ and body mass index (BMI), and 15 variants shared between SCZ and triglycerides (TG). Furthermore, we discovered four novel single nucleotide polymorphisms (SNPs) (rs3865350, rs9860913, rs13307 and rs9614186) and four proximate genes (DERL2, SNX4, LY75 and EFCAB6) which were shared by SCZ and BMI. We observed that the novel genetic variant rs13307 and the most proximate gene LY75 exerted potential effects on SCZ and BMI comorbidity. Also, we observed a mixture of concordant and opposite direction associations with shared genetic variants. We demonstrated a moderate to high genetic overlap between SCZ and cardiometabolic traits associated with a pattern of bidirectional associations. Our data suggested a complex interplay between metabolism-related gene pathways in SCZ pathophysiology.
Revised time estimation of the ancestral human chromosome 2 fusion
Authors: Poszewiecka Barbara , Gogolewski Krzysztof , Stankiewicz Paweł , Gambin Anna 
Published: August 2022

Abstract
Background
The reduction of the chromosome number from 48 in the Great Apes to 46 in modern humans is thought to result from the end-to-end fusion of two ancestral non-human primate chromosomes forming the human chromosome 2 (HSA2). Genomic signatures of this event are the presence of inverted telomeric repeats at the HSA2 fusion site and a block of degenerate satellite sequences that mark the remnants of the ancestral centromere. It has been estimated that this fusion arose up to 4.5 million years ago (Mya).

Results
We have developed an enhanced algorithm for the detection and efficient counting of the locally over-represented weak-to-strong (AT to GC) substitutions. By analyzing the enrichment of these substitutions around the fusion site of HSA2 we estimated its formation time at 0.9 Mya with a 95% confidence interval of 0.4-1.5 Mya. Additionally, based on the statistics derived from our algorithm, we have reconstructed the evolutionary distances among the Great Apes (Hominoidea).

Conclusions
Our results shed light on the HSA2 fusion formation and provide a novel computational alternative for the estimation of the speciation chronology.
Integrated transcriptomic and transgenic analyses reveal potential mechanisms of poplar resistance to Alternaria alternata infection
Authors: Huang Ying , Ma Huijun , Yue Yuanzhi , Zhou Tianchang , Zhu Zhenyu , Wang Chao 
Published: August 2022

AbstractBackgroundPopulus davidiana × P. bollenais a species of poplar from northeastern China that is characterized by cold resistance and fast growth but now suffers from pathogen infections. Leaf blight caused byAlternaria alternatahas become a common poplar disease that causes serious economic impacts, but the molecular mechanisms of resistance toA. alternatainP. davidiana × P. bollenaare still unclear.ResultsIn this study, the transcriptomic response ofP. davidiana × P. bollenatoA. alternatainfection was determined via RNA-Seq. Twelve cDNA libraries were generated from RNA isolated from three biological replicates at four time points (0, 2, 3, and 4 d post inoculation), and a total of 5,930 differentially expressed genes (DEGs) were detected (| log2fold change |≥ 1 and FDR values < 0.05). Functional analysis revealed that the DEGs were mainly enriched for the “plant hormone signal transduction” pathway, followed by the “phenylpropanoid biosynthesis” pathway. In addition, DEGs that encode defense-related proteins and are related to ROS metabolism were also identified. Numerous transcription factors, such as the bHLH, WRKY and MYB families, were also induced byA. alternatainfection. Among these DEGs, those related to JA biosynthesis and JA signal transduction were consistently activated. Therefore, the lipoxygenase genePdbLOX2, which is involved in JA biosynthesis, was selected for functional characterization. Overexpression ofPdbLOX2enhanced the resistance ofP. davidiana × P. bollenatoA. alternata,whereas silencing this gene enhanced susceptibility toA. alternatainfection.ConclusionsThese results provide new insight into the molecular mechanisms of poplar resistance toA. alternatainfection and provide candidate genes for breeding resistant cultivars using genetic engineering.
Introducing quality clusters in general practice – a qualitative study of the experiences of cluster coordinators
Authors: Kousgaard Marius Brostrøm , Mikkelsen Thorbjørn Hougaard , Bundgaard Maria , Madsen Marie Henriette , Klausen Morten Bonde , Kristensen Mads Toft , Kjellberg Pia Kürstein , Søndergaard Jens 
Published: August 2022

Abstract
Background
In 2018, the concept of clusters was introduced as a new model for data-driven quality improvement in general practice in Denmark. However, there is little research on the development and implementation of general practice clusters. The study explores how the cluster coordinators responsible for leading the clusters forward enacted and experienced their role during the early years of the clusters with attention to the challenges and enablers perceived in the process.

Methods
Qualitative, semi-structured interviews with 25 cluster coordinators from clusters that had carried out at least two meetings on a specific professional topic. The coordinators represented clusters of varying sizes and different geographic locations. Key topics in the interview guide were the development and structure of the cluster, the role of the coordinator, obtainment of data for the meetings, the role of external support, the form and content of the meetings, the participation and engagement of the members. A thematic analysis – shaped by the original aims and categories of the study while also being open to emerging themes – was performed on the transcribed interview material.

Results
Important enablers in the process of developing the clusters included the positive engagement of the GPs, the support offered by regional quality units and a national quality organisation for general practice, and the funding provided by the formal cluster framework. Challenges initially included setting up the clusters administratively and translating the open cluster concept into a local, workable model; and later obtaining relevant data for the cluster meetings and facilitating peer discussions about the data.

Conclusion
The coordinators generally experienced that the development of the clusters had progressed relatively fast with engagement from most of the participating GPs. Still, challenges with data obtainment, data analysis, and facilitation will have to be addressed ongoingly. Future research should investigate learning processes at the cluster meetings and how the clusters impact clinical practice and collaborative relations between general practice and other health care providers.
The value of diffusion kurtosis imaging and intravoxel incoherent motion quantitative parameters in predicting synchronous distant metastasis of rectal cancer
Authors: Ding Xue , Sun Danqi , Guo Qiuchen , Li Yeting , Chen Hao , Dai Xiaoxiao , Fan Guohua , Wu Yongyou , Chen Guangqiang , Li Yonggang 
Published: August 2022

Abstract
Background
The incidence and mortality rate of rectal cancer are still high, the metastasis of rectal cancer are main causes of death. The control of the distant metastasis is one of the main concerns in the treatment of locally advanced rectal cancer, but there are few studies on predicting synchronous distant metastasis (SDM) of rectal cancer.

Method
The data of patients with rectal adenocarcinoma confirmed by endoscopic biopsy or postoperative pathology from September 2015 to May 2020 in hospital A (center 1) and hospital B (center 2) were analyzed retrospectively, including age, sex, carcinoembryonic antigen, carbohydrate antigen 19–9, tumor location, tumor length, image staging and characteristics. The average age of the 169 patients consisting of 105 males and 64 females in study is 61.2 years. All patients underwent rectal routine rectal MRI, DKI and IVIM examinations on a 3.0-T scanner. Two radiologists sketched regions of interest (ROIs) on b = 1000 s/mm2 DKI and IVIM images to obtain quantitative parameters with FireVoxel manually. We evaluated the difference of histogram analysis, clinical and image data between SDM group and non-SDM group, and evaluated the efficacy of each index in predicting SDM of rectal cancer.

Results
The 90th percentile of f values in the SDM group is lower than that in the non-SDM group (29.4 ± 8.4% vs. 35 ± 17.8%, P = 0.005). CA19-9 in the SDM group is higher than that in the non-SDM group (P = 0.003). Low and high rectal cancer are more likely to develop SDM than middle rectal cancer (P = 0.05 and P = 0.047). The combination of these three indexes has a greater area under the curve (AUC) than any one index (0.801 vs. 0.685 (f (90th percentile)) and 0.627 (CA19-9), P = 0.0075 and 0.0058, respectively), and its specificity and sensitivity are 80.0% and 71.6%, respectively. When this combination is incorporated into the predictive nomogram model, the c-index is 0.801 (95% confidence interval (CI): 0.730–0.871).

Conclusions
IVIM quantitative parameters combine with CA19-9 and tumor location can better predict the risk of SDM of rectal cancer.
The impact of the COVID-19 pandemic on children with medical complexity
Authors: Diskin Catherine , Buchanan Francine , Cohen Eyal , Dewan Tammie , Diaczun Tessa , Gordon Michelle , Lee Esther , MooreHepburn Charlotte , Major Nathalie , Orkin Julia , Patel Hema , Gill Peter J. 
Published: August 2022

AbstractBackgroundDescriptions of the COVID-19 pandemic’s indirect consequences on children are emerging. We aimed to describe the impacts of the pandemic on children with medical complexity (CMC) and their families.MethodsA one-time survey of Canadian paediatricians using the Canadian Paediatric Surveillance Program (CPSP) was conducted in Spring 2021.ResultsA total of 784 paediatricians responded to the survey, with 70% (n = 540) providing care to CMC. Sixty-seven (12.4%) reported an adverse health outcome due to a COVID-19 pandemic-related disruption in healthcare delivery. Disruption of the supply of medication and equipment was reported by 11.9% of respondents (n = 64). Respondents reported an interruption in family caregiving (47.5%,n = 252) and homecare delivery (40.8%,n = 218). Almost 47% of respondents (n = 253) observed a benefit to CMC due to COVID-19 related changes in healthcare delivery, including increased availability of virtual care and reduction in respiratory illness. Some (14.4%) reported that CMC were excluded from in-person learning when their peers without medical complexity were not.ConclusionCanadian paediatricians reported that CMC experienced adverse health outcomes during the COVID-19 pandemic, including disruptions to family caregiving and community supports. They also describe benefits related to the pandemic including the expansion of virtual care. These results highlight the need for healthcare, community and education policymakers to collaborate with families to optimize their health.
Access, utilization, and barriers to using malaria protection tools in migrants to Iran
Authors: Okati-Aliabad Hassan , Ansari-Moghaddam Alireza , Mohammadi Mahdi , Nejati Jalil , Ranjbar Mansour , Raeisi Ahmad , Kolifarhood Goodarz , Shahraki-Sanavi Fariba , Khorram Alireza 
Published: August 2022

Abstract
Background
Imported malaria cases could be considered one of the threats to malaria elimination. Therefore, increasing migrants’ access to malaria preventive measures can play an essential role in maintaining appropriate conditions and preventing malaria outbreaks. This study aimed to provide detailed information about access, utilization, and barriers to using malaria protection tools in migrants to Iran.

Methods
This study was conducted in a vast region consisting of 4 provinces and 38 cities located in the south and southeast of the country. Study participants were migrants who moved to the study area in the past three months. A sample of 4163 migrants participated in the study. They were selected through a multi-stage sampling method to obtain a representative community sample. Data were collected through interviewer-administered questionnaires about participants’ socio-demographic specification, commuting characteristics, travel aim, access, ways of preparing, and reasons to use or not to use malaria protection tools. Quantitative and qualitative variables were described and analyzed finally.

Results
The mean age of individuals was 28.6 ± 10.8, with a range of 3–88 years old. Migrants’ country of origin was Afghanistan (56.6%), Pakistan (38.4%), and Iran (5%). Most migrants (69.2%) did not have malaria protection tools while staying in Iran. Among those who procured the protection tools, 74% used long-lasting insecticidal nets (LLINs), 13.4% used mosquito repellent sticks and coil, and 12.7% did not use any tools. Respectively, lack of knowledge about where they can get LLINs, followed by being expensive, unavailability in the market, not cooperation of health officer, and no need to use were expressed as the causes for having no access. The main reasons for non-using the tools were lack of knowledge about their application, followed by a defect in protection tools, ineffectiveness, and being harmful, respectively. Migrants who were supported by an employer accessed more to LLINs.

Conclusions
This study reveals significant shortcomings in knowledge, access, and utilization of malaria protection tools among migrants in Iran. Inequitable access to public health services is predictable during migration; however, access to sustainable protection tools is recommended.
Effect of hyaluronic acid on cytokines and immune cells change in patients of knee osteoarthritis
Authors: Jin Lixia , Xu Kangli , Liang Yun , Du Peng , Wan Shengcheng , Jiang Chang 
Published: August 2022

Abstract
Purpose
To evaluate the changes of cytokines and immune cells after Intra-articular hyaluronic acid(IAHA)injections in patients with knee osteoarthritis (KOA).

Patients and Methods
Sixteen patients were included in the study, with a total of 65 IAHA injections. The Numeric Rating Scale (NRS) and Lysholm scores were evaluated at each visit. The immune cells and 14 cytokines of synovial fluid were analyzed at each visit. The association between immune cells and cytokines were examined.

Results
IL-6 and IL-8 were the most common cytokines in the synovial fluid of KOA patients. The synovial fluid was orchestrated by macrophages (69%) and Lymphocytes (18%). Neutrophils were less to count of the total cell population (< 2%). The cytokines decreased significantly after the first injection and then tended to be stable. Lymphocytes increased a lot, while Macrophages decreased in the early stage, then increased after multiple injections. The proposition of M1 decreased in the early stage, then increased after multiple injections, while M2 increased consistently. M1 and M2 were positively associated with IL-6 and IL-8.

Conclusion
The synovial fluid of KOA patients was orchestrated by macrophages (69%) and Lymphocytes (18%) and cytokines like IL-6 and IL-8. IAHA may play an anti-inflammatory functional role through the decreased production of IL-6 and IL-8 by macrophages through polarization. The results from this study partially revealed the effect of IAHA on cytokines and immune cells change in KOA patients, and therapies targeting pathogenic cytokines and immune cells might be used to attenuate the knee joint inflammation and release pain.

Trial registration
ChiCTR2100050133; date registered 17 August 2021.
A multicenter study on surgical procedure selection and risk factor analysis of postoperative complications after TIP and Duckett hypospadias repair
Authors: Fang YiWei , Sun Ning , Song HongCheng , Zhang WeiPing , Tang YunMan , Huang LuGang , Yang Yi , Chao Min , Ma Hong , Zhang JingTi , Zhang XuHui , Li ShouLin , Li Ning , Chen Chao , He DaWei , Wu WenBo , Xie Hua , Guan Yong 
Published: August 2022

Abstract
Background
Hypospadias is a common congenital malformation in pediatric urology with surgery being the only curative treatment. Although there are hundreds of surgical methods for hypospadias, no single method can treat all types, and there are still high rates of postoperative complications. We performed this study to investigate surgical procedure selection and perform risk factor analysis of postoperative complications in hypospadias repair.

Methods
Retrospective analysis was performed of complete clinical and follow-up data of children with hypospadias who were treated and followed up at 15 children’s clinical centers in Mainland China from December 2018 to December 2019. Children were divided into groups according to Barcat classification and surgical methods in order to analyze the surgical choice for different types of hypospadias and the influencing factors of different surgical methods for complications.

Results
In total, 1011 patients were followed up for 26 months. According to Barcat classification, there were 248 cases of distal type hypospadias, 214 of intermediate, and 549 of proximal type. Transverse preputial island flap urethroplasty (Duckett) and tubularized incised plate urethroplasty (TIP) were performed in 375 (37.1%) and 336 cases (33.2%), respectively. The postoperative complication rate of distal hypospadias was 23.4% (15.8–57.1%), mid shaft 29.0% (22.7–40.0%), and proximal 43.7% (30.2–52.9%). Among the 375 patients in Duckett group, 192 had complications. Multivariate logistic analysis showed that the length of prepuce island flap (OR = 3.506, 95% CI: 2.258–5.442) was an independent risk factor for complications after Duckett operation (P < 0.001). In TIP group, there were 336 cases with 84 complications. Multivariate logistic analysis showed that the width of urethral plate after longitudinal resection (OR = 0.836, 95% CI: 0.742–0.942) and glans width (OR = 0.851, 95% CI: 0.749–0.965) were independent risk factors for postoperative complications after TIP (P = 0.003, P = 0.012).

Conclusion
Several anatomical features play a role during the selection process among the different surgical approaches, including glans size, urethral plate width, and the meatal position. The width of the urethral plate and glans width were risk factors for postoperative complications after TIP. The length of prepuce island flap was a risk factor for complications after Duckett operation.
Stakeholder perceptions affecting the implementation of teleophthalmology
Authors: Snider Molly J. E. , Maa April Y. , Guyton Arthur C. , Park Hannah , Hunt Kelly J. , Pope Charlene 
Published: August 2022

Abstract
Purpose
Teleophthalmology has become the subject of heightened interest and scrutiny in the wake of the SARS-CoV-2 global pandemic. A streamlined implementation framework becomes increasingly important as demand grows. This study identified obstacles to teleophthalmology implementation through summative content analysis of key stakeholders’ perceptions.

Design
Summative content analysis of transcribed interviews with key stakeholders (including patients, technicians, ophthalmic readers, staff, nurses, and administrators at two teleophthalmology clinic sites).

Methods
Keyword Were counted and compared to examine underlying meaning. Two analysts coded text independently using MAXQDA for summative qualitative content analysis to derive themes and hierarchical relationships as a basis for future refinement of TECS implementation. xMind ZEN was used to map conceptual relationships and overarching themes that emerged to identify perceived facilitators and barriers to implementation

Results
Analysis revealed two themes common to perceptions: (1) benefits of care, and (2) ease of implementation. Perceived benefits included efficiency, accessibility, and earlier intervention in disease course. The quality and quantity of training was heavily weighted in its influence on stakeholders’ commitment to and confidence in the program, as were transparent organizational structure, clear bidirectional communication, and the availability of support staff.

Conclusion
Using a determinant framework of implementation science, this report highlighted potential hindrances to teleophthalmology implementation and offered solutions in order to increase access to screening, improve the quality of care provided, and facilitate sustainability of the innovation.