bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of geographic isolation on the Bulbophyllum chloroplast genomes
Authors: Yang Jiapeng , Zhang Fuwei , Ge Yajie , Yu Wenhui , Xue Qiqian , Wang Mengting , Wang Hongman , Xue Qingyun , Liu Wei , Niu Zhitao , Ding Xiaoyu 
Published: April 2022

AbstractBackgroundBecause chloroplast (cp) genome has more conserved structures than nuclear genome and mitochondrial genome, it is a useful tool in estimating the phylogenetic relationships of plants. With a series of researches for cp genomes, there have been comprehensive understandings about the cp genome features. The genusBulbophyllumwidely distributed in Asia, South America, Australia and other places. Therefore, it is an excellent type genus for studying the effects of geographic isolation.ResultsIn this study, the cp genomes of nineBulbophyllumorchids were newly sequenced and assembled using the next-generation sequencing technology. Based on 19 Asian (AN) and eight South American (SA)Bulbophyllumorchids, the cp genome features of AN clade and SA clade were compared. Comparative analysis showed that there were considerable differences in overall cp genome features between two clades in three aspects, including basic cp genome features, SSC/IRBjunctions (JSBs) and mutational hotspots. The phylogenetic analysis and divergence time estimation results showed that the AN clade has diverged from the SA clade in the late Oligocene (21.50–30.12 mya). After estimating the occurrence rates of the insertions and deletions (InDels), we found that the change trends of cp genome structures between two clades were different under geographic isolation. Finally, we compared selective pressures on cp genes and found that long-term geographic isolation made AN and SABulbophyllumcp genes evolved variably.ConclusionThe results revealed that the overall structural characteristics ofBulbophyllumcp genomes diverged during the long-term geographic isolation, and the crassulacean acid metabolism (CAM) pathway may play an important role in theBulbophyllumspecies evolution.
Impact of baseline impedance of pulmonary vein antrum on success of catheter ablation for paroxysmal atrial fibrillation guided by ablation index
Authors: Sun Yuanjun , Xiao Xianjie , Yin Xiaomeng , Gao Lianjun , Yu Xiaohong , Zhang Rongfeng , Wang Zhongzhen , Dai Shiyu , Yang Yanzong , Xia Yunlong 
Published: April 2022

Abstract
Objective
Ablation index (AI) is an effective ablation quality marker. Impedance is also an important factor for lesion formation. The present study evaluated the influence of the baseline impedance in the effect of ablation for atrial fibrillation (AF) guided by AI.

Methods
This was a retrospective study. 101 patients with paroxysmal AF (PAF) were enrolled. All patients underwent radiofrequency ablation guided by the same AI strategy. The ablation strategy was pulmonary vein (PV) isolation with non-PV triggers ablation. The baseline impedance of the ablation points was recorded. The patients were followed up every 3 months or so.

Results
During a median follow-up of 12 (4–14) months, freedom from AF/atrial tachycardia recurrence were 82.2%. No difference existed in baseline characteristics between the success group and the recurrence group. The average baseline impedance was 124.3 ± 9.7 Ω. The baseline impedance of the ablation points in success group was lower compared to the recurrence group (122.9 ± 9.4 vs. 130.5 ± 8.8 Ω, P < 0.01). The ratio of impedance drop in the success group was higher than the recurrence group ([8.8 ± 1.4]% vs. [8.1 ± 1.2]%, P = 0.03). Multivariate analysis revealed that baseline impedance, PAF duration and AI were the independent predictors of AF recurrence. The cumulative free of recurrence rate of low-impedance group (≤ 124 Ω, n = 54) was higher than that of high-impedance group.

Conclusion
Baseline impedance correlates with clinical outcome of radiofrequency ablation for PAF guided by AI. Higher impedance in the same AI strategy may result in an ineffective lesion which probably causes recurrence.
The effect of subdiaphragmatic vagotomy on heart rate variability and lung inflammation in rats with severe hemorrhagic shock
Authors: Khodadadi Fateme , Ketabchi Farzaneh , Khodabandeh Zahra , Tavassoli Alireza , Lewis Gregory F. , Bahaoddini Aminollah 
Published: April 2022

Abstract
Background
The influence of cutting the sub-diaphragmatic branch of the vagus nerve on heart rate variability (HRV) and inflammatory reaction to severe hemorrhagic shock has not been determined prior to this study.

Methods
Male Sprague–Dawley rats were divided into four groups of Sham, sub-diaphragmatic vagotomized (Vag), subacute (135 ± 2 min) hemorrhagic shock (SHS), and sub-diaphragmatic vagotomized with SHS (Vag + SHS). Hemodynamic parameters were recorded and HRV calculated during multiple phases in a conscious model of hemorrhagic shock. The expressions of TNF-α and iNOS were measured in the spleen and lung tissues at the conclusion of the protocol.

Results
Decreases in blood pressure during blood withdrawal were identical in the SHS and Vag + SHS groups. However, heart rate only decreased in the Nadir-1 phase of the SHS group. HRV indicated increased power in the very-low, low, and high (VLF, LF, and HF) frequency bands during the Nadir-1 phase of the SHS and Vag + SHS groups, albeit the values were higher in the SHS group. In the recovery phase, the HF bands were only lower in the SHS group. After hemorrhagic shock followed by resuscitation, the expression of TNF-α and iNOS increased in the spleen and lung of the SHS group, and the expression of these genes was significantly lower in the Vag + SHS group than in the SHS group.

Conclusion
Parasympathetic activity increases during the hypotensive phase of hemorrhagic shock, whereas the cardiac vagal tone decreases in the recovery phase. Sub-diapragmatic vagotomy blunts the cardiac vagal tone during hemorrhagic shock, but its effect is reversed in the recovery phase. The vagus nerve plays a role in proinflammatory responses in the lungs and spleen in subacute hemorrhagic shock followed by resuscitation.
Blinded sample size re-estimation in a comparative diagnostic accuracy study
Authors: Stark Maria , Hesse Mailin , Brannath Werner , Zapf Antonia 
Published: April 2022

AbstractBackgroundThe sample size calculation in a confirmatory diagnostic accuracy study is performed for co-primary endpoints because sensitivity and specificity are considered simultaneously. The initial sample size calculation in an unpaired and paired diagnostic study is based on assumptions about, among others, the prevalence of the disease and, in the paired design, the proportion of discordant test results between the experimental and the comparator test. The choice of the power for the individual endpoints impacts the sample size and overall power. Uncertain assumptions about the nuisance parameters can additionally affect the sample size.MethodsWe develop an optimal sample size calculation considering co-primary endpoints to avoid an overpowered study in the unpaired and paired design. To adjust assumptions about the nuisance parameters during the study period, we introduce a blinded adaptive design for sample size re-estimation for the unpaired and the paired study design. A simulation study compares the adaptive design to the fixed design. For the paired design, the new approach is compared to an existing approach using an example study.ResultsDue to blinding, the adaptive design does not inflate type I error rates. The adaptive design reaches the target power and re-estimates nuisance parameters without any relevant bias. Compared to the existing approach, the proposed methods lead to a smaller sample size.ConclusionsWe recommend the application of the optimal sample size calculation and a blinded adaptive design in a confirmatory diagnostic accuracy study. They compensate inefficiencies of the sample size calculation and support to reach the study aim.
The effectiveness of the sarcopenia index in predicting septic shock and death in elderly patients with community-acquired pneumonia
Authors: Huang Sha , Zhao Lingdan , Liu Zhaoyuan , Li Yang , Wang Xi , Li Jianqun , Chen Xiaoyan 
Published: April 2022

Abstract
Background
Community-acquired pneumonia (CAP) causes high morbidity and mortality in all age groups worldwide. Lower muscle radiodensity was associated with worse clinical outcomes (including shock) and higher in-hospital mortality. Prompt detection of sarcopenia in older adults with CAP is important. The measurement of muscle mass often involves specialized and expensive techniques. A relatively simple and inexpensive method such as the sarcopenia index (SI) to measure muscle mass would be helpful. Therefore, we performed a retrospective cohort study to assess the association between SI and septic shock risk and mortality in older patients with CAP.

Study design
In this retrospective cohort study, information on hospitalized CAP patients, including general information and septic shock, were obtained from the medical record database of the Southwest Medical University Zigong Affiliated Hospital, China. Data on patient survival and mortality (all-cause) were acquired from government authorities and telephonic follow-up. Serum creatinine (Cr) and cystatin-C (CysC) levels on admission were included in the database. The SI was determined as the serum Cr/CysC ratio × 100 and the participants were assigned to low and high SI groups. The association between SI and septic shock was evaluated by logistic regression, and that between SI and mortality by Cox regression analysis.

Results
In total, 769 older adults (≥ 60 years) with CAP were included, of which 480(62.4%) were male and 289(37.6%)were female. We found that the total prevalence of septic shock in older adults with CAP was 16.0%. In the female group, septic shock was more prevalent in the low SI group than in the high SI group (low SI vs. high SI, 22.22% vs. 11.52%, p = 0.024). Following adjustment for confounders, there was a significant association between high SI and a lower risk of septic shock in female patients (OR = 0.38, 95%CI: 0.16–0.94; p < 0.05). The total death toll of older adults with CAP was 332(43.2%). Irrespective of sex, there was a higher risk of mortality in the low SI group (total group: low SI vs. high SI, 63.02% vs. 36.57%, p < 0.001; male group: low SI vs. high SI, 63.03% vs. 39.34%, p < 0.001; female group: low SI vs. high SI, 73.61% vs. 28.57%, p < 0.001) and, after adjustment for confounding factors and irrespective of sex, high SI was a protective factor for mortality in older adults with CAP (total group: HR = 0.64, 95%CI: 0.48–0.84; p < 0.05; male: HR = 0.69, 95%CI: 0.49–0.97; p < 0.05; female: HR = 0.39, 95%CI: 0.24–0.62; p < 0.05).

Conclusion
While the SI effectively predicts mortality in older adults with CAP, it was only found to be associated with septic shock in older females.
Injuries from falls by older adults in long-term care captured on video: Prevalence of impacts and injuries to body parts
Authors: Komisar Vicki , Dojnov Aleksandra , Yang Yijian , Shishov Nataliya , Chong Helen , Yu Ying , Bercovitz Ian , Cusimano Michael D. , Becker Clemens , Mackey Dawn C. , Robinovitch Stephen N. 
Published: April 2022

Abstract
Background
Falls are the leading cause of injuries in older adults. However, most falls in older adults do not cause serious injury, suggesting that older adults may fall in a manner that reduces the likelihood of impact to body sites that are most vulnerable to injury. In this observational study of falls in long-term care (LTC), we tested whether body parts differed in their probability of impact and injury.

Methods
We recorded and analyzed videos of 2388 falls by 658 LTC residents (mean age 84.0 (SD = 8.1); 56.4% female). We used Linear Mixed Models to test for differences between body parts in the probability of impact and injury, and injury when impacts occurred.

Results
Injuries were reported in 38.2% of falls, and 85.9% of injuries involved direct impact to the injured body part. Impact occurred most often to the hip/pelvis (probability (standard error) = 0.95 (0.01); p < .001 relative to other body parts), and least often to the head (0.35 (0.01)). Conversely, injury occurred most often to the head (p < .001 relative to other body parts). The probability of injury when impacts occurred was 0.40 (0.01) for the head, and 0.11 or less for all other body parts.

Conclusion
Our results help to explain why most falls by older adults in LTC do not cause serious injury: residents land on body parts that are the most resilient to injury. The high susceptibility of the head to injury reinforces the need to enhance upper limb protective responses for fall arrest. The dominant role of direct impact as the mechanism of injury supports approaches to attenuate impact forces through strategies like protective clothing and compliant flooring.
Predicting the risk of active pulmonary tuberculosis in people living with HIV: development and validation of a nomogram
Authors: Chen Jinou , Li Ling , Chen Tao , Yang Xing , Ru Haohao , Li Xia , Yang Xinping , Xie Qi , Xu Lin 
Published: April 2022

Abstract
Background
Diagnosis of pulmonary tuberculosis (PTB) among people living with HIV (PLHIV) was challenging. The study aimed to develop and validated a simple, convenient screening model for prioritizing TB among PLHIV.

Methods
The study included eligible adult PLHIV participants who attended health care in Yunnan, China, from January 2016 to July 2019. Participants included before June 2018 were in the primary set; others were in the independent validation set. The research applied the least absolute shrinkage and selection operator regression to identify predictors associated with bacteriological confirmed PTB. The TB nomogram was developed by multivariate logistic regression. The C-index, receiver operating characteristic curve (ROC), the Hosmer–Lemeshow goodness of fit test (H–L), and the calibration curves were applied to evaluate and calibrate the nomogram. The developed nomogram was validated in the validation set. The clinical usefulness was assessed by cutoff analysis and decision curve analysis in the primary set.

Result
The study enrolled 766 PLHIV, of which 507 were in the primary set and 259 in the validation set, 21.5% and 14.3% individuals were confirmed PTB in two sets, respectively. The final nomogram included 5 predictors: current CD 4 cell count, the number of WHO screen tool, previous TB history, pulmonary cavity, and smoking status (p < 0.05). The C-statistic was 0.72 (95% CI 0.66–0.77) in primary set and 0.68 (95% CI 0.58–0.75) in validation set, ROC performed better than other models. The nomogram calibration was good (H–L χ2 = 8.14, p = 0.15). The area under the decision curve (0.025) outperformed the existing models. The optimal cutoff for screening TB among PLHIV was the score of 100 (sensitivity = 0.93, specificity = 0.35).

Conclusion
The study developed and validated a discriminative TB nomogram among PLHIV in the moderate prevalence of TB and HIV. The easy-to-use and straightforward nomogram would be beneficial for clinical practice and rapid risk screening in resource-limited settings.
Enhanced serodiagnosis of melioidosis by indirect ELISA using the chimeric protein rGroEL-FLAG300 as an antigen
Authors: Wajanarogana Sumet , Taylor Water R. J. , Kritsiriwuthinan Kanyanan 
Published: April 2022

Abstract
Background
The accurate and rapid diagnosis of melioidosis is challenging. Several serological approaches have been developed using recombinant antigens to improve the diagnostic indices of serological tests for melioidosis.

Methods
Fusion proteins from Burkholderia pseudomallei (rGroEL-FLAG300) were evaluated as a potential target antigen for melioidosis antibodies. A total of 220 serum samples from 38 culture proven melioidosis patients (gold standard), 126 healthy individuals from endemic (n = 37) and non-endemic (n = 89) Thai provinces and 56 patients with other proven bacterial infections as negative controls were tested using indirect enzyme-linked immunosorbent assays (ELISA).

Results
Using an optical density (OD) cut-off of 0.299148, our assay had 94.74% sensitivity (95% confidence interval (CI) = 82.3–99.4%), 95.05% specificity (95% CI = 90.8–97.7%), and 95% accuracy, which was better than in our previous work (90.48% sensitivity, 87.14% specificity, and 87.63% accuracy).

Conclusion
Our results suggest that the application of chimeric antigens in ELISA could improve the serological diagnosis of melioidosis and should be reconfirmed with greater patient numbers.
Effect of a carbohydrate-rich beverage on rate of cesarean delivery in primigravidae with epidural labor analgesia: a multicenter randomized trial
Authors: Ding Ting , Deng Chun-Mei , Shen Xiao-Feng , Bai Yao-Wu , Zhang Xiao-Lan , Liu Ji-Ping , Yang Li-Juan , Yu Hai-Tao , Xie Lei , Chen Hong , Mu Dong-Liang , Qu Yuan , Yang Hui-Xia , Bao Ai-Rong , Zhu Sai-Nan , Wang Dong-Xin 
Published: April 2022

Abstract
Background
Labor represents a period of significant physical activity. Inefficient energy supply may delay labor process and even lead to cesarean delivery. Herein we investigated whether ingestion of a carbohydrate-rich beverage could reduce cesarean delivery in laboring women with epidural analgesia.

Methods
This multicenter randomized trial was conducted in obstetrician-led maternity units of nine tertiary hospitals in China. Primigravidae with single term cephalic pregnancy who were preparing for vaginal birth under epidural analgesia were randomized to intake a carbohydrate-rich beverage or commercially available low-carbohydrate beverages during labor. The primary outcome was the rate of cesarean delivery. Secondary outcomes included maternal feeling of hunger, assessed with an 11-point scale where 0 indicated no hunger and 10 the most severe hunger, and maternal and neonatal blood glucose after childbirth.

Results
Between 17 January 2018 and 20 July 2018, 2008 women were enrolled and randomized, 1953 were included in the intention-to-treat analysis. The rate of cesarean delivery did not differ between the two groups (11.3% [111/982] with carbohydrate-rich beverage vs. 10.9% [106/971] with low-carbohydrate beverages; relative risk 1.04, 95% CI 0.81 to 1.33; p = 0.79). Women in the carbohydrate-rich beverage group had lower subjective hunger score (median 3 [interquartile range 2 to 5] vs. 4 [2 to 6]; median difference − 1; 95% CI − 1 to 0; p < 0.01); their neonates had less hypoglycemia (1.0% [10/968] vs. 2.3% [22/956]; relative risk 0.45; 95% CI 0.21 to 0.94; p = 0.03) when compared with those in the low-carbohydrate beverage group. They also had higher rates of maternal hyperglycemia (6.9% [67/965] vs. 1.9% [18/953]; p < 0.01) and neonatal hyperglycemia (9.2% [89/968] vs. 5.8% [55/956]; p < 0.01), but none required special treatment.

Conclusions
For laboring primigravidae with epidural analgesia, ingestion of a carbohydrate-rich beverage compared with low-carbohydrate beverages did not reduce cesarean delivery, but relieved maternal hunger and reduced neonatal hypoglycemia at the expense of increased hyperglycemia of both mothers and neonates. Optimal rate of carbohydrate supplementation remains to be determined.

Trial registration
www.chictr.org.cn; identifier: ChiCTR-IOR-17011994; registered on 14 July 2017.
Religious practices of Muslim women in the UK during maternity: evidence-based professional practice recommendations
Authors: Hassan Shaima M. 
Published: April 2022

Abstract
Background
Muslim women commonly observe certain religious practices during their maternity journey and research in this area suggests that more could be done from a service provision perspective to support Muslim women in the UK through this significant life event.

Aim
This study identifies Muslim women’s religious practices during maternity, needs and challenges of religious practice while engaging with maternity services, and support needs from healthcare professionals.

Method
Qualitative mixed method study; that includes eight longitudinal interviews with first-time pregnant Muslim women, five focus groups with 23 Muslim mothers experiencing childbirth in last three years in UK, and 12 one-to-one interviews with Health care Professionals (HCPs) with previous experience working with Minority Ethnic groups. Participants recruited from local Muslim community groups and Maternity Care Provider, North West Coast, England. Data analysed using thematic analysis.

Result
Qualitative findings indicate common religious practices that Muslim women exercise at different stages of their maternity journey. These practices can be divided into two categories of common religious practices for Muslim women that 1) require only healthcare professionals’ awareness of these practices and 2) require awareness and active involvement of healthcare professionals. Findings highlight key recommendations for healthcare professionals when addressing Muslim women’s religious needs in the UK.

Discussion/Conclusion
This study provides evidence-based recommendations for professional practice to assist healthcare professionals in developing understanding and addressing Muslim women’s religious practice needs in the UK. Further research is required to explore the impact of these recommendations for professional practice.
Effects of HMGA2 on the epithelial-mesenchymal transition-related genes in ACHN renal cell carcinoma cells-derived xenografts in nude mice
Authors: Liu Ying , Lv Guangyao , Bai Jianxin , Song Lingling , Ding Elizabeth , Liu Lin , Tian Yuqin , Chen Qian , Li Kai , Liu Xianfeng , Ding Yan 
Published: April 2022

Abstract
Background
The architectural transcriptional regulator high-mobility group AT-hook 2 (HMGA2) is an oncofetal protein which has been reported to be ectopically expressed in a variety of cancers. A high expression of HMGA2 in human renal cell carcinoma (RCC) is related with tumor invasiveness and poor prognosis. Recent in vitro studies have shown that HMGA2 knockdown was able to decrease cell proliferation and migration, and regulate the gene expression related to epithelial-mesenchymal transition (EMT).

Methods
To understand the HMGA2’s effect in vivo, HMGA2 expression was knocked down in ACHN cells using small hairpin RNA (shRNA), then the HMGA2-deficient ACHN cells were xenografted into the BALB/c nude mice. Tumor growth was monitored and the expression of EMT-related genes was analyzed.

Results
HMGA2 expression was confirmed to be knocked down in the cultured and xenografted ACHN cells. The xenograft tumor of HMGA2-deficient cells demonstrated a retarded growth pattern compared with the control. The expression of E-cadherin was increased, whereas N-cadherin and Snail were decreased in the HMGA2-deficient xenograft tumors.

Conclusions
In conclusion, to the best of our knowledge, for the first time, we have successfully developed an in vivo experiment using HMGA2-silencing ACHN cells to be grown as xenografts in nude mice. Our findings show that HMGA2 deficiency was sufficient to suppress the xenograft tumor growth in vivo, which support our hypothesis that HMGA2-induced renal carcinogenesis occurs at least in part through the regulation of tumor associated EMT genes.