bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex Hormones and Risk of Aneurysmal Subarachnoid Hemorrhage: A Mendelian Randomization Study
Authors: Molenberg Rob , Thio Chris H.L. , Aalbers Marlien W. , Uyttenboogaart Maarten ,   ISGC Intracranial Aneurysm Working Group*, Larsson Susanna C. , Bakker Mark K. , Ruigrok Ynte M. , Snieder Harold , van Dijk J. Marc C. 
Published: June 2022

Background:
The risk of aneurysmal subarachnoid hemorrhage (aSAH) is increased in postmenopausal women compared with men of similar age, suggesting a role for sex hormones. We aimed to explore whether sex hormones, and age at menarche/menopause have a causal effect on aSAH risk by conducting a 2-sample MR study (Mendelian randomization).

Methods:
We obtained sex-specific genetic instruments for serum estradiol, bioavailable testosterone (BioT), SHBG (sex hormone-binding globulin), and age at menarche/menopause from genome-wide association studies. The associated sex-specific aSAH risk was estimated with inverse-variance weighted MR analyses with various statistical sensitivity analyses. Multivariable and cluster MR analyses were performed for BioT and SHBG to account for a genetic and phenotypic correlation between the 2 exposures. The clusters represented (1) single-nucleotide polymorphisms primarily increasing SHBG, with secondary decreasing effects on BioT, and (2) single-nucleotide polymorphisms affecting BioT without affecting SHBG.

Results:

Univariable MR analyses showed an 18% increased aSAH risk among women per 1-SD increase in genetically determined SHBG levels (odds ratio, 1.18 [95% CI, 1.05–1.34];
P
=0.007). Suggestive evidence was identified for a 27% decreased risk of aSAH among women per 1-SD increase in BioT (odds ratio, 0.73 [95% CI, 0.55–0.95];
P
=0.02). The latter association disappeared in cluster analysis when only using SHBG-independent variants. MR analyses with variants from the cluster with primary SHBG effects and secondary (opposite) BioT-effects yielded a statistically significant association (odds ratio, 1.21 [95% CI, 1.05–1.40];
P
=0.008). No other causal associations were identified.

Conclusions:
Genetic predisposition to elevated serum levels of SHBG, with secondary lower serum BioT levels, is associated with an increased aSAH risk among women, suggesting that SHBG and BioT causally elevate aSAH risk. Further studies are required to elucidate the underlying mechanisms and their potential as an interventional target to lower aSAH incidence.
Inequality regimes in male-dominated trades: What role do apprenticeship intermediaries (GTOs) play?
Authors: Bamberry Larissa , Bridges Donna , Wulff Elizabeth , Krivokapic-Skoko Branka 
Published: June 2022

AbstractIn Australia and internationally, women continue to be underrepresented in male-dominated trade occupations. A notable barrier is the apprenticeship system, which requires women to overcome obstacles in employment and training. Government and industry stakeholders have encouraged women’s apprenticeships in male-dominated trades through the development of Group Training Organisations’ (GTOs) that operate as intermediaries between apprentices and employers. Extending Acker’s model of workplace inequality regimes, we argue that inequality regimes operate between organisations at an industry-wide level. We ask ‘Do GTOs operate to produce and reproduce workplace and industry-wide inequality regimes? Or can they facilitate improved gender diversity in male-dominated trades?’ Drawing on a recent study of regional tradeswomen’s employment, we find that although GTOs have an important role in facilitating gender diversity, they have inconsistent results in challenging existing inequality regimes. There is a risk that they may become a vector of transmission for workplace inequality regimes to the broader industry.
p57Kip2 regulates embryonic blood stem cells by controlling sympathoadrenal progenitor expansion
Authors: Kapeni Chrysa , Nitsche Leslie , Kilpatrick Alastair M. , Wilson Nicola K. , Xia Kankan , Mirshekar-Syahkal Bahar , Chandrakanthan Vashe , Malouf Camille , Pimanda John E. , Göttgens Berthold , Kirschner Kristina , Tomlinson Simon R. , Ottersbach Katrin 
Published: June 2022

AbstractHematopoietic stem cells (HSCs) are of major clinical importance, and finding methods for their in vitro generation is a prime research focus. We show here that the cell cycle inhibitor p57Kip2/Cdkn1c limits the number of emerging HSCs by restricting the size of the sympathetic nervous system (SNS) and the amount of HSC-supportive catecholamines secreted by these cells. This regulation occurs at the SNS progenitor level and is in contrast to the cell-intrinsic function of p57Kip2 in maintaining adult HSCs, highlighting profound differences in cell cycle requirements of adult HSCs compared with their embryonic counterparts. Furthermore, this effect is specific to the aorta-gonad-mesonephros (AGM) region and shows that the AGM is the main contributor to early fetal liver colonization, as early fetal liver HSC numbers are equally affected. Using a range of antagonists in vivo, we show a requirement for intact β2-adrenergic signaling for SNS-dependent HSC expansion. To gain further molecular insights, we have generated a single-cell RNA-sequencing data set of all Ngfr+ sympathoadrenal cells around the dorsal aorta to dissect their differentiation pathway. Importantly, this not only defined the relevant p57Kip2-expressing SNS progenitor stage but also revealed that some neural crest cells, upon arrival at the aorta, are able to take an alternative differentiation pathway, giving rise to a subset of ventrally restricted mesenchymal cells that express important HSC-supportive factors. Neural crest cells thus appear to contribute to the AGM HSC niche via 2 different mechanisms: SNS-mediated catecholamine secretion and HSC-supportive mesenchymal cell production.
Global DNA hypomethylation of colorectal tumours detected in tissue and liquid biopsies may be related to decreased methyl-donor content
Authors: Szigeti Krisztina A. , Kalmár Alexandra , Galamb Orsolya , Valcz Gábor , Barták Barbara K. , Nagy Zsófia B. , Zsigrai Sára , Felletár Ildikó , V. Patai Árpád , Micsik Tamás , Papp Márton , Márkus Eszter , Tulassay Zsolt , Igaz Peter , Takács István , Molnár Béla 
Published: June 2022

AbstractBackgroundHypomethylation of long interspersed nuclear element 1 (LINE-1) is characteristic of various cancer types, including colorectal cancer (CRC). Malfunction of several factors or alteration of methyl-donor molecules’ (folic acid and S-adenosylmethionine) availability can contribute to DNA methylation changes. Detection of epigenetic alterations in liquid biopsies can assist in the early recognition of CRC. Following the investigations of a Hungarian colon tissue sample set, our goal was to examine the LINE-1 methylation of blood samples along the colorectal adenoma-carcinoma sequence and in inflammatory bowel disease. Moreover, we aimed to explore the possible underlying mechanisms of global DNA hypomethylation formation on a multi-level aspect.MethodsLINE-1 methylation of colon tissue (n = 183) and plasma (n = 48) samples of healthy controls and patients with colorectal tumours were examined with bisulfite pyrosequencing. To investigate mRNA expression, microarray analysis results were reanalysed in silico (n = 60).Immunohistochemistry staining was used to validate DNA methyltransferases (DNMTs)and folate receptor beta(FOLR2)expression along with the determination of methyl-donor molecules’ in situ level (n = 40).ResultsSignificantly decreased LINE-1 methylation level was observed in line with cancer progression both in tissue (adenoma: 72.7 ± 4.8%, and CRC: 69.7 ± 7.6% vs. normal: 77.5 ± 1.7%,p ≤ 0.01) and liquid biopsies (adenoma: 80.0 ± 1.7%, and CRC: 79.8 ± 1.3% vs. normal: 82.0 ± 2.0%,p ≤ 0.01). However, no significant changes were recognized in inflammatory bowel disease cases. According to in silico analysis of microarray data, altered mRNA levels of several DNA methylation-related enzymes were detected in tumours vs. healthy biopsies, namely one-carbon metabolism-related genes—which met our analysing criteria—showed upregulation, whileFOLR2was downregulated. Using immunohistochemistry,DNMTs,andFOLR2expression were confirmed. Moreover, significantly diminished folic acid and S-adenosylmethionine levels were observed in parallel with decreasing 5-methylcytosine staining in tumours compared to normal adjacent to tumour tissues (p ≤ 0.05).ConclusionOur results suggest that LINE-1 hypomethylation may have a distinguishing value in precancerous stages compared to healthy samples in liquid biopsies. Furthermore, the reduction of global DNA methylation level could be linked to reduced methyl-donor availability with the contribution of decreasedFOLR2expression.
Aflatoxin exposure among children of age 12–59 Months in Butajira District, South-Central Ethiopia: a community based cross-sectional study
Authors: Ayele Mary , Haile Demewoz , Alonso Silvia , Sime Heven , Abera Adugna , Balcha Kifle Habte , Roba Kedir Teji , Guma Geremew Tasew , Endris Bilal Shikur 
Published: June 2022

Abstract
Background
The continued provision of safe food, free of aflatoxin remains a huge challenge in developing countries. Despite several favourable climatic conditions that facilitate aflatoxin contamination in Ethiopia, there is little information showing aflatoxin exposure in children. Therefore, this study assessed aflatoxin exposure among young children in Butajira district, South-Central Ethiopia.

Methods
Community based cross-sectional study stratified by agro-ecology was employed in Health and Demographic Surveillance Site (HDSS) of Butajira. The study included 332 children aged 12–59 months and were selected by simple random sampling technique using the HDSS registration number as a sampling frame. We collected data on dietary practice and aflatoxin exposure. Aflatoxin M1 concentration in urine was measured by Enzyme-Linked Immunosorbent assay (ELISA). The data analysis was carried out using STATA.

Results
Detectable urinary Aflatoxin M1 was found in 62.4% (95% CI: 56.9 – 67.5%) of the children at a level ranging from 0.15 to 0.4 ng/ml. Children living in lowland agro-ecological zone had [AOR = 2.11 (95% CI; 1.15, 3.88] odds of being exposed to aflatoxin as compared to children living in highland agro-ecological zone. Children at lower socio-economic status [AOR = 0.27 (95% CI; 0.14, 0.50] and medium socio-economic status [AOR = 0.47 (95% CI; 0.25, 0.87] had 73% and 53% lower odds of being exposed to aflatoxin as compared to children in the higher socio-economic status, respectively.

Conclusions
Aflatoxin exposure among young children was very high in South-Central Ethiopia. This high aflatoxin exposure might emphasize the need for aflatoxin exposure mitigation strategies in Ethiopia. Especially, raising awareness of the community towards aflatoxin exposure is very crucial. In addition, further research is required to assess long-term aflatoxin exposure and its association with child growth and development.
Analysis of the effect of meteorological factors on hemorrhagic fever with renal syndrome in Taizhou City, China, 2008–2020
Authors: Zhang Rong , Zhang Ning , Sun Wanwan , Lin Haijiang , Liu Ying , Zhang Tao , Tao Mingyong , Sun Jimin , Ling Feng , Wang Zhen 
Published: June 2022

Abstract
Background
Hemorrhagic fever with renal syndrome (HFRS) is endemic in Zhejiang Province, China, while few studies have concentrated on the influence of meteorological factors on HFRS incidence in the area.

Methods
Data on HFRS and meteorological factors from January 1, 2008 to December 31, 2020 in Taizhou City, Zhejiang Province were collected. Multivariate analysis was conducted to the relationship between meteorological factors including minimum temperatures, relative humidity, and cumulative rainfall with HFRS.

Results
The HFRS incidence peaked in November and December and it was negatively correlated with average and highest average temperatures. Compared with median of meteorological factors, the relative risks (RR) of weekly average temperature at 12 ℃, weekly highest temperature at 18 ℃relative humidity at 40%, and cumulative rainfall at 240 mm were most significant and RRs were 1.41 (95% CI: 1.09–1.82), 1.32 (95% CI: 1.05–1.66), 2.18 (95% CI: 1.16–4.07), and 1.91 (95% CI: 1.16–2.73), respectively. Average temperature, precipitation, relative humidity had interactions on HFRS and the risk of HFRS occurrence increased with the decrease of average temperature and the increase of precipitation.

Conclusion
Our study results are indicative of the association of environmental factors with the HFRS incidence, probable recommendation could be use of environmental factors as early warning signals for initiating the control measure and response.
Adopting and maintaining a healthy lifestyle in low SES families: How the experience of motherhood shapes responses to dietary and physical activity public health guidance
Authors: Wittels P. , Kay T. , Mansfield L. 
Published: June 2022

Abstract
Background
Public health guidance and associated interventions seek to bring about change in diet and physical activity behaviours to improve life expectancy and healthy life expectancy in the population. Low socioeconomic status (SES) groups suffer from reduced life/healthy life expectancy compared with the population as a whole. This in-depth qualitative study, investigates the lives and experiences of mothers with young children living in a low SES area in a London (UK) borough, to understand the context in which current public health guidance on diet and physical activity is received and viewed, and how this understanding could be used to inform the development of public health guidance and interventions for this group.

Methods
The mothers (n = 20), were recruited from a Surestart Centre, Children’s Centres and through the local branch of a national charity. The mothers took part in a series of three in depth interviews over two years (2016–2017). Thematic analysis was used to generate an iterative set of codes informing an understanding of motherhood, diet and physical activity.

Results
Motherhood was found to be a major factor for understanding and interpreting how women in low SES areas respond to public health guidance on diet and physical activity. The mothers were well informed about dietary guidance, considered that provision of healthy food was critical to the mothering role, but found it difficult to implement the guidance in their own lives. In contrast, physical activity was not seen as integral to the mothering role, although it was acknowledged that it played a part in ensuring that the mothers remained healthy enough to fulfil all their duties. Constrained by the ethic of care, and a lack of material and time resources, the mothers prioritised their family’s health above their own. This study, enabled the mothers to articulate ideas for interventions that would be supportive of a healthy lifestyle and of practical application in their busy lives.

Conclusions
Mothers from this low SES area responded differently to the public health guidance on diet and on physical activity. Whilst providing and modelling a healthy diet was seen as an essential part of the mother’s role, participating in leisure based physical activity was problematic, and unless carefully framed, could be perceived as selfish behaviour, inappropriate for the “good” mother.
Endoscopy-aided retrieval of broken drainage tube after lumbar spine surgery
Authors: Hao Shenshen , Dong Shengli , Li Hongke , Liu Shuai , Chen Honglei , Zhang Zhifang 
Published: June 2022

Abstract
Background
A ruptured drainage tube which remains in the incision is a rare surgical complication. The usual mode of retrieval is to detach the suture and explore the pre-existing incisional wound. However, spinal endoscopy provides an alternative method for successful removal, avoiding the enlargement of the surgical wound.

Case report
A 53-year-old male patient underwent open lumbar spine surgery for lumbar spondylolisthesis between the 5th lumbar and 1st sacral vertebral bodies. Prior to closure, two negative pressure ball drainage tubes were inserted, one of which broke during removal,beneath the fascia. Use of spinal endoscopy enabled the complete removal of the broken drainage tube. Both the original incisional and endoscopic wounds healed well without any sign of infection.

Conclusions
The use of spinal endoscopy to remove the broken drainage tube is an alternative to open the surgical wound and should be took into account.
Factors affecting the use of long term and permanent contraceptive methods: a Facebook-focused cross-sectional study
Authors: Al-Husban Naser , Kaadan Dalia , Foudeh Jude , Ghazi Tara , Sijari Yumen , Maaita Maher 
Published: June 2022

Abstract
Introduction
In the Muslim world, the use and acceptance of long-term and permanent contraceptives were limited. Our aim was to investigate those limiting factors so we can help making these methods widely available and acceptable to the society.

Methods and data analysis
There were 1365 women from Facebook groups in the period 08/10/2020–8/11/2020. Participants were married women, living in Jordan. This was a cross-sectional study. Statistical Package for Social Sciences (SPSS), version 16, software was used for statistical analysis (Chicago, Illinois, USA).

Results
Among participants, 22.3% had never used any contraceptives. Non-hormonal IUCD was the most commonly used method. There was a statistically significant association between the use of hormonal IUCD and women's age, marriage duration, education and number of children (p < 0.0001). Tubal ligation was adopted by only 44 (3.22%) participants. 19.68% of participants declined tubal ligation merely due to religious issues. Women who completed only high school level of education underwent tubal ligation significantly more than those with university (Bachelor) and post-university (Master or PhD) degrees (p < 0.0001 and 0.026, respectively). Only 1.83% of women's partners underwent vasectomy, the majority of these vasectomies (72.0%) were done because of the need for lifelong contraception. Around 17% of women's partners had poor knowledge about vasectomy. Further, women's employment status (housewives or full-time employees) was found to be the only variable that affected acceptance of vasectomy (p = 0.0047).

Conclusions
Women endured a heavy burden of contraception. Cultural and religious taboos influenced tubal ligation. Vasectomy was still very rarely adopted by men due to the lack of knowledge about the procedure. Our results raised the need for further dissemination of contraception knowledge and counselling through the primary care and maternity centers, mosques and media in official, comprehensive and integrated programs. Future research is needed in the field of permanent contraceptive methods.
Impact of classroom-based MASK-ED™ (KRS simulation) on physiotherapy student clinical performance: a randomized cluster trial
Authors: Ryall Tayne , Preston Elisabeth , Mahendran Niruthikha , Bissett Bernie 
Published: June 2022

Abstract
Background
In physiotherapy there is a growing body of literature exploring the benefits simulation could have in the university-setting, prior to the commencement of work-integrated learning. MASK-ED™ simulation is one form of simulation that could be beneficial for student learning and improve performance in the clinical setting. MASK-ED™ simulation involves an educator donning a silicone mask and portraying a patient role that has been specifically developed to meet learning objectives.

Objective
To evaluate the effectiveness of MASK-ED™ simulation compared to role-play with peers for training pre-clinical physiotherapy students.

Methods
A single-centre, single-blind, cluster randomized trial with concealed allocation, between group post-measures, and intention-to-treat analysis was conducted at an Australian university between February 2018 – January 2021. Participants were 144 physiotherapy students, cluster randomized by tutorial groups (exp n = 70, con n = 74), undertaking their neurological curricula. The experimental group was exposed to MASK-ED™ simulation in five out of a potential thirty-two tutorials (16%) whilst the control continued with role-play with peers. The primary outcome measure was Assessment of Physiotherapy Practice scores from the students’ rehabilitation work-integrated learning clinical placement. These were compared between the experimental and control groups using Mann–Whitney U tests. Secondary outcome measures include practical and written examination scores. These were compared between groups via independent t-tests. Participant satisfaction surveys were also administered to the experimental group.

Results
One hundred thirty-two participants’ (exp n = 62, con n = 72) results were analyzed. There were no significant differences between the experimental and control groups for Assessment of Physiotherapy Practice scores (p = 0.699–0.995). There were no significant differences found between the groups, across the secondary outcome measures. Participants found MASK-ED™ simulation was somewhat helpful for preparing them for clinical practice, however felt that a group setting was not as effective as a one-on-one encounter would have been.

Conclusions
MASK-ED™ simulation was no more effective than role-play with peers in preparing physiotherapy students for work-integrated learning. The influence of the design of simulation on effective learning and the number of classroom-based simulation encounters required to impact clinical performance requires further investigation.
Optimizing allocation of curricular content across the Undergraduate & Graduate Medical Education Continuum
Authors: Ginzburg Samara B. , Hayes Margaret M. , Ranchoff Brittany L. , Aagaard Eva , Atkins Katharyn M. , Barnes Michelle , Soep Jennifer B. , Yacht Andrew C. , Alexander Erik K. , Schwartzstein Richard M. 
Published: June 2022

Abstract
Background
Medical educators struggle to incorporate socio-cultural topics into crowded curricula. The “continuum of learning” includes undergraduate and graduate medical education. Utilizing an exemplar socio-cultural topic, we studied the feasibility of achieving expert consensus among two groups of faculty (experts in medical education and experts in social determinants of health) on which aspects of the topic could be taught during undergraduate versus graduate medical education.

Methods
A modified Delphi method was used to generate expert consensus on which learning objectives of social determinants of health are best taught at each stage of medical education. Delphi respondents included experts in medical education or social determinants of health. A survey was created using nationally published criteria for social determinants of health learning objectives. Respondents were asked 1) which learning objectives were necessary for every physician (irrespective of specialty) to develop competence upon completion of medical training and 2) when the learning objective should be taught. Respondents were also asked an open-ended question on how they made the determination of when in the medical education continuum the learning objective should be taught.

Results
26 out of 55 experts (13 social determinants of health and 13 education experts) responded to all 3 Delphi rounds. Experts evaluated a total of 49 learning objectives and were able to achieve consensus for at least one of the two research questions for 45 of 49 (92%) learning objectives. 50% more learning objectives reached consensus for inclusion in undergraduate (n = 21) versus graduate medical education (n = 14).

Conclusions
A modified Delphi technique demonstrated that experts could identify key learning objectives of social determinants of health needed by all physicians and allocate content along the undergraduate and graduate medical education continuum. This approach could serve as a model for similar socio-cultural content. Future work should employ a qualitative approach to capture principles utilized by experts when making these decisions.