bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishment of optimized in vitro disinfection protocol of Pistacia vera L. explants mediated a computational approach: multilayer perceptron–multi−objective genetic algorithm
Authors: Gammoudi Najet , Nagaz Kamel , Ferchichi Ali 
Published: July 2022

Abstract
Background
Contamination−free culture is a prerequisite for the success of in vitro − based plant biotechnology. Aseptic initiation is an extremely strenuous stride, particularly in woody species. Meanwhile, over−sterilization is potentially detrimental to plant tissue. The recent rise of machine learning algorithms in plant tissue culture proposes an advanced interpretive tool for the combinational effect of influential factors for such in vitro − based steps.

Results
A multilayer perceptron (MLP) model of artificial neural network (ANN) was implemented with four inputs, three sterilizing chemicals at various concentrations and the immersion time, and two outputs, disinfection efficiency (DE) and negative disinfection effect (NDE), intending to assess twenty−seven disinfection procedures of Pistacia vera L. seeds. Mercury chloride (HgCl2; 0.05–0.2%; 5–15 min) appears the most effective with 100% DE, then hydrogen peroxide (H2O2; 5.25–12.25%; 10–30 min) with 66–100% DE, followed by 27–77% DE for sodium hypochlorite (NaOCl; 0.54–1.26% w/v; 10–30 min). Concurrently, NDE was detected, including chlorosis, hard embryo germination, embryo deformation, and browning tissue, namely, a low repercussion with NaOCl (0–14%), a moderate impact with H2O2 (6–46%), and pronounced damage with HgCl2 (22–100%). Developed ANN showed R values of 0.9658, 0.9653, 0.8937, and 0.9454 for training, validation, testing, and all sets, respectively, which revealed the uprightness of the model. Subsequently, the model was linked to multi−objective genetic algorithm (MOGA) which proposed an optimized combination of 0.56% NaOCl, 12.23% H2O2, and 0.068% HgCl2 for 5.022 min. The validation assay reflects the high utility and accuracy of the model with maximum DE (100%) and lower phytotoxicity (7.1%).

Conclusion
In one more case, machine learning algorithms emphasized their ability to resolve commonly encountered problems. The current successful implementation of MLP–MOGA inspires its application for more complicated plant tissue culture processes.
The value of myocardial work in assessment of ventricular function in patients with non-obstructive hypertrophic cardiomyopathy
Authors: Yang Chenguang , Guo Ying , Wang Xiang , Zhang Ruisheng , Wang Fang , Zhu Huolan 
Published: July 2022

Abstract
Background
To evaluate myocardial work using speckle tracking echocardiography in patients with non-obstructive hypertrophic cardiomyopathy (HCM).

Methods
Fifty patients with HCM and 50 normal controls were included. Left ventricular ejection fraction (LVEF) was quantified using the bi-plane Simpson’s method. Myocardial work parameters, which included global work index (GWI), global constructive work (GCW), global waste work (GWW), and global work efficiency (GWE), were derived from the 2D strain-pressure loop.

Results
The patient group was older (49.19 ± 14.69 vs. 37.16 ± 7.49 years old) and had a higher body mass index (24.93 ± 3.67 vs. 23.26 ± 3.32 kg/m2) and systolic blood pressure (121.81 ± 16.50 vs. 115.30 ± 11.01 mmHg) (P < 0.05). The mean LVEF in patients was 51%, with 54% of patients had LVEF ≤ 50%. Compared to controls, GWI (946.42 ± 360.64 vs. 1639.72 ± 204.56 mmHg%), GCW (1176.94 ± 373.23 vs. 1960.16 ± 255.72 mmHg%), and GWE (83.96 ± 7.68 vs. 95.26 ± 1.98%) were significantly decreased, while GWW (158.17 ± 82.47 vs. 79.12 ± 40.26 mmHg%) was significantly increased (P < 0.05) in the patient group. In patients, GWE showed a trend of positive correlation with LVEF (r = 0.276, P = 0.06), while GWW had a trend of negative correlation with LVEF (r = − 0.241, P = 0.09). No correlation between myocardial work and LV diastolic function or QRS duration was observed. Maximal wall thickness significantly correlated with all the myocardial work parameters.

Conclusions
Assessing myocardial work adds useful information of LV function in patients with non-obstructive HCM.
Trauma team training in Norwegian hospitals: an observational study
Authors: Bredin Ida Celine , Gaup Hedi Marina Joks , Brattebø Guttorm , Wisborg Torben 
Published: July 2022

Abstract
Background
Traumatic injuries are a leading cause of deaths in Norway, especially among younger males. Trauma-related mortality can be reduced by structural measures, such as organization of a trauma system. Many hospitals in Norway treat few seriously injured patients, one of the reasons for development of the Norwegian trauma system. Since its implementation, there has been continuous improvement of this system, including trauma team training. Regular trauma team training is compulsory, with the aims of compensating for lack of experience and maintaining competence. The purpose of this study was to present an overview of current trauma team training activities in Norway.

Methods
For this observational study, the authors developed an online questionnaire and mailed it to local trauma coordinators from 38 Norwegian hospitals—including four trauma centers and 34 acute hospitals with trauma function. The study was performed during April–June 2020, with a two-month response window. Trauma team training frequency was assessed in four predefined intervals: < 5, 5–9, 10–15 and > 15 times per year. The response rate was 33 of 38, 87%.

Results
All responding hospitals conducted regular trauma team training. The frequency of training increased significantly from 2013 to 2020 (Chi square test, Chi2 8.33, p = 0.04). All hospitals described a quite homogenous approach. The trauma centres trained more frequently as compared to the acute care hospitals (Chi square test, Chi2 8.24, p = 0.04).

Conclusions
All responding hospitals performed regular trauma team training using a homogenous approach, which is in line with previous assessments. We observed a minor improvement in frequency compared to prior assessments. Our findings suggest that Norwegian trauma teams likely maintain their competence through team training. All hospitals followed the current recommendations from the National Trauma Plan.
Application of variance components to the identification of determinants of modern contraceptive use in the Tanzania demographic and health survey data
Authors: Donni Oliva Safari , Bishanga Dunstan Raphael , Mbalawata Isambi Sailon 
Published: July 2022

Abstract
Background
Over time, demographic and health survey (DHS) data remain valuable to examine variables relating to nationally representative population outcomes for low- and middle-income countries. In Tanzania, there are very limited DHS-based studies on the uptake of Modern Contraceptive Use (MCU). Present studies have focused on measurements at the level of individuals, yet research has shown that MCU variations exists at other levels within populations. In this study, we use a variance component modelling approach to explore variation in MCU at primary sampling unit (PSU) and regional levels while considering survey sample weights.

Methods
Using DHS data from 2016–2017 in Tanzania, we study different variance structures and the respective variation on MCU in a sample of 5263 Women of Reproductive Age (WRA) defined as between the ages of 15–49 years. First, a single variance component was used, followed by its extension to a random coefficient model and we tracked changes in the models.

Results
There was an influence of random variations on MCU on the levels of populations much explained by PSU-level clustering than region. On the fixed part, age of a woman, husband education level, desire to have children, and exposure to media and wealth tertiles were important determinants for MCU. Compared to WRA in 15–19 years, the odds of MCU among middle aged women (20–29 and 30–39 years) were 1.94 (95%CI:1.244–3.024) and 2.28 (95%CI:1.372–3.803). Also, increases in media exposure and middle and rich wealth tertiles women led to higher odds for MCU. We also found the presence of random effects influence of wealth tertiles levels on MCU.

Conclusion
This study highlighted the utility of accounting for variance structures in addressing determinants of MCU while using DHS national level data. Apart from MCU, the DHS data have been widely applied to examine other variables pertaining to public health issues. This approach could be considered a better modelling technique for the DHS studies compared to traditional survey approaches, and to guide hierarchical population-based interventions to increase MCU.
Characteristics and perioperative complications of hip fracture in the elderly with acute ischemic stroke: a cross-sectional study
Authors: Zhang Yaqian , Fu Mingming , Guo Junfei , Zhao Yuqi , Wang Zhiqian , Hou Zhiyong 
Published: July 2022

Abstract
Background
Patients with acute ischemic stroke (AIS) after hip fracture in the elderly have worse prognosis. We aimed to describe the characteristics and complications of hip fracture with AIS in the elderly.

Methods
This cross-sectional study selected patients with hip fracture (age ≥65 years) from January 2018 to September 2020. The collected data included age, sex, fracture types, comorbidities. In above screened patients, we further collected cerebral infarction related information of AIS patients. The least absolute shrinkage and selection operator (LASSO) logistic regression was performed to identify the strongest predictors of AIS after hip fracture. Multivariate logistic regression analysis was conducted to find independent risk factors for AIS after hip fracture.

Results
Sixty patients (mean age 79.7 years;female 56.7%) occurred AIS after hip fracture in 1577 cases. The most common infarction type was partial anterior circulation infarction (PACI) (70.0%). The majority of these infarction lesions were single (76.7%) and most infarction lesions(65.0%) were located in the left side. 81.7% of AIS patients had mild (Health stroke scale NIHSS <4) AIS. Older patients with AIS after hip fracture were more frequently complicated by hypertension(73.3%), prior stroke (46.7%), diabetes(35.0%) and were more likely to have hypoproteinemia(68.3%), electrolyte disorders ( 66.7%), anemia (65.0%), deep vein thrombosis (51.6%), pneumonia (46.6%),cardiac complications (45.0%). Combined with hypertension (OR 2.827, 95%CI 1.557-5.131) and male sex(OR 1.865, 95%CI 1.095-3.177) were associated with the increased risk of AIS after hip fracture.

Conclusions
Older patients combined with hypertension are more likely to have AIS after hip fracture. For these patients, early preventions should be administered. AIS patients after hip fracture are prone to have multiple complications under traumatic stress, and we should enhance the management of these patients to reduce the stress and avoid occurrence of complications.
The influence of the COVID-19 pandemic on surgical therapy and care: a cross-sectional study
Authors: Hillebrandt Karl H. , Moosburner Simon , Winter Axel , Nevermann Nora , Raschzok Nathanael , Malinka Thomas , Sauer Igor M. , Schmelzle Moritz , Pratschke Johann , Chopra Sascha 
Published: July 2022

Abstract
Background
Due to the COVID-19 pandemic, an extensive reorganisation of healthcare resources was necessary—with a particular impact on surgical care across all disciplines. However, the direct and indirect consequences of this redistribution of resources on surgical therapy and care are largely unknown.

Methods
We analysed our prospectively collected standardised digital quality management document for all surgical cases in 2020 and compared them to the years 2018 and 2019. Periods with high COVID-19 burdens were compared with the reference periods in 2018 and 2019.

Results
From 2018 to 2020, 10,723 patients underwent surgical treatment at our centres. We observed a decrease in treated patients and a change in the overall patient health status. Patient age and length of hospital stay increased during the COVID-19 pandemic (p = 0.004 and p = 0.002). Furthermore, the distribution of indications for surgical treatment changed in favour of oncological cases and less elective cases such as hernia repairs (p < 0.001). Postoperative thromboembolic and pulmonary complications increased slightly during the COVID-19 pandemic. There were slight differences for postoperative overall complications according to Clavien-Dindo, with a significant increase of postoperative mortality (p = 0.01).

Conclusion
During the COVID-19 pandemic we did not see an increase in the occurrence, or the severity of postoperative complications. Despite a slightly higher rate of mortality and specific complications being more prevalent, the biggest change was in indication for surgery, resulting in a higher proportion of older and sicker patients with corresponding comorbidities. Further research is warranted to analyse how this changed demographic will influence long-term patient care.
Biopsychosocial risk factors of depression during menopause transition in southeast China
Authors: Chu Ketan , Shui Jing , Ma Linjuan , Huang Yizhou , Wu Fan , Wei Fang , Meng Xingjun , Luo Jie , Ruan Fei , Zhou Jianhong 
Published: July 2022

Abstract
Objective
More than 2 billion women are experiencing menopause transition in China and some of them suffered from depression; while the risk factors of depression during menopause transition were still unclearin China. We aimed to investigate the risk factors in mid-life women in Southeast China.

Method
This study included 1748 Chinese women aged 40–65 years-old who visited gynecology outpatient department of Women’s hospital School of Medicine, Zhejiang University during 2010–2018. Demographic information was collected, and the modified Kupperman Menopausal Index (mKMI) and Hamilton Rating Scale for Depression were assessed. Circulating levels of sex hormones were tested. Ordinal logistic regression analysis was performed to identify risk factors for depression.

Results
The prevalence of depression symptoms was 47.43%. The majority of women had mild (38.56%) or moderate depressive symptoms (8.00%); only 0.86% had severe depressive symptoms. Compared with perimenopausal women, postmenopausal women had increased risks of more severe depression. The associations between menopausal syndromes and the intensity of depression were strongly positive (OR 6.69, 95% CI 5.39–8.29). Elder age, higher follicle stimulating hormone levels, lower estradiol levels, and fewer parity were positively related with the intensity of depression. Among postmenopausal women, underweight, mKMI > 14, earlier age at menopause, shorter reproductive period, and longer duration after menopause were risk factors for incresed intensity of depression.

Conclusions
The results demonstrated a high proportion of depression in women complaining of menopause. Menopausal symptoms were strongly related to the intensity of depression. In postmenopausal women, estrogen related events are associated with the intensity of depression. Gynecological endocrinologists in China should consider screening for depression in high-risk women.
“Medicines is all that I can sometimes offer them”: challenges of providing primary diabetes care to persons with disabilities in Tamil Nadu
Authors: Thiagesan Rajeswaran , Soundari Hilaria , Gopichandran Vijayaprasad 
Published: July 2022

Abstract
Background
Persons with disabilities have a higher risk for and poorer outcomes of type 2 diabetes. Primary health care providers face several challenges in providing primary diabetes care for them. This study was conducted to explore the challenges faced by primary health care providers in delivering primary diabetes services to persons with disabilities.

Methods
We performed a qualitative research study by conducting in-depth interviews among 13 primary health care providers including medical officers, staff nurses, community health workers and a physiotherapist. We adopted a descriptive qualitative research approach to data collection and analysis.

Results
Primary health care providers often could only prescribe medications to persons with diabetes by proxy due to poor accessibility of the facilities. They felt that these patients also had poor compliance to treatment. They felt that the lack of standard guidelines for diet and exercise for persons with disabilities prevented them from giving them appropriate advice on the same and even if they did, persons with disabilities would find it very difficult to adopt dietary changes and physical activity as they were dependent on others for even their daily activities. They also felt that they couldn’t perform annual screening tests due to lack of accessibility to higher facilities. Some primary care providers did local innovations such as formation of peer support groups, utilization of resources of other programs to reach out to persons with disabilities and innovative physical activity techniques to care for persons with disabilities. They recommended that there is a need for specific guidelines for management of diabetes among persons with disabilities, treatment of chronic diseases among persons with disabilities must be incentivized and there must be intersectoral coordination between social welfare department and health department to achieve the goal of care for persons with disabilities.

Conclusions
Primary health care providers faced substantial challenges in providing primary diabetes care for persons with disabilities. There is a need for an effective public health policy to address these challenges.
Comparative genomic analysis of Babesia duncani responsible for human babesiosis
Authors: Wang Jinming , Chen Kai , Yang Jifei , Zhang Shangdi , Li Youquan , Liu Guangyuan , Luo Jianxun , Yin Hong , Wang Guangying , Guan Guiquan 
Published: July 2022

Abstract
Background
Human babesiosis, caused by parasites of the genus Babesia, is an emerging and re-emerging tick-borne disease that is mainly transmitted by tick bites and infected blood transfusion. Babesia duncani has caused majority of human babesiosis in Canada; however, limited data are available to correlate its genomic information and biological features.

Results
We generated a B. duncani reference genome using Oxford Nanopore Technology (ONT) and Illumina sequencing technology and uncovered its biological features and phylogenetic relationship with other Apicomplexa parasites. Phylogenetic analyses revealed that B. duncani form a clade distinct from B. microti, Babesia spp. infective to bovine and ovine species, and Theileria spp. infective to bovines. We identified the largest species-specific gene family that could be applied as diagnostic markers for this pathogen. In addition, two gene families show signals of significant expansion and several genes that present signatures of positive selection in B. duncani, suggesting their possible roles in the capability of this parasite to infect humans or tick vectors.

Conclusions
Using ONT sequencing and Illumina sequencing technologies, we provide the first B. duncani reference genome and confirm that B. duncani forms a phylogenetically distinct clade from other Piroplasm parasites. Comparative genomic analyses show that two gene families are significantly expanded in B. duncani and may play important roles in host cell invasion and virulence of B. duncani. Our study provides basic information for further exploring B. duncani features, such as host-parasite and tick-parasite interactions.
Regulatory roles of alternative splicing at Ezh2 gene in mouse oocytes
Authors: Guo Shi-meng , Liu Xing-ping , Tian Qing , Fei Cai-feng , Zhang Yi-ran , Li Zhi-ming , Yin Ying , He Ximiao , Zhou Li-quan 
Published: July 2022

Abstract
Background
Enhancer of zeste homologue 2 (EZH2), the core member of polycomb repressive complex 2 (PRC2), has multiple splicing modes and performs various physiological functions. However, function and mechanism of alternative splicing at Ezh2 exon 3 in reproduction are unknown.

Methods
We generated Ezh2Long and Ezh2Short mouse models with different point mutations at the Ezh2 exon 3 alternative splicing site, and each mutant mouse model expressed either the long or the short isoform of Ezh2. We examined mutant mouse fertility and oocyte development to assess the function of Ezh2 alternative splicing at exon 3 in the reproductive system.

Results
We found that Ezh2Long female mice had normal fertility. However, Ezh2Short female mice had significantly decreased fertility and obstructed oogenesis, with compromised mitochondrial function in Ezh2Short oocytes. Interestingly, increased EZH2 protein abundance and accumulated H3K27me3 were observed in Ezh2Short oocytes.

Conclusions
Our results demonstrate that correct Ezh2 alternative splicing at exon 3 is important for mouse oogenesis.
Protocol for a randomised, assessor‐blinded, parallel group feasibility trial of flat flexible school shoes for adolescents with patellofemoral pain
Authors: Mazzella Natalie , Fox Aaron , Saunders Natalie , Trowell Danielle , Vicenzino Bill , Bonacci Jason 
Published: July 2022

AbstractBackgroundThere are limited evidence‐based treatment options for adolescents with patellofemoral pain (PFP). Flat, flexible footwear have been shown to reduce patellofemoral joint loading and pain in adults with PFP. The efficacy of this intervention in adolescents with PFP is not established. The primary aim of this study is to determine the feasibility of conducting a large‐scale randomised controlled trial (RCT) of the effect of flat, flexible school footwear, when compared to traditional school footwear, in adolescents with PFP. The secondary aim is to describe changes in self‐reported outcome measures for adolescents with PFP while wearing flat, flexible footwear when compared to traditional school shoes.MethodsTwenty‐four adolescents with PFP will be recruited from the community. Following baseline assessment, participants will be randomly allocated to receive either (i) flat, flexible school footwear or, (ii) traditional school footwear. Participants will wear the shoe as per school requirements throughout a 12‐week intervention period. Feasibility will be assessed with (i) ≥ 75% adherence to allocated shoe wear of their total weekly school wear time, (ii) a recruitment rate of one participant per fortnight, and (iii) a dropout rate of ≤ 20%. Patient reported outcome measures will describe changes in knee pain, function, quality of life and global rating of change at 6 and 12 weeks. Descriptive statistics will be used for the primary outcomes of feasibility.DiscussionThis study will determine the feasibility of conducting a large scale RCT evaluating the effect of flat, flexible school shoes for adolescents with PFP. A full‐scale study will guide evidence‐based management of adolescent PFP.Trial registrationAustralian New Zealand Clinical Trials Registry reference: ACTRN12621001525875, Date registered: 9th November 2021.