bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clonal hematopoiesis in patients with stem cell mobilization failure: a nested case-control study
Authors: Hazenberg Carin L. E. , de Graaf Aniek O. , Mulder René , Bungener Laura B. , van Bergen Maaike G. J. M. , Mulder André B. , Choi Goda , Schuringa Jan Jacob , de Groot Marco R. , Vellenga Edo , Jansen Joop H. , Huls Gerwin , van Zeventer Isabelle A. 
Published: October 2022

Abstract
Inadequate mobilization of peripheral blood progenitor cells (PBPCs) is a limiting factor to proceeding with autologous hematopoietic cell transplantation (auto-HCT). To assess the impact of clonal hematopoiesis (CH) on mobilization failure of PBPC for auto-HCT, we investigated the characteristics of poor mobilizers (with a total PBPC collection &lt;2 × 106 CD34+ cells per kg) in a consecutive single-center cohort of 776 patients. Targeted error-corrected next-generation sequencing of 28 genes was performed in a nested case-control cohort of 90 poor mobilizers and 89 matched controls. CH was detected in 48 out of 179 patients (27%), with most patients carrying a single mutation. The presence of CH (detected at variant allele frequency [VAF] ≥ 1%) did not associate with poor mobilization potential (31% vs 22% in controls, odds ratio, 1.55; 95% confidence interval, 0.76-3.23; P = .238). PPM1D mutations were detected more often in poor mobilizers (P = .005). In addition, TP53 mutations in this cohort were detected exclusively in patients with poor mobilization potential (P = .06). The incidence of therapy-related myeloid neoplasms (t-MN) was higher among patients with mobilization failure (P = .014). Although poor mobilizers experienced worse overall survival (P = .019), this was not affected by the presence of CH. We conclude that CH at low VAF (1%-10%) is common at the time of stem cell mobilization. TP53 mutations and PPM1D mutations are associated with poor mobilization potential and their role in subsequent development of t-MN in these individuals should be established.
Anti-aging effect of β-carotene through regulating the KAT7-P15 signaling axis, inflammation and oxidative stress process
Authors: Zheng Wei V. , Xu Wang , Li Yaqin , Qin Jie , Zhou Tao , Li Dezhi , Xu Yanwei , Cheng Xianyi , Xiong Yu , Chen Zaizhong 
Published: October 2022

Abstract
Background
Research on aging is growing as the elderly make up a greater share of the population, focusing on reversing and inhibiting the aging process. The exhaustion and senescence of stem cells are the fundamental drivers behind aging. β-Carotene has been depicted to have many biological functions, and we speculate that it may have an anti-aging effect.

Methods
Firstly, the anti-aging property of β-carotene was investigated in vitro using mesenchymal stem cells (MSCs) induced by H2O2. The anti-aging effect was characterized using Western-bloting, confocal laser scanning microscopy, indirect immunofluorescence, and immunohistochemistry. The anti-aging property was also tested in vivo using aged mice.

Results
The in vitro experiment revealed that β-carotene could relieve the aging of MSCs, as evidenced by a series of aging marker molecules such as p16 and p21. β-Carotene appeared to inhibit aging by regulating the KAT7-P15 signaling axis. The in vivo experiment revealed that β-carotene treatment has significantly down-regulated the aging level of tissues and organs.

Conclusions
In this work, we explored the anti-aging effect of β-carotene in vivo and in vitro. The experimental results indicate that β-carotene may be an important potential anti-aging molecule, which can be used as a drug or in functional food to treat aging in the future.
Mainstreaming adult ADHD into primary care in the UK: guidance, practice, and best practice recommendations
Authors: Asherson Philip , Leaver Laurence , Adamou Marios , Arif Muhammad , Askey Gemma , Butler Margi , Cubbin Sally , Newlove-Delgado Tamsin , Kustow James , Lanham-Cook Jonathan , Findlay James , Maxwell Judith , Mason Peter , Read Helen , van Rensburg Kobus , Müller-Sedgwick Ulrich , Sedgwick-Müller Jane , Skirrow Caroline 
Published: October 2022

Abstract
Background
ADHD in adults is a common and debilitating neurodevelopmental mental health condition. Yet, diagnosis, clinical management and monitoring are frequently constrained by scarce resources, low capacity in specialist services and limited awareness or training in both primary and secondary care. As a result, many people with ADHD experience serious barriers in accessing the care they need.

Methods
Professionals across primary, secondary, and tertiary care met to discuss adult ADHD clinical care in the United Kingdom. Discussions identified constraints in service provision, and service delivery models with potential to improve healthcare access and delivery. The group aimed to provide a roadmap for improving access to ADHD treatment, identifying avenues for improving provision under current constraints, and innovating provision in the longer-term. National Institute for Health and Care Excellence (NICE) guidelines were used as a benchmark in discussions.

Results
The group identified three interrelated constraints. First, inconsistent interpretation of what constitutes a ‘specialist’ in the context of delivering ADHD care. Second, restriction of service delivery to limited capacity secondary or tertiary care services. Third, financial limitations or conflicts which reduce capacity and render transfer of care between healthcare sectors difficult. The group recommended the development of ADHD specialism within primary care, along with the transfer of routine and straightforward treatment monitoring to primary care services. Longer term, ADHD care pathways should be brought into line with those for other common mental health disorders, including treatment initiation by appropriately qualified clinicians in primary care, and referral to secondary mental health or tertiary services for more complex cases. Long-term plans in the NHS for more joined up and flexible provision, using a primary care network approach, could invest in developing shared ADHD specialist resources.

Conclusions
The relegation of adult ADHD diagnosis, treatment and monitoring to specialist tertiary and secondary services is at odds with its high prevalence and chronic course. To enable the cost-effective and at-scale access to ADHD treatment that is needed, general adult mental health and primary care must be empowered to play a key role in the delivery of quality services for adults with ADHD.
The impact of volunteering with a student-run free clinic on medical student specialty selection
Authors: Thomson Kyle B. , Mirpuri Pranav , Chen Melissa 
Published: October 2022

Abstract
Background
The shortage of primary care physicians in the United States is expected to grow to 17,800–48,000 physicians by 2034. Student Run Free Clinics are an increasingly popular component of medical schools and may provide an avenue for increasing medical student interest in primary care specialties. However, there is limited research on the impact of Student Run Free Clinics on medical student specialty choice. This investigation sought to determine whether volunteering with the Interprofessional Community Clinic (ICC), the Student Run Free Clinic associated with Chicago Medical School, was associated with an increased likelihood of matching into primary care specialties. Secondarily, the authors investigated associations between volunteering and matching into family practice. Finally, the authors explored associations between volunteering and the competitiveness of specialty choice.

Methods
This retrospective review utilized data on medical school graduates from 2015 – 2021 including their matched specialties, the number of ICC shifts they volunteered for, and whether they held an ICC leadership position (executive officers). Primary care specialties were defined as internal medicine, family practice, pediatrics, or combined internal medicine/pediatrics. Residency fill rate was used as a proxy for competitiveness.

Results
This analysis included 506 medical students (254 ICC volunteers and 252 non-volunteers). Among ICC volunteers, 47.2% matched into a primary care specialty compared to 36.5% of non-volunteers (RR 1.29, 95% CI 1.05–1.59). Each additional shift worked at the ICC was correlated with increased odds of matching into family practice by a factor of 1.042 (95% CI 1.005–1.079).

Conclusions
Medical students who volunteered with the ICC were more likely to match into primary care residencies. Students who volunteered more frequently were more likely to match into family practice. Further investigation is warranted to determine whether these associations are causative and could thus be leveraged to encourage medical students to pursue primary care careers.
Mental health task-sharing in South Africa – a role for clinical associates?
Authors: Moodley Saiendhra Vasudevan , Wolvaardt Jacqueline , Grobler Christoffel 
Published: October 2022

Abstract
Background
South Africa (SA) lacks the specialised workforce needed to provide mental health services particularly in the public sector and in rural areas. Mid-level medical workers offer a potential option for mental health task-sharing in countries where they exist, including SA. The objectives of the study were to explore the roles that SA’s mid-level medical worker cadre (clinical associates) could play in mental health service delivery, and to explore views on advanced training in mental health for this cadre.

Methods
This was an explorative, qualitative study involving key informants linked to the three clinical associate training programmes in SA. A total of 19 in-depth interviews were conducted with university-based academic staff, facility-based trainers, and student representatives. The interviews were audio-recorded and professionally transcribed. Thematic analysis was conducted with the aid of Atlas.ti software. Themes and subthemes were identified.

Results
The first theme identified was ‘there is a place for them at the table’. Participants felt that there was a definite role for clinical associates in mental health service provision. The levels of care thought most appropriate were primary health care facilities and district hospitals. The most frequently identified role for clinical associates was in providing immediate care and stabilising mental health patients presenting in emergency settings. Other potential settings included inpatient wards, outpatients’ departments, and in communities (e.g. home visits). The second theme identified was ‘earning a seat at the table’. There was virtually unanimous support for additional training and in particular a postgraduate clinical specialisation in mental health. Participants felt a clinical specialisation in mental health would strengthen the health system by addressing workforce shortages as well as access and equity issues. They also held the view it would strengthen the profession by creating a career path and providing more employment opportunities for clinical associates.

Conclusions
There was broad support for a role for clinical associates in mental health service delivery in SA as well as for the establishing a clinical specialisation in mental health for clinical associates. Clinical associates with advanced training in mental health could potentially play an important role in rural settings to alleviate the shortage of specialist mental health practitioners.
Different phenotypes of microglia in animal models of Alzheimer disease
Authors: Wei Yun , Li Xianxiao 
Published: October 2022

AbstractMicroglia are immune-competent cells that are critically involved in maintaining normal brain function. A prominent characteristic of Alzheimer disease (AD) is microglial proliferation and activation concentrated around amyloid plaques in the brain. Recent research has revealed numerous microglial phenotypes related to aging and AD, apart from the traditional M1 and M2 types. Redox signalling modulates the acquisition of the classical or alternative microglia activation phenotypes. The numerous microglial functions can be achieved through these multiple phenotypes, which are associated with distinct molecular signatures.
Moving towards a continuum of safer supply options for people who use drugs: A qualitative study exploring national perspectives on safer supply among professional stakeholders in Canada
Authors: Foreman-Mackey Annie , Pauly Bernie , Ivsins Andrew , Urbanoski Karen , Mansoor Manal , Bardwell Geoff 
Published: October 2022

Abstract
Background
Novel public health interventions are needed to address the toxic drug supply and meet the needs of people who use drugs amidst the overdose crisis. Safer supply – low-barrier distribution of pharmaceutical grade substances – has been implemented in some jurisdictions to provide safer alternatives to the unregulated drug supply, yet no studies to date have explored professional stakeholder perspectives on this approach.

Methods
We used purposive sampling to recruit professional stakeholders (n = 17) from four locations in British Columbia, Ontario, and Nova Scotia, including program managers, executive directors, political and health authority representatives, and healthcare providers involved in the design, implementation, and/or operation of safer supply programs in their communities. Semi-structured, one-to-one interviews were conducted, and interview data were coded and analyzed using thematic analyses.

Results
Participants defined safer supply as low-barrier access to substances of known quality and quantity, offered on a continuum from prescribed to a legal, regulated supply, and focused on upholding autonomy and liberation of people who use drugs. Stakeholders expressed support for safer supply but explained that current iterations do not meet the needs of all people who use drugs and that implementation is limited by a lack of willing prescribers, stigma towards people who use drugs, and precarity of harm reduction programs to political ideology. Stakeholders expressed strong support for wider-reaching approaches such as decriminalization, legalization, and regulation of substances as a way to fully realize a continuum of safer supply, directly address the overdose crisis and toxic drug supply, and ensure equity of access nationally.

Conclusion
The results of this study highlight the need for innovative strategies to address the overdose crisis and that safer supply has the potential to benefit certain people who use drugs. A one-size-fits-all approach is not sufficient and the perspectives of professional stakeholders should be considered alongside those of people who use drugs when designing and implementing future safer supply.
Anatomical observation, classification, fracture and finite element analysis of the posterior process of the Asian adult talus
Authors: Yang Han , Liao Liqing , Xue Fan , Li Yikai , Hu Guanyu 
Published: October 2022

Abstract
Background
Fractures of the posterior process of the talus are rarely seen and frequently overlooked. In our study, anatomical observation and classification of the posterior process of the talus were carried out, and related imaging and finite element methods were combined. The study aimed to observe and provide anatomical data related to posterior process of talus in Asian adults and explore the potential relationships between the different types with fracture of posterior process of talus.

Methods
Combined with the anatomical morphology and imaging data, the posterior process of talus was divided into four types, and the incidence and fracture situation were statistically analyzed. The finite element models of four different types of talus processes were established and verified, and the stress and strain were simulated and analyzed.

Results
The total incidence of the posterior process of the talus was 97.47%. The proportions of the four types were neck-like 10.13%, flat 36.29%, pointy 12.66% and round blunt 38.39%. The overall incidence of bone cracks of the posterior process of the talus was 4.98%; the most common type was neck-like type. Compared with the value on the other types, the maximum von Mises stress increased by 67.66%, 83.90% and 111.18% on the neck-like posterior process of talus respectively.

Conclusions
It is speculated that different types of the posterior process of the talus may be related to the probability of fracture, and it may be better to consider different treatment strategies for different types of fractures.
Effects of C/N ratio on the growth and protein accumulation of heterotrophic Chlorella in broken rice hydrolysate
Authors: Cai Yihui , Zhai Ligong , Fang Xiaoman , Wu Kangping , Liu Yuhuan , Cui Xian , Wang Yunpu , Yu Zhigang , Ruan Roger , Liu Tongying , Zhang Qi 
Published: October 2022

Abstract
Background
Microalgae protein is considered as a sustainable alternative to animal protein in the future. Using waste for microalgal culture can upgrade low-value raw materials into high-value products, helping to offset the cost of microalgal protein production. In this study we explored the feasibility of using microalgae heterotrophic fermentation to convert broken rice hydrolysate (BRH) into protein.

Results
The results showed that the increase of BRH supplemental ratio was beneficial to the increase of biomass production but not beneficial to the increase of intracellular protein content. To further improve protein production, the effect of C/N ratio on intracellular protein accumulation was studied. It was found that low C/N ratio was beneficial to the synthesis of glutamate in microalgae cells, which in turn promoted the anabolism of other amino acids and further the protein. When the C/N ratio was 12:1, the biomass productivity and protein content could reach a higher level, which were 0.90 g/L/day and 61.56%, respectively. The obtained Chlorella vulgaris biomass was rich in essential amino acids (41.80%), the essential amino acid index was as high as 89.07, and the lysine content could reach up to 4.05 g/100 g.

Conclusions
This study provides a theoretical basis and guidance for using Chlorella vulgaris as an industrial fermentation platform to convert broken rice into products with high nutritional value.
Preoperative prediction of lymph node metastasis in nonfunctioning pancreatic neuroendocrine tumors from clinical and MRI features: a multicenter study
Authors: Zhu Hai-bin , Nie Pei , Jiang Liu , Hu Juan , Zhang Xiao-Yan , Li Xiao-Ting , Lu Ming , Sun Ying-Shi 
Published: October 2022

Abstract
Background
The extent of surgery in nonfunctioning pancreatic neuroendocrine tumors (NF-PNETs) has not well established, partly owing to the dilemma of precise prediction of lymph node metastasis (LNM) preoperatively. This study proposed to develop and validate the value of MRI features for predicting LNM in NF-PNETs.

Methods
A total of 187 patients with NF-PNETs who underwent MR scan and subsequent lymphadenectomy from 4 hospitals were included and divided into training group (n = 66, 1 center) and validation group (n = 121, 3 centers). The clinical characteristics and qualitative MRI features were collected. Multivariate logistic regression model for predicting LNM in NF-PNETs was constructed using the training group and further tested using validation group.

Results
Nodal metastases were reported in 41 patients (21.9%). Multivariate analysis showed that regular shape of primary tumor (odds ratio [OR], 4.722; p = .038) and the short axis of the largest lymph node in the regional area (OR, 1.488; p = .002) were independent predictors for LNM in the training group. The area under the receiver operating characteristic curve in the training group and validation group were 0.890 and 0.849, respectively. Disease-free survival was significantly different between model-defined LNM and non-LNM group.

Conclusions
The novel MRI-based model considering regular shape of primary tumor and short axis of largest lymph node in the regional area can accurately predict lymph node metastases preoperatively in NF-PNETs patients, which might facilitate the surgeons’ decision on risk stratification.
De Winter presentations and considerations: a case series
Authors: Shahri Bahram , Vojdanparast Mohammad , Keihanian Faeze , Eshraghi Ali 
Published: October 2022

Abstract
Background
The electrocardiogram has a critical role in the diagnosis and risk assessment of patients presenting with chest pain in the emergency ward.

Case presentation
We present 11 Iranian patients with diagnosis of de Winter referred to our center. Right coronary artery involvement was seen in four cases, left circumflex artery in three cases, proximal left anterior descending artery in two cases, and middle left anterior descending artery in seven cases. We present the case of a 52-year old Iranian male patient in detail.

Conclusion
Recognizing the electrocardiogram of de Winter as an ST-elevation myocardial infarction equivalent in cases with suspected acute infarction is very important.
No matter how much space and light are available, radial growth distribution in Fagus sylvatica L. trees is under strong biomechanical control
Authors: Dongmo Keumo Jiazet Joel Hans , Dlouha Jana , Fournier Meriem , Moulia Bruno , Ningre François , Constant Thiery 
Published: October 2022

AbstractKey messageThis study presents the first attempt to quantify how the thigmomorphogenetic syndrome is involved inFagus sylvaticaL. tree growth responses to thinning. An experimental design preventing mechanosensing in half of the trees demonstrated that radial growth distribution in roots and along the tree stem is under strong biomechanical control.ContextStudies on the mechanosensitive control of growth under real forest conditions are rare and those existing to date all deal with conifer species. In the current context of global changes, it is important to disentangle how different biotic and abiotic factors affect tree growth.AimsWhereas growth changes after thinning are usually interpreted as responses to decreased competition for resources, this study investigates the importance of how mechanosensing controls growth distribution inside the tree.MethodsIn an even-aged beech stand, 40 pole-sized trees (size class at first thinning) were selected, half of the plot was thinned and, within each sub-plot (thinned and unthinned), half of the tree were guy-wired in order to remove mechanical stimulations to the lower part of the stem. Four years later, all trees were felled and volume increment, ring width distribution along the tree height, and the largest ring width of the structural roots were measured. The effect of mechanical stimulation in the two treatments (thinned and unthinned) was assessed.ResultsRemoval of mechanical stimulation decreased the volume increment in the lower part of the stem as well as radial root growth but did not affect axial growth. When mechanical strain was removed, the ring width distribution along the stem height changed drastically to an ice-cream cone-like distribution, indicating a strong mechanosensitive control of tree shape.ConclusionIn a forest stand, the growth allocation inside the tree is under strong mechanical control. Mechanical stimulations explain more than 50% of the increment stimulated by thinning, whatever the growth indicator. A further challenge is to better understand how cambial cells perceive strains during growth in order to integrate mechanosensing into process-based tree-growth modeling.