bluuebunny/crossref_metadata_2025_split huggingface dataset:
A cost-minimization analysis comparing teledermoscopy and face-to-face evaluations of suspicious skin lesions in Southern Denmark
Authors: Vestergaard Tine , Andersen Merethe Kirstine , Kidholm Kristian 
Published: February 2022

Introduction Skin cancers are common in European populations and generate considerable costs. In Denmark, patients with suspicious skin lesions will usually consult their general practitioner who may refer the patient to a dermatologist or plastic surgeon if necessary. However, it is also possible for the general practitioner to take and send dermoscopic and macroscopic photographs of the suspicious skin lesion for evaluation by a dermatologist, so-called teledermoscopy. This study aims to calculate and compare costs of teledermoscopy and standard care in the form of face-to-face evaluation by a dermatologist of suspicious skin lesions referred by general practitioners in the Region of Southern Denmark. Methods A cost-minimization study was performed. Investment costs, costs in general practice, hospital-associated costs and patient costs were included to calculate the average cost per patient episode. Results The overall cost of teledermoscopy was €17.2–€23.1 higher than that of standard care. However, hospital-associated costs and patient costs were reduced. Discussion The total cost of teledermoscopy was slightly higher than the cost of standard care. Sensitivity analyses indicated that the number of preventable face-to-face evaluations and the distance to the dermatologist were the two factors that influenced costs the most.
High male specific contribution of the X-chromosome to individual global recombination rate in dairy cattle
Authors: Kadri N. K. , Zhang J. , Oget-Ebrad C. , Wang Y. , Couldrey C. , Spelman R. , Charlier C. , Georges M. , Druet T. 
Published: February 2022

Abstract
Background
Meiotic recombination plays an important role in reproduction and evolution. The individual global recombination rate (GRR), measured as the number of crossovers (CO) per gametes, is a complex trait that has been shown to be heritable. The sex chromosomes play an important role in reproduction and fertility related traits. Therefore, variants present on the X-chromosome might have a high contribution to the genetic variation of GRR that is related to meiosis and to reproduction.

Results
We herein used genotyping data from 58,474 New Zealand dairy cattle to estimate the contribution of the X-chromosome to male and female GRR levels. Based on the pedigree-based relationships, we first estimated that the X-chromosome accounted for 30% of the total additive genetic variance for male GRR. This percentage was equal to 19.9% when the estimation relied on a SNP-BLUP approach assuming each SNP has a small contribution. We then carried out a haplotype-based association study to map X-linked QTL, and subsequently fine-mapped the identified QTL with imputed sequence variants. With this approach we identified three QTL with large effect accounting for 7.7% of the additive genetic variance of male GRR. The associated effects were equal to + 0.79, − 1.16 and + 1.18 CO for the alternate alleles. In females, the estimated contribution of the X-chromosome to GRR was null and no significant association with X-linked loci was found. Interestingly, two of the male GRR QTL were associated with candidate genes preferentially expressed in testis, in agreement with a male-specific effect. Finally, the most significant QTL was associated with PPP4R3C, further supporting the important role of protein phosphatase in double-strand break repair by homologous recombination.

Conclusions
Our study illustrates the important role the X-chromosome can have on traits such as individual recombination rate, associated with testis in males. We also show that contribution of the X-chromosome to such a trait might be sex dependent.
Genome-wide identification of the NLR gene family in Haynaldia villosa by SMRT-RenSeq
Authors: Huang Zhenpu , Qiao Fangyuan , Yang Boming , Liu Jiaqian , Liu Yangqi , Wulff Brande B. H. , Hu Ping , Lv Zengshuai , Zhang Ruiqi , Chen Peidu , Xing Liping , Cao Aizhong 
Published: February 2022

Abstract
Background
Nucleotide-binding and leucine-rich repeat (NLR) genes have attracted wide attention due to their crucial role in protecting plants from pathogens. SMRT-RenSeq, combining PacBio sequencing after resistance gene enrichment sequencing (RenSeq), is a powerful method for selectively capturing and sequencing full-length NLRs. Haynaldia villosa, a wild grass species with a proven potential for wheat improvement, confers resistance to multiple diseases. So, genome-wide identification of the NLR gene family in Haynaldia villosa by SMRT-RenSeq can facilitate disease resistance genes exploration.

Results
In this study, SMRT-RenSeq was performed to identify the genome-wide NLR complement of H. villosa. In total, 1320 NLRs were annotated in 1169 contigs, including 772 complete NLRs. All the complete NLRs were phylogenetically analyzed and 11 main clades with special characteristics were derived. NLRs could be captured with high efficiency when aligned with cloned R genes, and cluster expansion in some specific gene loci was observed. The physical location of NLRs to individual chromosomes in H. villosa showed a perfect homoeologous relationship with group 1, 2, 3, 5 and 6 of other Triticeae species, however, NLRs physically located on 4VL were largely in silico predicted to be located on the homoeologous group 7. Fifteen types of integrated domains (IDs) were integrated in 52 NLRs, and Kelch and B3 NLR-IDs were found to have expanded in H. villosa, while DUF948, NAM-associated and PRT_C were detected as unique integrated domains implying the new emergence of NLR-IDs after H. villosa diverged from other species.

Conclusion
SMRT-RenSeq is a powerful tool to identify NLR genes from wild species using the baits of the evolutionary related species with reference sequences. The availability of the NLRs from H. villosa provide a valuable library for R gene mining and transfer of disease resistance into wheat.
Nomogram to predict cause-specific mortality of patients with rectal adenocarcinoma undergoing surgery: a competing risk analysis
Authors: Zhang Xu , Xu Fengshuo , Bin Yadi , Liu Tianjie , Li Zhichao , Guo Dan , Li Yarui , Huang Qiao , Lyu Jun , He Shuixiang 
Published: February 2022

Abstract
Background
Rectal adenocarcinoma is one of major public health problems, severely threatening people’s health and life. Cox proportional hazard models have been applied in previous studies widely to analyze survival data. However, such models ignore competing risks and treat them as censored, resulting in excessive statistical errors. Therefore, a competing-risk model was applied with the aim of decreasing risk of bias and thereby obtaining more-accurate results and establishing a competing-risk nomogram for better guiding clinical practice.

Methods
A total of 22,879 rectal adenocarcinoma cases who underwent primary-site surgical resection were collected from the SEER (Surveillance, Epidemiology, and End Results) database. Death due to rectal adenocarcinoma (DRA) and death due to other causes (DOC) were two competing endpoint events in the competing-risk regression analysis. The cumulative incidence function for DRA and DOC at each time point was calculated. Gray’s test was applied in the univariate analysis and Gray’s proportional subdistribution hazard model was adopted in the multivariable analysis to recognize significant differences among groups and obtain significant factors that could affect patients’ prognosis. Next, A competing-risk nomogram was established predicting the cause-specific outcome of rectal adenocarcinoma cases. Finally, we plotted calibration curve and calculated concordance indexes (c-index) to evaluate the model performance.

Results
22,879 patients were included finally. The results showed that age, race, marital status, chemotherapy, AJCC stage, tumor size, and number of metastasis lymph nodes were significant prognostic factors for postoperative rectal adenocarcinoma patients. We further successfully constructed a competing-risk nomogram to predict the 1-year, 3-year, and 5-year cause-specific mortality of rectal adenocarcinoma patients. The calibration curve and C-index indicated that the competing-risk nomogram model had satisfactory prognostic ability.

Conclusion
Competing-risk analysis could help us obtain more-accurate results for rectal adenocarcinoma patients who had undergone surgery, which could definitely help clinicians obtain accurate prediction of the prognosis of patients and make better clinical decisions.
Linked nosocomial COVID-19 outbreak in three facilities for people with intellectual and developmental disabilities due to SARS-CoV-2 variant B.1.1.519 with spike mutation T478K in the Netherlands
Authors: Gorgels Koen M. F. , Dingemans Jozef , van der Veer Brian M. J. W. , Hackert Volker , Hensels Audrey Y. J. , den Heijer Casper D. J. , van Alphen Lieke B. , Savelkoul Paul H. M. , Hoebe Christian J. P. A. 
Published: February 2022

Abstract
Background
Individuals with intellectual and developmental disabilities (IDD) living in congregated settings have increased risk of COVID-19 infection and mortality. Little is known about variant B.1.1.519 with spike mutation T478K, dominant in Mexico. We describe a linked SARS-CoV-2 B.1.1.519 outbreak in three IDD facilities in the Netherlands.

Methods
Following notification of the index, subsequent cases were identified through serial PCR group testing. Positive specimens were submitted for whole-genome-sequencing. Clinical information was gathered through interviews with staff members of the three facilities.

Results
Attack rate (AR) in clients of the index facility was 92% (23/25), total AR in clients 45% (33/73) and in staff members 24% (8/34). 55% (18/33) of client cases were asymptomatic, versus 25% (2/8) of staff members. Five client cases (15%) were hospitalized, two died (6%). Sequencing yielded the same specific B.1.1.519 genotype in all three facilities. No significant difference in median viral load was established comparing the B.1.1.519 variant with other circulating variants. The index of the linked outbreak reported no travel history or link to suspected or confirmed cases suggesting regional surveillance. Observed peak regional prevalence of B.1.1.519 during the outbreak supports this.

Conclusion
AR, morbidity and mortality prior to control measures taking effect were high, probably related to the specific characteristics of the IDD setting and its clients. We assessed no evidence for intrinsic contributing properties of variant B.1.1.519. Our study argues for enhanced infection prevention protocols in the IDD setting, and prioritization of this group for vaccination against COVID-19.
Morphometry of cerebral arterial bifurcations harbouring aneurysms: a case-control study
Authors: Ćmiel-Smorzyk K. , Kawlewska E. , Wolański W. , Hebda A. , Ładziński P. , Kaspera W. 
Published: February 2022

Abstract
Background
Conclusions from studies evaluating vessel dimensions and their deviations from values resulting from the principle of minimum work (PMW) on the formation of intracranial aneurysms (IAs) are still inconclusive. Our study aimed to perform a morphometric analysis of cerebral arterial bifurcations harbouring aneurysms.

Methods
The study comprised 147 patients with basilar artery (BA) and middle cerebral artery (MCA) aneurysms and 106 patients constituting the control group. The following morphometric parameters were evaluated: the radii of vessels forming the bifurcation, the junction exponent, the values of the bifurcation angles (Φ1 and Φ2 angles between the parent vessel trunk axis and the larger or smaller branches, respectively; α angle, the total bifurcation angle) and the difference between the predicted optimal and observed branch angles.

Results
The analysed parameters for internal carotid artery (ICA) bifurcations were not significantly different among the groups. The MCA and BA bifurcation angles and the radii of the parent MCA and BA vessels with aneurysms were significantly higher than those of the control group. The differences between the predicted optimal and observed branch angles were significantly higher for BA and MCA bifurcations with aneurysms compared to the control group. The mean junction exponent for bifurcations in the circle of Willis (i.e., ICA and BA bifurcations, respectively) and MCA bifurcations with aneurysms was significantly lower than the theoretical optimum and did not significantly differ among the groups. In a multilevel multivariate logistic regression analysis, the branch angles and the radius from the parent vessel were significant independent predictors of the presence of an IA. The ROC analysis indicated that the α angle was the best performer in discriminating between aneurysmal and nonaneurysmal bifurcations.

Conclusions
The dimensions of the arteries forming the circle of Willis do not follow the PMW. Deviation from the energetically optimum geometry for bifurcations beyond the circle of Willis (particularly, a larger radius of the parent artery and a wider total bifurcation angle) may lead to the formation of IAs. Further studies are warranted to investigate the significance of vessel dimensions and the bifurcation angle on the magnitude of shear stress in the walls of arterial bifurcations.
Perception of pregnant women towards early antenatal visit in Fiji: a qualitative study
Authors: Maharaj Renita , Mohammadnezhad Masoud 
Published: February 2022

AbstractBackgroundAntenatal Care (ANC) is an opportunity to provide care to prevent potential maternal and new born mortality and morbidity and reduce new born mortality and morbidity. There has been an increase in the number of women receiving early ANC over the last two decades, however, in many developing regions such as Fiji, women are still delaying initiation of ANC. Therefore, the aim of this study is primarily to explore reasons for delayed initiation of ANC appointments and to explore knowledge and perception of pregnant mothers towards early antenatal appointments in Fiji.MethodsThe study uses a qualitative approach. Data was collected among pregnant women more than 18 years of age after 12 weeks of gestation attending their first ANC clinic at the Ba Mission Hospital (BMH) from February 28 to April 2, 2020. Heterogenous purposeful sampling method was used to select 25 pregnant women for the study. A semi-structured open-ended questionnaire was used for face to face in-depth interviews. Data was analyzed manually using thematic content analysis after verbatim transcription of the interviews.ResultsThe mean age of the participants was 25.8 ± 5.9 years (age range of 19–40 years). The average gestational age of those making a booking for a consultation was 5.4 ± 1.4 months with a range of 4 to 8 months. The majority of women were multigravida (64%) and multiparous (40%). The main themes that emerged from the study were: i) perception of early ANC booking; ii) perceived barriers of early ANC booking and; iii) enabling factors of early ANC booking. Even though pregnant women have a good knowledge of when to initiate ANC, the practice of early booking was influenced by many other factors.ConclusionsThe results of this study highlight the need to change the current booking system. Efforts are needed to attract the hard-to-reach women through outreach visits and increased communication between health care workers and the community with the use of community resources such as community health workers and traditional birth attendants. The media should be used to create awareness on timing and importance of early ANC visits at a community level.
Substance use in childhood and adolescence and its associations with quality of life and behavioral strengths and difficulties
Authors: Frobel Wiebke , Grafe Nico , Meigen Christof , Vogel Mandy , Hiemisch Andreas , Kiess Wieland , Poulain Tanja 
Published: February 2022

Abstract
Background
Substance use in childhood and adolescence continues to be a current health concern. The aims of the present study were to identify trends in the use of alcohol, cigarettes, and cannabis in children and adolescents in the last 10 years and to assess associations between substance use and quality of life and behavioral strengths and difficulties.

Methods
Substance use was examined in 1829 9- to 18-year-old German children and adolescents participating in the LIFE Child cohort study between 2011 and 2020. Quality of life was investigated using the KIDSCREEN-27 questionnaire. The Strength and Difficulties Questionnaire was used to assess behavioral strengths and difficulties. Associations were assessed using linear regression analyses. All effects were adjusted for age, gender, and family socio-economic status.

Results
38.44% of participants reported drinking alcohol at least sometimes. Smoking (6.23%) and the use of cannabis (3.94%) were less frequent. While we observed no significant changes in smoking between 2011 and 2021, the consumption of cannabis and the frequent consumption of alcohol has increased in this time period. Cigarette and cannabis use were associated with additional symptoms of hyperactivity/inattention and reduced prosocial behavior. For all three substances, usage was associated with more conduct problems. We also found significant associations between substance use and a lower quality of life in the areas of physical wellbeing, psychological wellbeing, parent relation and autonomy, and school environment. One noteworthy finding was that cigarette consumption and frequent alcohol use were associated with higher quality of life in terms of social support/peer group relations. Some significant interactions between substance use and child age indicated that associations between substance use and quality of life or behavioral difficulties were stronger in younger than in older children.

Conclusions
The results show that quality of life and behavioral difficulties are associated with substance use and should be considered when developing or implementing preventive measures to counter substance use. Furthermore, the findings indicate that substance use can be accompanied by improved peer relations. Therefore, the influence of peers, especially of peers who use these substances, should not be underestimated.
Does gender matter? The association between different digital media activities and adolescent well-being
Authors: Svensson Robert , Johnson Björn , Olsson Andreas 
Published: February 2022

Abstract
Background
Previous research on the relationship between social media use and well-being in adolescents has yielded inconsistent results. We addressed this issue by examining the association between various digital media activities, including a new and differentiated measure of social media use, and well-being (internalizing symptoms) in adolescent boys and girls.

Method
The sample was drawn from the four cross-sectional surveys from the Öckerö project (2016–2019) in eight municipalities in southern Sweden, consisting of 3957 adolescents in year 7 of compulsory education, aged 12–13. We measured the following digital media activities: playing games and three different activities of social media use (chatting, online sociability, and self-presentation). Our outcome measure was internalizing symptoms. Hypotheses were tested with linear regression analysis.

Results
Social media use and playing games were positively associated with internalizing symptoms. The effect of social media use was conditional on gender, indicating that social media use was only associated with internalizing symptoms for girls. Of the social media activities, only chatting and self-presentation (posting information about themselves) were positively associated with internalizing symptoms. Self-presentation was associated with internalizing symptoms only for girls.

Conclusion
Our study shows the importance of research going beyond studying the time spent on social media to examine how different kinds of social media activities are associated with well-being. Consistent with research in psychology, our results suggest that young girls posting information about themselves (i.e. self-presentation) might be especially vulnerable to display internalizing symptoms.
Middle-aged preparation for healthy aging: a qualitative study
Authors: Solhi Mahnaz , Pirouzeh Razieh , Zanjari Nasibeh 
Published: February 2022

Abstract
Background
Preparing for aging is investing resources in preparing to cope with the challenges that are expected to happen in older age. This will lead to an increase in the quality and well-being in aging. The present study was conducted to elucidate the preparation of the middle-aged people for healthy older age in Tehran, Iran.

Methods
The present study was performed with a qualitative approach and using semi-structured interviews with 23 Iranian middle-aged people (45 to 59 years old), selected by purposive sampling, and the interviews continued until theoretical saturation. Data were analyzed using the content analysis technique with MAXQDA 10 software.

Results
The preparation of the middle-aged people was examined in four main categories including staying healthy, financial perspective for the future, outlook on aging, and planning for use time productively. The middle-aged people paid more attention to Staying healthy than other dimensions and the saw their future financially as very dark. Outlook on aging and planning for use time productively dimensions were less considered by the subjects.

Discussion
Preparing for healthy aging is a multidimensional concept. The results of the study showed that the middle-aged studied in Iranian society rarely had the necessary preparation and planning to have healthy aging, also preparation is outside the individual behavioral factors and is more affected by the economic situation of the society. So, interventions and the country’s macro-policy are needed to plan for healthy aging these people.
Association between plasma sRAGE and emphysema according to the genotypes of AGER gene
Authors: Sin Sooim , Lim Myung-nam , Kim Jeeyoung , Bak So Hyeon , Kim Woo Jin 
Published: February 2022

Abstract
Background
Higher soluble receptor for advanced glycation end product (sRAGE) levels are considered to be associated with severe emphysema. However, the relationship remains uncertain when the advanced glycation end-product specific receptor (AGER) gene is involved. We aimed to analyse the association between sRAGE levels and emphysema according to the genotypes of rs2070600 in the AGER gene.

Methods
We genotyped rs2070600 and measured the plasma concentration of sRAGE in each participant. Emphysema was quantified based on the chest computed tomography findings. We compared sRAGE levels based on the presence or absence and severity of emphysema in each genotype. Multiple logistic and linear regression models were used for the analyses.

Results
A total of 436 participants were included in the study. Among them, 64.2% had chronic obstructive pulmonary disease and 34.2% had emphysema. Among the CC-genotyped participants, the sRAGE level was significantly higher in participants without emphysema than in those with emphysema (P < 0.001). In addition, sRAGE levels were negatively correlated with emphysema severity in CC-genotyped patients (r = − 0.268 P < 0.001). Multiple regression analysis revealed that sRAGE was an independent protective factor for the presence of emphysema (adjusted odds ratio, 0.24; 95% confidence interval (CI) 0.11–0.51) and severity of emphysema (β = − 3.28, 95% CI − 4.86 to − 1.70) in CC-genotyped participants.

Conclusion
Plasma sRAGE might be a biomarker with a protective effect on emphysema among CC-genotyped patients of rs2070600 on the AGER gene. This is important in determining the target group for the future prediction and treatment of emphysema.