bluuebunny/crossref_metadata_2025_split huggingface dataset:
Navigating the Life‐Limiting Illness Journey: A Mixed‐Method Systematic Review of Advance Care Planning Experiences Among Healthcare Providers, Patients and Family
Authors: Pimsen Apiradee , Sumpuntharat Suparinya , Rodney Tamar , Wirojratana Virapun , Shu Bih‐Ching 
Published: December 2024

ABSTRACTBackgroundAdvance care planning (ACP) enables individuals with life‐limiting illnesses to make decisions regarding future healthcare. It involves patients, families and healthcare providers in discussions on treatment preferences and end‐of‐life care. Understanding their experiences is key to improving ACP practice.AimsTo systematically review and analyse the experiences of patients, families and healthcare providers with ACP for life‐limiting illnesses.DesignThis study employed a mixed‐methods systematic review (MMSR) with a convergent integrated approach.MethodsLiterature searches were conducted using CINAHL, Cochrane Library, ERIC, MEDLINE, Scopus and Web of Science, as well as hand searches and reference list checking, for articles published between 2010 and August 2024. Two independent reviewers extracted and analysed the data using the JBI guidelines for MMSR.ResultsOf the 1405 citations, 26 studies involving 1599 participants (1076 patients, 398 healthcare providers and 125 family members) were included. The main findings highlight the importance of patient empowerment, family involvement and the integration of ACP into routine care. Eliminating barriers, such as lack of training, resource limitations and challenges with timing discussions, are essential for effective ACP implementation.ConclusionThe MMSR emphasises the need for patient‐centred ACP that actively involves families and addresses systemic barriers. Early initiation, tailored emotional support and equitable care across conditions are crucial for an effective ACP.Implications for the Profession and Patient CareThe MMSR highlights the importance of family involvement and enhanced training for healthcare providers in ACP, emphasising the need for emotional support and systemic changes to improve patient care. These improvements should include better educational programs and policies to ensure early, effective and equitable ACP discussions among various patient groups.ImpactThe MMSR underscores the need for structured ACP practices that are currently limited by insufficient training and vague guidelines. Early initiation of ACP discussions and inclusion of patient and family preferences are essential for improving care for individuals with life‐limiting conditions. These findings are vital for healthcare providers, policymakers and educators to implement more effective patient‐centred ACP approaches. Family involvement remains a key aspect, with the review advocating for a support system that empowers families to play an active role in ACP.Reporting MethodsPreferred Reporting Items for Systematic Review and Meta‐Analyses (PRISMA).Patient or Public ContributionNo Patient or Public Contribution.
Pleiotrophin Prevents H2O2‐Induced Senescence of Dental Pulp Stem Cells
Authors: Liu Chang , Lei Wanzhen , Zhang Lili , Zhang Chen , Gao Runtao , Jin Luyuan 
Published: December 2024

ABSTRACTBackgroundDental pulp stem cells (DPSCs) are widely used in research on dental tissue regeneration and systemic disease treatment. However, the oxidative microenvironment often causes cellular senescence, leading to decreased function. Our previous study demonstrated that pleiotrophin (PTN), a secreted extracellular matrix‐associated protein, could rescue the proliferative capacity and osteogenic differentiation of replicative senescent DPSCs.ObjectiveThis study aimed to explore the influence and mechanism of PTN on dental pulp stem cells under H2O2‐induced oxidative microenvironment.Materials and MethodsDPSCs isolated from human third molars were treated with 100 μm H2O2 for 4 h, mimicking the oxidative microenvironment. To investigate the influence of PTN on DPSC under H2O2‐induced oxidative microenvironment, 50 pg/mL PTN was added in the culture medium for 48 h. RT‐qPCR, western blotting, SA‐β‐gal staining, intracellular ROS production and immunofluorescence staining assays were used to analyse the cellular senescence, osteogenic differentiation capacity, oxidative stress conditions and possible mechanism.ResultsH2O2 treatment increased the ratio of SA‐β‐gal‐positive DPSCs and upregulated the senescence‐related gene expression, including P53, P21 and P16. PTN pretreatment downregulated the ratio of SA‐β‐gal‐positive DPSCs and the expression of these genes. Besides, PTN pretreatment partially reversed the H2O2‐induced decreased osteogenic differentiation potential of DPSCs, total antioxidant capacity and Nrf2 and HO‐1 mRNA expression in DPSCs. Western blotting and immunofluorescent staining results indicated that PTN pretreatment enhanced the Nrf2 nuclear translocation under oxidative stress conditions and observable higher fluorescence signals in the nucleus denoted PTN and Nrf2 colocalisation. Western blotting results showed that PTN reversed the decreased expression of p‐AKT in the H2O2−induced oxidative environment. However, the PI3K inhibitor LY294002 blocked the upregulated levels of total Nrf2. Immunofluorescence staining displayed that LY294002 also inhibited the nuclear translocation of Nrf2 which was enhanced under PTN pretreatment.ConclusionsThis study demonstrated that PTN could prevent senescent damage induced by H2O2 on DPSCs, mainly by combining with Nrf2 and enhancing its nuclear translocation.
Astaxanthin Increases Tumor Suppressor Gene Expression and Affects Cellular Biological Behavior in Oral Dysplastic Keratinocytes by Regulating DNA Methylation
Authors: Wang Peiyan , Yu Xiaofei , Sun Pei , Pan Keqing , Sun Jian , Guo Yiqing , Liu Zhaochen , Jiao Mengyu , Deng Jing , Zhang Hui 
Published: December 2024

ABSTRACTBackgroundThe inactivation of tumor suppressor genes (TSGs) caused by abnormal DNA methylation is confirmed to be widely present in oral potential malignant diseases (OPMDs). Carotenoids like lycopene and astaxanthin can regulate DNA methylation and exert anticancer effects. Therapeutic effect of astaxanthin in OPMDs and oral squamous cell carcinoma (OSCC) models is confirmed, but the relationship between the anti‐cancer ability of astaxanthin and its DNA methylation regulation ability remains unclear.MethodsWhole‐genome bisulfite sequencing (WGBS) were used to provide biological information associated with DNA methylation. Methylation specific PCR was used to detect the methylation level of specific sites. Related markers were evaluated by qRT‐PCR and western blot. CCK8 assay, cell scratch assay, flow cytometric analysis were performed to investigate the cell viability, migration, cell cycle, and apoptosis after treated with concentrations of astaxanthin.ResultsWGBS revealed that HOXA3 and SOX1 were the TSGs with significant differences in promoter CpG methylation of oral dysplastic keratinocytes (DOK) cells. After treatment with 8 μM astaxanthin, the promoter CpG methylation levels of the TSGs were significantly reduced, resulting in the increase in gene expression. The overall effect of astaxanthin on DOK cells is inhibiting cell viability, reducing cell migration, leading to cell cycle G0/G1 arrest, and promoting apoptosis.ConclusionsThis study confirmed significant differences in DNA methylation patterns among oral normal, dysplastic, and cancerous cells. Astaxanthin can reduce the promoter CpG methylation level of TSGs by reducing DNA methyltransferase 1 protein expression level, upregulating mRNA and protein expression, and subsequently modulating the biological behavior of DOK.
A Network Map of Intracellular Alpha‐Fetoprotein Signalling in Hepatocellular Carcinoma
Authors: Ramakrishnan Krishnapriya , Sanjeev Diya , Rehman Niyas , Raju Rajesh 
Published: December 2024

ABSTRACTAlpha fetoprotein (AFP) is a glycoprotein of foetal origin belonging to the albumin protein family. Serum AFP is a long‐conceived early‐diagnostic biomarker for HCC with its elevated expression in different liver pathologies ranging from hepatitis viral infections to fibrosis, cirrhosis, and HCC. Beyond their utility as biomarkers, in support of its contribution to these clinical outcomes, the function of AFP as an immune suppressor and inducer of malignant transformation in HCC patients is well reported. Multiple reports show that AFP is secreted by hepatocytes, binds to its cognate receptor, AFP‐receptor (AFPR), and exerts its actions. However, there is only limited information available in this context. There is an urgent need to gather more insight into the AFP signalling pathway and consider it a classical intracellular signalling pathway, among others. AFP is a highly potent intracellular molecule that has the potential to bind to many interactors like PTEN, Caspase, RAR, and so on. It has been shown that cellular AFP and secreted AFP have different roles in HCC pathophysiology, and a comprehensive map of the AFP signalling pathway is warranted for further theranostic applications.
A US‐Based Multi‐Site Pilot to Screen Hepatitis B Surface Antigen‐Positive Patients for Hepatitis D
Authors: Li Maggie , Hunt Bijou , Balani Bindu , Ogedegbe Chinwe , Gordon Peter , Hayden Joshua , Glick Nancy , Chang Anita , Wang Su , Caponi Mitchell , Yarber‐Cambron Lisa , Bhat Sandeep , Ward Tyshea , Suryadevara Madhu 
Published: December 2024

ABSTRACTHepatitis D (HDV) is a severe infection with well‐recognised clinical ramifications that remains relatively neglected and underdiagnosed; consequently, the epidemiology of HDV is poorly characterised, both in the United States and globally. In 2022, a pilot project involving eight healthcare institutions was undertaken to ascertain the prevalence of HDV in healthcare institutions with an HBV seropositivity of at least 1%, describe the characteristics of patients testing positive for HDV, and evaluate diagnostic and laboratory processes of HDV screening. From August 2022 to April 2024, a total of 106,693 patients were tested for HBsAg, of whom 65,341 (61.2%) were female and 40,863 (38.3%) were male, with a mean age of 47 years. The overall HBsAg positivity rate was 1.04% (n = 1112). Among the HBsAg+ samples, 645 (58.0%) underwent HDV Ab testing. The HDV Ab positivity rate was 0.81% (n = 9), with 2 cases of HDV RNA positivity (0.18%). The incomplete testing reflects several challenges associated with screening for both HBV and HDV. Further research is necessary to better understand the epidemiology and burden of HDV in the United States and considerations for implementation.
Successful Central Banks Can Afford to Pay Scant Attention to Money
Authors: Francesco Papadia , Leonardo Cadamuro 
Published: December 2024

ABSTRACTIn the last few decades, central bankers and economists have paid little attention to monetary aggregates, in contrast with the experience of the 1970s and the 1980s. Our evidence shows that monetary aggregates lose relevance when central banks maintain low and stable inflation, as has occurred in recent decades. However, to move from unstable to stable inflation, our findings also show that attention to monetary aggregates is needed. Our findings help resolve the long‐standing controversy about the importance of monetary aggregates for the conduct of monetary policy: monetary aggregates are vital to move from unstable to stable inflation but lose relevance once a central bank has consistently reached price stability.
Assessing Compliance: Violations of WHO Code in Breast Milk Substitute Marketing, Ecuador
Authors: Tello Betzabé , Katherine Silva‐Jaramillo , Angélica Tutasi‐Lozada , Rocío Caicedo‐Borrás , María Valencia Luz , Estefanía Rodríguez 
Published: December 2024

ABSTRACTBreast milk substitute (BMS) marketing significantly influences global infant feeding practices. Ecuador, like many countries, seeks to regulate these promotions under the WHO's International Code of Marketing of Breast‐Milk Substitutes. This cross‐sectional analysis assessed BMS marketing compliance with WHO's Code in Ecuador. Surveys were conducted with mothers (n = 330) and healthcare professionals (n = 66), complemented by observations at health facilities (n = 33) and retail outlets (n = 44). Media monitoring and product labelling evaluations were also conducted. The study revealed widespread exposure to BMS marketing outside health facilities (91.21% of mothers). Promotional activities targeted healthcare professionals, with significant interactions involving free supplies (26.09%) and gifts (21.74%). Retail outlets prominently displayed BMS promotions, often featuring discounts (95%). Compliance with labelling criteria was notably low, particularly concerning nutrition and health claims (39%). TV emerged as the dominant platform for BMS advertising, with 2884 ads aired over 16 h and 24 min, totalling $1,876,915.50 in expenditures. Digital platforms also featured BMS ads, with significant engagement on social media (533,845 interactions). This study reveals widespread violations of the WHO Code in Ecuador, emphasizing the need for stronger regulations and targeted education for healthcare professionals and the public to protect infant health and promote breastfeeding. Despite existing regulations, the pervasive advertising and substantial investment in BMS marketing across various media underscore significant enforcement gaps. To effectively safeguard maternal and child health, Ecuador must fully incorporate and rigorously enforce all Code recommendations within its national legislation.
Ancient Hybridisation Fuelled Diversification in Acropora Corals
Authors: Wu Tianzhen , Xu Alan Ningyuan , Lei Yanli , Song Haijun 
Published: December 2024

ABSTRACTIntrogression is the infiltration or flow of genes from one species to another through hybridisation followed by backcrossing. This may lead to incorrect phylogenetic reconstruction or divergence‐time estimation. Acropora is a dominant genus of reef‐building corals; however, whether this group has an introgression history before their diversification remains unclear, and previous divergence‐time estimates of Acropora have not considered the impact of introgression. In this study, we broke through the limitation of a few genes and a few species and proved the existence of ancient introgression in the evolution of Acropora from whole‐genome protein‐coding sequences. We inferred 21.9% of all triplet loci (homologous loci from three different species) with a history of introgression and a series of introgression events with a genetic material contribution of up to 30.9% before diversification. Furthermore, 7756 nuclear loci were clustered into three groups using a multidimensional scaling algorithm, the heterogeneity of which resulted in different phylogenetic relationships. The diversification time of Acropora was estimated to be middle to late Miocene when we retained only the gene group with the lowest degree of introgression. The collision of Australia with the Pacific arcs and the Southeast Asian margin in the early Miocene, and a series of cooling events in the middle to late Miocene, may provide geographical and climatic conditions for the diversification of Acropora, respectively. Therefore, our results indicate that at the genome‐wide level, ancient introgressive hybridisation may have promoted the radiation evolution of Acropora. Based on our results, the influence of introgression should be taken into account when reconstructing phylogenetic relationships and evaluating divergence time.
Effect of trait anxiety on visual working memory capacity: The role of filtering efficiency
Authors: Yin Mengxin , Wei Huaihuai , Zou Mingxuan , He Yuqing , Hu Hui , Wang Xiuchao 
Published: December 2024

AbstractPrevious research has consistently shown that high trait anxiety (HTA) reduces spatial and verbal working memory capacity. However, its effects on visual working memory (VWM) are inconsistent, and the underlying mechanisms remain unclear. This study investigates the impact of trait anxiety on VWM capacity and the role of filtering efficiency through two experiments. Experiment 1 utilized a change detection task (CDT) with 2–5 colored squares. The results indicated that low trait anxiety (LTA) individuals had significantly higher K scores than individuals with HTA, particularly under high memory load, indicating limitations in VWM capacity within the HTA group. Additionally, the contralateral delay activity (CDA) amplitude in the HTA group stabilized earlier than in the LTA group, further suggesting a deficit in VWM capacity among HTA individuals. Experiment 2 introduced neutral distractors. Under low load conditions, both groups were unaffected by the distractors. However, under high load, the HTA group was susceptible to interference, whereas the LTA group effectively filtered out distractors. CDA patterns revealed that individuals with HTA could filter distractors under low load but not under high load, whereas LTA individuals showed effective filtering under both conditions.
Whether the Indications for Reverse Shoulder Arthroplasty Should Continue to Be Expanded? A Systematic Review and Meta‐Analysis
Authors: Li Huankun , Bao Hangsheng , Yang Zhidong , Hu Baijun , Pan Yaocheng , Wang Yi , Chen Jiayi , Chen Hongjun , Shen Bisheng , Zou Yonggen 
Published: December 2024

ABSTRACTBackgroundIt is still unclear whether reverse total shoulder arthroplasty (RTSA) has advantages over traditional hemiarthroplasty (HA) and anatomic total shoulder arthroplasty (ATSA) in the treatment of complex shoulder joint diseases. Therefore, this study aims to evaluate the clinical effectiveness of RTSA in the treatment of complex shoulder joint diseases and further determine whether it is necessary to expand the indications of RTSA.MethodWe conducted a systematic search of studies published between January 1, 2012 and May 31, 2023 in PubMed, Embase, and Cochrane databases. The experimental group included patients who underwent primary reverse total shoulder arthroplasty (RTSA), while the control group consisted of patients who underwent primary hemiarthroplasty (HA) or anatomic total shoulder arthroplasty (ATSA). The minimum follow‐up period was 1 year, and a random‐effects model was utilized for data synthesis.ResultsA total of 45 studies were included in the meta‐analysis. Compare to HA, RTSA showed significant advantages in postoperative ASES scores (p = 0.004), forward flexion (p < 0.0001), and abduction (p < 0.0001). Compare to ATSA, RTSA showed significantly lower postoperative Constant scores (p = 0.004), ASES scores (p = 0.001), SST scores (p < 0.0001), forward flexion (p < 0.0001), abduction (p = 0.011), internal rotation (p < 0.0001), and external rotation (p < 0.0001). Further meta regression analysis was conducted, considering factors such as region, age, gender ratio, and follow‐up time, excluding the influence of relevant factors. Overall, RTSA did not demonstrate advantages in postoperative functional scores and range of motion. In terms of complication and revision rates, RTSA had lower rates compared to HA and ATSA, except for the complication rate, where there was no significant difference between RTSA and ATSA (p = 0.521), but statistically significant differences were observed in other measures.ConclusionRTSA demonstrates better clinical efficacy compared to HA but is inferior to ATSA. It can be considered for expanding treatment options for elderly patients with 3 or 4‐part proximal humeral fractures, but it is not suitable for treating end‐stage shoulder arthritis and humeral head necrosis. Overall, the decision to use RTSA should be carefully evaluated based on the extent of the patient's rotator cuff injury.
Management of Bone Defects and Complications After Bone Tumor Resection Using Ilizarov Method
Authors: Zheng Kai , Yu Xiu‐Chun , Cai Jinfang , Xu Ming , Cui Haocheng , Chen Qian , Zhang Jing‐Yu 
Published: December 2024

ABSTRACTObjectiveIlizarov technology is highly effective in addressing complex orthopedic challenges. This study aims to describe our experience with distraction osteogenesis in managing bone tumors in the lower extremity, focusing on composite bone defects and associated complications.MethodsA retrospective clinical study was conducted to analyze patients with primary bone tumors who underwent distraction osteogenesis using the Ilizarov method from 2010 to 2020. Some young children received epiphyseal distraction and bone transport as part of their sarcoma surgical treatment. Additionally, external fixation, bone transport, or limb lengthening were employed to address complex postoperative complications associated with bone tumors. The clinical outcomes assessed included the patient's general information, the location of bone defects, the length of bone repair, the status of bone healing, and limb function.ResultsEleven patients were followed up for an average of 66 months (range, 24–132 months). The average length of repaired bone defects was 13 cm (range, 2.5–32 cm). The cohort comprised three females and eight males, with ages at presentation ranging from 6 to 42 years (mean, 18 years). The sites of involvement included the distal femur (n = 4), femoral diaphysis (n = 3), proximal tibia (n = 2), and the distal tibia (n = 2). Nine patients were diagnosed with osteosarcoma, while one presented with Ewing's sarcoma and another with a giant cell tumor of bone. Three young children were successfully treated with epiphyseal stretching; however, one patient experienced treatment failure. Additionally, seven patients underwent external fixation to address complex postoperative complications, including infection, bone defects, and limb shortening. At the last follow‐up, with the exception of one failure, the average Musculoskeletal Tumor Society (MSTS) limb function scores for the remaining 10 patients were 25 (range, 21–30). Three months post‐fixator removal, the Asociación Latinoamericana de Oncología (ASAMI) bone score was rated as excellent in 63.6% (7/11) of patients, whereas the ASAMI function score was excellent in 36.4% (4/11) and good in 54.5% (6/11) of cases.ConclusionThe Ilizarov method demonstrates some clinical value in the resection and reconstruction of bone tumors, as well as in the management of postoperative complications associated with such tumors.