bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare provider and patient perspectives on access to and management of atrial fibrillation in the Northern Province, Sri Lanka: A rapid evaluation of barriers and facilitators to care
Authors: Sheron Vethanayagam Antony , Shanmugathas Shivany , Gooden Tiffany E , Guruparan Mahesan , Kumarendran Balachandran , Lip Gregory Y.H. , Manaseki-Holland Semira , Nirantharakumar Krishnarajah , Shribavan Kaneshamoorthy , Subaschandren Kumaran , Haniffa Rashan , Surenthirakumaran Rajendra , Thomas G. Neil , Uruthirakumar Powsiga , Greenfield Sheila , Lane Deirdre A. , Beane Abi 
Published: April 2022

Abstract
Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia that affects 60 million people worldwide. Limited evidence on AF management exists from low- and middle-income countries and none from Sri Lanka. We aimed to investigate the existing AF care pathway and patients’ perception on AF management to identify barriers and enablers for optimal AF care in Northern Province, Sri Lanka.Methods: A rapid evaluation was undertaken with use of qualitative methods. Local healthcare providers (HCPs) mapped the intended pathway of care for AF patients which was then explored and annotated through 12 iterative sessions with additional HCPs. Topics of inefficiencies identified from the finalised map were used to guide focus group discussions (FGDs) with AF patients. AF patients who were attending the anticoagulation clinic at the only tertiary hospital in Northern Province were recruited and invited to participate using purposive sampling. The topic guide was developed in collaboration with local clinicians and qualitative experts. FGDs were conducted in the native Tamil language and all sessions were recorded, transcribed verbatim and thematically analysed using a deductive approach. Results: The mapped pathway revealed inefficiencies in referral, diagnosis and ongoing management. These were explored through three FGDs conducted with 25 AF patients aged 25 to 70 years. Two key themes that contributed to and resulted in delays in accessing care and ongoing management were health seeking behaviours and atomistic healthcare structures. Four cross-cutting sub-themes identified were decision making, paternalistic approach to care, cost impacts and lifestyle impacts. These are discussed across 10 unique categories with consideration of the local context. Conclusions: Strengthening primary healthcare services, improving public health literacy regarding AF and building patient autonomy whilst understanding the importance of their daily life and family involvement may be advantageous in tackling the inefficiencies in the current AF care pathway in Sri Lanka.
A Scoping Review of Gay Family Networks: HIV Preventative Implications for Black MSM
Authors: Smith Martez Dexter Ray , Leblanc Natalie M , McMahon James M , Nelson LaRon E 
Published: April 2022

Abstract
Gay family networks (GFNs) are social supports that have been shown to influence protective and risk factors for HIV transmission among Black men who have sex with men (MSM). The purpose of this scoping review is to provide a conceptual overview and mapping of HIV-related prevention research with Black MSM belonging to GFNs. We identified 352 articles for title and abstract review; of these, 28 were included in the final analysis. Our review includes a discussion of identified themes including, social network characteristics of GFNs, psychosocial factors affecting vulnerability for HIV transmission, and HIV prevention interventions. Research suggests the potential to bolster GFN assets to promote protective factors against HIV acquisition for Black MSM. The few HIV prevention interventions involving GFNs show promise, but only quasi-experimental studies have been completed to date. Identifying and strengthening assets among Black MSM’s GFNs, as well as utilizing experimental study designs should be a priority for future research.
Effects of perfluoroalkyl substances (PFAS) and benzo[a]pyrene (BaP) co-exposure on phase I biotransformation in rainbow trout (Oncorhynchus mykiss)
Authors: Solan Megan E. , Franco Marco E. , Lavado Ramon 
Published: April 2022

Abstract
The presence of perfluoroalkyl substances (PFAS) in the environment, especially in aquatic ecosystems, continues to be a significant concern for human and environmental health. Previous studies have suggested that several PFAS do not undergo biotransformation due to their chemical stability, yet perfluorooctanesulfonic acid (PFOS)- and perfluorooctanoic acid (PFOA)-exposed organisms have presented altered activity of important biotransformation pathways. Given the fundamental role of biotransformation in biological organisms and the significant distribution of PFAS in aquatic environments, the present study investigated the influence of PFOA and PFOS on phase I biotransformation enzymes in vitro using the rainbow trout liver RTL-W1 cell line and in vivo using juvenile rainbow trout. Cells and fish were exposed and co-exposed to environmentally relevant concentrations of PFOA, PFOS, and benzo[a]pyrene (BaP), for 72 h and 10 days, respectively, prior to measurements of cytotoxicity and biotransformation ability through measurements of CYP1A1-, CYP1A2- and CYP3A4-like activities. Our results indicate that exposure to PFAS-BaP binary mixtures altered CYP1A-like activity in vivo; however, those alterations were not observed in vitro. Similarly, while BaP did not significantly induce CYP3A4, exposure to the PFAS led to significantly lower enzymatic activity relative to basal levels. These observations may have implications for organisms simultaneously exposed to PFAS and other environmental pollutants for which biotransformation is necessary, especially in detoxification mechanisms. Furthermore, the interference with biotransformation pathways could potentially increase adverse outcomes, compromising the stability of fish populations inhabiting PFOA- and PFOS-polluted environments.
The Virgin and Child with the Infant St. John the Baptist by Sandro Botticelli (1445-1510): does the child have Pompe Disease?
Authors: de Campos Deivis 
Published: April 2022

Abstract
Purpose: Current literature describes that art can be used to teach observation skills in medical students. In this way, many medical schools have developed formal observational training on works of art to improve their students' visual diagnostic skills. In this context, this description presents unprecedented evidence that Sandro Botticelli (1445-1510) may have represented a rare neuromuscular disorder, known as Pompe Disease (accumulation of lysosomal glycogen primarily in the heart, skeletal muscles, and the nervous system) in one of the characters that make up Virgin and Child with the Infant St. John the Baptist (1490-1500).Methods: Observational study.Results: The painting reveals that the Infant Jesus has facial features consistent with some of the main clinical manifestations of Pompe Disease (poor head control, facial weakness with open mouth posture, tongue protrusion and eyelid ptosis). Conclusion: These results may indicate that Botticelli in 1500 may have made the first pictorial representation of Pompe's Disease that was only described in the medical literature in 1932. Furthermore, this description demonstrates the importance of the medico-artistic field for the study of any disease during the Renaissance period, which will be essential for the learning process of visual diagnostic.
Comparative efficacy and tolerability of target agents and immune checkpoint inhibitors in combination with chemotherapy as First-line treatment for advanced gastric cancer: A Bayesian network meta-analysis
Authors: Liu Shu , Wong Heung Yan , Xie Li , Kim Yoojin , Shu Danhua , Zheng Beishi , Liu Naxin , Xing Chungen , Chen Xiaolei , Dong Qiantong 
Published: April 2022

Abstract
Background
The use of target agents and immune checkpoint inhibitors have changed the treatment landscape for AGC in the first-line setting. However, the crosswise comparison between each regimen is rare. Therefore, we estimated the efficacy and safety of targeted therapy or immunotherapy with chemotherapy in AGC patients as the first-line treatment;
Method
Included studies were divided into “unselected” or “selected” group according to whether the patients were selected by a certain pathological expression. We conducted a Bayesian network meta-analysis for all regimens in both groups;
Results
In unselected group, no regimen showed significant improvements in overall survival (OS) and progression free survival (PFS), while pembrolizumab and nivolumab combined with chemotherapy were ranked first and second respectively without an obvious safety difference. In selected group, zolbetuximab plus chemo-therapy significantly prolonged OS (HR 0.53, 95%CI 0.31–0.89) and PFS (HR 0.45, 95%CI 0.23–0.89). The top three regimens were zolbetuximab-chemotherapy, tratuzumab plus pertuzumab-chemotherapy and nivolumab-chemotherapy respectively, with no significant safety risk.
Conclusion
For average patients, immune checkpoint inhibitor PD-1 plus chemotherapy will be the promising regimen. For patients with overexpression of HER-2 or CLDN18.2, dual HER-2 targeting strategy or zolbetuximab combined with chemotherapy comes with greater survival benefits.
Adaptive MHC-E restricted tissue-resident NK cells are associated with persistent low antigen load in alveolar macrophages after SARS-CoV-2 infection
Authors: HUOT Nicolas , Planchais Cyril , Contreras Vanessa , Jacquelin Beatrice , PETITDEMANGE Caroline , Lazzerini Marie , ROSENBAUM Pierre , Rey Félix , Reeves R. Keith , Grand Roger Le , Mouquet Hugo , Müller-Trutwin Michaela 
Published: April 2022

Abstract
Natural killer (NK) cells are innate lymphocytes with potent activity against a wide range of viruses. In SARS-CoV-2 infection, NK cell activity might be of particular importance within lung tissues. Here, we investigated whether NK cells with activity against Spike+ cells are induced during SARS-CoV-2 infection and have a role in modulating viral persistence beyond primary clearance from nasopharyngeal and tracheal tissues. We performed an integrated analysis of NK cells and macrophages in blood and bronchoalveolar lavage fluids (BALF) of COVID-19 convalescent non-human primates in comparison to uninfected control animals. SARS-CoV-2 protein expression was detected for at least 9–18 months post-infection in alveolar macrophages. Convalescent animals segregated into two groups based on cellular phenotypes and viral persistence profiles in BALF. The animals with lower persistent antigen displayed macrophages with a regulatory phenotype and enhanced MHC-E restricted NK cell activity toward cells presenting peptides derived from the SARS-CoV-2 Spike protein leader sequence, while NK cell activity from the other convalescent animals, control animals and healthy humans were strongly inhibited by these Spike peptides. The adaptive NK cell activity was not detected in blood but in tissue-resident NK cells, and cross-reacted against MERS-CoV and SARS-CoV Spike-derived peptides.
Perinatal Characteristics and Neonatal Outcomes of Singletons and Twins in Chinese Very Preterm Birth Infants: A Cohort Study
Authors: Yang Min , Fang Lingyu , Wang Yanchen , Li Xiaoying , Cao Yun , Sun Jianhua , Ting Joseph , Chen Xiafang , Fan Xiaobo , Dai Jiale , Tong Xiaomei , Chen Dongmei , Wang Jimei 
Published: April 2022

Abstract
Background: The prevalence of preterm birth has been raising, and there is a paucity of nationwide data on the perinatal characteristics and neonatal outcomes of twin deliveries of very preterm infants (VPIs) in China. This study compared the perinatal characteristics and outcomes of singletons and twins admitted to neonatal intensive care units (NICUs) in China. Methods: The study population comprised all infants born before 32 weeks in Chinese Neonatal Network (CHNN) between January 2019 and December 2019. Results: During the study period, there were 6634 (71.2%) singletons and 2680 (28.8%) twins, with mean birth weight of 1333.70g and 1294.63g, respectively. Twins were significantly more likely to be delivered by cesarean section (p<0.01), to have antenatal steroid usage (p=0.048), to have received assisted reproductive technology (ART) (p<0.01), and have higher prevalence of maternal diabetes (p<0.01) and more were inborn (p<0.01) compared with singletons. In addition, twins had a lower prevalence of small for gestational age, maternal hypertension, primigravida compared to singletons (all p<0.01). After adjusting for the potential confounders, twins had higher mortality (adjusted odds ratio [AOR] 1.28, 95% confidence interval [CI] 1.10-1.49), short term composite outcome (AOR 1.28, 95% CI 1.09-1.50), respiratory distress syndrome (RDS) (AOR 1.30, 95% CI 1.12-1.50), bronchopulmonary dysplasia (BPD) (AOR 1.10, 95% CI 1.01-1.21), surfactant usage (AOR 1.22, 95% CI 1.05-1.41) and prolonged hospital stay (adjusted mean ratio 1.03, 95% CI 1.00-1.06), compared to the singletons. Conclusion: Our work suggest that twins have a greater risk of mortality, higher incidence of RDS and BPD, more surfactant usage, and longer NICU stay compared with singletons among VPIs in China.
Intramuscular delivery of formulated RNA encoding six linked single-domain antibodies is highly protective for exposures to three Botulinum neurotoxin serotypes
Authors: Mukherjee Jean , Ondeck Celinia A. , Tremblay Jacqueline M. , Archer Jacob , Debatis Michelle , Foss Alexa , Awata Junya , Erasmus Jesse H. , McNutt Patrick M. , Shoemaker Charles B. 
Published: April 2022

Abstract
Single domain antibodies (sdAbs) have substantial biophysical advantages over conventional antibodies and are increasingly being employed as components of immunotherapeutic agents. One particularly favorable property is the ability to link different sdAbs into heteromultimers. This feature allows production of single molecules capable of simultaneously targeting more than one antigen. In particular, cooperative binding of multiple linked sdAbs to non-overlapping epitopes on the same target can produce synergistic improvements in target affinity, variant specificity, and in vivo potencies. Here we seek to test the option of increased component sdAbs in these heteromultimers by testing different sdAb heterohexamers in which each of the six camelid sdAb components (VHHs) can neutralize one of three different Botulinum neurotoxin (BoNT) serotypes, A, B or E. Each heterohexamer bound all three targeted BoNT serotypes and protected mice from at least 100 MIPLD50 of each serotype. To test the potential of mRNA therapeutics encoding long sdAb heteromultimers, one heterohexamer was encoded as replicating RNA (repRNA), formulated with a cationic nanocarrier, and delivered to mice via intramuscular injection. Heterohexamer antitoxin serum expression levels were easily detected by 8 hours post-treatment, peaked at 5-10 nM around two days, and persisted for more than three days. Mice treated with the formulated repRNA one day post-treatment survived challenge with 100 MIPLD50 of each toxin serotype, demonstrating the function of all six component VHHs. Use of long sdAb multimers, administered as proteins or repRNA, offer the potential for substantially improved versatility in the development of antibody-based therapeutics.
Functional improvement and satisfaction with a wearable hip exoskeleton in community- living adults
Authors: Kim Jihye , Chun Hyelim , Lee Su-Hyun , Lee Hwang-Jae , Kim Yun-Hee 
Published: April 2022

Abstract
Background: Demand for wearable devices and supportive technology is growing as these devices have the potential to enhance physical function and quality of life in users. The purpose of this study was to investigate usability and satisfaction after performing functional and gait exercise with a wearable hip exoskeleton in community-living adults. Methods: Two-hundred and twenty-five adults (mean age 67.52 ±10.99) residing in the local community participated in this study. All participants (middle-aged group, n=75; old-aged group, n=150) performed 40-minutes of exercise once with a wearable hip exoskeleton in various environments. The EX1 (Samsung Electronics Co., Ltd., Suwon, Republic of Korea), which functions as a wearable hip exoskeleton, was used. Physical function was assessed before and after exercise with the EX1 using the 10-meter walking test (10MWT), four square step test (FSST), timed up and go test (TUG), 6-minute walking test (6MWT), and short physical performance battery (SPPB). In addition, after completing exercise with the EX1, the usability and satisfaction questionnaires were evaluated.Results: Gait speed, TUG, and FSST showed statistically significant improvements after exercise with the EX1 in both groups (p<0.05). In 6MWT, a significant increase was observed in the middle-aged group (p<0.05) but not in the old-aged group. In SPPB, there was a significant improvement in the old-aged group (p<0.05) but not in the middle-aged group. On the other hand, positive results in usability and satisfaction were noticed in both groups. In preference between resistance and assist mode of the EX1, the old-aged group preferred the assist mode and the middle-aged group preferred the resistance mode.Conclusion: These results demonstrate that a single session of exercise with the EX1 was effective in improving physical performance of both middle- and old-aged adults, with positive feedback from most of the participants.Trial registration: Clinical trials registration information: ClinicalTrials.gov Identifier: NCT05106881 (03/11/2021).
‘Tropicalization’ of megafauna community in a South Atlantic warming hot spot: evidences from demersal fisheries off Brazil
Authors: PEREZ JOSE ANGEL , Sant'Ana Rodrigo 
Published: April 2022

Abstract
The Southwest Atlantic Ocean comprises a major ‘marine warming hotspot’ subject to significant marine ecosystem changes. Among them, a process of ‘tropicalization’ of demersal fauna has been proposed, as determined by the increasing influence of the warm Brazil Current, gradually expanding towards higher latitudes. We identified signals of fauna ‘tropicalization’ analysing commercial catches of 29,021 multispecies demersal fishing operations conducted in the Brazilian Meridional Margin between 2000 and 2019. These signals included changes in species catch composition and patterns of biomass gains and losses of species with affinities for warm- and cold-waters, respectively. In addition, annual variability of the Mean Temperature of the Catches increased sharply from 2013 onwards at a rate of 0.41°C yr− 1, explained by increasing sea bottom temperatures (with 0 and 1-year time-lag) and the transport volumes of the Brazil Current (4-year time-lag).
Relationship between Helicobacter pylori infection and white matter lesions in patients with migraine
Authors: Öcal Serkan , Öcal Ruhsen , Suna Nuretdin 
Published: April 2022

Abstract
Background/aim: White matter lesions (WMLs) are more frequently observed in migraine patients than in the average population. Associations between Helicobacter pylori (H. pylori) infection and different extraintestinal pathologies have been identified. Here, we aimed to examine the effect of H. pylori infection on WML in patients diagnosed with migraine.Materials and methods: A retrospective study was conducted with 526 subjects with a diagnosis of migraine. Hyperintensity of WML had been previously evaluated in these patients with brain magnetic resonance imaging (MRI) examinations. Previous endoscopic gastric biopsy histopathological examination of the same patients and reports on H. pylori findings were recorded. The demographic characteristics of the patients, such as age, drugs, and gender, were recorded. Statistical evaluation was made.Results: Evaluation was made among 526 migraine patients who met the inclusion criteria, comprising 397 (75.5%) females and 129 (24.5%) males with a mean age of 45.57 ± 13.46 years (range, 18-69 years). Of the 211 (40.1%) subjects who were negative for H. pylori, WML was not detected in 140 (26.6%) and was detected in 71 (13.5%) on brain MRI. WML was not detected in 137 (26.0%) of 315 (59.9%) subjects who were positive for H. pylori and was detected in 178 (33.8%) on brain MRI (p <0.05). Subjects who are H. pylori-positive migraine were observed at a 2.5-fold higher incidence of brain MRI WML (odds ratio: 2.562, 95% CI 1.784-3.680). WML was found to be more significant in patients with hypertension and migraine than those without (p <0.001). Conclusion: It was concluded that H. pylori infection, a chronic infection, can be considered a risk factor in developing WML in subjects with migraine.
Universal structures for embedded integral control in biological adaptation
Authors: Araujo Robyn , Liotta Lance 
Published: April 2022

Abstract
At the molecular level, the evolution of life is driven by the generation and diversification of adaptation mechanisms. A universal description of adaptation-capable chemical reaction network (CRN) structures has remained elusive until now, since currently-known criteria for adaptation apply only to a tiny subset of possible CRNs. While adaptation is known to require some form of embedded integral control, current approaches can only identify an internal integral structure in simple special cases. Here we identify the definitive structural requirements that characterize all adaptation-capable collections of interacting molecules, however large or complex. We show that these network structures implement a form of integral control in which multiple independent integrals can collaborate to confer the capacity for adaptation on specific molecules. We present a universal method to test for adaptation capacity, and for detecting the adaptation-conferring integrals, in any CRN. Using this new approach, we demonstrate the existence of embedded integrals in a variety of biologically important CRNs that have eluded previous methods, and for which adaptation has been observed experimentally. This definitive picture of biological adaptation at the level of intermolecular interactions represents a blueprint for adaptation-capable signalling networks across all domains of life, and for the design of synthetic biosystems.